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Hurdles and How-To’s

Cookie Cutter Solutions, Myths, IBCLC judgement, theories and the real McCoy

At this point in my IBCLC career (the beginning, but also a long time building up to this starting point), I am starting to think more about something that really interested me the moment I opened the book and read about “cookie cutter” solutions. I really do love that word… but why? Breast milk is not a cookie, it is not a quick fix or a buy in. It’s something that is socialized and also sets up a baby for life, yet it’s got me questioning (with some excitement!) what is life itself?!

Cookie solutions are appropriate at times. When you are stressed and you need a quick fix; or an ability to put a simple band aide on something and ask it to resolve on its own. For example: nipple confusion is considered a discussion point for a quick fix in my opinion. Pacifier use to help soothe gas- quick fix. Follow up feeding with bottles is like a quick fix for someone that may need help with family dynamics. The nice thing about quick fix cookie cutter solutions is that they often kind of have a lingo to them and thus, you can kind of reach out to something or an ibclc or someone and let them know that you might need help in this area. But sometimes, you need help with something deeper, something deep down that the mother and child desire together, that they can only make happen for themselves in the feeding department and that is the nature of wonderment in the eyes of the ibclc.

As a new IBCLC, I keep my commitment to being sort of your cheerleader and encourager as my utmost priority. I’d like to thank other ibclcs for also building up a sense of trust in the nurturing department. However, at the same time I’d really like to question other things that aren’t really cookie cutter solutions. Things that the mom and baby can help themselves out with for example increasing hindmilk can milking the duct help with this, yes it can but it matters how it is done. Thus it is not necessarily a cookie cutter solution. Family issues around feeding, such a scheduling, wasting breastmilk, routines such as changes, need to be addressed but it matters how it is done in that various people in the family like their new role or find meaning in it. For example, if a mother is forced to wean against her own accord, this may be disempowering to the mother. But, if the baby is led to wean on behalf of the family, the mother gets to see the babies progress and grow with the mother.

As a new IBCLC, I keep my commitment to being sort of your cheerleader and encourager as my utmost priority. I’d like to thank other ibclcs for also building up a sense of trust in the nurturing department.

This also brings up the point of theories. There is lots of literature out there on breastfeeding that is written by a licensed medical professional that does not hold an ibclc license. For example the book baby wise is a theory about following a schedule to get the baby some more hind milk and slowly distancing sometime between feedings essentially stating that weaning is inevitable in relation to someone’s sleep or maybe even in a broader sense tying weaning back into something that has to do with the mother’s body so she doesn’t get too depressed when weaning. For example, maybe switching or not switching sides in relation to feeding or maybe that how a mom deals with engorgement sets her up for the nature of her breastfeeding experience or maybe thinking about how some feedings can be lighter than others in relation to the breastfeeding experience.

As a new ibclc it is nice to give myself permission to use cookie cutter solutions in the form of education but also thinking about the power of either not using a cookie cutter theory solution or backing up your idea with concepts from a theory because this is the nature of connecting breastfeeding to humanity and letting everybody decide and grow in the breastfeeding world for themselves. For example, it is okay to pump and dump when drinking but using awareness of how alcohol might be affecting your milk might be better. Keeping milk moving through engorgement might be best for preventing mastitis but may lead to more engorgement issues to be dealt with affecting breastfeeding. Keeping the mother and baby a dyad can help with this issue because one may help another but at the same time keeping the mother and baby a dyad might be harder for someone going back to work or just wanting a sense of independence from their baby. A mother who is aware of her baby and her baby’s needs is stronger than an ibclc any day of the week, but it doesn’t mean that an ibclc can’t be helpful in any situation.

I want to change the world in relation to breastfeeding, I want to get out there and take some risks and some of my ideas may be sort of new and different, for example possibly starting breastfeeding education earlier in some cultures where formula is over utilized or giving mom’s independence in areas where other cultures where moms are rooted down to their homes but at the same time, it doesn’t mean that we can’t be on different pages of breastfeeding and it also means that as a people this begins the ibclc’s journey and this is essentially why I have started this blog. We are all different and yet all the same.

