Homebirth Options in Alabama

Over the past two weeks or so many women have found themselves questioning the wisdom of going into a busy hospital where the sickest among us are congregating in order to deliver their baby. We're being told to avoid gathering in large groups, so those who were already hesitant about going to the hospital have started researching midwifery options in Alabama.

Yes! Midwifery and homebirth is legal in Alabama, and there is likely a CPM (Certified Professional Midwife) serving your area. She is trained to monitor a pregnancy through prenatal visits, labor, and postpartum visits. If there are problems that make a hospital birth safer, she will advise you to have your baby there. However, if you are low-risk she can take care of you and your baby at home with less interventions in the process than you would have at the hospital while avoiding viruses and bacteria foreign to your family.

The best place to start would be here, the Alabama Midwives Alliance website. You can contact a midwife serving your area up an interview. I have to add a small plug here for the midwife I apprentice with, Rebekah Myrick, because we now have the option of doing prenatal visits here at A Nurturing Moment in Huntsville! Find her information on her website. 

Other options would be to give birth across the border in Tennessee if you don't like the idea of birthing in your own home. Midwives there have done that before, and would be able to give you guidance on how to do that. The website for the Tennessee Midwives Association can give you the contact information.

We Welcome our New Owner!

by Glenni Lorick, IBCLC

Michele Trosclair was the first
owner of A Nurturing Moment.

I am so excited to announce that A Nurturing Moment is taking the next BIG step in its history! Regina Woodley is purchasing the boutique and will continue offering the best lactation care available!

A Little History

In May of 2005 Michele Trosclair, a former NICU nurse, opened a tiny maternity and breastfeeding boutique in Madison because she felt that breastfeeding moms needed a place where they could get good nursing bras and supplies as well as support. I first met her that summer when I introduced myself and offered to help with the breastfeeding support. We quickly outgrew our tiny space on Slaughter Road and moved to a much more spacious location on Hughes Road where we had room for meetings and classes. In late 2006 we expanded to a second location on Airport Road, eventually closing the Hughes Road location in 2008.

Regina Woodley nursing baby Talia
at work at the store.

In October of 2008 I bought A Nurturing Moment from Michelle because her husband was being transferred to Colorado with his job. We saw a lot of growth from 2008 -2011 when I made the decision to purchase Huffman's Baby Furniture and move to the Rosie's Cantina Shopping Center. I quickly realized that I wasn't really that interested in selling Baby Furniture, but I did love having the Best Chairs Nursery gliders and recliners available for moms. We moved into our current suite in 2012.

In 2015 Kailey Dozier approached me with an idea to incorporate 4D Ultrasound into our offerings, and our partnership with The 4D Ultrasound Lady began. Then in June of 2018 right after my second grandchild was born, Kailey and I switched roles. Instead of her renting from me, I began renting space from her. We shortened our hours and returned to our main focus of supporting breastfeeding mamas!

Regina Moves to Town

Regina's daughters McCulla and Kyleigh are
already giving mom a hand at work!

Regina moved here from Texas in November of 2017. She had reached out to me, and we had corresponded a little bit, but we didn't actually meet until the summer of 2018. I invited her to help with our Athens breastfeeding support group on Fridays since she lives in Athens, and over the course of the next few months we grew much closer. She began doing some consults for A Nurturing Moment that year, and I was really impressed with her skill set and her compassion for moms. She also became an admin on Huntsville Mommy Milk Meet-up, offering terrific advice to our mamas.

Not only is Regina an IBCLC, she is also a doula and an herbalist. She is also in the process of becoming a Certified Professional Midwife. Last April I broached the subject of her buying the store very tentatively. I honestly had expected to be here at ANM until I died because I just hadn't met anyone I felt truly comfortable selling the store to. I knew if I ever sold it, I would only sell to an IBCLC who loved the Lord and had a heart for ministry to moms. I wasn't sure Regina would even be interested, but I knew she was the right person and hoped she would say yes!

