Tuesday, June 27, 2017

Your Secret Weapon for Breastfeeding Success

From the NPR Morning Edition, June 26, 2017
by Glenni Lorick, IBCLC

Yesterday NPR (National Public Radio) ran a fascinating story about breastfeeding mothers in Namibia. It is really worth taking a few minutes to listen to it.  It turns out that mothers there struggle with breastfeeding just like mothers in the United States do. They get sore nipples; they may have supply problems; they have to learn to breastfeed just like American moms do. However, they have a huge advantage that the vast majority of US moms do not have: a culture of breastfeeding.

The Grandmother Factor

This article explains in detail how the Himba people in the northern desert of Namibia have a culture that makes breastfeeding work. They live in mud huts, and babies are born at home, so there is no separation of mother and baby after birth for medical procedures. Their maternal and infant mortality rates are both high. For every 100,000 births, 265 mothers die, and or every 1000 live births 36 babies die. Obviously, I am not advocating giving birth in a mud hut as a solution to our breastfeeding problems. And even Himba mothers do struggle with learning how to breastfeed.

When 17 year old Bethany had her baby, her mother
supported her and taught her how to breastfeed.
But that is where they have the amazing "Grandmother" factor. Himba mothers actually go in the third trimester of pregnancy to the compound where their own mother lives. The new grandmother sleeps in the hut with mother and baby, even serving as an alarm clock to awaken the new mother and remind her to nurse. The grandmother teaches the new mother how to position the baby, how to help baby get the best latch possible, how to safely sleep with baby, and all the other little details necessary for parenting. The new mother remains with her mother for several months following the birth.

In the US we have a generation of great-grandmothers whose doctors told them that formula was the best way to feed a baby. Their daughters who are now grandmothers likely had no support for breastfeeding from either their mothers or the medical community. This lack of help often spelled lactation failure for that generation of mothers. Those who persisted are able to support their daughters in an amazing way, and usually those daughters benefit from their wisdom.

A grandmother who can help with breastfeeding is a treasure.
But there is another glaring obstacle that mothers in the US face. They are expected to jump right back into the routines of life within days or weeks after giving birth. I have worked with mothers who had to return to work or school as little as 2 weeks after giving birth. They aren't even able to give their bodies time to recover, let alone get breastfeeding well-established. The scant 6 weeks that so many employers deem as "generous" maternity leave is actually the bare minimum to move a mother beyond the post-partum period. Employers who allow 12 weeks are much more in tune with what mother and baby both need.

Another big difference between our culture and the Himba culture is the normalization of breastfeeding within the society. There it is completely expected that mothers will feed babies at the breast. Although there is some supplementation with goat's milk when mothers don't have enough milk, it is not the normal way to feed a baby in that culture. In contrast, new mothers here often feel uncomfortable and embarrassed about breastfeeding their babies with anyone else around. We do not have a breastfeeding culture here where children grow up seeing breastfeeding as the normal method of infant feeding.

Lessons We Can Learn from the Himba People


So how can we take this information and use it to increase breastfeeding success among US mothers? I see several ways in which we can learn from the Himba culture.
Skin-to-skin contact during the early days is
critically important for Mother and Baby.

