Was it Something I Ate? Food Sensitivities in the Breastfed Baby: Part 3

By Lindsey Hurd, MS, RD, LDN, IBCLC and Owner, Angel Food Lactation & Nutrition, LLC

Last month we probed a little deeper into understanding how mom’s gut influences baby, what causes an unhappy digestive system, and what we can do about it.  From leaky gut syndrome to food sensitivities in baby, maternal dietary modifications have become the first line of defense, despite the inevitable difficulties one may face when narrowing the focus of problem foods. A mom’s diet during pregnancy and during lactation is often a hot topic among anyone close enough to ask questions about her experience… even someone in the checkout line at Target! From your Aunt Sally to your Grandpa Joe, everyone seems to have an opinion about what a mom should and shouldn’t eat.

Often times we hear myths such as spicy foods, cruciferous veggies, beans, garlic, etc. cause excessive gas and GI upset in babies therefore moms should always avoid these foods. What about allergy risks? Shouldn’t moms avoid high allergen foods to reduce the risk of their baby suffering from allergies?  Most importantly for our discussion here, once an allergy or sensitivity in baby has been detected, many foods are considered to be a cause for concern and are encouraged to be eliminated all at once. This is often with no direction into the how, why, or to what capacity… so what’s a mama to do with all of this information? As a Registered Dietitian specialized in lactation related food sensitivities, below are tips and tricks I share with each client I see, via skype or in person, on how to make an elimination diet work for you. 

First Things First…

How do we know when our baby is showing signs of an allergy, sensitivity, or is just ‘being a baby’? Throughout the first few years of life, we go through many phases of maturation, growth spurts, improved function of the internal organs, and cognitive development that lead to variability in bodily functions. As our little ones grow, much like a child or teenager, these phases can be fast or slow, contributing to symptoms signifying the ease or difficulty in coping with such change. When infants have variations in their digestive habits, something many parents have held under strict observance, it can lead to a lot of anxiety and concern about the normalcy of what they see. Each infant’s stool pattern and appearance have individual variations of normal, similar to that of older children and adults. This could be a series of blog posts on its own! For the sake of our discussion on allergies and gut health, the top two signs that tell us something isn’t quite right are the presence of blood and/or mucus in their diapers.  

Digestive symptoms such as these often appear around the 2-month age mark when immunity shifts from maternal based to becoming more dependent on baby. At the onset of symptoms, the presence of blood can become slightly tricky. If accompanied by other symptoms of discomfort, it can be associated with an infection, much like a stomach bug for children or adults. However, once screened negative for infection, the continuous presence of blood, dark brown in appearance, begins to direct us toward mom’s diet as a potential causative factor. Mucus often times is paired with green stools and can signify irritation in the baby’s digestive system. If found independent from blood, this sign of irritation can be associated with food sensitivities. If mucus is found in combination with blood-tinged stools, it can be an additional indicator of an allergy present in baby. As with all abnormal symptoms, it is best to check in with your baby’s doctor to rule out other causative factors, especially those medical in nature. 

To eat or not to eat…That is the question. 

Corn, tomatoes, cow’s milk, OH MY! Often times the prescription for an elimination diet comes with lack of clarity in what to avoid, how to avoid it, and what to eat instead. Moms are so responsive to their baby’s needs that most are quick to do whatever they can to help their baby find a little relief. This, however, can come at the expense of their own sanity and nutritional status. Determining which foods to eliminate requires in depth knowledge in the mother’s specific dietary habits, baby’s specific symptoms, and an understanding in how the two intersect. Most often, moms come to my practice having already eliminated a handful of foods, randomly selected from a list of ‘top allergens’ or a friend’s personal experience with no regard to their intake. Unfortunately, often times this elimination is only partially complete as ‘hidden’ foods are consumed with no knowledge of the allergen’s presence. Listed below are the top 4 steps toward completing an appropriate elimination diet and getting you and your baby on your way to tip top shape! 

1. Recruit your support team. Find evidence based blogs, peer-to-peer support, a personal chef, cooking classes, and most importantly a registered dietitian experienced in lactation related food sensitivities to help you as you progress throughout this process. Having your toolbox full of resources will definitely be the best investment of time and energy in getting you back in control of your diet. Organizing your course and plan of attack, prior to removing potential allergenic foods, will help with efficiency and the level of control during this unpredictable process! 

2. Create a food log & symptoms log. Personalization and preservation are the two top goals for me as a professional working with moms on elimination diets. For 3-4 days, I recommend keeping a log of every food and beverage you consume, the time of consumption, and the time and type (breast or bottle) of feeding for your little one. Additionally, it is best to log the time and type of symptoms you see. Although this can be a huge undertaking, it is the gold standard in narrowing down potential causative factors in mom’s diet. 