Unbeknownst to me, Regina had a dream of opening a store someday. She didn't know how to approach me to ask if I would be willing to sell ANM to her at some point, so when I asked her if she might possibly be interested, she thought it would be a lot further down the road, but she was definitely excited about the possibility. She gave birth to her tenth baby at home in November, and felt like she would be ready to move forward after the beginning of the year.So this week is our transition week!

I get to spend more time having fun
with my precious grandchildren!

The Best Is Yet to Come

Regina will continue to offer the same amazing service that you have come to expect from A Nurturing Moment. I will be focusing my energies on my work at Athens Limestone Hospital, a new ministry to women called the Dandelion House, and my precious grandchildren!

I want to thank all of you for allowing me to serve you for the past 14 years. It has been such a privilege. I feel like Michele gave birth to A Nurturing Moment, I have raised it through its adolescence, and now Regina will take it into adulthood. I can't wait to see where Regina and ANM go in the future!!

2020 MOM Foundation Calendar

The 2020 MOM Foundation Calendar will be here in less than 3 weeks, so it's time to order yours now! As you're doing your Cyber-Monday shopping, be sure to include your favorite doctor, nurse, midwife, lactation consultant or doula! This beautiful calendar filled with images of nursing mothers makes the perfect gift. Ten different local photographers are represented in this year's calendar with thirteen stunning photographs.

The MOM Foundation supports low income and teen moms with breastfeeding help, nursing bras and discounted pump rental. Each year your purchase of a calendar helps to allow the foundation to continue providing this much-needed help.

The presale price is $20 for one calendar or $18 each for two or more. If you would like your calendar to be mailed to you, please include $5 for one or two calendars and $10 for 4 or more. Calendars will be mailed in order to arrive in time for Christmas. The Presale is  December 2-10, so be sure to get yours today!

If you plan to pick up your calendar in the store, please put that in the notes. Otherwise, let us know you would like it to be sent to you and pay the corresponding amount! The $20 option is for one calendar to be picked up the store. The $36 option is for 2 calendars to be picked up in the store, and the $25 option is for one calendar to be mailed to you. If you want something different, please choose your own amount to send.

To All You Beautiful Moms

by Amanda Robison

We started our family in 2011 after my husband’s first deployment. God blessed us with an incredible little girl with her daddy’s strength and all her mommy’s sass! We had plans of expanding our family after she turned 2, but another deployment separated our family for 18 months. When we were ready to try, we found ourselves holding countless pill bottles and syringes instead of a baby as we underwent several infertility therapies.

Finally, after 3 years we saw the faintest blue line and heard the sweetest heartbeat. Sadly, the tiny little boy that filled us with so much joy was not meant to be ours, and his heart stopped at 10.5 weeks. Our D&C was followed by an emergency surgery to remove what we thought were cancerous cells. Finally, 2 months later, after 3.5 years, 5 surgeries, 2 IUIs and countless prescriptions we saw another faint blue line. We held hands and prayed at every ultrasound until we heard that precious thump, thump. On April 17, 2019 God blessed our tiny family with a beautiful rainbow. She came into the world with a calmness about her and a spirit that puts all those around her at ease.

Our breastfeeding journey has had ups and downs, but I’m so incredibly proud of the journey and our success. I want to share some encouragement from a post wrote in Huntsville Mommy Milk Meet-up this week.

To all you beautiful moms:

The weeks are long and crazy hard to survive. The early mornings to shower, nurse, pack lunches, get everyone ready and out the door on time are nuts. The day is packed with meetings, e-mails, paperwork, phone calls and pumping. The evenings are a rushed scene of homework, cooking, cleaning, bath time, laundry, bedtime routines and prepping for the next day that lasts late into the night. 

