A Brief (and Fascinating) History of Breastfeeding and its Alternatives

Painting by Artemisia Gentileschi

Breastfeeding has never been without cultural commentary. Breast milk is arguably one of the most provocative of bodily fluids—we do not feel as passionate about urine, sweat, snot, or tears—and yet breast milk is a biggie. Since the beginning of time, breast milk has been revered…and has been a substance of great contention. The history of breastfeeding is fascinating, especially seen in the context of our current culture about breastfeeding.

Breastmilk has been revered since ancient times. In Classic Greece, the milk of a Greek goddess was thought to confer immortality to those who drank it. It was Hera’s breastmilk that made Hercules invincible. It was Hera’s breastmilk that formed the Milky Way itself (so the story goes). The Mother Mary was exempt from sex, pain in childbirth, and perhaps many bodily functions (at least as the story goes)—and yet she breastfed. Baby Jesus at the breast of Mary has been one of the most popular and powerful artistic images for millennia.

Painting by Leonardo DaVinci

In ancient Egypt, wet nurses were exalted, despite their station as servants. They were invited to royal events. The children of royal wet nurses were considered kin to the king. In the great tale of Odysseus, only two individuals recognized the protagonist after his long absence from home—his loyal dog and his wet nurse. History has long recognized and exalted the special nature of the breastfeeding relationship.

But history has also complicated the breastfeeding relationship by adding cultural and ethical baggage to what is a biological function. We all know the current conditions around which our babies are fed—the importance given to breast milk, the push for formula by some and the rejection of it by others, the judgments that are made about women who want or don’t want to breast feed, women who can and cannot breastfeed, women who love and women who loathe breastfeeding, women who breastfeed a short while and those who nurse for years. It all comes highly charged.

And this high charge is nothing new. Formula vs breastmilk may be the contemporary dichotomy of choice (with a long list of subtler but equally divisive nursing nuances), but there have long been alternatives to a baby nursing at his or her mother’s breast.

We think of formula as a relatively new invention, but seeking breastmilk substitutes has long been a human enterprise (however unsuccessful many of those attempts). Breast-shaped clay bottles have been found in ancient sites in Europe that date back to 3500BC. Some historians believe that cows and goats were actually domesticated for the reason of providing a human breast milk substitute to infants. Babies may have suckled directly from these animals or been given human-fashioned devices very roughly akin to our modern baby bottles. Cow and goat milk substitutes largely fell out of favor when people learned that babies do not thrive on these human milk alternatives. Records from 18^th century Europe, for example, show that babies given milk from these animals early on suffered greater rates of diarrhea and death compared to those fed human breast milk.

Animal shaped ceramic feeding bottle from Regensburg, Germany, ca. 1350–800 BCE

In addition to the long search for human milk substitutes, history shows us a long storied use of proxy milk givers—the practice of a woman other than the child’s mother nursing the child. This practice—called wet-nursing—is ancient and was one of the few ancient professions open exclusively to women. While not a common or accepted practice in the West today, wet nurses were once so popular that they had to advertise their services and compete for business. In 16^th century England, how-to books were published for new parents about how to hire a wet nurse and what attributes she should possess. In Renaissance Florence, wet nurses gathered in public squares to sing songs in promotion and celebration of their services.

The use of wet nurses began in the upper classes; but, like many elite trends, it trickled down to the masses. (Formula use followed a similar trend.) By the 1600s in Europe, over half of all women were sending their babies off to be nursed by other women paid for such a service. In 1780, less than 10 percent of all Paris-born babes were nursed by their mothers, according to one historian. Expensive wet nurses even sent their babies off to be nursed by cheaper wet nurses so they could keep their supply for paying customers.

The Wet Nurse, c.1802, by Marguerite Gerard

Why such popularity in wet nurses? Historians postulate many reasons for the rave. Some argue that men did not wish for their wives to breast feed for a gamut of reasons. One, it “ruined their maidenly bosoms.” Two, it took women and their affections away from men. Three, nursing was understood to compromise a woman’s fertility—the more a woman lactated the fewer babies she made. Men seeking progeny and heirs became great critics of lactating wives. There were also superstitions that intercourse somehow tainted breastmilk, another reason for a lack of support for breastfeeding.

As with so many popular trends, there came a backlash against the use of wet nurses. Come the late 1700s/early 1800s—as part of the reform movements that swept across the social landscape of Europe and the United States—many women and men were calling for a return to in-home breastfeeding of babies by their own mothers. It was even billed as a feminist issue, though women still bore the brunt of this new creed—where once you were not a “good enough woman” if you DID breastfeed; now, you were not “good enough” if you DIDN’T nurse your babes. (Sound familiar?)

In 1793, the French declared that women who did not breastfeed were ineligible for welfare. In 1794, the Germans took it a step further and made it a legal requirement that all healthy women breastfeed their babes. By the early 1800s, elite women were bragging about their commitment to breastfeeding. Ah how the tides do change.

Woman breastfeeding in Victorian Era

Though wet nursing has never regained popularity, similar themes have risen and met their demise in times since. The 20^th century equivalent came with the advent of infant formula. Elite men and women again led the charge. Formula has historically been both hailed and rejected. At one time, formula was considered superior to breast milk in purity and nutrition. Later it was condemned as a harmful substitute for human milk. Other arguments swirl around these, many of which we know well for we still swim in these cultural waters.

Original source unknown

The sway between breastfeeding and formula use has been striking in the United States in the last hundred years or so. Prior to 1930, most all mothers nursed their babies. By the early 1970s, only 22 percent of mamas breastfed, and most only for the first few weeks of life. Today, breastfeeding rates are on the rise. In 2011, 79 percent of newborn infants were breastfeed. Though the World Health Organization currently recommends babies breastfeed for 2 years, many nursing pairs do not breastfeed that long. Of infants born in 2011, 49 percent were breastfeeding at 6 months and 27 percent at 12 months.

Women throughout all of history have been subject to the cultural ideals and mores of the current day. All women throughout time have done their best, given the constraints of work, responsibility, familial and social expectations, desire, health, and ability.

Florence Owens Thompson (mother), taken in 1930s in Nipomo, California

Please note that this article does not attempt to be exhaustive in covering of breastfeeding’s history, which is certainly a topic that could be covered in MUCH greater detail. This article does not cover historic breastfeeding trends worldwide, but rather, primarily focuses on Western culture, and even within this sphere of focus, much is surely uncovered.  We invite you to delve further into this rich history should you so desire and share with us your interesting findings!

The information in this article is largely based on a chapter from Natalie Angier’s phenomenal book “Woman: An Intimate Geography.” For all those who love and care for the female body, this book is an incredibly insightful and valuable read.

Breast Feeding after Breast Reduction (BFAR)– One mama’s journey through the first 6 months

BFAR – My Journey through 6 Months

Photo credit: Render Photography

When I became pregnant with my son, George, I knew I wanted to breastfeed him.  There were a lot of reasons that this was important to me: nursing him would be better for his health, for my health, and it just felt like it was the natural thing to do.  Every time I learned another thing about breastfeeding, I was amazed.  

 

I read so many horror stories on the internet, from bleeding nipples, to low milk supply, to oversupply.  In fact, my mom hadn’t been able to nurse me due to recurring mastitis, and she never even tried with my brother.  I knew that nursing could be really hard – it could be impossible.  And that was from women who had never had breast surgery.  

