Monday, April 6, 2015

Coming Soon: More Fluff and More Breastfeeding Stuff

by Glenni Lorick, IBCLC
We are so excited to announce that we are making some BIG changes which will result in us having a HUGE selection of cloth diapers as well as an expanded selection of breastfeeding supplies and apparel.

Moo Moo Caboose is taking over all the cloth diaper merchandising within A Nurturing Moment. Owner Beth Shortt has long dreamed of having a cloth diapering business, but didn't see how it would be possible since she is homeschooling her houseful of boys. As we talked, we realized that this is a perfect solution for both of us because Beth can fulfill her fluffy desires, and I can free up money to put into breastfeeding supplies and clothing!

We will have a grand opening for Moo Moo Caboose on Saturday, April 11 from 10:30 - 2:00. She will feature all the lines we currently carry, Cotton Babies (Bum Genius and Flip), Rumparooz, Thirsties, Babee Greens, GroVia, BottomBumpers, SuperUndies and Bummis, as well as SmartBottoms, Imagine, Planet Wise and other brands to be announced in the near future! Beth will have an entire wall of cloth with a large selection of newborn diapers and will be making weekly orders so that you can get your entire stash right here! She will also have some pretty cool incentives to keep you shopping here like a frequent buyer card!

A Nurturing Moment will be adding another bra line in the near future, bringing in more breastfeeding supplies and adding more nursing apparel over the next couple of months. The only baby carriers we will feature will be ring slings and Baby K'tan because they are so practical for breastfeeding mothers. We encourage you to visit Acorn Treasures for all your other babywearing needs.

Our goal is to better serve the local mama community by providing the best selection possible for all your breastfeeding and cloth diapering needs. We can't wait to show you the changes, so please be sure to stop by frequently over the next few weeks! Go like Moo Moo Caboose on Facebook today to be entered into a drawing that Beth will do on Saturday.

Saturday, March 14, 2015

Getting Breastfeeding Off to a Great Start

Skin to skin family bonding after birth!
by Glenni Lorick, IBCLC

You know that you want to breastfeed your baby, but maybe you've heard stories about mothers who didn't make enough milk or who had a variety of problems. Many (not all) breastfeeding problems can be avoided by getting off to the right start. Today we're going to examine what that looks like!

Immediate Skin-to-Skin

The first step to a long term breastfeeding relationship is skin-to-skin contact right after birth. Let the nursing staff know that as soon as baby is born you want him placed directly on your chest. They can do all of the procedures that they need to do with baby right there on your chest. He doesn't need to be placed under a warmer because your chest is the perfect warmer for him!

Skin to skin before baby is bathed is best!
Baby will be placed on your chest naked and a warm blanket will be used to cover both of you. Some hospitals will allow you to delay eyedrops until after the first feed. It is important to note here that if there are any complications with mother or baby, this may not be possible. 

If you labor without any medication, your baby may actually latch on by himself with no help from you at all after birth. However, if you do have an epidural or even a C-section, your baby will still be ready to nurse within the first 30-45 minutes after birth.

Baby on top of mom for feed.
Research shows the following benefits for immediate skin to skin contact:

  • It helps regulate baby's body temperature
  • It helps regulate baby's breathing
  • It helps to raise baby's glucose levels
  • It facilitates breastfeeding

Positioning Baby for First Feed

If you are in a reclined position, baby may just lay right on top of you either horizontally or vertically. Baby will most likely be able to latch on with little or no help from you! 

If you feel like sitting up  instead of lying down, then you might find a reverse cradle hold or a football hold will help provide the support baby needs to stay on the breast. 

The goal of the first feed is to let baby achieve the best latch possible with as little intervention as possible. 

Baby lying horizontally with mom reclining.
Listen for swallows during the first feed.  The sound almost like tiny sighs. You should see movement all through baby's jaw, and you will see her throat move as she swallows. Even though your milk isn't in yet, your baby is getting colostrum that will form a protective seal for her intestinal tract and provide her valuable immunity. 

Let baby stay latched as long as he wants to. If he comes off and is interested in nursing on the other side, then switch sides. If not, then you will just nurse on the other side next feed.

During the First Few Days

A good latch with very little areola showing.
Every time you nurse your newborn during the first few days of life, you are creating prolactin receptors on each of your milk glands. Research indicates that early frequent feeds are a key indicator for successful long-term production of milk. You need to nurse your baby every 2-3 hours around the clock from beginning of feed to beginning of feed. The first four days or so, your newborn needs to nurse AT LEAST 10-12 times in a 24 hour period. Some babies may nurse even more!

