I received a video today from a fellow Bosom Buddy of her son nursing.  It was so precious, genuine, and simplistic in it’s beauty.  It reminded me of this video I came across years ago and had shared with the group way back when.

I am an active member of the Monmouth/Ocean Breastfeeding Consortium and the group’s webmaster (being the self-proclaimed geek of the group).  Recently we updated our Breastfeeding Guide; Getting Started (formerly known as the Breastfeeding Resource Guide); the revision was a true group effort.  The guide was created to help families get breastfeeding off to a good start in the first few days and weeks of breastfeeding.  The guide is cut and pated below or you use this link for a PDF copy to print out and bring with you to the hospital, http://www.njbreastfeeding.org/files/Download/MOBC%20Breastfeeding%20Getting%20Started%20March%202012.pdf

The Monmouth/Ocean Breastfeeding Consortium

Breastfeeding Guide

Getting Started

1. Getting Started

o Within the first hour of life, holding your baby skin to skin and allowing your infant to latch on his own can help get breastfeeding off to a good start
o When latching and positioning your baby at the breast start by holding your baby close with the baby’s nose close to your nipple
o Stroke the baby’s mouth with your nipple, waiting for them to open their mouth in a wide gape
o When they open wide, guide the baby in towards your nipple, pointing the nipple slightly up towards the top half of the baby’s mouth (with more of the areola, the dark area surrounding the nipple, in the baby’s mouth below, near the chin. More areola will be visible above, near the nose, than below)
o The baby’s chin should be against your breast when latched
o A good latch should feel comfortable with no pain; however, in the beginning it is not uncommon to feel some discomfort when the infant first latches. If there are more than a few moments of discomfort, or if he is suckling only on the nipple, break the suction with your finger, remove the baby, and try again. Several tries may be necessary. The nurse or lactation consultant can help.

2. How often to feed

A new baby needs to nurse at least 8-12 times in 24 hours. To breastfeed successfully, it’s important to nurse whenever the baby is hungry. Usually this works out to a feeding every 1 ½ -3 hours from the start of one feed to the start of the next, but often is erratic and can’t be timed. It’s best not to try to feed at scheduled times. Some babies like to bunch/cluster several feedings into only a few hours, and then may take a longer nap.

3. How to tell when your baby is ready to feed

Follow your baby’s lead; watch and listen for feeding cues:

o Sucking movements of mouth and tongue
o Restlessness or increased body movements, especially hand to mouth movements
o Opening their mouth wide and turning head (rooting)
o Small sounds
o Watch for feeding cues, even if he is asleep
o Crying is a late hunger sign, so try to feed him before he starts to cry

These signs mean the baby is hungry and wants to feed.

4. How long on each side

Leave the baby on the first breast until he will no longer suck and swallow when you massage the breast or stroke his cheek. Then nurse on the other side if he is willing. It’s fine to nurse on just one breast per feeding if your baby is satisfied. Let the baby decide when the feeding is over – he will let go on his own and probably fall asleep. It is good positioning and not limits on the amount of time your baby need to nurse that prevents soreness.

5. How to know when your baby is swallowing

In the beginning your baby should swallow after every few sucks. He’s swallowing if you:

o Hear him swallow (this may be hard to do in the early days of breastfeeding)
o See him swallow
o See or feel his throat move; try placing a finger gently on his throat to see if you feel movement
o See a change in sucking pattern from fast, shallow sucks to longer, deeper sucks where the jaw moves and there is a pause before they take their next suck

6. How to manage engorgement

Many women find their breasts may feel very full, warm, and sore starting on day 2 to 5, within the first week of nursing (while others may notice little change). This is a good sign that your mature milk is coming in, but may leave you temporarily uncomfortable and discouraged. This will pass in 24-48 hours.

o Nurse often, a minimum of 8-12 feedings in 24 hours; don’t skip feedings.
o You may need to soften the nipple and areola to make it easier for your baby to latch
- Place your thumb and fingers on the lighter skin area just behind the areola; the areola is the darker area surrounding the nipple
- Press back toward your chest wall
- Press fingers gently together, keeping them just in back of the areola
- Rotate fingers and repeat
o Apply cold packs between feedings to reduce swelling

7. Breastfeeding without schedules, whenever your baby wants without adding extra foods such as water or formula is important in the first 3-6 weeks

Healthy, full-term babies do not need bottles of water or formula unless there is a medical reason. The first milk, colostrum, is the perfect food for your newborn, and is present in just the right amount. A newborn baby’s stomach is about the size of a marble, growing to the size of a shooter marble by day 3 and a golf ball by day 10 of life. Bottles flow too fast and give the baby too much milk. They may interfere with the baby’s learning to breastfeed and with your milk supply. If your baby needs additional breastmilk or formula for a medical reason, using expressed breastmilk is preferred. Talk to your nurse and lactation consultant about your feeding options; they can also provide special help in getting him back to the breast.

