Tackle Your Postpartum Trouble Spots - Butt

Written by guest blooger, Autumn Bonner, co-owner and co-founder of My Tailored Fitness.

Hi Moms!  Autumn here from Tailored Fitness back this week to help us tackle our next trouble spot, the Butt, with a baby-wearing workout you’ll love.  If you missed our first post about how to tone the tummy, you can check it out here, Tackle Your Postpartum Trouble Spots: Tummy.  

There are 3 changes that occur during pregnancy that affect our backsides:

1. Weight gain – It is completely normal to gain weight in places other than your belly during pregnancy.  It’s part of the way your body makes sure you have enough nourishment for the growing baby. You may have noticed that as your front was getting larger (aka: breasts and belly) that your backside was getting larger too (aka: your butt).  I like to think of it as nature’s way of making sure we don’t fall over .   
2. Loss of muscle tone – Towards the end of pregnancy, the weight of your growing belly makes it much harder to exercise and to build up the intensity necessary to maintain muscle tone. We end up losing much of our muscle tone, especially in our glutes!  
3. Postural Shift – There are also some crazy postural changes that occur during pregnancy. If you look at the two pictures below showing your posture pre-pregnancy and your posture at the end of pregnancy, you can see that your pelvis tilts forward. This causes the muscles on the backs of your legs (your glutes and hamstrings) to stretch and in turn lose some of their strength.  

So to get your derriere back where it belongs after pregnancy, it takes the same 3 things we talked about last week:

1. Toning
2. Cardio
3. Healthy Eating

Here’s a 20 minute Butt Toning Plan that combines toning and cardio! Combine this plan with your healthy eating and your tummy toning workout from last week and you will be well on your way to your pre-baby body (or an even better one)!  As with any exercise plan, be sure to get your doctor’s clearance before starting any activity.

Warm up – Put your baby in the Ergobaby carrier and find a set of stairs you can climb. If you don’t have any at your house or in your apartment complex, look for a nearby office building or park that has some you can use.  Chances are they will be empty. To warm up, walk up and down the stairs for 2 minutes. Be sure to be near the handrails in case you lose your balance.  It’s harder to see your toes when wearing your baby, although you may be used to that from being pregnant! 

Cardio - To get your heart rate up, alternate between 1 minute of quick stair climbing (of course safety is #1, so only go as quickly as you feel comfortable, it won’t take much to get your heart rate up) and 1 minute of slow start climbing with a glute squeeze after each step. The photo shows a glute squeeze, but basically as you step up on a stair, lift your back leg straight behind you and squeeze your glute! Keep alternating for a total of 5 minutes.

Strength –Keep that baby in your carrier for these strength exercises. 

1 – Squat and Squeeze – With one foot on the step, lower into a squat with the weight on your heels. Since you are wearing your baby, you will naturally want to drop your chest, but keep your chest up and let the legs do the work. Rise up from the squat and step onto the step lifting your outside leg up into a side glute squeeze. You will need to engage your abs to maintain your balance as you lift your leg.  Slowly return to the starting position and repeat for 10 reps, then switch legs and do 10 reps on the other side. Rest and then repeat another set.

2 – Wall Sit – Find a stable, smooth wall. Place your back against the wall and lower down until your thighs are parallel to the ground. Make sure your entire back and shoulders stay against the wall and hold for 1 minute. Rest and then repeat for another minute.  This is a great time to connect with your little one. She/he can definitely help distract you from your burning legs! 

3 – Butt Blaster – This one is killer, but so good for targeting the glutes. Take your baby out of the carrier and lay his/her below you on a matt. Come onto your hands and your knees. Keeping your leg bent, lift one leg up pushing the heel up to the sky. Return to the start and then open the knee to the side. Keep alternating lifting back and side on the same leg for a total of 10 reps. Then switch and repeat on the other side. Rest, and repeat both sides a 2ndtime.

Stretch – Finish by stretching as your baby lies nearby on the floor. Also, be sure to drink lots of water throughout the day. 

If you are looking for more ideas for how to tone your glutes with your baby in your Ergobaby carrier, check out this lower body strength video from My Tailored Fitness, my fitness program for moms. 

Be sure to check back next week as we tackle our final trouble spot: arms!

Common Concerns While Breastfeeding - What is That White (and painful!) Spot on My Nipple?

Welcome back to our blog series…. Common Concerns While Breastfeeding.  These aren’t the complicated, ‘come-to-my-house-immediately’ phone calls we receive.  Rather, these are the questions that come from clients and friends in the middle of the night, by text or by email, that don’t necessarily warrant a lactation consultation.  They can often be easily resolved with a few simple tricks.  So, we would like to share those tricks with you!

Many moms know the pain associated with a shallow latch during the early days, but have you ever had nipple pain suddenly begin after weeks or months of pain-free breastfeeding?  After checking nipples for signs of a poor latch, you notice a white spot on the nipple in question - you pick at it for a few seconds, but it still remains.  What is it?  What caused it?  What can you do to resolve it and get back to pain-free breastfeeding?  This is what’s called a “milk blister” or “milk bleb” and is not cause for great concern, but it can be an uncomfortable and unwelcome guest!

 

What is a milk blister?

