Make Time for Tummy Time

2019-11-11T05:53:38+00:00November 11th, 2019|Categories: Fertility Blog|Tags: , , , , , |

As our babies grow, they need new ways to exercise their bodies and brains. Sitting up, rolling over and putting random items in her mouth all make new connections in her brain and help her develop coordination. Making sure your baby has plenty of time out of her crib or car seat has many crucial benefits. Spending time playing on her stomach, aka Tummy Time, strengthens her neck and back muscles. Most importantly, tummy time can help your baby stay safe by reducing the risk of SIDS.

During Tummy Time your baby is lifting her head and using all the muscles in her upper body. Essentially doing a miniature baby plank. The ability to lift her head up can help your baby avoid rebreathing her air if she rolls on her stomach or gets into a tight spot. The saying “back to sleep, tummy to play” is a good way to remember to put your little one on her tummy when you or a caregiver is watching. Then always put your baby to sleep on her back without any pillows or blankets in the crib with her.

There are many reasons to let your baby play on her stomach as much as possible:

  1. Upper body strength for safety and repositioning (see above)
  2. Reduce the risk of positional plagiocephaly (flat spot on the head). Usually if a flat spot does develop, it will be on the back of the head from the pressure of her head being in contact with her crib or car seat for extended periods of time. Around 20% of babies have a flat spot on their head that resolves as they approach 1 year of age
  3. Tummy time helps your baby reach physical milestones on time since they are moving and using muscles in different ways
  4. Have an interesting toy within reach so your baby can practice moving her body, reaching and grasping

Safe tummy time tips:

  1. Tummy time should be after a nap or other time when your baby is wakeful.
  2. Carefully watch your baby, make sure she isn’t spitting up
  3. Wait 30-45 minutes after feeding to allow for digestion time
  4. Tummy time can be on your/dad’s/caregivers chest too
  5. Don’t give up if your baby gets cranky, start for 2-3 minutes at a time.

There are several other recommendations for safe sleep from the American Academy of Pediatrics. Read the full article here

Mastitis Prevention and Treatment

2019-10-19T19:05:52+00:00October 19th, 2019|Categories: Fertility Blog|

Breasts are complicated! The parts that we see are the nipples, areola and skin. But there is so much more happening inside: milk-making cells, ducts and lobes do the work of milk production, storage and delivery to your baby.

Mastitis occurs when there is an infection of the cells of the breast – you will probably have a fever, chills and feel exhausted. Check out your breasts for a warm, red area that feels like it has a hard marble under it. Anyone can get mastitis (even men!) although it is most common in breastfeeding moms during the first few weeks of lactation. To avoid mastitis pump of feed your baby frequently, emptying the breast keeps your milk moving and bacteria from growing. Another strategy for avoiding mastitis is to wear a bra that fits correctly, a too-tight bra can keep your milk from emptying and give bacteria a chance to grow.

You should nurse and pump when you have mastitis – it is the best way to help resolve your infection. Try to keep the breast with the infection as empty as possible, keep milk moving and bacteria from growing. Mastitis is often caused by a clogged milk duct, it feels like a hard lump in your breast. When your nurse your baby, or use your breast pump, use gentle pressure on the lump to try and move the clog out of the duct and out of the breast.


Since mastitis is generally caused by bacteria, antibiotics are almost always effective. You should begin to feel better within a day or two of starting antibiotic treatment. While you are recovering try to rest more, increase your fluid intake and keep a warm wash cloth over the red and inflamed area. Pump and nurse frequently to keep your milk moving and bacteria from growing. To help with your fever and aches, take acetaminophen or ibuprofen


To prevent mastitis, pump or feed frequently. This is great advice for a strong milk supply and avoiding mastitis. Use hands on pumping and breast compression to move milk out of your breasts and bacteria from growing. Watch for signs of mastitis when your are weaning too. Any time your baby isn’t nursing as often, your milk isn’t moving and mastitis could develop.

