Breast Wishes to You!

Knowledge is Power, What the Baby Friendly Hospital Initiative's "10 Steps to Successful Breastfeeding" (Should) Look Like In Action

These 10 Steps to Successful Breastfeeding are the official guidelines for Baby Friendly hospitals to adhere to, put into place by UNICEF to ensure that more mothers and babies are able to breastfeed. They are considered to be "best practices". What we know to be true from our experience in helping new moms is that these guidelines can end up being ignored in the normal hustle & bustle of mainstream maternity care. 

And to the army of postpartum doulas and lactation specialists out there, nodding along with us, carry on! There is a lot of work left to be done.

Forget the gear- Here are the most thoughtful ways to welcome a baby and support breastfeeding!

Let's face it...these days there's a gadget or gizmo to help with every aspect of parenting imaginable. So with the holidays upon us, I felt compelled to write a list of the most thoughtful ways (and best gift ideas) to help welcome a new baby that will support new parents, and encourage breastfeeding!



1) BREASTFEEDING SUPPORT AND ENCOURAGEMENT

A breastfeeding care pack is a great gift idea for a new mom!  It's a simple, thoughtful gesture that lets your friend know you are there to support them through their breastfeeding triumphs and challenges. All you need is a basket, perhaps some pretty handmade cloth pads, rice sacks to soothe postpartum aches and pains, and maybe a beautiful nursing necklace.  And don't forget the most cherished of all- a gift certificate for house cleaning and private in-home lactation support.  These are items that help drive the point to Mom that nothing matters more than focusing her time and energy on her new baby- and you want to help her succeed at breastfeeding! I also like the idea of including a book on breastfeeding as well, such as "A Nursing Mother's Companion"  or "Ina May's Guide to Breastfeeding".


2) THE GIFT OF NOURISHMENT   

A great idea to help a friend with a new baby is to coordinate a meal train with other mutual friends.  That way the family can have plenty of meals on hand so their main focus can be getting to know their new baby instead of cooking!  Ask people to consider foods like casseroles, pastas, and soups that all freeze well and the family can enjoy at their leisure.  Remember to stay cognitive of any dietary restrictions and consider foods with lots of fresh, wholesome ingredients.  Using an online community meal train organizer such as Take Them A Meal can help coordinate the support.


3) OFFER TO BUY GROCERIES 

Sometimes it's not always easy to get a shower let alone make it out to the grocery store when adjusting to life with a newborn.  The simple act of dropping off some groceries or household items is a huge relief to someone who is trying to get their bearings as a new mom or perhaps recovering from the birth.  On your way over for a visit with the new baby, offer to swing by the store to pick up a few things.  This easy gesture will be very much appreciated!



4) HELP WITH OLDER SIBLINGS AND PETS

If the new mom is recovering from a traumatic birth or otherwise bedding-in with her new baby, she will need a little continued help when her partner must return to back work.  Offer to support the family by helping to arrange play dates, carpools, or activities for older siblings. There are great organizer sites such as Lotsa Helping Hands to set up calenders and schedules and coordinate community care giving.  If there are no older brothers or sisters, and only "fur babies", offer to maybe stop by and take the dog for a walk or clean the litter box.  

5) DON'T FORGET THE OLDER BROTHER/SISTER

It's natural for an older sister or brother to feel a little left out or even somewhat resentful when a new baby is welcomed into the home.  To them, it seems like countless visitors are stopping by to see the baby and to give the baby gifts.  This is also something that weighs heavily in the hearts and minds of second-time around parents- the feeling of being stretched too thin and worrying that older brother or sister is not getting enough attention. So, if you are planning on bringing the new baby a gift, consider bringing a little something for the older siblings so they can feel like part of the joyous occasion too!  It doesn't have to be extravagant.  But something to let them feel that becoming the older brother or sister is a wonderful and important place in their family tree!  If you are close to the family, perhaps take them to the park or out for ice cream!  It will give the kids some one on one time with someone, and the parents some alone time with the new baby.

6) DON'T EXPECT TO HOLD THE BABY

New moms can be a little tense, especially with their firstborns.  And those "Mamma Bear" instincts are starting to emerge and kick into overdrive.  Remember new parents are also getting to know their babies.  So it's not the time to be hogging the baby.  It's time to support the new family and promote precious bonding.  It's okay to ask to hold the baby, but keep your hands-on time limited to a few minutes.  Always show basic manners by washing your hands first, and at any point if the parents seem uncomfortable or uneasy, or the baby becomes fussy or tries to latch on to anything at all, it's time to pass the baby back to mama.  There will be plenty of time for you to hold the baby when things settle down and the parents have established a routine that is comfortable for them.


