Lactation Laura

Breastfeeding Paper

2011-11-27T17:56:00.000-08:00

Hi guys. I hope that you all who celebrate it had a good Thanksgiving. I did. I am blessed beyond what I could have ever fantasized for myself. Seriously. And wow, did you see that I have 17 Google followers now? How did that happen? I must be famous. My facebook fan-page was, unbeknownst to me, mysteriously "unpublished." It should be up and running now. "Like" me if you do. :)

Anyway, I'm writing a paper about >surprise< breastfeeding. Among lots of other stuff, I am writing about the reasons mothers cite for weaning. There is an obvious trend of "I don't have enough milk," that we are all too familiar with, wheather in our work or among family and friends. So I'm trying to explain in my paper, in non-technical/ medical language about what we talk about in our field as perceived insufficient milk supply. Which is mostly culturally induced and the point of my paper.

Why am I sharing this with you? Well I found this really good post about the topic. It's from way back in 2009. What a concept: something written almost three years ago is actually worthwhile. Is it because of the internet that we're obsessed with the latest, research/ evidence-based information? Let's not throw the baby out with the bathwater. You know, way back in, I don't know, 2004, I was totally fine with anything published in the last 20-30 years unless it was medical research or addressed something that had seriously shifted in our culture...So I found this and I'm not going to reinvent the wheel. I have no idea who this person is or what her credentials are. Whaaaaaa!!!!!??? I know. You can leave my blog now if you have lost all respect for me. Thanks for humoring me with your kind visit. Seriously, what she wrote resonates with me as true, and also holds up to what I have learned as a lactation consultant. I feel like I couldn't have written this better myself, so I will share it with you here.

My only issue, something that I have changed in recent years, is that she uses the phrase, feeding on demand, which I think makes babies sound like high-maintainence little tyrants. I would hope that my husband (by the way, today is our one year anniversary) wouldn't say that he has conversations with me on demand.* He has chosen to be my life partner and it is a basic need of mine, and it benefits him too. So...anyway, you get the idea; that's where I'm coming from on that. I prefer the expressions unrestricted access to nurse and feeding on cue. I'm not talking about my husband anymore. You know what I mean. I wouldn't be surprised if the author of this post has also changed her language since writing this, if she works with breastfeeding moms at all.

And anyway, here is the lovely, informative post, with citations and everything. Yowza lady, thanks for your hard work. :)
thetruthaboutbreastfeeding.com

Update: the author is a scientist, a mama and a writer. Who knew? All I had to do was click on her ABOUT page to find out.

Thanks for caring to educate yourselves on this stuff. I really feel like better breastfeeding rates and respect for it in our culture will ulitmately bring us a more peaceful planet. I know, I know, don't bother commenting, "dirty hippie." I just trust my vibes. You are welcome to trust them or not. :) I hope that you at least trust your own!

So, Love! Love! Love! to you all. I'm so busy with school, I really miss being immersed in birth-y breastfeeding stuff. But I meditate a lot and have been thinking about all you parents, especially ya'll that are first-time parents whose babes are less than a year. It can be overwhelming, but you can do it! You are making a difference. For your baby and for our future. Ya'll, it's pure LOVE flowing from your breast to your baby. Yeah, it happens to nourish the baby, but oh my, no matter how much you make, or if you're able to "make enough," you are nuturing your baby. In love, with love. Doesn't that trump everything else? Our bodies are amazing and can bounce back from getting a little junk, just as babies' bodies can recover from recieving formula for a time if you struggle with supply.**Don't beat yourself up. It's not your fault. A lot of times you've been booby trapped. And please call or write someone for help with your supply. At least look at Kellymom.com for suggestions. Don't give up. You can do it! Can you tell that I was a cheerleader?

*Yes, thanks KJ Rinke, RN, IBCLC, goat-cow-chicken farmer of Athens, Georgia who opened my eyes to what using the phrase, feeding on demand really implies.
**By the way, don't forget about donated breastmilk, via community milk-sharing and wet nursing, as an option before formula if your child needs to be supplemented. See EatsonFeets.org for more info on that.

Food Questions

2011-10-03T13:29:00.000-07:00

Michael Pollan, author of, The Omnivore's Dilemma answers questions about food. Well, he got the answer to this one right. Wait, what was the question again? Oh yea, in vitro meat. I've never heard of it, but like I said, he got the answer right in my opinion.

http://www.nytimes.com/interactive/2011/10/02/magazine/29mag-food-issue.html#/pollan

"Think about baby formula:we've been working on that one for a century and a half, and for reasons we don't totally understand, it still doesn't do all that genuine mother's milk does. We flatter ourselves by thinking we can outdo and even approximate nature's foods."

Evenflow mother-in-law video

2011-09-07T07:05:00.000-07:00

Have you heard about a little video that Evenflow had up on youtube? I read about it at phdinparenting.com and had planned to watch it later. I logged online to watch it this morning and found out it's been pulled! I guess that's good, because it sounds like it was pretty awful; and it was probably pulled because of all of the pressure from blog posts like the above. But I'm sorry that I missed it. I am busy with school, and if this had been before school started, I would have likely watched it on the same day that I heard about it. I'm sure there will be more situations like this. I also haven't been on my facebook in a good while. I don't have a whole lot of time for my Lactation Laura stuff while I am in school full time. It's so much fun, by the way. Anyone want to do some guest blogging? Write me. I'll link to your piece to your website or blog if you wish.
Love, Laura

Feeding options for adopted young children

2011-06-28T07:18:00.000-07:00

This is the first in a series of posts originally written as a teaching handout for clients.
Feeding options for adopted young children
by: Laura Dunn, LPN, IBCLC, RLC
There is a whole spectrum of options and factors to consider when deciding how you will feed your adopted child. Options are listed here with further resources for more information.

It is recommended that babies receive only breastmilk without any complementary foods for at least six months. After that it is recommended that babies are breastfed alongside other foods for up to two years of age and beyond.

1. Relactation
When a mother has nursed a biological child she can relactate to provide milk for her adopted child. The more recently she has nursed, the easier and more abundantly her milk will flow. When a supplement is needed she can provide it using one of the methods below.
Here's a link with further resources.

2. Induced lactation
When a mother has never nursed before she can induce lactation to feed her adopted child. She will likely be supplementing her milk via one of the methods described below. Induced lactation involves pumping and may or may not include herbs or medications prescribed by her healthcare provider based on her choice. I recommend seeking advice from a registered lactation consultant, also known as an IBCLC for help with this. One IBCLC has written an article covering this topic.

3. Supplementing
Donor milk can be obtained through informed milk-sharing or from a human-milk bank. Informed milk-sharing is possible within your community through friends and family or via networks that facilitate contact between donors and recipients. Many mothers find themselves with extra pumped milk for one reason or another and are willing to share with a family who needs it. Ideally the donated milk was pumped for a child that is the same age as the recipient and is available within the same geographic region. It is my view that safe informed milk-sharing is entirely possible despite FDA's warning against it. Ways to minimize the risks include requesting evidence of health such as lab test results; you can request that a donor have further specific lab tests performed and interview them about their lifestyle choices per your standards. Home pasteurization can be done as an extra measure against certain diseases. Alternatively, at milk banks, the donors go through screening lab tests, and the milk through processing treatment and tests, these procedures make the milk costly; about $4 per ounce. Unfortunately banked milk is reserved for preterm and sick babies and requires a doctor’s prescription.

Click here for information on suggested blood tests for donors.
Click here for ideas about what questions to consider asking your donor.

Infant formula, though expensive, is readily available in the U.S. in powdered, liquid and concentrated liquid form. There are risks to feeding infant formula, since no formula comes nutritionally close to breastmilk. Provided formula is appropriately prepared and fed, some of the risks include allergies, infections, especially ear and respiratory, impaired cognitive development and visual acuity and obesity and its complications.

For information on the risks of early complementary feeding (infant formula or food) see Infant feeding the physiological basis Bulletin of the World Health Organization, Supplement to volume 67, 1989 (Chapter 4, pages 62-65) at this link.

Choosing a formula
Unless a family is vegan, in the case of a baby not tolerating cow’s milk or for a rare condition known as galactosemia, I recommend against the use of soy formulas. In some cases, parents of babies who have a family history of milk allergy choose to use soy infant formula. But there are studies showing that soy formula interferes with proper hormone function. Read the American Academy of Pediatrics recommendations in this regard here.

When companies that manufacture breastmilk substitutes use marketing techniques that undermine breastfeeding, they are in violation of the World Health Organization’s International Code of Marketing for Breast-milk Substitutes. Besides price, this is another reason why families who use breastmilk substitutes (infant formula) choose to support companies that are generic and less powerful.

In future posts in this series I will cover modes of feeding your adopted child and further global and local resources.

Breastfeeding Myths

2011-05-09T08:57:00.000-07:00

Today I have a guest post from a friend of mine; a mama, an aspiring lactation consultant, and a local postpartum doula. Her name is Jacqui. We met over a year ago when she was selling a baby wrap that I wanted for a client. She blogs here at The Breastfeeding Blog. She is also the mastermind behind It Takes a Village Oregon website which connects families to birth-year (pregnancy, postpartum, breastfeeding) resources.

Breastfeeding Myths

by: Jacqui Castle

From the moment a mom develops a visual “baby bump”, she will usually find herself on the receiving end of endless advice from friends, family, and well-meaning strangers. When it comes to breastfeeding, everyone seems to have some input. With all of the contradictory information coming in from various sources, it can be hard for a new mom to know what to believe. Although most advice givers only want to help, there are many breastfeeding myths floating around that can be detrimental to a new breastfeeding relationship. Below are 10 common breastfeeding myths that I’m sure most moms have heard at least a few of:

Your breasts are too small to breastfeed – women with all size breasts are able to breastfeed just fine!
If your baby is nursing more than every two hours, you don’t have enough milk – It is perfectly normal for your baby to breastfeed often during the first few months and beyond. Remember that breastfeeding is also comforting so your baby may nurse often during times of stress or after a tumble.
You have to give baby a bottle when you are sick – The best thing that a mom can do when she is sick is to keep baby close and nurse as much as possible. By nursing your baby when you are sick you are making sure she is getting the antibodies that she needs to protect herself from getting sick as well.
You have to give baby a bottle when you have had any alcohol – It is okay to have one or two drinks and still breastfeed.
If your baby is still waking up at night he needs to eat solid foods- It is perfectly normal for babies to wake during the night to breastfeed; and babies do not need anything other than breast milk until at least 6 months of age. Try to enjoy these night nursing sessions and special nighttime cuddles with your baby. It goes so fast! Sleeping with your baby often makes nighttime parenting easier.
Breastfeeding is purely instinct- Although breastfeeding is natural, it is also learned. If you run into problems please contact a Board Certified Lactation Consultant or call your local La Leche League Leader.
You need to toughen up your nipples to prepare for breastfeeding – Babies who are latched correctly will nurse from the breast, not the nipple. Although some mothers experience mild tenderness during the early days, nursing should not be painful.
You need to wean when your baby gets teeth – Simply not true. The World Health Organization recommends exclusive breastfeeding for 6 months of age with continued breastfeeding (along with appropriate solid foods) for up to two years of age or beyond.
Your baby needs to be on a schedule – Breastfeeding is a process of supply and demand and in order for your body to produce the right amount of milk for your little one, she needs to be able to eat when she is hungry.
Your baby gets all of the benefits of breast milk in the first 3 months, there is no point in breastfeeding past that time – Your baby will continue to receive benefits from breastfeeding for as long as it is continued.

For more breastfeeding myths visit: http://www.breastfeeding.com/all_about/all_about_myths.html

I would like to thank Jacqui for her contribution to my blog. If you want to be a guest blogger here at Lactation Laura, please email me at LactationLaura(at)gmail(dot)com.

Continuing Education

2011-05-07T12:36:00.000-07:00

It's time for GOLD again! GOLD11 is happening now. Well the speakers have already spoken, but I have until the end of the month to listen to all the recordings and watch the presentations, so for me, it is happening now. This is my second GOLD conference.

GOLD stands for Global Online Lactation Discussion. It's an online conference that I'm so excited about. As a lactation consultant I have to keep up with the latest expert research, techniques and skills. To prove I'm doing that I have to have 75 CERPs (continuing education recognition points) specific to the field of lactation. LC's need 75 CERPs in 5 years or they must retake the exam. Everyone must retake the exam, no matter what, after 10 years.

