Saturday, April 12, 2014

Seasonal Allergies and The Nursing Mother

The Triangle is unsurpassed in it's Spring beauty, and formidable during allergy season. According to Allergy Capitals, a part of the Asthma and Allergy Foundation of America (AAFA), Raleigh–Durham–Chapel Hill ranks at No. 31 amongst US cities with the most severe allergies. What does this mean for Breastfeeding Mamas and Babes?
 

Breastfeeding Helps Your Child with Long Term Allergy Issues. A Swedish study conducted by the Department of Environmental Health in Stockholm, concluded that there is a correlation between breastfeeding and the prevention of early development of allergic diseases up to two years of age.

Medications Mitigating Your Milk There are plenty of medications that will keep you feeling healthy during the allergy season, but beware of others that can tank your supply. A great website to learn more about your options is www.infantrisk.com. Here's a breakdown from Texas Tech University:

Antihistamines It is advised for a breastfeeding mom to use the newer non-sedating antihistamines instead of the older antihistamines. These include Cetirizine (Zyrtec), Loratidine (Claritin), and Fexofenadine (Allegra). The older sedating antihistamines include Diphenhydramine (Benadryl), Chlorpheneramine (Aller Chlor), and Brompheneramine (Dimetapp). Sedation in a newborn or young infant can lead to apnea or temporary breathing cessation and therefore is something to be concerned about.

Decongestants  Pseudoephedrine (Sudafed) and Phenylephrine (Vicks Sinex Nasal) are two of the most commonly used decongestants on the market. Pseudoephedrine is secreted into milk in low levels, however, it has been shown to decrease milk production and should be used with extreme caution in late-stage lactation (>8 months). Although levels of phenylephrine in milk have not been documented, they are thought to be low and theoretically can decrease milk supply. Antihistamines such as Zyrtec-D or Claritin-D contain these decongestants and should be used with caution by a breastfeeding mother. Oxymetazoline (Afrin) is a nasal spray decongestant that can be used to treat acute congestion. It should not be used for more than three days as it can cause rebound congestion.

Mast-Cell Stabilizers Mast Cell Stabilizers such as Cromolyn Sodium (Nasalcrom) suppress mast cell degranulation thereby reducing allergy symptoms. There is no data on its transfer into milk, but because it has a low pKa minimal levels would be expected in milk. This drug is used frequently in pediatric patients and poses little risk to an infant.

Corticosteroids Corticosteroids can be administered orally, inhaled, or intranasally. Inhaled corticosteroids include Beclomethasone (Beclovent) while intranasal ones include Fluticasone (Flonase, Flovent), Budesonide (Rhinocort), and Mometasone (Nasonex). Intranasal and inhaled corticosteroids may be safely used by a breastfeeding mother as the maternal plasma levels are low and therefore milk levels are low to undetectable. If oral steroids are used (i.e Prednisone), it is preferred for the dose to be kept low
Immunotherapy Allergy Immunotherapy or allergy injections are composed of protein substances that are unlikely to enter into milk. Allergy injections are safe to use in breastfeeding. Although adverse effects are unlikely, the infant should be observed for allergic reaction.

 
Staving Off the Sneezes, Naturally. There are many ways to stay comfortable during the allergy season while continuing to nurse.
  • Keep your windows closed in the home and car during allergy season to avoid over exposure to pollen.
  • Change your clothes when coming indoors to keep pollen outside.
  • Dust and vacuum often to remove remaining pollen, if possible, with a hepa filter/
  • Avoid outdoor activity during high pollen days, you can read the forecast by visiting www.pollen.com
  • Rinse that Allergy Away-The Neti pot is a non evasive way to rinse the nostrils and sinuses of pollen. It seems odd and looks a little weird, but it feels wonderful and can work wonders on stuffy noses and postnasal drip.

Sunday, March 30, 2014

Fun and Informative!