7) DON'T OFFER UNSOLICITED ADVICE OR TRY TO TELL THE PARENTS WHAT THEY ARE DOING WRONG

I wish someone was around to whisper this one in a few ears when I had my little one!  Often, new parents are stressed out and confused enough as it is.  And they have probably already heard an opinion on every little detail that could possibly pertain to a new baby.  Remember, even if you have several children of your own, every baby is different.  If you happen to notice something that is of major concern, be thoughtful and courteous, not overbearing, in the way you approach the subject.


8) GO VISIT, BUT DO SOMETHING HELPFUL

 It's exciting when a close friend or family member brings home a new baby.  And yes, you want to rush over and see the new bundle of joy.  More than likely, you are welcome to!  But remember the new parents may be feeling overwhelmed as it is.  They may be energy deprived, or the new mom may still be physically recovering from labor and delivery.  It's not the time to comment on the stack of dirty dishes that continues to pile up.  In fact, the courteous thing to do when you visit a family's new addition, is to offer a helping hand with a household chore or two.  Put away the dishes or start a load of laundry.  Perhaps run the vacuum around the house.  This small gesture will be so appreciated, especially when most partners usually have limited time off work to spend with their growing families. 


9) REMEMBER TO CALL AHEAD AND OTHERWISE JUST BE THOUGHTFUL 

Don't drop by unannounced.  It's rude to begin with, and especially so if there is a new baby in the house.  Schedule your visit ahead of time and plan on keeping it short.  Newborn babies are usually nursing around the clock.   Breastfeeding is not a spectator sport.  And often, it's difficult enough to get a new baby to nurse as mama and baby are both navigating the learning curve, especially in the presence of an audience.  So if the baby is getting fussy, or if Mom and Dad just generally seem uneasy, don't get offended.  It may be time to cut your visit short and return at a later date.  If you are close with the family, it's a nice gesture to offer to help watch the baby so Mom can grab a quick shower or a short nap.



A new baby in the home makes for a happy and exciting time, but it should also be a time of vital bonding and attachment for the growing family.  Many times, new parents are made to feel like they must entertain countless visitors while their little one is being paraded around, when the focus of the community should be that of supporting the family bond!  Remember, it's not the time for new parents to be entertaining house guests, but rather be bonding together as a growing family and these are just a few suggestions to help new parents embrace their Fourth Trimester.

 ~

*** Don't forget about the special mama-to-be in your life! We are extending this fabulous offer-  

purchase our prenatal session now through 12/24/2013, and receive a free gift! 

Studies have shown that prenatal education increases maternal breastfeeding self-efficacy, which then results in increased breastfeeding duration. (Noel-Weiss et al 2006)

Holiday Special!

What is better than giving the gift of education and support? 

Our in home prenatal sessions are one-on-one private lactation education that can help new parents get breastfeeding started on the right foot. Clients can ask all of their questions and get a consistent "game-plan" in place for when baby comes. The best time to have this session is during the 3rd trimester, but it can be purchased anytime by using the Paypal buttons on our website. 

Comes gift wrap-able! 

FREEBIE: Green Child Magazine

The Fourth Trimester Team just wanted to share this freebie with ya, a free online magazine- Green Child!


Now, speaking of green children, we are on our way to go talk to 6th graders for the Great American Teach In about breastfeeding. Topics we'll be covering include lactation basics, anatomy, supply/demand, why breastfeeding is important, what a normal work day is like for The Fourth Trimester, the math that is involved in lactation work, and what we actually DO during a client visit.

Whew! I bet you'd love to be a fly on THAT wall.

Every Drop Counts!

Establishing The Fourth Trimester: Success In The Hospital

We were called upon recently to see a new mama who had just delivered her perfectly healthy, beautiful baby boy at the hospital. We will call her "Jane". Jane had a history of breastfeeding difficulties with her older children and she wanted to set the stage for an optimal breastfeeding experience with this baby. The hospital lactation staff had brought a pump to her room, but because of their heavy caseload, she felt that she could get more personalized support for nursing her baby by calling in private help. She had lots of family in town staying in their home for the much anticipated arrival of this baby, so believing that she would benefit from less interruption and distraction, Jane wanted us to come to her bedside before leaving the hospital.

Jane had an unmedicated, normal vaginal birth at a local hospital. She had sought out all of the pieces of the puzzle for an optimal birth and postpartum experience, she had researched and chosen a Baby Friendly hospital based on their written breastfeeding policies and normal birth outcomes. She hired a supportive birth doula. She delegated the care of older children to her support team and requested additional lactation help.