 

When I was 17, I had a breast reduction.  It was not a tough decision to make.  I was told that there was a chance I wouldn’t be able to breastfeed, but I was 17 and not thinking that far down the line.  I had the surgery the summer I graduated from high school, and I felt so much more confident.  Although I had the scars to remind me, it became a distant memory.

 

Fourteen years later as I prepared to give birth, I started researching as much about breastfeeding after breast reduction as possible.  I read Diana West’s book, Defining Your Own Success: Breastfeeding after Breast Reduction Surgery.  In it were many stories about women who had varied amount of success with breastfeeding.  I felt like the book prepared me to fail, to be mentally OK with the idea that exclusive breastfeeding was not the only option.  

 

I called my plastic surgeon to ask his office which type of surgery I’d had (inferior pedicle).  That method was known to have the best success rate for nursing because it leaves the nipple intact.  I was relieved.

 

I read and read and googled everything I could on the internet.  I think I found one success story on a blog but for the most part success stories were few and far between, especially for first time moms.

 

Perhaps the best thing I did was read Ina May’s Guide to Childbirth.  Her book helped shape my whole birth plan.  Instead of giving birth in a hospital, I chose to have my baby in a freestanding birth center.  Although her book did not directly discuss breastfeeding after a breast reduction, it did offer many suggestions applicable to all women attempting to breastfeed – skin to skin contact immediately after the birth of the baby, rooming in with the baby, initiating breastfeeding as soon as possible after the birth, limiting the use of drugs and other modern interventions so that baby is wide eyed and awake after birth, no pacifiers, bottles, supplementing, etc.  I felt that having a natural birth, without any medical intervention (no pitocin, no pain medications, etc) would set me up for the best breastfeeding journey.  Additionally, the birth center released its patients just 5 hours after the birth of the baby.  I’d recover in my own bed, with my husband and mom caring for me, instead of nurses I didn’t know, which was one of my biggest fears about a hospital setting.

 

I’m not sure if I would have been as successful breastfeeding had my birth story been different, but I am so thankful that I had an uncomplicated labor and delivery, and I was home in my own bed the night that George was born, snuggling with my sweet baby.  

 

My milk came in within 48 hours of having George.  George was born 2 weeks late at 9 lbs, 6.5 oz.  I think he got down to about 8 lbs 12 oz, and was back to 9 lbs 1 oz by day 6.  He nursed like a champ!  He was hungry ALL the time and those first couple of weeks my nipples were SO sore, but no one, myself included, ever asked if he was getting enough milk.  There was never a doubt in my mind.

 

I wanted to wait we had really settled into a routine to write about my experience.  It was so wonderful, I didn’t want to jinx it.  

 

I exclusively nursed George until he was just 5 days shy of 6 months old.  We then started introducing solid foods via baby led weaning.

 

I think that there are a couple of things that really helped us to have a successful nursing relationship.  One: a birth team and husband who knew a lot about breastfeeding and who were 100% supportive.  Two: a ton of education while pregnant.  The birth center offered a one on one consultation with a lactation consultant during one of the last visits; one of the Bradley Method classes was dedicated to breastfeeding; in addition, I had the chance to do lots of research on sites like kellymom.com, which I bookmarked for questions that arose after George was born.

 

Nursing my son might be the coolest thing I’ve ever done.  It’s definitely the most beautiful thing my body has ever done, in addition to growing this tiny, perfect human.  I hope and pray that every woman who wants to breastfeed has the opportunity to do so, and that my story can help offer some hope to women who have chosen breast reduction surgery.

 

UPDATE:

George is now 9 months old are we are still enjoying nursing – maybe more than ever!  It calms him if he’s upset, it helps him sleep if he’s tired, and it’s so easy now that he can more actively participate.  I’m planning to let George self-wean, and I definitely don’t see that happening anytime soon.

Extended Breastfeeding

Source: kellymom.com

While there is much important information out there about nursing in the early days, weeks, and months of your child’s life, we hear less about the nursing relationship after a child’s first birthday and beyond.  Nursing beyond the first year of life is often referred to as extended breastfeeding here in the US, though other cultures don’t consider breastfeeding to be “extended” until after a child’s third birthday, as longer nursing relationships are more common.

Rates of Extended Breastfeeding

According to the CDC’s 2011 Breastfeeding Report Card, approximately three-quarters of mama-baby pairs initiate a breastfeeding relationship after birth.  At six months, about half of all mama-baby pairs are breastfeeding and at baby’s first birthday, about one quarter of all mama-baby pairs still enjoys a breastfeeding relationship. In Minnesota, about 23% are nursing by the child’s first birthday.

In many nations, the rates of breastfeeding at one year are much higher; for example, India, Iran, and the majority of countries in Africa have breastfeeding rates at one year at or above 90%.

Extended breastfeeding in the US

A 1994 study in the journal Birth looked at the characteristics of women and their children when breastfeeding continued beyond a year.  This study found that:

• Longer duration of breastfeeding was associated with greater maternal age and education and longer rates of exclusive breastfeeding
• Nearly 70% of women who continued to nurse beyond 1 year had returned to work before the child’s first birthday.
• About half of the women reported nursing on demand.
• At 12 to 15 months, 54% of children were sleeping separate from their mothers (in cribs) and 37% were co-sleeping
• The most frequently cited reason for continuing the breastfeeding relationship was the perception that it was a special way to nurture and bond with baby.

Another study of 179 women who nursed beyond one year found that the average age of weaning among this group was 2.5 to 3 years of age, with a span ranging from one month to 7 years.  Most of the women in this group described weaning as gradual and child-led.  Some also cited a subsequent pregnancy as the reason for weaning.

Support for extended breastfeeding

Most major health organizations both in the US and internationally recommend extended breastfeeding, citing significant health benefits to both mother and child.

• The World Health Organization recommends breastfeeding for at least 2 years.

• The American Academy of Pediatrics recommends that “Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child… Increased duration of breastfeeding confers significant health and developmental benefits for the child and the mother… There is no upper limit to the duration of breastfeeding and no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer.”(AAP 2012, AAP 2005)

• The American Academy of Family Physicians recommends that breastfeeding continue throughout the first year of life and “should ideally continue beyond infancy,” though not the cultural norm in the United States. They cite that the natural weaning age for humans is between two and seven years. They also recognize that continued breastfeeding offers a child immune protection, better social adjustment, and a sustainable food source in times of emergency and offers the mother a reduced risk of breast cancer and other illnesses. They also note that, “If the child is younger than two years of age, the child is at increased risk of illness if weaned.” (AAFP 2008)

• The Academy of Breastfeeding Medicine affirms breastfeeding beyond infancy as the biological norm, with average age of weaning between six months to five years.  The president of The Academy says idea that breastfeeding beyond infancy is harmful to mother or infant has absolutely no medical or scientific basis.   He notes the more salient issue is the damage caused by modern practices of premature weaning.”  The Academy further notes that increased breastfeeding duration is associated with reduced maternal risks of breast cancer, ovarian cancer, diabetes, hypertension, obesity, and heart attack.” (ABM 2012)

Benefits of extended breastfeeding for children

Evidence shows that breastfeeding continues to be a valuable source of nutrition and disease protection for as long as breastfeeding continues.  A 2005 study noted that human milk expressed beyond the first year has significantly increased fat and energy contents, compared with milk expressed by women who have been lactating for shorter periods.  A 2001 study noted that, “Breast milk continues to provide substantial amounts of key nutrients well beyond the first year of life, especially protein, fat, and most vitamins.”