3. Take it one food at the time. Finding purpose in each action we take can release our reactionary response of jumping in with both feet. When offering little thought into the aftermath of this technique, we find that as the allergy symptoms begin to fade, we are left with confusion and uncertainty of the true offender! This can make the road toward reintroduction very tricky and sometimes unsuccessful. To preserve your sanity and protect your preferred food selection, it is best to choose one food to eliminate at a time. It is frequently stated that 2-3 weeks are required to see a complete recovery from an eliminated food. While this statement is valid in some cases, for many, improvement appears within 24-48 hours after food elimination begins. Visualizing this change on a short-term basis allows for continued elimination until baby is well and the preservation of mom’s diet is honored… especially when meal preparation and planning are difficult enough! 

4. Reintroduce when the time is right. Unless otherwise directed by your pediatrician, do not fear the process of reintroduction! Permanently eliminating the food from your diet does not allow your baby the opportunity to build up adequate immunity toward this food prior to consuming it directly via solid foods. Before considering this step, allow time for your baby’s body to heal and demonstrate its ability to be symptom free for 2-3 weeks. This is most important prior to initiating this final step. Once successful, begin with the least offensive food and reintroduce in small amounts, eating a portion once per day, or once every other day. Give this step 3-5 days and if all is well, continue down the list until your diet is back to normal. It is important to keep great inventory of your intake and your baby’s symptoms via your food log to keep a good hold on what’s going on just in case symptoms resume. If your baby begins to show signs of intolerance, back off slightly until he/she is symptom free again, holding steady at the highest stage possible. Give your baby’s immune system a couple days to settle into this allergen load. Once ready, begin again, slowly introducing as tolerated. 

The key to success during an elimination diet is personalization, education, patience, and breastmilk! Despite having a potential allergen or sensitivity within mom’s milk, the immune boosting cells, digestive enzymes, and anti-inflammatory properties, to name a few, far surpass the effects of the sensitivity... especially when considering the potential harm from alternate sources of infant nutrition. For most, the benefit of breastmilk is crucial in the continued development of baby’s immune system and in prevention of further concern down the road. Although this process varies for each mom/baby dyad, the steps toward successful elimination hold true for each case. 

Want to find out more? Visit www.angelfoodlactationandnutrition.com to schedule a Skype consult with Lindsey and begin your journey toward better health and a happier baby today! Want to stay connected between posts? Find Angel Food Lactation & Nutrition on Facebook at www.facebook.com/angelfoodlactationandnutrition for current articles, events, fun discussions and more!

Podcast and Personal Stories about Tongue Ties and Lip Ties

Written by Robin Kaplan, M.Ed, IBCLC

Last week on The Boob Group, I had the esteemed pleasure of interviewing one of the most prominent experts on tongue ties and lip ties, Catherine Watson Genna.  Catherine has written multiple articles and books about the mechanics of the tongue while breastfeeding, as well as the breastfeeding challenges that can occur when a baby has a tongue or lip tie.  One of her earliest articles was written for the American Academy of Pediatrics, helping to bring awareness to this subject for the practitioners who babies see the most.

Click here to listen to The Boob Group's podcast episode: Tongue Ties and Lip Ties: Symptoms, Treatment, and Aftercare.

Here is a list of SDBFC's articles about tongue ties and lip ties, including serveral personal memoirs from breastfeeding mothers who experienced this with their children.

Does Your Baby Have a Tongue or Lip Tie? 

Advocating When Your Baby has a Tongue or Lip Tie

The Tongue Tie/Lip Tie Challenge

What a Difference a Tongue Tie Revision Can Make

Breastfeeding After a Tongue Tie Revision

If you have a story to share about breastfeeding a child with a tongue or lip tie, whether you have the revision procedure or not, please send it to Robin Kaplan (robinkaplan@sdbfc.com)

You Know You Are a Breastfeeding Mother of a Toddler When....

Jenn: You can have a conversation with him WHILE he has a mouth full of boob!

Julie: Your boob is visibly lopsided because it’s full and you’re at the park so your kids is too distracted to nurse.

Tiffany: Your nipples start reminding you of Stretch Armstrong. 

Stacy: Your lap is full of toys and your toddler is dangling off the furniture while he eats.  You have to tell your utensil-obsessed kiddo that spoons are for the table, not mommy’s milk.  You laugh when people say that nursing a toddler is for YOUR benefits and not for the toddler.  They have obviously never tried to get a toddler to nurse who didn’t want to, or stop one who does.

Lindsay: Your toddler offers her mommy milk to her teddy bear, dolls, toy animals, and daddy.  It’s so nice she is willing to share!

Cat: They ask you to hold their cracker.

April: When he/she is hurt, the first words are, “Boob! Mommy! Boob!”

Julia: They announce, “That kid needs boo-boo” every time they hear a kid crying.

Laura: He’s dancing all over your chest, tummy, chair, the floor, the walls, the dog, WHILE nursing!

