Should We Pump and Dump After A Night Out?

2019-03-07T18:00:20+00:00March 7th, 2019|Categories: Fertility Blog|

I have a friend that brought a bottle of chardonnay right into the delivery room, packed in her hospital go bag. As soon as the cord was cut, the chilled wine flowed into mini red solo cups she packed just for this moment.  She and her husband wanted to celebrate the occasion in their own way and they just had the one small cup and didn’t overindulge. But she felt like she owned the moment and got to lift a glass (well plastic cup) in a toast to her new son and her motherhood journey.

Like my friend, about half of breastfeeding moms have a drink now and then. Since breastmilk is made by taking nutrients and fluid from your blood, some alcohol shows up in your milk. When you take a drink of wine or beer, the fluid travels to the stomach and then exits to the small intestine, where it is absorbed into your bloodstream. Your blood transports the alcohol to the liver, where enzymes break it down. Our liver can get rid of about 1 ounce of alcohol an hour. Any extra accumulates in the blood and body tissues until the liver can process it. This extra alcohol makes us feel tipsy and singing Journey’s “Don’t Stop Believin’” at the office Christmas party seems like the best idea ever (not me, happened to a friend…)

If you have a glass of wine or other adult beverage, the amount of alcohol that could pass through to your breast milk is very small. A review of 41 studies in the journal Basic & Clinical Pharmacology & Toxicology finds that even in a binge drinking scenario, if a mom breastfed, the blood alcohol of the infant would be less than .005%. The researchers concluded “It appears biologically implausible that occasional exposure to such amounts should be related to clinically meaningful effects to the nursing children.”  Still, the American Academy of Pediatrics recommends that women minimize alcohol consumption during lactation and if you drink, limit your intake to 2 ounces of liquor, 8 ounces of wine, or two 12-ounce beers.

You can safely have a few drinks without getting your baby drunk, but if you are concerned about your supply, stick to non-alcoholic beverages. Despite stories about beer and wine increasing milk supply, the research doesn’t support it. Studies have shown drinking alcohol while breastfeeding inhibits the milk ejection reflex, also known as the let-down (this reflex moves your milk from the lobes of your breasts to the nipple and out to your baby). For let-down to occur, the nerve connections from the nipple to the hypothalamus area of the brain need to be ready to receive the signal from your baby suckling at your breast to release oxytocin. Alcohol can deaden these signals and leave milk in your breasts and your baby frustrated. We know the milk product works on supply and demand; breasts need to be empty to signal your body to make more milk. If you are drinking alcohol regularly, this lack of intact nerves, hormone release and breast emptying results in a decrease in milk production of up to 23%. If you are stressed about your supply, avoid alcohol until you get back on track.

It also needs to be mentioned that anyone, including you, caring for your baby is required to be sober. Keeping a baby or toddler safe critical thinking and unclouded decision making; remember the Journey story from paragraph 2? You can make bad choices if you are drunk. Your children are counting on you to keep them safe.

If you co-sleep make alternative sleeping arrangements if you have been drinking. Alcohol can put you into a deeper sleep and this has been strongly linked to a higher risk of sudden infant death syndrome or accidental suffocation. Don’t drive if you have been drinking or get into a car with anyone else that has.

Just like pre-mom days, alcohol is fun occasionally but can easily lead to problems if used to excess. Feel free to have a drink now and then but deal with your mom stress in healthier ways.

Newborn baby sleeping in mother’s arms in hospital

The Smallest Victims of the Opioid Epidemic

2019-01-22T05:01:46+00:00January 22nd, 2019|Categories: Fertility Blog|

The opioid crisis has touched all of us; more than 2.5 million Americans are dealing with addiction to prescription or illicit opioids. The origins of the epidemic can be traced back to the late 1990s when pharmaceutical companies began to aggressively market drugs like Oxycodone to providers. Drug manufacturers reassured the medical community that their products weren’t addictive and were the best option for managing short term and chronic pain. As the number of prescriptions grew, it became clear that opioids could be highly addictive.

Now that we have looked back to the start of this public health crisis – where does that leave us today? According to a 2018 study by the CDC, the number of women with Opioid Use Disorder (OUD) at labor and delivery has quadrupled in 10 years.  Unfortunately, this isn’t surprising. Opioid use has grown in all demographics with the largest increase occurring in women. Pregnant women with OUD face numerous barriers to care – limited financial resources, access to treatment, stigma, and fear of legal consequences.