Some argue that breast milk doesn’t provide the same benefits after the first year.  However, some of the immune factors in breast milk increase in concentration during the second year and also during the weaning process. In several studies, breastfeeding toddlers between the ages of one and three have been found to have fewer illnesses, illnesses of shorter duration, and lower mortality rates.  The World Health Organization notes the importance of breastfeeding in the treatment and prevention of childhood illness, and states that “a modest increase in breastfeeding rates could prevent up to 10% of all deaths of children under five.

The benefits of extended breastfeeding continue beyond the body.  Research shows the longer a child nurses, the greater their cognitive development (as measured by IQ scores and grades in school later on).  Other studies show that children breastfed longer are more socially developed and have lower rates of mental health problems throughout childhood and adolescence.

Benefits of extended breastfeeding for mothers

Studies show the following benefits of extended breastfeeding for mothers:

• Delayed return of fertility
• Easier ability to lose weight if desired
• Lowered risk of:
  • breast cancer
  • ovarian cancer
  • uterine cancer
  • endometrial cancer
  • osteoporosis
  • rheumatoid arthritis
  • cardiovascular disease
  • Type 2 diabetes mellitus in mothers who do not have a history of gestational diabetes

Beyond the measurable

Elizabeth Baldwin, attorney and author of “Extended Breastfeeding and the Law” notes the following:

“Breastfeeding is a warm and loving way to meet the needs of toddlers and young children. It not only perks them up and energizes them; it also soothes the frustrations, bumps and bruises, and daily stresses of early childhood. In addition, nursing past infancy helps little ones make a gradual transition to childhood[…] Meeting a child’s dependency needs is the key to helping that child achieve independence. And children outgrow these needs according to their own unique timetable.”

 

 

Sources:

http://www.cdc.gov/breastfeeding/pdf/2013breastfeedingreportcard.pdf

http://kellymom.com/ages/older-infant/ebf-benefits/

http://kellymom.com/fun/trivia/bf-numbers/

Mastitis

Mastitis is inflammation of the breast that can occur in breastfeeding women.  This condition can be caused by an allergy, infection, or an obstruction.  While mastitis is the most common in the first 2 to 3 weeks of breastfeeding, it can occur at any time during lactation.  Approximately 1 in 3 (other sources say 1 in 5) postpartum women in the West will experience mastitis.

This condition often comes on abruptly and often affects only one breast.  It may last for a few hours or up to a week or so.

Symptoms of mastitis include:

• Breast area that is warm, hot, sensitive and may be painful
• Red or reddish streaks on the tissue of the affected area
• Fever of 101.3 or more
• Chills
• Generalized aching
• Flu-like feelings

What causes mastitis?

Sometimes the cause of mastitis is unknown.  Possible causes or contributing factors can include:

• Plugged ducts
• Cracked or damaged nipples, which let germs in
• Ineffective or infrequent nursing or pumping
• Pressure from a baby carrier or a bra
• Fatigue
• Being “run down”

Other effects of mastitis, which can help indicate illness include:

• Decrease in milk supply from the affected breast temporarily
• Expressed milk that looks like strings or grains of thick, fatty milk; lumpy, clumpy milk (this is safe for baby, but some moms like to strain this out.
• Milk may contain more sodium and chloride, making it saltier—baby may refuse or resist the breast due to this temporary change in flavor.
• In more serious cases, milk can contain mucus, pus, or blood.

How to prevent mastitis

• Breastfeed or pump frequently
• Fully drain the milk from your breasts while breastfeeding
• Allow baby to completely empty one breast before switching to the other breast
• If baby nurses for only a few minutes on the second side (or not at all) begin on that side for the next feeding
• Alternate the breast you offer first at each feeding
• Regularly change the position you use to breastfeed
• Ensure that baby is latching properly
• Take good care of yourself– get enough rest, eat well, and drink enough fluids

What do to if you suspect mastitis

If you feel you may be experiencing mastitis or a plugged duct, please call or page the midwives if you are a current client.  A visit to determine the cause of your symptoms and potentially a prescription for antibiotics (if infection is present) and/or a recommendation for over-the-counter anti-inflammatory medication may be in order.

There are also many things you can do at home to help treat mastitis.

1. Apply cold or heat: apply a cold pack (frozen peas work great) or a heat pack or compress, whichever feels better to the area, 20 minutes on then 20 minutes off and repeat.  Hot showers and soaking (with the affected breast immersed) in warm water with Epsom salt can also help.
2. Empty the breast often:  frequently nurse or pump or hand express (at least every 2 hours) on the affected side to keep the milk moving.  (Don’t neglect the unaffected breast)
3. Rest: it is so important to rest as much as you can.  Rest means lying down sleeping or resting for as much of the day as possible.  Get help around the house as much as possible
4. Eat well and stay hydrated, drinking plenty of water throughout the day
5. Go braless if possible
6. Massage:  some call this the “bag of marbles” massage.  Cup your affected breast with both hands, fingers interlaced, and massage as if you were rolling marbles around in a bag.  You can also rub the affected area in a circular motion with 2 or 3 fingers.  You can massage as baby nurses, toward the nipple, to help with milk flow and clearing out obstructed ducts.
7. Natural remedies: speak with your midwife to see about the appropriateness of using raw garlic (2-5 cloves per day), Echinacea tincture, Oregon Grape Root tincture, Propolis tincture, and/or vitamin C
8. Raw potato or cabbage leaves:  applied to the breast.

After mastitis has resolved, it is common for the area to be red or feel bruised for up to a week longer.

Additional Resources on Mastitis:

http://kellymom.com/bf/concerns/mother/mastitis/

http://www.storknet.com/cubbies/breast/naturalremediespt2.htm

http://www.breastfeedinginc.ca/content.php?pagename=doc-BD-M

Benefits of probiotics in pregnancy, postpartum and for baby

Probiotics (which roughly translates to “for life”) are beneficial forms of bacteria/microbiota that can assist the human body in preventing and treating many types of illness and disease—from cancer to diarrhea.  We have these beneficial bacteria in our body naturally, but supplementation can greatly support the body in health and healing.

While nearly everyone can benefit from consuming probiotics, using probiotics is especially important and advantageous during pregnancy and once baby is born.  Read on to learn all about the amazing benefits of probiotics for mom and baby.

What are probiotics?

Probiotics are the beneficial bacteria living in your body that help protect against illness.  We can take supplements of these beneficial bacterial or obtain them from some food sources.  There are hundreds of different strains of probiotic, which are all important to overall health.  Certain strains are particularly good for pregnant women and others best for new mamas and babies.

While we typically think of probiotics as being good for digestive health, they do more to promote health in the body.  Probiotics are found lining the mucous membranes of your digestive, urinary, and vaginal tracts.  This last one is particularly important in pregnancy, because we want to foster healthy vaginal tissues before and during delivery (more about why below).

Additionally, probiotics are key to a healthy immune system.  These beneficial bacteria make up approximately 70% of your immune system, making them an important part of your daily defense mechanisms.  Ensuring a healthy balance of good bacteria in the body can foster overall wellness.