A milk blister is a small white or yellow spot on your nipple - it is normally blocking a milk duct, hence sometimes the pain associated with it is felt both at the tip of the nipple as well as radiating out into the breast.  It can’t easily be wiped away or removed.  It may sometimes be associated with a plugged duct.  It is perfectly safe to continue to breastfeed while you have one.

What causes a milk blister?

There are two causes for what we call a milk blister.  One is that a bit of skin has grown over an open milk duct, blocking it and creating a blister.  The other is the build up of fatty milk at the site of the milk duct, and the calcification of this fatty milk, which then blocks milk from flowing from this duct. The things that can increase risk for a milk blister are:

• A recent plugged duct

• Nipple is pinched often while baby is breastfeeding

• Oversupply

• Unusual pressure from a bra or sleeping position

• Thrush

How can I get rid of the milk blister?

• Place some organic coconut oil on a cotton ball and place it on your nipple, inside your bra, in between feedings for a few days.  This will help break down the calcification at the tip of the nipple, as well as fight off any bacteria or yeast.

• Soak your nipple/breast in a saline bath of warm water several times a day.  According to Kellymom.com, add 2 tsp of epsom salt to 1 cup hot water.  Allow the salt to dissolve and soak your affected breasts prior to feeding. Then place a hot, wet facecloth over your breast right after the saline bath and right before breastfeeding/pumping.  This should help to soften the nipple and help the blister release while baby is feeding or while pumping.

• Apply moist heat to nipple prior to feeding

• Try to remove the skin prior to feeding - rub with a warm washcloth

• If all else fails, you can also ask your healthcare provider to use a sterile needle to open the blister.  After this procedure, follow up with organic coconut oil to keep the area moist and allow it to heal.

What if I keep getting milk blisters?

• Consider seeking help from a Lactation Consultant to try to resolve the underlying cause of the recurring blisters.

• Be sure your bras provide soft but strong support - avoid ones with underwire that may cause plugged ducts.

• Consider reducing the amount of saturated fat in your diet.

• Consider taking sunflower lecithin, 1200mg, 4 times a day, to keep milk ducts ‘slippery’ thereby preventing recurring plugged ducts and milk blisters.

What Every Mom Should Know About Breastfeeding During the Early Weeks

How much breast milk does my baby need per feeding?
What is common nursing behavior for a newborn?
How will I know that my baby is getting enough?

As a new mom, these are common questions that you may ask your pediatrician, midwife, postpartum nurse, family, and friends and GUESS WHAT..... they may all have a different answer!

How complicated is that?  

Sometimes you may feel like there are ‘too many cooks in the kitchen’ and that all of the advice you receive contradicts what you just heard from someone else 5 minutes ago. 

Talk about frustrating! 

Well, one of our goals at the San Diego Breastfeeding Center is to make breastfeeding as seamless and uncomplicated as possible.  We want to empower moms with knowledge and confidence to get breastfeeding off to a great start!

After listening to local moms express discontent about hearing contradictory breastfeeding information, we decided to do something about it.   First, we canvased our local breastfeeding mamas and asked, “What information do you wish you would have known about breastfeeding during those early weeks?”  Then we hired one of those awesome mamas, Elisa Suter, of Paper Doll Design Studios, to design a brochure that shares our top tips that every mom (and pediatrician) should know about breastfeeding during the early weeks.

Here is the final product!  Isn’t it beautiful?  We hope that this brochure provides the clear, consistent, evidence-based breastfeeding information our mamas are looking for.  

If you live in San Diego and would like us to deliver these brochures to your pediatrician's office, please email us at robinkaplan@sdbfc.com. 

If you live outside of San Diego and would like to order the Adobe file to personalize this brochure for YOUR local pediatricians and clients, please email us at robinkaplan@sdbfc.com

Tackle your Postpartum Trouble Spots: Tummy

Written by guest blooger, Autumn Bonner, co-owner and co-founder of My Tailored Fitness.

Happy New Year Moms!  Now that the family is gone, holiday cookies are eaten, and presents are all opened, you are probably settling back into your normal life as a mom.  If you are like most people, you are probably thinking about 2014 and how you’d like to make it even better than last year.  One of the areas you might like to improve in the New Year is your health.  Let’s face it: as a mom, caring for yourself usually takes last place.  You make sure your baby’s needs are met, take care of your spouse/partner, and after that, if there’s time, you take care of yourself.  Sadly this often leaves us disappointed…with how our clothes fit, with how often we get to exercise, and with our lack of energy.

To be the best moms we can be, we must take care of ourselves. The good news is that by carving out just 20 minutes a day you can make some big changes this year!  It’s also important to know that your exercise routine can go hand in hand with your breastfeeding goals!  Research proves that exercise does not impact the quantity or quality of your milk supply.  All you need to do is make sure to eat at least 1500 calories per day and a few more to make up for the calories you burn on those days when you exercise. Here’s a great postdedicated to exercise and breastfeeding with some helpful tips. Exercise has so many other benefits for a new mom like relieving stress, helping you sleep better, and boosting your immunity, so it is definitely worth making a priority!

Over the next 3 weeks, we are going to tackle the top 3 trouble spots for moms: tummy, butt, and arms. You’ll get a plan that you can do in just 20 minutes a day.  And the best part is that your baby will be right there with you as you use your baby carrier during your workout! So let’s get started with our first trouble spot: Tummy!

