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Posts Tagged ‘breast feeding’

NOTEWORTHY WEDNESDAY FRIDAY!

As a follow-up to a recent post of mine I would like to comment on the article in the Wall Street Journal that is quoted below.

Hospitals can definitely play a significant role in the success of breastfeeding especially if they follow what Georgetown University Hospital is doing to actively encourage women and their infants to bond and breast feed soon after delivery.

I am not surprised that this example is from a teaching hospital in a major metropolitan area. Patients can be selective and demanding about where they deliver and these teaching hospitals want to offer all they can to provide what is recommended best for moms and babies. I am in no way putting down other hospitals but in my experience the teaching institutions will get on board with recommendations faster than other hospitals. The reasons are many  but in today’s healthcare environment economics is a very motivating factor.

On the topic of economics…obstetrics traditionally is not a money maker for hospitals the way cardiovascular surgery is…that being said hospitals are businesses and pouring money and time into obstetrical services is not something that is done without serious financial considerations.

In my practice, I have had moms say that nurses and lactation consultants have been “Nazis” when it comes to breast feeding immediately after delivery and they have not liked the attitude that is has been conveyed to them in the hospital.

My question about the shift in breastfeeding strategy is ,when are we going to learn to be gentle with new moms and be encouraging with kindness? New moms are often scared and unsure of themselves and sometimes they are even afraid of their newborns and afraid of all the body changes that they are experiencing immediately after delivery.

New moms need to be catered to while in the hospital…they will be home soon enough dealing with a whole new world now that their baby is finally here.

Hospitals can be encouraged to shift their strategies ….that is all well and good but until they have the  nurses and lactations consultants with a gentle touch, who are not overworked…but who are devoted to “helping” the new mom with her new baby without being judgmental, breastfeeding will still be much more of a challenge for mom and baby than it needs to be.

It is my belief that much more emphasis should be placed on the approach that is used with the new mom in combination with the strategies of early breastfeeding and bonding.

Maybe we need to revisit “Reva Rubin”s Postpartum Theory” to understand what the mom is emotionally experiencing in the first hours and days after delivery and use Reva’s observations to guide us in the care of the mother and newborn.

a. Taking-In Phase. During this phase the mother is oriented primarily to her own needs. She primary focuses on sleeping and eating. She may be quite passive and dependent. The mother is reacting to the intense, physical effort expended during delivery and the intense, emotional effort required of her during labor. The mother does not usually initiate contact with the infant. This is not out of disinterest. It may result from her own immediate dependency. Nevertheless, she is taking-in information that helps her to identify the infant. She may use her finger-tip to touch her infant. This serves as one of the first steps in the identification process. She holds the baby facing her so they can explore each other’s face (in the face position). The mother relives the delivery experience which allows her to integrate it fully with reality, fully realized her baby is born, and to identify her infant as being outside and separate from her. This phase, taking-in phase, may last for a day or two. The nurse should plan activities so that the patient can rest as much as possible because failure to allow the patient to receive the necessary and earned rest may yield a “sleep hunger” which may be manifested by irritability, fatigue, and general interference with the normal restorative process. The father’s role is primarily being supportive of his wife and his family.

b. Taking-Hold Phase. During this phase the mother strives for independence and autonomy, she becomes the “initiator.” She is concerned about her ability to control her bodily functions (that is, bowels, bladder, and if breast-feeding, concerned about adequate amount and quality of milk). She takes an active part in trying to control these functions. She is concerned about her ability to take care of her newborn. This phase is associated with a great deal of anxiety (especially by a new mother). She may have several mood swings. The mother might be involved in a lot of activity trying to accomplish tasks. Fatigue and exhaustion may occur if the mother is not helped to set realist expectations and limits for herself. The nurse is responsible to allow the mother to actually perform infant care tasks, reinforce all positive actions (do not impose yourself), and provide guidance, instruction, and demonstration, as necessary. Reassurance and explanation about infant care are especially needed in this phase. This phase lasts for about ten days (most of this phase is accomplished at home).

c. Letting-Go Phase. Generally, this phase occurs when the mother returns home. The mother must accomplish two separations during this phase. The separations are to realize and accept the physical separation from the baby and to relinquish her former role of a childless person. The mother must adjust her life to the relative dependency and helplessness of her child. If she quits work, she must adapt (even if only temporarily) to less freedom, less autonomy, and less social stimulation. If she continues to work, she must handle the additional strain of finding sitters and meeting additional workload. The mother may experience a let-down feeling, which is called postpartal, or baby, “blues.” This is a form of depression that is usually temporary and may occur in the hospital.

via Psychological Needs of the Postpartal Patient.