It's like if we had to take nursing boards all over again, every 5-10 years. It's that big of a deal. That's what LCs have to do. I think it's grand fun to attend conferences, take classes, read and research about my field; but I probably wouldn't have spent the money to find out that continuing education is worth the money if I didn't have to. In the end, I'm glad they made me do it, because it is worth it. Perpetual student, that's what I am; it's what I believe I need to be, to rock at what I do. If I wasn't so hungry to learn about this stuff I wouldn't be where I am today. New research and discoveries happen all the time that can change the way you practice and what you teach parents. Now that I do private practice, I'm not around more experienced lactation consultants as often as I was in the hospitals, so I really miss out on gleaning from them. Conferences ensure that I'm keeping up my skills, and I consider them a very good thing. For me it's like going to a festival, honestly.

So do you help mamas and babies? Are you a doula, midwife, breastfeeding educator or counselor? You may not need lactation specific education credits to keep your license, but I'll bet it would behoove you....

What if it were free? The GOLD conference isn't free, but there are talks that you can hear for free at the health-e-learning website. Here is a link to where you can hear the free lectures.
I highly recommend James Akre's talk, What is the Problem with Breastfeeding? from GOLD10. Jim is the author of The Problem with Breastfeeding which I recommend.

Here's the blurb about him on the GOLD site:

James Akre has both academic and practical experience in sociology, public and international affairs, and public health, with an early focus on economic and social development and the welfare of populations in low-income rural environments. His community development and international public health nutrition career spans four decades, including over 30 years working in agencies of the United Nations system dealing with labour and social affairs, and public health. He serves as a member of the Board of Directors of the International Board of Lactation Consultant Examiners (IBLCE), the Editorial Board of the open-access International Breastfeeding Journal and the Scientific Committee of La Leche League France.

Oh yeah, and James is a friend of mine and I'm working with him to set up a new blog called Planet Breastfeeding, if you read his book, The Problem with Breastfeeding you know all about his vision. But if you listen to the talk, you'll get a glimpse of that too. I'll be letting you know here once Planet Breastfeeding rolls out. I'm hoping for another printing of this book, I think the message is that important.

I. B. C. huh?

2011-05-04T17:21:00.000-07:00

by: Laura Dunn, LPN, IBCLC
June 28, 2010

No wonder the public is mixed up, there are so many confusing letters behind the names of people who are 'breastfeeding helpers.'

CBC, CBE, CLC, CLE, CLS or IBCLC?

CBC- Certified Breastfeeding Counselor

CBE- Certified Breastfeeding Educator (not to be confused with Childbirth Educator, sheesh)

CLC- Certified Lactation Counselor (nothing to sniff at, it's what I was before 2009)

CLE-Certified Lactation Educator (Through CAPPA, the labor doula certifying organization)

CLS- Certified Lactation Specialist

IBCLC, LC or RLC- International Board Certified Lactation Consultant or Lactation Consultant or Registered Lactation Consultant (If someone is one of these, they are all three, they are used interchangeably)

Here's why I care so much.
Well, you see, I have the top credentials for my field, IBCLC, and I only recently earned the privilege of putting those letters behind my name in 2009. That was after many years of school, extensive self directed study, work experience and finally, a grueling exam.

There are big differences in training, experience and scope of practice that totally sets apart the IBCLC from the rest of these certifications. It would've been unethical misrepresentation to call myself an LC before 2009, because I wasn't. Now that I have the credential, when people do this, I feel like my hard work is not being valued as being beyond these other certifications, which is the case.

I have nothing against people with these certifications and I applaud anyone who just wants to further their education on breastfeeding, no matter how far they intend to take their education. Many take these paths as the beginning stepping stone to get to the LC level, myself included. Before 2009, which is when I passed the exam, I was and still am, a nurse (LPN) who had the CLC certification (certified lactation counselor).

I worked in the lactation department of a hospital where I had worked as a postpartum nurse for years and before that as a nurse tech. I referred to myself as a Lactation Nurse, because I am a nurse who worked in the lactation department, or a Lactation Counselor because that's what I was, a Certified Lactation Counselor. A Lactation Counselor is very different, my friends, from a Lactation Consultant and I was respectful not to call myself an LC before I earned the right. I worked to inform other birth professionals like nurses, doctors, doulas and childbirth educators, usually by simple correction or explanation of the differences between a CLC and an LC when they misunderstood my title, amount of training or scope of practice.

More confusion: LC isn't short for CLC but for IBCLC. They sound very similar, I know, but it's like the difference between a B.A. and a Ph.D. Many people still continue to mix up lactation counselor and lactation consultant, I mean why wouldn't LC also stand for a lactation counselor? It makes sense; but to call oneself an LC implies the IBCLC or lactation consultant credential. Again I have nothing against those who have these certifications who are practicing appropriately within their scope of practice.

Here's another reason why I care when people unethically use the letters:
In the IBLCE Code Of Ethics under Principles of Ethical Practice state that LCs will:
"14. Present professional qualifications and credentials accurately, using IBCLC only when certification is current and authorized by the IBLCE, and complying with all requirements when seeking initial or continued certification from the IBLCE"
(Code of Ethics for IBCLCs, page 2 Effective December 1, 2004) Available for download here by clicking 'Code of Ethics'

In fact, as an LC, I could be subject to disciplinary action by the board if I helped someone misrepresent themselves as an LC if they were not authorized by the IBLCE to use the credential. So I don't take it lightly.

I don't blame anyone, it is soconfusing and it was for me too, but I also feel a mission to teach others. It's not just about me and what I've earned either. I want to inform professionals and the public for the sake of getting correct information and skilled help to breastfeeding families. The public could be misled in a way that may potentially stagnate any progress that has been made in the field, in a way that could damage breastfeeding relationships. That grieves me.

I'd like to start with those who really should know the difference, that is those in the business of childbirth: doulas, nurses and childbirth educators and maybe even those who carry the CBC, CBE, CLC CLE or CLS credentials themselves. How can we expect the average person to understand if professionals in the field don't?

My favorite resource for explaining the differences in the professional breastfeeding supporters is broken down here by one LC, 'Alphabet Soup' . She goes a bit into more detail about each certification.

Most of these certifications are 2-3 day courses and completing one doesn't necessarily qualify someone to 'put out a shingle,' as they say, to counsel mothers. These courses are valuable for people who are already doulas, doctors, educators or nurses so the participants just add their new breastfeeding knowledge to what they already practice. My CLC course was 5 days and it was made very clear to me that by itself, it didn't qualify me to go out and counsel as a profession; it was extra education on the topic of breastfeeding for those who already worked in the field. (With the exception of WIC counselors, that's the government's Women Infant and Children Program)(1)

2-3 day courses? Seriously? So, in addition to class hours, guess how many hours of direct breastfeeding counseling practice that I had to have to even qualify to sit for boards? 4,000. Four. Thousand.(2) I'm not talking about observing someone counsel, but actually counseling. Thanks, I worked my butt off for that. Even if someone has nursed 7 kids, even if she is 15 years older than me, if she hasn't put in the work to earn those letters behind her name, she still shouldn't promote herself as an LC or allow the public or her colleagues to misunderstand her qualifications.(3)

To give you an idea about the exam we take, it's not unlike the state board exams that nurses have to take after graduating from school before they can put the letters LPN or RN behind their name and practice as such.

Just thought I'd share that there are some differences between nursing state boards and the exam to be an LC:

our certification is internationally standardized and recognized
we have to RETAKE the exam every 10 years and sometimes every 5 years depending on the fulfillment of the required continuing education
It's not yet computerized and there are tons of pictures
you can contest the questions.
It takes months for the exam to be hand graded
it's only given once a year by the International Board of Lactation Consultant Examiners, (IBLCE) and everyone all over the world takes it on the same day.

That's right, you can contest the questions; so even though LC's 'provide holistic, evidence-based breastfeeding support and care' ( Scope of Practice for IBCLCs Adopted March 8, 2008, page 1) which seems to be a lot about facts, breastfeeding still remains an art.

Tidbit: Did you know that there is only one LC in the country of Nigeria? I heard a presentation from her at the Global Online Lactation Discussion 2009 conference. There was a Japanese presenter at the conference too. I also learned that in 1996, when I lived in Japan, there were no LC's in the country.

Speaking of continuing education
I think it's safe to say, especially for a lot of non-hospital LC's like me (I do private practice now), we barely break even when you compare our income to what we spend on our required continuing education, which includes books. I mention that to say, I've never met an LC who didn't passionately love what they do, and they kind of have to when you look at it from a financial point of view. That includes me, I love it too, the education and all!

Apart from loving what I do, I am very good at it. I am very proud of what I have accomplished to be officially counted among such honorable professionals as a lactation consultant.

(1)Shout out to WIC peer counselors: God's going to bless you my sisters, please press on with your work.

(2)Soon after I applied, the requirement for my pathway was decreased to a 2,000 hours with a change in the requirement that it be within the last 5 years instead of 10. That wouldn't have affected me either way, but I share that to say, it really was a 4,000 hour requirement when I applied.

(3)By all means please seek help from someone who has nursed 7 kids or is a lot older than me or whomever you want, even if they don't have IBCLC behind their name, if that resonates with you. Not being an LC certainly doesn't mean that they aren't good at what they do. They may have let their LC license lapse or never bothered to seek the credential even though they have all of the counseling experience under their belt. Or perhaps they are on a path to be an LC, (it takes a long time) and they need to counsel people to get all their hours and they might have any combo of a variety of certifications or licenses already. In seeking counsel, also look at the other credentials they have like RN, CPM, LMT, CLD etc. Those say a lot too, but they don't necessarily say 'breastfeeding friendly.' Though if any of the breastfeeding helper initials are behind a practitioners name, they probably are breastfeeding friendly.

more letters
CPM- Certified Professional Midwife
LMT- Licensed Massage Therapist
CLD- Certified Labor Doula
LPN- Licensed Practical Nurse
CNM- Certified Nurse Midwife
FNP- Family Nurse Practitioner
CST- Craniosacral Therapist
LCCE- Lamaze Certified Childbirth Educator
LLLL- La Leche League Leader

Birthingway College of Midwifery looking for Breastfeeding Models

2011-04-08T10:58:00.000-07:00

Hi nursing mamas in my area,
Birthingway in PDX is looking for breastfeeding models on May 3rd, particularly young babes (those are the mostly likely to nurse among distractions and talking anyway) and they pay a small stipend. Here is the email that I got and was asked to pass on to my contacts. If you're gonna be in PDX anyway, I'll bet you'll meet some really cool folks.
Happy nursing!
Love, Laura

Hi there everyone!

Every year we teach a Breastfeeding Skills class to compliment our Breastfeeding I,II and III classes.This year we are looking for breastfeeding mamas who might be interested in helping students demonstrate their consultation skills (supervised by an IBCLC).

Mamas will be paid a small stipend for their time and snacks/tea will be provided.

Tuesday May 3rd at 6:30pm. Mamas with babes between the ages of 4-8 weeks of age preferable but we love to see all stages of the breastfeeding relationship!

If you could kindly pass the word to your friends, co-workers, clients,and/or community that would be most appreciated!

You can contact me at : Stacey@Birthingway.edu for more information

Stacey Marshall, CD(DONA),PCD,BC,CBE

Specialized Programs Practicum Coordinator, Outreach Coordinator

Birthingway College of Midwifery

February Links

2011-03-07T15:47:00.000-08:00

Here are links to stuff people were talking about in February. I know, I'm behind. It's stuff that I did or want to read.

ADD and diet: http://www.medicalnewstoday.com/articles/215744.php

http://www.telegraph.co.uk/science/science-news/8335564/Flavours-in-mothers-milk-may-determine-the-foods-children-like.html

http://www.commercialfreechildhood.org/actions/nomaternitymarketing.html

Moisture in Pumps

2011-02-25T13:23:00.000-08:00

I'm on a lactation professionals list where we can discuss cases, research and practice and give encouragement. You may have heard the talk online about mold being found in certain open system breastpumps. There are some obvious questions about the possible role that may play in recurrent yeast infections in Moms/Babies. Here is one such place that has mentioned this mold issue by a blogger/ and CLC*, she also goes in to Medela's noncompliance with the International Code of Marketing of Breastmilk Substitutes, but that's not the issue that I speak of today.