No other part of our body goes through as much change during pregnancy as our tummy.  Sadly, it doesn’t just bounce back to our pre-pregnancy shape easily.  It takes 3 key things to get a toned tummy post-baby:

1. Toning – Since your ab muscles were stretched so much during your pregnancy, they lost a lot of strength. Toning exercises for your core will help you regain the strength you need in that area.  Think beyond crunches, as there are a lot more effective ways to work your core as you’ll see in the plan below.   
2. Cardio – You also need cardio to get your abs back.  Sadly, you can do hundreds of crunches, but never see your abs because they are hidden under a layer of fat.  The best exercise for fat burning is a combination of strength and cardio.  So add some cardio to the toning exercises for maximum fat burning! 
3. Healthy eating – This one goes right along with the cardio. You can exercise all you want, but if you aren’t fueling your body with good foods, you won’t see results. Fill up on fresh fruits, veggies, lean meats, and whole grain breads.  As a new mom, you want to focus more on WHAT you are eating than on cutting calories.  Just remember, as I mentioned above, you have to make sure you are eating enough calories (at least 1500 per day) to ensure that your milk supply doesn’t drop. 

Ready to get started?  Here’s your 20 minute plan to tone your tummy!  Repeat this plan twice a week.

Note: As with any exercise plan, be sure to get your doctor’s clearance before starting any activity.

Warm up – Put your baby in a carrier and head outside for a walk.  Walk at an easy pace for 2 minutes to get warmed up.

Cardio - To get your heart rate up, alternate between 1 minute of fast walking and 1 minute of medium pace walking for a total of 8 minutes. If you have any hills nearby, include that in your route.  Pick a loop where you’ll end up back at your house at the end of the 8 minutes.

Strength – Head back inside, but keep that baby in your carrier for these strength exercises. 

1 – Zig Zag – Wrap your arms around your baby using your hands to support their head. Lower into a plie squat with knees and toes pointed out. Keeping your hips and legs still, lean side to side engaging the obliques. Repeat for 10 reps each side, rest, and repeat a 2ndset.

2 – Lunge with rotation – Regaining your balance is very important after pregnancy, and comes largely from strengthening your core. Lunges with rotation help challenge your core and balance effectively.  Step forwards into a lunge making sure your knee stays over your ankle. Then twist your torso towards your front leg. Push back to standing and repeat on the other leg. You are also getting some great leg work with this exercise! Repeat for 10 lunges on each leg, rest and repeat a 2nd set.

3 – Plank – This is probably the best exercise you can do for your core. Take your baby out of the carrier and lay him/her below you on the ground. Come into a plank position on your elbows and knees (if you are newly postpartum) or elbows and toes (if you are feeling stronger).  Hold this position for 30-60 seconds, rest, and then repeat a 2nd time.

Stretch – Finish by stretching as your baby lies nearby on the floor. Also, be sure to drink lots of water throughout the day. 

If you are looking for more ideas for how to exercise with your baby in your baby carrier, check out this postnatal core video from my fitness program for moms. We have whole video series with exercises with your baby. We even have a free 30 day trial. (The workout website is compatible with Chrome or Safari, so please use one of those browsers. Make sure you have clearance from your doctor before beginning exercise. By clicking the link above, you are agreeing to the Tailored Fitness Terms of Use.  For some of the exercises, it is important for your baby to have good head control.  Modify or skip exercises as needed to keep things safe for you and your baby.)

Keeping Up Your Milk Supply During the Holiday Season

Since Winter Break has descended onto our homes, Ashley and I are taking the next few weeks off from blogging to spend some quality time with our families.  However, that doesn't mean that you'll be left without our breastfeeding support until the new year!  We have over 300 articles on the San Diego Breastfeeding Center blog, which means there is no reason for you to google 'sore nipples' at 3:30am.  Just check out our extensive article list and you will be well on your way!

Here are some of our favorite tips for keeping up your milk supply during the holidays

1. Holiday recipes often include herbs that can affect supply.  Don't eat too much sage or mint - these are herbs used to temper down or dry up a mom's milk supply.  One mint cookie won't do it, but be aware of the amounts you are consuming.
2. Continue to breastfeed or pump at regular intervals.  It's very easy to skip feedings and/or pumping sessions with all of the holiday festivities, which can lead to plugged ducts and mastitis.  Yuck! Try to stick to your regular breastfeeding/pumping schedule to prevent your breasts from getting overly full and uncomfortable.
3. Traveling during the holidays, expecially with a baby or toddler, can really wear your body down.  To keep up your milk supply, stay hydrated, bring tons of nourishing snacks for the trip, and do you best to get good sleep.  Plus, follow your child's lead and squeeze in a nap or two throughout the trip.  Your immune system will definitely thank you for it!
4. Find your comfort level with breastfeeding around family members.  Enlist your partner as your cheerleader and advocate so that you can feel comfortable breastfeeding your baby in all holiday situations. If you feel timid around certain family members and friends, invest in a breastfeeding cover, like this one from Bebe Au Lait, so you don't have to leave the room everytime your baby is hungry.  It's also a good idea to practice at home in front of a mirror, you'll see how very little of your breast is actually exposed and this may help you to feel more comfortable.
5. If you start feeling under the weather, stick with herbs and over-the-counter medications that don't dry up your mucus membranes, as they may dry up your milk supply as well.  Herbs that support your immune system, that are safe to take while breastfeeding, are echinacea and vitamin C.  If you feel like you are coming down with a cold, you can take homeopathic oscillococcinum and yin chiao to build your immune system and speed up your recovery.  For over the counter medications recommendations, listen to our Boob Group podcast with Dr. Frank Nice, Breastfeeding and Medication.  You can also contact your local lactation consultant and ask her to look up a particular medication to see if it is safe to take while breastfeeding.