Colina: Nursing begins to feel more like a Cirque du Soleil performance.

Sarah: You see nothing wrong with sittin on the couch with your boobs hanging out for the quick ‘run by milking!’

Paula: After nursing you find gum on your nipple!

Laura: You are simultaneously a food source and a raceway for Matchbox cars.

Ariel: You get bras that are specifically padded to hide your nipples from twiddling hands.

Elisa: Your aren’t phased by nursing with a baby standing up!

Shannon: When you actually pray that he will sit and nurse longer than 4 minutes at a time so that you can rest for just a minute!

Cindy: You have to remind your kid to unlatch BEFORE walking away from you.... or jumping on the bed!

Ariel: When they know you’re touched out, so they ask for ‘just a little bit’ oh, so sweetly.

Kristin: They are constantly upside down.

Jamelle: Sometimes they just want to hug their boobies.  They play ‘Tune in Tokyo” on whichever one is not being used.

Lisa: When you can’t make it from the dining room table to the shower without a nursing break.

Maryjane: When they put your boobs away after nursing! (I actually really appreciate this one!)  When they tell YOU having milk (just a tiny little bit) will make them feel better.

Check out some of our fantastic articles about breastfeeding a toddler:

Toddler Nursing Part 1: How it Helped Me Manage My Circus

Toddler Nursing Part 2: Toddler vs. Breastfeeding

Toddler Nursing: Part 3: Super Breastfed Baby!

Check out some of our awesome podcasts about breastfeeding a toddler:

Breastfeeding Beyond Two Years

Breastfeeding Toddlers: Frequency, Biting, and Staying Motivated

Breastfeeding Toddlers: Night Nursing and Weaning

How would you finish the following sentence: You know you are a breastfeeding mom of a toddler when....

Was it Something I Ate? Food Sensitivities in the Breastfed Baby: Part 2

By Lindsey Hurd, MS, RD, LDN, IBCLC and Owner, Angel Food Lactation & Nutrition, LLC

Last month, we talked about the prevalence of food allergies, how a baby’s immune system is established, and how maternal immunity plays a role.  This month, we are diving a little deeper into understanding how mom’s gut influences baby, what causes an unhappy digestive system, and what we can do about it.  

 

Are You Being A Good Host?

Deep within the crevices of our gut we are hosts to billions of microorganisms, or bacteria that make up our Microbiome. These gut dwellers are such an important part of our body. They kill ‘bad’ germs that make their way into our digestive system, establish and maintain our immune system and even help digest our food. We need them to be happy, healthy, hard workers! Certain aspects of our American lifestyle cause many people to lack the hospitality necessary to keep these good bacteria alive. Behaviors such as being overweight/obese, an excessive use of antibiotics, a highly processed diet low in fiber, poor intake of fruits and vegetables, chronic stress, and poor bowel habits are a few examples. The key outcome from each of the offenders listed above is inflammation. A number of chronic health concerns have been linked to inflammation such as autoimmune diseases, arthritis, Ulcerative Colitis, IBS, chronic fatigue, and even heart disease. Some may say, “You mean if I am overweight and have symptoms of IBS,  I have inflammation... the same inflammation that could lead to other chronic conditions?” The answer is yes! 

Take a look at this image to find out how this affects our digestive system. 

Image found at: http://lyndabuitrago.com/stress-and-your-gut-part-2/

Inflammation over time damages the lining of our gut. The folds of tissue you see in the healthy intestinal lining increase the square footage of our intestines, helping to absorb all the nutrients found in food. Notice how they are virtually gone in the damaged gut, leading to poor digestion and, over time, something called leaky gut syndrome. This is where the bad news enters the scene… when our cells become leaky, they allow particles, allergens, bacteria, and other offenders to pass through into our system where it can cause many unwanted side effects.  

How does this relate to lactation? 

The cells that line our gut are the same types of cells that make up our milk-making factory! How does this relate to allergy and sensitivity risk, you ask? For some women with chronic inflammation or leaky gut syndrome, this inflammation is present within their milk making cells, allowing whole proteins and antigens to pass through their milk to their baby. 

Now, let’s stop here and point out that even with this undesirable process, breastfeeding your baby is still the best choice to make for your little one. Know why? Some studies are linking maternal gut health with baby gut health, meaning that mom’s gut environment develops and establishes the baby’s gut en utero, as well as throughout lactation. So even before feeding your baby, his/her gut cells may be predisposed to this inflammation. 

But wait; don’t throw in the towel just yet. We have something on our side… the most amazing food known to man, one that’s easily digestible and equipped with anti-inflammatory, antibacterial, antiviral, and antifungal properties. What am I referring too? Breast milk! There is no other source of infant nutrition that can compare to the powers of breast milk, making it the best food to aid in the growth of a healthy immune and digestive system.