This mama’s bones are tired and her heart is aching...was I enough today? Enough of a mommy to an infant so she knows, despite her time at daycare, I’m always here for her and think she was worth all the nights spent praying for her? Enough of a mama to the little girl, who isn’t as little as she used to be, so she knows that despite her new attitude and ever-growing curiosity about the world around her that I’m never NOT in her corner and will always be on the sidelines cheering the loudest? Enough of a wife to the husband who has seen all my highs and all my lows and loves me with all my flaws? Enough of a friend, a co-worker, a colleague, a chauffeur, a shoulder to cry on and a safe place to all those in my little world needing me? Truthfully, probably not and truthfully that’s okay. I’m doing the best I can and that’s okay. 

There’s beauty in both my success and my defeat, my triumphs and my failures. There’s still 2 little girls who light up when I walk into a room and think I’m pretty awesome, even on the days I know my best just wasn’t enough. There’s still peace in early mornings, just before the dawn fills the sky and the house is still, that I remember God blessed me with this craziness and someday my heart will ache again longing for the mess and chaos.

To those families who cradle emptiness and those families who mourn for the tiny bundles they’ve lost, we see you and we mourn with you. For those that are holding their gifts and rocking their tiny rainbows, we rejoice with you. If I’ve learned anything on this journey, it’s that God truly works in mysterious ways and there is reason hidden in the madness. I count my blessings daily that a couple of high school sweethearts were blessed with 2 precious baby girls and given an opportunity to sit front row as they grow and leave their marks on the world around them.

I Was Able to Have a Breech Baby Vaginally!

by Jessica Reese, Guest Blogger

Baby Elias was a vaginal breech birth!

Summer 2018 after a short amount of trying we were pregnant with my second child.  Unfortunately, we found out at the 12 week ultrasound appointment that the pregnancy was due to a blighted ovum and I needed to have a D&C to clear the remaining tissue that did not pass on its own.  We were able to become pregnant on the first ovulation post D&C with our third child.  For the beginning of all of our pregnancies, I go to see Dr. Michael Podraza at St. Francis Women's Health and Fertility in Memphis, TN. Dr. Podraza will see patients as soon as they get a positive pregnancy test.  He is also a doctor trained in Naprotechnology, which means that he incorporates natural family planning (cycle charting) into his approach.  I see him because I have hypothyroidism and luteal phase deficiency, and he provides a different approach than most OB/GYNs or Endocrinologists.  Since, I have luteal phase deficiency, he prescribes progesterone injections up to 14 weeks to help maintain the pregnancy.

At 16 weeks, I was able to get a transfer appointment with Dr. Aguayo in Huntsville, AL.  Dr. Podraza had placed me on daily progesterone suppositories starting at 14 weeks because of a previous preterm birth at 35+3 weeks.  Upon transferring to Dr. Aguayo, she suggested switching from the suppositories to Makena (progestin in oil) for weeks 16-36.  During weeks 14-24, I had ultrasounds to check my cervical length to see if a cerclage was needed to prevent preterm labor.  Fortunately, my cervix remained long and closed.

Since, I had had a previous preterm baby without warning signs, this pregnancy I was cautious to get several checks for preterm labor whenever I had too many consistent contractions in an hour.  Upon one of these preterm checks, I received a positive fetal fibronectin test.  Since, there is a high false positive rate with the test Dr. Aguayo had me come into her office for an ultrasound to check my cervix.  This ultrasound show a low level of amniotic fluid (4 low pockets and a single acceptable pocket).  Due to the result of this ultrasound and preterm delivery history, Dr. Aguayo referred me to a Maternal Fetal Medicine specialist from Brookwood, Dr. Antonio Gonzalez-Ruiz  for a more extensive ultrasound.  I received weekly ultrasounds from Dr. Gonzalez-Ruiz's office, each showing my baby boy was happy and healthy, but my fluid level was staying within the low-normal range and my baby, since the beginning, was staying in a breech position.