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Hurdles and How-To’s

Birth Plans

Do you plan to birth? {I do !} If so, I do not necessarily suggest or defer away from the sense of a birth plan, but rather suggest that you look at the whole picture and collaborate with your provider to let them know your wishes. Let me talk a little about my birth plans and how it related to my birth experience. Overall, I would suggest understanding the energetic wish behind your birth plan and how it relates to your providers role in your birth experience. When I handed my provider my electronically submitted birth plan, she said “no, this helps me,” what did your provider say?

                Different situations call for a different plan. For example, coronavirus is a situation causing for worry among providers, among patients, and could it be possible that even babies be effected? In that case, I would suggest that you take in the considerations of your provider’s worries, along with your trust in your provider. People choose different things for different reasons.

                When I gave birth to my first child, I picked 3 things on my birth plan per March of Dimes format along with my nurse. They were practical things that were already endorsed with the hospital such as skin to skin time directly after the birth, waiting to give a bath until baby had acclimated to its feeding situation, preference towards breastfeeding, preference towards husband cutting the umbilical cord. I can’t remember exactly but also some preference towards reduction of pain medication, or at least not offering it to me.

       When I gave birth to my first child, I picked 3 things on my birth plan per March of Dimes format along with my nurse. They were practical things that were already endorsed with the hospital such as skin to skin time directly after the birth, waiting to give a bath until baby had acclimated to its feeding situation, preference towards breastfeeding, preference towards husband cutting the umbilical cord.

                When I made my birth plan, each thing I chose had something to do with a personal commitment to myself should I choose to carry it through. Not offering pain medication meant I would have to be the one to ask for it. Skin to skin time meant being with child in a loving way and embracing differences in the way that I had been brought into the world, preference towards breastfeeding meant I would do my best to always feed my child. I made a mistake with two of my internal commitments to myself because they were done with a weaker energy of asking a question… I chose to distance myself from the inevitable and they were followed through by other people. My husband did not cut the cord in relation to my consent to life. {The provider may not have known my birth plan}, yet with hope we were able to get life going together. When I became a NICU mom, everything changed in relation to my birth wishes.

                Every birth wish had to do with resuscitation in a time a COVID, I placed my wishes in writing to have to do with being present at a time of resuscitation, to having access to a mask and also a throw up bag at all times and a few other things that I placed in a preferencial order but luckily, may not be too relevant this time.

                Every birth, every wish has a hope yet uniting my trust with the provider bringing life into the world was my greatest hope of all.

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Hurdles and How-To’s

To Normalize or Not to Normalize? Is What to Wear the Question?

Can what we wear actually help us to normalize pregnancy and breastfeeding? In my opinion, yes it can. Normalization is the process of saying everyone can do this, it is acceptable and understood in our culture. I think that for the most part pregnancy and breastfeeding is pretty normalized, however, I would never assume so and think that especially for certain types as moms such as someone visiting from another culture, a shy or sensitive mom, even a boisterous outspoken mom, or anyone who is somewhat of an outlier to society could probably benefit from a sense of normalization of pregnancy or breastfeeding. It can help Dad’s too. It can help society as a whole accept some of the ups and downs of pregnancy and breastfeeding so that we can all grow together and enjoy the process. At the same time, it is still important for people to accept differences and acknowledge unique personalities contributing to the process in their own unique way. It’s a little bit like getting dressed in the morning. We all know we have to wear clothes to leave the house but depending on what we are doing that day, how hot it is and how we are feeling we all accessorize with different clothes differently.

This morning when I left the house for my prenatal care appointment, I felt pretty good about what I was wearing, and it made a difference in my day because it was comfortable, practical and similar to what other people were wearing which happens to fit into my unique and stable beliefs. However, I also don’t feel this way every single day. Especially when I am pregnant or in the postpartum period…

What can moms do to feel good every day in every way possible without neccesarily spending a fortune on a new wardrobe when dressing as a pregnant person or a breastfeeding mom? They can revitalize the wardrobe they already have. I am not saying you can’t ever throw out clothes that don’t fit you anymore, but sometimes keeping a couple things around that may run a little large or a little small and repurposing them into a maternity style or breastfeeding outfit can be a beautiful way to feel gratitude in your mind, body or spirit, especially if it was an old outfit that meant a lot to you, that someone gave you, or just a piece of material that you really love. Take a look and see if you already have something that could work for you. I happen to love and treasure maternity fashion, the high empire waste lines, the stretchy but quality fabric and the panels that are woven together in a lacey synched fashion. It can be fun and different than everyday wear and also highlight the body and make us feel good about ourselves in a variety of functional ways. When I began to enter the postpartum period, I still had some maternity favorites that I continued to repurpose and wear because I loved the vibrant color or I still felt it looked pretty good on my body. And so the cycle continues…

Ultimately it was the joy and confidence I found in being a mom that helped me to normalize it for myself and hopefully a few others.

