San Diego Big Latch On 2019 T-shirts are ON SALE!

Who wants an awesome Big Latch On 2019 T-Shirt???

We are so excited to partner up with Heart and Soul Printing, one of our favorite local designers and screenprinters, to offer you a San Diego Big Latch On 2019 t-shirt or tank top.  

Each t-shirt costs $20 and will only be on sale from July 8 - July 21, 2019, so don’t miss your opportunity to have one of the most adorable event t-shirts out there! We will have a very small selection of t-shirts available for sale at the event (for $25), but we ran out of those within the first hour of the event last year.

All shirts can be picked up at the San Diego Breastfeeding Center - we will email you with the exact date once all orders are in. If you are unable to pick up your shirt before the event, you can pick it up day of.

*** We will not ship t-shirts. You must pick up your shirt at our office or at the event.

All proceeds will be donated to the San Diego Breastfeeding Center Foundation to help pay for lactation consultations for local low-income families.  

Ready to see the awesome T-shirts????

HEATHER GRAY LADIES CREW T-SHIRT - AVAILABLE IN S, M, L, XL, 2XL

HEATHER GRAY LADIES CREW T-SHIRT - AVAILABLE IN S, M, L, XL, 2XL

Sizes

NAVY BLUE LADIES RACERBACK TANK - AVAILABLE IN XS, S, M, L, XL, AND 2XL

NAVY BLUE LADIES RACERBACK TANK - AVAILABLE IN XS, S, M, L, XL, AND 2XL

Sizes

SEA GREEN LADIES SLOUCHY TANK - AVAILABLE IN S, M, L, XL, 2XL (RUNS A LITTLE BIG)

SEA GREEN LADIES SLOUCHY TANK - AVAILABLE IN S, M, L, XL, 2XL (RUNS A LITTLE BIG)

Sizes

For more details about the Big Latch On Event, check out our FB event page: 

https://www.facebook.com/events/347252742653283/

As well as our blog: 

https://www.sdbfc.com/blog/2019/5/31/biglatchon2019

Meet SDBFC's Newest Lactation Consultant - Ashley Tehrani!

We are so thrilled to introduce you to our newest lactation consultant at SDBFC! Ashley Tehrani joined our team in September 2017, as our Wednesday Breastfeeding Support Group leader and our Social Media Coordinator. After over a year of clinical hours and course work, Ashley is now ready to see her own patients at SDBFC and we couldn’t be more excited! We can't wait for you all to meet her!

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Ashley, tell us about yourself!

I grew up in Southern California and moved to San Diego to attend SDSU in 2008. I enjoy playing beach volleyball, fastpitch softball, hiking, reading and a good television show. I love to travel and hope to visit more spots within the U.S in the coming years. I had my daughter in 2015 and was introduced to the amazing community surrounding conception, birthing and postpartum that we have in San Diego.

What inspired you to become a lactation consultant?

The birth of my daughter definitely thrust me into this passion for supporting breastfeeding/lactating families. I had no idea the changes, challenges, happy moments and sad moments that being pregnant and becoming a parent would bring. I am so thankful to have had expert lactation support while in the hospital when my daughter was born, and for being directed by online support groups to the San Diego Breastfeeding Center for when I needed help later on. I was fortunate to be able to stay home with my daughter for the first few years, but found myself wanting to begin working again. The birth of my daughter and many encouraging friends and family helped me to begin my slow progression towards becoming an IBCLC.

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What are you most excited about working with SDBFC?

I am excited to join a group of practitioners who are highly trained and well versed in breastfeeding and in supporting families. I am thankful for this opportunity and look forward to learning from these amazing IBCLCs and from the amazing families I will work with. I look forward to helping new families navigate breastfeeding and parenthood.

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What are you top 3 tips for a brand new breastfeeding family?

  1. While pregnant, go to breastfeeding support groups (especially if you’ve never really seen people breastfeed), visit with an IBCLC prior to having baby, have an appointment with an IBCLC booked for a week or so after baby is born, bring your partner or support person along for all of this – they will likely be the one there most while you are breastfeeding in the early weeks giving you encouragement and support. 

  2. Ask for, and or accept offered help (breastfeeding or not, new to parenthood or ‘old pros’…help is essential).  This was a personal struggle I dealt with early on and still do at times. If you want/need help, there is no shame in asking for it and no shame it putting boundaries around that help (i.e yes, you can bring over a meal for us, but we are trying to settle in so please leave it on the porch). 