And then during our visit with her that morning, where her goal was to work on latch pain and positioning difficulties, her effort to nurse her baby was interrupted 8 times over the course of about 2 hours. The baby was even removed from the room without Jane's direct consent for 30 minutes. 

Those immediate hours and days after having a baby should be sacred- but it didn't feel that way. 

In that moment, our mothering instincts went into overdrive. We wanted to create a safe space for the mama and baby who desperately needed the time to get to know each other. A baby’s desire and physiology to nurse are driven instinctively. And those instincts are triggered by the touch of mama’s skin, the warmth of her body when she holds him close to hers, when he smells her colostrum, and by hearing the familiar sound of her beating heart. It is so important in those immediate moments, hours and days after birth, to keep mother and baby close and connected. 

~

Some hospitals are finally catching on to the benefits of "the magical hour" and family-focused recovery (which has been connected to better breastfeeding outcomes) by even implementing a protocol or adopting similar policy to the Baby Friendly Hospital Initiative: “Ten Steps To Successful Breastfeeding”-

1. Have a written breastfeeding policy that is routinely communicated to all healthcare staff.
2. Train all health care staff in the skills necessary to implement this policy.
3. Inform all pregnant women about the benefits and management of breastfeeding.
4. Help mothers initiate breastfeeding within one hour of birth.
5. Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
6. Give infants no food or drink other than breastmilk, unless medically indicated.
7. Practice rooming in - allow mothers and infants to remain together 24 hours a day.
8. Encourage breastfeeding on demand.
9. Give no pacifiers or artificial nipples to breastfeeding infants.
10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center.

Even in the best of circumstances, the best birth possible, and in the most “breastfeeding-friendly” of hospitals the fast-paced setting and number of different staff members with different roles can make it difficult for the facility to fully adhere to their own policies! For example, even when nursing on cue is encouraged, if there are rules that say the mother and baby must each have their vital signs checked every x number of hours, then the vital signs will be checked and breastfeeding will be put off “for a few minutes”. The issue starts to become problematic when every cue is being put off because there is another test, another check of the hospital bracelet, another hospital photographer, another person popping in to bring a tray, take a tray away, and so on until hours have passed and the swaddled baby has fallen asleep without a chance to just be at his mother’s breast undisturbed. So, how can you protect your Fourth Trimester experience while you are in the busy hospital environment? As you gather your birth team and postpartum support, start a discussion about the importance of breastfeeding and the Fourth Trimester to you. Allow your postpartum support people to be gatekeepers and advocates keeping this time sacred for you and your newborn.

Set limits and expectations with the hospital staff by:

photo credit skintoskinbenefits.com

• Explaining to every nurse and lab tech whose shift rotates through your hospital room that you want your newborn to stay bed-side. Staff should never assume you are comfortable with them taking the baby away for bathing or tests.
• Placing a note on your door whenever you are breastfeeding your baby to come back later. Tests can be delayed. Newborns that are undisturbed and skin to skin with their mothers are calmer, cry less, regulate their body temperature more efficiently, and of course have an easier time breastfeeding.
• Letting everyone know that your priority is to nurse and get to know your baby. Your care team should support this. You can kindly ask for a new nurse assignment if you are not feeling supported.
• Reminding your care team that everything should be done in your presence. Remember, you are always entitled to ask “why”, and should be encouraged to do so. Even the simplest request to postpone or decline your newborn’s bath can have an enormously positive impact on breastfeeding. 

6 Ways Our Facebook Page Can Help You Out

The Fourth Trimester Facebook page might not be as good as face to face support, in-home lactation services, or a personalized care-plan, but it's a great way to help your breastfeeding relationship continue to blossom. Here are six ways that "liking" our Facebook page will help you.


1) You can scroll through for evidence based information on infant feeding and breast health. Plus cute memes and gorgeous photos.

2) Having in-real-life friends who exclusively breastfeed can keep you on track too, and if you send those friends our way when they are struggling, we can make sure they have all the support the need.

3) We'll keep you up to date on local baby and breastfeeding happenings, prenatal classes, special birthy events.

4) Find a doula, childbirth educator, or midwife among our friends- we're well connected.

5) Our fans have a lot of great wisdom to share, too. Ask a question on our wall, make friends, get connected!

6) Are you a doula, educator, or midwife? We welcome you to post on our wall with a tidbit about yourself and anything relevant you'd like to share with us.


Have you swung by the  Fourth Trimester Facebook page yet?

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It's good to have a family like the Barefoot Birth family

Check it out, we've been featured on the Barefoot Birth blog!

What Is The Fourth Trimester, And Why Do I Need To Prepare For It?

