It makes me sad when a mom tells me, "I really wanted to breastfeed, but my doctor said I couldn't because of a medication I have to take." Sometimes, in very rare cases, the medication may truly be incompatible with breastfeeding. Certain drugs like Lithium, argatroban, any type of radioactive iodine, any chemotherapy agent and a handful of other drugs are definitely not safe for a nursing baby.
However, many medications that may be acceptable come with a manufacturer's label discouraging use by nursing women. Why is this? Perhaps it is an attempt by the drug manufacturers at CYA (just in case something were to happen....) Perhaps a drug may not be safe for use during pregnancy, so the assumption is made that it isn't safe during lactation either.
Whatever the case, many health care practitioners are quick to tell a mother that they can't continue breastfeeding while taking a certain medication, even if the evidence does not bear that out. Ideally, it really is best to limit the medication a breastfeeding mother takes to only what is truly necessary. But when a mother needs a particular medication to be healthy, she should certainly take it!
Dr. Thomas Hale, Ph.D. has devoted much of his career as a pharmacist to studying the effects of various medications on breastfed babies and on the breastmilk itself. He is a professor of Pediatrics at the Texas Tech University School of Medicine. Dr. Hale, who is widely recognized as the leading authority in this field, has authored a book called Medications and Mothers' Milk which is now in its thirteenth edition. Any health care provider who works with nursing mothers and babies should have a copy of this book to use as a reference.
Dr. Hale defines the following categories for lactation risk when considering a particular drug:
L1 - Safest - These drugs have been taken by many breastfeeding women with no adverse effects. Controlled studies fail to demonstrate a risk to a nursing infant, and the possibility of harm to the breastfeeding infant is remote, or the substance is not orally bioavailable to the infant.
L2 - Safer - These drugs have either been studied in a limited number of breastfeeding women without any increase in adverse effects in their infants or there is scant evidence of a demonstrated risk likely to result as a use of these medications.
L3 - Moderately Safe - There are no controlled studies in breastfeeding women; however, there is a possibility of a risk. Or controlled studies that do exist may show only minimal non-threatening adverse effects. These drugs should be used only if the potential benefit justifies the potential risk to the infant.
L4 - Possibly Hazardous - Positive evidence exists showing a risk either to the breastfed infant or to the mother's milk production; however, the benefits from the use of the drug may be acceptable despite the risk to the infant (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which a safer drug does not exist or is not effective.)
L5 - Contraindicated - Studies in breastfeeding mothers have demonstrated that there is significant and documented risk to the infant, or it is a medication that has a high risk of causing significant damage to the infant. The risk of using these drugs in nursing mothers absolutely outweighs any possible benefit from breastfeeding.
The next time you are faced with needing a medication, be sure to ask your doctor to check Dr. Hale's book. If he doesn't have it, find a lactation consultant who does, and do your research! There's no need to stop breastfeeding unless you absolutely have to!
Wednesday, November 11, 2009
Sunday, November 8, 2009
Response to Dr. Rosemond
I am an advocate of Attachment parenting, but I am also an advocate of parents using common sense and setting age-appropriate boundaries for their children. I believe the two actually go hand in hand.
The little that I had read of popular author and speaker John Rosemond in the past led me to appreciate his practical common sense approach to parenting. Recently I had lunch with my good friend Lysa Parker, one of the founders of Attachment Parenting International. Dr. Rosemond was planning a visit to Huntsville; therefore, he came up in our conversation. I told Lysa I appreciated his common sense approach (remember, I haven't read a LOT of his stuff...just a little and mostly dealing with older kids). Lysa explained that he is a strong opponent of all things AP. I was quite surprised.
I wasn't able to go hear him speak, though I would have liked to, but I did see an article in the Huntsville Times today that I found to be quite enlightening. Apparently in his address to about 250 people at Huntsville High School he said " 'psychobabble' about fostering a child's self-esteem and being ultra-involved in a child's life has had a disastrous effect on children's behavior." According to the article, he also said "his mother 'never paid much attention to me,' but she set clear ground rules for what she expected from him at an early age."
I read that line and felt sorry for him. Setting ground rules with clear expectations is wonderful. However, as a 61 year old adult his memory is that his mother never paid much attention to him. And now he is advising a generation of parents not to become too attached to or involved in their children's lives.
According to the Times article, "One of the biggest errors parents make, he said, is that they are in relationships with their children rather than being figures of leadership and authority. Because of those relationships, he said parents hunger for popularity and acceptance with their children, something which he said nullifies their ability to lead."