Each time your baby nurses, he “talks” to your body, telling it how hungry he is and how much milk he needs. Your body “listens” and responds hormonally, making the right amount of milk. If schedules or bottles interfere, your body may not get the milk supply right.

Once breastfeeding is well-established, generally between 3 and 6 weeks, an occasional bottle of pumped breastmilk may be introduced without compromising breastfeeding. Every time you breastfeed, milk is removed from the breast, giving your breast a chance to make more milk for the next feeding. If you miss a chance to breastfeed, it is important to remove the milk from your breast using a breast pump, so that your breasts can continue to keep making more milk for the next feedings. The American Academy of Pediatrics (AAP) recommends just breastmilk for the first 6 months for maximum protection against allergies and illnesses.

8. How to store your milk
Milk Storage Guidelines*
Room Temperature 60-85ºF 3-4 hours optimal, 6-8 hours acceptable
Refrigerator 39º F 72 hours optimal, 5-8 days acceptable
Freezer 0ºF 6 months optimal, 12 months acceptable

o Use a clean container (baby bottle, plastic nurser bag)
o Label with date of the first milk placed in the bottle. You may add more milk to the bottle but if the milk is frozen, you need to chill the newly expressed milk in the fridge before adding it to already frozen milk
*Human Milk Storage, Academy of Breastfeeding Medicine, Retrieved February 27,2012 from http://www.bfmed.org/Media/Files/Protocols/Protocol%208%20-%20Eng lish%20revised%202010.pdf

9. Where to get help if you have problems with breastfeeding after you leave the hospital

Your physician or nurse will give you a list of local resources for breastfeeding support or you can visit the Monmouth /Ocean Breastfeeding Consortium website to find a list of local resources, http://www.njbreastfeeding.org/

10. How to tell if your baby is getting enough milk: The number of wet and soiled diapers can help you determine if your baby is getting enough milk.
o The chart on the last page will be your guide for the first week
o If your baby has at least the number of feedings, the number of wet diapers, and the number of soiled diapers listed on the chart for each day, he is getting enough
o After day 7, your baby should continue to have at least 6 wet diapers and 3 bowel movements every 24 hoursBy the second month, the pattern may change to fewer daily bowel movements

Is the diaper really wet? It may be difficult to tell if a disposable diaper is really wet – putting a clean white tissue in each new diaper will help you know when the baby has urinateCALL YOUR HEALTH CARE PROVIDER IF BABY:

HAS FEWER WET OR SOILED DIAPERS THAN SHOWN ON THE CHART NURSES FEWER THAN 8 TIMES EVERY 24 HOURS SLEEPS MOST OF THE TIME AND IS DIFFICULT TO WAKE UP FOR FEEDINGS

OR IF MOM:
• HAS BREAST ENGORGEMENT WITH FEVER, CHILLS, AND FLU-LIKE SYMPTOMS

The Monmouth/Ocean Breastfeeding Consortium

DAILY BREASTFEEDING RECORD

Baby’s name____________________________________ Date & time of birth________________________

• Cross off the hour (or in between) each time the baby nurses
• Cross off a W each time you change a wet diaper
• Cross off an S each time you change a soiled (poopy) diaper
• If you cross off all the W’s and S’s for each day, and meet the goal for each day, you’ll know that your

baby is getting enough breast milk

GOALS:

