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Archive for November, 2012

“Ready to Wean:” A new children’s book about weaning

We’re very pleased to share an interview with Elyse April, author of the new children’s book, Ready to Wean:  The Return of the Dangling Red Earrings.

This book is a welcome addition to the growing library of children’s books about breastfeeding, and is the only current one about the topic of weaning.

Want to see more children’s books about breastfeeding?  Here’s our complete list!

Why did you want to write a  children’s book about weaning?
After eight years of promoting breastfeeding books like: We Like to Nurse, Breastfeeding: Your Priceless Gift to Your Baby and Yourself, and We Like to Nurse, Too, I had moms approaching me at trade shows, like the National WIC (Women, Infant & Children) Convention, saying how they loved the books in “The Family & World Health Series” from HOHM Press, but that they have had weaning nightmares when ending their experience of breastfeeding.  “How could this be?” I wondered.  To me, how we end breastfeeding is as important as how we begin breastfeeding and how we parent.  It’s a process and an initiation into the next stage of life, moving out into the world, yet still wanting to know that mom is there.  Why a picture book?  Through this series of books, I have found that while children delight in the pictures, we are assisting in parent education.  This is a less intimidating way to get across information for parents and more engaging than a pamphlet.  Ready to Wean is for both young children and parents!
You suggest talking to babies about weaning when it is happening, no matter what their age. Why?
When I became pregnant with my son, I was very aware that a being was growing inside me, not just a body, but a conscious, sensing, presence whom I was now responsible for.  This is a contrary perception to the blank slate metaphor.  I do believe that babies bring something with them that is uniquely their own, and I see the importance of providing a nurturing environment that establishes mutual love and respect.  The monumental book Conscious Parenting by Lee Lozowick is the foundation for all of the books in the Children’s Division of HOHM Press & Kalindi Press.  That is why I suggest in We Like to Read, reading to babies still in the womb (“Little ears listen…”).   How we speak, move, conduct our daily lives – all that affects the baby in our womb and then the child in our life. By talking to our baby softly and gently about the ending of breastfeeding, whenever that is for our circumstance, whether it be for financial, medical or emotional reasons, we can assure our child that this closeness will extend beyond the breastfeeding time through physical touch, cuddling, play and growing together.  Saying to the child that there will come a day for new ways to be close is a way to plant a seed for both the child and the parent.
You say that there is no need to explain the “why”of weaning to a child. Why is that?
Not burdening the child with one’s own struggle as an adult is an important part of parenting and maintaining appropriate boundaries.  Babies have to get their basic needs met for food and protection as well as touch.  And they need assurance that we are the parents who will steward them into the world.  Simply saying, ” Mommy has to go back to work now,” or “Mommy’s body feels that it is time to end the breastfeeding” is enough, REALLY.  To get into intricate explanations entangle the child in our drama.  How we handle stress and obligations will be a template for our children.  We do not want them to feel responsible in any way for our life choices.  To free our children to experience their own destiny, we need to be clear as to what is ours and reassure them that we will remain central in their lives.
 
What was your own weaning experience like?
Six months into nursing my son, I developed a severe infection in my left breast that required antibiotics.  There were no lactation consultants then and my milk dried up on one side.  I had one torpedo breast on the right and one shrunken breast on the left – not great for my body image, but I was determined to keep nursing.  For my son to get the balanced brain development that happens as a result of alternating nursing on each breast, I would adjust his positioning so he would experience right-left nursing.  When he was two, I was beginning to get antsy.  I wanted a normal body again.  I started talking to Aaron, my son, who was a big boy at two (people thought he was four) about lessening the amount of our our nursing.  I explained that when he was three, we would be close in other ways like reading and playing games, cuddling and drawing and having all sorts of adventures together.  He loved nursing and probably would have continued far beyond three if it was up to him, but I knew that I was beginning to struggle with it and it felt timely.  Even though we reduced nursing, I always let him nurse when he needed comforting.  This was never denied.  I also told him how on his third birthday, he would wake up to find his favorite snack on the night table beside his bed.  Since I gave it one year and kept periodically speaking to him about the time when he would turn three, he delicately nibbled at his birthday treat on that morning and never asked to nurse again.  He was done.  Now that he is a man, I look back on those cherished days and there is no doubt for me that our breastfeeding and weaning experience significantly contributed to his growth into a bright and creative adult. I wish that for more children and hope that Ready to Wean can assist in that happening.