I had an ultrasound at Dr. Gonzalez-Ruiz's office at 35 weeks, and we discussed with him regarding attempting an ECV.  He suggested that the ECV may not work due to the lower fluid levels, but it was a very low risk procedure.  He also encouraged us that when he was practicing in Ohio with 12 midwives, that he would let people like me who fit certain criteria attempt a vaginal breech birth if they desired.  He told us a good candidate for a breech birth in the hands of an experienced provider was not unnecessary risk.  After, speaking with Dr. Aguayo's office I learned that she only performs ECVs at 38 weeks or later and in conjunction with either induction or, if the ECV fails, performs a c-section.  Since, I was worried that I had had a previous fast, progressing labor and a preterm birth, I really wanted to attempt the ECV sooner to avoid being very far along with a breech baby and rushed into an emergency c-section.  I was definitely influenced by the research in this article:y/.

Upon asking for recommendations, I got a consultation with Dr. Joshua Johansson to attempt an ECV. He agreed to attempt the ECV and suggested using the epidural, since there was a lower chance of success with lower fluid levels.  At 36+5 weeks, Dr. Johansson attempted an ECV, unfortunately after 4 attempts the baby did not turn.  However, the baby tolerated the ECV well and his heart rate did not drop.  Dr. Johansson stated that sometimes he would offer people a second attempt, but in this case he felt it would not be worth the time.

Dr. Bootstaylor's criteria for a vaginal breech birth.

During this process, I had also tried spinning babies to help turn the baby.  I was seeing a Webster trained chiropractor, Dr. Misty Browning, to help create space for the baby to move.  Because I realized there was a decreasing chance the baby would turn before labor, I assumed I might have to have a c-section due limited options.

Since I was still very worried about having a fast labor with a breech baby, and not having any skilled OBs in the area, I was considering what I could do.  Upon the recommendation of Dr. Gonzalez, at 37 weeks I got a consultation with an experience breech provider and Maternal Fetal Medicine Specialist Dr. Brad Bootstaylor  at See Baby in Atlanta who told me I was a good candidate for a breech birth. He said he would be willing to accept me as a late transfer at 39 weeks if I was motivated for a breech birth. Interestingly enough, See Baby's motto is "Bring Birth Back."

At this point, I was still torn on the decision.  I had my 38 week appointment with Dr. Aguayo, and she discussed the c-section with us.  She also told us that I could be a good candidate for a vaginal breech birth, but she was unable to do it and there was no doctor in Huntsville that would do it.  She also said I would be a candidate for a VBAC for the next pregnancy, but that in all future pregnancies I would always be considered a VBAC.

Still weighing my decision I had an appointment with Dr. Gonzalez that Tuesday to discuss his view on the breech birth.  Monday night at 5:30 PM after I was home from work baby Elias kicked the amniotic sac and my water broke.  Since, with my daughter my water broke and labor did not begin until around 20 hours later I knew I would have time to drive to Atlanta for the birth.  My parents came and got our 2 year old and my husband and drove to Atlanta.

We called Dr. Bootstaylor's office and he called us back and stated I may not want to go into the hospital until I was further along in labor.  When we got to Atlanta we got a hotel in downtown Atlanta to rest and wait for labor to begin.  Much later in the evening I was having some regular contractions that I was working through in the shower.  Since the contractions were regular we decided to check into the hospital.  At that point I was 4 cm dilated and 80% effaced and station -2, since I had a fast labor previously I decided to stay in the hospital.  While I was at the hospital, my blood pressure was very erratic during monitoring.

Later that morning, Dr. Bootstaylor came in with a nurse midwife trainee to discuss my progress and care.  He was concerned that my blood pressure numbers were high and erratic and I was still 4 cm and 90% effaced and station -2. He explained that there were some decisions we needed to make.  Dr. Bootstaylor said if I stayed in the hospital with higher blood pressures and labor stalled, and already being a higher risk with a breech baby then it seems more likely to start discussing a c-section per hospital protocol.  Also, he said with breech it is not ideal to augment the labor with Pitocin, especially at this first labor stage.  He told that we do have the option of taking an AMA and leaving the hospital.  He said if I stayed in the hospital with erratic blood pressures, then they would want to monitor my blood pressures, and I wouldn't be able to have the freedom I would at home to rest, eat, and move around which are all things that help labor progress naturally.