I had a thought about a possible partial solution to this mold in pumps. I started to write a post for the listserv, but decided maybe I'd like to share this info with my readers too. Here it is.

Hi fellow breastfeeding professionals,
So I had an idea. I wonder if anyone has tried it. If you did, what kind of results did you find?

Let's say a Mom is already opening her suspect pump to clean and inspect for mold and mildew. Can she put something in there after it is cleaned to prevent the moisture from causing trouble so quickly? I immediately think of the little silica packets that come in some medication bottles for this purpose.

I also thought of rice. You know how we give our cell phones 'rice baths' to dry them out after they get water logged? Also, what about how we put it in our salt shakers supposedly to absorb moisture? Is rice something that could be used? Would a little fabric pouch of rice fit in there? Would it work to absorb moisture?

Picture from yumsugar.com

There are also commercial products that seem to be similar to the clays and compounds that are in the little silica packets in our medications. They are readily available in grocery stores. I do not know the safety of this. Is there any such product that would fit the job description? But is it safe near the milk, Mom/Babe?

Damprid is one such company that makes this type of thing.
Here is their MSDS info for their products in PDF form

I will let those of you more knowledgeable than myself about toxic/ nontoxic things wade through that, if you don't mind.

The experience of finding mold in pumps that my colleagues share will change my practice for sure. This is one more factor in resistant yeast. A factor that I have never thought of asking about.

I am also thinking of how this will change my teaching. I'm thinking of a typical situation where a Mom buys a pump, barely uses it, but has a baby two years later and THIS time, has to go back to work after babe. She is ready to reap the benefits of making an investment in an expensive pump a couple years prior. Or is she? It seems it would be in great condition if it was barely used. Well, it sounds like it might depend on how it was stored. I'm considering sharing with families not to store their unused but usable pumps in attics or garages, or other such places where the temperature, and by default humidity level, is uncontrolled.

Also, maybe they should be reminded not to leave or store their open system pump in kitchens or bathrooms where the dampness can creep in. Does anybody know where the mothers kept their pumps which have been cultured positive?

Thanks for all the work you do!

Warmly,
Laura Dunn, LPN, IBCLC

Definition of 'Open System': any single user pump is considered an open system. The only pumps that certain companies, like Medela, makes that aren't an open system are their hospital grade pumps, the kind usually available for rental; these are meant to go from person to person with no troubles, and so have seals in place that would prevent any mold exposure.

*Post about difference between a CLC and all the other alphabet soup of breastfeeding helpers

Disclaimer

Just a reminder: nobody pays me to write what I write. I write to share information, experience and resources.

To my readers, if you are a Mama with a dead Pump In Style just sitting around. Would you consider trying to open it to see what you see how it's insides are faring? Just as an experiment. Photograph and share with me what you see, if anything. Thanks!

La Leche League Newberg

2011-02-07T13:53:00.000-08:00

This week, on Wednesday at Coffee Cottage Meeting House is the second La Leche League meeting for the new Newberg group. Jacqui Castle is the leader. Here is her description of what La Leche League is:

It's from 9-10:30 on the second Wednesday every month.

"It's a great place for moms to connect and make friends. LLL is centered around mother-to-mother support surrounding breastfeeding issues and all breastfeeding moms are welcome to come."

Here is a link to the info about the group along with her contact info:
Yamhill County La Leche League Meeting.

Your Baby's Waste and You

2011-02-02T13:26:00.000-08:00

Repost from March 2010
by: Laura Dunn LPN, IBCLC

Have you ever heard of a child going through their entire stage of infancy without a diaper?

As parents you have a lot of decisions to make including how, if and how frequently you plan to diaper your baby. That's right, I said if you plan to diaper your baby.

Some parents are opting out of using diapers in favor of what is known as 'Elimination Communication' (EC) or Natural Infant Hygiene. Yes, I'm talking about potty training an infant.
Wikipedia says:
"Elimination communication (EC) is a toilet training practice in which a caregiver uses timing, signals, cues, and intuition to address an infant's need to eliminate waste. Typically the goal is to partially or completely avoid the use of diapers. EC emphasizes communication between the caregiver and child, helping them both become more attuned to the child's innate rhythms and control of urination and defecation. The term "elimination communication" was inspired by traditional practices of diaper-less baby care in less industrialized countries and hunter-gather cultures. Some practitioners of EC begin soon after birth, although it can be started with babies of any age."

Diaperfreebaby.org is a non-profit website started by two moms that provides support and information about EC. They describe Elimination Communication as a:

"modern adaption of an ancient method of childcare. Traditionally this method was seen and practiced by the whole community, learned naturally over a lifetime."

EC is appealing to me because of it's impact on the earth, or lack of. Also, it's cheap and I like that it's about being in tune with your baby. To do EC, you have to be in a close relationship with your baby and learn their little signals or cues. It's not unlike a breastfeeding relationship. And if you are doing both, they tie right into each other.

Other waste management options are disposable diapers, cloth diapers and hybrid diapers. Those are for another post. Please share with me your experiences with any of these for me to share with readers. Email them to me at LactationLaura(at)gmail(dot)com. Thanks.

Diaper Free Adventures: a Mommy Blogger's take on EC
Ehow article on how to do Elimination Communication

Is Elimination Communication something that you think you would try? Have you already?

Mandy and Meara's Story

2011-01-05T12:08:00.000-08:00

Mandy called me for help when Meara was one month old. She was being supplemented with pumped breastmilk for weight loss and only able to nurse with a nipple shield. Here, Mandy tells her story. Thanks for sharing Mandy, it's a sweet, sweet story and I am so happy that you guys are doing so well.
______________________________________________________________
by: Mandy Graybeal (2010)

As a pregnant mama, I didn't give a thought to the "how-to of breastfeeding". I was sold on breast milk and had no plans for any other method of nourishing my baby. In hindsight, it would have been a good idea to study up on the technique of breastfeeding a little bit before Meara’s arrival. I thought breastfeeding was pretty straight forward - apply baby to breast until babe is satisfied, done - simple. Turns out it wasn’t that simple for us in the beginning.

Our sweet babe came via C-section. Due to some late pregnancy swelling and the surgery - I had flat nipples and this proved challenging for her to latch. The hospital’s lactation consultant mentioned tongue tie, but I thought "why do you want to cut my baby?" I didn't give it another thought.

Turns out, she was tongue tied. However, we didn't make this discovery until 8 weeks. In the meantime she was not gaining weight properly and we had to use many tools to provide her with breast milk. Our exceptional midwife, Patricia from Bella Vie Gentle Birth Center, helped us with recommendations for boosting my milk production and provided the tools to give Meara supplemental breast milk and weigh her daily to monitor her growth. She also referred us to Laura Dunn for lactation support services.

(2010) Mandy and Meara
Laura came to our home and arrived with a cheery disposition. She was confident and helped us get off the shield and taught me about breastfeeding. She talked to me about pumping to protect my milk supply and taught me how to use the SNS. I pumped after every feeding, and we used a shield, SNS and bottle at times to make sure Meara was getting adequate milk. Meara’s weight gain rebounded and we eliminated the supplemental feedings.

Laura also recommended cranio-sacral therapy (CST) and told me about a clinic in Portland. She accompanied us to the clinic and was very helpful by being an extra pair of hands. The CST was helpful relieving the tension in Meara’s neck that was also negatively impacting her breastfeeding.

At eight weeks, unfortunately, I blistered badly and had to stop breastfeeding. I pumped and my husband bottle fed Meara for 10 days. Those 10 days were heart breaking for me. I realized how much I missed Meara and our special time together. My resolve to breast feed her became stronger. I contacted Laura immediately. She concluded that we had a possible tongue tie issue and referred us to Melissa Cole a lactation consultant in the Vancouver/Portland area. Laura, once again accompanied us to Portland which was extremely helpful.

Melissa has worked with a number of tongue tie cases and helped us meet this challenge by confirming the tongue tie and referring us to an ENT that would perform the clipping. Laura once again accompanied our family to the ENT's office in Portland for the procedure. After that we met with Melissa for a follow up. Melissa taught us how to do oral exercises and re-train Meara’s tongue for breastfeeding.

Laura and Melissa worked together in harmony with us to meet our ultimate goal of exclusive breastfeeding. When we re-introduced breastfeeding we began using the shield again. Both Laura and Melissa provided valuable emotional and practical support via email and phone contact.

I’m thrilled to say that at about 126 days we stopped using the shield. And on Meara's 140th day, we also became bottle and pump free. It is real FREEDOM for a work at home Mom to be able to SIMPLY and efficiently feed my sweet girl without shield, pump or bottle.

Meara has only had breast milk in her young life; I never had to give her formula. This journey was not easy. I shed many tears and we worked very hard together. Without the support of my husband and sister and the help from our midwife and lactation consultants we wouldn’t have achieved this goal. I’ve found that often times the most difficult things in life are the most rewarding. This has been the most difficult thing I’ve ever done and I’ve done many difficult things. I can honestly say it’s also been THE MOST REWARDING! I am so thankful to be able to provide my baby with the best nutrition and to share the sweetest moments bonding with her.

Thank you Brandon for late night burping, bottle feeding, diaper changes and hauling that pump everywhere we’ve gone for the last 4 months. Stacy, thank you for all your advice and for listening to me chronicle this journey. *
Patricia, Laura and Melissa, thank you for working together so beautifully and helping us reach our goal!

Meara and I love breastfeeding!

Laura's notes and definitions:
SNS: this stands for 'supplemental nursing system,' it's a tiny tube system that attaches to the breast and the baby takes it in along with the mother's nipple during the latch and is able to draw from a container of pumped or donor breastmilk or formula (also known as ABM or artificial breastmilk). SNS systems are one way to supplement should it become medically necessary to do so, or for adoptive moms. There are benefits to supplementing at the breast and not using artificial nipples. They take some practice to master.

nipple shield: a nipple shield is a soft, flexible silicone cover that goes over the nipple during feeds. It is more like a bottle nipple than the mother's nipple. In certain situations this can be helpful when a baby has been unable to latch. Nipple shields come with risks so lactation consultants always consider them a temporary tool until we can get to the bottom of the breastfeeding difficulties and baby has had time to 'practice' nursing without one. If you resort to using one, you should be in touch with your IBCLC regularly. I consider them to be an artificial nipple, but to avoid further breastfeeding troubles, I still prefer them to bottle supplementing in most situations where supplementing has become necessary.

*Brandon is Mandy's husband and Meara's Daddy. Stacy is Mandy's very supportive sister, a breastfeeding mama herself.

Excuse

2010-12-15T13:41:00.000-08:00

So I have an excuse for not posting very much from November until now. I was planning and then celebrating my wedding! Yay. I am so happy. Here we are with our very pregnant minister who married us. I thought it was appropriate to share that small detail here. :) And we're headed to a Georgia version of the festivities, without a ceremony, at New Year's, so more planning, and more busy time. See you again soon with things settle down after the new year.

News Page

2010-11-15T16:07:00.000-08:00

Hi. Don't forget about my news page.
It's always available as a link to the right under PAGES. It's links to things about breastfeeding and related matters in the media. Blog posts, articles, videos, news releases. Thanks to all my readers for your interest in educating yourselves about breastfeeding and other health matters and if you work with moms, for your hard work and commitment to keep up with the latest information.

Laura's Recommended Reads

2010-10-15T08:46:00.000-07:00

I'm re-posting my reading recommendations with updates. Original post from March, 2010.

Especially for a family preparing for childbirth:

Ina May's Guide to Childbirth by Ina May Gaskin

A great reference for healthy choices:
The Whole Parenting Guide (1999)
Strategies, resources, and inspiring stories for holistic parenting and family living
by Alan Reder, Phil Catalfo, and Stephanie Renfrow Hamilton

And for anyone planning to breastfeed:

Breastfeeding
Keep it Simple (2006)

by Amy Spangler

You can order and flip through the first couple of pages at the author's website: Babygooroo.com.
Read through this one before you have the babe. It's less than 100 pages long with lots of drawings.

I recommend you get a good thorough reference book that tells more than just the basics about breastfeeding. This will be handy as questions come up after your babe is born and for trouble-shooting any common problems that might arise. Don't feel pressured to read it cover to cover or at even all, especially before your baby is born. Here is one option that you could get, The Breastfeeding Book by Dr. Sears and his wife Martha, an RN. There is no need to memorize or 'study' more than just the basics about breastfeeding before you try to nurse your babe. As long as you've read the basics, your next step would be to watch someone nurse, especially latch, even if it is just video clips on youtube. See my Lactation Laura youtube channel where I have lists and links to helpful movies including a playlist of three 'sample' latches. Explore other videos on there, I think you'll find it helpful.