With breastfeeding there are also lots of options. Some people prefer a modest look with a slit on the side, other prefer a double layer, some like to slip under others prefer to unbutton and others like to pull down and pop out. Some throw a modest layer over the top which can also help the baby to soothe and enjoy playing peekaboo with mama. As a mom, I had trouble getting my baby to even latch in a public place in the first four months due to positioning issues and over stimulation. I hope this will go better for me this time around. I hope it will go well for other mothers and babies in their feeding situation. What you wear can affect your confidence, but I would also like to acknowledge that as you go about breastfeeding and letting it teach you to be a better mom in all sorts of ways, it doesn’t matter so much what you wear, and that is part of the normalization process. Ultimately it was the joy and confidence I found in being a mom that helped me to normalize it for myself and hopefully a few others. I remember one day reading online the comment of “are you a pull up or pull down person?” and thinking to myself happily how I like how that person took it so lightly and also acknowledged that people have all sorts of differences and that matters in some ways in not of others. Clothes certainly aren’t the be all, end all when it comes to normalizing pregnancy, childbirth and breastfeeding, but I say, if it makes it more fun… then hopefully you can go for it, whether it is buying an outfit you really love, or repurposing something you already have with a sense of gratitude. Both ways are powerful, and hopefully all will win!

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Hurdles and How-To’s

The Peaceful Fight: The ways of Mothers

In these days of the Corona Virus, as much as people may deny, life is happening as we know it. Yes there are still people having babies. I would like to take a moment to go over the different types of immunity and how they can affect us all in these crazy times.

Passive Immunity. This is something you receive from another being, such as a mother, through an umbilical cord or through breastmilk. It can help you to fight a disease in the here and now if you are sick, it may (but no guarantee) also help you develop immunity to a potential host down the road, but, it depends on how the passive immunity is acquired, as in how it is acquired from the mother. For example if the mother has corona virus and she is able to breastfeed and not give the corona virus to her children then this would help to prevent a corona virus outbreak down the road if there was no vaccine. The only other way I hypothesize it might help prevent a corona virus is if the person were able to overcome corona virus while breastfeeding and take it to the next level of immunity by fighting back with their own immune system at the same time. This is called passively acquired immunity.

Passively Acquired Immunity is mostly occurring when we receive a vaccination. When you are given attenuated, or dead viral cells that your own immune system is allowed to develop immunity to in a passive way without getting sick. It can also be when you are around another sick person who has infected other people around the same time, but you, yourself has not spread the virus even though your body has been a host. Both of these types of immunity happen fairly quickly and may or may not prevent viral spread in the future.

The last type of immunity is the strongest: Active Immunity It is when you get sick, and your body fights back, your immune system remembers the blueprint of the virus and will always be able to fight it off. You may still be able to pass on passive immunity to others through breastfeeding or having children. Life goes on after viruses and this is our bodies’ way of saving future generations.

The last type of immunity is the strongest: Active Immunity—It is when you get sick, and your body fights back. Your immune system remembers the blueprint of the virus and will always be able to fight it off. You may still be able to pass on passive immunity to others through breastfeeding or having children. Life goes on after viruses and this is our bodies’ way of saving future generations.

The CDC’s stance on breastfeeding, is currently supportive of breastfeeding, yet does not fully specify how. Everyone makes their own choices. Some breastfeed longer, some shorter, some more, some less. Every milk is different but luckily made especially for your baby and comes at a small expense of the mother. Aside from this, mama milk is also very, very nutritious and promotes a lifelong quality connection between a mother and her child. It is impossible to social distance while breastfeeding in my opinion, but boy is it worth it! As an IBCLC and a mom I sure do feel encouraged by the CDC’s stance on breastfeeding. Be sure to ask your doctor for more information. We are here to fight, not flight- lets work together and stay strong and peaceful.