I agree that the roles of parent and friend cannot be one and the same when a child is growing up. However, I consider my grown children dear friends. My son and I talk every day about everything under the sun. I wonder if Rosemond counts his grown children among his closest friends? Attachment parenting does not mean that we seek to be "popular and accepted" by our children. It does mean that we create a relationship with them which fills them with a sense of security and well-being. The relationship begins at birth and continues throughout the child's life. It does not mean that a parent does nothing but cater to her child's every whim.
The problem is that authors like Rosemond equate Attachment Parenting with Permissive parenting or parenting without boundaries. They fail to understand the premises set forth by Dr. William Sears. As both a pediatrician and a father, he has years of experience working with patients, but also a proven track record of raising terrific kids who are making a real contribution to society.
Rosemond believes that his approach to parenting is a Biblically based method. Yet the picture I see of God in the Bible is one of a loving Father who tenderly cares for His own or a shepherd who cares deeply for each sheep. Specific imagery related to breastfeeding and attachment can be seen in Isaiah as God talks about His loving care for His people. I think it's time that Christians begin advocating for strong Biblically based Attachment Parenting. If we truly want to raise a generation of selfless, giving, confident young adults, then we must teach them the most basic lessons of trust from infancy on.
The little that I had read of popular author and speaker John Rosemond in the past led me to appreciate his practical common sense approach to parenting. Recently I had lunch with my good friend Lysa Parker, one of the founders of Attachment Parenting International. Dr. Rosemond was planning a visit to Huntsville; therefore, he came up in our conversation. I told Lysa I appreciated his common sense approach (remember, I haven't read a LOT of his stuff...just a little and mostly dealing with older kids). Lysa explained that he is a strong opponent of all things AP. I was quite surprised.
I wasn't able to go hear him speak, though I would have liked to, but I did see an article in the Huntsville Times today that I found to be quite enlightening. Apparently in his address to about 250 people at Huntsville High School he said " 'psychobabble' about fostering a child's self-esteem and being ultra-involved in a child's life has had a disastrous effect on children's behavior." According to the article, he also said "his mother 'never paid much attention to me,' but she set clear ground rules for what she expected from him at an early age."
I read that line and felt sorry for him. Setting ground rules with clear expectations is wonderful. However, as a 61 year old adult his memory is that his mother never paid much attention to him. And now he is advising a generation of parents not to become too attached to or involved in their children's lives.
According to the Times article, "One of the biggest errors parents make, he said, is that they are in relationships with their children rather than being figures of leadership and authority. Because of those relationships, he said parents hunger for popularity and acceptance with their children, something which he said nullifies their ability to lead."
I agree that the roles of parent and friend cannot be one and the same when a child is growing up. However, I consider my grown children dear friends. My son and I talk every day about everything under the sun. I wonder if Rosemond counts his grown children among his closest friends? Attachment parenting does not mean that we seek to be "popular and accepted" by our children. It does mean that we create a relationship with them which fills them with a sense of security and well-being. The relationship begins at birth and continues throughout the child's life. It does not mean that a parent does nothing but cater to her child's every whim.
The problem is that authors like Rosemond equate Attachment Parenting with Permissive parenting or parenting without boundaries. They fail to understand the premises set forth by Dr. William Sears. As both a pediatrician and a father, he has years of experience working with patients, but also a proven track record of raising terrific kids who are making a real contribution to society.
Rosemond believes that his approach to parenting is a Biblically based method. Yet the picture I see of God in the Bible is one of a loving Father who tenderly cares for His own or a shepherd who cares deeply for each sheep. Specific imagery related to breastfeeding and attachment can be seen in Isaiah as God talks about His loving care for His people. I think it's time that Christians begin advocating for strong Biblically based Attachment Parenting. If we truly want to raise a generation of selfless, giving, confident young adults, then we must teach them the most basic lessons of trust from infancy on.
Wednesday, October 28, 2009
Should You Rent a Breastpump?
Every week we have several moms come in to A Nurturing Moment to find out about renting a breastpump. Sometimes they want to make sure breastfeeding is going to work before they invest two or three hundred dollars in a good pump. Many times, though, they are trying to decide if they should rent or buy. That's a really good question, and the answer depends on several factors.