Still worried? Take a deep breath because all of this can be reversed. With good nutrition, you can make your way back to being the hospitality queen… renovating your gut environment to serve your microbial ‘guests’ the best food and provide the strongest cells for their home. Strengthening your microbiome and reducing inflammation will get you and your little one on the fast track to improving your gut health and overall wellbeing.

I am in! Now what do I eat? 

Improving your diet can begin with 3 simple steps. 

First, begin boosting your microbiome of good bacteria by consuming probiotics in the form of fermented foods such as kefir, kombucha, sauerkraut, tempeh, kimchi, and more. If these foods do not appeal to your palate, find a probiotic supplement that contains many strains and species of bacteria and take on a daily basis. Remember to check with your doctor before using supplements. 

Second, increase the fiber rich foods in your diet via fruits, vegetables, and whole grains. Why do you ask? First, fiber, also sometimes called prebiotics, is the ‘food’ that feeds your good bacteria. Once we place them in our digestive system, we must feed them! Additionally, fiber helps to regulate our digestive system, allowing bowel habits to improve and, therefore, reducing inflammation caused by constipation. 

Lastly, monitor the fats you are consuming on a daily basis. Focus on consuming healthy fats. Omega 3 fats are known to reduce inflammation and improve the health of our cells. This can be found in foods like salmon, walnuts, rice bran or olive oil, flax seeds, etc instead of the omega 6 and saturated fats found in the abundance of processed foods we find on our grocery store shelves.  Guess what? The fats you choose to consume reflect the fats found in your milk and en utero! That’s right, if you increase the omega 3’s found in your diet, you will directly increase the amount in your baby’s diet. This special perk can increase the retinal development in your baby’s eyes, as well as increase cognitive development for your baby’s brain! 

Next month, don't miss Lindsey's next article about elimination diets: when they are needed and how to do them. 

Want to find out more? Visit www.angelfoodlactationandnutrition.com to schedule a Skype consult with Lindsey and begin your journey toward better health and a happier baby today! 

Want to stay connected between posts? Find Angel Food Lactation & Nutrition on Facebook at www.facebook.com/angelfoodlactationandnutrition for current articles, events, fun discussions and more!

Does your baby react to the foods you are eating?  

Have you tried fermented foods and a high fiber diet to help heal your gut?

A Resolution to the LA Fitness Nursing in Public Harassment Incident

Last month I shared a story about how a breastfeeding mother had been involved in a nursing in public harassment incident at a local LA Fitness.  During this incident, Monique Golueke was told that her only option for breastfeeding in the Oceanside LA Fitness facility was in the Kids Klub restroom.  After some media coverage, a nurse-in, and several cordial email exchanges between the San Diego Nursing in Public Task Force and Jill Greuling (Vice President of Operations for LA Fitness), I am elated to report that we have come to an incredibly positive resolution!  

Today, I received an email from Ms. Greuling, stating that the following memo will pop up for every LA Fitness employee in California when they log on June 5th, requiring an acknowledgement that they read and understand the information contained in the memo:

"According to California Civil Code, section 43.3, “Notwithstanding any other provision of law, a mother may breastfeed her child in any location, public or private, except the private home or residence of another, where the mother and the child are otherwise authorized to be present.”  To accommodate breastfeeding women in LA Fitness facilities, staff members may recommend reasonable places for her to do so, such as the foyer, the sales area or in the Kids Klub. It is not reasonable to tell a woman that the only place she can breastfeed her baby is in the Kids Klub restroom."

The San Diego Nursing in Public Task Force would like to commend Monique Golueke and Ms. Greuling for having the initiative to take tangible, practical actions that will prevent any incidences like this from happening in the future.  We are thrilled we were able to collaborate with her to bring forth such a positive resolution.

Defining my Breastfeeding Experience: Inclusive Breastfeeding

Written by Aran Tavakoli

It has been nine months and I just put away my pump. Getting it ready for storage was bitter sweet. How many hours have I spent with that machine in the past 9 months? Its usefulness outweighed the annoyance.  Once again, at this point in time, I am redefining my breastfeeding relationship with my baby. 

Breastfeeding has been an extraordinary journey. I have experienced and learned so much. I keep searching for a word that captures and defines my experience, but I can’t find one. I believe the breastfeeding community is actually missing a term for mamas that fall into their own camp. There is the exclusively breastfeed group and the formula group. Research often distinctly divides mamas and babies into these two groups. But, there is an ever-growing group of mamas that breastfeed and give formula to support their breastfeeding relationship with their baby. The current words used to describe this group include combo feeding or more commonly, low supply needing supplementation. 

From the true definition, I do not "exclusively" breastfeed my baby. However, I do exclusively give my baby all the breast milk that I have.  But he needs more to be happy and healthy, so he also receives formula and when he was really little, he received donor milk. Honestly, I am so tired of the “low supply” conversation, I wish there was a different word for how I feed my baby. A word that matches the pride of the mamas who do exclusively breastfeed their little ones all that they produce.  