Reva Rubin believed that a mother needed time to absorb and integrate her labor and delivery. This takes place in the first couple of days postpartum while the mom is trying to get to know her newborn and begin the awesome task of taking care of him/her, changing diapers, bathing and feeding. The new mom probably does not pass through the “taking-in phase” before she is discharged home from the hospital.

Over the years postpartum hospital stays have gotten shorter and shorter so mom has had to condense her “taking-in” experience into hours rather than days. She has to get comfy with diapers, bathing, swaddling, and of course feeding…breast or bottle. Postpartum nurses have had to adjust their care to give mom a “crash” course in newborn care…this is a tall order and in my opinion it takes a skilled educated nurse to accomplish this effectively with a new mom.

To encourage breast-feeding, Georgetown University Hospital staff place the newborn on the mother as soon as possible, usually within a half hour after birth. The hospital, in Washington, D.C., delays weighing and measuring the baby until after this skin-to-skin bonding takes place, says Carol Ryan, who manages Georgetown’s lactation team. For women who had caesarean sections, healthy babies are brought to the mother as soon as possible and touch the mothers’ face if they can’t be placed on her, says Ms. Ryan. Infants also are roomed with the mother 24 hours a day, rather than being taken to the nursery.

The U.S. government’s goal for the end of the decade is for about 60% of women to be breast-feeding at least part of the time for the first six months, according to the government’s 2020 Healthy People objectives.

via A Shift in Strategy to Get More Mothers to Breast-Feed – WSJ.com.

We need more than strategies from hospitals…we need human kindness and a much more gentler approach to mother and baby in the hospital followed by a gentle approach at home while this dyad begins to take on the tasks before them. There needs to be a real effort made to make breastfeeding a “socially” acceptable thing. Education of the general public would greatly help in this area.

Then maybe we will begin to see a serious increase in breastfeeding success.

related posts:

https://parentingintheloop.wordpress.com/2011/08/04/world-breastfeeding-week/

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Breast milk baby-doll, I never thought about it to be truly honest. But now that it has been a discussion on “The View” and other morning news shows, I guess I do have an opinion.

Personally, I think that this doll can certainly teach children about breast feeding therefore it is a good thing. Children are learning all the time and playing with a breast-feeding doll will do no harm…I see it only as a positive experience.

Recently, I was walking with a 2 year old little girl who has a Princess Tiana doll. Now, the little two year old was caucasian and as we know Princess Tiana is a ‘black’ character from the Disney movie, ‘Princess and the Frog’.

We were actually walking through Chicago’s Midway airport. During this walk, I could see both white and black men and women smiling as they watched my little friend tending to Princess Tiana. This little one will soon learn that there is a difference in skin color but right now she is just being a child and enjoying herself.

I feel the same way about the breast feeding doll…little ones will be just being themselves while playing with this doll…they will not have acquired all of our ‘adult’ hang-ups about breast feeding.

Wouldn’t it be nice if we could look through the eyes  of  a ‘little one’ when it comes to breast feeding and simply see a mother feeding her child.

Adults have been preparing little kids for adulthood in wacky ways for generations. When I was in grade school, I had to coddle a bag of sand for two weeks, pretending it was my baby. My friends had to take care of an egg, making sure not to drop and break it.

Now, a Spanish company is bringing a breast-feeding doll for kids to the United States. The Breast Milk Baby works by making motions and suckling sounds when a sensor in its mouth gets close to a flowery halter top the child wears while “breast-feeding.”

The doll has already seen success in Europe, generating more than $2 million in sales for its maker, Berjuan Toys, since the doll was first released in Spain four years ago.

But the reception in the United States has been mixed.

Berjuan Toys’ U.S. spokesman, Dennis Lewis, told BlogPost on Monday that reactions to the doll have been 75 to 80 percent positive stateside.

“Once people sit down and think about it, there’s nothing controversial about it,” Lewis said.

Some of the support has come from breast-feeding advocates, who say the doll helps children learn about how to feed a baby in a natural way.

But parents interviewed by “Good Morning America” were split on the issue.

via ‘Breast Milk Baby’ breast-feeding doll headed for U.S. – BlogPost – The Washington Post.