Timing of Baby's Birth
If your baby is a healthy, term baby, you should be able to exclusively breastfeed from the time he is born. As long as he is nursing well, you shouldn't need a pump to stimulate your milk supply. However, if your baby is 3 or more weeks early, he may have a very difficult time nursing. Even if he does latch on, he may not have the strength to help you establish an adequate milk supply. I tell mothers of premature babies that they really need to use a hospital-grade breastpump to establish their supply. The Medela Symphony pump actually has a preemie card, developed through extensive research, which helps the mothers of premature babies establish a more complete milk supply earlier than they would otehrwise. I think all mothers of preemies should have access to this technology!
How Nursing is Progressing
If everything is going well - no sore nipples, good milk supply, etc. - no pump is necessary in the early days. However, if a mother is experiencing cracked and bleeding nipples, then she should pump for at least 24 hours and finger feed the pumped milk using a curved tip syringe or a supplemental feeding tube. A hospital-grade pump is ideal for the mom in this situation. Even though she might have another pump, the hospital-grade pump will be more effective at helping establish and maintain a good supply.
Pumping should NEVER be painful. If it is uncomfortable, ask your lactation consultant to help you find breast shields that will fit you better.
Mom's Work Situation
First of all, I want to make a disclaimer here....I believe that ALL mothers are working mothers. The word mother implies lots and lots of hard work. Some mothers, however, have a second job outside of the home. Those mothers need to be able to pump their milk quickly and efficiently. Good pumps that a working mom can purchase include the Medela Pump in Style, Medela Freestyle, Ameda Purely Yours and Hygeia. Some mothers, though, prefer to rent a hospital-grade pump. You can rent a pump for about 4 months before it becomes more cost-effective to purchase a good quality double pump. The mom who struggles with decreased milk production when she returns to work may find that a hospital-grade rental pump will be more effective at helping her maintain her supply than a regular double pump.
What Is a Hospital-Grade Pump?
Many people really don't understand what makes a hospital-grade pump different. First of all, it is larger and has a more powerful motor. But the difference doesn't end there. Because it is a multi-user pump, a hospital-grade pump will always be a "closed" system. That means that it is engineered in such a way to make it impossible for milk to ever back up into the pump's motor. Therefore, it is totally hygienic and safe for multiple users. The two most popular hospital grade pumps are Ameda and Medela. You can use these links to find a rental station near you. Find out if the rental station allows short term rentals or pro-rates the price if you return the pump early. Some do, but many do not.
Ideally, you should rent your pump from a breastfeeding professional (IBCLC) if possible. That way you have someone who can give you solid research-based advice on your particular situation. Ultimately, your lactation consultant is the very best person to help you decide if YOU should rent a breastpump.
Timing of Baby's Birth
If your baby is a healthy, term baby, you should be able to exclusively breastfeed from the time he is born. As long as he is nursing well, you shouldn't need a pump to stimulate your milk supply. However, if your baby is 3 or more weeks early, he may have a very difficult time nursing. Even if he does latch on, he may not have the strength to help you establish an adequate milk supply. I tell mothers of premature babies that they really need to use a hospital-grade breastpump to establish their supply. The Medela Symphony pump actually has a preemie card, developed through extensive research, which helps the mothers of premature babies establish a more complete milk supply earlier than they would otehrwise. I think all mothers of preemies should have access to this technology!
How Nursing is Progressing
If everything is going well - no sore nipples, good milk supply, etc. - no pump is necessary in the early days. However, if a mother is experiencing cracked and bleeding nipples, then she should pump for at least 24 hours and finger feed the pumped milk using a curved tip syringe or a supplemental feeding tube. A hospital-grade pump is ideal for the mom in this situation. Even though she might have another pump, the hospital-grade pump will be more effective at helping establish and maintain a good supply.
Pumping should NEVER be painful. If it is uncomfortable, ask your lactation consultant to help you find breast shields that will fit you better.
Mom's Work Situation
First of all, I want to make a disclaimer here....I believe that ALL mothers are working mothers. The word mother implies lots and lots of hard work. Some mothers, however, have a second job outside of the home. Those mothers need to be able to pump their milk quickly and efficiently. Good pumps that a working mom can purchase include the Medela Pump in Style, Medela Freestyle, Ameda Purely Yours and Hygeia. Some mothers, though, prefer to rent a hospital-grade pump. You can rent a pump for about 4 months before it becomes more cost-effective to purchase a good quality double pump. The mom who struggles with decreased milk production when she returns to work may find that a hospital-grade rental pump will be more effective at helping her maintain her supply than a regular double pump.
What Is a Hospital-Grade Pump?