Usually mothers who nurse frequently in the first few days have their milk come in by the fourth or fifth day. At that point baby still needs to nurse at least 8 times a day, but many will continue nursing 10 or more times in a 24 hour period. 

Upper and lower lips should be flanged.
When you nurse be sure that baby has a good latch. Latch him on with his chin low on your areola. Support your breast using a C-hold with your thumb on top and your fingers on the bottom below the areola, aiming the nipple up toward the back of baby's mouth. Wait for him to open his mouth as wide as he can, then pull him on tight. Your partner can tuck a rolled up blanket behind the hand that is supporting him for extra support. You should note that his lips are flanged , and you should see very little areola (unless you just have really big areolas!)

If It Hurts

If a baby has a good latch, your nipples will not crack or bleed. You may experience some tenderness as you get used to breastfeeding, but if your toes are curling and it's all you can do to let your baby near your breasts, then something is definitely wrong! If you are still in the hospital ask to see a lactation consultant as soon as possible. If you are home, call for the next possible appointment. It could be a problem with baby's oral anatomy or it could be that baby's latch just needs to be adjusted, or maybe your baby just needs a little bit of suck training. But get help immediately to resolve whatever issue you're having so that you and your little one can have a terrific breastfeeding experience!

Feed your baby early and often!

Special thanks to all the ANM mamas who shared these precious photos with us!!


Thursday, March 5, 2015

Using a SNS to Save (or Create) a Breastfeeding Relationship

by Glenni Lorick, IBCLC

Did you know that adoptive mothers can nurse? And mothers who have problems with supply can nurse? And mothers who have premature babies with very week sucks can breastfeed? In fact, any woman who wants to breastfeed her baby can do so with an amazing device called a Supplemental Nursing System.

A mother can put formula, donor breast milk or her own milk in the bottle and attach the two tubes to the breast right at the nipple using paper tape (included with the SNS). The tubing can be closed off via a slit in the cap so that no milk will flow until it is released.

When the baby latches on and begins to suck, the mother can release the tubing allowing the supplement to flow. The specific method of use depends upon the mother's own milk supply, the baby's condition, and the reasons she is using the SNS.

Preemie or Special Needs Baby

The mother of a Premature or special needs baby will not be able to rely on her baby to establish a good milk supply. She will need to pump frequently in the early days (8-12 times a day for the first 4 days) in order to create an abundance of prolactin receptors on each milk gland. Once milk comes in, she will need to continue to pump at least 8 times a day for the next few weeks. Most exclusively pumping moms find that they settle into a routine of pumping 5-8 times a day by the time baby is a few weeks old. The SNS will allow mom to feed the pumped milk directly at the breast. Although the baby's suckling may produce some stimulation, it will not be sufficient at first. As a premature baby grows and gets stronger, his mother will find herself having to pump less and less for stimulation. Usually premature babies can wean off the SNS around the time of their actual due date or shortly thereafter.

When a premature baby first begins to feed with the SNS, mom needs to have the flow open from the beginning. Premature babies can burn a lot of calories nursing - valuable calories that they need to grow. The SNS (or a similar product like the Lact-Aid) makes it much easier to get the milk needed with much less effort. As baby grows, Mom can begin the feed with the tubing closed, then open it as the feed progresses and baby stops actively sucking and swallowing.

Infants with special needs like a cleft lip, Down Syndrome or any other condition that makes suckling difficult or ineffective may be able still have a breastfeeding relationship using the SNS. It truly varies from baby to baby, and a mother with a special needs baby really needs to work closely with an International Board Certified Lactation Consultant (IBCLC).

Mom with a Low Milk Supply

The SNS is a true blessing for mothers who struggle with milk supply because it allows the mother to supplement the baby right at her breast. This is vital because the active suckling of the baby actually helps stimulate Mom to make more milk.  Instead of nursing, then supplementing with a bottle if baby isn't getting enough, the SNS allows the entire feeding to happen at the breast. Whether her low supply is due to breast surgery, hypoplastic breasts, PCOS or any other condition, the SNS can help any mother feed her baby entirely at the breast.