40 Weeks to Freedom – It’s Worth the Wait

2019-09-23T06:19:12+00:00September 23rd, 2019|Categories: Fertility Blog|Tags: , , , , , , |

Why does it seem like the last month of pregnancy lasts longer than the previous nine? My fellow moms – I absolutely get  why you want to end it as soon as possible. The final weeks are uncomfortable and anxiety ridden. Waiting for the baby to arrive and FINALLY starting your maternity leave, plus meeting your baby is the most exciting day! It’s no wonder we want to rush to the end by inducing labor instead of allowing labor to begin naturally. Inducing labor is defined as: you or a care provider uses a drug or an action to cause labor to start before it starts on its own. Doctors and researchers don’t really understand how or why labor begins when it does, so the drugs and interventions don’t always result in labor actually beginning and progressing to delivery. One quarter of moms that are induced end up with a cesarean birth when labor stalls or goes on too long.

Researchers now believe the fetus actually signals the beginning of the labor process, possibly when the lungs have matured enough to take the first breath of air. The fetus likely signals a hormone release that relaxes the cervix and starts uterine contractions. Because of the complexity of the labor process, it is best to allow it to begin naturally even if your due date has come and past.

A due date can be misleading, the exact date of fertilization can be nearly impossible to know for sure. Also, just like babies reach milestones at different times, it’s normal to have a range of normal gestation. Anytime between 39 and 42 weeks is considered a safe time to deliver, and waiting for labor to start naturally is another reassuring signal your baby is ready to be born.

Doctors used to deliver babies earlier in pregnancy for their convenience and at mom’s request (if she was uncomfortable – what part of pregnancy IS comfortable??) Doctors noticed the number of babies that required special care for breathing problems, breastfeeding problems and inability to regulate their body temperature increased as babies were delivered earlier. The American Academy Of Pediatrics recommends waiting until 39 weeks to consider an induction. Read the AAP position statement here The Timing of Planned Delivery:Strengthening the Case for 39 Weeks

If you are thinking about trying to induce your labor at home, there are several things women have been told to try to get labor going. Unfortunately, none of the home remedies have been shown to be effective when reviewed by researchers.

  • Hypnosis: not effective, compared with doing nothing
  • Homeopathy: not effective, compared with doing nothing
  • Sexual intercourse: not effective, compared with doing nothing
  • Sweeping/stripping membranes (office procedure done with a vaginal exam): not effective, compared with doing nothing
  • Acupuncture: not effective, compared with doing nothing
  • Breast stimulation: increases the likelihood of starting labor, but more research is needed to understand safety (there are concerns that strong contractions could reduce oxygen flow to the fetus, although the study that raised this concern was done in women with high-risk pregnancies)
  • Castor oil: effective at starting labor, but does not decrease the chance of having a C-section. Castor oil causes nausea and diarrhea in most women. More research is needed to understand safety.

If you feel the need to induce your labor or have any health concerns, talk with your doctor before trying any of these techniques. There are times when induction is the right choice for you and your baby.


Vernix and the First Bath

2019-09-01T03:12:00+00:00September 1st, 2019|Categories: Fertility Blog|Tags: , , , , |

Babies are born needing a good wipedown. They are usually covered in amniotic fluid, a little blood and a waxy covering called vernix. The whitish vernix protects your baby’s tender new skin from soaking in amniotic fluid during your pregnancy. Vernix may look like onion dip all over your baby, but it serves an important purpose. Just look at your pruney fingers after soaking in the tub for 30 minutes and then imagine the wrinkled raisin you would have after 40 weeks.

Vernix does more than just create a barrier to protect your baby’s skin it has other beneficial properties too:

  • It protects your baby’s skin from injury and infections after birth. The antimicrobial properties of vernix help keeps any open areas from becoming inflamed or painful
  • Regulates body temperature, vernix can act as an insulator and keep your baby comfortable and reduce chilling
  • It acts as lubrication and reduces friction as your baby moves through the birth canal

The amount of vernix on your baby decreases as she matures and gets closer to her due date. Some full term babies are born with very little vernix while premature babies may have much more.