Lastly, here are some of our most popular breastfeeding articles to help you through the holiday season:

Advice for the Newly Breastfeeding Mama's Partner

Help A Mama Out; Ways Partners Can Bond with Baby Besides the Bottle

Help A Mama Out: Overcoming Nursing in Public Anxiety

Common Concerns While Breastfeeding: Sore Nipple Therapy for the Breastfeeding Mom

Common Concerns While Breastfeeding: Yikes!  Why are my Nipples Burning?

Common Concerns - Do I Have Mastitis?

We wish you a beautiful, peaceful holiday season and look forward to sharing more judgment-free breastfeeding resources with you in the new year!

Warmly,

Robin and Ashley 

Breastfeeding My Type 1 Diabetic Daughter

Almost 2 years ago, a dear friend of mine found out that her 19 month old daughter had type 1 diabetes and was fighting for her life.  Here's Theresa's triumphant story of how she was able to preserve her breastfeeding relationship while healing her daughter.  

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About a month ago a friend alerted me to a Facebook post that brought a wave of memories flooding over me from a day that changed my life forever as a parent.  A day that I will never forget, even though I wish I could.  It was literally the worst day of my life, but one that I will always be grateful for because it was the day my daughter’s life was saved.  

The Facebook post was from a worried mom whose child was hospitalized after being diagnosed with type 1, “juvenile,” diabetes that very day.  The mama was breastfeeding and was terrified not only for her child's life, but that she would lose the best way she knew to feed and comfort her baby.  A little over a year and a half ago I was in her shoes.  At 19 months old, we were told that our daughter had type 1 diabetes, was in diabetic shock, and needed to be rushed to the emergency room.  She came very close to losing her life and was in critical care for a week at a children’s hospital. 

While she was at her sickest (almost admitted to the ICU), she was not allowed to nurse.  For as comforting as breastfeeding can be, not being able to do it during a time of crisis was torture.  My daughter was barely conscious, was in pain and terrified while she was awake, and I could not even hold her because she wanted to nurse.  I hope no other mama has to experience the excruciating helplessness you feel in a situation like that.  Our children's hospital has no lactation consultants and, by the time they could find a pump for me, we had already skipped about 7 or 8 feedings.  I was scared to death and in physical pain myself.

When we were finally given the okay for her to eat, I had to fight tooth and nail to be able to breastfeed her.  The doctors finally consented to her having breast milk, but because she was not a tiny baby, the doctors did not think it was important.  They told me that she absolutely had to drink from a cup or bottle.  (I had a manual pump at home and did not respond well to it at all.  I could not imagine how difficult it would be to have to exclusively pump.)  I begged them to let me nurse her.  It was my milk after all, whether it came from a pump and was poured directly into a cup or came straight from my breast.  No mother should ever have to beg to be able to feed their baby.  It took hearing our daughter scream and sob hysterically for the doctor to finally take pity on us and let me breast feed her.  As I held my tiny girl in my arms, it was the first time I began to feel like there was a possibility that she would be okay. Still, we were encouraged to not let her nurse after that.

Eventually, we were able to meet with the hospital's diabetes dietician who helped me calculate the average amount of milk I produced per feeding.  We looked at the amount of milk I was able to express with a pump then, by using the general amount of carbohydrates contained in breast milk, we were able to determine a rough estimate for carbohydrates per feeding.  Together we came up with a plan to space out her feedings as much as possible to keep her blood glucose stable (after each meal and to go to sleep).  The dietician was a lifesaver and a champion for us!  She spoke with our doctor on our behalf and convinced him that including breastfeeding as part of our daughter's nutrition was in her best interest.  The doctor has since become supportive.

Continuing breastfeeding brought my daughter so much comfort in the months of learning to live with daily multiple injections and painful finger prick blood tests.  It was something normal and peaceful for both of us during a stressful time of adjustment.  It supported her overall health.  It was a perfect source of nutrition for her combined with solids and was amazing for bringing her blood glucose back up to a safe level if she began to drop low at night (we do use a fast acting sugar, like juice, instead if she is below a safe threshold).  I am so thankful that we were able to continue our nursing relationship until she was 32 months old.

Type 1 diabetes (T1D) is a life-threatening, autoimmune disease in which a person’s body attacks their pancreas, causing it to stop producing insulin, a hormone needed to properly process carbohydrates in the food we eat.  People with type 1 diabetes check their blood glucose levels every few hours and must inject insulin several times every day or continuously infuse with insulin through a pump.  There is no known cause of type 1 diabetes and, at this time, no cure.  It will never go into remission and cannot be reversed.  As a mom, you can't help but wonder if you caused it somehow but, it just isn't possible that you did.  It is not connected to poor diet or lack of exercise.  Our daughter never has had a drop of formula, never had sugar other than that naturally occurring in fruit, never drank juice prior to needing it to treat hypoglycemia, and eats primarily homegrown, organic solid food.