For professionals who help breastfeeding mothers:

La Leche League International

The Breastfeeding Answer Book (2003) (aka BAB)

I recommend that you invest in this reference book first. This book is great for troubleshooting and studying in general. It comes in a very easy to read question and answer format. Topics are grouped in chapters and the index makes it easy to refer back to specific information.

Look for the third edition, which is the most recent.

Are you in Newberg, Oregon? I have Amy Spangler's Breastfeeding book and the Dr. Sears Breastfeeding book available in my lending library; and The Whole Parenting Guide is available at the Newberg public library. My lending library is for my clients and birth workers that network with me.

More about why I recommend such a simple breastfeeding book as Amy's in this post. What are your favorites?

Anti-Rant Against Nursing in Public (NIP)

2010-09-01T09:40:00.000-07:00

She's so funny! See one LC's rant below, which she calls an 'anti-rant':

There are few things less attractive than a person eating. People who
do so in public should be charged with indecent exposure. At the very
least, they should apologize to all the other folk in the vicinity. If
they can't cover their naked mouths then they should stay at home!

I don't see why people can't either eat before leaving the house, or
just take an IV with them. It is a simple matter to carry the
necessary equipment and liquid nutrients in a small cooler. For
goodness sakes, companies give away the coolers for free! And did you
know that the growing trend is to wear a permanent hep-lock in your
arm?

Who wants to see people put food in their facial orifice in public?
Come on, we all know what mouths are for, and THAT is most
appropriately done in private!

If people insist on eating in public, the least they can do is to use
a head cover. There are so many attractive covers now available that
you can even match one to your outfit as a fashion statement. It is
easy to make your own from a yard of knit fabric, and you don't even
need to hem it.

As for this law I keep hearing about, prohibiting the harassment of
those who feed in public, well, that is just ridiculous! We need to
return the the good old days when public decency was more common.

Norma Ritter, IBCLC, RLC
Breastfeeding Matters in the Capital Region
www.normaritter.com

The Big Latch On

2010-07-30T15:12:00.001-07:00

MEDIA RELEASE – Thursday 1st July 2010
Portland’s Big Latch On

On Friday 6 August 2010 at 10:30am several hundred women and their babies will come together to take part in Portland’s The Big Latch On. This will be the first time the event will be held in Portland, and event organizer Joanne Edwards is encouraging all mothers and babies to join in. “It’s about getting women together and helping them to feel united in breastfeeding”, said Joanne. “Sometimes women can feel isolated or shy about breastfeeding, so this is a great way of celebrating together and support the wonderful work that nursing mamas do."

Starting in Canada in 2001, the event drew 856 mothers at 26 sites. By 2008, there were 7632 mothers in nineteen countries at over 300 sites taking part. Edwards, a UK qualified RN and health visitor, has previously been involved in the event in New Zealand, where in 2009 they had 1299 women breastfeeding simultaneously. “The event is loads of fun, really social, and provides a great community vibe. And we provide refreshments, goodie bags, as well as a prize draw.”

Breastfeeding contributes to the normal growth and development of babies, and babies who are not breastfed are at increased risk of infant morbidity and mortality, adult obesity, diabetes, cardiovascular disease, osteoporosis, and premenopausal breast cancer and ovarian cancer (both mom and baby.) The World Health Organization recommends breastfeeding exclusively for the first six months of a baby's life to optimize these benefits, continuing to breastfeed for 2 years and as long thereafter as is mutually desired by mother and baby. Held to coincide with World Breastfeeding Week, The Big Latch On will take place at a variety of venues throughout the Portland metro area. Mothers and their babies are encouraged to come along half an hour prior to the start time, and settle in. “Portland is such a great city for families, it just feels right to hold this event here.”

For more details and to find a venue near you go to www.biglatchonpdx.weebly.com
For more information:
Joanne Edwards
Tel: 503 919 8901
Email: biglatchonpdx@gmail.com

Hear an interview of the organizer of it all, Joanne, here at Pregnancy Place Radio Show.

Your local venue is: Pitter-Patter Consignment in downtown Newberg, Oregon
619 E. Hancock St. Newberg, Or. 97132.
Amy Rockwell is the owner, she is hosting the event: 503-538-4215.
Come a half hour early and be counted among the latched or check the website for a venue in the Greater PDX area closer to you. Tea and snacks and a grand goodie bag will be passed out to participants. See you there!

LAWS

2010-07-15T08:18:00.000-07:00

Several months back, I did a post about breastfeeding laws that mostly compared Georgia (USA) to Oregon. I'm rewriting the post because I am so excited about the new developments this year. It turns out Oregon's law was used as the model for the new federal provision effective March 23, 2010. (Patient Protection and Affordable Care Act)

According to the United States Breastfeeding Committee's website, Oregon has the 'strongest and most detailed' legislation already in place and 'the new federal law will provide a minimum level of support in all states, but if an existing state law provides stronger protections, the state law will prevail.'

Basically the Oregon law says that a mother can breastfeed in public places, they are exempt from jury duty, and they are allowed unpaid 30- minute breaks during four-hour work shifts to breastfeed or pump.

More information about the Oregon laws on Breastfeeding Coalition of Oregon's Website.

And here's a link to Breastfeeding Laws State by State, so you can see what was going on in each state before this change took place.

While the laws went into effect right away, the Department of Labor is working to put the rules of enforcement in place. Oregon law was signed in 2007. From US Breastfeeding Committee's FAQ page, here are creative ways employers can comply with the law:

Designated, permanent space, at least 4’ x 6’ with a chair, sink, and electrical outlet.

Space designated with a sign or reserved on a calendar that rotates throughout the workspace between offices, conference rooms, clinic rooms, etc.

Temporary use of manager office space in fast-food restaurants, police departments, or settings that lack other spaces with a locking door.

A curtained-off area that is non-accessible to the public, and meets privacy threshold because of clear, well-communicated policy with co-workers. This can even mean a chair behind a curtain in an employee-only bathroom lounge, if there is truly no other space available.

A designated space that serves employees from several employers, located in the employee-only areas of malls, airports, and retail strips.

An agreement between worksites, where a breastfeeding employee can visit a neighboring business to access a designated space within.

Privacy panels to block the windows of work vehicles such as patrol cars or construction vehicles on the road.

Use of City or County buildings by public employees on route, such as police on patrol, bus drivers, or meter readers

And I guess this is my contribution to all the talk of nursing in public, or NIP that has been happening online. :) Cheers to helping moms and babies.

Car Seat Safety

2010-06-10T13:29:00.000-07:00

Have you seen the movie Babies yet?
What do you think about that scene where the family drives home from the hospital on a motorcycle? (See a clip of it in the trailer here) Mommy, Daddy, big brother, newborn baby and all. Gasp. Their life in Mongolia is different from ours in so many ways.

But in our land it's the law that our babes are in special safety seats in our vehicles. They saved my nephews' lives back in 2007 in the car wreck that I lost my little sister in, so car seat safety is close to my heart; I'm grateful every day that Lonnie had her boys' seats properly installed and that they were safely buckled in. They crawled from the wreck with only some scratches, just missing their Mama.

Okay, that was your tear for this post and now here's your giggle:

It's no surprise that the baby seated in A BUMBO THAT HAS BEEN DUCT TAPED to the vehicle in this picture is the definition of car seat-safety FAIL, but sometimes it isn't as obvious that a seat is or isn't installed safely. Enter certified car seat installer extraordinaire, Shannon Baird, of Organic Baby Birth Services. According to her 87.5 % of car seats are installed incorrectly. Shannon is a birth doula, and she offers placenta services as well as certified car seat installation. I've personally spent time with Shannon and she is a down-to-earth sweetheart. She has four kids of her own and has had a variety of personal experiences to pull from as she helps mamas and babies.

Need help or reassurance with your car seat? Certified car seat installers can double check your seat for you, and if you're lucky, they do it at your home or an agreed upon location, which is exactly what Shannon does. It's a very convenient service and she offers discounts for multiple seats. The seats are all different, as anyone who works with them knows.

Shannon serves Dundee, McMinnville, Newberg and beyond. Check out her website for more information about all the services she provides. Look for her car seat safety classes coming soon to Newberg. Click here to find an inspection safety location near you if you aren't in our area of Oregon or are in a different state.

(Drawing is closed)

Local Drawing:

Shannon has graciously offered to do a free car seat installation/ check to one of my readers, a $40 value! If you are in the area, and would like to enter the drawing, please leave a comment or email me with your email address.* This will run for one week and I will draw a number with random.org and the winner will be contacted by Shannon to schedule. Drawing ends Thursday June 17, 2010 at 8pm. Good luck.
Other local resources:

The Newberg Fire Department conducts clinics where they inspect or install child safety seats every other month. Click here for more information and the downloadable clinic schedule. They also take appointments for inspections in addition to providing seats at a discounted rate, to low income/government assisted families.

*I will not use your email address for anything else and I will delete the comments after I have gathered the information to protect the privacy of your email address.

(Bumbo ATV Picture from Fail Blog.org)

So you want to feed your baby 'holistically' huh?

2010-06-03T14:47:00.000-07:00

This is a 'holistic feeding system.'
It creeps me out and I'm not going to say anything else about it. I'll let you check it out. The only thing I'll say is that I saw it first on KellyMom.com's facebook page.
Love, Laura

My Secret Life as a Postpartum Doula (Part 1 of my Journey)

2010-05-22T15:17:00.000-07:00

I've been asked about how I came to do what I do. It boggles some people's minds that I help people with their new babies and to breastfeed, but I don't have any kids of my own, and they want to know why. It seems a lot of women become doulas because of their personal experience with the birth of a baby and becoming a parent. My story is a bit different. I'll share the first part of my journey here. This is PART 1.

I was mostly raised in South Florida. Growing up, my mother, aunts and family friends nursed their children around me like it was normal, which it is. I was very aware of the cultural standard that a good little kid averted their eyes when the baby is latched and unlatched, for that is when the nipple may be exposed. I followed the proper protocol, lest I risk being labeled 'nasty' which meant perverted. So I didn't see much of the actual latch but I knew they were feeding their kids.

I had worked in the church nursery off and on as a kid, but mostly for pay and a lot of times because I'd rather watch the babies than go to the trite youth group activities. I was good with the babies, but I didn't think anything of it, I really did it for money.

After high school I went on a year long mission trip to Japan. I found myself thrown into a situation where I was the 'helper' for a mom of seven boys ranging from 1 to 15 years old. They were missionaries from Washington state and the mother had ~~seven boys~~ chronic pain and fatigue, so she really needed help. She was a home-birthing, breastfeeding mama. It was in their home that I learned that there were other ways of doing things besides the way that I had been raised. Hanging out in friends' homes as a kid had provided only glimpses of family-life that were really just a slight variation on the version of my own family-life in the 'burbs; but this missionary-mama's ways of mothering were totally different than anything I'd ever seen. I very much enjoyed being a part of their life and helping her with her little ones.

I came home from Japan and moved to Atlanta when I was 20. I fell into another similar role. A family approached me at church, they'd heard about the work I'd done in Japan. They hired me, and again, I was a 'nanny' of sorts for this family, but the mother was almost always home, just like with the missionary family. This mother was chronically sick as well. She tired easily and was in pain. She wanted to be the main caregiver of her children, but she needed help and I loved being the helper.

When that job ended because they were moving out of state, another family approached me to be their nanny. It was a very glamorous offer actually, and I accepted it right away. They had a baby, but she wasn't a newborn, and the situation wasn't like the two homes where I'd worked before. In this role the mother left or was in another part of the estate away from me and the three kids a lot. I hated it. It was very hard to care for three kids on my own, for hours on end, when they really just seemed to want their real Mama.

I had to do the hard work of mothering my charges, all without the joys and rewards of actually being their mother. Of course, they were adorable and I fell in love with them and being in their lives was reward enough, and yes it was a paid job, but still....it wasn't for me. I think it was stressful for the kids to have a stranger show up and suddenly be a caregiver while Mom's not involved; and that made it extra hard on me to be calm and consistent for their sake. I quit after a month. I wanted to do work where I was truly needed and not have a job just because someone could afford the luxury of hired help.