Many people really don't understand what makes a hospital-grade pump different. First of all, it is larger and has a more powerful motor. But the difference doesn't end there. Because it is a multi-user pump, a hospital-grade pump will always be a "closed" system. That means that it is engineered in such a way to make it impossible for milk to ever back up into the pump's motor. Therefore, it is totally hygienic and safe for multiple users. The two most popular hospital grade pumps are Ameda and Medela. You can use these links to find a rental station near you. Find out if the rental station allows short term rentals or pro-rates the price if you return the pump early. Some do, but many do not.
Ideally, you should rent your pump from a breastfeeding professional (IBCLC) if possible. That way you have someone who can give you solid research-based advice on your particular situation. Ultimately, your lactation consultant is the very best person to help you decide if YOU should rent a breastpump.
Saturday, October 24, 2009
Breastfeeding and Obesity
You may have read that breastfeeding helps prevent childhood (and by implication, adult) obesity. According to recent statistics 2/3 of US adults and 1/5 of US children are either overweight or obese. That's really appalling! Obesity is a contributing factor in a wide variety of serious health conditions ranging from blood pressure problems to diabetes to cancer.
Health experts agree that it is important to address this problem on both a national and a local level. In July the CDC released an important document, "Recommended Community Strategies and Measurements to Prevent Obesity in the United States." This document presents 24 strategies that local communities can implement in their effort to curb the rising tide of childhood obesity. The strategies deal with food choices, exercise, availability of safe public transportation, etc. One strategy, however, stands out to me as a lactation consultant.
Strategy 11 states: Communities Should Increase Support for Breastfeeding. The document urges all governmental employers to set aside a specific place where employees can pump and store their milk. It also shows the relationship between the percentage of breastmilk a baby receives and the likelihood of childhood obesity.
What a timely statement for the CDC to make. In this time of recession when many women truly can't afford NOT to breastfeed, they have yet another incentive to do just that! However, this message isn't making it to the women who most need to hear it. The challenge facing breastfeeding advocates is clear: we must find a way to work in cooperation with local, regional and state organizations to help all mothers understand the importance of breastfeeding. I'm excited about taking on this challenge in Huntsville! How about you? Will you rise to challenge in your community??
Health experts agree that it is important to address this problem on both a national and a local level. In July the CDC released an important document, "Recommended Community Strategies and Measurements to Prevent Obesity in the United States." This document presents 24 strategies that local communities can implement in their effort to curb the rising tide of childhood obesity. The strategies deal with food choices, exercise, availability of safe public transportation, etc. One strategy, however, stands out to me as a lactation consultant.
Strategy 11 states: Communities Should Increase Support for Breastfeeding. The document urges all governmental employers to set aside a specific place where employees can pump and store their milk. It also shows the relationship between the percentage of breastmilk a baby receives and the likelihood of childhood obesity.
What a timely statement for the CDC to make. In this time of recession when many women truly can't afford NOT to breastfeed, they have yet another incentive to do just that! However, this message isn't making it to the women who most need to hear it. The challenge facing breastfeeding advocates is clear: we must find a way to work in cooperation with local, regional and state organizations to help all mothers understand the importance of breastfeeding. I'm excited about taking on this challenge in Huntsville! How about you? Will you rise to challenge in your community??
Friday, October 9, 2009
Attachment Parenting Meets the Gridiron
I have two sons and a husband who are all sports fanatics. My 18 year old son played both football and soccer in high school. He isn't playing college sports this year, but may well be back on the soccer field next year! My 11 year old plays football, wrestles, and plays baseball. My husband played football and baseball in high school, too. So it should come as no surprise that Sports Illustrated is a staple in our household.
I picked up the Oct. 12 issue earlier this evening. An article about Florida Gator's quarterback Tim Tebow caught my eye. Though we aren't Gators fans, I think Tebow is one of the classiest young men I've ever seen. Not only is he an amazing athlete, but he also demonstrates true character. His faith has feet that take him to the Philippines to minister to children. His leadership both on the field and off it has made him a legend in his own time. In his "Point After" column, writer Chris Ballard discusses whether Tebow should play in this weekend's game against LSU.
The discussion centers on the safety of Tebow's getting back on the field after his concussion two weeks ago. As a mother of athletic kids, I felt myself responding to this column with a resounding "YES, IT'S ABOUT TIME!" reaction. We want our children to be safe and healthy. Our whole parenting style is built around helping them feel secure. Yet even at the Pop Warner level, it's so easy for both coaches and kids to want a player back in the game too soon. And pity the poor mother who says, "Um, I don't really think he's ready..."