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Hurdles and How-To’s

The Joy of Baby Massage: Getting Around Wiggles and Other Challenges

Touching and cuddling with a baby feels like a joy to many moms, dads, and other caregivers. When I was looking for other ways to connect with my baby, touch was my go-to, as it is one of the first ways that a baby begins to develop communication skills with a caregiver. I signed up for a baby massage class and was pleasantly surprised with what I found. The class was not always easy however, and some challenges presented themselves along the way.

If you are thinking of signing up for a baby massage class some of the challenges you might face are your baby crying during massage time. Also for some of the massage moves where you unbutton your baby’s diaper to reach their lower back and lower abdomen be prepared for the potential for your baby to poop on you. The last challenging aspect is that babies are very wiggly. It is harder to give a massage to a wiggling baby that won’t hold still, rather than to an adult, because the wiggles throw the massage moves off.

These challenges do not come up too much, but when they do, it is nice to be prepared with how to deal with them. For the messy diaper obstacle you can have your diaper laying right underneath and a change of clothes and wipes at the ready. For the crying aspect, it is important to remember that baby massage is not meant to be used to soothe a crying baby. Instead, one should use alternative soothing methods and use baby massage to bond during more happy moments. The challenging aspect of crying for me, is often I was not able to get in all the massage in that I liked before my baby started crying, and she was not always balanced on each side as a result. It is possible to learn to be more relaxed about this. Lastly, for dealing with wiggly-ness, I interpreted that as a part of the bonding aspect of  the massage time- as it was her massage, her way. I took time to enjoy her wiggles and smiles and let my massage to my baby be interactive in that regard.

Other things I learned in baby massage include the importance of using oil (I used a blend) so as not to create friction when doing a massage. Also, the massage does not need to be super gentle, in fact babies enjoy a firmer touch because it reduces their level of ticklish response, and as most of you know, being tickled during a massage can be quite annoying.

Babies are just like us. When we get a massage on a bad day, we are more likely to open up and talk to that person about our day. This is a form of trust and bonding. Although, a baby can’t talk to us about their day, you can see in a baby’s eye the form of trust and reliance when receiving a massage. Because babies rely on caregivers for so much of their care every day, it is so wonderful for them to realize the joy of massage in a trusting way.

There are many how-to guides on baby massage out there, but I recommend taking a class if you get a chance from someone who is trained in baby massage because you can really learn the basics best by practicing on your baby and they can observe you as you begin. Remember that the massage you are giving to your baby is different than a body worker such as chiropractor trained in craniosacral therapy. That professional would be doing joint manipulations, while you are more practicing a form of loving touch for the sake of joy and touch. Just like adults, both forms can complement each other and have many benefits for baby. This includes helping baby to gain weight and catch up developmentally.

I truly enjoyed my experience with baby massage, but I also realize that it is a practice. It is a special way to connect with another human being, but it takes discipline and patience just like any other practice that is worthwhile. I noticed after practicing baby massage on my baby, her digestion improved and she warmed up to me even more.

The biggest piece of knowledge to keep in mind is the purpose, which is to enhance the bond between you and your baby. Have fun and enjoy your special massage time with your baby. Everyone’s experience is unique, but with these simple tactics, you will be able to combat challenges that may arise during a class you may decide to take. You will be prepared and succeed in the baby massage process, whether you decide to take a class or practice it on your own.

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Hurdles and How-To’s

Approaching the Weaning Blues

Everyone’s breastfeeding journey is different and subjective. Perhaps yours began in a hospital room? At home? You could be breastfeeding your first child or your third. You may have had plenty of help and support, or you may have been on your own. Maybe you supplemented, pumped, and bottle fed? Maybe you decided against it. Often, everyone’s breastfeeding journey ends differently and at different times as well. As the weaning process varies from mom to mom and baby to baby. Wherever you are in the process, you have come so far and that alone is amazing.

Each day you breastfeed, you could consider it a day closer to weaning. Even though it is hard to fathom that this time may be approaching, it never hurts to be informed about how moms deal with the “weaning blues,” or for that matter, how little ones might react to weaning.