Jessica and Elias with their birth team

We discussed our options with Hannah Ellis, our doula, and we decided that I would take the AMA and we would stay close to the hospital.  After we left the hospital we went and ate lunch; I got a large ribeye steak, and then I went and rested.  A little bit later I asked my husband Jarrod if he wanted to walk from our hotel for 20 minutes to the Ponce Street Market and get some gelato.  So we walked, and I got some gelato.  As I was eating my gelato, I began to feel some more contractions picking up, especially walking back to the Airbnb.  When I got back I laid down for 20 minutes, and then I felt the need to go to the bathroom.

I had two bouts of diarrhea, and I decided to get in the shower and start working through contractions and timing them.  While I was laboring in the shower I did a lot of hands and knees to manage the back labor.  My contractions remained 5 minutes apart and we notified Dr. Bootstaylor that the contractions had picked up and labor was moving smoothly.  Hannah  also noticed blood signs of change in cervical dilation.  My contractions continued to be 5 minutes apart and I was thinking my labor might last another 6-7 hours.  I could also talk quite a bit between contractions.  After quite a long contraction, I felt baby Elias make a big rotation to get in position.  Then instinctively with the next contraction I started squatting.  Hannah asked me if I was feeling the urge to bear down, and I said yes.  She said we need to go to the hospital now.

She called Dr. Bootstaylor, and I got in the back of our van and tried not to push on the way to the hospital.  As I got to the hospital, we pulled up to the valet parking and I walked as quickly as I could to the elevator to get up the stairs.  Elias' booty was hanging out before I was getting on the elevator.  I got to L&D and they got me into a room quickly and I got up on the bed in hands and knees.  Kim Holderfield, Dr. Bootstaylor's trainee was already there.  Since I came in so far along, there were several people in the room.  One nurse was able to get right by my ear and get me to focus and tune everyone out.  Dr. Bootstaylor arrived a little bit later.  The nurse helped me focus on pushing and making every push count by pushing past the contractions to get the head out quickly.

Elias Jude Reese was born on 5/14/19 at 8:06 EST with 4.5 of active labor 6 lbs 2 oz and 20" long.  Thanks to Dr. Brad Bootstaylor and midwifery student Kim Holderfield who did most of the delivery as he guided her.  Elias was healthy when he was born, and only needed some bulb syringe suction which is typical of breech babies.  Dr. Bootstaylor encouraged us to have delayed cord clamping.  I am very thankful to have the option and shared decision making and shared responsibility provided by the See Baby team.  

New CNM Delivering at Huntsville Hospital

Tiffany Golub, CNM, CRNP is now
delivering babies in Huntsville.

by Glenni Lorick, IBCLC

Tennessee Valley mothers have a new birth option available to them: Midwife-assisted birth in a hospital setting. Now that CPM's (Certified Professional Midwives) are legal and licensed in Alabama, many mothers who have wished for a midwife birth can have one at home. However, not all mothers who want a midwife are necessarily comfortable giving birth at home. That's where Tiffany Golub, CNM, CRNP can help!

Tiffany is part of the professional staff at Women 4 Women OBGYN. Dr. Anne Marie Reidy had the vision to create a  practice that would give expectant mothers a variety of options in their birth experience. She hired Dr. Allison Warren who has a similar perspective, and then they brought in Tiffany Golub to serve their patients who prefer a midwifery
model of childbirth.

Elizabeth Irby, CRNP, Tiffany Golub, Dr. Ann
Marie Reedy and Dr. Allison Warren form
the medical team at Women 4 Women.