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Strange and Disturbing Breastfeeding News of the Week.

This has been a week for breastfeeding news. Again, I am referring my readers to “Phd in Parenting” s blog. She is such a wonderful advocate for moms and babies.

California Protective Services visited Mariah Carey in the hospital, because she was drinking beer to help produce a better milk flow…she is breastfeeding her twins. Good for her…breastfeeding twins is a challenge and  according to current scientific findings beer  in moderation will not hurt or her babies.

Now, on to the legislation in Georgia which seeks to restrict where a mother can breast feed a toddler….

Please check out the link above for a great discussion.

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NOTEWORTHY WEDNESDAY!

By now if  you read this blog at all you know that I am a fan of  “Phd in Parenting” and her blog. She is an ardent supporter of breastfeeding as am I.

To be truthful…I did not breastfeed due to medications that I was taking which were excreted in my breast milk. This was a few years back since I am now a grandmother. I missed the opportunity to breast feed way back then. But I did not miss being discriminated against.

Once when I asked to be seated in a restaurant in a large West Palm Beach department store, the hostess asked me if I intended to breast feed as it was not allowed in the dining room because it was offensive to the other patrons, who were mostly elderly. She then suggested I use the ladies room for privacy. What a relief came over her when I told her I was not intending to breast feed.

I never forgot this incident and it seems that not much has changed over the last  25 + years. How sad is that?

I share this post below “50 Reasons for Breastfeeding Anytime”…I could not say it better.

Once again, there has been an incident where someone went up to a breastfeeding mother and told her she had to cover up or leave. Once again, the media feels to need to create a breeding ground for ignorance by asking questions like “should there be any restrictions on breastfeeding in public?” The answer to that stupid question and yes…there are stupid questions, is simply NO. There should not be any restrictions. There is a myriad of reasons why women should and are able to breastfeed anytime, anywhere.Human Rights1. It is illegal to discriminate against or harass a woman because of her sex, including pregnancy and breastfeeding. or if it isn’t where you live, it should be!

via 50 Reasons for Breastfeeding Anytime, Anywhere | PhD in Parenting.

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NOTEWORTHY WEDNESDAY!

Breast is best…the comments…

“So overall, yes, breast is probably best. But not so much better that formula deserves the label of “public health menace,” alongside smoking. Given what we know so far, it seems reasonable to put breast-feeding’s health benefits on the plus side of the ledger and other things—modesty, independence, career, sanity—on the minus side, and then tally them up and make a decision. But in this risk-averse age of parenting, that’s not how it’s done.

….

My best guess is something I can’t quite articulate. Breast-feeding does not belong in the realm of facts and hard numbers; it is much too intimate and elemental. It contains all of my awe about motherhood, and also my ambivalence. Right now, even part-time, it’s a strain. But I also know that this is probably my last chance to feel warm baby skin up against mine, and one day I will miss it.

via The Case Against Breast-Feeding – Magazine – The Atlantic.

Here’s my message to other moms anxious about formula-feeding: If you absolutely hate breastfeeding for whatever reason, stop. Let it (and the guilt) go. Breastfeeding may be healthier than formula, but the formula they’re making these days is pretty awesome, too. The extra nutrients and antibodies a woman’s breast milk provides may not be worth crying every time you have to breastfeed. The truth is that your child can thrive on breast milk or formula, but an unhappy mama does not a healthy baby make. So let’s stop using how we feed our babies as an occasion to make ourselves — or other moms — miserable.

Not breastfeeding and feeding baby formula don’t make you a bad mother.”

My thoughts…

Breast Feeding has been in the news this past week with the IRS giving moms a tax-break on breast pumps. Finally, there is recognition for moms who need pumps for a myriad of reasons to help them continue to breastfeed.

Let me start out by acknowledging that I did not breastfeed either one of my children…it was a decision I made without any guilt even though I was a maternal-child nurse and had a fair amount of knowledge about breastfeeding.

It was part of my job to help women with breast feeding after delivery and during their post partum  hospital stay which in the 70’s when I began my career was on average 4-5 days for a vaginal delivery and 7-8 days for a c-section, unlike today’s very brief hospital stays after delivery. Nurses played an important role in mother-baby care for more of an extended period of time in those days of lengthier hospital stays.

Breast feeding was really on the upswing in New York City during the 70’s and many moms were choosing it as an option.