Per Merriam-Webster, ‘exclusive’ is defined as, “not shared: available to only one person or group.” ‘Inclusive’ is defined as, “covering or including everything: open to everyone: not limited to certain people.” 

Thinking about it, I have never been an exclusive type of person, so the opposite of exclusive is inclusive. I have inclusively breastfed my baby for 9 months (way longer than I would have thought in the beginning!). This is the word that I am using to define my breastfeeding experience. 

In the inclusive camp, mamas know the best and worst of both worlds. The best of breastfeeding includes that joys of nourishing your baby with your body and making personalized milk. Then there is the best of formula: the intervention that provides life saving nutrition to support healthy growth and development. The worst of breastfeeding includes the sometime difficulties: mastitis, plugged ducts, yeast, blebs and so on! On top of breastfeeding, there might also be pumping, all the equipment and time that is required. For formula, besides the cost, the worst includes the bottles to be cleaned, sterilized and cleaned again. 

In the inclusive camp, the mamas are incredible as they work so hard to maintain their milk supply for their little ones, while also accepting help in the form of formula or donor milk. It is not one way or the other, it is all the ways: the breastfeeding, the pumping, the supplementing, the love, the dedication, the tears and the sweat (especially on hot days)! The inclusiveness of the experience. 

I don’t want to use a breastfeeding definition that makes mamas feel bad that their milk supplies are low (I worked through that one) or that they feel badly for needing to use formula (I worked though that one, too). Saying that, 'I inclusively breastfeed" is so much more positive and empowering than saying, "I have low supply and need to supplement." My lactation consultant, Ashley, always said to me, “He is getting your milk.” That has become my motto. He’s getting my milk, the amount doesn’t matter, and he is getting my milk.

So...Mamas who Inclusively Breastfeed, shall we adopt a new term?

You Know You Are a Breastfeeding Mother When...

Cyndi: You have to plan your work meetings around your pumping schedule.

Sherry: You walk around the house for a few minutes before realizing you never put your boob away.

April: All your shirts open in the front.

Amy: You go to run a 10k and pack your pump as part of your post-race routine.

Kelly: Every shirt you own had a stain from leaking over one or both breasts.

Amy: You workout and apologize to your friends for smelling like a mixture of sweat and milk due to random let downs.

Dana: You are happy to have limo tint on the back windows of your car because you spend so much time pumping in the back seat.

KC: Your husband wakes up to a ‘peep show’ and you’re passed out.

Christine: Your knit shirts are all stretched out because of your toddler reaching down and grabbing for self service.

Bethany: You feel your boobs all day to see which one needs to be nursed from next.

Angelique: You fear the mailman has had a free peep show, but you don’t even care.

Melissa: You question how much milk spillage is acceptable on a shirt before you change it.... and the answer is A LOT!

Ruthii: When sitting next to you becomes a splash zone.

Jennifer: You catch your toddler breastfeeding her dolly.

Jennifer: You walk out the front door and reflexively grab your chest to make sure your boobs aren’t hanging out!

Julie: When you cry over spilling an ounce of milk on the counter.

Suzanne: You use your milk as a cure everything from sunburns to eye and ear infections. Breast milk is the equivalent to Windex from the film "My Big Fat Greek Wedding."

Ashley: You’re excited for a date night because it means you don’t have to choose your clothes based on which are the easiest to take off in public.

Jacqueline: Your boobs are often lopsided.

Alethra: When hunger, tiredness, getting hurt, or any other dilemma is solved and smoothed over with whipping out the boob.  Problem solved!

Brittany: You’re in public and when you hear a baby start to cry, your first thought is, “Oh, man!  I hope I put on my breast pads today!”

Angela: When you bring your breast pump on your Vegas trip and plan everything around your pumping schedule.  Times have changed!

Advocating When Your Baby has a Tongue or Lip Tie

To help parents understand a bit more about how tongue and lip ties can affect breastfeeding, over the next few weeks we will be featuring stories from moms whose babies experienced these challenges.  We would like to extend a HUGE thank you to the brave mamas who submitted their stories for our blog!  We know you went through a ton of challenges and we are so appreciative that you were willing to share your stories!  If you have a story you would like to share on our blog, please send it to robinkaplan@sdbfc.com.

For more information about tongue and lip ties and how they can affect breastfeeding, please see our article: Does Your Baby Have a Tongue or Lip Tie?

_____

Written by Kimberly Berry

I am often referred to as a "boob nerd" by many friends. Articles, research, blogs....anything breastfeeding related always interested me. I absorb the information like a sponge. Sharing and helping moms with nursing just came naturally. I never heard of tongue or lip tie though until I was pregnant with my second. A few things I read made me wonder if some of the struggles I had with my daughter were due to a possible tongue/lip tie in her. She had self weaned recently though, so I never gave it much more thought. That reading on tongue ties proved to be invaluable to me in just a few short months however.