Day 1	AM12 1 2 3 4 5 6 7 8 9 10 11 PM12 1 2 3 4 5 6 7 8 9 10 11 Wet diapers: W Soiled diapers (black, tarry meconium): S	Breastfeed as soon as possible Keep baby in the room with you Keep baby skin to skin as often as possible No bottles or pacifiers
Day 2	AM12 1 2 3 4 5 6 7 8 9 10 11 PM12 1 2 3 4 5 6 7 8 9 10 11 Wet diapers: W W Soiled diapers (black or brown stool): S S	Nurse often: 8-10 times/24 hours Keep baby in the room with you Keep baby skin to skin as often as possible No bottles or pacifiers
Day 3	AM12 1 2 3 4 5 6 7 8 9 10 11 PM12 1 2 3 4 5 6 7 8 9 10 11 Wet diapers: W W W Soiled diapers (green or yellow): S S	8-12 nursings Breasts feel full as colostrum begins to change to milk Keep baby in the room with you Keep baby skin to skin as often as possible
Day 4	AM12 1 2 3 4 5 6 7 8 9 10 11 PM12 1 2 3 4 5 6 7 8 9 10 11 Wetdiapers:W W W W Soiled diapers (loose yellow): S S S	8-12 nursings Breasts may feel full as colostrum changes to milk
Day 5	AM12 1 2 3 4 5 6 7 8 9 10 11 PM12 1 2 3 4 5 6 7 8 9 10 11 Wetdiapers:W W W W W W Soiled diapers (loose yellow): S S S	8-12 nursings
Day 6	AM12 1 2 3 4 5 6 7 8 9 10 11 PM12 1 2 3 4 5 6 7 8 9 10 11 Wetdiapers:WW W W W W W Soiled diapers: S S S S	8-12 nursings
Day 7	AM12 1 2 3 4 5 6 7 8 9 10 11 PM12 1 2 3 4 5 6 7 8 9 10 11 Wetdiapers:W W W W W W W Soiled diapers: S S S S	8-12 nursings Feeling confident with breastfeeding

I have been following the news stories about brown rice syrup containing arsenic since mid February; the uproar was based on a recent Dartmouth study linking brown rice syrup with high arsenic levels.  Here is more information, http://todayhealth.today.msnbc.msn.com/_news/2012/02/16/10425025-high-arsenic-levels-found-in-organic-foods-baby-formula

“Organic brown rice syrup is often used as a substitute for high fructose corn syrup in prepared organic foods. One of the infant formulas tested contained twice the inorganic arsenic allowed in drinking water, according to Environmental Protection Agency standards. One cereal bar contained 12 times the legal limit for drinking water of 10 parts per billion (ppb). High-energy foods tested had 8 to 17 times the limit.

I wanted to learn more and see if any formal statements or recalls would ensue, but it appears that rice contamination with arsenic may not be a “new” problem.

For those unfamiliar with the issue, here is a nice synopsis from Natural News, http://www.naturalnews.com/035010_arsenic_baby_formula_brown_rice_syrup.html.  How much arsenic is safe (I know–what a DUMB question) but it appears that there are no regulatory limits for food (only water levels) here in the US.  Brown rice syrup (a substitute for high fructose corn syrup) is commonly found in “organic” items–can formula be organic?  Isn’t the whole idea of formula artificial in nature.  I mean no disrespect to those that use formula or use “organic” formula–I am merely pointing out the issue with semantics.  The word Formula implies a chemical formulation. When it comes to infant feeding, isn’t the only truly organic option Human Milk?

For now, there does not appear to be any “formal” statements or recommendations regarding the use of this formula.  Personally I would reserve using any infant formula with the main ingredient “brown rice syrup” until more information becomes available.

Yesterday, the American Academy of Pediatrics (AAP) reaffirmed their Breastfeeding Policy, Breastfeeding and the use of Human Milk (abstract below), 2012. In 1997 the AAP wrote a strong evidenced based policy on Breastfeeding and strengthened the policy  again in 2005; the 2012 update is the newest version.  The policy was well received in the field of lactation and by those who are supportive of breastfeeding; although, 15 years has gone and we still face many of the same issues and obstacles in our culture and in our medical community.  Where other policies written and adopted by the AAP seem to be considered “gospel” and are strictly adhered to by all in the medical profession, the Breastfeeding Policy is not given the same regard.

Whether it is the high use of supplementation (the lack of support and encouragement for exclusivity), the disregard for evidenced based medicine (i.e.. formula is just as good as breastmilk), or any of the many other issues that still exist–it is the inability to support parents who choose to breastfeed that is our biggest concern.  Parents have gotten the message that breast is best – they want to breastfeed, but they need SUPPORT.  They need good evidenced based care, encouragement, and someone who is willing to help them overcome any obstacles they face.  Unfortunately, many mothers claim one of their biggest obstacles is the health care provider.  How can that be?  Why?