  1. Mothers and babies should NOT be separated at birth for any reason unless there is a genuine medical reason. Many hospitals have implemented policies to protect the Golden Hour because the evidence clearly points to improved outcomes when mothers and babies have this uninterrupted time together immediately after birth until after the first feed. 
  2. Mothers and babies should have as much skin-to-skin contact as possible in the early post partum period. Research shows that this elevates hormone levels which increase mother/baby bonding. It also helps milk come in faster and increases the rate of breastfeeding success.
  3. Mothers need to go home to somebody who will take care of them as they are learning to care for and feed their babies. This person needs to be supportive of breastfeeding, ideally having breastfed herself. Mothers need several weeks of this encouraging care and support. If a supportive grandmother, sister, aunt or close friend is not available to fill this role, a postpartum doula is an option. A Nurturing Moment actually offers a postpartum support package that provides some of this kind of ongoing support to new moms who don't have a grandmother/sister/friend to help out. It is very interesting to note that in the NPR broadcast yesterday morning they actually mentioned IBCLC's as an alternative for mothers who don't have "the Grandmother factor."
    India has a mandated 6 month maternity leave!
  4. Our lawmakers need to get serious about providing a minimum of 12-16 weeks maternity leave to employees. As a small business owner, I understand the hardships that can cause, but as a lactation consultant, I see daily the hardships caused by the lack of adequate maternity leave. Research as well as the experiences of mothers and companies in the rest of the world have clearly shown the benefits of making sure that a strong maternal leave policy is implemented across society. 
  5. From their earliest days, children need to see breastfeeding as the normal way that babies are fed. Children's books should feature pictures of babies nursing, not getting a bottle. Mothers should try to expose their children to other breastfeeding mothers, explaining that this is how babies are designed to be fed. Science classes at the elementary level should include breastfeeding in their curriculum when children are learning about mammals. At the secondary level, breastfeeding should be included in instruction about reproduction and family planning. A breastfeeding culture is built by one mother and baby at a time normalizing infant feeding at the breast. I am optimistic that together this generation of mothers can make that happen!


Thursday, June 15, 2017

Does Your Baby Sleep....Like a Baby?


by Glenni Lorick, IBCLC
Does your baby sleep like a baby? You know, waking every 2 or 3 hours, maybe crying, nursing or taking a bottle, then falling back asleep? Physiologically newborns are not programmed to sleep a stretch longer than about 4 hours. By about 6 months, they might be capable of sleeping a stretch of at least 6 hours (many infants do sleep longer) at night. The fact is that some babies are simply born with easier temperaments than others, making nighttime much easier for some parents than for others.

Why Babies Wake Up

A newborn has a tiny tummy. In fact at birth his tummy will hold about 5- 7 ml of breastmilk comfortably. Many formula feeding parents mistakenly think that their babies need to take most of the 60 ml formula bottle the hospital gives them. Even 20 ml can cause baby's stomach to be too full, leading to discomfort and spitting up. Newborns nurse very frequently - every 2-3 hours or perhaps even more often. Breastmilk is designed to digest quickly, so often newborns wake up hungry after just an hour or two.

Many infants will cluster feed in the evening because that is how they prepare for a slightly longer sleep stretch at bedtime. Breastmilk composition changes throughout the day. In the evening, there is less milk, but it is actually higher in long-chain fatty acids like tryptophan (that wonderful amino acid found in turkey that makes you want to fall asleep after Thanksgiving dinner). It is also higher in sleep-inducing melatonin. A lot of mothers worry that they don't have enough milk in the evening because baby is nursing non-stop. So they end up supplementing in the evening. But that really isn't necessary. The frequent nursing helps baby get what he needs and helps mama produce more milk.

As they approach about 2 months of age, some babies do start sleeping longer stretches of 4-8 hours at night. That is normal. But it is also normal for babies to continue waking several times at night to nurse. At this age babies are still sleeping pretty deeply when they are actually asleep.

Around 4 months many babies experience a sleep regression. A baby who was sleeping a 6-8 hour stretch may suddenly be waking every 3 hours again. The good news is that baby's brain is maturing. The bad news is that these changes are permanent. You will need to help your baby adjust to falling back asleep when he awakens. One way to do that is to help him learn to fall asleep in his crib without you. Most experts do not recommend letting baby "cry-it-out" because research has shown that can actually be harmful. However, there are gentle methods to help baby learn to sleep. The No Cry Sleep Solution by Elizabeth Pantley is a terrific resource that many parents have found to be invaluable.