  3. If you have challenges with breastfeeding in the beginning it is helpful to remember that this won’t be forever and that you and baby are new to this and learning together.

Welcome to the SDBFC team, Ashley!

Help!  My baby won’t take a bottle!

Seen this face before?

Photo by  Brytny.com  on  Unsplash

Photo by Brytny.com on Unsplash

Good luck trying to get a bottle in this mouth!

So, breastfeeding has been going well!  Your little one feeds like a champ.  You have stored a bunch of breast milk in your freezer.  You have found a caregiver that will love your sweet, little muffin almost as much as you do.  Now, it is time to make sure your baby will be fed right while you are back at work and suddenly you run into a hiccup..... your adorable, lovely little one has decided that she is not interested in a bottle and downright refuses it!  

WHAT?  How can this happen?  

This is precious breast milk that you pumped with love!  How can she be that stubborn at such an early age? 

If it brings you any consolation, I see this all of the time at our breastfeeding center.  I have seen the stress in a parent's eyes when she has to return to work and her baby refuses everything, but the breast.  Well, I am here to alleviate that stress with a bunch of tricks to help your sweet, albeit opinionated, infant take a bottle before you return to work. 

List of Tricks to Help your Breastfed Baby Take a Bottle

  1. Have dad/partner try to give the bottle, not the breastfeeding mom. If he/she is not completely successful, have an experienced bottle feeder (grandma/grandpa, aunt/uncle, friend, nanny, daycare provider, etc.) give it a try. They may also not be as offended as dad/partner may be:)

  2. Patience is key! If your baby isn't interested, try at a different time of day. My kids were usually more calm in the morning than in the afternoon, so I would always try new things at the beginning of the day.

  3. Be playful! Rest the nipple on your baby's philtrum (the crease that connects her upper lip to her nose) and let her decide when she will take it in her mouth. This mimics what goes on during breastfeeding.

  4. Try different feeding techniques. Try feeding your baby with a bottle in a cradle hold. If that doesn't work, try feeding her facing you, either on your lap or in a bouncy chair. You can also try walking around.

  5. Some babies like to smell their moms while bottle feeding, so let her snuggle in one of mom's t-shirts or with her pillow case while bottle feeding.

  6. Choose a bottle nipple that looks most like your anatomy. Start with the slow-flow nipple. This will give your baby more sucking time, just like at breast. If your baby is a little older, or if you have a really fast-flow, your baby may prefer a faster flow nipple. Choose what most resembles you and your baby's breastfeeding experience.

  7. Use baby-led bottle feeding techniques to make bottle feeding more like breastfeeding. You can check out our YouTube channel for a video on how to do this!

  8. Experiment with different bottles and nipples. Babies have preferences, so give yours an opportunity to choose her bottle and nipple....without breaking the bank, of course!

  9. Warm the nipple under running water before offering it to your baby. She might have a temperature preference, too.

  10. You can always try a cup. Yes, even infants can drink from a cup. They usually lap it up rather than actually gulping. For more info on cup-feeding, check out Dr. Sear's article on alternatives to bottle feeding

  11. Try and try again! Something that didn't work the first time around may work on another day. It is like introducing avocado to your baby for the first time. Some babies love it. Others need to taste it over 10 times before they enjoy it.

If all else fails, call a lactation consultant!  We often can identify the root cause of why a baby isn’t taking a bottle and can offer suggestions for other bottles or other feeding methods.  At the San Diego Breastfeeding Center, we also have a variety of bottles to try in our office that we can try during a bottle-feeding consult!  You can make an appointment for one of those consultations HERE.

Hopefully this list has put your mind at ease and offered some advice to help you get through this challenge.  If the first trick doesn't work, just keep on going down the list.  If you have one that has worked for you, please add it to the comments.  Let's share our advice so that all parents can use this as a resource!

Our Biggest Announcement in Years!

When I think about my own Going Back to Work experience, as well as our lactation clients’ experiences, there are some common themes and emotions that come top of mind.

  • Feelings of overwhelm and stress while preparing for this transition. How can I get my baby, my baby’s caregiver, and my supervisor all on the same page?

  • Anxiety about our milk supplies decreasing. How is my pump going to keep up my milk supply?  How will I find time to pump?