 

The “Weaning Blues” and what to expect

It is very common for women to experience a deep sadness during and after weaning. These feelings can vary between lasting only a few short weeks, to being severe and needing medical help. Many people explain the weaning blues as a form of grieving the loss of the bond that breastfeeding creates between mother and child.

The weaning blues can also be linked to chemical or hormonal unbalance because less of the relaxing chemical, oxytocin, is needed to produce milk.

Oxytocin is known as the “love hormone”, so when there is less of it, depression tends to ensue.

Often times, when a mother is weaning, partners and other family members may not fully understand what she is going through. A partner may react negatively to her depression and not connect it to the fact she may be weaning the child. Our culture often thinks of weaning in an overly simplified way, such that it can be easily controlled and managed and that it is a conscious choice one may make. In fact, weaning starts early on with a baby’s first bite of food and can continue long after that. Evidence-based practice suggests that weaning should be child-led. Ideally, it would begin around the time that the baby is expressing less interest in nursing and the mother’s ideas are not imposed on the little one. Additionally, moms should remember to give their partner a loving heads up that they are going through the weaning period, and this should help to curb any negative comments or feelings.

 

Weaning has its positives

The process of weaning can help to make the final days of breastfeeding less abrupt, in addition to being easier on your little one. It is important to practice good and healthy habits during the weaning time period. Continue to pursue good nutrition, go to sleep at a regular time, practice deep breathing and meditation, and exercise. Try and encourage the oxytocin hormone in other ways, such as kissing and hugging your partner and children.

Other ideas moms can tie in to make weaning seem like less of a sad time, is to throw a weaning party or a celebration for the little one with other children that have weaned and can involve eating solid food treats.

Sometimes children can relate to other children about their nursing experience in ways that adults can’t. This can also be seen as somewhat of a celebration because the mom and child have a newfound sense of independence, and the child can be even more a part of the dinner table. There are even some children’s books written about weaning from breastmilk and this can help a child relate to what is going on in a conceptual and fun way.

 

The choice is yours

Mothers wean at different times and it is important for the mother not to feel guilty for weaning. Hopefully, a mom feels like when to wean is partly her decision and not pushed into it by people around her or by society. It is important for a mother to look at her situation before deciding to wean and see if there is a compromise. For example, a mother going back to work may not have to wean if she is able to continue pumping and still deliver some breast milk through a bottle.

My nursing journey is still a fairly new one. There are so many ups and downs and different things to learn along the way. For me personally, I see weaning as something that will happen between me and my child within the next couple of years. You may see weaning as something to begin tomorrow, today, or it may have happened yesterday. Remember it is all a part of your nursing experience and not just “the end.”

This article was also published at https://www.mimijumi.com/blogs/mimijumi-blog/approaching-the-weaning-blues.

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Hurdles and How-To’s

Weaning from the Nipple Shield: A Personal Depiction of my Breastfeeding Experience

It’s amazing how in a flash breastfeeding can change, for better or for worse. In my case, I birthed a late preterm infant. Breastfeeding has only gotten better and better day by day. I even had a major breakthrough, which was weaning from the nipple shield (a nipple shield is a plastic layer that goes over the nipple when breastfeeding a baby that can make a nipple more pronounced and also change the flow of milk affecting breastfeeding).

Also, as I begun to nurse, I realized that in my eyes as mother no matter how I looked at, my daughter always seemed to be nursing so perfectly. I felt lucky that I didn’t feel any nipple pain, when many mother’s do. But to me my daughter was learning! I was just so proud of my young daughter.

I am an aspiring IBCLC (International Board Certified Lactation Consultant) and an RN (Registered Nurse) who has done plenty of studying and formed my own opinions and impressions about breastfeeding.  I definitely wanted to do everything right from the get-go, provide strong milk for my baby, and be successful with the process.  I vowed never to use a nipple shield because it can have an effect of limiting your supply of milk and offer less benefits to your baby, especially when it comes to some of the benefits breastfeeding gives to your baby by mechanically exercising their mouth properly. I was surprised when nipple shield use played out differently for me during my breastfeeding experience. It’s amazing how excited I was to breastfeed, and still am, but it’s also amazing how much I had over simplified it.  I was stuck in an “if then” style of thinking.  For example, if I don’t use a nipple shield then my supply will be better. If my daughter is able to learn to latch then she will always know how to latch, etc. When you are so happy to try something new, you have a tendency to over simplify it in your mind in order to connect with the excitement.  It’s not bad; just something for which to be aware.

