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

Madonna-Child

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

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 18th 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

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 16th 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

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.

Victoria Era breastfeeding

Woman breastfeeding in Victorian Era

Though wet nursing has never regained popularity, similar themes have risen and met their demise in times since. The 20th 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.

porch nursing

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.

WPA PSA

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

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.

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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

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.
 
BabyGeorgeI’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.  
 
RockingchairI 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.
 
milkdrunkgeorgeNursing 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.
TracyGeorge

Herbs and Breastfeeding

herbs and breastfeedingA 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

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?

pregnancy 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.

happy birth

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 breastfeedingOxytocin, 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.

Interview: Welcome Baby Care’s Carey Lindeman

wbcWe 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? 

ppdoula

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).

twins

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.

gma

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. 

 

Insurance Coverage for Breastfeeding Support: Pumps and Lactation Services

Breastfeeding_a_baby

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.