I've been pretty lucky with my kids' coaches, but I do remember my son passing out with a concussion following a nasty hit his junior year. He was back in there way too soon, and stayed in until the coach realized that he just wasn't sharp and wasn't functioning normally. AP mom that I am, I had urged him not to play. But he was determined not to let his team down, and his coach believed him when he said he was good to go!. Fortunately, he didn't take another nasty hit, and was able to recover completely.
But the article I read tonight made me realize that I will be much more proactive with son #2. If my momma instincts tell me he's not ready to get back into a game, I'm gonna listen! Pity the poor coach who tries to cross me! Son #1 used to say I was just too protective. He thought he was invincible (common mindset for teens). I knew he wasn't, but I didn't make too big a fuss when I thought he was hurt. It will be very different with Son #2!
I'm realizing more and more how important the AP principles are to all of parenting, not just when they're little. And I'm all the more thankful that I was blessed enough to learn about this wonderful parenting philosophy!
I picked up the Oct. 12 issue earlier this evening. An article about Florida Gator's quarterback Tim Tebow caught my eye. Though we aren't Gators fans, I think Tebow is one of the classiest young men I've ever seen. Not only is he an amazing athlete, but he also demonstrates true character. His faith has feet that take him to the Philippines to minister to children. His leadership both on the field and off it has made him a legend in his own time. In his "Point After" column, writer Chris Ballard discusses whether Tebow should play in this weekend's game against LSU.
The discussion centers on the safety of Tebow's getting back on the field after his concussion two weeks ago. As a mother of athletic kids, I felt myself responding to this column with a resounding "YES, IT'S ABOUT TIME!" reaction. We want our children to be safe and healthy. Our whole parenting style is built around helping them feel secure. Yet even at the Pop Warner level, it's so easy for both coaches and kids to want a player back in the game too soon. And pity the poor mother who says, "Um, I don't really think he's ready..."
I've been pretty lucky with my kids' coaches, but I do remember my son passing out with a concussion following a nasty hit his junior year. He was back in there way too soon, and stayed in until the coach realized that he just wasn't sharp and wasn't functioning normally. AP mom that I am, I had urged him not to play. But he was determined not to let his team down, and his coach believed him when he said he was good to go!. Fortunately, he didn't take another nasty hit, and was able to recover completely.
But the article I read tonight made me realize that I will be much more proactive with son #2. If my momma instincts tell me he's not ready to get back into a game, I'm gonna listen! Pity the poor coach who tries to cross me! Son #1 used to say I was just too protective. He thought he was invincible (common mindset for teens). I knew he wasn't, but I didn't make too big a fuss when I thought he was hurt. It will be very different with Son #2!
I'm realizing more and more how important the AP principles are to all of parenting, not just when they're little. And I'm all the more thankful that I was blessed enough to learn about this wonderful parenting philosophy!
Saturday, September 19, 2009
Breastfeeding in the Work Place
Last night on CNN Campbell Brown addressed the case of LaNisa Allen, the mother of a 4 month old who was fired by Totes/Isotoner because she was taking pumping breaks to provide breastmilk for her baby. While other employees could take smoke breaks or bathroom breaks, LaNisa lost her job for taking the same length break.
In her introduction, Brown talked about how lucky she is to have an employer who allows her to pump milk regularly for her baby. Not all women have that opportunity, however. Rep. Carolyn Maloney (D-N.Y.)also appears on the segment talking about a bill she has sponsored, The Breastfeeding Promotion Act. Maloney's bill would provide protection for breastfeeding in the workplace under civil rights law. No woman could lose her job or be discriminated against in any other way for pumping during a break. Employers would have to provide break time to pump. They would also be required to try to find a private, secure place for nursing moms to express their milk. It would provide a tax credit for up to fifty percent of any expenses an employer incurs as a result.
We have a lot of working moms come into A Nurturing Moment. Many of them are professional women who have lactation rooms at their companies or who have private offices. Nevertheless, we still see many mothers like LaNisa who have to pump in a restroom, arguably the most germ-filled place in the whole company. No mother should have to pump in a bathroom! So we tell moms that we will work with their human resource director to help make pumping work for them.
Pumping Benefits Everybody
The U.S. Department of Health and Human Services has put together a comprehensive guide for employers called The Business Case of Breastfeeding. This material is available free of charge to companies. It details the many benefits to the company itself when it creates a lactation support program.