Also, as I begun to nurse, I realized that in my eyes as mother no matter how I looked at, my daughter always seemed to be nursing so perfectly. I felt lucky that I didn’t feel any nipple pain, when many mother’s do. But to me my daughter was learning! I was just so proud of my young daughter.

The biggest piece of information I found was to not allow my baby to fatigue during breastfeeding. This was a large part of the reason why she went to the NICU (Neonatal Intensive Care Unit) along with struggling to pass the glucose protocol. But it is so interesting to me that we did not need to use a nipple shield right off the bat.  My husband and I waited until she was approximately seven days old.  We tried it out of the blue.  My reasoning was that she had already been exposed to a bottle; why not a nipple shield too? Also, I hoped she would be able to leave the NICU as soon as possible with as little intervention as possible. To me, even though bottles were not ideal as far as breastfeeding goes, they sure were less invasive than a glucose IV or a temporary feeding tube.  I figured that if I used the nipple shield, it would help her be able to be more apt to accept bottles.  Bottle feeding is where she would be getting most of her nutrition for a while, from my pumped breast milk as well as donor milk, and then we would still be able to breastfeed for 15 minutes each time in order to “practice.”

In the NICU, I asked to work with a lactation consultant once or twice a day, and I sure did take advantage of that! To me, being in the NICU was a challenge and sometimes sad.  Getting to work with a lactation consultant was a way for me to “treat myself.”  After all, as an aspiring IBCLC, just being in other lactation consultants’ presence was very reassuring.  As they worked their magic, it always seemed we had a better nursing session. I thought the IBCLCs were so great I was sure I would be able to wean from the nipple shield in no time, but it was much a harder than that. But it did evolve and I never gave up

Ultimately, we ended up weaning from the nipple shield around two and a half months after birth, and I do believe it was baby-led. Although I tried to push it a few times, I, as the mom made sure I never went too far so as to curb any negative experiences.  Sometimes she would be crying and upset afterwards, but in those cases I would always give her the nipple shield. If that made it smoother for her, then so be it.  We would always finish our nursing.

We tried all the tips in the book and nothing seemed to produce a result. We tried pointing my nipple to the roof of her mouth. We tried starting with the nipple shield and removing it part way through a feeding and drying off my nipple and re-latching, etc.

Along the way, with this, I found out I had a bit of an oversupply and also learned that nipple shields can help with this, and help to inhibit the flow of milk so that the baby could handle it better, so that could have been a contributing factor of why a nipple shield was helping. Also the fact that I had smaller nipples. I had to work on bringing my supply and flow down a bit so she could handle it a bit better along with getting more hind milk (which is the fatty portion of the milk that follows the foremilk towards the end of the feeding).

Ultimately, we ended up weaning from the nipple shield around two and a half months after birth, and I do believe it was baby-led. Although I tried to push it a few times, I, as the mom made sure I never went too far so as to curb any negative experiences.

But eventually it happened and I think it was partly developmental and baby led… she started kind of fiddling with the nipple shield during nursing which to me was a sign that she was annoyed with it. And right after I went to one la leche meeting (a meeting which offers breastfeeding support), I could see her beginning to wean from it. However I always wondered why they called it weaning? It seemed more like a break through to me. Although we had been working on it for a long time it seemed like one day we were using it, then another day, we weren’t.

I was so overjoyed when we no longer needed the nipple sheild. Less plastic to wash, I was more connected during nursing, and I knew my hard work had paid off. I learned that there truly is a mother-child connection and when the mom is working hard and patient with something the child senses it and takes baby steps in that direction to trying the easier way for the mom… whether psychologically, spiritually or physically. I’ve heard from other moms that they loved their NICU experience, and even though it was a struggle at times, I think in the end you own your experience, the struggles and the growth periods. I don’t know if I would have traded my experience for another, I never really let myself go to that place, instead I look fondly back on my experience and it is part of me, it is mine, just like this new child is mine also.