If a mother is struggling with supply she needs to begin the feed with the SNS closed. I recommend nursing on one breast until baby stops actively sucking and swallowing, then switching to the other breast with the SNS still closed. After baby has nursed on both breasts and is no longer swallowing, return to the first breast, but open the SNS so that baby receives the supplement flowing through the tube as he nurses. This will help the baby to continue actively sucking and swallowing and actually enable him to suck deeply enough to receive some of the hind milk. It is up to Mom whether he needs to burp and switch sides again. But if he is getting more than 1 oz. of supplement, it is a really good idea to split it between the two breasts so that he is nursing 2 times on each breast
From the San Diego Breastfeeding Center. 
Photo: Barbara Robertson, IBCLC

Adoptive Moms

Just because you didn't conceive and give birth to your baby doesn't mean that you can't breastfeed him! In fact, some adoptive mothers even begin to make breastmilk by following this protocol set forth by Dr. Jack Newman. The SNS is an integral part of adoptive breastfeeding. Some adoptive mothers are able to obtain breast milk from a donor or a milk bank. NEVER pay for breast milk from an individual. If you do choose to use a donor, make sure it is someone you know and trust.

An adoptive mother will set up the SNS tubing on both breasts and begin the feed with the tube open so that baby will receive milk throughout the feed. In fact, the SNS actually helps stimulate her body to make milk. Generally, however, adoptive moms do end up needing the SNS for all feedings. is

Whether a mother is using it short term or long term. with a premature baby, a special needs baby or an adoptive baby, the fact is that a SNS is a true Godsend for the mom who cannot otherwise have a fulfilling breastfeeding relationship.


Saturday, February 21, 2015

It's Time to Take FMLA to the Next Level

Philadelphia photographer Melissa Hassey created this!
by Glenni Lorick, IBCLC
This year marks the twenty-second year since the Family and Medical Leave Act has been passed. Certainly many families have benefited from its provision that allows mothers to take up to twelve weeks of leave with their babies and still keep their jobs and insurance coverage. However, there are still improvements that could be made to extend its benefits to more workers.

The Current Situation

Let's look at who benefits the most under the current FMLA. Those who are employed full-time with an employer who has over 50 employees in a 75 mile radius are usually considered eligible for FMLA. The employer guarantees that the employee will still have her job, and promises to continue paying for her insurance. Those employees who work for smaller companies or are not full time do not have any kind of coverage.

The biggest obstacle, however, that many employees face is the loss of income when they take their leave. Mothers who are already living on a shoestring sometimes go back to work even before the baby is six weeks old because they feel they don't have a choice. Some companies do offer at least a partially paid maternity leave, but there is no public policy mandating that they do so. In fact, the United States is only one of three countries in the world that does not have some sort of law mandating some form of paid maternity leave. The other two are Swaziland and Papua New Guinea. Our neighbor to the north, Canada, actually allows parents to receive employment insurance payments of 55% of their regular salary up to a maximum of $524 per week for up to 37 weeks following the birth of a child.
How we compare! From ThinkProgress.org 

Where Do We Go From Here?

The obvious answer is that we need to find a way to provide mothers with a paid maternity leave without placing an undue burden on employers. Small businesses are often the first to feel the pinch when it comes to any extra taxes or financial obligations. However, if every other industrialized country in the world has found a way to do this, then we should be able to find a way to make it work, as well. Canada's employment insurance model makes a lot of sense. In Switzerland employees are required to take 8 weeks of paid maternity leave as part of the Swiss social insurance system. In Sweden both parents are expected to take parental leave, and are given up to a total of 480 days of leave that may be divided between them. They continue to receive about 77% of their pay. The cost is divided between employer and government.

In the United States we have a very different type of economy. We are not a socialist state, nor do most Americans want to pay the taxes associated with a plethora of government-provided services. Nevertheless, there has to be a solution that will respect our capitalistic roots and still care for mothers and babies. The solution is really quite simple, and has been implemented in New Jersey and California: It is a very small tax (less than $3/month) that every employee pays. The program ends up paying for itself and contributes to a stronger, more stable, and ultimately more profitable workforce. This article from Forbes Magazine explains it better than I ever could.

Great comparison chart from KellyMom

Framing the Dialogue

I think it is important to frame this dialogue correctly. We are not talking about welfare or an entitlement program here. Rather we are talking about moving the United States into its rightful position as a world leader in the treatment of women. Even countries where women's rights are scorned have laws on the books requiring a paid maternity leave! That should be a source of embarrassment for our governing authorities. 