When a pregnant woman is addicted to opioids, she is likely to have a constant level of the drug in her blood and her baby is receiving a constant dose through the placenta.  When her baby is delivered, a drug withdrawal syndrome called Neonatal Abstinence Syndrome (NAS) begins.  A new study found that incidence of NAS is rising in the United States. There was a five-fold increase in the proportion of babies born with NAS from 2000 to 2012 —equivalent to one baby suffering from opiate withdrawal born every 25 minutes. Newborns with NAS are more likely than other babies to also have low birth-weight and respiratory complications. In 2012, newborns with NAS stayed in the hospital an average of 16.9 days, compared to 2.1 days for other newborns.

Research shows Medication Assisted Treatment (MAT) is the first-line recommendation for pregnant women with opioid use disorders. The goals of treatment are to manage withdrawal, reduce cravings, and prevent the feeling of getting “high”. Pregnant mothers receiving MAT are more likely to have prenatal care, better nutrition and have a higher birth-weight baby. MAT also helps to reduce illicit drug use and infections.

Researchers are learning more about moms and moms-to-be battling addiction. The more we know, the more we can help them with safe and effective treatment, helping them give their infants the very best start.

 

Products Moms Will Love in 2019

2019-01-21T21:48:04+00:00January 3rd, 2019|Categories: Fertility Blog|Tags: , , , , , |

Each year baby gear gets cooler, smarter and more parent-friendly. 2019 will be no exception, there are some ingenious products launching this year and I wanted to share my favorites.

My criteria for choosing the best products is simple, I ask myself “would I buy this?” I am notoriously cheap and like to keep clutter to a minimum, so I set the bar high for things I let into my house.

My top 5 products in no particular order are:

1. Keenz & Stroller wagonKeenz 7s Stroller Wagon (Grey)

I love how this folds down small enough to keep in your trunk but is roomy enough for a couple of kids and their gear. The roof would keep the sun or rain off little faces and looks like a rolling room. Tires are rugged enough for off-roading at the beach or hiking trails.

2. Little Martin’s Feeding Lamp

Little Martin’s Night Light for Baby Breastfeeding (Pink)

This soft light lamp is perfect for night time feedings. You can adjust the brightness by stretching the lamp upward for more light, or compacting it down for less. The LED light uses a USB cord so you can charge it and use it anywhere. And it comes in pink or blue to match your decor.

3. The Shrunks Bed Tent

Best-New-Baby-Products-for-2018

We live in the Pacific North West and camping is a part of every summer. Having a designated bed would be so convenient and safer too since sleeping arrangements can be tricky in a tent. This little bed tent would be great for living room or back yard camping too. The toddler bed would work well for road trips or anytime you have to travel with your little one. I wish they made this in my size.

4. Osprey Pack Kid Carrier

Osprey Packs - Poco AG 20L Kid Carrier - Seaside Blue

We used this all the time! My husband would wear it with our daughter in it when cooking dinner, I used it for taking walks with friends. We both like to hike and strollers aren’t practical everywhere, but this went everywhere with us. It really freed us up and strengthened our legs at the same time. We used a friend’s then gave it back when our daughter outgrew the seat, I am sure it has carried 2 or 3 more babies by now.

5. Milk-Saver On The Go

Collect and store more milk? Yes please. As a leaky mom, products that kept me dry and helped me collect more breast milk were always worth the price. As the creator of the original Milk-Saver this product is near to my heart. Moms left us hundreds of comments and reviews. Based on those, we created a product that could protect sore nipples and collect more than an ounce at a time. Easy to use and discreet, no one will even know you are wearing them.

There you have it folks, these are my favorite new baby products – I will be watching for more amazing products in stores this year.  Enjoy!

Boy-Moms at Higher Risk for Post Partum Depression

2019-01-22T21:32:49+00:00December 14th, 2018|Categories: Fertility Blog|Tags: , |

Hey Boy-Moms, a new study out of the UK finds you are way more likely to suffer with post-partum depression (PPD) than Girl-Moms. Researchers looked at 300 women over several decades and found the odds of developing (PPD) for moms of males is 71 – 79% higher than moms of female babies.

The moms at an even higher risk for (PPD)…those with birth complications. The study also found that mothers who had to manage birth complications were 174% more likely to suffer (PPD) than moms that had no birth complications. Examples of birth complication include: preterm labor, gestational diabetes, preeclampsia, breech presentation and hemorrhage.

There is a wide range of PPD symptoms including extreme sadness, low energy, anxiety, crying, irritability, sleeping too much or not enough, and eating too much or not enough. Some moms have extreme anxiety about hurting themselves or their baby. Onset of PPD is typically between one week and one month following childbirth, although symptoms can show up anytime in the first year.