5 Childbirth & Breastfeeding Guidance Program
Starts This Thursday!
 

When: 6-8:30pm Thursdays
Where: Cary Pediatrics, 1001 Crescent Green Dr, Cary, NC 27518
Who is this class for? First Time and Seasoned Parents Welcome.
What Do You Need? Comfortable Clothing, The Course Provides the Rest
Cost: $199, Register Here

Summary: This class is as entertaining and it is educational. My goal is to empower Families through education... with a bit of levity along the way! By understanding the how and why of labor, birth and breastfeeding, these wonderful experiences are normalized and fear subsided. In this class, you will also learn about how to advocate for yourself and on behalf of your Partner. We will cover the risks, benefits and alternatives to interventions, so that you are able to make an informed decision. The breastfeeding portion of this class will prepare for you for nursing your baby and how to best support Mama in this process. Here are what past students have said about this course:

Thank you for making us feel empowered about the birthing process and that it is a natural thing to go through, knowing what to expect and being prepared for the pain management and support from our husbands and birthing team. Wonderful class!!

You are the best & we love you. Not only did we walk away from the class feeling empowered, I felt I gained a new friend you in, Karissa & the other classmates. I had an amazing birth experience. Hands down the most amazing experience of my life and I know that because of your class, and the information that both myself and my husband walked away with, we felt confident and capable of having the birth I wanted. I also felt I was educated enough about the process in case we needed to make a change in our plan during labor & delivery. Thank you for being apart of the most amazing experiences of our lives!

I have thoroughly enjoyed this class. Not only is it helpful to the birth mother but also to her partner. It has opened up the communication lines between my partner and I regarding the birthing process. It has also taken the "fear" and "unknown" aspect out of the birthing process.

Saturday, March 22, 2014

May 10th Baby Reunion


CELEBRATING FAMILIES
Saturday May 10th 10-Noon
North Cary Park
 
I am celebrating my 5th year in the Childbirth Birth Community and invite past clients, students and mentors to kick off Mother's Day Weekend by visiting with friends and make new ones!

Click Here to Attend!
 
 
 

Wednesday, January 29, 2014

A Mother is Born from a Doula

Next week I celebrate the birth of my daughter, Cora Marie. It was three years ago that my life changed in such unexpected, beautiful, and very humbling ways. Motherhood is the great equalizer. Whether you're a teen or a nearing forty, parenthood is an experience that can bring you to your knees- in exhaustion and exultation. It's miraculous and monotonous and every emotion that can be described.



I can now admit, that I was a much better parent before I had children. I knew exactly what needed to be done to birth and raise a healthy, well adjusted, brilliant and well mannered child. I was a Doula. and studying to become a Lamaze Educator. I attended Birthing from Within and Hypnobabies classes. I was planning a homebirth where I would bring my baby into this world in a warm tub by the light of the fireplace. It was going to be perfect.


Perfect is not a word that should be used to describe pregnancy and parenting plans. Nothing and no
one is perfect. The closest thing to perfection during my birthing time was my team. I had amazing Midwives, Doulas and husband who supported me with love and compassion that still makes me fall deeper in love with him at the thought. These women and my Partner, coupled with my education, is what made a very imperfect event empowering.



I developed preeclampsia at nearly 37 weeks and I was required to be hospitalized. I was fortunate in that I had attended many births and knew that flexibility is what can make or break a Mother psychologically. I viewed the hospital health care team as allies and I collaborated on my care plan. I felt empowered because I was informed. I was empowered because I was supported.

I made the hospital my home for the days that I labored. I had expected an induction to be binding, painful and terrifying, but the love around me created a safe environment where I never paid mind to the IVs and monitors. Later, upon viewing photos of myself in labor, I was surprised to see that for all intents and purposes I looked like a cascade of interventions,  but it was so far from what I felt at the time.

My birth was beautiful and fierce. Though it wasn't what I had planned, it was healthy and holistic. I was tended to mind, body and soul. I advocated for myself, and when I exhausted, my husband stood in and protected my space and wishes. My Doula stood by me for the days I labored, my midwives spoke gently to me, and my girlfriends honored the sacred space and made me feel like a goddess. Every woman deserves to feel mighty in their birth- it more easily ushers the ferocity required of Motherhood.