Delaying your baby’s first bath keeps the vernix in place, protecting your baby through the first hours of life. New evidence even suggest delaying your baby’s first bath can improve your breastfeeding experience. When a hospital in Ohio changed their policy so a baby’s first bath occurred after 12 hours instead of 2 hours, the exclusive breastfeeding rate of their new moms jumped from 59% to 68%. Researchers don’t know the exact reason for the increased breastfeeding rate but suggested that keeping mom and baby together gets breastfeeding off to the best possible start.

Instead of a bath, ask your nurse to wipe your baby with a towel and not too thoroughly, leave some vernix behind to moisturize your baby’s skin. Place your baby skin to skin to share your good bacteria and body heat along with your colostrum and kisses.


Sore Nipple Strategies

2019-08-17T22:50:34+00:00August 17th, 2019|Categories: Fertility Blog|Tags: , , , |

.Most of us had an idea in our head about how breastfeeding would go. You probably pictured the serene moments gazing into each other’s eyes, then your milk drunk baby slipping off to sleep in your arms.  The reality of the early days of breastfeeding can be surprising, as those of us that have lived them can attest. For 80-90% of moms, nipple and breast pain is part of their new mom life, at least in the short term since almost all nipple pain resolves in the first 2 weeks.

Nipple pain it’s not just for new moms, it can re-emerge with each baby. Issues like a shallow latch, slow let-down and tongue tie are unique to each baby. Although your breastfeeding experience will help you solve these problems much faster the second time around.

If you are suffering from nipple pain, here is a list of possible reasons and solutions:

-Shallow latch. You baby should have a wide open mouth before latching onto the nipple and surrounding areola, not just the nipple. Top and bottom lips should both be curled back and the chin firmly pressed on the breast. This position allows the nose to remain unobstructed with correct positioning.

– Pulling your baby off before breaking suction. When you are ready to take your baby off the breast, place a finger in the side of the mouth to release the suction first. Otherwise you stretch and strain tender nipple tissue.

-Slow milk flow. Your baby may be spending extra time on your breast or try to suck with greater force if your let-down reflex takes a while. To speed it up, self express a bit of milk before feeding to get milk flowing and soften up your breast before latching your baby. Once your baby is on the breast, use breast compression to keep milk flowing quickly without much suction from your baby.

-Using the same breastfeeding position every time. Depending on the angle, you baby’s mouth can apply pressure in different parts of your breast and nipple. If you have a tender spot when using the football hold, try lying on your side next time you feed.

-Dry, cracked nipple tissue. Your nipple has natural lubrication from the oils released by your Montgomery Glands, the little bumps that surround your areola. But the friction of your baby’s mouth can strip away your natural oils leaving your nipples red and cracked. There are several nipple creams available that can help your tender tissue heal. Check out our Milkies Nipple Nurture Balm  for an organic olive oil based cream that doesn’t need to be removed prior to putting your baby to breast.

Your nipple pain should taper off and go away entirely by day 14. If your nipple pain lasts longer or is accompanied by other breastfeeding problems like full breasts or a frequently fussy baby, see your lactation consultant.


Breast Anatomy Beyond the Nipple

2019-07-18T13:29:10+00:00July 18th, 2019|Categories: Fertility Blog|Tags: , , , , |

The internal structures of breasts were first described in 1840 by Sir Astley Cooper. And since then, our knowledge of breasts has changed to include many more than Cooper could have visualized. He described the breast being composed of glandular and adipose (fat) tissue held together by a loose framework of fibers he called Cooper’s ligaments (of course). Cooper’s ligaments support the structure of our breasts and are blamed for stretching during pregnancy and breastfeeding, leading to sagging. If you are interested, there are several exercises that claim to strengthen Cooper’s ligaments. I reviewed them and it appears they work the pectoral muscles (push ups, chest flys and chest press) which lay under your breasts. Working out your pectoral muscles helps your posture but is unlikely to have an impact on the connective tissue inside the breast.