- Greater employee satisfaction
- Higher retention rates
- Reduced employee absenteeism
- Lower health-care costs for babies receiving breastmilk
We will help companies evaluate their situation to find the optimal lactation program that will work for them. We will even contract with them to provide on-site breastfeeding support and education for their employees and for spouses of employees.
LaNisa's little boy is now four. She took her case against Totes/Isotoner all the way to the Ohio Supreme Court where she lost. They said the case was about her taking unauthorized breaks. I wonder what the company would have done if she was smoking instead of pumping? My bet? She'd still have her job!
In her introduction, Brown talked about how lucky she is to have an employer who allows her to pump milk regularly for her baby. Not all women have that opportunity, however. Rep. Carolyn Maloney (D-N.Y.)also appears on the segment talking about a bill she has sponsored, The Breastfeeding Promotion Act. Maloney's bill would provide protection for breastfeeding in the workplace under civil rights law. No woman could lose her job or be discriminated against in any other way for pumping during a break. Employers would have to provide break time to pump. They would also be required to try to find a private, secure place for nursing moms to express their milk. It would provide a tax credit for up to fifty percent of any expenses an employer incurs as a result.
We have a lot of working moms come into A Nurturing Moment. Many of them are professional women who have lactation rooms at their companies or who have private offices. Nevertheless, we still see many mothers like LaNisa who have to pump in a restroom, arguably the most germ-filled place in the whole company. No mother should have to pump in a bathroom! So we tell moms that we will work with their human resource director to help make pumping work for them.
Pumping Benefits Everybody
The U.S. Department of Health and Human Services has put together a comprehensive guide for employers called The Business Case of Breastfeeding. This material is available free of charge to companies. It details the many benefits to the company itself when it creates a lactation support program.
- Greater employee satisfaction
- Higher retention rates
- Reduced employee absenteeism
- Lower health-care costs for babies receiving breastmilk
We will help companies evaluate their situation to find the optimal lactation program that will work for them. We will even contract with them to provide on-site breastfeeding support and education for their employees and for spouses of employees.
LaNisa's little boy is now four. She took her case against Totes/Isotoner all the way to the Ohio Supreme Court where she lost. They said the case was about her taking unauthorized breaks. I wonder what the company would have done if she was smoking instead of pumping? My bet? She'd still have her job!
Monday, September 14, 2009
Insufficient Milk Supply
I get a lot of calls from mothers with a wide variety of problems: sore nipples, poor latch, baby's weight gain etc. But one of the most frequent calls I get goes something like this:
Mom: "I'm not making enough milk for my baby."
Me: "What makes you think that?"
Mom: "He's hungry after he nurses, and still needs another ounce of formula after we nurse."
At this point, I find out the baby's age (varies) and how often the baby is nursing (often less than 8 times per 24 hours). I also ask if she has PCOS or a thyroid condition. I find out if she has recently started taking birth control or gone back to work. Any of these situations can have a negative impact on milk supply.
Solutions
Based on the information she gives me, I make one or more of the following suggestions:
- Make sure you nurse every 2 1/2 to 3 hours during the day. Count your time from the beginning of one feed to the beginning of the next. You should have a minimum of 8 feeds every 24 hours. If you're trying to increase supply, 9 or 10 times might be even better. Sometimes going to bed for 24-48 hours with your baby and nursing as often as she wants helps. Make sure you've got somebody feeding YOU and taking care of YOU!
- If you are using a breastpump, try renting a hospital grade pump for a couple of weeks to get the stimulation you need.
- Be sure you're getting enough rest. When your baby is asleep, you need to rest, not do laundry! Also be sure to get at least 2400 calories and enough fluids so that you aren't thirsty.
- Certain foods help increase supply. They are called galactagogues. Oatmeal, Brewer's Yeast and Ovaltine are a few common foods that can help increase your supply.
- Herbal galactagogues can also be very helpful. Motherlove More Milk Plus has fenugreek, blessed thistle, nettle leaf and fennel in an extract form. It often makes a difference within 48 hours. It is important not to eat or drink anything 20 minutes before or after you take it, though, for maximum absorption. Moms with PCOS or thyroid conditions benefit from More Milk Special Blend which also contains Goats Rue to help with the development of milk-producing tissue.
- Use a Lact-aid nursing trainer to increase the amount of milk your baby gets at the breast. More effective suckling will help you produce more milk.
- Two drugs are often used to increase milk supply: Reglan (metaclopramide) and Domperidone. Both can have serious side effects, but both do increase supply successfully. I encourage each mother to talk with her doctor about these possible galactagogues.