At the end of my time with that family the mother suggested that I might be good at helping families when they first come home with new babies, she'd read about such work in a magazine. I thanked her, told her I'd look into it, and didn't think about it again. This was in the 90's. As a person ~~trapped~~ immersed in mainstream American life, I'd never heard the word doula and we didn't have Google.

Around this time I went on several short term mission trips, mostly medical. This was taken in the Dominican Republic, I am about 20 years old. (1997)

It just so happens that the next few families I worked with had new babies and one was pregnant on bedrest and needed help with her two year old. I generally found that I really loved staying with these families until I was no longer needed, which I had a good sense of. When I was toeing the line of the true 'nanny' role, I was ready to move on and I did. It was weird because I knew I was a 'mother's helper' but to me a mother's helper was someone who was too young to be an actual babysitter or nanny and because of their youth, could only help when the mother was home. Still I went with it, it was what I loved. Eventually I started telling people that I only came and helped mothers in the first weeks and up to 2-3 months after a new baby. Sometimes there were special situations where I stayed longer if a parent or the baby was sick.

After being in several homes in this capacity, one of the mothers asked me a baby care question. It was something about sleep or bathing I think. Of course it wasn't about feeding, for I knew nothing about breastfeeding at that time. Well I just told her that I didn't know the answer to her question. She pried it out of me that I did know, in fact I knew of several ways and options and could even demonstrate to her what she was asking about. I did know how to take care of babies and I'd learned about so many parenting philosophies and family management styles in my work travels. This mama encouraged me that I could teach her that knowledge and what her options were. This had not even occurred to me, as this mother already had a two year old child, so I figured she already knew what she needed to know. Besides, what did I know? I didn't even have any kids of my own. But she was right. She gave me the confidence to start trusting myself and giving myself credit for my experience and knowledge base. The role I ended up taking in her home carried over into the role I took with clients that came after her. I had carved a niche for myself professionally as a postpartum doula, but the job description seemed to come out of thin air. I ended up with a waiting list of people who wanted me to come help them after the birth of a baby. It was a secret, even from me, that I was working as a postpartum doula.

This is only the beginning of my story, I haven't even gotten to the nursing school portion or how I came to specialize in helping mothers breastfeed. More to come in Part 2.

Are used breastpumps safe?

2010-05-17T15:23:00.000-07:00

Used Breast Pumps

Written by: Cindy Curtis,RN,IBCLC,CCE

Updated 12/02/2007 Posted with permission.

The concern of buying a used pump is something many breastfeeding moms encounter. Although a used pump may be more affordable than a new one, there are real health implications involved.

The practice of re-using single user pumps may be dangerous because some disease organisms are know to be present in the breast milk of infected women. Additionally, if a woman has used the breast pump during an episode of cracked bleeding nipples, blood contamination may have also occurred. Home sterilization methods are not always reliable to ensure the safe destruction of all pathogens especially in the rubber parts such as washers and diaphragms. Some pumps have internal diaphragms that cannot be removed and cleaned or replaced. In addition, even if you get a new collection kit (the part the touches your breast and collects the milk) it may be possible for air-born pathogens or droplets of milk that are not visible to the naked eye to get into a pump motor and cause contamination to the next user. Most single user pumps are "open system" pumps and do not have any protective barrier to prevent cross contamination to multiple users.

Many of the diseases that can be found in the milk of infected women are very serious or life threatening. Pathogens like Human immunodeficiency virus (HIV), hepatitis, cytomegalovirus (CMV) and others can be found in the breastmilk of infected women. (Lawrence 94) These diseases frequently go undetected for long periods of time, so even if the former user of the pump is trustworthy and willing to share this personal health information with you, she may not be aware she or her partner are carriers. Though there have not been any documented cases of mothers or babies being infected through the use of a second-hand pump, I don't believe sharing single user pumps is worth even a very small or theoretical risk.

Other very difficult to clear fungal infections like candidiasis, more commonly known as yeast or thrush, may also be transmitted. Yeast organisms are very stubborn pathogens that can live on surfaces for long periods. Some lactation consultants will go as far as recommending replacing old pump equipment when working with a mom who has an especially persistent yeast infection because of the difficult in ensuring the complete destruction of the fungus even with careful cleaning.

In addition to the health risks of borrowing a pump there are ethical ones as well. I have worked with several moms who purchased or borrowed a used pump from a friend or relative, only to have that pump break or stop operating while they were using it. These moms then felt obligated to purchase a new pump,if it was a borrowed pump, the new pump had to be returned and the mom had spent a lot of extra money that she didn't need to. The approximate cost to formula feed a baby for one year is $2,300.00 , a new breast pump is very reasonable compared to that price.

Most breast pumps come with a one year warranty, but this only applies to the original owner, any sharing of the pump negates the warranty.

The FDA states "Only FDA cleared, hospital-grade pumps should be used by more than one person."

The following pumps are are designed to be used by multiple users:
These pumps operate on a "closed system", meaning that it is impossible for milk reach the motor, hence these are safe to be used my multiple mothers.
Hollister Elite® Hollister Lact-e®
Hollister SMB® Breast pump®
Medela Classic® Breast pump
Medela Lactina® Breast pump
Medela Symphony® Breast pump
Bailey Nurture III®
Above list subject to change, please consult the FDA site for the most up to date information.
All other pumps are desigened to be single user pumps and shoud not be shared. Please note that even pumps that cost over $100.00 to $300.00 are still single user pumps.

From the FDA Website

Should I Buy a Used Breast Pump or

Share a Breast Pump?

"You should never buy a used breast pump or share a breast pump."
Only FDA cleared, hospital-grade pumps should be used by more than one person. With the exception of hospital-grade pumps, the FDA considers breast pumps single-use devices. That means that a breast pump should only be used by one woman because there is no way to guarantee the pump can be cleaned and disinfected between uses by different women.
The money you may save by buying a used pump is not worth the health risks to you or your baby. Breast pumps that are reused by different mothers can carry infectious diseases, such as HIV or hepatitis.
Buying a used breast pump or sharing a breast pump may be a violation of the manufacturer’s warranty and you may not be able to get help from the manufacturer if you have a problem with the pump."
FDA Breastpump Website

Websites on Used Breast Pumps.....
Medela Information on Used Breast Pumps
FDA - How to Choose A Breastpump
Where to report a faulty or painful Breastpump

Are Used Breastpumps a Good Option?

Search for FDA Approved Pumps

Written by: Cindy Curtis,RN,IBCLC,CCE

Updated 12/02/2007

This handout may be copied and distributed without further permission, on the condition that it is not used in any context in which the WHO code on the marketing of breast milk. substitutes is violated.

Disclaimer

ABC'S What Would You Do?

2010-05-15T18:13:00.000-07:00

Actors set up a situation where a breastfeeding mom is harassed in a cafe by the manager to see how the public reacts. They do a few different scenarios changing up the situation. In one, the mom is drinking a beer, and how other customers react is interesting. Mostly supportive, moving, but also maddening at least once. Here's an 8 minute clip from the show.

Is my baby too old to breastfeed?

2010-05-14T09:12:00.000-07:00

The American Academy of Pediatric (AAP) recommends:

"Exclusive breastfeeding for approximately the first six months and support for breastfeeding for the first year and beyond as long as mutually desired by mother and child."

The World Health Organization (WHO) recommends:

'A recent review of evidence has shown that, on a population basis, exclusive breastfeeding for 6 months is the optimal way of feeding infants. Thereafter infants should receive complementary foods with continued breastfeeding up to 2 years of age or beyond.'

The CDC (Center for Disease Control) mentions both the AAP and the WHO recommendations on their breastfeeding FAQ page on their website.

D-MER

2010-05-12T07:00:00.000-07:00

I only heard of Dysphoric Milk Ejection Reflex in the last six months.

'Dysphoric Milk Ejection Reflex is a newly recognized condition affecting lactating women that is characterized by an abrupt dysphoria, or negative emotions that occur just before milk release and continuing not more then a few minutes.'

(D-MER.org, 2010)

Check out D-MER.org for more information.

Breast Surgeries

2010-05-11T07:00:00.000-07:00

Have you had surgery on one or both of your breasts? You can still breastfeed! Your milk supply can be affected from surgical incisions, so read up on the particular procedure that you've had online or in books and talk to someone ahead of time.

When I suggest talking to someone ahead of time, this doesn't include the pre-op conversation you had with your surgeon that may have gone like this:

You: Will I still be able to nurse my future babies? That's important to me.

Doc: Absolutely, you will still be able to breastfeed after this procedure, don't let anyone tell you otherwise.

I'm sorry to tell you, but that's not the end of the story. The good news is that the surgeons are right, you absolutely will still be able to breastfeed after surgery.

What people don't want to hear is that there may be possible effects on your breastmilk supply from breast surgery. I highly doubt that if people knew this tidbit of information that it would keep them from having the procedures performed (assuming it was elective), and I'm in no way suggesting that they shouldn't have been performed in the first place. What I'm telling you is that you may have to work do a little extra research before the baby is born. You can start with researching how the changes brought on by a surgery can affect your breastfeeding relationship. It's not that involved, really; will probably take less than a couple of hours of reading.

Start here @ the Breastfeeding after breast and nipple surgeries website
Specifically read about augmentation here.

THE TRUTH
Here's another reality: breastfeeding may be more involved for you if your milk supply ends up affected by those surgical changes. That's if your supply ends up affected: surgery does not mean an automatic supply-fail. There are definitely things you can do if your supply is low; and they take time and commitment to carry them out. This may include pumping and other supply inducing interventions and potentially supplementing. If this situation pops up, I think the stress of it is greatly reduced if you have had prenatal or pre-problem education on the topic.

I can definitely say that I have met mothers who were successful to reach their goals who really had no idea that cuts made into their breasts, tissue removal and resulting scars would affect nursing their babies; so if you don't get a chance to look into it before the baby is born, it's not the end of the world.

Your milk supply may not be affected at all, actually. I just think you'll have a much better chance of being successful if you educate yourself.

People typically think of breast augmentation when they think of breast surgery. But examples of other surgeries that can potentially affect milk supply are biopsies and breast reductions. In clients that I've helped, the augmentations seem to affect breastfeeding the least; many people have very successfully exclusively breastfed their babies after augmentations. For an LC, the important question to ask is why someone had the procedure done in the first place. I ask, not because I question a woman's decision and choice to get it done, but because reasons besides the standards might indicate an underlying issue.

What I'm saying is that the reason that you got your breasts augmented in the first place, might actually affect your nursing relationship with your baby more than the surgery or implants themselves.

Standard reasons I've heard for augmentations: 'I just wanted to be bigger,' and 'I wanted to be able to wear different styles of tops,' 'I lost a lot of weight,' or 'to be beautiful and sexy.' Any reasons that deviate from these standard reasons can indicate further help may be needed, including: 'because my breasts were very disproportionate in size,' or 'because one or both breasts really never developed,' a condition known as hypoplastic or underdeveloped breasts.

A couple of years ago a patient shared with me about a website that helped her with breastfeeding after her reduction. She had successfully breastfed a previous child after reduction and I was helping her with her second. She was just spouting off information left and right and teaching me tips about it and excitedly telling me all about how well it went with her first. I got all into it, I was so happy that she had reached her goals with her older child that I wanted to stop and do a cheerleader chant right then and there. She shared with me about the BFAR website. It stands for 'breastfeeding after reduction' but it has expanded to be a site about 'breastfeeding after breast and nipple surgeries.' BFAR has a sister site, lowmilksupply.org. I haven't much explored that one, but it's nice to know it's there.

Don't forget that at the end of the day you define what you consider 'successful' breastfeeding. You might want to exclusively nurse for 6 mos. After that, many want to continue nursing along with offering solid foods for a year or two and beyond as long as you and the baby desire, as the WHO, AAP and CDC recommend. If those are your goals, then those are your goals, full stop. Not everyone shoots for that, and that's okay.

And just like any other area in life, we don't always meet the goals we set for ourselves, and it's not for lack of trying necessarily but for reasons beyond our control. And what if it were for lack of trying? Big whup! If it were me I'd go easy on myself. Love yourself and enjoy your baby.