Beyond the ligaments, the inside of a breast is an amazingly complicated structure. Surrounding the nipple like daisy petals are 15 to 20 sections, or lobes. Inside these lobes are smaller sections, called lobules that are arranged in clusters, like grape bunches. At the end of each lobule are tiny “bulbs” that produce milk. The bulbs are called alveoli and that’s where the magic of milk production occurs. From the alveoli,your milk enters the ducts, the thin tubes that carry the milk from the lobules to the nipple. When the milk-ejection reflex occurs, small muscles around the alveoli are squeezing the milk out into the lobules to the ducts and out of the nipples.


Imagine a stalk of broccoli and the tiny flower bits are the alveoli, the stem is the ducts which carry the milk to the nipple. Fat fills the spaces between the lobes and ducts. Actually, most of our breast volume is fat. When you shop for a bra, your cup size is mostly determined by how much fat you have between your connective tissue. That’s why your cup size has no relation to your ability to breastfeed. Smaller breasts (A to C cups) can be easier for babies to latch on, especially in the first days of life.


Working our way out of the breast, the last stop is the nipple. The nipple is in the center of a dark area of skin called the areola. The areola contains small glands that lubricate the nipple during breastfeeding. The bumps on the perimeter of your nipple are glands called Montgomery glands. They constantly secret oil to keep your areola and nipple healthy and moisturized. Montgomery glands also secret your unique scent that attracts your baby to the nipple and helps initiate breastfeeding. We have 12-14 openings in each nipple, and they can spray in any direction as anyone that his squirted milk in unpredictable directions knows.


Breastfeeding and Your Period

2019-07-04T01:06:03+00:00June 23rd, 2019|Categories: Education, Fertility Blog|

Can nursing get any better? Let’s list the ways it simplifies mom life: no equipment, no prep, always ready and available. Need one more reason to breastfeed? How about a break from your period. That’s right – no Aunt Flo or Ladies Days for up to a year!

The pause in menstruation means that you are not ovulating again and are very unlikely to get pregnant until your period restarts. This pause in your period is known as lactational amenorrhea. When used as birth control it’s called the Lactational Amenorrhea Method, or LAM.  Research shows LAM is more than 98% effective at preventing pregnancy as long as you are exclusively breastfeeding, your baby is younger than 6 months of age, and your periods have not restarted.

If you nurse frequently, your menstrual cycle and ovulation is most likely going to be suppressed. That means every 4 hours or less during the day and every 6 hours or less overnight. Every mom is different. I didn’t have a period for more than a year with both of my exclusively breastfed babies. I had friends that told me their period came back in 1-2 months and they were breastfeeding too. The research supports this – some exclusively breastfeeding moms start having periods within the first few months of nursing. Others whose babies sleep for long durations and have supplemental feedings will not have a period for twelve months or longer. Some women go as long as two years or more without menstruating after the initial flow of lochia (vaginal bleeding for 2 to 4 weeks after birth) has stopped.

Most moms will notice some light bleeding or spotting before having a regular period. And if your period came on schedule before pregnancy, your monthly visitor might surprise you and just drop in anytime. Expect your period to be irregular and variable in flow and length.  Any bleeding is a sign your body is ready to be fertile again and you should start using contraception (unless you are ready to be pregnant again of course!). A “warning period” is a common term to describe the first signs menstruation and fertility are returning. A delightfully ominous term I think!

It is possible for a nursing mom to become pregnant while she is breastfeeding and before she has her first menstrual period. But this is very unlikely since the shedding of the uterine lining is the beginning of the cycle. When your warning period arrives, or even better before it arrives, it’s time to start thinking about using contraception. Birth control pills or any other hormonal method can have a negative effect on your milk supply. Use condoms or another barrier method.

Post Partum Preeclampsia – Signs and Symptoms

2019-05-31T14:46:44+00:00May 31st, 2019|Categories: Fertility Blog|

The road to motherhood is different for each of us. Every mother and baby takes their own path through pregnancy, delivery and beyond. Our bodies are able to grow our babies, nourished and protected from the world until, for some unknown reason, labor begins. In the overwhelming majority of pregnancies and deliveries, all goes well. Most moms are worn out, exhausted and wearing their oh-so-soothing ice diaper in the early post-partum period. But within days, they start feeling better, breastfeeding gets easier and moms find their stride.