Not many people think that a baby or toddler can develop type 1 diabetes, however it is definitely possible.  Not all doctors think of it either and it is commonly misdiagnosed as the flu, with deadly results.  It is very important to know the possible warning signs.  I would recommend all moms be aware of any major changes in nursing.  A sudden onset of increased nursing (past the length of time a growth spurt or teething would account for) along with much more frequent wet diapers can be a signal of diabetes.  Diaper rash (especially without a history of it) and yeast infections can be symptoms of high blood glucose.  Also, consider vitamin D supplements if a blood test returns low for vitamin D levels and investigate further if the test results are extremely low.  The researchers think there may be a link between low vitamin D and diabetes, however they don't know if it is a cause of diabetes or a symptom of it.  Our daughter had increased nursing and wet diapers, weight loss and developed labored breathing. Thankfully our pediatrician picked up on the problem and took action immediately.

Warning signs of type 1 diabetes can include:

 • Extreme thirst

 • Frequent urination

 • Drowsiness, lethargy

 • Sudden vision changes

 • Increased appetite

 • Sudden weight loss

 • Fruity, sweet, or wine-like odor on breath

 • Nausea or vomiting

 • Heavy, labored breathing

 • Stupor, unconsciousness

 • Sugar in urine

Most importantly, if you feel that something is wrong, go with your gut and keep asking until you find answers!  A quick finger prick test to check the blood glucose level can rule out diabetes.  For this test, a small drop of blood from the tip of the finger is sampled.  Results are often immediate.  A simple urine test can also check for abnormalities.  Undiagnosed and untreated T1D can become deadly very quickly.

If you have a little one diagnosed with diabetes, ask to speak to the nutritionist about continuing to incorporate breastfeeding into their nutritional plan.  By pumping once and measuring the amount expressed or by weighing the baby before and after feeding they can help you determine the general amount of milk and therefore carbohydrates they receive at the breast with each feed.  (Because it is an estimated number and not exact, they can often account for the difference in the allotted carbohydrate plan.)

Also, there are amazing support resources available for small children with T1D!  Facebook groups like “Diapers & Diabetes” and organizations like JDRF offer support for families, education, a place for children to feel encouraged and like any other child, and help navigate the uncertain and ever-changing waters that are type 1 diabetes.  Additionally, JDRF funds research and is constantly striving to improve life for type 1 diabetics.  Most importantly, they are fighting for a cure for type 1 diabetes.

*** Please note that these are just our experiences.  I'm not giving medical advice and don't claim to be an expert on diabetes--I'm just a breastfeeding mom doing everything she can to keep her daughter healthy!  Seeing her grow and thrive, and watching her play momma and nurse her baby dolls, I think I might be doing an okay job.

If you want to learn more about type 1 diabetes, www.jdrf.org is a wonderful resource.  For a glimpse into our life with it or to help fund a cure, please visit:

 http://www2.jdrf.org/site/TR/Walk-CA/Chapter-SanDiego4053?px=2922459&pg=personal&fr_id=2382

or watch our story at: https://www.youtube.com/watch?v=2Fc6r8HEnn0

My Village of Breastfeeding Support

 Over the next few weeks we will be sharing stories of triumphant breastfeeding mamas and their biggest supporters who helped them reach their personal breastfeeding goals.  If you would like to share your breastfeeding story and thank your biggest breastfeeding cheerleaders, check out the details in our recent blog article.

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Here is Stephanie's story.

It has truly taken a village to help me be successful in nursing both of my babies!  I knew I wanted to breastfeed, but, after the birth of my first son, my passion and commitment to it were a surprise to even me.  I was also caught extremely off-guard by the difficulties both of my boys encountered as we began our breastfeeding journeys together.  Tongue ties, lip ties, low weight gain, low supply, poor latch, pain/cracking/bleeding, overactive letdown, and more were all hurdles we had to cross.  There is absolutely NO way I could have made it to 13 months formula-free with my first son and still going strong and formula-free at 6 months with my second without these amazing people.

My husband!  My passion and commitment to breastfeed my babies surprised him also, but he never questioned it and stood by me no matter what decisions I made!  He became just as committed and passionate about it, knowing it was the best thing we could do for our boys.  He came to appointments, helped get the baby latched on time after time, stood up for me when others questioned why I didn’t just quit, and let me cry when it all just became too much!  He has truly been my rock through all of this, and I can sense his gratitude for the sacrifices I have made to give our boys this amazing gift!

My Lactation Consultants! Four different lactation consultants have come alongside my babies and me in our journey together.  Every single one of them encouraged me that I could do it when the hurdles seemed insurmountable.  They provided a listening, sympathetic ear when I just needed to vent or cry or talk it out.  They provided help, advice, referrals, and life-changing solutions that kept us going!