 Probiotics in pregnancy

Regular use of probiotics in pregnancy can offer women many benefits.  These benefits include lower risk of:

• illness (colds and flu)
• constipation
• gestational diabetes
• preeclampsia
• urinary tract infections
• yeast infections
• premature labor

Use of probiotics in pregnancy has also been found to keep levels of Group B Streptococcus (Group B Strep) low.  Group B Strep is a common bacterium of the vaginal lining, but if levels of these bacteria get too high at the end of pregnancy it can pose some risks to baby.  When this issue presents itself, it is often managed during labor/delivery with antibiotics.  However, steps in pregnancy, including probiotic use, can reduce the risk of this condition.

Healthy vaginal flora is crucial to baby’s health.  Babies are born with a sterile gastrointestinal system and exposure to mom’s vaginal flora is their first exposure to the bacteria their systems will be colonized by.  Healthy vaginal flora helps give baby’s immune system a good start.  Babies also continue to receive beneficial bacteria through breastfeeding, being held skin to skin, and via saliva exchange (think pacifier “cleanings,” shared spoons, and the like) in the first year.

Postnatal Probiotics Benefits 

Recent studies have found that consuming probiotic supplements beginning in the first trimester of pregnancy and continuing their use through at least the first six months of exclusive breastfeeding can help women lose weight after the birth of their baby.  Supplements with Lactobacillus and Bifidobacterium were linked to less central obesity (defined as a body mass index (BMI) of 30 or more or a waist circumference over 80 centimeters).

Probiotic use can be especially important if you need to take antibiotics for any reason in the postpartum period (really any time you take antibiotics, you can benefit from use of probiotics).

When mamas consume probiotics, the health benefits also find their way into breast milk and are passed on to baby. Breast milk is actually the source of our first immune-building “good” bacteria.  Since baby’s gut bacteria continues to culture throughout the nursing time, it is great for mama to continue taking probiotics in the postpartum and as long as she breastfeeds.

Probiotics for baby 

In addition to receiving probiotics via breast milk, probiotics can also be given to baby directly.  Supplementation to baby can take a few forms: you can add a bit of probiotic to a bottle of milk, you can take a little probiotic on your finger to give to baby orally, or you may even put a little on your nipple and baby will ingest it during a feed.

Probiotics have numerous potential benefits for babies including the prevention and treatment of:

• allergies
• asthma
• eczema
• food sensitivities, especially in infants with a family history of allergy
• colic, one study found decreased crying times by up to 75% (look for product containing Lactobacillus reuteri)
• diarrhea
• ear infection
• illness (colds and flu)

Research shows that good probiotic exposure in infancy can actually help optimize baby’s weight later in life.  Early probiotic exposure may modify the growth pattern of the child by restraining excessive weight gain during the first years of life.

Probiotics: Sources and Guidelines

Different blends of different strains of probiotic may be optimal depending on whether you are pregnant or taking them in the postpartum (or giving to baby).  We have a few excellent supplements at the clinic and we can talk to you further about what to look for in a probiotic.

Generally speaking, recommendations tend toward 1 to 10 billion Colony Forming Units for infants, and 10 to 20 billion CFU for older children and adults. To achieve and maintain a therapeutic effect, probiotics must be used consistently to ensure a sufficient and consistent population levels over time.  It can be difficult to say exactly what dose is ideal, as products vary.  Different probiotics have been shown to be effective at different levels.  Products containing a higher number of live probiotics may not be better than one with fewer.  It’s best to go with a reputable high-quality brand, ideally one that has been vetted by your health care professionals (such as us!).

There have been no reports of adverse reactions to supplementation of probiotics in moms or babies.

Food sources of probiotics

While supplementation is great, there are also many foods rich in probiotics.  Fermented foods are particularly rich in probiotics.

Food sources of probiotics include:

• Yogurt
• Kefir
• Sauerkraut
• Spirulina (with other great benefits in pregnancy and in general)
• Miso soup
• Pickles
• Tempeh
• Kimchi
• Kombucha tea

If you have questions about probiotics, be sure to discuss them with your midwife at your next appointment, give us a call, or stop in.  We’d be happy to talk with you further about what to look for in a probiotic or connect you with a great supplement we carry.

Sources:

http://www.nutraingredients.com/Research/Probiotics-may-help-women-regain-their-figures-after-pregnancy

http://www.ncbi.nlm.nih.gov/pubmed/20231842

http://www.ncbi.nlm.nih.gov/pubmed/24164813

http://cdrf.org/home/checkoff-investments/usprobiotics/probiotics-basics/

http://www.ncbi.nlm.nih.gov/pubmed?Db=pubmed&Cmd=ShowDetailView&TermToSearch=11172991&ordinalpos=36&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Herbs and Breastfeeding

A particular herb can be a powerful source of medicine or it can pose significant risks or unwanted effects, depending on who is consuming it and when.  In pregnancy, some herbs are incredibly beneficial, while others should be avoided entirely.  The same is true when breastfeeding.  In particular, some herbs are known to help increase the supply of breast milk, while others deplete or stop the supply.

What is considered safe and ideal depends on the woman’s aim, among various other factors.  If she is trying to build her supply, galactagogues are ideal.  If she is trying to wean or needs to dry up her milk (perhaps because of infant loss), she may want to use a different set of herbs.

Or it may be that she is considering the use of an herb for a reason unrelated to breastfeeding and wants to know if and how those herbs may affect her supply.

Below is a partial list of common herbs that can build or deplete breast milk supply.   It is always good to speak with your health care provider before beginning any new herb or medication when pregnant or breastfeeding.

Galactagogues: Herbs that promote breast milk production

Some of the most commonly used herbal galactagogues are:

• Fenugreek
• Blessed thistle (a bitter herb known to help liver and digestive problems as well)
• Alfalfa
• Anise seed (also considered good for colic and gas pains)
• Chaste Berry
• Fennel seed
• Hops
• Milk Thistle seed
• Nettle Leaf

It is important to note, however, that most women do not need to take such herbs or take any other medications or foods to increase or maintain their supply.

Cases where such herbs may be useful include:

• Working mothers may use these herbs to increase their pumping output (since pumps are typically less effective at milk removal than babies are).  This may be true even if their supply is adequate when baby nurses.
• Moms who adopt children may use galactagogues to increase the amount of milk they provide their babies.
• Some moms who have a genuinely low milk supply may use these herbs in combination with increased nursing and pumping.

If you suspect a low supply, you should speak with a lactation consultant and/or a La Leche League leader first.

Herbs that can deplete breast milk supply

These are herbs that most breastfeeding women will want to avoid, unless they are weaning or needing to abruptly stop breastfeeding with good cause.  The ability of these herbs to deplete milk supply is dependent on how frequently and how much of the herb is consumed.  Consuming a small amount of the culinary herbs below generally will not affect supply.

• Sage
• Jasmine flowers
• Peppermint (especially peppermint oil)
• Thyme
• Spearmint,
• Parsley
• Chickweed
• Black Walnut
• Stinging nettles (not nettle – that increases milk supply)
• Yarrow
• Lemon Balm
• Oregano
• Periwinkle Herb
• Sorrel

 Word to the wise

When considering any herbal remedies while breastfeeding, it can help to follow these precautions:

• Avoid pharmacologically active herbal teas. Drink herbal teas in moderation.
• Limit herbal preparations that combines several active ingredients.
• Always check the label. Even vitamins and echinacea may contain herbs that should not be used by breastfeeding mothers.
• Use only reputable brands that have ingredients, concentrations expiration date and name of the manufacturer and distributor clearly marked on the label
• Be sure to check with your health care provider before taking any natural remedy, since it could interact with other medications.