Health care providers have the opportunity to make such a positive impact on breastfeeding, but all it takes is one phrase or intentional “tone” to derail breastfeeding.  For example:

Mom at  office says: I don’t think I am making enough milk.  My baby is hungry all the time.  He eats for 45 minutes and then wants to feed again in an hour.  I don’t know what to do.

Health care provider (Dr/Nurse/Midwife, etc): He eats for 45 minutes (said in accusingly tone–not expecting an answer, but letting mom know that 45 minutes is absurd–she must be doing something wrong)?  Well that is a lot of feeding, perhaps you should offer formula after each feeding; it sounds like he is still hungry (not only is this advice not evidenced based it is harmful and will likely derail breastfeeding).  If he is not hungry he won’t eat the formula (we know babies don’t turn down Thanksgiving Meals and will gladly overeat).

or another example (I really could go on all day):

Mom at office says: I am so tired, I am getting no sleep.  My baby nurses all night long.

Health Care Provider: What, they aren’t sleeping through the night (making mom feel like she is doing it wrong)?  Most babies at this age sleep……….(fill in whatever you want, but this type of advice was pulled out of you know where).

I have heard it all….the reality is our “opinion” enters into our health care advice far too often.  Many times when health care providers talk about breastfeeding our own opinions play far too great of a role.  We need to try to stick to the facts but that can be difficult.  I can’t tell you how many nurses/docs I have heard tell parents, “Well we were raised on formula and I think we turned out OK.”  The  use of “we” implying that we are alike and in it together and the “we turned out OK” implying there is nothing wrong with using formula.  Statements like that are medically negligent. They go against medical evidence and do not allow parents any informed decision making.

So where do we go from here?  I think it is great that the AAP continues to update and publish their Breastfeeding Policy; however, I think most change in perception and our culture will happen as a result of consumer driven change.  Parents are smart and savvy.  Hopefully they have read the AAP policy on Breastfeeding or books and other information about breastfeeding and when they receive advice that contradicts what the policy or newest information says, they will question it and will search out a health care provider that is supportive of breastfeeding.

Breastfeeding and the Use of Human Milk

I have spent all my spare time this week trying to organize our family photos.  No, I am not taking about the actually hard copies–they still sit in boxes in our basement.  They have been there since we moved to our house here in Colts Neck, 5 years ago.  That is a project for another day. Instead I have spent all this week trying to organize our digital photos.  All the photos we have accumulated since buying our first digital camera when our oldest was about 5 years old–that is almost 10 years of photographs that have been transferred to CDs, USB drives, online storage, from computer to computer sitting there waiting to be enjoyed.

I love my digital camera and my iPhone camera and I although I am not a “photo” person, I have accumulated almost 5000 digital photos (don’t be too impressed this number includes lots of duplicates and photos that need to be deleted)–the big question is what to do with them.  I am not a scrapbooker and although I would love to make some albums on Snapfish–let’s face it–I will never get around to it and if I did they would probably end up in those boxes in the basement.

Now, don’t get me wrong–I LOVE looking at photos but there has to be a better way to organize them.

Some suggestions for digital photos:

1) BACK UP and then BACK UP again; always have copies of all your photos/albums (I lost a laptop hard drive once and my biggest concern was the photos; thankfully I could restart the device is safe mode to retrieve all the photos)

2) Look into online storage; this can also serve as your back up

3) Find a way to organize and take the time to do it (I am using Photoshop)

4) A friend suggested making an album a year on sites like Snapfish and I thought this was a nice compromise especially if you have little ones–it forces you to weed through all the photos and pick your favorites

5) Delete those awful photos–you know the ones you would never want anyone to see, the ones with your finger in the view finder, eyes closed, unflattering by anyones standards–let’s face it you will never print them out and they are just taking space.

Do you have any other suggestions? I would love to hear them.

On a parting note, I can’t tell you how much I have enjoyed looking at each and everyone of these photos.  The memories each photo brings me is priceless.  So although I may not know what to do with my digital photographs or how to keep them organized, I do know that I am going to try to take as many photos of my kids growing up as I can because let’s face it, my memory sucks already so I can’t imagine what it will be like in 20+ years.