If you have questions or concerns about your supply, the best thing you can do is contact your La Leche League leader or your lactation consultant. She is there for you!
Mom: "I'm not making enough milk for my baby."
Me: "What makes you think that?"
Mom: "He's hungry after he nurses, and still needs another ounce of formula after we nurse."
At this point, I find out the baby's age (varies) and how often the baby is nursing (often less than 8 times per 24 hours). I also ask if she has PCOS or a thyroid condition. I find out if she has recently started taking birth control or gone back to work. Any of these situations can have a negative impact on milk supply.
Solutions
Based on the information she gives me, I make one or more of the following suggestions:
- Make sure you nurse every 2 1/2 to 3 hours during the day. Count your time from the beginning of one feed to the beginning of the next. You should have a minimum of 8 feeds every 24 hours. If you're trying to increase supply, 9 or 10 times might be even better. Sometimes going to bed for 24-48 hours with your baby and nursing as often as she wants helps. Make sure you've got somebody feeding YOU and taking care of YOU!
- If you are using a breastpump, try renting a hospital grade pump for a couple of weeks to get the stimulation you need.
- Be sure you're getting enough rest. When your baby is asleep, you need to rest, not do laundry! Also be sure to get at least 2400 calories and enough fluids so that you aren't thirsty.
- Certain foods help increase supply. They are called galactagogues. Oatmeal, Brewer's Yeast and Ovaltine are a few common foods that can help increase your supply.
- Herbal galactagogues can also be very helpful. Motherlove More Milk Plus has fenugreek, blessed thistle, nettle leaf and fennel in an extract form. It often makes a difference within 48 hours. It is important not to eat or drink anything 20 minutes before or after you take it, though, for maximum absorption. Moms with PCOS or thyroid conditions benefit from More Milk Special Blend which also contains Goats Rue to help with the development of milk-producing tissue.
- Use a Lact-aid nursing trainer to increase the amount of milk your baby gets at the breast. More effective suckling will help you produce more milk.
- Two drugs are often used to increase milk supply: Reglan (metaclopramide) and Domperidone. Both can have serious side effects, but both do increase supply successfully. I encourage each mother to talk with her doctor about these possible galactagogues.
If you have questions or concerns about your supply, the best thing you can do is contact your La Leche League leader or your lactation consultant. She is there for you!
Wednesday, September 9, 2009
Say "I Love You" While You Can
One week ago today my friend Dana died suddenly and unexpectedly in her sleep. We still don't know exactly what happened. She was my age, 49. Actually Dana was one month and eleven days younger than me! She was healthy, fit, vibrant, full of energy, and lit up a room when she entered it.
She was also an amazing mom! Her two boys are 14 and 18. Her older son is one of my son's college roommates. Her younger son is in my high school daughter's freshman class; they've been friends since 5th grade. Last semester her son and my daughter both homeschooled. They did their science and math classes together, and I grew even closer to Dana during that time. Their math teacher was a nursing mom who often nursed her baby in the sling during class time. Sometimes it was a little awkward for a 14 year old boy. But Dana told him that he had nursed and how completely natural it was.
It's always hard when kids leave the nest, but Dana did all she could to make it a smooth transition. We all went down to help our boys get moved in (there are 3 roommates who all played HS soccer together). She made frequent Sam's runs so the boys would have plenty of food. After the last shopping trip, her son said "I love You" before he headed back to school. She told him that she loved him, too. That was the last time he saw her.
Dana did a great job of raising two incredible young men of faith who have the resources necessary to make it through this time. We never know how long we'll be given to enjoy and love our kids. Sometimes mothering can be overwhelming. You feel like if you have to change another diaper, wipe another snotty nose or mediate another sibling fight, you'll go stark-raving mad. But when you're right in the middle of that, remember what a gift your kids are. Remember what a gift life is. And pause for a minute; then say "I love you."
She was also an amazing mom! Her two boys are 14 and 18. Her older son is one of my son's college roommates. Her younger son is in my high school daughter's freshman class; they've been friends since 5th grade. Last semester her son and my daughter both homeschooled. They did their science and math classes together, and I grew even closer to Dana during that time. Their math teacher was a nursing mom who often nursed her baby in the sling during class time. Sometimes it was a little awkward for a 14 year old boy. But Dana told him that he had nursed and how completely natural it was.
It's always hard when kids leave the nest, but Dana did all she could to make it a smooth transition. We all went down to help our boys get moved in (there are 3 roommates who all played HS soccer together). She made frequent Sam's runs so the boys would have plenty of food. After the last shopping trip, her son said "I love You" before he headed back to school. She told him that she loved him, too. That was the last time he saw her.