Tiffany is excited to be able to attend births at Huntsville Hospital and has already delivered a number of babies in her short time here. As a nurse midwife she is able to work with a mother during her labor in a more interactive, personal manner than a traditional obstetrician. She encourages mothers to move during labor, take advantage of the shower or tub in the delivery room, and deliver in a position that is comfortable. Many of her patients will have a doula attending the birth as well, and Tiffany works well with doulas.

Tiffany is a Huntsville native. She received her BS in nursing from the University of Alabama and her Master of Science from Georgetown University. She was a labor and delivery nurse at Huntsville Hospital for 11 years. It was there that she became passionate about helping mothers by educating them and ultimately being an integral part of the delivery process. Nevertheless, there are certain limitations to the births that she is able to attend. If a mother has certain risk factors she will refer her to one of the doctors with whom she works. She also provides gynecological care as part of her commitment to women throughout their lives. She is currently accepting both obstetrical and gynecological patients.

2019 MOM Foundation Calendar is Available

by Glenni Lorick, IBCLC

Are you looking for the perfect gift for a new mom, your favorite OB or your doula? Look no further! The gorgeous 2019 MOM Foundation Calendar is now available to order for a donation of just $20! Order two or more, and they are just $18.50 each.

Area photographers submit some of their best breastfeeding photographs of the year to use in this annual fund-raiser for the MOM Foundation. Some of the photographers featured this year include well-known North Alabama names like MaryEllen Pollard of LighthousePhotography, Allison Jansen, Keelan Walker, Kat Parker, Amanda Whitley and Jennifer Myers. We have a total of 12 photographers who have generously provided breathtakingly beautiful images for this year's calendar! The proceeds allow the MOM Foundation to continue its work with low-income and teen moms. In 2018 we have served over 100 mothers with our various projects.

Many mothers have benefited from our sliding fee scale for Lactation Consultations, paying as little as just $5 for professional breastfeeding support. These mothers are able to come back as often as necessary at no additional cost for weight checks and additional help. We also have at least 10 mothers who have been able to rent a hospital-grade breast pump for half price. About 20 mothers have received free nursing bras through our Bosom Buddies program which provides 2 free gently used nursing bras every 6 months to teen moms and mothers on the WIC program in the last trimester of pregnancy and as long as they are breastfeeding.

Our other big project is the North Alabama Cloth Diaper Bank. About 60 mothers this year have received loans of cloth diapers. These loans offer a sustainable alternative to continually buying disposable diapers. Cory Ann and Sarah, our volunteer coordinators have done an amazing job educating mothers about cloth diaper usage and meeting the needs of mothers all across North Alabama.

The MOM Foundation Calendar is our primary annual fund-raiser, so we encourage those who have the means to support our amazing work with moms to buy several calendars - one for yourself and 2 or 3 to give as gifts. The PreSale will last through the end of November. The Calendars will be here by the second week of December, and the donation will be $25 each. So take advantage of the presale discount and order your calendar now! You can use the PayPal button below to order.

1 Calendar is $20.

2 or more Calendars are $18.50 each.
Shipping: if you want your calendar mailed to you please add $5 for 1-2 calendars. Add $10 for 3 or more calendars. Be sure to include your address in the comments. Calendars will be mailed by the third week of December.
You will receive an email confirmation of your donation. If you have any questions, email anm@knology.net.

A Postpartum Doula Can Make Life After Baby a Lot Easier

By Regina Woodley, IBCLC, guest blogger

Why is Having Babies so HARD?!?

Through most of history, new parents would have had their own extended families and involved neighbors to come around them and help when a new baby was born.  There’s no shame in that, and a lot of need for it.  Wouldn’t it be nice to have someone who cared for you while you cared for your baby?  Someone who could help with some of the housework, make sure you were eating well, or just an extra set of arms when baby wanted to be held.  There is someone who does just that.  If you don’t have a knowledgeable, non-judgmental group of relatives and friends who can come spend hours helping you, then you need to know about Post-partum Doulas.

What Exactly is a Postpartum Doula?