Sources:

www.kellymom.com (multiple pages)

http://www.mobimotherhood.org/MM/article-herbalgal.aspx

15 Cool Facts about Breastfeeding

We all know the saying “breast is best” but here are some of the colossal benefits, and a couple quirky facts, about breastfeeding.

1.  Human milk boosts a baby’s immune system big time—helping baby fight viral, bacterial, and parasitic infections, including:

• Respiratory tract infections
• Ear infections
• Bacterial meningitis
• Pneumonia
• Urinary tract infections
• Infant diarrhea
• Common colds and flus

2.  Breastfeeding can actually reduce baby’s risk of disease later in life, including:

• Type I and II diabetes
• Hodgkin’s disease
• Leukemia
• Obesity
• High blood pressure
• High cholesterol levels
• Crohn’s disease
• Ulcerative colitis
• Asthma
• Eczema

3.  Breastfeeding reduces mama’s risk of ovarian and breast cancer, heart disease, and osteoporosis.  The longer she breastfeeds, the higher the benefit.  In fact, a woman who breastfeeds for 8 years has nearly a 0% risk of breast cancer.

Get this—breastfeeding a baby girl actually reduces her lifetime risk of breast cancer by 25%.

4.  Breastfeeding saves a family approximately $2 to 4 thousand dollars annually (compared to cost of formula).

5.  Breastfeeding helps mama heal faster in the postpartum, helping her uterus return to pre-pregnancy size faster and lowering overall postpartum blood loss.

6.  Breastfeeding can help mama return to her pre-baby weight.  It takes 1000 calories a day on average to produce breast milk.  Women are advised to consume an extra 500 calories a day, and the body dips into reserves it built up in pregnancy to make the rest (it’s important to consume those extra calories or the body actually goes into “starvation mode” and holds onto the reserves).

7.  Producing breast milk consumes 25% of the body’s energy; the brain only uses 20% by comparison.

8.  On average, babies remove 67% of the milk mama has available—they eat until fullness, not until the breast is emptied.

9.  Almost 75% of all moms produce more milk in their right breast, whether they are right- or left- handed.

10.  Mama’s body is constantly making the perfect milk for baby.  Milk changes its nutritional profile as baby grows (milk made for a 3 month old is different than for a 9 month old).  Milk can even change day to day—for example, water content may increase during times of hot weather and baby-sickness to provide extra hydration.

11.  Human milk contains substances that promote sleep and calmness in babies (who doesn’t love that?)  Breastfeeding also calms mama and helps her bond to baby.

12.  Breastfed infants are at lower risk for sudden infant death syndrome (SIDS)

13.  Mama’s breasts can detect even a one degree fluctuation in baby’s body temperature and adjust accordingly to heat up or cool down baby as needed.  This is one reason skin-to-skin contact in the early days is so crucial.

14.  Breastfeeding reduces baby’s risk of cavities later on and may lower the chance they will need braces as kids.

15.  Breastfeeding mamas sleep on average 45 minutes more a night, compared to those who formula feed.

Oxytocin in Childbirth: A Labor of Love

Last week, we talked about the role of endorphins in natural childbirth and today we turn our focus to oxytocin, another crucial hormone in the symphony of chemicals created naturally in the body to help mom and baby through childbirth.

There are four major hormonal systems active during labor: endorphins, oxytocin, adrenaline and noradrenaline, and prolactin.

What is oxytocin?

Oxytocin, known as the “love hormone,” is a hormone and neuropeptide that causes both physiological and behavioral effects when produced in the body.  It is produced in the hypothalamus of the brain and is released into the bloodstream via the pituitary gland.

Our bodies produce oxytocin when we are attracted to a mate, during lovemaking (it assists with arousal, fosters bonding and may facilitate sperm and egg transport), following positive social interactions (it can even potentially improve wound healing following such positive interactions, say experts), and with other positive experiences.  It is thought to enhance our capacity to love ourselves and others.

Oxytocin is produced in pregnancy, levels increase significantly during active labor and childbirth, and both mom and baby produce oxytocin after birth and as long as baby breastfeeds.

Oxytocin evokes feelings of contentment, trust, empathy, calmness and security and reduces anxiety and fear. Under certain circumstances, oxytocin can hinder the release of cortisol, or stress hormones.

What are the functions and roles of oxytocin in childbirth?

Oxytocin plays a major role in the following:

• Uterine contractions that help facilitate dilation in labor
• Facilitating the milk let-down reflex
• Fostering the mother-baby bond
• Encouraging maternal behavior in the first hour after birth
• Released during breastfeeding, oxytocin causes mild uterine contractions after birth to expel the placenta and close of many blood vessels to prevent bleeding
• Assisting the uterus in clotting the placental attachment point postpartum

What helps to facilitate the production of oxytocin naturally during labor?

Unhindered production of oxytocin is important in labor because oxytocin is responsible in large part for uterine contractions.  Oxytocin initiates labor and helps it keep going strong.

Because the production of oxytocin is so connected to our emotions, it is paramount that a laboring mama feel calm, secure, and uninhibited in her environment and that she trust those around her.  A dim room without too much excitement or distraction is an environment conducive to the unhindered production of oxytocin.

Natural ways to stimulate oxytocin production in labor include:

• Caring, non-medical touch
• Nipple stimulation (this can be helpful in getting labor started in some cases, or to increase strength and frequency of contractions)
• Laughter and humor
• Kissing (Ina May, a famous midwife, touts “smooching” as a great way to keep labor going)
• Gentle exercise, dancing and rhythmic movement
• Feeling grateful and loving (a partner’s words and actions can be so instrumental in helping mama create oxytocin and so help her labor along)
• The repetitive use of mantras, prayer or sounds
• Meditation, positive visualization and hypnosis
• Relaxation
• Warm bath

What can diminish oxytocin levels in labor?

Again, because of the emotional connection, any experience of fear, anxiety, stress, tension, discomfort, or distrust can negatively effect oxytocin production during labor.  A feeling of being watched can also hinder oxytocin release.  The use of synthetic oxytocin (Pitocin)—which also stimulates contractions and is used to induce labor—can also slow the body’s own production of oxytocin.

Oxytocin in Breastfeeding

Oxytocin, also called the cuddle hormone, is released by both mama and baby during breastfeeding.  It can cause slight sleepiness, mild euphoria, a higher pain threshold, and increased love for one another.  It also helps build the attraction and strengthen the bond between mama and baby.

As you can see, oxytocin is an amazing gift and tool our bodies make to help us through childbirth and postpartum.

Storing Human Breast Milk

While our breasts may know exactly how to create the perfect food for our babes, they don’t come with an instruction manual for how to store and keep this amazing liquid in the event that we wish or need to express milk for our babies.  Expressing milk for the times when we cannot be with our babies is a great way to ensure they receive the myriad benefits of breast milk (e.g. optimum nutrition and protection against diseases).

While there are varying recommendations on how to store breast milk, this information is the product of a careful review of the best evidence available and is an appropriate guideline for storing milk to be consumed by healthy, full-term babies.