For a small number of new moms, they don’t start feeling better. Post partum complications are rare but they happen and they can be dangerous. Most of us don’t see our doctor for 6 weeks after birth and complications can set in much earlier. One of the most common birth complications is post partum preeclampsia. Postpartum preeclampsia occurs when you have high blood pressure and excess protein in your urine soon after childbirth. Preeclampsia is a similar condition that develops during pregnancy, and it typically resolves with the birth of the baby. Most cases of postpartum preeclampsia develop within 48 hours of childbirth. However, postpartum preeclampsia sometimes develops up to six weeks or later after childbirth. This is known as late postpartum preeclampsia.

The cause of pre-eclampsia and late postpartum eclampsia is not well understood. One theory  is based on an imbalance between the blood supply demands of the uterus, placenta and fetus during pregnancy. This can cause damage to the cells and change the way our blood vessels expand and contract. Our blood pressure and regulation is a delicate balance of fluid regulation (by the kidneys) and blood vessel dilation or relaxation depending on the demands of the body.

Researchers are aware of some factors that place moms at higher risk for post partum preeclampsia:

  • High blood pressure during your most recent pregnancy. You’re at increased risk of postpartum preeclampsia if you developed high blood pressure after 20 weeks of pregnancy (gestational hypertension).
  • Obesity. The risk of postpartum preeclampsia is higher if you’re obese.
  • Having multiples. Having twins, triplets or more increases your risk of preeclampsia.
  • Chronic high blood pressure. Having uncontrolled high blood pressure before pregnancy increases your risk of preeclampsia and postpartum preeclampsia.
  • Diabetes. Having type 1 or type 2 diabetes increases your risk of preeclampsia and postpartum preeclampsia.

These are risk factors of many pregnancy complications but be aware of the of common symptoms of post partum preeclampsia. New moms that are busy caring for a newborn may not be thinking about their own health, but if you have a headache that won’t go away call your doctor or have your blood pressure taken. If you don’t have a blood pressure cuff at home, you can go to your closest fire department and they will take it there for you. If the bottom number is over 90, you have high blood pressure. For example 150/100. Other symptoms of post partum preeclampsia are: swollen ankles, cough and shortness of breath and changes in vision. Postpartum preeclampsia requires prompt treatment so go the hospital right away. Left untreated, postpartum preeclampsia can cause seizures, fluid in the lungs, damage to liver, lungs and other serious health problems. If you have any risk factors, be sure to have frequent check-ins with your doctor after your baby is born.

Soothing Strategies for Teething

2019-05-20T12:37:58+00:00May 20th, 2019|Categories: Fertility Blog|Tags: , , , , |

Our babies are born with all their teeth just waiting to pop through their little pink gums – although pearly whites usually don’t peak through until about 6 months of age. You might notice the first signs of teething as small bumps on the bottom jaw in the center front. These bumps are the teeth trying to break through the tough gum tissue – which can take a few days to weeks. Your baby will continue to get new teeth until all 20 have come in, usually by age 3.


With 20 teeth breaking through those little pink gums, teething can cause some serious discomfort. If your baby is in the age range and showing any of these signs, teething may be to blame:

  • Fussiness
  • Trouble sleeping
  • Irritability
  • Loss of appetite
  • Drooling more than usual

Your baby may have sore or tender gums when teeth begin to break through the gums. Some babies like to have their gums rubbed with a clean finger, a cool spoon, or a moist washcloth. A clean teether for your child to chew on may also help. Look for teethers made of solid rubber, and avoid liquid-filled teething rings or plastic objects that could break.

I made my own teether at home using a washcloth. You can too, just wet the washcloth, tie it into a knot and freeze it. The hard knot will give your baby a solid surface to chew and the cool temperature will reduce inflammation and pain.