During each stage of pregnancy, there are things you need to know and implement for best results. A lot of energy gets spent on figuring out how to "survive" pregnancy- in fact, as someone who has done it 3 times, I'm pretty sure I still Googled exactly that at some point around week 8. In the first trimester, mamas need to know about how to calculate a due date, how does implantation work, risks of miscarriage, diet and exercise, when they will start to show, and what is safe and what is not. Oh, and how to ease morning sickness!

In the second trimester, moms start wondering about the sex of their baby, how and where they want to give birth, whether or not to return to their job after the baby comes, and what supplies they need. Some wise mamas take this time to hire a labor doula (PS we know a bunch of awesome doulas- if you are expecting and need a good one, we can help you out).

In the third trimester, the weight of the baby starts to creep up on mama and as she becomes more and more ready for the birth, the birth, the birth! OH, and did we mention that much of the time, all she thinks about is the birth? And of course whether or not she has enough baby clothing in each size.

So, what is "The Fourth Trimester" and, if I'm prepared for my baby's arrival why do I need to prepare for it? Isn't that the same thing? 

"The Fourth Trimester" is a phrase coined by the author Susan Brink referring to the first few months of babyhood as "a crucial bridge from the comfortable world of the uterus to life in the world we all know" and "a period of intense development in which infants have more in common with the fetuses they were than with the human babies they are becoming." We like to think of it as a continuation of the pregnancy. All of the toys, fun baby gear, cute outfits, and "the most maneuverable stroller on the market" are not the things that will matter a great deal when there is some type of breakdown in communication between us parents as people and the new little one, who is happily wide eyed staring at the Venetian blinds (at best!) at 3 o clock in the morning. Or who is howling every time her mother is sure she has finished feeding her and sets her down. Or the 6 week old who predictably shrieks if daddy holds him, but is silent in his mother's hands.

                                      Photo credit: Kim Turner Photography

Preparing for the reality of this can make a huge difference in your sanity, happiness, and quality of life. A gentle shift in thinking is a great first step. Getting educated, developing a plan, and implementing a support team is even better.

We have the privilege of working with a lot of mamas, and are mamas ourselves, and we can tell you that our culture is hard on new moms. There is a certain amount of you're-in-the-supermom-club-now praise sprinkled on new moms who "feel great" right after their amazing natural birth, having their lovely little 8 lb 4 oz baby in the water. Or the mom who has a short labor and bore her baby down in two pushes. She naturally feels AMAZING! And all of the natural birth advocates said that this is one of the big benefits of forgoing the drugs- you feel great and get back to normal sooner. And this truth (most women really DO feel great after a natural birth), coupled with the well meaning praise from the fabulous supermom-club that a mom is doing great because she is out and about so early, means that mamas often expect that they will power-birth, nurse the baby, shower, and get on with things.

Those kinds of expectations are what leave a new mom feeling like a big failure because she hasn't gotten dressed, her toddler has missed gymnastics twice in two weeks, and she has no idea where her contact lenses are.

As a natural birth enthusiast myself, I really did feel good after my baby's birth, like I could have jumped up and taken my baby on parade (a slow parade, but still). And I have to say it took conscious effort on my part to get my unapologetic Fourth Trimester experience. It didn't just happen, it was as planned as any other facet of the pregnancy year.

Gladis Rubio and Emily Seelig-Rohrhuber are CLCs and co-founders of The Fourth Trimester, doing home visits for lactation support in the Tampa Bay Area. They can be reached at fourthtri@gmail.com.

Hey, Doula-friend!

We wanted all of our current and soon-to-be doula friends to know that we have something exciting going on behind the scenes at The Fourth Trimester. Please drop us a line... your clients will thank you!

<3

what gets breastfeeding off on the right foot??

Support and education, that's what!

Awesome Quote Of The Day

Making Time For Birth Story Healing

In our line of work, we see a lot of babies and hear a lot of birth stories. It's always enlightening, awe inspiring, and thought provoking.

Sometimes a story is like a tender sore spot for the one telling it, as she struggles to weave it into her newly emerging vision of herself as Mother. Unfortunately, many new mothers carry birth wounds and confusion as painful secrets, which postpones healing. Sometimes new mothers share their story to a less than ready listener, one who is unsure of how to hear her or how to respond, much less one who can guide her on her path to healing.

Local birth professional, Evelyn Ojeda Fox's Birth Story Healing workshop fills this need that so many new moms face every day, check her out!

Now THAT is smart!

Back in Shape: Answers for Nursing Moms

Click here for the PDF!

Check out where FL is on this breastfeeding infographic!