My tribe of other breastfeeding Mamas! Friends I have known since childhood, friends I’ve made in recent years, and people I met through the breastfeeding process made it all possible - others who had or were experiencing some of the same challenges, some who didn’t have trouble but believed just as passionately in the benefits of breastfeeding, some who visited, some who called, and one who even created an on-line community to connect us all!  There were many people in my life who didn’t understand why I didn’t give up when they saw the emotional and physical toll it was taking on me, but these other Mamas got it!  They knew why I couldn’t quit, why no challenge was too big!  

My virtual breastfeeding community!  Although I will never meet most of these women in person, the support, advice, commiseration, and encouragement they have provided have truly been critical!  To be able to jump online in the middle of the night when it just seemed like I couldn’t do it and have others on there to tell me that, yes, I could do it got me through many rough moments!  They have calmed nerves, answered questions, given virtual hugs, and just been an amazing support system!

My babies! Even from the very start and even in the face of all of our challenges, my babies have always loved nursing!  They didn’t quit so there was no way I could!

Nurturing your Child's Potential with Voila Montessori

This week, we’re highlighting a local practitioner who is helping parents establish and integrate their parenting beliefs and styles into a peaceful, nurturing environment for their children.  She also offers Skype consultations for those not located in San Diego.  I’m thrilled to introduce Jeanne-Marie of Voila Montessori!

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1. What does it mean to have a Montessori home?  

A Montessori home is one that is adapted to meet the child’s ever changing needs, as well as it being nurturing, peaceful and respectful to all family members. It is a home where obstacles to children’s natural development are minimized, enabling children to become life long independent and confident learners.

2. What modifications do you help parents make in their homes?  Why are these modifications important?

When helping parents make simple adjustment, I first look at the four main areas depending on the child’s age and the size of the home. These areas are the sleeping, feeding, personal care and movement areas. For example the feeding area at first will be for the sole purpose of bonding with the child while breastfeeding. I usually recommend a quiet, comfortable place where the caregiver can give a 100% of their attention to the infant. This area will then change once the child is introduced to other foods. 

To name only a few simple ideas I share with parents: make sure children have access to real child-size utensils to do ‘real work’, such as cooking, cleaning, personal care, caring for animals or plants as well as creating a quiet reading area just for them etc. I also recommend many different activities to set-up depending on the age and interest of the child.

(photo credit: Laura Christin Photography) 

These modifications evolve and change as the child grows and their needs are different; they are not going to be the same for an infant as they are for a walking toddler or a preschooler. These changes are also about being mindful parents, aware of the child’s needs by learning to observe and never interrupting when they are concentrating on their own self-construction. 

I believe that these changes are important in that they help the entire family to live in peaceful harmony.  These are small modifications that will make a world of difference for everyone involved. They are wonderful tools for the development of the child’s will as well as their self-esteem “I can do it!”

3. How does clutter in the home affect a child's ability to reach his/her full potential?

Clutter is actually an obstacle to their development. A home that is cluttered with too many toys and activities can be very overwhelming for a young child. Children have a real need for order and routines in their early years. External order brings internal order. Young children are absorbing so much information in these early years that it is helpful for the home to be clutter free and orderly to help them make sense of it all. I am always overjoyed to hear parents tell me how much their child’s behavior improved by simplifying their play area. 

4. How does having a Montessori home go hand in hand with Positive Discipline? 

Beautifully! There are a lot of misconceptions about Montessori that it is a place “where children are left to do whatever and it is a free for all”. Montessori is actually a very simple and intuitive way of life and educational method, where all freedoms are within limits. Positive Discipline is a great compliment to Montessori since it is a very respectful way of guiding children. It is firm and kind at the same time believing that connection before correction is crucial for the child’s healthy development.

5.  What type of consultations and classes do you offer to local parents?  Do you conduct Skype visits?

I have many different types of consultations. I work with expectant parents helping set-up a baby-focused nursery as well as parents, grandparents and any caregivers of young children from birth to six years. My consultations are for families wanting guidance on how to adapt their home to meet their child’s needs as well as for families who need help with having children be more cooperative and respectful. 

I offer workshops throughout the San Diego County. Small workshops can be created for specific parent groups.

I am also available to help set-up larger learning environments such as home daycares or family home school co-ops.

Yes, I do offer long-distance consultations either by phone or via Skype.  Parents from different parts of the country and world have asked for advice, so I needed to make myself available.  I’m also working on developing some online webinars.

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Jeanne-Marie's multicultural upbringing and travels planted the seeds of a lifelong curiosity regarding the fundamental needs of children and families.

Her goal is to help parents appreciate the true importance of their role – not as servants or teachers, but as supporters and guides of their children’s natural development. Families who work with Jeanne-Marie reap the benefit of her Masters in Montessori education, her two AMI Montessori certifications covering childhood development from birth through age 6, her Positive Discipline certification for both parents and the classroom as well as her extensive classroom experience, and first-hand parenting knowledge. 

She launched Voila Montessori in response to the overwhelming demand from parents for advice and guidance for raising children in a gentle, peaceful, and supportive environment that’s conducive to their full development – psychological, academic, artistic, spiritual, physical, cultural, etc.

Jeanne-Marie describes herself as “genuine, passionate, and straightforward”. She’s honest and direct, because she realizes that clear and precise information is what will help parents cut through the overwhelming amount of advice that engulfs them.