Researchers speculate the reason for the increased rate of PPD in boy-moms and following birth complications is related to inflammation. Inflammation is the immune system reacting to a threat and raising the alarm to fight it. Any time the immune system is activated for long periods, it places stress on the body. Pregnancy activates the immune response no matter your baby’s gender, but researchers think a male fetus produces a stronger response and more maternal stress.

What can you do to protect yourself, friends or clients from PPD? Know the risk factors and symptoms to intervene early. Two screening tools are Edinburgh Postnatal Depression Screen (EPDS) or Patient Health Questionnaire (PHQ). Ask your doctor about PPD and follow up frequently if you have the risk factors. Have your doctor’s number on hand and talk with your partner or other family members about the symptoms of PPD, they may be the first to notice your symptoms.

If you are a health care provider, be sure PPD is part of a routine new mother appointment since 10-15% of new moms suffer from some form of mood disorder. It is always helpful to develop a good relationship with patients prior to delivery, easing anxiety about potentially difficult conversations like PPD symptoms.

For more information about PPD visit https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml

Five Tips for Exclusively Pumping Moms

2018-11-20T19:50:21+00:00October 17th, 2018|Categories: Fertility Blog|Tags: , , , , |

Breastfeeding isn’t defined by putting your baby to breast. Many moms choose to pump and use a bottle to feed. By choice or necessity exclusive pumping is growing in popularity as pump technology improves and moms are heading back to work with the intention to continue feeding breast milk. There are many reasons for exclusively pumping (EP). Some moms don’t feel comfortable putting their baby to breast or a baby may be born with a condition that makes breastfeeding impossible, like a cleft palate.

While exclusive pumping can be done, it takes some additional preparation to be successful and keep your milk supply strong. Here are some time-tested tips to help you meet your exclusive pumping goals.

1. Be ready for pumping to take over your life for the first week. While you establish your milk supply, pump 12 or more times in each 24 hour period. This works out to pumping every 2 hours day and night, it’s tiring and your breasts may become sore. But, the early days of breastfeeding aren’t easy either, establishing your milk supply and caring for a newborn are challenges for every mom. Once you find your groove and you become a more efficient pumper, you might be able to increase your time between sessions to 4 hours.

2. Have extra pump parts and bottles. Expect the unexpected. You might find yourself without a working pump or clean parts if you have an emergency at home or your car breaks down. Have a spare (or two) of everything, even an extra pump. If your pump motor tires out or a part breaks, you still need to pump and you won’t want to run to the store in the middle of the night.

3. Washing pump parts and bottles will take some time and space in your kitchen. You may feed your baby 12 times per day – will you wash the bottle after each feeding or use a new bottle each time and wash once a day? Either way you will need set aside time each day to clean and organize bottles, nipples and other feeding supplies.

4. Your partner can take on more feedings. No breasts are required for bottle feeding and anytime your baby is hungry, milk is available to for caregivers to feed. Pump before going to bed and let your partner handle the night time feedings. Sleep helps your supply by signaling your body to release milk making hormones.

5. Use hands-on-pumping. Get a hands-free pumping bra or make your own using an old sports bra and use your hands to shorten pumping time. Once your pump is in place and turned on, push with your palms to create gentle pressure starting near your ribs and move toward the nipple. This moves more milk out of your breasts to support a strong milk supply and you finish pumping faster – double bonus!

The one thing EP moms want to share is that it gets easier. The early days of pumping, washing pump parts and bottles non-stop can be overwhelming. But as you and your partner find a system that works for you and your baby, it becomes a natural part of life.

Boob Tube episode 19 – Dealing with Fertility Challenges

2018-09-18T20:51:11+00:00September 18th, 2018|Categories: Fertility Blog|Tags: , , , |

In this episode we talk about the challenges some moms have trying to get pregnant. Tobi talks about her own journey to motherhood and we hear from other moms and moms-to-be about their struggles with fertility. For more of the Boob Tube check out The Boob Tube at Fairhaven Health.