My handsome baby boy came flying into this world at 5:01pm on a Friday afternoon. The moment he was handed to me after his birth, I saw it glaring right back at me as he cried and took his first breaths. A tongue tie. His frenulum stretched all the way to the tip of his tongue. I kissed and nuzzled him close to calm him, warm him. Once calm, I looked at my husband and said, "He has tongue tie." My husband, confused said, "..ok?" not knowing what I knew. Not knowing how that can affect breastfeeding. Not knowing the possibility for pain and injury for me while nursing our second child. The nurse nearby heard me and chimed in to say "Oh, it's just a small one, no worries!" I told her I wanted to see a lactation consultant. She nodded her head and continued on with her work. 

I then began the process of trying to get him to latch for his first feed, although I knew that it could quite possibly be as bad, or even worse than the pain I just endured to bring him into this world. He was disinterested. So we snuggled and I tried every five minutes or so. Finally, 45 minutes after his birth, he latched. I unlatched and relatched him over two dozen times before it felt even remotely close to ok. I asked again to see the lactation consultant on staff. I did breast compressions and massage to help encourage colostrum into his little mouth that he was trying so hard to get to work correctly. Becoming annoyed, I would then ask every person that came into my room to bring me a IBCLC. I was met with "Yes, sure thing!", "You are on the waiting list", "Your nipples are just too big for his mouth"... I could go on and on with the excuses I heard the rest of that day and overnight. We struggled through each feeding. He was frustrated, and so was I. When he cried, his tongue looked like a heart. My heart broke that this was going on and help was seemingly out of reach. 

Finally, at 9am the next day, a IBCLC stopped in to "see how breastfeeding was going." I told her that I had been asking to see a lactation consultant since his birth the evening before. Shocked, she said she was not made aware we needed her. We discussed for several minutes how crucial nursing support is to new mothers and who she was going to speak with about the situation. I made my notes on who to contact as well  as who to advise of the lack of proper treatment. Then we got down to the business at hand. She agreed immediately that my son had a tongue tie, and not "just a small one" as the nurse had called it. She called right then for the ENT to work us into the schedule immediately to have it clipped. Unfortunately, we were knocked back on the list several times due to other emergency surgeries that day. While I am a patient person, I was becoming angered that the fact that my child was having trouble eating was not a concern to most of the staff. 

The next day, the day of our discharge, arrived and we were still muddling through feeds. I was starting to become very sore. Again, we were told time after time that we were next in line for his procedure, only to be knocked back again by an emergency surgery. How many emergency surgeries were there?! How many other new mothers were waiting for the same help I was??? The IBCLC I had spoken with the day before was not working. The other IBCLC couldn't get to us until that afternoon. Our nurse was sympathetic, but said this seemed to be typical of the weekend. Finally, I said enough is enough and took matters into my own hands. I looked up the ENT my daughter sees. Being a Sunday, the after hours line was activated. I left a message to see if anyone could call me back to let me know if they preformed frenulectomies on newborns. Thankfully, a sweet nurse called me back after about 5 minutes. She said that they did do the procedures, but I would have to call back in the morning for a appointment. 

We left the hospital and never looked back. I bared through the pain of the feedings until that appointment with the ENT the next afternoon. The frenulectomy was not easy to watch, but it helped so much. When he nursed when it was over, I could tell a difference, not a huge one immediately, but enough that I didn't wince up and have tears in my eyes the whole time. We only had to relatch six times instead of more than a dozen times. Each day thereafter, nursing was getting better and better. We practiced the exercises and I continued trying to heal my nipples. After several days, he started gaining weight and I was settling into being a mommy of two. Nursing became a joy again. Something I once again looked forward to. It was now my time to look in awe at my newborn and be proud of my body’s amazing ability to grow this perfect being and now continue to nourish it. 

Without a doubt, if I didn't know anything about breastfeeding or tongue ties, I would have thrown the towel in and given up. It was clear for me to see why so many new mothers do. In a mom’s group I help with, I constantly tell new mothers to check for tongue/lip ties. Even if someone says there isn't one, or if its minor and won't affect breastfeeding, know how to look yourself and find someone who will help you. You have to be your own advocate. Your babies advocate. We look to these medical professionals to guide and help us. Unfortunately, sometimes that's not always the case. It's crucial for them to receive the proper training, listen to their patients, and have resources available to help mothers and babies. It's crucial for mothers to be determined, educated, and supported. All of these things go hand in hand for successful breastfeeding. My son went on to nurse until he self weaned at 13 months.

