Tuesday, December 30, 2008

Why A Sling?

Using a sling is so much a part of parenting my babies, I honestly do not know how I would survive babyhood, and certainly toddlerhood without one. Dr. William Sears has a saying about carrying your baby in a sling: When your baby is in a sling, he/she becomes a player, not a spectator. I can testify this to be true.

I just cannot get believe, in America, that we are so insistent on carrying our babies around in a car seat everywhere we go. Leave the car seat in the car and carry your baby! What I am advocating is a lifestyle, not just a handy, or comfortable, way to carry your baby when you are at a parade or on a walk.

When your baby is in a sling, it is like recreating the womb. The baby is so comfortable with your walk, the sound of your voice, your heartbeat, and being cozy against you again. I have never put a baby in the sling that didn't like it. I have no problem saying that all babies love a sling. It is about the parents being comfortable with using it. The baby knows how comfortable you are and they will let you know it.

Leave your sling in the car so that you are never caught without it. A lot of parents will keep one in the car and one in the house. If you are able to afford it, this is what I suggest. You truly will have a happier, and I believe, smarter, baby. My friend, Janet, is a great example of wearing her baby, continuously. Her sling goes on in the morning with her outfit and seems to stay there most of the day, whether the baby is in it or not. Her "pouch" is ready for the baby to jump right in. And, literally, her baby is in and out of the sling throughout the day. What a happy and well fed (physically and socially) baby.

You will talk to your baby when they are in a sling. They are right there with you and it would be unnatural to not talk to them. You'll tell them all about the items you are buying at the grocery store. They will be a part of your conversations with other people and feel included, even at a very young age. They will know they are valued.

A baby in a car seat will not be spoken to or have anywhere near this sort of interaction with his mama or with other people as a baby in a sling. Think for a minute about when you have talked to people, strangers or friends, when their baby is in a car seat (grocery cart, living room, etc.). Did you talk to the baby? You might have looked at the baby and even talked about the baby, but did you talk to the baby? Now think about when you have talked with people who have a baby in a sling on their hip. That baby was at the same level as the other people and was most definitely spoken to. They could make eye contact and facial expressions that are hard to ignore.

I have always felt that if I had my sling and an extra diaper, I could go anywhere. It makes parenting easier. The time is so short to carry our babies. I am going through this right now with my youngest. She'll be 4 in March and I feel so sad that my time of being able to physically pick her up and hold her is almost over. It's very emotional. You will not spoil your baby by carrying her "all the time." It will strengthen your relationship and you'll be grateful that you parented your sweet baby this way.

Sunday, December 21, 2008

Vitamin D, Iron, and Breastmilk

I receive emails from Mayer Eisenstein MD,JD,MPH periodically on different subjects, and this one stood out to me. It was addressing Vitamin D in breastmilk. It always bothered me that pediatricians claim breastmilk to be deficient in anything, as breastmilk is the perfect food. Here is what Dr. Eisenstein had to say about what he had recently learned:

"I attended a lecture by Dr. Bruce Hollis, "The Vitamin D Requirements During Pregnancy and Lactation". All of a sudden it became clear that the reason breastmilk was lacking in Vitamin D is either the mother was not in the sun enough (just 10-15 mins. a day with 40% body exposure will give you 5,000- 10,000 IUD) or because she was not getting enough Vitamin D supplementation.

As Dr. Hollis reported, when breastfeeding mothers have sun exposure or adequate supplementation, the Vitamin D levels in their breastmilk skyrockets. At this point Dr. Hollis' current recommendation is that pregnant and nursing mothers (because of their increased metabolic rate) need at least 6,000-10,000 IUD daily."
Another area of concern is iron. Babies are routinely tested for anemia. Especially breastfed babies. Yes, it is true that iron levels are low in breastmilk, but it is extremely well-absorbed -- 50% absorbed. In formula, only 10% of the iron is absorbed. Ironically, in iron-fortified formula, only 4% is absorbed.
I also have a theory I would like to throw out: Nearly all babies born in American hospitals have the cord clamped immediately after birth, stopping the blood flow from the placenta to the baby. Doing this deprives the baby of approximately 25% of his blood volume. That's huge. Is it possible that this is contributing to 80% of babies being anemic by their 1st birthday?

Your baby is getting all that he or she needs through breastmilk. Not just as an infant, but beyond. My 3rd baby didn't start solid food until 9 months. The pediatrician we had at the time was freaking out, basically telling me I was starving her and I had to
make her eat. I immediately switched doctors. Her new doctor laughed and said, "Look at her! She doesn't look starving to me!" He encouraged us to continue what we were doing and assured me that she would, indeed, one day eat solid food!