  • Worry that our children are going to be overfed by their caregivers. How much milk should I leave for my baby and how can I convince our caregiver that this is the correct amount?

  • Concern about managing work life and family life (balance never really happens, right?) How will I be able to do it all?

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But, when I look even deeper into where those emotions are coming from, I believe that they are coming from this......


We just spent the past weeks and months tirelessly establishing and nurturing a breastfeeding relationship with our child that we now might lose control over!

And the fear that going back to work will sabotage our ability to reach our personal breastfeeding goals scares the hell out of us.  

We feel like we have lost control over our breastfeeding relationship.

This is the thing, though…. You have the ability to retain control.  It is all in how you prepare for this transition in your overall journey.

BIG ANNOUNCEMENT!

This is exactly why I created an easy-to-follow process to prepare yourself, your pump, your baby, your baby’s caregiver, and your supervisor for a smooth transition where you remain in control of your breastfeeding relationship!

We are so excited to announce SDBFC's first online course, Breastfeeding for the Working Family! This is the easiest, most comprehensive step-by-step course to prepare everyone for this transition back to work.

With the purchase of this online course, you will receive:

  • 14 short, info-loaded videos to watch at your leisure

  • 6 customizable handouts

  • Access to our exclusive private FB group, where you can share all of your thoughts and advice with other pumping working parents, watch extra video content, and get special deals from our favorite product partners!

  • Weekly Live Q&As on our Facebook group, with a lactation consultant, to answer your burning questions (This might be my favorite part of the whole course!)

I want you to imagine how amazing it will feel to meet your personal breastfeeding/pumping goals, despite going back to work.

Ready to make this happen?

For more information about the course, check out our online course page

How to purchase the course RIGHT NOW:

In honor of our online course launch, you may use this coupon code (COURSELAUNCH20) to receive $20 off your purchase! This deal lasts only until June 30, 2019.

I can’t wait to support you along this journey!




San Diego Big Latch On Event 2019 - WHO'S READY???

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OMG! OMG! OMG!

Are you ready to find out the details for the Big Latch On San Diego 2019???

This year’s San Diego Big Latch On event is going to be our biggest and greatest one yet! Join the San Diego Breastfeeding Center, and our amazing co-hosts - Gymboree San Diego and Kindred Bravely, in a fun-filled event for the whole family!  We are returning to Liberty Station, but this time we will be in the HUGE grassy area, next to the playground and bathrooms on Cushing Road. All participants will have exclusive, free access to on-site Gymboree classes, a yoga class, and a babywearing workshop. So, while you wait for the actual Latch On to occur, you can grab some coffee/breakfast at one of the many delicious restaurants, hang out in the playground, attend a class/workshop, peruse the vendor booths (you won’t want to miss these!), and bid on our awesome opportunity drawing items!


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If you are a new to the breastfeeding world, you might be wondering what the heck is the Big Latch On?  The Big Latch On, is an event that started in New Zealand in 2005 during World Breastfeeding Week.  The mission of the Big Latch On is to protect, promote, and support breastfeeding women and each year groups of breastfeeding women come together at locations all around the world to latch on their children at a designated time and day in honor of this mission and to attempt to set a new record!  Our Big Latch On event will also serve as a major fundraiser for our non-profit organization, the San Diego Breastfeeding Center Foundation.

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Here are the preliminary details.  We will begin to share more about the event over the next few weeks!

When is the Big Latch On?

The Big Latch On event will take place on Saturday, August 3, 2019 from 8:30am-noon.  The actual Latch On (children latching on to set a world record) will take place at exactly 10:30am, so don’t be late!  

Where will the Big Latch On take place?

Liberty Station Park in Point Loma, right next to the playground/bathrooms on Cushing Road.  

Is there a charge to participate?

Not at all!  This event is totally FREE!

Can I bring my family or is this just for breastfeeding parents and child/ren?

This is a totally family-friendly event! There will be plenty of things to keep older children entertained, so bring them all!

Please stay tuned for registration and agenda details!

Wondering how you and your business can get involved?

Since the Big Latch On event is THE major fundraiser for our nonprofit organization, the San Diego Breastfeeding Center Foundation, we rely heavily on event sponsors and opportunity drawing donations.  If you are interested in becoming a sponsor or have a service/item to donate for our opportunity drawing, please send an email to Robin Kaplan (robinkaplan@sdbfc.com)

Get Ready for the Biggest Breastfeeding Event in San Diego!