A Postpartum Doula comes to your home and helps you with whatever you need help with in caring for your new baby.  Her goal is to take some of the burden of parenting off of you so you can enjoy your baby.  Often, postpartum doulas have expertise in breastfeeding, but can also help you safely prepare formula.  They have knowledge about what is normal in the postpartum period and what may need a referral.  The support is not just for mothers, but extends to fathers and other children, too.  Her goal is to help the family function more smoothly in the early weeks so that eventually you feel confident and knowledgeable enough to not need her anymore!

What Kinds of Things Will My Postpartum Doula Help With?

Each doula has a different set of skills, but generally they help with whatever the family needs at the moment.  Some even do night hours!  Her duties often include:

*Education about breastfeeding and baby care

*Soothing baby while parents sleep, eat, shower, etc.

*Preparing simple meals and snacks

*Helping with laundry

*Light housecleaning (washing dishes, sweeping, etc.)

*Playing with older children

*Organization and streamlining for baby care

That’s Amazing!  Is There Anything Postpartum Doulas DON’T DO?

Most Postpartum Doulas don’t do heavy housework or work that isn’t related to caring for a new baby.  For instance, she isn’t the person to change your oil or paint your house.  She also doesn’t provide medical care, but will tell you if she feels a doctor or other professional would be beneficial.  Many do not watch children while parents are not at home, since the goal is to help the family function on their own. She is not just a babysitter. 

Who can benefit most from a Postpartum Doula?

Every time a new member is added to the family there is a time of adjustment and healing for the mother where she needs extra help.  When getting postpartum help mothers benefit, babies benefit, fathers benefit, everyone benefits!  You especially need help if:

*This is your first baby

*You are a single parent

*You have other young children who need supervision

*Your baby is having feeding or health issues

*Mother has had a Cesarean or difficult birth

*Either parent is having health problems (physical or mental)

*There will be an early return to work for either parent

*There are issues which make parenting more difficult

*You have multiples

How do I find a Postpartum Doula?

There are websites where you can search for doulas near you, such as doulamatch.  Not all doulas are Postpartum Doulas, so be sure to include that.  The best way to find the right postpartum doula for you is probably by asking those who work with pregnant mothers and postpartum doulas. Baby store owners, pediatric chiropractors, lactation consultants, and support group organizers  can suggest the postpartum doulas they recommend.  Social media may also be a way that other mothers could share who helped them.  You can hire your postpartum doula either before baby is born or after.

Most Postpartum Doulas have packages that include a certain number of hours (the more hours, the less expensive per hour) and may include other services.  They generally provide a free interview so you can see if your personalities mesh.  It is best if both parents and even children can meet her before any contract is signed.  A contract that details exactly what you expect, the number of hours per day, and any limitations should be signed by both parties ahead of time, just so everyone is on the same page.

Remember, you are no less of a parent for asking for help.  In fact, it is very wise to know that families were never meant to be totally alone during this very important time in your life that you can only do once!

Regina Woodley is a Certified Childbirth Educator, Lactation Consultant (IBCLC), doula and postpartum doula living in Athens, AL. 

2018 MOM Foundation Calenders On Sale Now!

by Glenni Lorick, IBCLC

It's  that time of year where we hold our largest annual fundraiser for The MOM Foundation: the annual calendar filled with gorgeous photos of breastfeeding moms from the Tennessee Valley. I love this project because it allows local photographers to showcase their talent. This is the third year that we have done this project, and the photos coming in are absolutely magnificent.

The MOM Foundation

What is The MOM Foundation? It is the 501c3 non-profit organization that allows us to do many of the amazing things we do. The following programs are all sponsored by The MOM Foundation:

• The Bosom Buddy Project: This project allows low-income and teen moms to receive free gently used nursing bras. We measure each mother and help her find 2 bras that will fit her. The bras come from our generous Nurturing Moment family. When you bring in a bra to donate, you get a discount on your purchase that day, and we are always in need of all sizes of bras. If we don't have a single bra in our donation boxes that will fit a mother, then we provide her one bra from our ANM inventory. The MOM Foundation pays that cost.
• Sliding scale Lactation Consultations: We believe that every mother is entitled to the breastfeeding help she needs without worrying about finances. That's why The MOM Foundation allows us to provide our lactation services on a sliding fee scale. We tell every mother who comes in to pay whatever works in her budget.
  