Dana did a great job of raising two incredible young men of faith who have the resources necessary to make it through this time. We never know how long we'll be given to enjoy and love our kids. Sometimes mothering can be overwhelming. You feel like if you have to change another diaper, wipe another snotty nose or mediate another sibling fight, you'll go stark-raving mad. But when you're right in the middle of that, remember what a gift your kids are. Remember what a gift life is. And pause for a minute; then say "I love you."
Wednesday, August 26, 2009
The beauty of kangaroo care
More and more studies point to the changes that occur in preemies who are allowed to have kangaroo care with their mothers. I could point to any one of them to show that kangaroo care can be a powerful healer.
Instead of doing that, I'm going to point you to a story about one mother's experience with kangaroo care, and how it saved her tiny one's life.
Instead of doing that, I'm going to point you to a story about one mother's experience with kangaroo care, and how it saved her tiny one's life.
Monday, August 24, 2009
In the home stretch!
This summer has been the craziest that my family has been through. Four weddings, a trip to the beach, a birthday, two trips to Atlanta, a trip overseas, family and friends visiting us, starting home-schooling, damage from storms, starting two new jobs (luckily one is temporary)...it's just been wild. We're in the last two weeks of it - my daughter is in Maryland this week with her grandparents, and next week my husband and son will go up there to visit and pick her up, and then the kids will go to the beach with my parents while my husband and I are at a conference in Atlanta. Labor Day, we'll all come back home, and we'll be able to breathe a sigh of relief until the holiday season. Even for me, the amount that we've been doing has been too much.
Through all of this, my son has kept nursing. Even when we've been separated for three or four days, whenever we've come back together, he's eventually asked to nurse again. Some days he may nurse as many as four times; other days not at all. We're definitely in the last parts of our nursing days.
Even knowing this, I'm not totally prepared for the idea that he may wean completely next week. We'll be separated for seven nights and eight days while he's in Maryland and down in Gulf Shores - by far the longest period of time we've been separated. By the end of it, I don't know that he'll be thinking about nursing at all. I don't know that I want him to be thinking about nursing by that time either. But whenever I think that this Sunday/Monday might be the last time he nurses, I get a sad little ache around my heart.
Don't get me wrong - we've been nursing just over three years now, so it's not like he'll be weaning early. I have plenty of good nursing memories with both of my kids to look back on. Knowing, however, that he is my last, that this is the last child I'll ever nurse...it makes me a little melancholy, something I have never expected to feel when it came down to it.
Ah well. Life will be full of such lettings go. Right now, my daughter is in Maryland with her grandparents, and I won't see her for two weeks - much, much longer than I've ever gone with not seeing her. It's probably the combination of this next step along the path of my daughter's independence combined with the possibility of my son weaning that is making me feel sadder about this than I thought I would. And I know that when it's all said and done, I won't really give it another thought; it'll just be another parenting milestone hit, so to speak.
But for right now, I'm just a little sad about it all.
Through all of this, my son has kept nursing. Even when we've been separated for three or four days, whenever we've come back together, he's eventually asked to nurse again. Some days he may nurse as many as four times; other days not at all. We're definitely in the last parts of our nursing days.
Even knowing this, I'm not totally prepared for the idea that he may wean completely next week. We'll be separated for seven nights and eight days while he's in Maryland and down in Gulf Shores - by far the longest period of time we've been separated. By the end of it, I don't know that he'll be thinking about nursing at all. I don't know that I want him to be thinking about nursing by that time either. But whenever I think that this Sunday/Monday might be the last time he nurses, I get a sad little ache around my heart.
Don't get me wrong - we've been nursing just over three years now, so it's not like he'll be weaning early. I have plenty of good nursing memories with both of my kids to look back on. Knowing, however, that he is my last, that this is the last child I'll ever nurse...it makes me a little melancholy, something I have never expected to feel when it came down to it.
Ah well. Life will be full of such lettings go. Right now, my daughter is in Maryland with her grandparents, and I won't see her for two weeks - much, much longer than I've ever gone with not seeing her. It's probably the combination of this next step along the path of my daughter's independence combined with the possibility of my son weaning that is making me feel sadder about this than I thought I would. And I know that when it's all said and done, I won't really give it another thought; it'll just be another parenting milestone hit, so to speak.
But for right now, I'm just a little sad about it all.
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