Board Position Opening for the SDBFC Foundation

Are you passionate about breastfeeding and want to make a difference in the lives of local breastfeeding families?

Do you feel frustrated with the way our healthcare system marginalizes and often provides unequal care for low-income families?

If you answered ‘yes’ to both of these questions, keep on reading!!!

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The San Diego Breastfeeding Center Foundation is looking for a dynamic and creative person, who is passionate about resolving inequities in breastfeeding support, to join our board of directors for a 2-year term.  This is a volunteer position.

San Diego Breastfeeding Center Foundation mission:

The mission of San Diego Breastfeeding Center Foundation (SDBFCF) is to reduce socioeconomic disparities in breastfeeding support by increasing access to qualified lactation consultants for low-income families.  We do this by subsidizing free or reduced-fee breastfeeding consultations and classes to low-income and financially-limited families.

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Board Member Roles:

  • Attend about two 2-hour board meetings per year  

  • Attend our Big Latch On event during World Breastfeeding Week, the first week of August.

  • Help fundraise during our end-of-the-year email fundraising campaign

  • Provide creative ideas for community collaborations and fundraising campaigns/events

  • Assist with small tasks throughout the year that support/foster donor relations and solicit new donors

  • Available to respond to emails within 24 hours

Qualifications:

  • Passionate about breastfeeding and supporting breastfeeding families

  • Passionate about resolving inequities in the healthcare system

  • Availability to attend board meetings during business hours a few times per year

  • Natural ability to cultivate relationships

  • Willingness to fundraise within your own social circle, as well as through social media

  • Willingness to create and share new ideas for fundraising and community collaborations.

Please submit a cover letter and resume to Robin Kaplan, board president, by April 22, 2019.  sdbfcfoundation@gmail.com




Diaper Donation Drive to Support Refugee Families Resettling in San Diego

Written by Anna Choi, BS, IBCLC


When you think of having a baby, and the items that are an absolute MUST have, diapers are pretty close to the top of the list, second only to breastmilk or formula. Whether you choose to cloth diaper or use disposable diapers, you need something to cover that sweet baby’s bum! For families on a limited or fixed income, the cost of diapers can be very overwhelming. Since part of our mission at the San Diego Breastfeeding Center is to give back to our community, while working to grow a strong network of support for families in San Diego, we are excited to announce the details for our next diaper drive!

This year’s diaper drive will support refugee families who have resettled in San Diego, with diapers going to three organizations who make a hugely positive impact on the lives of refugee families: The International Rescue Committee of San Diego, The Syrian Community Network of San Diego, and Catholic Charities of San Diego. Having fled war, persecution, and poverty, these families need our support more than ever. During our last diaper drive, we collected more than 3,000 diapers for San Diego refugee families. This year, our goal is to collect 5,000 diapers! Our diaper drive will begin on Wednesday, April 3rd and end on Wednesday, May 1st.


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To tell you a little more about the refugee families that will receive these diapers, here are a few words from Chris Williams, a Program Manager for Refugee Services in San Diego:

“We are currently working with a number of Haitian families that have recently arrived in San Diego and are in a very difficult situation. Haiti is often described as the poorest country in the western world, with more than half of the entire population living below the poverty line and a quarter living in extreme poverty - surviving on less than $1.25 per day. This, on top of devastating natural disasters over the past decade, has caused many Haitians to flee their homes in search of a better life.

The relatively few families that make it to San Diego typically only get here after years spent living in similarly bad conditions in South and/or Central America and have often been victimized by human traffickers and other malicious actors. They are granted admission to the U.S. on humanitarian grounds, and in the past they have been offered a limited amount of government support along with work authorization to help them get on their feet here. In recent months, the government stopped providing this support and stopped providing new families with the documents they need to work - which is unfortunate, because all of them want to work.

This leaves the families in a precarious situation, and many of them are staying in church shelters. They don't have access to public benefits like food stamps and Medi-Cal, though many of the women are pregnant or have recently given birth. We are working to support these families - and these babies - in a number of ways, though a great deal of help is still needed. Diapers aren't cheap and are always in short supply, though always very much needed.”