• Half-price Breast Pump Rental: Mothers on the WIC program are entitled to half price breast pump rental. Instead of the normal $65 monthly rate, they pay only $32.50 a month for a Medela Symphony breast pump. This is a tremendous savings for those moms who desperately need a pump during the first month of baby's life before they are able to get one through WIC.
• The North Alabama Cloth Diaper Bank: Some mothers find themselves in a situation where they must choose between feeding their families and diapering their babies. So The North Alabama Cloth Diaper Bank provides free loans of cloth diapers to families in need. Instead of having to keep going back to get more disposable diapers, these mothers are able to receive a loan that provides enough diapers for their baby throughout infancy and toddlerhood.

Your Role

We couldn't do all of this without your support. As you look at your end of the year charitable giving please consider including The MOM Foundation in your plans. One way to support us is to make a donation to the MOM Foundation. Another way is to buy a calendar or two (or three...)! Important events like The Great Cloth Diaper Change, Mom Prom, The Big Latch On and Huntsville Mommy Milk Meet-up Meetings are listed on the calendar, so you never miss anything! These calendars make a great gift for your favorite doula, midwife, lactation consultant, WIC nutritionist, doctor or nurse. Why not get one for that special friend who is pregnant or breastfeeding!Think about who you want to bless this year with a calendar. And make sure to buy one for yourself, too! 

The Presale price this year is $20 for one calendar, or $15 each for 2 or more calendars. The presale begins today and will go through November 22. After that, the cost will be $25 for one calendar or $20 for 2 or more calendars. If you want your calendar mailed to you please add $5 for shipping for 1-2 calendars and $9 for shipping for 3 or more. It's easy to make your order, just click the donate button below, and in the note section be sure to leave your name and phone number. In early December, you will receive our calendars in plenty of time to give them as Christmas presents!

Your Baby's First Trip

A Baby Ktan makes the trek
through the airport easier!

by Belinda Moss, Guest Blogger

Traveling by road with your little one may be tedious and stressful, but it can be loads of fun for the family if you plan your trip ahead of time. I recommend that you get a good night’s rest before embarking on your trip, map out your route as carefully as possible with the aid of maps and GPS navigation, and last but certainly not the least do all your packing ahead of time. All essentials you would need during the trip should be packed into quick access bags that can be placed in the back seat. Some essentials you might need while on the road include:

• Diapers and wipes
• Blankets, change of clothes and bibs
• Formula and liquids
• Toys and portable video players

Be sure to stick to your baby’s feeding and nap schedules to keep him/her happy and comfortable during the trip. You can premix the dry ingredients for the formula then add liquids when needed. This will make it easier to feed your baby on time and make things easier to prepare.

Ensure your baby’s comfort during the road trip by using a car baby seat which supports your baby’s body. If your baby is alone in the backseat, and you are worried about keeping an eye on him/her, then have the baby seat installed behind the driver’s seat. That way you can keep an eye on your prince/princess from your mirror.

Take scenic routes and make stopovers at nice diners for a meal or at a motel for some rest. Make sure you take photos at all stops to document your trip’s memories for the family album.

You may consider playing sing-along audio CDs, which most babies tend to love, or you can opt for a portable video CD player that can be installed in the car to enable your baby have live visual entertainment. That will definitely keep the angel busy for a few hours!

But how do you plan for a flight with a baby? It’s not as tedious as you think! Check out these tips from babyinastroller.com to make sure you have everything needed for the big trip.

Belinda Moss first published this infographic here.

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!

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!