I am passionate about childbirth guidance because I feel as though I'm an example of having a good birth in less than ideal circumstances. I didn't just go along for the ride because my path changed- I still steered the wheel with the help of my team. Knowing what one's choices are and how to advocate is essential in our birthing culture. Empowering the Partner to support the Mother is crucial.

From my own experiences and the births I have witnessed, I have learned a few things including:
  • Find providers you trust. Know their back up providers and be sure that they align with your philosophy.
  • Get educated about the entire perinatal period. This includes childbirth and breastfeeding classes. La Leche is an excellent way to immerse yourself in Motherhood while pregnant.
  • Prepare for Parenthood. Birth is kinda like a wedding- many of us get wrapped up in the day only to be surprised that we should have had an understanding of the relationship... which will continue for a lifetime.
  • Get a Doula. They do not take the place of a Partner, only enhance the experience. To find a Doula, click here.
  • Find your Tribe. There is nothing more special than finding other New Mamas to laugh and cry with.
  • Own Your Birth. If it causes pain or happiness postpartum, share it, process it and whatever feelings you have, know that it's okay and normal to have your opinions because it was your experience. Click here for resources

Monday, January 20, 2014

A Partners Role in Breastfeeding


My Husband, by Stephanie Goulet Photography


When we think of the postpartum period, we often think about Mom and Baby and less about the Partner. What role does he or she play as a Parent when the focus is on breastfeeding, maternal recovery and acclimating the baby to life outside of the womb? "The Fourth Trimester" can be a wonderful adventure for Parents as they navigate these new waters, and for many Partners, it's also a time where they may flounder. Here are some tips on how to support the breastfeeding relationship while also integrating your important role into the Family. (To avoid confusion, I will refer to the Partner as Dad from here on out, fully recognizing that there exist female Partners of Mothers who are just as vital)

The Dads role in the breastfeeding relationship should not be underestimated. Support throughout the relationship, but particularly in the first weeks, when Mom has hormonal shifts, may have a steep learning curve in breastfeeding, and is more venerable to other's suggestions, is critical. Dads in this postpartum phase can do the following for Mom that makes all the difference:
  • Acting as Gatekeeper and Allowing Only Positive People Around Mom, or Limiting Access from Grumps
  • Providing Perspective During Challenging Moments and Reminding Mom that This Challenge Will Not Last Forever
  • Making Sure that Mom is Well Fed and Hydrated
  • Telling Mom that She is Doing a Great Job
  • Being Patient About Resuming Sex. It Will Happen, but Perhaps Not Immediately.

Dads are also an essential member of the family. Babies often respond immediately after birth to Dad's voice, having become familiar with it in the womb. Dads  not only calm Mom, but also the baby with their presence, and he can bond in the early weeks and months by
  • Holding Baby Skin to Skin
  • Wearing Baby in a Carrier such as a Moby Wrap
  • Making a Ritual of Changing Diapers (sing a song, provide massage afterwards)
  • Creating a Bathtime or Bedtime Routine

As Mothers, we become all consumed with our babies and often forget that our first loves were our Partners. It is essential to the relationship to recognize this and acknowledge this to your Partner, and to assure them that you know they may feel like the third wheel. Here are some ideas that you may want to try that could make your Partner feel more included, and fit into your new busy schedule.
  • Appreciation Goes a Long Way, thank Dad for all that he is doing for the Family
  • Point Out the Wins. Men are afraid to fail. If he is doing something for you that is particularly awesome, tell him!
  • Tell Him His Baby Loves Him. If you see that your baby is responding well to his touch or voice, let Dad know he's needed and recognized.
  • Carve Out 5 Minutes to Ask About His Day. Give your man a few moments of your undivided attention and ask him how he is feeling and what's going on in his day.
Resources for Partners