To learn more about Jeanne-Marie and how she can support you and your children, please visit www.VoilaMontessori.com and like her page, Voila Montessori, on Facebook.

Jeanne-Marie will be offering a monthly workshop at Nature’s Whisper Yoga starting Thursday, November 21, 2013.

Breastfeeding for the Adoptive or Intended Mother

Last week I had the pleasure of speaking at a workshop for families considering adoption and/or surrogacy.  The topic of my presentation was Breastfeeding for the Adoptive or Intended (through surrogacy) Mother.  Most of the families in the audience had no idea that a woman could breastfeed without birthing her child and their faces just lit up when I discussed that this was a possibilty for them.  

While I have worked with several mothers in San Diego to induce lactation for an adopted baby or baby born by surrogate, I thought I would invite my colleague, Alyssa Schnell, to answer a few questions about this process.  Not only has Alyssa personally experienced inducing lactation for her adopted daughter, but she also recently published a book on this topic as well, titled Breastfeeding Without Birthing:  A Breastfeeding Guide for Mothers Through Adoption, Surrogacy, and Other Special Circumstances (Praeclarus Press, 2013)

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Why would a mother consider breastfeeding her adopted baby or baby born by surrogate?

Most people are not even aware that it is possible to breastfeed a baby who arrives via adoption or surrogacy! The lucky few adoptive or intended (through surrogacy) mothers who learn that breastfeeding is possible for them usually learn about it through their own diligent research.  Many times, breastfeeding is just a sentence or two in a book about adoption.  

What are some benefits of breastfeeding an adopted baby or baby born by surrogate?

Breastfeeding is the normal, healthy way to feed and nurture babies.  All babies.  And babies who arrive via adoption or surrogacy may benefit from breastfeeding even more than most babies. 

• Human milk protects babies against illness.  The protection can be especially important for babies who have experienced adoption since adopted babies - for several reasons - are more likely than other babies to get sick (Gribble, 2006).
• Breastfeeding helps babies attach to their adoptive or intended mothers. All babies who experience adoption or surrogacy experience a disruption in attachment, because babies begin attaching to their mother in utero (Gribble, 2006).  Some adopted babies experience multiple breaks in attachment if they are in foster or institutionalized care before adoption.
• Breastfeeding helps babies to develop normally.  Babies who experience adoption are more likely to be developmentally delayed due to drug or alcohol exposure in utero, parental abuse, and/or institutionalized care.

Are there benefits for the mother, as well?

Yes, breastfeeding is just as important for mothers as it is for babies.  And, just as with babies, adoptive and intended mothers may benefit from breastfeeding even more than other mothers.

• Breastfeeding is a normal part of the female life cycle.  It provides protection against breast, ovarian, and uterine cancers, osteoporosis, and cardio-vascular diseases.  For women who do not experience the health benefits of pregnancy, breastfeeding can be especially important (Ip et al., 2007; Collaborative Group on Hormonal Factors in Breast Cancer, 2002). 
• Breastfeeding can help heal the loss associated with infertility.  Breastfeeding provides a unique opportunity for the adoptive or intended mother to participate in her baby’s birth cycle. 

Can a mother breastfeed without making milk?

Yes!  A mother can most definitely breastfeed without making milk.  She can feed her baby at her breast using an at-breast supplementer (a feeding tube attached to the breast) such as a Lact-Aid or Supplemental Nursing System (SNS).  Or, she can bottle-feed her baby and comfort nurse her baby at the breast (just as a baby might suckle on a pacifier for comfort).  Breastfeeding is so much more than making milk!

Photo credit: Barbara Robertson, IBCLC 

If a mother wanted to make milk for her adopted baby or baby born by surrogate, what are her options?

Even without being pregnant, frequent stimulation of the breasts and nipples - usually by a nursing baby or an electric breast pump - can cause a woman’s breasts to start making milk.  Taking medications or herbs can help the breasts to start making milk sooner and/or more abundantly.  Most mothers who induce lactation, or make milk without pregnancy and birth, will produce some milk and a few will produce a full milk supply.  Many adoptive or intended mothers will use an at-breast supplementer so that they can fully feed at the breast even if they are not producing a full milk supply.

Several protocols, or step-by-step instructions, have been developed to help adoptive or intended mothers induce lactation.  In my book Breastfeeding Without Birthing, I describe five protocols for inducing lactation, ranging from very simple to more intricate.  The simplest protocol for inducing lactation has been used by adoptive mothers in developing countries where there is no access to breast pumps or medications for inducing lactation.  Another protocol uses an electric breast pump and herbs but no pharmaceutical medications.  Another uses an electric breast pump as well as a couple of pharmaceutical medications.  Each adoptive and intended mother is encouraged to choose a protocol that suits her individual values and circumstances or, with the guidance of an International Board Certified Lactation Consultant, to mix-and-match the established protocols in order to customize an approach just right for her. 

An adoptive or intended mother can start the process of inducing lactation, or making milk without pregnancy and birth, several months or weeks before her baby arrives.  She can also wait until her baby is in her arms to begin.  There really isn’t one ideal time to start inducing lactation, since each mother’s circumstances are unique. 