The connection between your “cankles,” IV fluids in labor and your baby’s early weight loss

Did you have IV fluids during your labor and birth?  Did your baby lose a lot of weight in the early days of breastfeeding?  Did your ankles look more like cankles?
A growing body of research is making connections between these things, and it’s important that moms understand these connections for ourselves.
Getting IV fluids during labor is quite common.  Why?  For epidurals, for labor induction or augmentation, for a cesarean section, and for group b strep antibiotics, even for exhaustion.  Many women get fluids for several of these reasons, adding up to a remarkable amount by the time the baby arrives.
What happens next is the subject of a number of recent studies:
  • A 2010 study found“intrapartum fluid administration can cause fetal volume expansion and greater fluid loss after birth.”
  • A 2011 study found that “timing and amounts of maternal IV fluids appear correlated to neonatal output and newborn weight loss.”
  • And a 2012 study found that “maternal average IV ml per hour positively correlated with infant maximum weight loss.”
What these studies have found is something that some providers have suspected for some time:  having lots of fluid on board at birth can make a baby look like she’s losing too much weight.  In other words, some babies are born with extra fluid because of all of the fluids their mothers have received.   Their birth weights are inflated by this fluid, and when they shed it they may appear to be losing too much weight.
When babies’ birth weights are inflated by excess fluid, they are at greater risk of the interventions that come with large weight loss:  supplementation, and in some cases low milk supply and eventual early weaning.  It’s significant enough that one of the above studies concludes that babies’ birth weights should be considered their weights at 24 hours in order to avoid this inflation and resulting breastfeeding problems.

There are other breastfeeding problems which result from large amounts of IV fluids given in labor:  breast edema and delayed milk coming in.

When you’ve had a lot of IV fluids in labor, the fluid can collect in certain areas, including your breasts.  This fluid retention is called edema, and while it may be mistaken for engorgement, it’s quite different.  It can be very painful, and make it quite difficult for your baby to latch on and remove milk.  When milk isn’t removed, over time it can result in milk production problems.  Fortunately, there is something you can do to relieve breast edema and make it easier for the baby to latch on:  reverse pressure softening.

Having lots of fluid in labor is also a risk factor for your milk coming in late.  This can lead to other problems, like your baby becoming very sleepy, jaundice, poor feeding, supplementation, and later low supply.  That’s why milk coming in late is associated with early weaning.

What can you do to avoid getting a lot of fluids in labor?  Plan for a breastfeeding-friendly birth, with providers who have a good track record of low-intervention births, good labor support, use of non-pharmacological pain relief methods, ability to move around, and other factors associated with low-intervention births.  And if you run into any of the above problems, be sure to seek help from a qualified breastfeeding support person.

Herbal Care for Plugged Ducts

Have you had a plugged duct?

If so, you know that they can be painful and frustrating.  So we thought we’d share some of our favorite herbal remedies* to support the quick resolution of plugged ducts.

But before we do, here are the basic recommendations for resolving plugged ducts:

  • Empty the affected breast frequently by nursing.  If it is too painful to nurse, pump or express milk by hand while in a warm shower or tub, or hang your breast over the sink and run water over it as you gently massage toward the nipple.
  • Feed on affected side first.
  • Massage your breast gently toward the nipple while nursing.
  • Try different nursing positions, including (as funny as it sounds) a “dangling” position over the baby.
  • Check to see if there is an obstruction to milk flow at the nipple.  A bleb (milk blister) or a plugged nipple pore can prevent milk from flowing.
  • Apply heat and/or cold.  Try heat before nursing or expressing, and cold in between to reduce inflammation. Warm, moist heat applied with a compress, a “rice sock,” or hot water bottle will help unplug the ducts, and cold from an ice pack or frozen peas will ease swelling.
  • Make sure your bra , clothing, or pressure from your hand is not causing a restriction in milk flow, and see this list of other causes of plugged ducts.
  • Rest, to help your body prevent a plugged area from developing into an infection.
  • If you have fever, chills, red streaks on the breast, or extra fatigue you may have a breast infection (mastitis).  The Academy of Breastfeeding Medicine recommends:  “If symptoms of mastitis are mild and have been present for less than 24 hours, conservative management (effective milk removal and supportive measures) may be sufficient.  If symptoms are not improving within 12–24 hours or if the woman is acutely ill, antibiotics should be started.”

