This weeks blog is featured with The Pregnancy and Postpartum Health Alliance of Texas

I was recently asked to brainstorm on a blog for The Pregnancy and Postpartum Health Alliance of Texas. I wrote about the role of a postpartum doula, and the benefits in the sort of care. I reflect a bit on our society's mentality to internalize our needs, rather than vocalize for help. Here's a link to the full article, "Postpartum Doulas: The Support New Mom's Deserve"

Implementing a Nighttime Routine

Okay, so you are probably wondering by 12 weeks into development why your baby only sleeps an hour and half in between feeds some nights, and three and a half hours in between feeds other nights. The first year with baby can be a journey of the unknown, but it’s important to know that you are not alone in this venture. Many families struggle to attain a regulated schedule, even more so as we grow older and maybe even larger in number.

In terms of an infant, they have no concept of time or as my fellow Doula professional Allison Coleman of Austin Baby Guru says, “Babies don’t have a concept of your culture, in fact children don’t really gain an understanding of your family’s culture until the age of 5-7.” So, establishing a night time routine can be a good way to implement indicators that an infant can grasp.

Before we get into the thick of it, I want to make it clear. Night time routines are a practice, I can not guarantee magic with starting a night time routine as an infant’s needs are forever unpredictable. Also, consider the age of your baby. Babies younger than 8-12 weeks are often still developing so much, that it is unlikely they will trend anywhere near a regular routine. I encourage you to be patient, and more importantly to observe your child. You are already taking note of their likes and dislikes on an unconscious level, give yourself some grace, in order to tap in to your natural parenting instincts.

Infants are incredibly sensitive to their surroundings. Starting a nighttime routine can be as simple as turning the lights low, closing curtains, turning off any TVs or music playing in the house, and speaking in a soft tone of voice. When I work overnight with my families, one of the first things I do is go around and turn off unnecessary lighting. Believe it or not, your baby can tell a difference, even if they are not in the room.

One of my favorite things to do once the lights are low is run a warm bath for baby. Not all babies find bathing relaxing, but if your baby does a nightly bath is a great way to change the pace. No need to soap baby up every night, a warm water soak is just fine when baby isn’t too stinky. A nice segue from bath time would be a massage with lavender lotion. Make sure to diaper your little one first to avoid being tinkled on (this is advised for both boys and girls). I like to recommend coating baby’s bottom with either a mineral oil or any other food grade oil, so any yucky diapers filled overnight won’t irritate baby’s skin. Massage helps stimulates baby’s touch and smell senses and offers a form of aromatherapy. This practice can also benefit baby’s digestion, so you can lie them down on their back with less discomfort after a feed.

Once your little one is all soft and smelling delicious, you’ll want to dress them in clothing opposite of their daytime attire. I often recommend that parents dress babies in onesies during the day, and then switch them over to footy pajamas, or long-sleeved nightgowns at night. By juxtaposing the styles, it creates another indication in the change of day to night.

After baby is cozy you can do a few different things. This would be a nice place to implement any cultured practices already taking place in the house. Some families do story time, other families have a nightly prayer, it can be whatever your interpretation is, as long as it falls in the relaxed state of affairs.

Once your quiet interaction is finished you can start some white noise, or lullabies (if you so choose). Maybe you are an essential oils enthusiast, start a defuser with a soothing sent for baby’s room. Than nurse one more time, burp, swaddle and off to their bed they go.

This nighttime routine can take anywhere from 30 min-2 hrs, and can be as flexible to your schedule as you need. It should help baby sleep a bit longer into the evening, giving you a little break before their next feed. If they aren’t up in time for their normal feed, you can always keep them swaddled, and feed them in a sleep state. This is what we call a dream feed. I recommend doing this right before you go to sleep. This way baby will continue to sleep further into the evening, allowing you to attain more sleep before the next feed. One word of advice to any nursing parents, the feed may not be as full on as other feeds, so be sure to pump and empty before going to sleep.

A night time routine may not make any difference in your baby’s behavior at first. As stated before, this is a practice. Try and use it as an opportunity to check in with your baby daily and just enjoy some quiet interaction at the end of the day. You could even utilize it to implement your own nighttime routine some nights and pass the torch to partner. How ever you decide to utilize this information, make it your own. Parenting is about making confident decisions for your family and allowing yourself to change it up occasionally.