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About Alyssa: 

I am an International Board Certified Lactation Consultant (IBCLC) in private practice, a La Leche League Leader, and mother to three breastfed children – two by birth and one by adoption.  Breastfeeding my adopted daughter was a highlight of my life – something so special and so important to both of us that I want to do whatever I can to help other adoptive or intended mothers and their babies have the same opportunity we did.  For more information on breastfeeding a baby arriving by adoption or surrogacy, see my new book Breastfeeding Without Birthing:  A Breastfeeding Guide for Mothers Through Adoption, Surrogacy, and Other Special Circumstances (Praeclarus Press, 2013). It is available through my website www.BreastfeedingWithoutBirthing.com or on Amazon.  My facebook page is another great way to keep in touch!  www.facebook.com/BreastfeedingWithoutBirthing .

References:

Collaborative Group on Hormonal Factors in Breast Cancer. (2002). Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet, 187-195.

Gribble, K. (2006). Mental health, attachment and breastfeeding: implications for adopted children and their mothers. International Breastfeeding Journal, 1(5). doi:10.1186/1746-4358-1-5

Ip et al. (2007). Breastfeeding and maternal and infant health outcomes in developed countries: evidence report/technology assessment no. 157. Rockville, MD: Agency for Healthcare Research and Quality.

Breastfeeding in the Operating Room

Over the next few weeks we will be sharing stories of triumphant breastfeeding mamas and their biggest supporters who helped them reach their personal breastfeeding goals. 

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This story is from Dawn.

I have to thank my hospital TEAM for my breastfeeding success! 

When I gave birth to my son 5+ years ago, it wasn’t what any first time mom would like to experience. I was having problems with maintaining my blood pressure and when my little boys’ heart rate dropped too low, I was rushed into an emergency c-section. It was an extremely frightening process that didn’t even enter my mind as a possibility. The months that followed were hard. We struggled at finding a proper latch and feeding became such a difficult task, I dreaded it.

It never occurred to me that our difficulties at latching could have been because of the birth experience.

In early 2012 we received good news, we were expecting! I did my best to set everything up for a different birthing experience. I searched out a CDC accredited Baby Friendly Hospital in my area, researched VBAC’s and educated myself on the benefits of skin-to-skin.  It wasn’t until closer to my due date that I was informed I couldn’t have a VBAC.  No hospital would even consider me as a potential VBAC candidate because of my small heart issue as well as my age.  After fighting and pleading, I had to acknowledge that I had no other option, but another C-section.

I may have lost that battle, but I was going to do everything in my power to have skin-to-skin with my little girl. I was aware of the evidence-based research on the benefits of skin-to-skin and its success rate with c-section births. I talked to my pediatrician about this and he agreed.  (I since found out that it is the pediatrician who is in charge in the OR!)  I wrote my birth plan with the intentions of doing skin-to-skin immediately after the c-section unless there was a medical reason not to. 

Alas, I wasn’t able to make it all the way to my scheduled c-section date. This time I was low on amino fluids and baby’s lack of movement put me into the hospital at 36 weeks. With concern, my OB and the pediatrician, agreed, that under supervision, they would monitor me and try to get us to the 37th week and do the c-section. 

Now, prior to this, we made sure to talk with all the right people about our wishes for skin-to-skin.  Everyone was on board: our OB, the hospital’s labor and delivery nurses, and staff.  In fact, the hospital staff has been championing the change in procedures to allow skin-to-skin in the OR without success. 

The day of my C-section, my regular pediatrician was out of town and his standing replacement wasn’t comfortable at all.  I had to conveince the standing pediatrician that this was in my and my baby's best interest.  The hospital's Head Labor & Delivery nurse helped us get to a compromise!  She is my angel!  She proposed that if everything looked good my little girl would be immediately placed on my chest, without ANY other intrusion.... meaning the vernix would be wiped off her while she was on my chest and she would be weighted and measured later. 

When the hour came for us to have the c-section more drama around skin-to-skin unfolded, this time all the way up to the director of the Family Birth Center.  The director of the Family Birth Center was completely opposed to it and tried talking my OB out of it.  We were lucky we had enough support and commitment from the labor and delivery nurses and my OB to move forward. We finally got our wish!

I have to admit, because she was coming 3 weeks early, I wasn’t sure we would even get the option of skin-to-skin, but our little girl emerged perfectly!  She was screaming and quickly confirmed in perfect health! 

When she was placed on my chest and covered with a warming blanket, I was in awe.  This little 6 pound bundle was just perfect.  After a little while, she actually scooted and rooted for my breasts and eventually latched and nursed!   I just didn’t think I would get that experience since she was early.  The remembrance still makes me cry.  It was such an amazing experience.  I was so happy I had the team in my corner and the hospital went forward with my wishes.  

When I was first told I would have to have another cesarean, I felt completely out of control and very disappointed.   Creating a birth plan around my c-section allowed me to take a bit of control back and talking with all parties that come with a c-section allowed me the skin-to-skin connection that was deeply important to me.  

It has been over a year since Beth was born.  We are still nursing strong and have a connection that I attribute to the wonderful team that helped me get skin-to-skin in the OR! 

Side note:  I have since heard that they have allowed other moms the same experience!  The hospital team not only helped me, but also have persevered in getting policy “changed” at the hospital!  

Dawn Alva

Rumina Nursingwear