Where Baby Sleeps

The American Academy of Pediatrics came out with revised sleep recommendations in 2016. They recommend that babies sleep in a "separate but proximate"sleep environment. That means that baby should sleep in Mom and Dad's room, but not in their bed. Nevertheless, in this revision, the AAP did acknowledge that mothers do sometimes fall asleep while nursing. 
"However, the AAP acknowledges that parents frequently fall asleep while feeding the infant. Evidence suggests that it is less hazardous to fall asleep with the infant in the adult bed than on a sofa or armchair, should the parent fall asleep. It is important to note that a large percentage of infants who die of SIDS are found with their head covered by bedding. Therefore, no pillows, sheets, blankets, or any other items that could obstruct infant breathing or cause overheating should be in the bed. Parents should also follow safe sleep recommendations outlined elsewhere in this statement. Because there is evidence that the risk of bed-sharing is higher with longer duration, if the parent falls asleep while feeding the infant in bed, the infant should be placed back on a separate sleep surface as soon as the parent awakens."

 Dr. James McKenna is a professor of Biological Anthropology and the director of the Notre Dame Mother-Baby Sleep Laboratory. He has written extensively on the biological reasons for mothers and babies to share sleep environments. He also has created safe co-sleeping guidelines that any family who is practicing co-sleeping should be very careful to follow. Everyone agrees that the most dangerous place for an infant to sleep is a recliner or sofa, even with a caring adult. If that adult falls asleep the risk of the infant suffocating is many times greater than it would be on a firm sleep surface such as a futon or firm mattress.

Getting Help 

Fortunately  we have a local infant sleep expert. Dana Stone is the mother of four children. When she had serious sleep issues with her last baby, she looked for answers. She knew that the traditional cry-it-out method wasn't right for her family, so she found a program that helped her gently teach her child to sleep. She ended up becoming a certified Sleep Sense consultant and has helped dozens of local families get a good nights' sleep.  She offers a free download for parents entitled "Five Steps to Getting Your Baby to Sleep Through the Night." It is important to recognize that nobody expects an infant to sleep through the night. Physiologically they just aren't ready to do that. However, later in the second half of the first year, many babies are capable of sleeping an 8 hour stretch. Dana is able to work with your individual situation and help your baby sleep a little less like a baby!

Thursday, May 25, 2017

Local Businesses Roll Out the Red Carpet for Breastfeeding Moms

by Glenni Lorick, IBCLC

North Alabama is home to some amazing businesses that really understand how important it is to support their tiniest clients...and their mothers who are nursing them. Our moms have weighed in on which stores, restaurants and other businesses have made them feel welcome as they nursed their babies, and we want to share these with you. Be sure to thank these businesses for their outstanding customer service!

Restaurants

Alchemy at Lowe Mill   Lindsay says they were wonderful when she was having her non-dairy small latte there!

Bravo at Bridge Street  This restaurant gets our 5 star rating! Amanda was there the other night as part of a graduation party. While they waited up front for the party room to be set up, her baby got hungry. When the hostess noticed she was nursing she asked Amanda if she'd like a glass of water or sweet tea. Once they were seated the manager came out and brought a car seat hammock, helping them get settled in. When they saw her get out a bag of breastmilk to heat up, the waiter brought a glass of scalding water to warm it, and the female waitress assisting with the party noticed the glass was too full, so she brought a coffee cup and poured some of the milk into it, explaining that she heated her milk that way, too. Amanda never had to ask for anything. They obviously had a process in place and were very comfortable with nursing mothers. 

Buffalo Wild Wings in Huntsville  Leah has high compliments for their staff's treatment of breastfeeding mothers.

Casa Blanca  Justen said that the waiter took her order without any hesitation while she was nursing uncovered. He acted like it was a totally normal day for him, which was really nice.

Nothing But Noodles in Huntsville  Leah says their staff was particularly great about her nursing.

Phil Sandoval's  Holly says that although both of her nurslings are past the typical nursing age, this restaurant has always been super welcoming!