Here are some ways herbal care can help to resolve plugged ducts.  Use herbs in addition to, but not as a replacement for, the measures described above.

  • Make an herbal breast compress.  Herbs that work well in a breast compress are anti-inflammatory and reduce swelling (comfrey, chamomile, calendula, lavender), increase lymph circulation and drainage (cleavers, burdock root, yarrow), and draw out infection (slippery elm, marshmallow root).  Mullein leaf relieves pain. Pour boiling water over the herbs and steep 10-15 minutes.  When cool enough to touch, apply herbs as a poultice, or dip a cotton cloth in the warm infusion, wring it out and wrap around the breast and under the armpit.  Keep the poultice on until it cools.  Reapply throughout the day.  If infection is present, a clean poultice or cloth should be used every time.
  • Try a grated potato on the breast to draw out inflammation. It can be mixed with hot water or applied cold, whichever feels better.
  • The Nursing Mother’s Herbal recommends adding oats, marsmallow root, or fenugreek to a warm massage bath – enough to make the water “slippery.”  This will help reduce friction on the skin when massaging the breast.
  • A home remedy that has been used successfully to unplug ducts is to drink a small amount of undiluted apple cider vinegar.
  • For frequently recurring plugged ducts, some recommend a supplement of soy lecithinThe Nursing Mother’s Herbal also recommends reducing saturated fats in your diet and increasing consumption of unsaturated fats such as olive oil and omega-3 fatty acids.
  • If the plugged area progresses into an infection, there are additional herbal care remedies for mastitis.

*This information is provided for educational purposes only, and is not intended as medical advice.  See your health care provider for medical advice on this topic.

Dr. Jen’s Guide to Breastfeeding: A podcast interview with Dr. Jenny Thomas

If your best friend were a pediatrician and lactation consultant and wrote down her favorite breastfeeding advice, what would it say?

We think it might sounds like Dr. Jen’s Guide to Breastfeeding, a new book by the popular and always down-to-earth pediatrician Dr. Jenny Thomas.  Dr. Thomas is a practicing pediatrician and lactation consultant.  She is the Chief of the Chapter Breastfeeding Coordinators for the American Academy of Pediatrics (AAP), Chair of the Wisconsin Breastfeeding Coalition, and a fellow of the Academy of Breastfeeding Medicine.  In 2009 she won the AAP Special Achievement Award for work advocating for state law to protect nursing mothers.

Dr. Jenny talked with Tanya about why she chose to focus on breastfeeding, her “steps to breastfeeding success,”  why she gives out “got breastmilk” t-shirts to mothers who breastfeed for a year or more, how and why to talk with your pediatrician if you feel you’ve been given poor breastfeeding support, and more.

You can listen to the podcast using the player below, listen with Quicktime, or listen and download at our free iTunes store!

 

Could a cow really make human milk?

Have you seen headlines like these?

Genetically modified cows produce ‘human’ milk
Goats to produce human milk
Chinese produce human breast milk using genetically modified dairy cows

The frequent news about cows and other mammals producing human milk is enough to make you wonder if it might be possible for scientists to replace you and your milk.

But let us explain how science will never be able to create a cow, goat, sheep, or other mammal that can produce human milk or confer the health effects of breastfeeding.