The Ergonomics of Postpartum Recovery: Creating an accessible space.

Recovery! This is the operative word here. It is the 4th trimester after all, so giving yourself some grace throughout the early stages of recovery will help you tremendously. I will spend the next couple of weeks offering ways to help ease through your postpartum recovery. There are little things you can do around the house in order to make caring for both mother and baby more accessible.

Consider the layout of your home. Where will baby be sleeping? The American Academy of Pediatrics now recommends baby sleep in parents room for a full year. Where is your bed located in relation to baby’s needs. Diaper changes, sleeping area, nursing area. Maybe baby has a room upstairs and parent’s downstairs. Consider setting up changing stations around the home with a blanket/changing mat, and a little caddy with salves/wipes/diapers/hand sanitizer. In short, put things in arms reach. You will need to conserve your energy.

Below are some examples of products you can utilize in building a newborn savvy home. Next week I will be posting about Nursing support, and building your nursing stations.

 

Here are a few examples of a diaper caddies and changing mats, to build changing stations all over your home.

Here are a few examples of a diaper caddies and changing mats, to build changing stations all over your home.

A few examples of co-sleepers you can take in bed with you and your partner. This allows for baby to be close, but also garuntees safety perameters for baby to sleep in. 

A few examples of co-sleepers you can take in bed with you and your partner. This allows for baby to be close, but also garuntees safety perameters for baby to sleep in. 

These are also co-sleepers on a larger scale that will cater to a lengthy co-sleeping relationship.

These are also co-sleepers on a larger scale that will cater to a lengthy co-sleeping relationship.

Weaning Baby pt. 3

Now, for the later stages. Introducing solids is an exciting time for parents. By now baby is sitting up on their own, giggling, and even making demands. The timing of the introduction of solids varies for every baby, as well as every mother. Weaning a baby with solids is helpful, because it is an entirely different feeding process for baby, in comparison to bottle/breastfeeding. This way instead of refusing the breast and fighting baby to take a bottle, you can offer a new experience to share with mom, or whomever is feeding them at the time. This practice is often referred to as “don’t offer, don’t refuse.” Once you and your little one establish a rhythm with this, you can begin to utilize breastfeeding as a soothing technique. Maybe a tender intimate moment before naps and bed, or a nurturing moment after a bad spill at the park. This is often how mothers reestablish and/or continue the connection with their older children after bringing new babies home. Some of us can’t even fathom what it would be like still breastfeeding a five-year-old, or even a three-year-old. Oddly enough, a great deal of moms feel this way until they have found the love for these moments with their babies that is the pure joy of making the right decisions for you and your little ones. I commend mamas these days for offering encouragement and not judging other mamas for their choices. These decisions only grow into greater issues in the future, and we need to be able to feel confident that we have our children’s best interests at heart.

One aspect of weaning baby that often gets overlooked is the hormonal changes that come with reducing milk production. Prolactin,  and oxytocin  work in tandem to produce and bring milk down. Oxytocin, also known as the love hormone brings on feelings of calm and comfort, it works as a bonding agent for you and baby. It is hypothesized that any abrupt stop of breastfeeding can cause an influx in your hormones inducing feelings of sadness, depression, and even irritability. Some mother's will be more susceptible  to depression then others. This can be due to past history of mental illness, it could just be the current circumstance. Some ways to reduce the emotional drop would be to gradually decrease your feedings. Try and plan as far ahead as possible, removing one feeding a week and replacing with hand expression. Any sign of depression or change in normal behavior should be addressed. I have pasted a link below to a bonus blog of mine that will cover how to address depression and knowing your options

Weaning takes patience and persistence, similar to teaching your body to produce you are now conditioning it to stop producing. The frustration often arrives when bay becomes frustrated, and mama is exhausted from the changes in her body. Remember to give yourself and baby a break every once in a while, that comfort you exchange will help nurture your experience. Find joy in letting baby taste new flavors, and have a camera ready, those moments can be absolutely priceless. 

Next week we talk storing breast milk basics, in addition to my list of resources for this month's topic!