Keep it Clean

Human milk is a fresh living substance, so it’s important to be contentious of hygiene when handling breast milk.  Before hand expressing or pumping milk, it’s important to make sure your hands are washed and clean and all equipment used to gather the milk are clean and sterile.  Breast pumps have instruction manuals and how-to videos are available on the internet to acquaint you with how to clean and care for your breast pump.

One of the many amazing things about breast milk is that is actually contains properties that help safely preserve it outside of the body.  Its anti-bacterial properties—live cells and antibodies—help it stay fresh longer by discouraging bacterial growth when stored in a container.  (The same cells discourage bacterial growth in your baby’s intestines.)

Best Containers

The best containers for human milk storage are made of glass or hard BPA-free plastic (food-grade polypropylene or polybutylene) with properly fitted tops or lids.  Such containers should be washed with hot soapy water, rinsed thoroughly, and allowed to air dry before being used.  Some containers can also be washed in the top rack of the dishwasher.

If you plan to freeze in such containers, leave at least an inch of space at the top of the bottle since milk (and other liquids) expand upon freezing.

Polyethylene bags (bottle liners) do not preserve the nutrients and immune properties of milk as well as glass or hard plastic.  Using plastic bags expressly made to store breast milk can mitigate these effects to some degree.

Some of the downsides to using bags include:

• Higher risk of contamination
• less durability
• risk of leakage
• some bags destroy nutrients in milk

If you use plastic milk storage bags, make sure you:

• squeeze the air out of the top before sealing
• leave at least an inch at the top for milk expansion when frozen
• stand the bags upright in another container
• store this container toward the back of the refrigerator or freezer where the temperature is most consistent

Whatever you use, make sure the container is well sealed.  You may want to place baking soda in the frig to eliminate odors from other foods.

How much milk to store

Regardless of what container you use, it can be a good idea to only store 1 to 4 ounces of milk in each container.  This is the amount you are likely to need to provide a single serving to your baby.  This avoids waste and makes thawing easier.

Label your milk

Be sure to label your milk with the date it was expressed.  If you know where it is going (i.e. frig, freezer) you may also want to put a “use by” date on it, according to the guidelines below.  If your baby will be drinking the milk in a day care setting, also label the milk with your baby’s name.  You should use the oldest milk in your supply first, provided that it is still good according to your observation and the guidelines below.

Where to store milk and for how long

You can store milk at room temperature, in the refrigerator (does not need to be kept separate from other foods), in a freezer, or in a deep freezer.  It is best not to store milk in a frig or freezer door or near an ice dispenser, and is best kept toward the back of the frig or freezer where the temps are more consistent.  It is best to refrigerate or chill milk after its been expressed.  When possible, refrigerated milk is preferred over frozen milk because some of the anti-infective properties of milk are lost when it is frozen.  That said, frozen milk is still preferable to formula, as the former still has disease protective agents, other benefits and lacks some drawbacks associated with formula.

Where	Temperature	Time
Room temperature	66-79° F	Ideal: 4 hoursAcceptable: 6 hours Some sources say: 8 hours
Refrigerator	Under 39° F	Ideal: 3 days (72 hrs.)Acceptable: 8 days if collected in a very clean and careful way
Freezer	-0.4 to -4° F	Ideal: 6 monthsAcceptable: 12 month

Specific considerations:

• Freezer to frig: Previously frozen milk that has been thawed can keep in the frig for 24 hours.

• Refreezing thawed milk:  while some sources say that you can refreeze previously thawed milk within a few hours, this causes a further breakdown in the milk and a loss of antimicrobial activity.  It is not currently considered an ideal practice.

• Leftovers?  While there has not been conclusive research on this practice, some sources say that is it probably safe to refrigerate leftover milk for 1-2 hours and offer it again within that time.  (Say, if baby doesn’t finish the bottle in one sitting.)

• Keeping it cool: if you don’t have immediate access to a frig, it is best to store the milk in an insulated cooler with ice packs until you are able to refrigerate or freeze it (24 hours or less).

• Separation: Human milk naturally separates into a cream layer and a milk layer when stored; this is totally okay.  Just gently swirl before serving!

• Slow defrost: Human milk should be thawed and gradually reheated, since high temperatures destroy important properties in the milk.

• Frozen to drinkable: The ideal way to prepare frozen milk for consumption is to place it in the frig overnight (for a total of 24 hours maximum) or thaw under cool running water (you can gradually increase the temperature).  Milk should never be microwaved (it not only kills nutrients but it can cause hot spots milk that can burn baby).  Milk should also not be heated directly in a pan, though you can gently heat water in a pan and place the container of milk inside (no boiling water).

• Temperature:  Though breast milk is naturally body temperature, many babies are fine with room temperature or even slightly cooler milk.  For some babies, it is more important that the nipple not be cold.  (So you may want to store with a lid and add the room temperature nipple before serving.)

• Frig to drinkable: warm the milk under warm running water if desired.  Some babies will accept milk right from the frig.

• Soapy smell: some breast milk that has been stored smells soapy or may even taste soapy.  This is believed to be the result of excess lipase (an enzyme) activity in the milk, which begins to break down the milk fat after its been expressed (Lipase has many beneficial properties).  While this milk is safe to drink and some babies don’t mind it, some moms and babies are off-put by this change in taste and smell.  If milk becomes sour or rancid tasting/smelling it may no longer be safe.  If excess lipase activity is a problem, you can scald your milk after expressing to deactivate the enzyme.  After expressing, heat the milk directly in a pan so that it bubbles around the edges of the pan but does not boil.  Remove from heat, quickly cool, and store the milk (in the frig or freezer).

Interview: Welcome Baby Care’s Carey Lindeman

We had the pleasure of speaking with Carey Lindeman, founder of Welcome Baby Care to discuss postpartum care and her pioneering postpartum doula service in the Twin Cities.  Many people don’t know what a postpartum doula is or how they can help.  Hopefully, this interview will shed some light on this invaluable and unique type of postpartum support and what amazing doulas, like those at Welcome Baby Care, can offer.

What is a postpartum doula?

While a lot of people have heard what a birth doula is, not everyone has heard of or understands what a postpartum doula is.  Essentially, what a postpartum doula does is come into a family’s home after the birth. Our first priority is taking care of the mother and making sure that she is healing properly and bonding with her baby.  So our goal is to relieve her of the things that would normally be overwhelming her.  Whether that be laundry, changing the sheets, keeping the bathroom clean, cooking, maybe running errands.

So there is that piece and there is also the education piece where we educate on taking care of baby—you know, best practices, what’s normal, what’s not, as well as what is normal and what is not in her own recovery.  So a lot of the questions she may call the doctor about or wonder about, we are able to help with and so help her with the transition into a more confident parent and navigating all of the unknowns.

Having this support can speed up the process of becoming a more confident parent and bonding with your family, staying connected with your husband, all those things you are negotiating during this tremendous transition.

What does a typical doula visit look like? 

It could be two different things depending on whether it’s a day shift or an overnight shift.  A daytime shift is usually a minimum of 4 hours.  When the doula arrives at a family’s home she is going to assess what is going on—she may walk into a sink full of dishes,

piles of unfolded laundry, or mom may need some hands on help with the baby or with breastfeeding).  She is not going to ask, “what can I do” but instead will assess and do what needs to be done.  She may ask things like “Have you had anything to eat today?” to mom.  Usually what a doula will do is prepare snacks for the day for when mom is feeding, she’ll prepare food for later, she’ll clean up, and essentially her goal is to create a very stress-free environment.