Sunday, January 12, 2014

Breastfeeding Support at Cary Pediatrics


I have been teaching Breastfeeding Basics for Cary, Apex and Fuquay-Varina Pediatric Practices for nearly a year, and beginning this week, I will be begin earning my clinical hours to qualify to sit for the IBCLE exam. Over the past few weeks, I have shadowed the IBCLC at Fuquay Varina Peds, Dana, and am looking forward to getting started at Cary. I will be there Monday and Wednesday mornings 8:30-Noon to help support Mothers and Babies as a Certified Breastfeeding Specialist. It is my goal to earn my 1000 hours within the next year and to sit for the exam in 2015. I am very thankful to the Board of Directors who has allowed me to offer my services and call Cary Pediatrics my home. My journey into the childbirth and breastfeeding world has been a wonderfully busy one over the past five years, and has culminated into finding my calling. There is nothing more amazing to me than supporting Families in the perinatal and postpartum period through education.

Breastfeeding Support at Cary Pediatrics
  • Consults, Monday and Wednesday 8:30-Noon, By Appointment
  • Breastfeeding Basics Class, Third Saturday of each Month 10am-Noon
  • Breast Pump Workshop, Every other Month after Breastfeeding Basics

Saturday, January 4, 2014

Supporting the Nursing Mother



While our babies are made to breastfeed, and their instincts lead them to nurse, for many Mothers, it's doesn't initially feel natural. Breastfeeding is a learned behavior, and in our society, a woman's initial exposure to lactation could very well be when she's nursing her own baby! So, how do you set yourself up for success?

Are your Providers on Board?

Who is Catching Your Baby?
Choosing a prenatal healthcare provider who understands and respects the importance of breastfeeding can impact initial breastfeeding positively. Click here to learn about how you can choose prenatal providers who are breastfeeding friendly. To see a newborn nursing, visit this breastcrawl video.

Where You are Birthing?
You can learn more about Baby-Friendly birth sites that have incorporated the 10 Steps to Successful Breastfeeding to support New Mothers in their breastfeeding endeavors.





What Do You  Know about Your Baby's Care Provider?
If you have questions or concerns about your baby, you're most likely to call your Pediatrician or General Practitioner. Its important to find someone who encourages breastfeeding and understands that breastfed and formula fed babies can grow differently. The following websites can help you craft your questions when interviewing your baby's potential doctors.
 
What's in a Name?
As a pregnant woman, you are well aware that there are many professionals in the birthing world. The flurry of credentials can make your head spin- especially when it comes to those who provide breastfeeding guidance. Here are some of the groups and monikers you may become familiar with.

La Leche League Leaders
Peer to Peer support is a proven facilitator to successful breastfeeding. La Leche League Leaders have had personal experiences in breastfeeding their own children, and have the knowledge and resources to assist Mothers. Fellow Mothers at meetings are also instrumental in empowering one another and sharing their experiences from which others can learn. To learn more about our local LLL community, please visit www.lllofnc.org

International Board Certified Lactation Consultant (IBCLC) –These credentialed professionals have the most comprehensive knowledge and skills in breastfeeding support. IBCLCs are recognized around the world and work in a variety of settings including hospitals, doctors offices, birth centers and in private practice. To find an IBCLC, please click here.

Breastfeeding Peer Counselor Specialist or Educator (CLC, CLE, CBS, CBE)- A breastfeeding counselor can teach about the benefits of breastfeeding and can assist with basic challenges. Education can range from a one day to 90 hour+ curriculum. To learn more about my Certified Breastfeeding Specialist information, please click here.

WIC Peer Counselor-Peer counselors receive a 20-hour training and provides information on basic breastfeeding and can refer clients out to specialists.Click here to learn more.

Setting Up Realistic Expectations

A Family that understands breastfeeding together, keeps on going! Partners should attend a prenatal breastfeeding class with Mom. Expectations about support should be made clear to family and friends visiting prior to the baby's arrival. Here are some helpful sites and organizations:
Books
  •  The Womanly Art of Breastfeeding, LLL
  • Breastfeeding Mother's Guide to Making More Milk, West & Marasco
  • Mother Multiples, Gromada
  • Adventures in Tandem Nursing, Flower
  • Mothering Your Nursing Toddler, Bumgarner
  • Breastfeeding Your Premature Baby,Gotsch