I’ve Had My Baby - Now What? Breastfeeding During Weeks 3-6

Welcome back to our new series, I’ve Had My Baby - Now What?  This is a guide with basic information to help you navigate the first days, weeks, and months of breastfeeding your new baby.  

Today we’d like to talk about weeks 3 through 6 of your baby’s life, and what breastfeeding looks like.  What can you expect for normal behavior from your new baby, and when do you know there’s a problem that you should seek professional help for?

What does normal breastfeeding look like in weeks 3-6?  How often should my baby be eating, and how long should feedings take?

It’s extremely common for babies at this age to still want to feed frequently, every 2-3 hours.  Some *may* become more efficient and take in more at feedings and start to space them out a bit more, but don’t fear if your baby hasn’t done this yet!  Feedings may start to speed up as mom’s milk volume is higher and baby has had good practice breastfeeding, but again, don’t worry if your baby still feeds at the breast for as long as he/she did in the early weeks.  It can take some time for mom and baby to really get their groove and you may still be working out some kinks during weeks 3 through 6.

How much weight should my baby be gaining at this age?  How will I know if he/she is getting enough when I’m not seeing my pediatrician as frequently for weight checks?

Up to 4 months of age, we expect babies to gain .5-1 oz/day, or 4-7 ounces a week.  There are many ways other than weight to be sure that your baby is getting enough milk.  If your baby is having plenty of wet and soiled diapers each day, and generally seems content after feedings for two hours or more (outside of growth spurts and cluster feeding periods), you can feel good that he/she is probably getting enough.  If you want a little more concrete evidence, a great way to track your baby’s weight is by attending a free weekly breastfeeding support group.  There will often be a scale there to weigh your baby, you can do test weights to see how much baby is taking during that feeding, get help from a lactation consultant or educator, and, the BEST part, meet and connect with other moms.

Can I give my baby a bottle now?  If so, who should give it and how often should they do so?

 Once breastfeeding has been established, weeks 3-5 are the perfect time to introduce a bottle to your baby if you’d like them to take one.  It’s normally best that someone other than mom gives the baby the bottle, as babies often associate mom with breastfeeding and may refuse a bottle from her.  Plus, often times, partners and grandparents have been waiting for their moment to participate in the feeding of the baby.  We recommend that mom start pumping after week 3, once a day or so, to start to save up milk for that first bottle.  2-3oz is an appropriate amount to start with.  Be sure that the bottle is fed to the baby in a breastfeeding friendly manner.  If mom is going back to work, we recommend that baby receives a bottle on a somewhat regular basis, a few times a week, so that he/she remains familiar with it.  Plus, mom should pump every time baby receives a bottle to maintain her milk supply.

My baby is inconsolable for a few hours in the evenings.  Why is this happening and what can I do?

Many babies have a “witching hour”, or as I like to call it, “an unhappy hour”.  The term is a bit misleading as the behavior normally lasts for more than an hour!  It occurs most frequently in the late afternoon/evening hours.  Babies are often fussier than normal during this time, and want to eat often.  And while they want to feed often, they may pull off more frequently as well.  There are a number of theories as to what causes this fussiness at this time.  They may be feeding often to “tank up” on calories before taking a long sleep (sounds wonderful!).  They may be overstimulated from their day and having a hard time winding themselves down.  This is often a busy time for the entire household, as partners are home from work and older siblings may be home from school.  Best thing that you can do during this time is to offer the breast often.  Learning to nurse in a baby carrier can be a lifesaver as it will allow you to be hands-free while the baby is snuggled, fed, and comforted.

How will I know if my baby is colicky?  Is this the same as the ‘witching hour?’

Many parents confuse normal fussy behavior for colic.  Colic is defined as 3 hours or more of crying, 3 or more times a week, for 3 or more weeks in a row.  It normally resolves itself around month 4.  If your baby’s crying looks like this, he/she may have colic.  There are no definitive cause for colic, but it could be related to gut issues due to food sensitivities.  The “witching hour” is the period of time of day when your baby may seem unusually fussy, normally lasting for a couple of hours. This behavior peaks around 6 weeks and then often starts to fade.

If I am still having a challenging time building up my milk supply at this time, have I missed the window for increasing my milk supply?

Not at all!  Depending on the reason for mom’s low supply, there are plenty of things that can help boost  supply at this stage.  The most important thing is to learn why mom is struggling with her milk supply.  As always, lots of good breast stimulation is best - either from a baby or a hospital grade pump. There are also herbs and medications that are available that can help boost supply as well.

There may be times when things aren’t going the way they should.  If you find this, please contact an International Board Certified Lactation Consultant to help you.  Some signs that you might need some additional help:

• Sore, cracked, bruised, or bleeding nipples.

• Baby is gaining less than 4oz per week.

• You suspect your baby may be tongue-tied.

• Painful, recurrent engorgement.

• Oversupply.

• Baby is having problems stooling.

• Overly gassy, fussy, or colicky baby.