And, you know many times a doula is walking into chaos, there may be multiples or other challenging situations.  A doula’s role is to put a “calm” on the situation.

She may be managing other people as well—maybe there are grandmas involved or aunts, cousins—she may have to say to them “This is where you can be most helpful right now.”

 What about if there are older children there, how does that look with a postpartum doula? 

With other children, what a doula will do is find a way to entertain and manage them while mom needs to be breastfeeding or napping or whatever she needs.  But she also finds ways to incorporate the family together.  So it isn’t just a separation of mom from partner and other children.  Sometimes, for example, the doula will make a snack and ask dad or an older child to take it to mom and sit with her.  We are always trying to foster family bonding.

Great, and what about that overnight postpartum doula service you mentioned?

Yes, going back to our overnight care, this looks a little different.  This is a separate service and definitely our most popular.  A typical overnight shift will begin at about 9 or 10 at night. Mom and partner are off to bed immediately and we take over from there.  We are with the baby.  Mom may choose to pump and have us feed the baby or maybe she wants to breastfeed.  In that case, we would console baby for as long as possible, then bring the baby into her, she can breastfeed, and then we will change the baby and put him or her back to bed.  So we are with the baby all night long while the parents sleep.  The doula will stay as long as the family wants them in the morning but a typical shift ends about 6 am or so.  A lot of times we leave when everyone is sleeping.  And mom can get up with baby whenever that is.

What does service typically look like for a new or growing family—how often do people need care, is it different for everybody? 

You know it is different for each family, depending on if there are multiples or not, if it is a first child, etc.  We do have packages offered on our website that give some examples.  And I would say that most people buy one of our packages.  Probably in the next few weeks people will be able to purchase these right from the website (as well as our classes).

What does the training look like for a postpartum doula? 

We have our own postpartum doula training and certification program.  We have an excellent trainer formerly from Fairview and she has developed a certification program.  We felt that a lot of postpartum doulas coming to us as DONA-trained doulas (birth doulas with a piece of postpartum education) had great training but that it didn’t go far enough.  We wanted more extensive training.  So we developed our own specific postpartum training program.

People can go through it and not necessarily work for us, though there is always the option to interview with us, while other people will work independently or just want to learn this information for their own benefit.  We give people a max of 6 months to go through the program and there are 4 components: reading, classroom training, shadowing a doula, and pro bono work for moms in the community that need help.  The details of the classroom training content can be found on our website.

How did Welcome Baby Care come to be? 

One of the unique things about our service is that we also do senior care—so we are kind of a full spectrum in-home care provider.   How Welcome Baby Care started was with this senior business.  When my stepdaughter was having her first baby—and I have raised four children myself—I was there as a grandmother I thought, “I’m really rusty—I don’t really have all the answers to help out.” So what occurred to me at that time was, just like seniors, new moms need support, everybody needs a doula.  And its just one of those things, you know it’s the same type of care, the difference is the type of caregiver.  But it is still that turbulent time in people’s lives where they don’t know what they are getting into.  It’s so new.

So that is when we decided to have these two ends of the care spectrum (we split these into two sister companies).  And that’s how it came about.  Then I discovered that a doula with her expertise, the sixth sense they have…those were the kind of people that I wanted to do this care.  They are just so loving and caring and have such a heart.

Can you tell me more about the doulas you work with? 

The doulas are hand picked and multi-talented.  They all have their own gifts; they are all different in so many ways.  They are all doulas but they all have special additional gifts that they can offer.  So when we are interviewing with families, what’s great is that we have this whole team to pick from, not just one person.  So we can really assess what the family needs and hand pick the doula or doulas that are going to be the best fit.

Another great thing about having a doula team—and all of our doulas are our employees, none of them are contract—is that we have ongoing monthly training. So we may have speakers come in, and there is always a discussion session.  If there is ever something with a family that they maybe have a question or concern about, it’s all confidential, but they also have this team to talk with and get support from.  So they are not trying to figure things out all on their own.  And what’s really important is this ongoing training component.

When they go into a home, we always want that continuity of care.  So when you hire our doulas, you are not going to get someone different every time.  You are going to get the doula or two that are the best fit for you (# of doulas per family depends on # of hours needed).

What other services does Welcome Baby Care offer?

Through in-home care, lactation support, and classes, we offer:

• Information for bonding techniques for new families (including adoption)
• Breastfeeding support and counseling
• Special care for preemies and multiples
• Expertise in postpartum depression
• Overnight care
• Household care
• Bedrest support
• In-Home infant CPR

As far as our classes go, we offer a gamut of breastfeeding classes.  We have Breastfeeding 101, which is “the basics”.  The 201 class is not just breastfeeding or bottle feeding but also weaning, starting solids, and those types of things.

We also have a Grandmothers class, which is really popular.  This is where the expectant mom and her mother and/or mother-in-law come to class together.  And they talk about the differences between when grandma had the babies versus now.  A lot of new things that are happening, such as back to sleep and feeding and equipment, and all those things that may be new that grandma may not know about.

Kind of breaking down the barrier of her knowing what is important, and what mom feels is important, because often grandmas play a large role in raising the new child.  So with the help of this class, they are not going into it with preconceived ideas, barriers, and walls and not really discussing it.  And it’s learning on both ends—both the new mom and the grandma.  It’s a combination of education and facilitating communication between the generations.

What if you are not sure during pregnancy whether you want or need a postpartum doula? 

I would suggest pursuing it.  We are here to answer all questions without any strings attached.  And maybe its not even postpartum services she may have questions about.  We also have a separate lactation service so maybe if she is feeling uncomfortable about breastfeeding and has questions, you know she can ask without being locked into in-home services.

I think that it’s worth attending one of our classes. We help provide a postpartum plan.  You know a lot of people make a birth plan, but not always a postpartum plan.  And we help you develop a plan, which covers things you should be aware of postpartum.

And again, consider calling and asking questions or even interviewing someone just in case, because again no strings attached ever.  People don’t always realize the importance of having that care.  You know, in other countries, people have their families and they have people helping them and we just don’t have that in this country.  The lesson is from second world nations that really know how important extended family care is.

What if you are sitting at home one week postpartum and you realize you need some help.  Is it too late to call a doula? 

It’s never too late.  We answer our phone 24/7.  I get calls during the night.  Calls come in when people are in the hospital or are feeling like they need to go back to the hospital.  You know, I got a call from a mom recently, I couldn’t even understand her.  She was so tired and so overwhelmed—it was four in the morning—and I was trying to get information and finally I just asked: “Do you need help right now?”  She asked if we could call her back in the morning at nine.  So we called her back and she was so overwhelmed.  But we were able to help her.

So anytime, we are available for new moms.  We want you to call us.

What advice might you have for pregnant mamas?

No expectations.  I mean, plan, but have an open plan for how the postpartum is going to look.  I think one of the most damaging things about our social world and the media is they put such high expectations on new moms and I think that is a mistake.  To buy into that and listen to too many people ahead of time and have all these expectations and lofty goals is a mistake.

You know, take things a day at a time and realize that, more than anything, you just want to have time for that baby, and give them everything they need.  But don’t have this idea of what its going to look like—like you’re going to lose weight, you’re going to look like this, you are going to have all the perfect equipment and clothes, and everything is going to look perfect and composed, and then buying into what all your friends are saying.