Having met many refugee families and spoken with resettlement workers, I can’t tell you enough how much these donations are appreciated and needed. All donations can be dropped off at our weekly Breastfeeding Support Group, held at our office in La Mesa {8325 University Ave La Mesa 91942}, every Wednesday from 11:30am-1pm. If you would like to donate diapers, but are unable to drop off during that time, please contact Anna Choi to schedule a drop off. We hope you will help us reach our goal and stand with us as we support the refugee women and mothers in our local community.



Are Tongue and Lip Ties Being Overdiagnosed and Overtreated?

Written by Robin Kaplan, M.Ed, IBCLC, Owner of San Diego Breastfeeding Center

That has been the million dollar question of the week.  Since Rachel Cautero published her article in the Atlantic last week about this topic, conversations about tethered oral tissue (TOTs) have had a resurgence of epic proportion.  To discuss this topic, I was interviewed by Meghna Chakrabarti on NPR’s On Point this week. Her interview, entitled To Improve Breastfeeding, Babies Get Their Tongues Clipped.  Is it necessary?, included the Atlantic journalist (Rachel Cautero), a pediatric ENT from John Hopkins (Dr. Jonathan Walsh), and me, an IBCLC from San Diego.  

I encourage you to listen to this interview, as there were many important issues brought up that parents need to hear.  I also encourage you to consider listening through an unbiased lens, as the first 30 minutes are fairly skewed due to the sharing of personal breastfeeding experiences by Meghna and Rachel.  They talk about being informed of their infants’ tongue ties during a very vulnerable early postpartum period and how upsetting this information was to them. They shared how they both decided to stick with breastfeeding, despite significant pain for weeks and months, instead of considering a tongue tie release.  And they both ended up finding that breastfeeding eventually got better and that they felt frustrated with all of the discussions online about tongue tie and upper lip tie releases, which they feel is being sold as the ‘cure-all’ to lactation woes.

Keep in mind….these are just two individuals’ stories out of many.  We all have our personal stories of parenthood/breastfeeding/labor, etc that skew the way we view a situation because they evoke an emotional response in us.  These emotional reactions are normal, but are that person’s point of view.

What I would like to share are the most pertinent points about tethered oral tissue (TOTs) that were shared in this interview, as well as a few more that weren’t shared due to time constraints.

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4 Main Take-Aways about Tethered Oral Tissue (TOTs)


Tethered oral tissue can restrict range of motion in the tongue, lips, and cheeks

  • All people have frenulums, but to have tethered oral tissue (TOTs) means that the frenulum is restricting range of motion and impacting function.  Here is a handout that includes many of the symptoms that can be related to TOTs.

  • These TOTs do not stretch over time, but some children/adults learn to compensate despite the tightness.  This is why some children and adults don’t show or feel that they have long-term complications.

  • Releasing restricted frenula can have a profoundly positive effect on both parent and baby and their ability to meet their breastfeeding goals, but is not always necessary.


International Board Certified Lactation Consultants (IBCLCs) identify tethered oral tissue at a higher rate than pediatricians/ENTs because they are the professionals completing full oral/feeding assessments.  

  • IBCLC assessments are not 15 minute well-baby checks.  They are extensive assessments, lasting 1-3 hours, using research-supported evaluation tools.  

  • TOTs cannot be evaluated just by looking in the mouth or at a photo of the mouth, tongue, and lip.  Function must be taken into account.

  • Parents should be walked through each part of the oral/feeding assessment so that they can make an informed decision about what is best for their child.

  • It is always necessary to go back to basics (positioning and latch) first, before blaming a tongue or lip tie. If the symptoms for the breastfeeding parent or baby are not relieved with the basics, then further assessment is necessary.

  • Parents should be presented with a menu of options: bodywork (CST/PT/OT/Chiro, etc); oral exercises; tummy time; supplementing; exclusive pumping, etc. - everyone deserves to be supported regardless of their decisions.

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There has been an increase of identification of and recommendation to release tethered oral tissue in the past two decades, with good reason

  • Increased research and ultrasound investigation on how the tongue and lips function while feeding have shown what is necessary to achieve comfortable, effective breastfeeding and milk removal.  This information was not available until the past two decades.