Here's a bonus link to my latest blog featured with Stork Maternity Consulting. Here I address the steps you can take to get help during times of emotional turmoil:  http://storkmaternityconsulting.com/blog/your-new-identity-mom

Weaning Baby pt. 2 Bottle Feeding

Last week we discussed exclusive breastfeeding while working a full time job, and the challenges that can present with this style of care. What about our moms on medications unsafe for breastfeeding, or moms fed up with breastfeeding all together? Since we are eliminating the breast completely, you will no longer need to use a pump. Pumping will only encourage your body to produce more breast milk. Instead of pumping, you will want to hand express the milk until you feel more comfortable. When done as needed, this will significantly reduce the chance of engorgement, and will not cause any more milk production. Eventually you will be able to eliminate hand expressions all together. We will be addressing the two major decisions made with bottle feeding; what kind of bottle should i give my baby, and what kind of formula is best for my baby?

The best advice I can give parents when starting out, is buy 3 different types of bottles in the beginning. If you're still breastfeeding, pump for one feeding a day, and test out each bottle on your baby. They will tell you what they like. I want to be clear - start testing bottles and nipples only if you plan to bottle feed. It is best to stick to exclusive breastfeeding or exclusive bottle feeding within the first few weeks of development, so as to avoid nipple confusion.  

We as a generation are fortunate to have all the resources we do for such a time in our lives, but like many things that have been fine tuned over time, the over-abundance of choices can be very overwhelming. Lets talk about some of the details to consider when choosing a bottle for your baby. As of 2012 BPA (Besphonal-A) a chemical that is said to create hormone-like substances was banned from the manufacturing of plastic bottles. Most of the bottle companies were producing products without BPA long before the ban, but with this is mind it is safe to say you shouldn't just use any old bottle lying around. With these developments the option between plastic and glass bottles has surfaced. Consider your activity level as a mom, traveling with glass can be risky. For one, it is gonna be the heavier option and can potentially break. Lets not forget your budget, glass bottles will certainly be a more expensive purchase. On a positive note, by choosing glass you are narrowing down your options a great deal, and they also last a lot longer than your traditional plastic bottle.  

Now lets address nipples. Nipples are often a source of confusion for parents; You have slow flow, fast flow, orthodontic, traditional (bell shaped), or the latest on the market flat topped. These will vary with the manufacturers. They are produced in both latex and silicone, so you will want to consider any potential allergens you or partner have when deciding. NUK and Gerber produce the orthodontic, these nipples are said to be better for baby's teeth as the flat part rests on baby's tongue. The Bell shaped are said to be best for babies that both breast and bottle feed. It said to mimic the breast and reduce nipple confusion. The flat topped are the trendiest on the market currently being produced on most every new bottle, however the most popular bottles (tommee tippee, Comotomo, and Adiri) are still producing with the traditional bell shaped nipples. As for flow, this is often based on the child's development age. A newborn will require a slow flow as they are still learning how to feed. As the child develops over time you will notice cues that baby is not getting what they need, and you will want to consider the nipple flow when making changes as baby matures.

Just when you thought you were finished summing up all your options, we now will briefly address formulas. In this case you will want to seek out a formula that baby best responds to. One should watch baby closely after feedings and make sure they are comfortable and not having any issues digesting. This can be overwhelming to some, as not all babies respond to formulas the same way. Baby should seem rested, full, and keep the formula down post feed. Some babies spit up.- they just do. What we want to avoid are spit ups that are several ounces, as this can lead to acid reflux, discomfort, and lack of weight gain. Formula's are tough to nail down and are often chosen through trial and error. I would recommend doing your own research on what is available and most comparable to what you feel most comfortable feeding your baby. The marketing of formula's will seem focused on a few different brands (and while a topic for another day), this can make your decision making process a bit difficult. I urge you to search outside of the box, and ask your community how they made their decision. 

As you can see, there are prominent challenges for both breastfeeding and bottle feeding, and we are truly only scratching the surface on this topic. Try and practice patience with this process. Your baby is an ever evolving creature and this is just the first of many changes they will endure. 

Next week we take a look at weaning with solid foods, and choosing food for baby.  I will also be listing my direct resources for this months topic!

Weaning Your Baby pt. 1

Since we kicked off this month with World Breastfeeding Week, I thought we should expand on how breastfeeding looks in the later postpartum months. These next few weeks will include topics on weaning baby, working and breastfeeding, as well as storing breast milk. These are things many don’t really even consider, even after the immediate arrival of their new little one(s).