Rosie's on South Parkway  Keli notes that she breastfeeds here all the time. She has never felt uncomfortable, and they have always made her feel welcome!

Tzakikis in Madison  Rebekah says that they are SUPER welcoming and supportive of nursing mommas! Sometimes the girls from the Madison Breastfeeding group will go there for lunch, and they have everything all set up for them. She says this restaurant is awesome!

Retail

Moms and Babies are always welcome to hang out at
A Nurturing Moment
A Nurturing Moment  Rebecca says that so far this is the only place she has nursed in public. Rebekah adds that it is great to be able to shop and not feel judged or rushed with her nursing Toddlet. Kristi says she loves stopping by ANM to nurse when she is out this way. We offer nursing mothers a comfy place to sit as well as nursing pillows if necessary. We also have a refrigerator stocked with water because we know mamas get thirsty when nursing.

Acorn Treasures Caitlyn and Rebekah both say they are great.

Belk  Mary was shopping for her 8 year old when her baby got fussy. They showed her to a comfortable area by the dressing rooms, then left her alone to nurse in privacy.

Costco  Marie says they have a nursing room set up near their employee break room. Once when she was there the lady checking receipts saw that she was sitting at one of the tables to nurse. When Marie walked by her later, the lady told her that it was available if she needed it.

Posh Mommy & Baby, Too  Rebekah says they are great with nursing moms.

Professional Services

Dr. Patty Long welcomes nursing moms
Advanced Eye Care of Madison   Rebecca says that her eye doctor is incredibly supportive of breastfeeding. She was there when her baby was just a month old and they were still struggling with nursing. They gave her an exam room and told her to take all the time she needed to feed her baby. Furthermore, the staff - including her doctor - encouraged her to continue breastfeeding and made sure that she had a lactation consultant when she admitted that she was having problems. This is one business that really cares about their clients!

Chase Animal Hospital  April says that she had a bit of a wait there, and her baby got hungry. The doctor came in and said that she was breastfeeding, too. It made her feel much less self conscious.

Long Chiropractic  Rebekah says that Dr. Patty Long is very breastfeeding friendly.

Madison Speech Associates  While she was there, the receptionist and SLP overheard Claire mention that she was about to feed her daughter. They set her up in a private room during her son's speech therapy.

Whitesburg Gardens  Samantha is usually nursing her baby in her sling as she goes into her grandmother's nursing home. She has received verbal praise for breastfeeding from the employees. She has also had nurses or other employees peak in at her baby and talk to her while she's feeding without even a second glance. 

Travel/Entertainment

Insanity Skate Complex Mary praises the way they handled a guy who was harassing her as she nursed in a corner away from everyone: they threw him out!

Marriott Hotel by Space and Rocket Center  Sarah was there for a conference, and they had no place to pump aside from the restroom. However, a very kind female administrator let Sarah use her personal office.

Sunday, May 21, 2017

Attachment Parenting Produced an Amazing Graduate

Last year in Colombia
by Glenni Lorick, IBCLC

This has been a very special week in our family's life. My baby graduated from high school (for the second time) Friday night. His first graduation happened last year in Cali, Colombia, where he had spent his junior year. In Cali they only have 11 years of school, so he graduated with his eleventh grade class there and received a special honor because of his outstanding grades and his contributions to the school despite everything being in Spanish. By the time we went to Cali last year to see him graduate, he was completely fluent in Spanish.

But he wanted to come back to his school here, Westminster Christian Academy, to finish his senior year. He took 3 Advanced Placement courses this year and continued his habit of making straight A's, graduating with a 4.2 GPA. He has known since he was 12 that he wanted to serve his country as a military aviator. This year he applied to Annapolis, applied for a Navy ROTC scholarship and actually enlisted as a Navy Nuke! We were overjoyed when he received the NROTC scholarship to Auburn University where he will study Aerospace Engineering. Thursday afternoon at the awards ceremony two US Navy officers and the recruiter who has worked closely with John Carl all year presented him with a huge check representing his scholarship.
John's Navy ROTC Scholarship

John Carl is a product of Attachment Parenting. He nursed until he was two and a half. He slept with us as a baby and toddler. He was a product of gentle discipline, and always had a deep desire to please us. We were asked to write a letter to be given him at senior breakfast. I want to share with you what we wrote.