New recommendations from the FDA urges us to stick with teethers for pain relief and avoid products that numb the gums for kids younger than 2. In a statement from the FDA, “We are also warning that benzocaine oral drug products should only be used in adults and children 2 years and older if they contain certain warnings on the drug label,” the FDA said in a May 2018 statement. “These products carry serious risks and provide little to no benefits for treating oral pain, including sore gums in infants due to teething.” Benzocaine is an over-the-counter anesthetic, which the FDA notes are usually under the product names Anbesol, Hurricaine, Orajel, Baby Orajel and Orabase. Benzocaine has been associated with a rare but serious—and sometimes fatal—condition called methemoglobinemia, a disorder in which the amount of oxygen carried through the blood is greatly reduced.

Many parents like to use amber teething jewelry for babies to mouth and chew. Check frequently for fraying or weakness in the string and throw away any items that are at risk from breaks. The small pieces of amber can be a choking hazard.

Teething is a time when babies (continue to) put everything in their mouth. Help them sooth by having appropriate items handy for them. The items will be dropped frequently, so dishwasher safe is a plus. Some babies eschew all items and prefer to chew on their fist, this is convenient because it won’t be left behind or forgotten but your baby can develop a rash on his hand from the saliva. Try to wash his hand frequently and offer other items if you see a rash develop.


Get More Sleep Strategies For Moms

2019-04-29T11:50:56+00:00April 29th, 2019|Categories: Fertility Blog|

New parents are usually the more exhausted people in any room, caring for a baby is a 24/7 job. Getting more sleep is the goal of most new parents so methods like sleep training can look like the answer. The term “sleep training” is a loaded one. Most parents associate the idea with sitting on the floor, outside the nursery listening to your baby cry and scream themselves to sleep, leaving everyone traumatized and exhausted. A new wave of sleep experts say sleep training is more about teaching your baby that they are capable of falling asleep independently – but you decide. Every parent needs to choose the best way of managing sleep for their family. Some parents do fine on a few hours of sleep, others need more to have the patience to care for a baby. There are many factors to consider when caring for your baby.

Ideally, you want your baby to be able to fall asleep without you since they will inevitably wake at night and look for you to provide the same song, rocking, breast that helped them fall asleep the first time. But the best way to accomplish this isn’t clear and as with all things parenting, there are no rules. Even the “sleep experts” don’t agree on the best way to help babies sleep longer. Or if we should want them to. I mean of course we want to sleep longer, but for breastfed babies with small tummies that empty quickly, frequent nursing sessions through the night can keep your milk supply strong and help your baby get the nutrition they need to grow.

One thing the experts agree on to help your baby fall asleep is a consistent bedtime routine. Around six weeks old, pick the same time every evening to bathe, sing, read and feed your baby then place her into her crib. Consistent wake up times help too.

If you choose sleep training it should start between four and six months, according to some experts. There are many methods of sleep training, all involving some form of allowing your baby to cry and fuss without any soothing. Sleep training is not recommended by many lactation consultants, babies cry for many reasons and responding to your baby’s cries given them confidence in you and the safety of their environment.

Instead of sleep training, here are some tips for instilling good sleep habits early on:

  • Offer the breast frequently during the day. You want her to get the idea that the daytime is for eating and nighttime is for sleeping.
  • Wait to respond to nursery noises. It’s natural for a baby to wake up occasionally  during the night and they may fall back asleep without help from you. Wait outside the door to make sure your child needs soothing and not just whimpering in his sleep. If you go in the nursery, it may turn into a full-fledged wake up necessarily.
  • Aim for an early bedtime. An earlier bedtime—like 6:30pm or 7:00pm—may help your baby sleep longer. Putting your baby down earlier means less of a chance for them to be  overtired. Just like adults, overtired babies can find emotions get in the way, making the nighttime routine more difficult.
  • Open the blinds. Help your baby learn the difference between night and day by opening the blinds in the morning and going outside during the day. Try to keep the nighttime nursery environment quiet and dark. These cues help your baby learn the expectations and routines for night and day.

Sleep deprivation is definitely a real thing – and it can make us desperate for some rest. Try to sleep when your baby naps during the day, although this is tough if you also have older children. Be kind to yourself and focus on caring for yourself and you baby and ask for help if you need it!


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