In conclusion, if you really want to, you can do it! There may or may not be extra work involved after surgery to make breastfeeding successful. There are resources and people to help you. Think about doing a little extra soul searching about your reasons for breastfeeding and your commitment to your baby and yourself ahead of time. Education about the effects of surgery will offset the stress of finding yourself in an unexpected situation. Also, consider shifting your expectations appropriately as you learn more about your specific surgery.

So, how you will respond if you don't meet your goals? Here's a hint, you're not going straight to hell. I hope you respond to yourself in love, as you would want anyone else to respond to you or your own sisters.

Here's one mother's story about breastfeeding after a reduction.

Photo Macy

2010-05-10T11:50:00.000-07:00

Local photographers John and Erin Macy of Photo Macy were at our wonderful National Doula Month celebration event for First Friday ARTwalk at Pitter Patter Childrens Consignment. If you didn't make it out Friday night, you can still check out their photos which will be up at Pitter Patter for the entire month of May. Pitter Patter is located on College and Hancock in downtown Newberg, Oregon.

Photo courtesy of Photo Macy

Book Review: It Sucked and then I Cried by Heather Armstrong

2010-05-06T10:00:00.000-07:00

Heather Armstrong is the author of the most read mommy-blog, Dooce.com. Back in the day (all the way back in 2002) she was fired for things that she posted online. Six months later she went back to blogging about her life and doesn't seem to have looked back since.

In her book It sucked and then I Cried, she humorously tells her tale of pregnancy, childbirth and breastfeeding, including the rough emotional start that was the beginning of her daughter Leta's life. She ended up in the hospital with postpartum depression.

MY POSITIVE COMMENTS:

She's funny. She seems to tell her tale as she would to a friend and she's light-hearted about it all, which makes it a nice, fun read. She takes a supportive stance on breastfeeding. She's brutally honest about things that she struggled with during pregnancy, the transition to parenthood, breastfeeding and her depression. She doesn't feel bad about taking medication for her severe postpartum depression and I really like her take on things and how honest she is about it all. There is definitely still a stigma surrounding postpartum depression. I think Heather did a really good thing to just talk about it openly.

MY ONLY COMPLAINT:
Heather has an 'exaggerate-to-be-funny' style of humor. That's cool, entertaining actually, if I were reading a blog post once or twice a week. But I read all 253 pages of her book over 2-3 days and it got old. In her defense, I have the attention span of a gnat; so I'm not saying this is how everyone will experience this book, just how I did.

Here is an example of what I mean:

"....the list of things that I had to worry about ran the gamut from not mixing certain household cleansers to not touching lunch meat with my bare hands else risking the possibility that the baby would be born with three ears. And if I touched a piece of sushi each of those three ears would be covered in scales."

MY NEUTRAL WARNING:
Heather is a bit irreverent towards her Christian (Mormon to be specific) upbringing from which she has strayed. As for me, I eat that stuff with a spoon, I think it's hilarious; but I know there are some who do not agree. I wanted you to be saved from it being on your permanent record that you checked this book out. Did you know that there can be a court ordered subpoena for your library records? I'm just saying. Or (gasp) what if you were seen around town with it in your tote bag, and potentially being damned to hell for even considering an interaction with this book that didn't involve burning, banning or boycotting. So you have been warned: she uses cuss words and mentions spiritual things like hell in a way that you might not be used to. You're welcome.

It Sucked and Then I Cried is available at the Newberg public library.

Bike to stroller

2010-05-05T08:05:00.000-07:00

Don't even bother being jealous, this contraption costs $1400. Neat idea though.

Seen on NeatoBambino

Happy Mother's Day! All Month Long!

2010-05-04T09:12:00.000-07:00

I want to announce that for the entire month of May I am offering FREE SUPPORT for breastfeeding and newborn care issues and questions via email or phone.

No strings attached. Free.

Details
Email me: LactationLaura(at)gmail.com
Phone or text me: 503.935.9973
I will answer emails in 2-3 business days and I will return calls/ texts in 1-2 business days.
Phone support available within the 503 area code only.

Love, Lactation Laura

NEWS

2010-05-02T19:00:00.000-07:00

Dear Friends,
I'd like to bring your attention to a new page on my blog: NEWS. This will always be available as a link under 'Pages,' and I will update it regularly. Please notify me of anything that you think should be included. Love, Lactation Laura

5/7/10
Babies film opens. Link to trailer on my Youtube Channel

5/6/10
Crib recalls

5/1/10
Product Recall: Tylenol, Motrin, Zyrtec, Benadryl. Check your lot numbers to find out what to toss.

4/30/10
New diapers causing chemical burns?
And the facebook fanpage that they refer to here.

4/27/10
Afghan woman visits ARMC midwifery clinic

4/12/10
Handicap parking for pregnant women bill signed

4/6/10
New Study Published: Breastfeeding saves lives and billions of dollars

4/10
Starting in 2012, IBCLC exam eligibility requirements change for first-time candidates

2010
Doula! film coming soon

GO DADDY GO!

2010-04-27T10:34:00.000-07:00

One BabyDaddy demonstrates the Moby and loves on his baby while he's at it. I can tell that his tiny baby is very young, this Daddy caught on quickly! Be still our hearts.

Check out babywearingdads on tumblr to see other baby-wearing guys and to proudly share pics of your own.

I saw this video on phdoula's blog.

Prenatal Education

2010-04-20T11:59:00.000-07:00

When it comes to prenatal education, I have a belief that there is a such thing as too much information (TMI). This applies to pregnancy and childbirth, but I will address the issue of prenatal breastfeeding education.

Now, I do suggest you learn the basics. I recommend a very simple book, Breastfeeding: Keep It Simple for parents planning to breastfeed.

THE BASICS would include:

what a good latch is like,
feeding cues,
what to expect for the frequency of feeding in those first days,
when to expect the milk to come in plentiful amounts,
what to look for to reassure yourself that you are producing enough for your baby,
when to get help and where to get it
reasons an intervention like a supplement are needed
manually expressing your milk
pumping if you plan to go back to work, and
maybe, a very brief overview of your options for intervention-supplementing (might be helpful, especially if you deliver in a hospital; so you're somewhat prepared if you are told there is a medical reason for supplementing your baby)

Do you have those down?

Too much education beyond that is just so much information to process, and it seems parents are expecting themselves to actually remember solutions not just for minor glitches but to obscure pathological syndromes that may never happen to them. That's what reference books are for!

There are huge textbooks and lots of expert research in the field of lactation. To be a lactation consultant, it takes years of experience helping many breastfeeding families to even qualify to be tested on that knowledge base. Why are women expecting to learn this huge body of knowledge just to be able to breastfeed? After your basics are covered you can relax.

Some moms are really good students, and want to gather information to try to ward off troubles. Even if she were to diligently read, remember and apply her knowledge, in my opinion it would still come down to one thing:

EVERY SITUATION, JUST DEPENDS.

It depends on many factors, and unless you've watched babies nursing almost everyday for years, hundreds of them, then I wouldn't expect that a book, class or website could help you solve a complex breastfeeding puzzle, should one pop up. I encourage you to seek support in solving more than the common problems. I would expect that you would need help, actually. I like the idea that you keep a book about breastfeeding that goes into more depth on your shelf and refer to it when the glitches happen. You might find yourself more relaxed and more trusting of the process if you don't delve into all the many ways things could possibly go wrong, or went wrong for others. You have the security of knowing that you can refer back to that book. You can also ask other moms, support groups are great for that; someone in your circle of mothers may have had the same issue that you are going through.

I think you will see what works best for your family. It's a beautiful thing for me to witness when mothers go easy on themselves, when they are flexible and just go with the flow depending on how things go. Rule number 1: Enjoy your baby!* Right? Can I get an 'amen?'

Besides, there's always KellyMom.com, which has tons of great evidence-based information on babies, feeding and parenting with suggestions for common problems and more. You also have the option of contacting your lactation consultant for further breastfeeding assistance. It's what we are here for.

BEYOND BASICS
That said, there are some common glitches related to breastfeeding that actually are worth knowing the basics about:

If you still want to study beyond that, I recommend you go back and reread about latch basics until you could teach a class on it yourself. Still hungry for more? Look at latches on youtube. I have a few on my LactationLaura Youtube Channel. Some are great, some aren't, they are just examples. And you'll see different baby behaviors like rooting that are good to be able to recognize. If you would like you can then teach your partner, mom, friends and sisters what you've learned, especially about the latch.**

EXCEPTIONS:
Here are some reasons that you do want to get more information on your specific issue and how it may affect your breastfeeding relationship:

planned cesarean section
flat or inverted nipples
history of PCOS (polycystic ovarian syndrome)
history of breast surgery
maternal or newborn illness
maternal medications
if you were unsuccessful meeting your goals when breastfeeding a previous child***

CONCLUSION: Relax, you can do it! There is support available to help you succeed should the need arise. Know your resources, (1) where you can talk to a lactation consultant (interview them prenatally) and (2) what support groups meet in your area.

Tip: In, What to look for in a Lactation Consultant, Heather Kelly recommends visiting support groups prenatally, and I think that's a grand idea. You can find out about what is available and suits you before you need a group and to get a general feel for the group and moderators. I think of it as an informal way to interview lactation consultants. It is my dream as an LC that every mama sees latches up close and personal, as many as she can before her own baby arrives. Moms at support groups are usually more than happy let you take a peek of breastfeeding live and in person.

*By the way, the Number 2 rule is: Feed the baby. I'm just sayin'.

**If you are still hungry for more knowledge, I suggest you check out the pathways to becoming a lactation consultant. :) Cheers for helping mothers and babies!

***If you are unsure what the issues were, talk to someone. Even if you know why you were unsuccessful and how to prevent it, you still may need to process what happened and grieve. Doulas, midwives and LCs are all good for that and can direct you toward more help if it's needed.

Local resources in Newberg, Oregon

In Newberg there are two support groups for moms with babies up to a year that are free for anyone to attend no matter where you delivered your baby.

(updated 9-1-10) Attachment Parenting group meets at Pitter-Patter Consignment in downtown Newberg through November 21st, 2010 every Monday at 10am. All kiddos welcome and Dads too. After Nov 21st, the group will meet at rotating homes. See Attachment Parenting International's website at Attachment Parenting.org for more information about what exactly 'attachment parenting' refers to and what kind of topics might be discussed. Hint: they're big on exclusive breastfeeding and nursing beyond a year. Email Jacqui Castle at JacquiCastle(at)gmail.com to get on the announcement list. Jacqui is a future lactation consultant and a postpartum doula. A brand new group, you won't be the new person! I love to join this group of accepting, intuitive parents so you might see me there, and if my clients plan to attend, I may just go out of my way to be there as my schedule allows.
Providence Moms Group meets every Thursday from 10-11:30 at Providence Newberg Hospital (on 99, not far from Freddy's). One of the hospital lactation consultants, Lesley, leads this group. I visited this week. The moms seemed to have a blast and it seems a lot of moms in the community raves about how the group helped them when they had a little one.

I visited the other group this week as well. Shannon Moorman Burns of Bountiful, Beautiful and Blissful, also holds a support group every Tuesday at 9am at the main meeting room of the Conscious Cooperative Village for Mothers, which is in the same building as Pitter Patter Children's consignment (on Hancock in downtown Newberg). She's a birth doula, breastfeeding educator and yoga instructor. It's brand new and it has a lot of potential. It's very small, and that can be a big advantage, because you're not the only one who is new, everyone is! Since it's smaller, there is also more time for discussing topics that more specifically apply to the mothers in attendance. I plan to join Shannon at this group on occasion.

Disclaimer

Techno Parenting with Trixie Tracker

2010-04-10T08:46:00.000-07:00

Tracking wet and poo diapers for your newborn? There's an app for that. Would you use it?

Trixie Tracker was reviewed by Wired Magazine. It's a software that you use via website or iPhone/ iTouch application in which you can track your baby's wet and poo* diapers. There are options for tracking feeds as well.

What's the fuss about the pee and poo count? Well the count can be an indicator that the baby is getting enough to eat, a lot of people are aware of that. Over the years I have seen much anxiety over this idea that while breastfeeding, the baby might not be getting enough to eat because the exact volume of ounces in a given feeding is unknown. Since the diaper count can be an indicator, parents feel more secure in keeping close stats. As a lactation consultant, it is really not a worry to me that the parents keep close track, not in a normal newborn after a normal delivery. If you have an issue, that's something else, and I will ask for the count right away. A few examples of 'issues' would be weight loss, a sleepy baby that won't eat, a newborn that's gone an extended period of time without eating, a maternal history of breast reduction, preterm delivery, illness or medications in mother or baby. In those cases, yes, I want to know the count, but it is ONE factor.

