on the ins and outs of the lactation profession

The lovely Sarah Juliusson has featured us on the Birth Your Business blog! 

 We love what we do and feel so honored to walk with our mamas and babies on their journeys.

Photography provided by Kim Turner Photography

Oxytocin Love

What can YOU, as a childcare provider, do to help breastfeeding moms? And why does this matter?

Caring for infants and small children is no easy feat! Childcare providers and working parents of breastfed infants face some unique challenges. Namely, there is the whole pumping thing! More mothers than ever before are working and separated from their infants on a regular basis and intend to provide breastmilk during these separations. Unfortunately, this can be a difficult transition for a couple of reasons. In general, many people believe that working mothers have a hard time meeting their breastfeeding goals because they think that 1) breastfeeding is harder than formula feeding and that 2) women often do not produce enough milk. 

Before we tease apart these beliefs, we'd like to address why childcare providers are benefited by mothers being successful at breastfeeding their babies. The biggest benefits we see, in the daycare setting, are that breastfed babies are sick less frequently, and healthy babies are happy babies! And of course, the less sick babies daycare employees are exposed to, the less work they will have to miss. Also, when mothers are supported by their childcare team in meeting their breastfeeding goals, they are going to recommend the source of high quality care to others. And childcare providers are uniquely situated to make a difference! Whether they are working in the family's home, a home daycare, or an early learning setting, childcare providers see mothers day in and day out, on the best days and the most discouraging ones. They also tend to spend the majority of each day with the infants in their care, so they often develop close relationships with the families they serve. Even more important is the fact that childcare providers are a type of baby-professional and are a source of information about what is or isn't "normal" for many parents. While the vast majority of childcare providers aren't moonlighting as lactation professionals, we bet that each one could come up with at least one mom that they remember struggled with pumping after she returned to work. 

As we said earlier, there are a couple of beliefs about breastfeeding that tend to circulate in our culture. We, as a population, tend to believe that breastfeeding is a good thing, but that it is "harder" than formula feeding is, and by following that line of thinking many people feel that formula feeding is better for some situations (especially when moms are returning to work) because of the stress associated with breastfeeding. We would like to point out a couple of things regarding these beliefs. Firstly, breastfeeding can be hard, but we find that infants are simply very demanding of our time, energy, and resources. They only know to ask for what they need, and they have no understanding of boundaries. This includes both formula and breastfed babies! Secondly, breastfeeding sometimes has a learning curve. If it is painful or difficult, mothers can and should get help, and the sooner the better. Once breastfeeding is well established it is actually less work than formula feeding. There is no mixing, measuring, sterilizing, or running out in the middle of the night. Working moms reap those benefits during all of the time that they are with their baby, even if they do not have the ease of simply latching on during the day. When mothers breastfeed they also experience something called a "letdown". While letdown sounds like a negative thing, this is when the milk begins to flow more freely and is triggered by the release of oxytocin- a relaxing and soothing hormone. Both nursing mothers and babies benefit from the release of oxytocin, as it helps to reduce stress and promote bonding. What working mom doesn't need a good dose of oxytocin to boost her mood and help her reconnect with her baby in spite of all of the demands on her time? 

As far as the belief that many women have difficulty producing enough milk, we will say that this is a very common concern but that it really should not be happening in most situations. In a well established breastfeeding relationship, supply is regulated by stimulation and milk removal. As the baby nurses, the mother's supply is maintained. However, this natural balance can be upset by many different factors during the back-to-work months including long separations from the baby, pumping instead of breastfeeding, introducing early solids, or supplementing with formula. Working with a lactation professional can help! 

Here are some things that childcare providers can do to help prevent early weaning:

• Openly support nursing in public in the childcare setting. At the very least, know that this means you are following the law (here in Florida, women are legally permitted to breastfeed anywhere and without a cover). Better still is knowing that by encouraging a mother to nurse her baby last thing before she leaves and first thing when she returns, you are helping to keep the breastfeeding relationship strong. 
• Invite the nursing mom to stop in during her lunch hour to nurse if that is logistically possible for her. This is an excellent tactic if she feels like her supply might be getting low.
• Don't minimize her feelings in an effort to help her feel "better". Saying that it's "not that bad" to supplement with formula doesn't help to solve the actual problem. Do listen and empathize if she shares how hard this time is. 
• Educate yourself on what is normal for breastfeeding moms and babies. This includes how much and how frequently breastfed babies typically eat (guess what- it's different from formula feeding babies!), what pumping is generally like, and what some signs of trouble are. For example, if a mom is struggling to pump enough, or if she is experiencing any breast pain or sore nipples. 
• Ensure that all staff know the basics about human milk storage and handling. It's not a bio hazardous bodily substance, for example, yet many facilities require it to be stored in a separate refrigerator. It is normal for the cream to rise to the top, leaving the more watery milk at the bottom. We have heard of many parents and caretakers tossing moms milk out because it looked curdled after sitting for several hours. It's also important to not vigorously shake the milk to recombine the cream with the milk- this can damage the delicate live particles in human milk. 
• Finally, it is wonderful if you can point nursing mothers and babies in the right direction when they are struggling. Keep a list of local lactation professionals in your parent resources. Bonus points if they do home visits and are familiar with pumping and returning back to work! You might even think of handing this out to all of the new families that you take on.

Resources- Breastfeeding and Medications

Dr. Jack Newman: "Over the years, far too many women have been wrongly told they had to stop breastfeeding because they must take a particular drug. The decision about continuing breastfeeding when the mother takes a drug, for example, is far more involved than whether the baby will get any of the drug in the milk. It also involves taking into consideration the risks of not breastfeeding, for the mother, the baby and the family, as well as society. And there are plenty of risks in not breastfeeding, so the question essentially boils down to: Does the addition of a small amount of medication to the mother’s milk make breastfeeding more hazardous than formula feeding? The answer is almost never."

Read more about the topic of Breastfeeding and Medications from Dr. Jack Newman and the International Breastfeeding Centre here.

If your doctor is telling you that you must pump and dump your breast milk, or to stop breastfeeding all together, please visit the following resources and share the information with your prescribing physician:

CLICK HERE FOR - United States National Library of Medicine - Drugs and Lactation Database (LactMed)

"A peer-reviewed and fully referenced database of drugs to which breastfeeding mothers may be exposed. Among the data included are maternal and infant levels of drugs, possible effects on breastfed infants and on lactation, and alternate drugs to consider."

CLICK HERE FOR - Texas Tech University Health Sciences - InfantRisk Center - Dr. Thomas Hale

The InfantRisk Center will be dedicated to providing up-to-date evidence-based information on the use of medications during pregnancy and breastfeeding.  Our goal is to provide accurate information regarding the risks of exposure to mothers and their babies.  By educating healthcare professionals and the general public alike, we aim to reduce the number of birth defects as well as create healthy breastfeeding relationships. 

We are now open to answer calls Monday-Friday 8am-5pm central time. Please contact us at (806)-352-2519

- See more at: http://www.infantrisk.com/#sthash.hoyp3zmX.dpuf

The InfantRisk Center will be dedicated to providing up-to-date evidence-based information on the use of medications during pregnancy and breastfeeding.  Our goal is to provide accurate information regarding the risks of exposure to mothers and their babies.  By educating healthcare professionals and the general public alike, we aim to reduce the number of birth defects as well as create healthy breastfeeding relationships. 

We are now open to answer calls Monday-Friday 8am-5pm central time. Please contact us at (806)-352-2519

- See more at: http://www.infantrisk.com/#sthash.hoyp3zmX.dpuf

"The Infant Risk Center will be dedicated to providing up-to-date evidence-based information on the use of medications during pregnancy and breastfeeding.  Our goal is to provide accurate information regarding the risks of exposure to mothers and their babies.  By educating healthcare professionals and the general public alike, we aim to reduce the number of birth defects as well as create healthy breastfeeding relationships. 

We are now open to answer calls Monday-Friday 8am-5pm central time. Please contact us at (806)-352-2519."

Our personal message to "our mamas"-
We cannot stress this information enough... The unfortunate truth is that most doctors receive very little formal education about the science, benefits, or importance of breastfeeding for mother and baby. And even fewer know that there are resources available to them to help them properly advise patients on how pharmacology impacts (or doesn't impact) nursing babies. Newborn babies nurse very often and follow instinctual feeding cues which is vital to getting breastfeeding off to the best possible start and to ensure a solid nursing foundation.  Unnecessary disruptions to breastfeeding, based on bad advice can have unintended consequences to the nursing relationship. Take care before starting a medication, but be especially wary of any health professional that suggests stopping breastfeeding without a discussion of the risks and benefits.