This is not a Republican or a Democratic issue. It does not deal with less government control or more government control. It has nothing to do with liberal or conservative. No, it is an issue that every citizen who has a child, every citizen who respects the roles of mothers and fathers, every citizen who wants to see our children get the very best start in life must take seriously. We have seen the immense costs to our society of NOT having mandatory paid parental leave. In fact, one of the biggest costs of not having paid parental leave is an increase in the number of women receiving public assistance according to a Rutgers Study. 

Regardless of where you are on the political spectrum, take a few minutes to study this issue and let your elected representatives know that it is time for the United States to take leadership on behalf of parents throughout this great country!

Thursday, February 19, 2015

Did Your OB Talk to You About Breastfeeding?

by Glenni Lorick, IBCLC

Most mothers make the decision about whether they will breastfeed or not during their pregnancy. The one health-care provider who is most likely to be able to influence that decision is the mother's own doctor or midwife. Yet many times, despite the recommendation from their own organization ACOG that they encourage mothers to breastfeed, some OB/GYN's remain strangely silent on this subject.

Why the Silence from Some Providers?

Although many OB/GYN's are quick to encourage mothers to breastfeed, some take a very neutral stance on the subject, despite the proven benefits of breastmilk and risks of infant formula. Why is that? We think there may be several possible reasons.

  1. Lack of Education about the Benefits of Breastfeeding   Depending upon when and where your OB/GYN attended medical school, he or she may have had little to no instruction about breastfeeding. What instruction was given may have focused on problems related to the lactating breast as opposed to the benefits of breastfeeding for both mother and baby. If your physician is closer to retirement age, he or she may have actually been taught that formula is the "modern" way to feed babies.
  2. Relationships with Formula Companies  In a recent survey we did, many mothers reported receiving formula company gift bags from their OB's office. While it may seem like a nice little "gift," these samples coming from a physician actually tend to undermine a mother's confidence in her ability to exclusively breastfeed her baby.
  3. Her own lack of breastfeeding experience  If your doctor formula fed and has healthy children, then she may truly not believe that breastfeeding is all that important, despite what all the professional organizations say about it. She might also feel like all of this talk about breastfeeding being so important somehow casts her in a negative light for having formula fed. Or perhaps she had some real difficulties with breastfeeding and just didn't have the support she deserved.

The Physician's Role as a Health Advocate

One of the primary roles that all doctors have is to advocate with their patients for healthy practices. Nearly all Ob/Gyn's strongly discourage expectant mothers from smoking because the health risks are very obvious for both mother and baby. Did you know that there are actually risks associated with formula feeding?  So often we frame our pro-breastfeeding language in terms of the "benefits of breastfeeding," when in actuality all babies deserve to have reduced rates of upper respiratory infections and juvenile diabetes. The truth is that babies NOT receiving breast milk, but receiving formula instead actually increases the likelihood that they will get ear infections. diarrhea, eczema, asthma, and even childhood leukemia. 

If their simple recommendation to breastfeed could help make all the babies in their practice healthier, then why aren't doctors everywhere telling every mother they see to breastfeed? When I was born, my mother's doctor literally did NOT give her a choice. He told her that she would breastfeed me because that was her only option. I am not advocating such a heavy-handed approach with mothers, but certainly all expectant women deserve to know the truth about infant feeding methods. It should be the responsibility of every maternal health-care provider to educate every patient about breastfeeding. 

Bringing About Change

How do we effect change? If those mothers who are passionate about breastfeeding would initiate a dialogue with their doctors, it might be a good first step. Make sure your doctor is aware of the tools
available to him or her. In a recent survey over half the mothers said that their Ob/Gyn did mention breastfeeding. But that leaves many, many doctors who aren't saying a word, as well as many doctors whose offices are handing out formula gift packs like candy.

If your doctor's office gives you a sample (usually it will be a receptionist, not the doctor) make sure to bring it to your next appointment along with information about breastfeeding. Ask your doctor why they are promoting formula feeding when their own organization wants them to promote breastfeeding. Share positive resources with your doctor to aid in the formulation of a positive approach to breastfeeding promotion.

If a lactation consultant works at the hospital where your doctor is, try to enlist her help in providing positive breastfeeding resources for your doctor's office. If your physician hears enough voices encouraging strong breastfeeding promotion as a pro-health activity, change will begin to happen. It starts with ONE MOM speaking up. Are you THAT MOM??