• Breast infection - mastitis, abscess, or thrush.

For  more information about what normal breastfeeding looks like in the first few weeks, check out our article,What Every Mom Should Know About Breastfeeding During the Early Weeks, which highlights our brand new brochure!  Also, check out Ashley as she discusses more tips and tricks for breastfeeding during weeks 3-6 on the Boob Group episode, New Mom Breastfeeding Manual: Weeks 3-6.

Mother Kicked Out of LA Fitness for Breastfeeding in the Locker Room

It happened again in San Diego!  How is this possible?  Another nursing in public incident that clearly violated California state law!  An incident where a mother felt violated and shamed for nursing her baby in a public place.  Another reason that reinforces the need for our San Diego Nursing in Public Task Force.

Here is Monique Golueke’s story, in her own words. 

"It had been over a year since I had been to the gym and after what happened today, it's not likely I'll be returning, at least not to LA Fitness. I was so excited to attend a step class alongside one of my best gals.

On April 22, 2014, I reinstated my membership, paid the fees, and signed my boys up for the unlimited Kids Klub pass. Forty-five minutes into our class, I was notified that the boys had been crying and they weren't able to settle down. I swooped them up and took them directly to the ladies’ restroom/locker room where I washed both of their little hands. My 9-month old still seemed upset so I decided to nurse him while my toddler sat next to me and played with my phone. About five minutes later, I was approached by an LA Fitness employee.  She told me that we needed to leave and that children were not allowed in the locker room.

I explained that I was nursing my son and she responded by saying that since I was new I probably didn't know the rules. She told me that an "elderly" woman had complained. Upon signing back up for the gym, there was no mention of the rules regarding the children.

When approached, I felt completely mortified, embarrassed and ashamed. I asked the employee where I should be nursing and she told me that there was a bathroom located in the kids club. Escorted out I felt embarrassed, ashamed and humiliated.  Keep in mind that there are no signs posted stating that children are not allowed in the ladies’ restroom/locker room. My intention was to nurture and care for my children in a safe and friendly environment.

Escorted me out-what now?

They were more than happy to accept my money, then send me on my way.

I decided to call corporate and notify them of what happened and also have my account deactivated, I also asked them to refund my money. They were apologetic and handled the situation by having the manager from the Oceanside location contact me.

The manager called me and asked what had upset me: the fact that I was breastfeeding or the fact that the kids were in the locker room. I barely understood what he was asking. It was clear he didn't understand the legality of the situation. He told me that if I ever wanted to return to LA Fitness, I was welcome to nurse my baby in the restroom located in the Kids Klub.

I'm not positive but I think the only place to sit in the restroom that he was referring to is on the toilet. 

At that point, I decided to again contact Corporate and inform them of the absurd conversation I had with the manager.  They were apologetic and explained that if they needed to contact me they would. The conversation was strange and at this time I was heated and enraged. The woman didn't really say much."

After Monique shared her story in a private Facebook group, women from all over San Diego county banded together to organize a peaceful nurse-in in front of the Oceanside LA Fitness, showing their support for Monique as well as upholding a mother’s right to nurse in public.

Click here for the video from ABC 10 News showing the Nurse-In at LA Fitness.

Jill Greuling, Vice President of Operations for LA Fitness, issued this statement to 10News: 

"We support the right of women to breastfeed in our facilities. When Mrs. Golueke voiced her intention to do so to one of our staff, she was offered space in the Kids Klub or, as an option, the separate restroom within the Kids Klub and a chair if she wanted more privacy. The staff member initially spoke to Mrs. Golueke to let her know that children are not allowed in the locker room area. This conversation occurred because another member observed her in the locker room with small children and reported it to us.”

Unfortunately, this statement is untrue.  Monique was ONLY offered to breastfeed in the Kids Klub restroom and that is a significant problem.  The CA law states that a women is allowed to breastfeed her child, anywhere she and her child  are authorized to be.  If children are in fact not allowed in the locker room at LA Fitness, then the law doesn’t protect Monique in that area of the gym.  The issue is with the statement from the staff member who recommended that Monique breastfeed her baby in the Kids Klub bathroom.  This is not an appropriate place to breastfeed a child.  It is unsanitary and demeaning.  It is important for all LA Fitness staff to know that this is not an appropriate recommendation and that, instead, mothers should be alternatively told that they may breastfeed in the lobby or in a comfortable spot in the Kids Klub.

At this time, the San Diego Nursing in Public Task Force is sending a letter to the LA Fitness Corporate office kindly requesting that they create a breastfeeding-supportive policy statement for their members, including a list of appropriate areas where mothers may breastfeed their children in their facilities (not including a bathroom.)  We will also be offering language that they can share with their staff members on how to kindly respond to a mother who is breastfeeding her child in a place where her child is not authorized to be.

We will keep you posted!