Our precious, amazing son,

It is such a privilege to be your parents. You have brought so much joy and love into this family, and each family member has been touched by you in different ways. You have a strong relationship with each of your siblings, and Dad and I both really enjoy just being with you, too. From the time you were just a baby, you have always been a truly delightful person to be around.

I remember taking you to Nido when you were just three years old. You loved stopping by the panaderia on the corner to grab a special treat. Everybody loved seeing you come by! You were such a precious little caballero (NOT caballo)! Then you started Pre-K at Westminster, and everybody just loved you. You may actually be the only student who has been at Evangel, M&M, North Hills and Brockway campuses! From the earliest days at Westminster you excelled in everything. You wanted to do well; I think it was important to you that we were proud of you, but I also think you had an inner drive to succeed!
John's Spirit of Auburn Scholarship

When it came to sports, you never held back even a tiny bit. I wonder how many students have actually been forbidden to play football and soccer at recess?? You may have been a bit small for your age, but you were the most aggressive athlete out there many times! You allowed sports to shape you into a keen competitor who is fit both physically and mentally for the many challenges that lie ahead. I think now you can see that the many years of sports weren’t about winning or losing. Rather, they were about helping you become the man you are today.

I remember when you were 12 and told us you were going to be a military pilot and study aerospace engineering. You never wavered in your determination to pursue a military career, even going to the point of actually enlisting. The night you got word that you were awarded your NROTC scholarship was one of the happiest moments of my life! We would have been proud of you as a Nuke, but we are so thankful you can go in as an officer doing what you really want to do!

I will never forget the day we were walking around Colegio Americano and you told me you wanted to spend your junior year there. Letting you go to Cali last year was one of the hardest things we have ever done in our life. But we didn’t have a choice because the same God that was speaking to your heart was speaking to our hearts as well. We were so proud of you at graduation last year. You had grown so much during that year in so many ways.  Your accomplishments at Colegio Americano still amaze us, and we are so thankful that you had that life-changing experience.

We are so proud of our Honor graduate!
For many people, the high school years are the best time of their life. Not you! For many people, college is the best time of their life. Not you! The best time of your life will be the day that you are living today in the presence of your Savior. As you look back on your life when you are our age, may you see a lifetime that is full of God’s richest blessings, a lifetime that has been spent serving Christ and serving others, a lifetime that has made a difference in this world.  Cling to Christ like a shipwrecked sailor clings to his raft. Hold tight to Him in the bad times, but especially in the good times!

Son, we love you more than words could ever begin to express, and our hearts are bursting with pride as we see you graduate today. Last year’s graduation was just a prelude to this year’s. And tonight’s graduation is but a prelude to the rest of your life!

Love, 
Mom and Dad

Saturday, May 13, 2017

Local Mom Makes Heartfelt Plea for ABA Coverage for Spectrum Individuals

by Glenni Lorick, IBCLC
This morning I read the following letter that my friend Ashley Sparks wrote to Senator Paul Sanford. Ashley is an amazing woman who eloquently advocates not only for her daughter, Brinley, but for all individuals on the Autism Spectrum. I have known Ashley since before Brinley was born. I remember when she suspected that Brinley might have a problem, and when Brinley received her diagnosis. Ashley, like many other mothers of children on the Autism Spectrum, pours her heart and soul into advocating for her daughter!  