Our 4th baby didn't start solid food until after her 1st birthday. I was offering her food frequently -- she just wasn't interested. All of my children have been extremely healthy. Breastmilk will sustain your baby with the best nutrition they could possibly ask for. Don't be in such a hurry to feed your baby solid food. They will eat that their entire life. Starting solids too early substitutes an inferior food for a superior food. Truly, breast (milk) is best.

Thursday, December 18, 2008

Trusting Your Body When it Comes to Breastfeeding

I had the opportunity to visit with a struggling new mom tonight. I had heard almost a week ago that she was having trouble breastfeeding, but just got over there tonight. The baby is now 9 days old, born via c-section a week-and-a-half before her "due date." This mom is 29 years old, and this is not how she imagined pregnancy, birth, or breastfeeding.

Part of the problem is that women are given so much conflicting advice in the hospital by nurses, doctors, and even lactation consultants. This couple shared that they had talked to eight different people, and they all had different opinions on what this woman should do with her baby and breastfeeding. Would you believe that NO ONE told her to hold her baby tummy to tummy (mom to baby) to breastfeed her baby? That is Breastfeeding 101. They had told her "skin-to-skin" not tummy to tummy. They are two very different things.

The baby is very sleepy, as nearly all babies are. This is important because this is how and when they grow. It's not just about how much they eat when it comes to growth. The trick is not waiting until the baby is "freaking out" to try to breastfeed. That's when a frustrated mom just gives a bottle. Don't go 3 hours between feedings. Try nursing at 1 1/2 hours, when baby will be getting hungry but is not frustrated. Mom and baby will both be more patient and willing to work at it.

I could write a lot about the basics of breastfeeding, but I have to face my reality: it's Christmastime and I am barely keeping my head above water!

Bottom line:

This mom had been given poor advice to just pump and feed the baby a bottle of breastmilk. Yes, breastmilk is so very important, but she should have been taught HOW to breastfeed. Bottles create lazy babies. The baby won't want to work at the breast. I told her to get rid of the bottles. Trust her body. She wanted to know how she would know how much milk her baby is getting. Simple answer -- you don't. You simply have to trust your body. She knows she is producing milk. Now she has to teach her baby to breastfeed.

I'll say it again, if you are having trouble breastfeeding, there are so many women out there who are more than willing to help you. La Leche League is a great place to start. Or call your local Birth Boot Camp instructor. She should be able to steer you in the direction of a good lactation consultant.

Trust your body to be able to feed your baby. Trust your baby to be able to learn to breastfeed.

Saturday, December 13, 2008

How A C-Section Affects Breastfeeding

Did you know that a woman who has a c-section is only half as likely to breastfeed her baby as a woman who has had a vaginal birth?

I was invited to speak to a group of new mothers about breastfeeding in public this last week. I met several great women and am grateful for the opportunity to be working with new moms. Nearly half of these women had had c-sections and only one of them (of the women that had a c-section) was breastfeeding.

First of all, the c-section rates in North Texas were well represented in this group -- about 50%. At a local Arlington hospital, holding steady at a 60% c-section rate, 2 out of 3 of the women that had delivered there had c-sections. The one that did have a vaginal birth said she almost had a c-section.

I was called Friday night to go visit a woman from Russia who is having trouble breastfeeding. She had a c-section. I had plans with my husband, so I have not seen her yet. I hope that by the time I see her she has not resorted to bottle feeding.

So why is this? To begin with, so many c-sections are performed at 38 weeks. If the woman would have been "allowed" to start labor on her own, she might have been pregnant for several more weeks, allowing her baby more time to be ready to suck. It would also ensure that her body gets the message that it is time to make milk for this new baby.

Labor serves a purpose. We pretend, in this country, that it doesn't. We do everything we can to just skip it all together, whether it's through a c-section or an epidural. Rarely do women actually experience labor. Labor is a bridge between pregnancy and being this baby's mother. It is so important! In fact, I always tell my students not to hope for a short labor, but rather a longer one that allows for them to enjoy the journey and process the event. You appreciate the baby so much more when you have worked hard through labor to get the baby here. You trust yourself to parent your baby and your breasts to provide nourishment. A woman who has had a c-section has just learned to not trust her body -- that, even though it is likely not true, even subconsciously, her body doesn't work right. Doctors are very much to blame for this occurance -- "failure to progress" being the number one reason for a c-section sums it up. They have just told this woman that her body has "failed."

There are hormones that occur when labor begins on its own. When a woman is induced with pitocin, these hormones do not occur naturally. Naturally occurring oxytocin crosses a blood-brain barrier that gives the laboring woman endorphins to help her cope with labor. When a woman is induced with pitocin, the uterus is forced to contract harder, longer, and closer together than it would with regular contractions. The baby knows the difference, as seen in so many fetal distress c-sections that occur because of the pitocin. A woman who is induced is twice as likely to have a c-section than a woman who starts labor on her own. Her body simply wasn't ready to give birth.