You know make sure you know who your support people are: get the support.  But don’t surround yourself with people who tell you how you need to be—just get that loving non-judgmental support.  And know, too, that we come in with NO judgments—mom can decide and parent the way she feels is right.  You know, we will guide and support but we will not judge.  That’s the biggest thing—you do not want judgment around you because it is just toxic.

What advice do you have for new mamas, who are maybe going through the postpartum period right now?

For them, I would say, the same information applies.  You need the support of other people.  Do not isolate.  Get the support.  Find those people that don’t have expectations for you.  Because you are the parent and you know your baby better than anybody and you need to be the one to make decisions.  You know, 10 or 20 years from now, it is going to be your decisions that matter, not anyone else’s.  So I think you need to really look at your own “mama guts” because you know.  And don’t think you don’t know because you DO know what is best.

And also, there are so many good resources out there, so take advantage of these great resources.

And plenty of rest and relaxation, and try not to put too many expectations on yourself.

You can contact Welcome Baby Care on their website or by calling 952-942-5676. 

 

Breastfeeding class this month

Breastfeeding 101: “So that’s what they’re for!”

If you are pregnant or recently gave birth, consider signing up for this fantastic course filled with important information about breastfeeding your babe(s).  The class, put on by postpartum service provider Welcome Baby Care, will be held at Health Foundations on August 26 from 6 to 8:30pm. Please join us!

Details:

This breastfeeding class for new and expectant parents covers everything you need to know to get off to a great start with your breastfed baby. Taught by trained lactation counselors, and covering the first month after the birth. We provide evidence based information on:

– the benefits of breastfeeding
– milk production
– milk supply
– best latch techniques
– how to know baby is getting enough
– common stumbling blocks and how to overcome them
– pumping and storage
– and much much more!

Offering only the most up to date and evidence based information, you will leave this class fully informed and confident in your body’s ability to feed your baby!

Light snacks and refreshments will be provided.

For more information, please call us at (952) 942-5676 or visit us at http://welcomebabycare.com.

You can sign up at https://welcomebabycarebreastfeeding101.eventbrite.com/

Recipe: Lactation Cookies

This yummy oatmeal cookie recipe is one of the many ways for breastfeeding/pumping mamas to maintain their milk supply!

Lactation Cookies
Recipe by MilkinMamas

2 Tablespoons flax seed meal

4 Tablespoons water

1 cup butter, soften to room temperature

1 1/2 cups firmly packed brown sugar

2 eggs, room temperature

1 teaspoon vanilla

2 cups flour (all-purpose or white whole wheat)

3-4 Tablespoons brewer’s yeast

1 teaspoon baking soda

1 teaspoon salt

3 cups rolled oats

1 cup chocolate chips

1. Preheat oven to 350 degrees
2. In a small bowl, combine the flax seed meal and water. Let stand for 5 minutes.
3. In a large bowl or stand-up mixer, beat butter and brown sugar well.
4. Add eggs and beat well.
5. Add flax seed mixture and vanilla, beat well.
6. In a separate bowl, sift together flour, brewer’s yeast, baking soda & salt.
7. Add dry ingredients to butter mixture, mix well.
8. Stir in oats and chocolate chips.
9. Scoop by rounded tablespoons onto baking tray.
10. Bake 12 minutes.
11. Cool on baking tray for 5 minutes before transferring to a cooling rack.

Be creative and try these variations or additions:

• 1 teaspoon cinnamon
• flaked or shredded coconut
• dried cranberries, cherries, apricots or raisins
• white chocolate chips

Insurance Coverage for Breastfeeding Support: Pumps and Lactation Services

The Good News:

Under the federal Affordable Care Act (ACA) of 2010, insurance companies are now required to cover the costs associated with breastfeeding, such as breastfeeding pumps and lactation services, without a copayment or co-insurance to meet your deductible so long as the services are “in-network.”*

The Bad News:

The language of the act is a bit vague and so insurance companies are setting their own specific policies about what is covered and how to go about procuring the breastfeeding support services and supplies you need.

This has created much confusion about the law and what it means to mamas.  We are here to help you understand your rights and advocate for the benefits to which you are entitled by law.

Call your Insurance Company First

Contacting your insurance provider is the first step in understanding what breastfeeding-related coverage and benefits you are eligible for.  Generally speaking, lactation consultants typically fall under preventative care, while breast pumps are considered medical supplies.

We’ve seen mamas get lots of different answers from their insurance providers about what is covered.  Some will cover hospital-grade pumps, while others only cover hand pumps.  Some have specific brands of pumps they will cover, and many require that you purchase such pumps at specific medical supply locations. This is due to their “in-network” requirements.

It’s best to call your insurance company before your baby is born (but, of course, its not too late once they’ve arrived).  Your insurance card should have the company’s toll-free member services number on the back.

Questions to Ask about Breast Pumps:

• What type of pump can I get? (hospital-grade rental pump, double or single electric personal-use, battery or manual pump)
• Do I have brand options?
• Do I have to get the “recommended” pump or can I choose to purchase one (aka “out-of-network”) and submit the receipt for reimbursement?
  • If yes, what amount will I be reimbursed? Is there a dollar limit on coverage for breast pumps?
  • If I have already obtained a breast pump, can I submit a claim for reimbursement?
  • Do I have to get the breast pump approved first?
  • When can I get my breast pump? Before giving birth? After the birth of my child(ren)?
  • Where can I get my breast pump? Does it have to be from a designated place (aka “in-network” provider) or can I choose where to get it?
  • Do I have a rental pump option? Do I need a prescription for proof of medical necessity?

 Questions to Ask About Lactation Consultations:

• Is there a limit on the number of visits with a lactation consultant?
• Do I have to get the lactation visits approved first?
• Where can I receive lactation counseling services? Are there approved in-network providers? Can I get reimbursed if I use a lactation counselor out-of-network?

Medela has great tips on talking to your insurance provider, especially if you encounter difficulty getting the coverage provided by law.

Contact the Medical Supply Providers or Lactation Consultant

Once you have obtained a list of “in-network” providers, it’s a good idea to contact the medical supply providers your insurance company gave you.  Ask them about what types and brands of breast pumps they carry and if there are any specific requirements related to obtaining your desired pump as covered by insurance.  For example, some medical suppliers will not allow you to obtain a pump prior to birth.  Some will let you pick up the pump, while others will deliver it to your home.

Same goes for lactation consultants—be sure to call the ones your provider gave you to get details about the services they offer.

Breast Pumps and Minnesota Care

If you are receiving Minnesota Care you may also be eligible for coverage.  The same recommendations apply: call your insurance company first and then call the medical supply providers.  (You may also have to contact your Minnesota Care caseworker.)  Make sure the medical supply provider is aware that you are covered under Minnesota Care, as this can affect the type of pump you are eligible to receive.

Getting Help Getting Covered

If your insurance representative doesn’t give you the answer you’re looking for, ask to speak to a supervisor. If that doesn’t work, tell them your going to file a request for assistance with the Department of Insurance.  Often, this is enough to prompt action.  If not, the Department of Insurance can be of assistance.  They can be reached with questions at 1-800-657-3602 or 651-296-2488.  Select the Insurance option (choice #1) on message menu to speak with an insurance investigator who can assist you.

Wishing you a smooth and easy experience obtaining the breastfeeding support services and equipment you need!

*Note: This federal law covers private and commercial insurance carriers but does not cover Medicaid or WIC.