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.

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

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