Weaning a baby from the breast is a mother’s personal decision. I know I stress this in almost every blog I have posted, but mothers often allow the pressures of other people’s opinions to shape their choices for their own baby. It is important for every mother to know that she has the right to make every decision for her baby (within reason, of course, and in times of potential health risks). I also would like to point out that this decision (while it should be discussed with your partner) is solely up to mom, as it is her body.

There are various reasons why babies are weaned off the breast. The most common instance is the six-month mark, when it is recommended that you introduce solids. This process can take place earlier for mamas who have to take meds which are not safe for breastfeeding. Other moms may have to return to a full time job, and some mamas just don’t feel comfortable enough doing it, and have found more joy in bottle feeding.  

How does this process look in the earlier stages of infancy? Starting to wean this early can often seem very tedious. However, it is important that you remain as patient as you can with this change. Baby will often challenge anything unfamiliar to them, especially a substitute to their favorite thing ever.

We will start by discussing the process for mamas that have to go back to work and want to continue giving baby breast milk. You will want to start preparing for this juncture at least 4 weeks out, maybe more (if you can). In order to increase supply and begin storing breast milk, try pumping once each morning. The morning is a prime time to pump, as that is when you have the most milk. The following week, start by replacing baby’s least favorite feed with a bottle. If baby refuses the bottle, it’s likely they can sense “their boobs” nearby. See if dad or grandma (etc.) will take them and try feeding. You will also want to replace that feeding with a pump session, this will help maintain your milk supply for baby, and will help build up your storage supply in the freezer. Your goal is to have baby used to exclusive bottle feeds in the afternoons while you’re away. You will have to work out a pumping schedule with your workplace in order to continue offering baby breast milk exclusively. This is very common in this day and age, and shouldn’t be an issue. One thing to keep in mind while pumping is where you are doing it. Try to arrange your pump session in a place that you are most comfortable. It is important that you remain relaxed during pumps in order to be as efficient as possible with your milk production. In addition to a pump schedule, you will also want to work out a system for storing the milk until you get home. Most, if not all, offices have access to a freezer, I recommend freezing your supply and labeling it at work, then toting it home in a mini cooler so it doesn’t thaw. Remember to date and initial your breast milk supply so as to not confuse it with another mama’s in the office. Any daycare/nanny/partner should have complete access to your breast milk through the frozen supply you will have built up by pumping instead of feeding. If it’s not too confusing for baby, you could keep your nightly feeds together on the breast and continue to use these moments as incentives for baby as they mature.

Next week we will discuss weaning baby off breastfeeding as well as breast milk, how to assess the right formula for baby, and avoiding engorgement and clogged ducts in the process.

 

 

The Benefits of Babywearing: For Everyone

 

Babywearing allows for a deeper connection between daddy and baby. Mommies get to wear baby inside for 9 months, so this gives daddy the opportunity to have such an influence on their new baby. This is also highly recommended for adoptive parents, as well as mothers enduring postpartum depression. Baby is able to get used to a parent’s voice, heartbeat, their facial expressions, and unique gestures.

Babywearing also allows for the more practical things in your life to take place. You can keep baby close, and still have your hands free. This allows for play time with the elder sibling, cleaning around the house, and prepping dinner. Imagine the freedom in a crowded neighborhood gathering. No need to push a stroller through large crowds of people, and you can go where a stroller can’t. This makes for nature hikes, and less complicated trips to and from airports.

So, what kind of baby carrier should you buy, and which one is best for you? Next week we discuss a few types of carriers and safety tips for wearing baby. 

The Benefits of Babywearing: Kangaroo Care

Last week we discussed the fundamentals of babywearing in your own home. Now, we will see it's benefits in a medical setting. The US has been fortunate enough to have the technology to support preterm infants. Other countries have had to come up with less costly ways to support these preemies in need. 

 Often referred to as Kangaroo Care (K-Care), hospitals with small budgets in areas like Guatemala have utilized K-Care in lieu of incubators. According to a study done by Susan Ludington at UCLA, having baby close allows mother’s body to regulate to baby’s needs. Preterm babies are placed between the mother’s breasts inside her clothing. This has shown proof of temperature regulation; it also improves respiratory function. Baby attunes to wearer’s heartbeat, breathing, and movement (walking, reaching, bending). This stimulation has proven faster weight gain, and k-cared babies prove to be healthier than babies who have not endured such stimulation. 

Amazing what the human body is capable of! Next week we continue our discussion on babywearing and how this practice can benefit both parents in the home.