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!

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.

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."