Mark your calendars- The Fourth Trimester is going to be at this upcoming event, Monday August 26th, at the Bayou Club in Largo, FL. We'll be on hand for answering questions and scheduling counseling sessions. There will also be goodie bags and door prizes, including something special from us!

Get all the details here:  https://www.facebook.com/events/545146855521066/

The Fourth Trimester team was recently featured in a "Getting to Know You" spotlight feature by the Tampa Bay Birth Network!  

Check it out here! 

Nursing In Public- Just Do It!

     We have all seen news stories about this: A restaurant or a store will ask a breastfeeding mother to go sit in the bathroom to feed her baby (GROSS) or ask her leave the establishment altogether. And within days, a flock of nursing mothers will appear with online protests, nurse-ins, and calls to the media. Is this simply to show the business owner/manager/employee that he or she is being an ignorant jerk? Well, partly. But there’s more to it than that. These women have come to make a statement to other women.

     For decades now, because of the media portrayal of pop culture icons and misogyny towards women in advertising, breasts have become highly sexualized. This has made way for the public perception that the purpose of them is to merely stimulate, excite, or to sell a product. THIS idea has become the norm. The image of Kim Kardashian’s bosom spilling out of her low-cut top, plastered on a giant billboard in the middle of Time Square isn’t given a second thought, yet often women who are simply meeting the basic needs of their children are asked to hide in a corner shrouded under a blanket in shame. And what’s most ironic is that the act of breastfeeding reveals far less bare skin than the average denim jeans commercial. I’m not saying that breasts shouldn’t make women feel beautiful, sexy, and celebrated. What I am saying is that, in addition to being decorative, women’s breasts serve an actual purpose. And that purpose is the reason why they exist in the first place…to feed babies! But at some point in time, that message became lost. 

     So when a woman is asked to go hide away with her baby in the bathroom, or she stays home to feed her child, it is relevant to ALL women, because babies have the right to eat without shame. In our culture there is a clear double standard with regards to breasts. And breastfeeding your baby without shame is a way you can do your part to send the right message to society about women and their bodies!  

     A woman’s right to feed her baby wherever, however, and by whatever means she deems necessary is protected by state laws (to varying degrees). Many state laws leave much room for improvement, but many others (like Florida’s) are comprehensive. The real issue is that most people don’t know about these laws. Most average non-lactivist people assume that since breasts are considered sexy and we typically keep the nipples covered that legally it must be considered “indecent exposure" to breastfeed in public spaces. Actually, asking a woman to “cover up" while nursing is (in the state of Florida) a violation of her civil rights! 

     We all know about the amazing health benefits of breast milk and that (in our culture) most moms who intend to nurse their babies exclusively throw in the towel in the first few weeks. And generally, we all want what is best for babies- even when we don’t have kids of our own. But most people just don’t know what they can do to help improve breastfeeding rates. Business owners, restaurant patrons, teenage employees, husbands, and grandmothers are ready to be educated about the right to breastfeed in public! This is why the Fourth Trimester team is working on an advocacy campaign for the Tampa Bay Area called Breastfeeding Welcome Here. Breastfeeding Welcome Here highlights local businesses and organizations that welcome proudly nursing mothers in their establishments and that have chosen to educate their employees about a woman’s right to nurse in public. By applauding their efforts to support nursing mothers, we hope to create a ripple effect that will spread encouragement and reduce shame.

     To look up your state’s laws that protect breastfeeding rights, check out this website and to learn more about the Breastfeeding Welcome Here campaign and how your business can get on board, visit our page.


About the Authors:  Emily Seelig-Rohrhuber, CLC & Gladis Rubio, CLC are mothers, lactivists, and co-founders of The Fourth Trimester.  For more information, visit http://www.thefourthtrimester.net/

The Big Latch On looks like it's going to be a BIG party!

The Fourth Trimester team has been BUSY. We've been seeing clients, getting our message out in the community, spending time with our babies, AND working as board members of the Tampa Bay Birth Network. Our first big project for TBBN is The Big Latch On, and it looks like it is going to be a BIG party. 

It's not just mamas and babies latching for the official count- it's going to be a great family day out with professional children's entertainment by You and Me and Music Together AND by Fancy Nancy, a portrait studio corner hosted by photographer Greta Green, babywearing demos by Tampa Bay Babywearing, and CUPCAKES by Cupcake Obsession. 

We hope to see you there!

You can RSVP here!

Welcome to The Fourth Trimester Blog!

We are really excited about adding this new blog feature to our site. This is where we'll be posting about our work and what we've been doing, informative pieces/reader Q & As, links to articles we've written for other websites, and breastfeeding in the news.

Check back weekly for new content!