  • There has been a shift in the international culture to be more pro-breastfeeding than it was during the 1900s.  It is unfortunate that some families feel ‘pressured to breastfeed’, as Rachel mentioned in the interview. Personally, I think this shift in societal views towards breastfeeding has more to do with current research identifying the vast health-promoting and immunological benefits to mom and baby when breastfeeding, rather than parents feeling pressured to breastfeed.

  • TOTs are nothing new.  Tongue ties and frenotomy descriptions can be found in early Japanese writings, other historical documents, and even the bible.  In the 1600s, frenotomy was widely known and there is documentation that describes that midwives would keep one fingernail long and sharp so that she could release the tight frenulum without the use of an instrument.

  • In the early 1900s, formula was advertised as better than breastmilk and breastfeeding was considered as something that only impoverished people do.  Up until then, if a mother could not breastfeed her baby, the family hired a wet nurse or the baby would die due to lack of nourishment. Formula changed the way we looked at infant nutrition and breastfeeding, which meant tethered oral tissue wasn’t viewed as important to address.  With this pendulum shift to positive views about breastfeeding, parents want answers when challenges arise. And many of these challenges can be attributed to TOTs.

There is a lack of evidence specifically studying the long term effects of tethered oral tissue (TOTs)

  • There are several case studies and randomized control studies on how frenotomies improve breastfeeding outcome.

  • There are some correlations between TOTs and challenges eating solid foods, speech and change in oral/dental structure, but there is only a small amount of research to back this up.   We clearly need more research.

  • What we do know is that children with TOTs often mouth breathe, which is widely recognized as pathological and may lead to:

    • open-mouth posture, which can block the airway when sleeping, leading to bruxism, snoring, sleep apnea

    • impaired swallowing, which can lead to a palate that doesn’t naturally expand and Eustchian tubes not opening and equalizing pressure in the middle ear


So, what’s the overall take away message?


When a family has breastfeeding challenges and doesn’t receive a comprehensive oral/feeding assessment that evaluates tongue and lip function, then we run the risk of tongue/lip ties being overdiagnosed and overtreated.   


For more information about tethered oral tissue, check out these resources:

Dr. Ghaheri’s website

SOS for TOTs by Lawrence Kotlow, DDS

Tongue-Tied by Richard Baxter, DMD, MS

Kellymom: Breastfeeding a Baby with a Tongue Tie or Lip Tie (Resources)


Check Out Our Line-Up of New Classes at SDBFC!

Check Out Our Line-Up of New Classes at SDBFC!

We are so excited to share with you our line-up of new classes starting in February at the San Diego Breastfeeding Center.  Our new space in La Mesa is truly feeling like a new home and we are loving how comfortable and welcoming it feels.  Branching out to offer classes beyond breastfeeding is something new for us, but we realized that there are very few places in East County that offer parenting support for new families.  Our goal is to offer a wide variety of classes, full of resources to support you throughout the first few years of your parenting journey, creating a community in our space and beyond.

SDBFC Will Match Your Donation Until the End of 2018!

Looking for an awesome nonprofit to donate to before the end of the year? Everyone wants a tax write-off, right?

With only 5 days remaining in 2018 and $975 left to go to reach our goal of raising $5000 for the San Diego Breastfeeding Center Foundation, we thought we would offer you a little incentive.  

From now until January 1, 2019, the San Diego Breastfeeding Center will match donations to the San Diego Breastfeeding Center Foundation (up to $1000 total)!  


Want to know where our money was spent in 2018?

  • 65 low-income families received a free-$25 private initial breastfeeding consultation

  • 39 low-income families received a free-$25 private follow up breastfeeding consultation

  • 150 families enjoyed festivities at our free Big Latch On 2018 event


With a new partnership with Black Infant Health in 2019, we hope to increase the number of consultations by at least 25%.  Will you please help fund our programs in 2019 by donating today?


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Inspired to make a difference in the life of a new family?

  • $85 pays for one initial 90-min breastfeeding consultation for a low-income family

  • $55 pays for one follow up breastfeeding consultation for a low-income family.

  • Any amount will help us to reach our goal of $5000 for 2018!  We are only $975 away from reaching our end-of-year goal!  SDBFC will match funds up to $1000 total until the end of 2018.

Donate online through our CrowdRise campaign or directly through our SDBFC Foundation website.

To donate by check, please send to:
San Diego Breastfeeding Center Foundation
3355 4th Ave.
San Diego, CA 92103