Episode 19 – Infertility and reasons you might not be getting pregnant

Posted by Belly to Breast: Fairhaven Health on Thursday, September 13, 2018

Boob Tube Episode 18 – Bringing Home Baby Survival Guide

2018-08-28T23:47:38+00:00August 28th, 2018|Categories: Fertility Blog|

This episode Tobi and I talk about the reality of the first days and weeks and how it compares to our ideal experience. Tune in to hear more about our first days as moms and comments from viewers about their experiences too! To see more episodes click on the link
The Boob Tube at Fairhaven Health

Boob Tube Episode 18 Bringing Home Baby – Your Newborn Survival Guide

Posted by Belly to Breast: Fairhaven Health on Tuesday, August 21, 2018

Jaundice 101

2018-08-22T16:31:36+00:00August 22nd, 2018|Categories: Fertility Blog|Tags: , , , , |

Most infants (50-70%) develop jaundice in the first weeks of life. If your baby has jaundice, he may have yellow-tinted skin or eyes. The yellow color is the result of too much bilirubin in your baby’s blood; bilirubin is a brownish – yellow color. Typically parents notice yellowing in the face and eyes in the first 2-4 days of life; the yellowing starts in the face and moves down to the toes. Bilirubin levels typically peak between 3 to 7 days after birth.

Before birth, your baby’s body uses your placenta to remove bilirubin from his blood. But during the first days of life, your baby’s liver can be slow to begin working and bilirubin can build up. We all have bilirubin in our bodies, it is a naturally occurring waste product created when our bodies replace red blood cells (the lifespan of a red blood cell is 120 days). Usually our liver filters out the bilirubin and we excrete it in our stool. If you have ever wondered where our poop gets it is color – look no further than bilirubin!

The best way to shorten the duration of jaundice, or prevent it all together, is to breastfeed your baby early and often. Breastfeeding within the first hour of life helps your baby pass the dark, sticky poop called meconium and takes out bilirubin with it. In the first hours, your baby is drinking colostrum, which is a laxative in addition to an immune system booster. Put your baby to breast often, frequent breastfeeding helps your baby pass more stool and bilirubin too.

There are 3 common types of jaundice:

1. Physiological jaundice. It is often most noticeable when the baby is 2 to 4 days old. The most common type of jaundice, it does not cause any distress and disappears without treatment by 14 days old.

2. Breastfeeding jaundice. This type often occurs in breastfed babies during the first 7 days of life. If your baby has difficulty breastfeeding or your milk comes in after day 3, your baby may develop breastfeeding jaundice.

3. Breast milk jaundice. Develops after the first 4-7 days of life, persists longer than 14 days and has no other identifiable cause. Doctors are still unsure what causes breast milk jaundice. However, evidence suggests it is related to the interaction between some of the components in breast milk and bilirubin.

If you notice a yellow tint to your newborn’s skin or eyes, talk to your baby’s doctor about the need for testing and monitoring her bilirubin level. Bilirubin levels can be tested with a blood or skin test. A very high level of bilirubin can result in a condition known as kernicterus and brain damage.

Most cases of jaundice resolve without treatment as the liver matures and filters blood more effectively; frequent breastfeeding helps the bilirubin pass through and out in your baby’s stool. More severe jaundice may require treatment with a bili-light (or phototherapy). Phototherapy is a common and highly effective method of treatment that uses light to break down bilirubin in your baby’s body. It looks like a little tanning bed; your baby will only be in a diaper and wearing protective goggles. Absorbing the special blue-spectrum light through the skin helps your baby break down bilirubin.

While most babies develop jaundice, few need treatment. The combination of frequent breastfeeding and your baby’s liver working more effectively usually take care of the problem. See your pediatrician if your baby acts more tired than usual or you have any concerns.

Lowering Your Baby’s Risk of Peanut Allergy

2018-07-21T21:27:25+00:00July 21st, 2018|Categories: Fertility Blog|Tags: , , |

New research suggests mothers can lower their child’s risk of peanut allergy by eating peanuts during pregnancy and breastfeeding. This is big news since peanut allergy is increasingly common in the US, it effects 1-2% of the population here. And if it seems like more people are suffering from peanut allergy, it’s true. The prevalence of peanut allergy has tripled from .4% in 1994 to 1.4% in 2010 and 2.5% in 2017. Approximately 20% outgrow their allergies after adolescence.

The increasing number of kids with peanut allergies is forcing changes in school cafeteria offerings, airline meals and the labels on baked goods. Tree nut allergy often accompanies peanut allergy and in fact 25-40% are also allergic to walnuts, pecans and almonds. Exposure to allergens cause symptoms to occur within minutes and can cause reactions from mild to life threatening. Symptoms of an allergic reaction are:

• Itchy skin or hives, which can appear as small spots or large welts
• An itching or tingling sensation in or around the mouth or throat
• Nausea
• A runny or congested nose
• Anaphylaxis (less common), a potentially life-threatening reaction that impairs breathing and can send the body into shock

Researchers have been battling the increasing number of peanut allergies for decades. In 2000, pregnant and nursing moms were advised to avoid peanuts, especially if they had a family history of allergies. Parents were also advised to wait until age 3 to give peanuts, when digestion was more mature. This advice was abandoned in 2008 when the rates of new allergy diagnosis continued to rise.