'We want to see how much the baby is getting.' I've heard this like a broken record as a reason to give up or not try breastfeeding at all. Not just from mothers, but a lot of times from friends and primary support people too. So it makes sense that people would feel security in tracking the wet and poo diapers since they can't count the exact volume of fluid intake as they can with a bottle. They want a way to know. Numbers seem to help them.

I would argue that while reassurance that the baby is getting enough is important, tracking wet and poo diapers is not necessarily the only, most reliable or easiest way to know. This is good news. It means if your baby is a normal newborn, you don't have to obsessively track via pen or screen; your child will survive and you won't be considered a 'bad' parent. Unless, of course, you want to, and that is your choice.

I joined the website. There was a free two-week trial period in which I could track stats for my imaginary baby, since I didn't have a real newborn handy. You can track times of feeds, including how many minutes and on which breast your baby spent those minutes. There was also a spot for how much supplement is given, if any. And of course, there was a section to track wet and poo diapers with options to describe their color and consistency.

The companion app is called 'Diaper Tracker.' There was another tracking app for nursing and even one that says it syncs eleven different baby tracking apps into one for 5 bucks.

Features of Trixie Tracker
The Trixie Tracker website boasts that it can be synced with the iPhone tracking application. Also, one can download graphs and charts to email with their doctors, friends and family. You can also set a goal for a stretch of time that you would like for your baby to go without having a leaky or 'blowout' diaper.** Really? Do people find that a fun game?

My opinion: the website was too involved and overwhelming for me personally; the app, on the other hand is pretty intuitive, especially if you are familiar with how to use your iphone or itouch. I like to think that I have a very open mind, so I can see how technologies like video monitors and diaper counting applications work for families. But the hyper logging of the wet and poo diapers and feedings would bog me down with too much information, and I really just wonder if it's necessary.

In a future post I will go over why counting may be helpful and some tips for doing so, but more importantly, answer the question:

HOW DO WE KNOW THE BABY IS GETTING ENOUGH?
which is really what is behind any good reason to count baby diapers.

*I try not to describe babies as dirty, that's why I use the term poo
**Definition, side note and tip:
A 'blowout' is when a child's gooey poo goes all up their little backs and squishes out of the leg holes of their diapers.
Side note: I've found that it's usually an indicator that the baby is ready for the next size up in diaper when they have a couple of blowouts in a row. As in 2-3 within 2-3 days.
Tip: On a disposable diaper, don't forget to make sure that the ruffle around their little legs isn't tucked in, for that's an easy route for the poo to escape onto any and all fabric surfaces in the vicinity and beyond.

What do you think about Trixie Tracker or the idea of using a screen to track diaper counts?
disclaimer

Update 6/11/10: Click here to see a discussion about using such apps on Kellymom.com's facebook fanpage.

Free Slings

2010-04-05T16:48:00.000-07:00

No Mother Left Behind free baby slings to families who cannot afford them.

You can donate your slings that you aren't using anymore, even if they need repair, your crafts that they may be able to sell for their cause, and of course, straight up money donations help.

AM I FLAT OR INVERTED?

2010-03-31T16:50:00.000-07:00

Flat or inverted? Have you heard these terms to describe nipples? Having either can affect breastfeeding.

Click here for a simple guide to assess weather your nipples are flat or inverted

If you discover that you do have flat or inverted nipples, you can absolutely still nurse! I think you will have more success meeting your goals if you are prepared. Your nursing experience may differ from descriptions in the breastfeeding chapter of your typical pregnancy books. Support and knowledge of those differences will help.

I recommend that you take the extra time to examine your nipples prenatally. Your midwife or lactation consultant can help you determine if you truly have flat or inverted nipples. They can also direct you to resources that may be needed.

Also, please note that hormones, edema from IV fluids or a latching baby can all be potential factors in changing the status of your nipples one way or another. Some people have flat nipples their whole lives, then they have a baby, and like MAGIC they protrude. Some have 'textbook' nipples and are surprised to find themselves flat or what some call 'short.' (I prefer petite)

Further reading and suggestions can be found at LaLecheLeague's FAQ page about flat/ inverted nipples. Professional opinions vary on this topic, but I will mention that I do not recommend the Hoffman technique.

Lactation Laura's general disclaimer

Diapers

2010-03-28T17:07:00.000-07:00

Thong diapers: 'They cause a bigger mess than if there were no diaper at all.' This goes along with my post about Elimination Communication.

SNL Diaper Thong Skit

Nichole | MySpace Video

Birth Plans part 2

2010-03-27T12:43:00.000-07:00

So now we've covered what a birth plan is in a previous post.

Some may wonder why birth plans are such an important topic to someone like me, as I do not assist in actual childbirth, I'm involved after the baby is born.

There are several good reasons, but I think that this quote sums up my view on the importance of a positive childbirth experience:

From an article about support that mentions La Leche League
La Leche League supports the view that alert and active participation by the mother in childbirth is a help in getting breastfeeding off to a good start, and that the breastfeeding relationship can stimulate the optimal physical and emotional growth of the child and the development of close family relationships.

I have opinions about birth plans, and I will share those, but let me start by saying that I AM NOT ANTI- BIRTH PLANS, I believe they have a place and are a tool to be used wisely.

My thoughts and experience:

Over a span of ten years I have worked at two hospitals on the obstetrical floors. I have seen a definite pattern of bad outcomes from families that came in with birth plans. I tried really hard not to believe it, for lack of scientific evidence, but there is no denying it. The other staff acknowledged it as well.

Hold the phone. Having a birth plan sabotaged a woman's plan for her birth?

That can't possibly be true. How could that be? This made no sense to me, at all! I couldn't wrap my head around it. So the ones who had researched their choices and thoughtfully considered this big day and expressed themselves so clearly, those ones? Their simple action of writing it out and sharing it worked against them? I wanted to know why.

Some say that the doctors and nurses are full of contempt towards a woman who comes in wanting to do things all naturally; that they resent a woman trying to dictate the way they should perform their job duties, a job they do everyday. This line of thinking suggests that the staff actually sabotage the experience for the mother. As in "Set up the OR, she has a birth plan." I cannot believe that is the case, because too many of us were very supportive of natural childbirth and breastfeeding at the hospitals where I worked; we wanted them to succeed! And besides, it's their body, baby and birth and we all know they have the right to refuse anything. Who wouldn't want to support and empower a woman for that? In fact it's a big factor in seeking such a line of work, at least among the L&D staff that I've ever met.

Some of the more experienced nurses shared with me their theories and I think they were partially right. But I later found a better explanation in my reading. I will share with you both the nurses ideas and the explanation that I found that made most sense to me in a future post.

Sweater Breast

2010-03-26T15:32:00.000-07:00

Have you heard about knitters uniting to provide free prosthetic breasts to mastectomy patients?
If not, you can read all about it here: The Knitting Experience

They call them 'knitted knockers.' I'm not usually a fan of cutesy references to breasts, like Hooter Hiders, but I know they're doing a good thing, so I'll save my energy and pick my battles.

But that got me thinking. Heeeey! I want a knitted knocker. What a useful tool to teach breastfeeding.

CLICK BELOW TO READ MORE OF THIS POST

But then I found this:

in MotherHenDoula's etsy shop.
Brilliant! I quickly decided that this was a situation in which a bigger breast may actually be the better breast, especially if you are teaching more than a couple of people. But then I got to thinking, now who, pray tell, could I commission to knit me a giant baby? And while they were at it, how about more breasts? Like one with with flat nipples, one with inverted nipples, dense tissue, engorged......wait I don't have room to store all those breasts. Can you imagine going in to teach a class? Don't mind my giant bag of breasts, they go with me everywhere. Or how about one breast with a collection of different nipple types that can be changed out and attached with velcro or snaps? Who's crafty?

Well maybe a breast like this will be limited to teaching about normal latching. You know, 'textbook' breasts. But what a great visual tool. Only 5 dollars!

Art

2010-03-25T15:28:00.000-07:00

Nursing, painting by Alex Grey

One of my many sisters exposed me to Alex Grey. It's probably the nurse in me, but bones and nerves and fat and muscles are just TOO COOL! Then, the fact that one of his paintings is all those elements adding up to be a mother/ baby nursing dyad... I'm sold, he is an amazing artist. My favorite painting is Nursing, shown here, with Pregnancy as a very close second.

There are strict rules for using his images. He only allows the use of one image with a clear link. Believe me, I would otherwise be posting several others for your viewing pleasure.

To check out the beautiful Birth and Pregnancy paintings:
On alexgrey.com, click on PAINTINGS and then PROGRESS OF THE SOUL.

I also found out in the small print that you can use his image as a tattoo for free. The website states that you must find the best tattoo artist to do the work and then send pictures of the tattoos back to Alex Grey with permission for him to use them. Now that would be a cool tat. Kind of involved though.

Do you have any birth or baby tats? Have you thought of getting one? Not necessarily one that is obviously baby or birth related, but one that is a commemoration of their life?

I've seen and like the idea of a tattoo of their little footprints.

Postpartum Doulas

2010-03-24T13:18:00.000-07:00

When most people think of a doula, they typically think of what would be more specifically called a labor or birth doula. A birth doula is with you before you have your baby. They support you beginning in your pregnancy, all through your labor and delivery and at least some of the time after the baby is born. Besides education, a POST PARTUM DOULA is only with you after your baby is born.

Q: What does a postpartum doula do?
A: It depends on the doula and what the family needs.

Translated from Greek, doula means 'female slave to the child-bearing woman.' Now people describe it as 'mothering the mother.'

This is how I like to describe it:
postpartum doula: we do things for a new mother that her mother or sister would do if her mother or sister were there

YOUR SISTER FROM ANOTHER MOTHER: Enter a postpartum doula.

From AmericanPregnancy.org:

A postpartum doula works with each family individually to find out their particular needs. Some of the duties that a postpartum doula will perform include:

Breastfeeding support
Help with the emotional and physical recovery after birth
Light housekeeping so that mom does not feel so overwhelmed
Running errands
Assistance with newborn care such as diapering, bathing, feeding and comforting
Light meal preparation
Baby soothing techniques
Sibling care
Referrals to local resources such as parenting classes, pediatricians, lactation support and support groups

All doulas are there to support you. All postpartum doulas have experience with newborns and helping mothers in the time immediately following childbirth.

Here's a video of an example of one postpartum doula and how she helped a family. Another family may have a totally different story about how she helped them, because every family is different. As you can see in this video, they help dads too. They help the transition of adding a member to your family go more smoothly.

It seems that a lot of doulas have their own specialty, such as massage. It looks like FOOD is this doula's specialty. I've never known of a doula to cook as extensively for a family as she does in this movie. Wow, she's great. She's setting the bar high. I do light cooking or meal prep, I can prepare and serve snacks and kid meals for older siblings, but I'm not quite a gourmet chef yet.

My specialty is lactation, but I also feel I've had exceptional success supporting first time mothers, giving them confidence in their mothering. I can very much relate to them. Go figure, since I don't have any kids of my own.

What specialty would you seek in a doula? If you had one after your baby, did she have a specialty? Any doulas who read my blog, what's your specialty?

Looking for a birth doula? Click here to check out Nicole, a Portland based birth doula who will travel anywhere in the Portland area including McMinnville, Sherwood and Newberg. She supports both home and hospital births.

READY TO BE A PARENT 'TEST'

2010-03-20T12:01:00.000-07:00

Email forwarded to me by Brittnye, mother of three, from Georgia.

MESS TEST
Smear peanut butter on the sofa and curtains. Place a fish stick behind the couch and leave it there all summer.

TOY TEST
Obtain a 55-gallon box of LEGOs (or you may substitute roofing tacks). Have a friend spread them all over the house. Put on a blindfold. Try to walk to the bathroom or kitchen. Do not scream because this would wake a child at night.

GROCERY STORE TEST
Borrow one or two small animals (goats are best) and take them with you as you shop. Always keep them in sight and pay for anything they eat or damage.

DRESSING TEST
Obtain one large, unhappy, live octopus. Stuff into a small netbag making sure that all the arms stay inside.