Often the first couple of days breast feeding would go fairly smoothly. It was a learning time for both mother and baby.  It seemed that gentle coaxing and encouragement gave a new mom and baby all they needed.

Then on the third post-partum day something dramatic occurred…. mom’s milk came in and the “honeymoon” period for mother and baby was usually over.

At this point, sometimes mom would even have a slight fever and be somewhat uncomfortable until baby breast fed and relieved the pressure from her warm breasts…but other moms would be initially so engorged with milk they would be crying as would baby who was having difficulty attaching to mom’s rock hard nipples. Then for some moms there was the problem of sore nipples to contend with…ouch!

Moms seemed to have a difficult time with all these adjustments in the hospital atmosphere, rooming-in was encouraged but there were still schedules to contend with and those were not always conducive to the calming conditions that are needed for mom and baby to successfully begin breastfeeding.. If the mom was recovering from a c-section the scene was usually more complicated and more painful for her. This usually added to her frustration which carried of course over to her newborn. Nurses tried their best to encourage and provide a soothing setting for both mom and baby so that they both could enjoy the breastfeeding experience which was known to be so important.

Newborn care in the hospital in those days was slightly different as well, due to the extended length of stay. Baby’s weight would be closely monitored as would any level of jaundice. Jaundice is a threatening condition depending upon many factors. Feeding encourages babies to pass stool which excretes bilirubin which causes jaundice…if baby does not get enough liquid this can cause a problem. Breast feeding was always something that caused some concern…as to whether the baby was getting enough milk… now I am not saying that breast feeding causes jaundice but many factors enter in to the picture here and feeding whether bottle or breast is observed closely if jaundice is a problem.

Even in the 70’s we knew that “breast was best” but it seemed that we did not freak out when mothers made the decision to formula feed their newborn…we realized that it was their choice as it is today. Bonding was encouraged and healthy feeding techniques were taught. Skin to skin touch was emphasized.

My decision to formula feed… was not by choice. I was taking medications that were excreted in breast milk. These medications would have been very problematic for my baby so breastfeeding was not an option. The decision was really made for me…in all honesty after working with post-partum moms I was not sure I was up to the task. It had always been super amazing to me to see the adjustment period of mom and baby to breastfeeding just as amazing perhaps as the birth of each child.

I honestly believe breast or bottle feeding does not determine what kind of mother you are…there are so many factors that go into mothering and parenting it is a wonder that any of us make it through to adulthood.

One thing I have learned is that children do take a village to raise and it starts at birth…adequate support is important to get mom and baby off to a good start. I believe that we all need to recognize our own prejudices and allow others to self determine without pressure.

In the end, we are not raising another mom’s child and really don’t we have enough to do raising our own?

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Noteworthy Wednesday!!

Parents these days seem in such a hurry to move their kids through the milestones of development.

But moving kids from formula to solid food is one change parents may want to take their time making. Trying solid food with formula-fed kids before they hit four months of age raises the odds they’ll be overweight as preschoolers, according to research findings just published online by the journal Pediatrics.

via Weighty Issue: Keep Junior Off Solid Food During His First 4 Months : Shots – Health News Blog : NPR.

Obesity in children is a serious problem and there seems to be many reasons for it. Good nutrition has always been important from day one of a baby’s life.

Whether formula or breastfeeding the information in this recent report indicates that there seems to be a connection between when babies are started on solids and their developing obesity.

Many parents are encouraged by others to feed solids to their baby at an early age with the hopes that the infant will in fact sleep better. This of course is fallacy.

I can remember being told by a well-meaning relative that my baby was hungry and I definitely needed to give her some rice cereal to quiet her down and have her sleep longer. I was anxious to do the right thing so I tried the cereal.

Oh…but when I watched my tiny darling struggling with it I soon abandoned the effort and low and behold my daughter slept through the night at 6 weeks just as the all the books predicted she would.

So…my feeling is stick to breast or formula feeding your infant. Do not be in a hurry to introduce solids into their diet. And when you do begin feeding solids make sure that they are nutritional ones. There are many wonderful infant food resources available. Please take advantage of them.

Do not be fooled by the advertisers of convenient baby food products that we have all grown up with. Many of them are not nutritionally sound and have large amounts of sodium in them despite what we know about too much sodium. So read, read, read and become an advocate for your families eating habits right from the start.

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