The current recommendation is a complete reversal. In a 2014 study published in the Journal of the American Medical Association (JAMA) of 8,205 children, 140 of whom had allergies to nuts, researchers found that children whose mothers ate the most peanuts or tree nuts, or both, during pregnancy had the lowest risk of developing a nut allergy. The risk was most reduced among the children of mothers who ate nuts five or more times a month.

The researchers, led by Dr. A. Lindsay Frazier of Dana-Farber/Children’s Hospital Cancer Center in Boston, wrote: “Our study supports the hypothesis that early allergen exposure increases the likelihood of tolerance and thereby lowers the risk of childhood food allergy.” They added that their data “support the recent decisions to rescind recommendations that all mothers avoid peanuts/tree nuts during pregnancy and breast-feeding.”

Recommendations from the American College of Asthma, Allergy and Immunology (ACAAI) are in line with the data. In 2017 the group updated their guidelines; recommending early peanut introduction (EPI) beginning around 4 to 6 months of age in infants with severe eczema and/or egg allergy and around 6 months for all other infants. Other studies from around the world show similar results with eggs and cow milk. Early introduction (4-6 months) of these foods reduced the risk of developing an allergy to that food. If you have concerns about introducing peanuts to your baby, follow this link to watch a video from ACAAI for helpful information https://www.youtube.com/watch?v=9pVNFWi0XvU

All the researchers agree more data is required to determine the impact of a mother’s diet during pregnancy and breastfeeding on food allergies. It’s still unclear why some babies develop food allergies and others don’t – if you have concerns about introducing peanuts to your baby, see your pediatrician or allergist for guidance.

This article was writing using these sources-

https://www.mayoclinic.org/diseases-conditions/peanut-allergy/symptoms-causes/syc-20376175
https://ncats.nih.gov/pubs/features/five-ctsas-enable
https://jamanetwork.com/journals/jamapediatrics/fullarticle/1793699
https://acaai.org/allergies/types/food-allergies/types-food-allergy/peanut-allergy

Identifying and Addressing Risk Factors for Perceived Low Milk Supply

2018-06-22T04:40:53+00:00June 22nd, 2018|Categories: Fertility Blog|

Low milk supply is the most common reason mothers give for supplementing with formula and giving up breastfeeding altogether. While the actual percentage of moms that wean early due to Perceived Insufficient Milk (PIM) is tough to pin down – the data ranges from 35-80% – milk supply appears to be the top concern of breastfeeding mothers around the globe.

Several studies show most moms look at their infant’s behavior to gauge their milk supply and this, combined with low confidence in her milk-making abilities can powerfully undermine her breastfeeding plan. Mothers that reported their infants seemed unsatisfied after feeding or fed often led them to think they were not producing enough to meet their nutritional needs and began supplementing then weaned from breast milk entirely. A mother’s confidence can be measured with several evaluation tools – The H&H Lactation Tool, Breastfeeding Personal Efficacy Beliefs Inventory (BPEBI), Infant Feeding Intentions scale. Scoring on the tools helps you as the clinician identify areas your patient may struggle and address them antenatal. Addressing PIM prenatally is crucial because drop off happens early, with the highest rate of weaning between 1 and 4 weeks. A 2001 study showed 64% of moms that weaned before 4 weeks did so due to PIM.

As more hospitals get on board with Baby Friendly practices (even without the official designation) formula administration by nursing staff is less common but still occurs. As most mothers have not entered lactogenesis II before being discharged after typical hospital stay, offering formula is inappropriate. Incredibly, an older study from 2002 showed 16% of moms weaned before even discharging due to PIM!

Researchers have determined there is little connection between PIM and Actual Insufficient Milk (AIM). The good news is the most influential factors in PIM (1. Infant hanger cues 2. Maternal confidence) are modifiable through education and support. Best practices for addressing PIM:

1. Identify low confidence moms early with an evaluation tool.

2. Strongly encourage low confidence moms to take a breastfeeding class with her partner or co-parent.

3. Educate mothers about the prevalence of PIM. If she develops PIM, bring in her baby for pre- and post- feed weights.

4. Teach both parents to recognize infant hunger cues and put baby to breast frequently.

5. Avoid supplementing with any liquids or pacifiers.

Helping moms battle PIM is a powerful way to increase breastfeeding duration and boost a mother’s confidence in her parental efficacy.

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