Here’s why:

A few pieces don’t make a puzzle.  Reports of other mammals producing “human milk” usually focus on a few components of breastmilk – things like lysosyme, lactoferrin, and alpha-lactalbumin.  These are all important parts of breastmilk, but human milk contains hundreds of components, and some constituents haven’t even been identified yet.

We don’t even know what the completed puzzle looks like.  Of the components of human milk that have been identified, we’re still figuring out exactly why they’re there.  It’s only recently, for example, that we’ve figured out why some complex sugars called oligosaccharides exist in human milk, since we’ve known for some time that they’re indigestible.  (We now know that they are a form of prebiotic, fueling important probiotics in the baby’s gut).  We’re just beginning to understand the function of a number of cancer-fighting components, and we’ve only recently discovered that breastmilk contains stem cells.  So, these cows are producing a milk that is a far cry from human milk, in part because we’re just beginning to understand how human milk works.

Your milk is a personalized product.  Even if science could create a match for many of the major ingredients in human milk, it still wouldn’t hold a candle to the milk you make without even thinking about it.  The reason:  the milk you make for your baby contains antibodies against pathogens you have been exposed to.  If your friend, who has a cold we’ll call Virus Q, sneezes on you, your lungs will take in that virus, and your lymphatic system will send a message to your breasts to make milk with antibodies that protect your baby against Virus Q, exactly.  It works the same way with bacteria you take in by mouth.  To make a cow, sheep, or goat which could do this is just not possible, because they’re not exposed to the same stuff as you and your baby.

Your milk is alive.  Human milk direct from the source is a “live” fluid, containing millions of live cells carrying out their respective duties in your baby’s system.  Live white cells, called leukocytes engulf pathogens and T-memory cells can live for years and provide long term protection.  Any manufactured, packaged, and shipped product is not alive, and can’t provide this kind of benefit.  Of course, if you pump and freeze your milk, the cells in your milk aren’t alive.  But a remarkable amount of protection survives pumping, freezing, defrosting, and even pasteurizing.

Your milk changes all the time, depending upon your baby’s needs.  Human milk constantly changes to meet the needs of individual babies.  The milk you made on day 1 of your baby’s life is different than what you made on day 10 or will make on day 100.  The milk you make in the morning is different than the milk you make at night (fattier, and filled with sleep inducing neucleotides), and the milk your baby gets at the beginning  of a feeding (full of brain-building sugars) is different than the milk he gets at the end (full of “good fats”).  Anyone who has pumped milk will notice that at times there is a thick layer of cream at the top and at times there is a thin one – another adjustment for hour-by-hour needs of your baby.  A thin layer may mean that you haven’t fed for a while and your body knows that the first priority is to hydrate your baby – hence a higher proportion of water.

Even more ways breastmilk is tailored to you and your baby.  And the list goes on:  Some components of your milk are specific to your (the mother’s) blood type.  What you eat determines the flavor of your milk, and helps introduce the flavors of your family’s diet to your baby.  Preterm milk is differently composed than full term milk.  Your milk even reflects your genetic material.

There’s power in the act of breastfeeding itself.  In our fascination with the impressive composition of breastmilk, we sometimes lose sight of the fact that some of its power derives from the act of breastfeeding itself.   The act of breastfeeding properly forms a child’s palate, requires an interaction that supports a child’s social and emotional development, elicits the release of hormones which help mothers fend off postpartum depression.  And the act of breastfeeding is probably why breastfed babies are less likely to be obese and overweight as children.  Research has found that, when comparing breastfed and bottle fed babies, bottle fed babies are at higher risk even when the bottles contained breastmilk.  Why?  Probably because it’s not the milk but the method of feeding:  breastfed babies control their intake, bottle fed babies’ intake is controlled by the person feeding them.

And it’s about your health, too.  Making milk offers mothers protection against a number of diseases and health conditions.  Among them are breast cancer, ovarian cancer, Type 2 diabetes, and postpartum depression.  And research is accumulating showing that breastfeeding is important to long term weight, blood pressure, heart health, diabetes, and the whole constellation of problems called metabolic syndrome.  It might even give you better breast aesthetics than if you have a baby and don’t breastfeed!

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