Breastfeeding Friendly Businesses

Wow, I just realized it's been nearly a year since any of us have posted! I really want to apologize to everybody for that. Amanda got really busy with home-schooling, and I was combining home-schooling with 3 jobs - my store, my magazine and the census. For a while I was working 60-80 hours a week and juggling my ninth grader's schedule. My fifth grader was at a Christian school, and providentially, my husband was able to help a lot with the kids during that time.

I'm so thankful for the extra income that really helped during a time of need, but I found other things sliding a bit, and for that I do apologize.

I'm back in the store most of the time now. My daughter is, for the first time in her life, attending a public school, and I am thankful for the many blessings we've had this year.

One of those blessings on a professional level has been the recognition by Medela of A Nurturing Moment as a Medela Certified Nursing Center. We were very pleased to receive this recognition.

Now Bravado, my favorite maker of nursing bras, has come up with a wonderful site that lets moms know where they can find a breastfeeding-friendly business. This is particularly useful if you're traveling! Think how nice it would be if you're visiting relatives this Christmas and you're out and about in an unfamiliar area to pull out your phone, go to this site, and find a place where you can comfortably nurse your baby!

If you find a business that is particularly open to nursing mothers, you can add it to the site. And you can also leave comments about the businesses listed there. What a great way to reward businesses that are mother-baby friendly.

And so we move on

After 3.5 years of nursing, my son weaned over the holidays. He's been slowly going that way for a while, only nursing once every couple of days for the past few months. Then at some point after the craziness of the holidays, I realized that it had been three weeks since he had nursed.

I had thought I would feel more muddled about things. I know so many women who were happy but sad and kinda confused about being happy and sad when they were finished nursing their last. But while I feel a slight bit of melancholy about it, on the whole I'm pretty good with it. It's been 6 years since the last time my body was my own, no baby inside or outside dependent upon it. I always enjoy going into the next stage of things, and I'm looking forward to seeing where we go now.

He's asked a couple of times since then, but it's half-hearted at best, and when I say no he's easily distracted. I didn't have the chance to really analyze things when I weaned Liz; it happened quickly with her because I was so tired and so pregnant, and I just couldn't anymore. But with Connor, I've been able to savor each step in the journey and to know that we made the journey together, rather than the needs or wants of one dominating the other. I'm happy with the way it ended.

Nestle Picture Upsets My Son!

My oldest son just got home from an amazing conference in Atlanta, Passion 2010. He already felt called to mission work, but came home really pumped about all kinds of opportunities. It's exciting to see God at work in this young man who nursed until his third birthday, slept with us when he was little, spent many hours in a baby sling, and learned about trust from day one as we taught him to trust us.

He was five when our family went to Costa Rica, then Peru to serve as missionaries. During his formative years, he saw me working as a lactation consultant in developing countries. He also heard our dinner table conversation which occasionally consisted of diatribes against Nestle born of my frustration with the damage they were causing to mothers and babies in Andean countries (and around the world).

Fast forward to Passion 2010. The ministries involved did a great job of presenting the work they are doing in developing nations around the world. He was particularly impressed with the work of one organization who has a project designed to support prenatal health and postpartum care and instruction. He even told the representatives that his mom would LOVE to be involved in providing any breastfeeding information they might need! (Then he called me to make sure I was okay with that!)

However, as he looked at the many pictures of precious children suspended from the ceiling at their display, he saw one picture which caused an immediate strong reaction of anger! It was a picture of a smiling tyke holding a carton marked Nestle. His anger wasn't directed at the mission agency at all. He realized they were simply trying to portray the reality of what children experience. But he felt furious at Nestle for compromising the health of so many infants. He was even able to explain to his girlfriend just what it was that made him so angry about the picture.

As he told me this story, my mama heart swelled with pride because he really gets it! He understands that supporting and protecting people in developing countries means helping mothers trust their own ability to provide the very best nutrition for their babies.

Day After Christmas Musings

Although most scholars agree that Jesus wasn't born on Dec. 25, my mind still wanders back to Bethlehem this time each year. I wonder what Mary was thinking the day after Jesus' birth. I wonder if they were still housed in a crude stable, or had someone helped them find a more suitable place to stay? We know that shepherds came the night of the day he had been born. The Bible tells us that Mary treasured these things in her heart.

Today her amazing new baby is a day old. Her body is still feeling the effects of just having given birth. She probably didn't get a lot of sleep last night. Or perhaps she was so exhausted that she was able to sleep despite the rustic conditions. It would have been normal for a Jewish mother to keep her baby close to her during the night as she nursed him and kept his body temperature stabilized. By the light of the new day, is Mary marveling at all the things the shepherds said? Of course, she already knew exactly who Jesus was. She knew that she was still a virgin despite having given birth yesterday. She knew that the baby suckling sweetly at her breast was the Very Son of God.

Oh how I wish that I could interview this amazing young mother. I can only imagine the joy radiating from her face as she recounts the miraculous events of the last nine months. I would love to hear her talk about her reaction to the angel's announcement that she would give birth to the Messiah. It would be fascinating to hear her describe those difficult early days when she first told her beloved Joseph that she was with child and the amazing relief she must have felt when God protected her by sending an angel to Joseph as he slept.

Perhaps one day in Eternity there will be time for a birth junkie like me to share a few minutes with Mary. But for today, I will simply rest in the certainty that God, in His amazing providence, chose the perfect young woman to bring forth, nurture, protect, love and teach His only Son!

Dads Help Make Breastfeeding Work!

I used to talk to the fathers in my breastfeeding classes about how important they were to helping their wives successfully breastfeed. I emphasized the father's role as encourager and support person for his wife. I suggested he bring her a drink when she was nursing, and offer to change the baby etc. All of those things are important. However, I recently met a very interesting Army midwife and lactation consultant who gave me a very different perspective!

Major Jarold (Tom) Johnson is much more than a healthcare provider in an army hospital. He is also the father of seven breastfed children. In the breastfeeding classes Major Johnson teaches, he helps fathers learn how to REALLY help their wives breastfeed. He teaches dads how to recognize a good latch and how to help both mother and baby nurse successfully.

So what exactly does Dad do?

Evaluate Latch
Dad is in the perfect position to really see how baby's latch looks. So it is important that he know what to look for. He should look for a wide-open mouth with the nipple and areola deep in baby's mouth. Baby's cheeks will look full, and baby's chin and nose will be touching the breast. His lips should be flanged around the areoala.

Evaluate Suck
Dad is also in a great position to help Mom evaluate baby's suck:swallow ratio. Once her milk lets down, baby should be swallowing with every suck or at least every other suck. Baby will have spurts of actively sucking and swallowing, then he may rest for a half minute or so before beginning another suck/swallow burst.

Evaluate Pain
Breastfeeding should NOT be painful. Pain is an indication that something isn't right. Usually the problem is the latch. If Mom is experiencing discomfort, Dad can slide his finger between the baby's chin and Mom's breast, pulling down on the chin while he pulls baby's head in tighter to the breast. Sometimes it may take two or three tries, but this technique should deepen the latch and eliminate any pain.

A father's role in breastfeeding success cannot be overestimated. The husband who is willing to focus on evaluating his baby at his wife's breast will reap multiple rewards: a grateful wife, a healthy thriving baby, and the knowledge that he played an integral role in the process.

Medications and Breastfeeding

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!

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.

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.

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??

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!