A Bill mandating insurance coverage for the expensive ABA therapy needed by children on the Autism Spectrum passed the House by a unanimous vote. However in the Senate, it was referred to committee. Senator Sanford was only one of two "No" votes in the committee that approved the bill 14-2. My prayer is that this letter touches Senator Sanford's heart and the hearts of other Senators who may happen to see it. Please share it far and wide in the hope that every Alabama state senator will see it and understand how critical the ABA funding really is!  


Senator Sanford,
I would be surprised if you remembered me, but we spoke at length several times during your first campaign. At the time, I had no idea my second child would have an autism diagnosis and would struggle to get through a normal day without sensory overwhelm and, often, violent meltdowns. I just knew you coached my cousin's basketball team, ran a killer barbecue joint, and supported the legalization of midwives. Each time I spoke to you I was encouraged because I felt you were someone I could count on to always do the right thing. Your integrity was what stood out to me, above all else. So I not only voted for you, I campaigned for you. I walked streets and handed out flyers, I advocated for you to anyone who would listen, and I held signs on election day.
I know that often the "right thing" is not always black and white, especially in the murky political world. I understand that you have firm beliefs in small government, and the right of the free market to regulate itself. As such, I can understand why you would balk at a bill mandating private insurance companies to cover any specific therapies.
Brinley in the middle of a meltdown. I wasn't able to touch
her for nearly half an hour while she screamed "Mommy!
Help me!" She could not tolerate being touched due to her
sensory overwhelm, but wanted my help. There is nothing
 more heartbreaking than watching your child suffer
when you are helpless to fix it.

But senator, I do believe that this is one of those times that departure from your political principles is not only reasonable, it is critical. You see, a free market might well regulate itself into including these coverages through competition. There are compelling arguments on both sides of the fence about the feasibility of that actually coming to pass. However, it requires a great deal of something of which we simply don't have the luxury - time.

My daughter, Brinley, is six years old. She has already lost the most critical years for ABA therapy, but if this bill were passed, she could still greatly benefit from therapy. She might one day sit in a regular classroom, at least for part of her day. She might be able to go out to a restaurant without covering her ears and screaming halfway through the meal because of her learned coping skills. She might even, someday, be independent enough to have a job and even a home of her own. But only if her critical supports are provided. As you can see, I can't wait for a free market to sort itself out. Neither can the other 50,000 plus individuals in Alabama with Autism Spectrum Disorders. While we respect that economics must be a considered factor, we must prioritize our children's greatest needs. For Brinley and tens of thousands of others, that need is ABA and the time it is needed is yesterday.

Senator, I am urging you - no, pleading with you - to support this bill. I am begging you to support the removal of the amendment capping the age at 16. Autism is a lifelong condition and while the greatest needs for ABA are in the younger years, the need for access doesn't magically disappear at any given age. A child who required thirty hours of ABA at age six might only require a couple of hours a week at age sixteen, but they may still desperately need that support at a time in their lives when their worlds continue to change rapidly. I am also asking in desperation that you remove the amendment that would limit coverage requirements to plans for fifty or more employees. This would exclude at least half of Alabama families, and severely limit tangible job opportunities for parents of children on the spectrum. It would prevent parents from venturing into small business for themselves, and could easily become a functional cap on the ingenuity and entrepreneurship of Alabamians. Please, sir, don't let that happen.
Brinley with her service-dog-in-training, Max. Moments like this
we get to see our daughter - really see her, and not just her autism.
Moments like this give us hope. ABA therapy would mean far
more moments like this and fewer like the one above.

I voted for you in the confidence that you would always do the right thing. I was so disheartened to hear your votes in committee the other day because it was clear to me that you and I were not on the same page about what the right thing was regarding this bill.

Please look at this sweet girl. Look in the faces of our children who need this therapy to lead lives with meaningful communication and relationships. They need this therapy to lead full lives. I think when you look at them, senator, you will know in your heart that the right thing to do in this situation is not about political philosophy, but about human dignity - and that is passing this bill, preferably free of the amendments.
Thank you for your time. You have my faith to do the right thing.
Sincerely, 
Ashley Sparks