FEEDING TEST
Obtain a large plastic milk jug. Fill halfway with water. Suspend from the ceiling with a cord. Start the jug swinging. Try to insert spoonfuls of soggy cereal into the mouth of the jug, while pretending to be an airplane. Now dump the contents of the jug on the floor.

NIGHT TEST
Prepare by obtaining a small cloth bag and fill it with 8-12 pounds of sand. Soak it thoroughly in water. At 3:00 p.m. begin to waltz and hum with the bag until 9:00 p.m. Lay down your bag and set your alarm for 10:00 p.m. Get up, pick up your bag, and sing every song you have ever heard. Make up about a dozen more and sing these too until 4:00 a. m. Set alarm for 5:00 a.m. Get up and make breakfast. Keep this up for 5 years. Look cheerful.

INGENUITY TEST
Take an egg carton. Using a pair of scissors and pot of paint turn it into an alligator. Now take a toilet paper tube and turn it into an attractive Christmas candle. Use only scotch tape and a piece of foil. Last, take a milk carton, a Ping-Pong ball, and an empty box of Cocoa Puffs. Make an exact replica of the Eiffel Tower.

AUTOMOBILE TEST
Forget the BMW and buy a station wagon. Buy a chocolate ice cream cone and put it in the glove compartment. Leave it there. Get a dime. Stick it into the cassette player. Take a family size package of chocolate chip cookies. Mash them into the back seat. Run a garden rake along both sides of the car. There, perfect.

PHYSICAL TEST (Women)
Obtain a large bean bag chair and attach it to the front of your clothes. Leave it there for 9 months.. Now remove 10 of the beans.

PHYSICAL TEST (Men)
Go to the nearest drug store. Set your wallet on the counter. Ask the clerk to help himself. Now proceed to the nearest food store. Go to the head office and arrange for your paycheck to be directly deposited to the store. Purchase a newspaper. Go home and read it quietly for the last time.

FINAL ASSIGNMENT
Find a couple who already have a small child. Lecture them on how they can improve their discipline, patience, tolerance, toilet training and child's table manners. Suggest many ways they can improve. Emphasize to them that they should never allow their children to run wild. Enjoy this experience. It will be the last time you will have all the answers.
Janis Hurtado

Parents, anything you would add?

Youtube Channel

2010-03-17T12:03:00.000-07:00

Hey guys. Lactation Laura now has a Youtube channel. It's a little collection of video clips about birth, babies and breastfeeding. It will contain movies I've featured in my blog posts all in one place and more. I'll add to it over time. Send me suggestions for movies and clips to review. Cheers!

Check it out: www.youtube.com/LactationLaura

Latch Video

2010-03-12T15:35:00.000-08:00

This is a great little 5 minute video that explains, among other things, how far back a mother's nipple needs to go into her baby's mouth when they nurse. If you watch nothing else, check out the animation at the two minute mark.

I would like to clarify something. This video describes how you will feel 'tugging' but should not feel discomfort. It goes on to say breastfeeding should not be painful. I do not agree with telling new parents this information. Mothers do report pain, and I cannot support just saying across the board,

'you're not doing it right or you wouldn't be in pain.'

It's really not unusual to feel uncomfortable especially in that first half a minute or so after they latch in those first couple of weeks.

So, is it supposed to hurt?

Well, your nipple goes back pretty far into the baby's mouth when they are latched. Farther than most may think.

TRY IT: Run your tongue on the roof of your mouth. Do you feel where your hard palate becomes your soft palate? That's how far back the nipple-areolar complex needs to be pulled into your baby's mouth. That's what this video describes as the 'comfort zone.'

If your baby doesn't pull the nipple and surrounding tissue deeply enough into their mouth to get to that comfort zone, then you get into having a 'shallow' latch which is painful and the baby won't be getting as much milk. If your latch is shallow, your nipple may be rubbing against the roof of his mouth. Ouch. Now, that's painful.

So, discomfort from that stretching, especially in those first couple of weeks, is normal. Your level of comfort may depend on the size of your nipple and how stretchy or dense the surrounding tissue is. But no matter what, it's about to be stretched a considerable distance further than it's used to, on a regular basis. So......

NORMAL= discomfort from your nipple 'stretching' in those first weeks

NOT NORMAL= abrasions, bruises, scabs, hickies, bleeding or toe curling pain (seek help)

Some possible causes of abnormal trauma or pain to nipples:

Breast congestion or engorgement
Anatomically short nipples
Infant ankyloglossia (Tongue-tie)
Poor latch/ position

Credit to Amy Spangler RN, IBCLC (babygooroo.com)writer and speaker for helping me to so clearly understand this reason so many report latch discomfort on a normal latch.

This video was made by a pump company. I am neither promoting nor being compensated by them; they just happened to make a good video.

Disclaimer

COOL MOMMY BLOG

2010-03-09T09:22:00.000-08:00

Design and art: if I didn't appreciate them, I wouldn't be able to appreciate the love of my life, an art designer and illustrator.

So of course I love this blog, DesignMom.com. She's a designer/art director in Colorado, she's a mother of five, and she blogs about where 'design and motherhood intersect.' She posts the coolest stuff along with fun pictures, all in an artistic kind of way. Check out these birthday party invitations that she did with a Cricut die cut machine. So creative. I'm jealous.

Birth Plans

2010-03-07T17:00:00.000-08:00

Expecting a baby? No doubt you've heard of birth plans.

What is a birth plan?

"A birth plan is a written outline of what an expectant couple would and would not like to take place during labor and delivery."

( The Whole Parenting Guide Strategies, resources, and inspiring stories for holistic parenting and family living by Alan Reder, Phil Catalfo and Stephanie Renfrow Hamilton p. 47)

To create a birth plan, an expectant couple usually goes to one of the many birth plan generating websites. They simply check off, then print the options that they want for their birth and share them with their health care providers. They also bring a copy in for the staff on labor and delivery when they are admitted to the hospital for delivery. When you review the plan with your provider(s) prior to delivery, they would typically 'sign off' on the birth plan. This is essentially putting their initials on the plan indicating that they went over it with you. The point of having one is to make known your wishes that deviate from the normal hospital birth experience. Here is an example of a birth plan template commonly used.

From Woman'sHealthcareTopics.com:

BIRTH PLAN TEMPLATE
create your birth plan with our print-out template!

GENERAL INFORMATION:

Birth Plan for the _________________________ family.

Mother's first and last name:

Father's first and last name:

Due Date:

Coach's first and last name:

Other support people:

Name of obstetrician:

Desired hospital:

EARLY/FIRST STAGE LABOR

Environment
Low lighting
Quiet room
Music
Wear own clothing
Coach/partner only desired attendees other than medical staff
I would prefer to wear my contact lenses/glasses
I want my labor and delivery photographed/video recorded
I do not want my labor and delivery photographed/video recorded
Other _______________________________________________

Mobility
choose one:
Unlimited freedom to move (walking, bathroom, rocking chair, fitness ball, etc.)
Mobility is not important to me

Shaving/Enema
{most hospitals no longer shave the pubic area or use enemas, but just in case...}
I would like to avoid the use of an enema.
I would like to avoid having my pubic area shaved.

I.V.
I.V. insertion is acceptable at any point
I.V. placement should be attempted only if dehydration occurs
Please attempt to insert I.V. on left/right (circle)

Hydration
No restrictions
Clear fluids
Ice chips
IV

Monitoring
choose one:
Intermittent monitoring (Fetoscope, Doppler, etc.)
Continuous monitoring (External leads, internal monitoring)
No monitoring except in emergency situations

Catheritization
I would like to avoid catheterization unless it is absolutely necessary
Pain Relief Offer
choose one:
Do not offer; I will ask if I desire it
Offer if I appear uncomfortable
Offer as soon as possible

Pain Relief Options
Natural
Relaxation techniques
Hot or cold compresses
Positioning
Water therapy (bath, whirlpool, shower)
Massage
Accupressure
Hypnotherapy

I.V. Medication
Stadol
Nubain
Demerol
Other ______________________________

Epidural
Walking epidural
Traditional epidural

Labor Induction/Augmentation
No induction
No augmentation
Cervical gel
Pitocin
Rupturing of the amniotic sac
I prefer my amniotic sac be allowed to rupture on its own

SECOND STAGE LABOR

Pushing
{check all pushing options which are acceptable}
Push in position of my choosing
Squat/Birthing Bar
Pushing while on hands and knees
I am not concerned with positioning
Foot pedals rather than stirrups
People as leg support rather than stirrups
Spontaneous pushing (when I feel the need)
Pushing with medical direction

Delivery
I would like to touch baby's head when it crowns
I would like a mirror available to view pushing/crowning/birth

IMMEDIATELY FOLLOWING DELIVERY
I want baby placed on my chest immediately after birth
I would like my partner/coach to cut the cord
I would like to cut the cord
Partner/coach does not want to cut cord
Please delay cord clamping and cutting until pulsating ceases
I would like to hold the baby while delivering the placenta
I do not wish a pitocin injection to assist with placenta delivery
I wish baby to be examined in my presence.
If baby cannot be examined in my presence, I wish my partner/coach to remain with baby at all times
I do not wish baby to be placed under heat lamps; I will hold baby and provide body warmth instead
I want to donate cord blood
I want to bank cord blood

EPISIOTOMY
I do not want an episiotomy unless there is an emergency situation
I would like to attempt perineal massage to stretch the perineum.
I would like an episiotomy to reduce risk of tearing
I would like a local anesthetic during repair of tear/episiotomy
I would not like a local anesthetic during repair of tear/episiotomy

BABY CARE
I wish to breastfeed exclusively
I wish to breastfeed, but formula supplementation is acceptable
I wish to formula feed
I do not want baby to be given a pacifier
I would like to meet with a lactation consultant as soon as possible
I want baby circumcised
I do not want baby circumcised

PRIVACY
I would like a private room, I understand that there will be an additional charge
I would like baby to "room in"
I would like baby to sleep in nursery
I would like baby to be brought to me for all feedings
I welcome all well wishers
I wish to limit visitors
I would prefer my door closed with a sign requesting that visitors and staff members knock before entering
I do not wish to have medical students involved in my care
Other ___________________________________________

CESAREAN
In the event that a cesarean section is deemed necessary, I would like the following:
Partner/coach present
Other support present _________________________
Pictures/video
Screen lowered at delivery
I would like the procedure described as it is happening
Partner would like to cut cord
Other _________________________

In the Event that Baby Requires Special Care Due to Trauma or Illness:
I would like to breastfeed/pump breast milk
Partner/coach will accompany baby if transferred to another hospital
I would like to be transferred to baby's hospital

With a well-considered, well-organized plan in place you'll relieve stress by knowing what to expect and by ensuring that your wishes and preferences are known to all - including your doctor.

Mother's Signature __________________________ Date ____________

Father's Signature __________________________ Date ____________

--------------------------------------------------------------------

IN FUTURE POSTS:

Let me know if you would like for me to go more in depth on this topic. Do you have specific questions about items on this sample birth plan? I can talk to you about some reasons why you might not want one, and what information is necessary to include if you do choose to use a birth plan. I can share my point of view and experience with them as a hospital staff member. Also, please share what you think about birth plans? Did you use one? Plan to use one?

Just To Make You Laugh: Website

2010-03-05T11:51:00.000-08:00

New parents are sleep deprived at times. It can make you irritable and you just need a good laugh. This website might come in handy when you can't sleep because the baby will only stop crying when you are standing or sometimes doing squats.

Upside down celebrities at freakingnews.com ( a photoshop website) works such wonders for me when I'm stressed that I want to share about it.

I just ignore the details of the contest and scroll down to see all the goofy faces that have been photo shopped. They make the celebrity's chin their forehead and their forehead becomes their chin. Feeling sexy now Angelina? Mrs. I-have-lots-of-kids-and-never-look-tired-or-stressed? Nice beard! Brilliant.

Also, some might find it creepy, but at this website: ManBabies they switch the men and babies' heads through photoshop. I find it entertaining.

Breastfeeding as Meditation

2010-02-28T09:46:00.000-08:00

Finding Effective Meditations-- powered by eHow.com
I've been reading a bit about meditation and how helpful yet difficult it can be. I found a series of clips about simple, everyday ways to meditate.

Elizabeth Rose has video clips on meditating while walking, with aromatherapy, art meditation and others. In this general one, 'Finding Effective Meditations' she actually mentions how she used nursing her son as her meditation. Awwww... I have to share.