One of the purposes of labor is to send a message to the breasts that the baby will be here soon and it will be time to feed the baby colostrum. Obviously, in a woman that never experiences a single contraction and has her baby surgically removed from her body, her breasts didn't get that message. They will over the course of several days, but she may have given up breastfeeding by then. She will need lots of encouragement and support by other women who are knowledgeable about breastfeeding, and frankly, most women don't have this support system.

Some babies are not ready to nurse when born too early. The baby could easily have needed another month in the womb. This can contribute to a woman giving up on breastfeeding. A baby must work to breastfeed -- which is so good for them for so many reasons -- and with a bottle, they don't have to work nearly as hard. If they receive a bottle early on, they may not want to work later.

When a mother gives birth without medication, the oxytocin (love hormone) is the highest it will ever be in her life right after giving birth. This is the time that she falls in love with her baby. Mother and baby must be kept together to breastfeed and bond during this time. How sad to miss that opportunity, whether by drugs that inhibited the natural process, a c-section, or stupid nurses that thought the baby needed to be weighed and bathed immediately after birth. Fight for this critical time with your baby!

Many babies receive a bottle early on after being delivered via c-section. The mother is often not feeling well -- go figure -- and someone else takes care of the baby besides the mother, which means feeding the baby a bottle.

Ultimately, women need more information on breastfeeding. And why a c-section is so much more far-reaching than just a (bad) way of getting your baby out of your body. My number one piece of advice in avoiding a c-section? Do not get induced and do not have drugs in labor. I teach an entire class on avoiding a c-section, but none of it matters if you have drugs in your system. There are so many things you can do, but not if you can't move and have subjected your body to drugs that inhibited labor from progressing the way it needs to.

Ladies, trust your bodies to birth your babies and breastfeed them when they arrive. You were made to do this. And if you have trouble, there are so many women who want to help you succeed. If the first one doesn't help, find someone else. All lactation consultants are not created equal. Some are better than others. A La Leche League leader will be able to help you. Seek her out.

Sunday, December 7, 2008

Ah, the Glorious C-Section

I received this email from a former student of mine. She gave me permission to share it with you. Her baby was born about a year ago. She was induced (sudden spike in blood pressure) and had a rough labor because of it. She worked really hard to birth her baby vaginally, but ultimately, I don't think her body was quite ready. In the end, she had a prolapsed cord (the cord came out before the baby) and they did a c-section. Her emotional recovery continues. It's been a rough year for her and her husband.

No woman should meet her baby for the first time like this.

"I don't think I ever sent you this picture, so I'll share it w/ you now. My first picture of Kate & I together after her birth. You can see the hideous hospital gown, the blood pressure cuff, my eyes are red & watery & my face is covered in broken blood vessels from pushing for almost 4 hours and from vomiting once in labor, and then again during the c-section. (I guess that's very common when they ramp up your anesthesia so fast.) I have no memory of this photo - you can see I'm not even looking at her.

Moments before this, I remember telling the room "I'm going to throw up." And someone said, 'that's ok." And all I could think was, I'm pinned on my back, my arms are strapped down, I can't hardly lift my head. I'm going to choke on my own vomit & drown choking on my own vomit on this op table because no one is looking at me, they're looking at the surgeon. It was yucky & terrible, and I felt so alone yet I was surrounded by attending people (many nurses, surgeon, anesthesiologist & his assistants, AND my midwife.) Kip was late coming in because they made him change into special clothes - by the time they ushered him in they had already removed my uterus and it was laying outside the wound as they stitched it. He got to see it all. Luckily, he's not the fainting type!

I don't know why I suddenly felt compelled to share this w/ you, sorry so random, hope you don't mind the gory details. I guess I just needed a safe place to vent. Phew. Thanks, Donna."

As you can tell, it was business as usual at the hospital. They showed no compassion for this woman or her husband. She struggled with breastfeeding, which in the end, didn't last long. She struggled with depression. Her husband hasn't even wanted to begin to think about another baby because this was such a difficult experience.

I'm just left with thinking about why anyone would choose a c-section. Our birthing experiences are so underestimated in this country. We suffer from this mentality, "As long as the baby is healthy, it doesn't matter how it gets here." It does matter. For the baby and the mother, and even the father.

I was talking with a woman this weekend who was telling me that she's had 4 c-sections. One of her children is being tested for ADD. On the paperwork, she said there were loads of questions asking about the pregnancy and delivery. She was so surprised by that. I'm not.