This article, “Can Moms with Different Parenting Styles Still be Friends” caught my eye this morning.  I think because I have often thought about this, especially when my boys were younger, and we have talked  about “judgement” in the Bosom Buddies Breastfeeding Support Group many times. We have talked about how judging other mothers and other parents can be so harmful since we all parent different. Here is a post I wrote awhile back about the harm of judging parenting in public especially when the scenario involves a child who is autistic. Since we never know the whole story and have not walked in the other parent’s shoes there has to be a better way to show support or kindness.  Even moms and dads parents differently, each with their own style, so we are bound to run into other mothers who just don’t “see it” or “do it” like we do.

Parenting can be like politics.  Everyone has their own opinion and those who deviate from your passionate stance can cause a strong visceral like response. My hubby begs me to not talk politics at parties or in any social situation because I can get “heated”.  I love debating and I can be very opinionated (and of course, my opinion is the right one [said with a smile]).  Parenting is like that; we feel strongly about our beliefs and how we choose to raise our kids.

Soooo can moms with differing parenting styles still be friends?  What do you think?

This video was released a few weeks ago and I posted it on The Lactation Lady, LLC Facebook fanpage but I want to add it to this post.  I loved this video when I saw it–I love the mom, her facial expressions and intonation of her voice are perfect.  I have said all these things at some point in time. I did not “share it” on my personal Facebook page because I know that may of my fiends would not “get it”–many of my friends think I am that “crunchy/crazy” momma and they did and do not feel the same way I do–but they are my friends nonetheless.  For all you crunchy momma out there, I hope you get a good laugh:

An article in a UK paper today caught my eye, “Women need a whole year to recover from childbirth despite the ‘fantasy’ image of celebrity mothers, study claims.”  Article here,
http://www.dailymail.co.uk/health/article-2102517/Women-need-year-recover-childbirth-study-finds.html  Quote from article:

“New mothers may be told that they will be back to ‘normal’ within six weeks of giving birth, but a new study has found that most women take much longer to recover.”

I love that they put normal in quotes because the reality is that there is no normal and NOTHING will ever be the same but I would go on to argue over the use of recovery too.  There is no recovery–instead of thinking that women need to recover, as if this was a malady or illness, I prefer to think of it as “time to adjust” or “transition”.  Time to adjust to the new “normal” or transition into the beginning stages of parenthood.

Six weeks is NOT enough time to adjust.  Parenthood is a whole new ballgame.  Giving women more time to transition into their new role, supporting them as a new mother, would benefit society as a whole.  A mother who has had time to adjust to her new role as a parent may transition more easily into a working mother’s role when compared to the mother who must return to work at six weeks.  The stress and pressure of a new mother returning to work impacts her family negatively.  The mother at six week has not fully adjusted physically or mentally—not to mention the negative effect on the breastfeeding relationship.

Wouldn’t it be nice if mothers were given a full year to adjust to “their new job”.

I have shared this video with our moms in the Bosom Buddies Support Group and on The Lactation Lady, LLC Facebook Fanpage, but I wanted to post it here for you.  I LOVE LOVE LOVE this breastfeeding promotional video created by The Bump and I hope you love it too.

In response to the Facebook “Nurse-In” that took place yesterday, we had a discussion on our Bosom Buddies Breastfeeding Support Group online boards about why would anyone want to post pictures of themselves nursing on Facebook.

The Facebook issue emerged a few years ago and recently got more press (the issue never really went away).  Here is a group established years ago to protest the removal of photos–you can look through the old photos, https://www.facebook.com/groups/2517126532/photos/ –they are very touching.

or this But this photo caused reactions that were border line ridiculous

P. S. this photo is actress Julie Bowen breastfeeding her twins (the actress from Modern Family)

or this magazine cover that caused such a controversy

Here is one of my favorites–there are many depictions of Madonna feeding her baby–whoops, she did not get the message that breastfeeding in public is offensive–where is her cover??

P.S. when we talked about this in the past, I mentioned to the moms that one of my BIGGEST regrets was not having a photo of me nursing.  I am very sad about that.  Nursing made me feel strong, powerful, nurturing, and special–I am so proud that I nursed; there is no good way to explain how important is was to me, but nothing else I have done in my life or will do can compare.  I would have loved to have a photo of me nursing one of my boys.