The Fourth Trimester is honored to be your advocate~

The InfantRisk Center will be dedicated to providing up-to-date evidence-based information on the use of medications during pregnancy and breastfeeding.  Our goal is to provide accurate information regarding the risks of exposure to mothers and their babies.  By educating healthcare professionals and the general public alike, we aim to reduce the number of birth defects as well as create healthy breastfeeding relationships. 

We are now open to answer calls Monday-Friday 8am-5pm central time. Please contact us at (806)-352-2519

- See more at: http://www.infantrisk.com/#sthash.hoyp3zmX.dpuf

Sneak Peek

We recently did a Fourth Trimester photo-shoot with the lovely Kim Turner Smith of Kim Turner Photography for a super secret project... Now, Kim really specializes in birth photography, but since she was at Emily's youngest child's birth and there is that special bond, she agreed to do some dreamy photographer work for us- and they are too gorgeous to not share a tiny sliver of. We love you Kim Turner!

Want more details about this thing we're keeping hush hush? Stay tuned!

What is Baby-Led Weaning: Introducing Solids & Full-Term Breastfeeding

Baby-led weaning is the simple concept of allowing your baby to feed himself solid foods in their whole state, rather than spoon-feeding purees. It typically starts later than spoon feeding purees because it's very foundation is the baby's developmental readiness for solid foods. There are many signs of readiness to look for including sitting unassisted, fine motor skills that enable baby to pick up bite sized pieces of food- typically in a pincer grasp over a raking grasp, and the ability to move foods around in the mouth (babies who aren't ready aren't sitting up and their tongue thrust reflex typically pushes food out immediately). The other piece of the readiness puzzle is interest in food. As a baby becomes less dependent on exclusively breastfeeding, he simultaneously becomes more interested in food. This is a natural and healthy progression, but it's not always a linear process. A baby who is allowed to self-feed is in touch with his own hunger and fullness, and he will sometimes eat more solids and sometimes eat less. Trusting the baby's body to know what to do can be unnerving, because in our culture, we tend to obsess over whether or not babies and children are eating enough.

Following your six month old baby's cues about solid foods is every bit as important for developing healthy eating habits as following your 6 day old baby's cues about frequency of nursing and duration! In fact, we see baby-led weaning as the natural extension of the breastfeeding relationship. Baby-led weaning is simple, but very different from how many of us were weaned. There are no strict schedules. No coercion.

Following your six month old baby's cues about solid foods is every bit as important as following your 6 day old baby's cues about frequency of nursing and duration!

Babies eat when they are hungry and stop when they are full. It requires no pureeing or spoon-feeding, and usually very little preparation. You just offer your baby healthy foods, prepared the way you would eat them. Some parents choose to start out slow, offering only one new food per week to ensure that they catch any evidence of an allergic reaction. Others choose to feed their baby any and all appropriate foods that the family is eating each day. Either way, as your baby grows, you will be exposing your child to healthy food combinations. This includes the flavors and spices of your family's favorite cuisines!

The idea is to teach baby about eating and self- regulation through the exploration of the colors, textures, and flavors of real food. Good choices to start with include avocado, banana, cooked carrots, sweet potato,  peas, beans, meats, fish, peaches, corn, broccoli, asparagus, sliced olives... Introducing grains after fruits, veggies, and protein foods is recommended by the World Health Organization because grains are now known to be a fairly allergenic food group! This is obviously going to be a shock to anyone who expects all babies to begin solids with infant cereal. Other potential allergens include tree nuts, peanuts, egg whites, and dairy. We suggest that you consult with your pediatrician or use caution if your family has several known food allergies. Getting over the fear of choking can be difficult for parents, especially when the weaning baby has no teeth. The good news is that babies typically know what they can handle and what they can't, and most of the foods we mentioned can be mashed between the gums pretty well. Some gagging with certain textures might happen, but it is usually not a problem.

So, when is a good time to begin offering pieces of "real food"? We suggest to our mamas that they wait until their babies are six months old. The World Health Organization (WHO) recommends that infants should be exclusively breastfed (which means only receiving breastmilk) for the first six months of life to achieve optimal growth, development, and health. After six months, infants should receive nutritionally adequate and safe complementary foods, while continuing to breastfeed for up to two years or more. The Fourth Trimester wholeheartedly agrees with the WHO recommendation and counsels to its recommendations.

And yours does too!