Trusted Information for Healthy Pregnancies
breastfeeding
Methadone and Breastfeeding
Mar 21st
Up until 2001, the American Academy of Pediatrics (AAP) recommended that methadone was compatible with breastfeeding in women taking less than 20 mg per day. Because most women on methadone maintenance therapy typically require 50 to 15o mg of methadone per day during pregnancy, this meant that most women on methadone were not able to [...]
Antiepileptic Drugs in Breastfeeding: Neurodevelopmental Outcomes
Jan 24th
Because breastfeeding has many psychological and medical benefits for both the mother and her child, many women would like to breastfeed. However, all medications taken by the mother are secreted into the breast milk. While various studies have addressed the safety of antiepileptic drugs (AEDs) in nursing infants, none have systematically assessed the long-term effects [...]
Serotonin Reuptake Inhibitor (SRI) Use Associated with Reduced Intention to Breastfeed
Oct 26th
Given the potential health benefits of breastfeeding on both mother and baby, the U.S. Public Health Service for Healthy People 2010 set a goal to have 75% of mothers breastfeed in the early postpartum period and 50% of mothers to continue breastfeeding to 6 months by the year 2010 (US Dept of Health and Human [...]
Ultrasound Reveals Breastfeeding Mechanics
May 12th
Although it might look like a baby is chewing on the mother's nipple, ultrasound images show that the infant actually removes milk by creating a vacuum - also known as sucking.
The finding is important, as it could explain why some babies fail to take to the breast. It may also shed new light on why - for a minority of women - breastfeeding really can be a painful experience.
"There have been two theories about how breast milk is expressed," says Donna Geddes of the University of Western Australia in Crawley.
"One is that the baby uses a peristaltic or compression motion to actually push the milk out of the nipple and breast. The other theory is that vacuum is primary in removing the milk."
Until now, most studies examining the mechanics of breastfeeding have focused on bottle-feeding infants, or on old X-rays that were of poor quality.
Instead, Geddes and her colleagues combined ultrasound imaging of infants suckling on the breast with measurements of the strength of the vacuum created by the baby's mouth in 20 infants aged 3 to 24 weeks as they breastfed.
"What we see is that when the tongue is lowered and the vacuum is applied, that's when the milk is coming out of the breast, and that doesn't involve any compression of the nipple," says Geddes. "It's not a milking action at all."
They also found that infants who struggled to breastfeed generated much weaker vacuums than successful breastfeeders. This may explain why babies with a cleft palate often fail to breastfeed, as do premature babies: preterm infants don't have strong enough mouth muscles to suck hard enough.
The next step is to devise a simple and universal test that could be used to assess babies' ability to suck. This could reassure mothers whose infants are struggling to feed that it's not their fault. "Currently there are no measurements to assure the mother or the clinician that things [in the breast] are working," says Geddes.
For such women, keeping the milk flowing using a breast pump and using this to top up breastfeeding until the baby is strong enough to suck effectively may be a better option than giving up on breastfeeding altogether.
The team also looked at women who found breastfeeding painful and discovered that their infants had a particularly vigorous action.
"They're strong suckers," says Geddes. Some were also distorting or crushing the nipple. Further study of these infants may aid the development of better nipple shields to reduce pain during breastfeeding.
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Lithium and Breastfeeding
May 12th
Bipolar disorder (types I and II) affect up to 5% of the population in the United States. As the onset of this condition typically occurs during or before the reproductive years, the management of bipolar disorder in women is often complicated by pregnancy. There are concerns regarding fetal exposure to medication, the impact of untreated [...]
7 Tips to Get Ready for Breastfeeding
May 6th
The world tells us breast is best, but when you're pregnant for the first time, planning to breastfeed can be intimidating.
All the conflicting advice doesn't help -- toughen up your nipples! No, don't touch them!
You're going to be leaking milk like crazy! No, that milk won't come in for days after baby's born!
The Stir got the skinny on what you really need to know to be ready to breastfeed from Laura Keegan, a family nurse practitioner and author of Breastfeeding With Comfort and Joy: A Photographic Guide for Mom and Those Who Help Her, who maintains a holistic family practice in southern Dutchess County, New York.
"Communication with your partner, family, and friends about your plans to breastfeed and what you'll need from them in the early weeks is THE most important component of breastfeeding preparation during pregnancy," says Keegan. "There's a learning curve experience to breastfeeding and everyone in your circle needs to be prepared."
Chat up your family. Limiting visitors postpartum is recommended by the World Health Organization's Baby Friendly Hospital guidelines to get acclimated to breastfeeding. But you'll have to tell grannies and aunties beforehand.
"A good rule for visitors in the first weeks is to limit their stay to 15 minutes per visit and request that they bring a meal," Keegan says. "To provide perspective, in cultures where breastfeeding is the norm, women and their families have a period of 40 days with minimal visitors and activities outside the home combined with full support from their community in terms of meals and child care."
Talk to your partner about what to expect. "Although it's difficult to anticipate the experience of a crying baby having difficulty taking the breast in the middle of the night, it's important to talk about the importance of staying calm and focused during those challenging times and understanding and anticipating that it's a normal part of the learning curve," Keegan says.
Talk to your health-care provider. "Let them know that you want to have your baby placed immediately on your chest at birth and to delay all routine procedures until after you've had time skin to skin with your baby, allowing your baby the opportunity to feed within the first hour of birth," Keegan suggests. "Consider writing a birth plan to communicate your preferences, because how you birth your baby can impact breastfeeding. With a Cesarean birth, the baby can be brought to the chest and feed even as the incision is being closed."
Find a pediatrician with breastfeeding expertise or a lactation consultant. "Ask if someone will be able to observe and evaluate your baby feeding during an office visit, if there's a concern about the baby’s weight," Keegan says. "Have a phone number available for a trusted lactation specialist or consultant in your area to call should you need assistance."
Talk to the hospital staff. Ask for the baby to "room in," and let them know there should be no use of artificial nipples (i.e., pacifiers, formula bottles).
Find breastfeeding moms. Talk to them for tips now but also so you'll have someone to reach out to when baby comes. They can work with you on ways to hold the baby that "facilitate ease in breastfeeding rather than the ways you may be accustomed to seeing for bottle-feeding," Keegan says.
"In cultures where breastfeeding is the norm, moms hold their babies more to the center of their bodies than you might expect because with bottle-feeding, we hold our babies more to the side of our bodies for bottle placement," she explains. "This bottle-feeding imprinting causes many unnecessary challenges for breastfeeding, and the desire to correct this imprinting was the inspiration for Breastfeeding With Comfort and Joy."
Talk to your boss. "Seek out comfortable places to nurse in advance for when you're on the go, so you'll feel prepared to nurse outside your home in comfort just as a bottle-feeding mom is comfortable nursing outside her home," Keegan suggests.
What’s Safer for Breastfeeding: Lithium or Lamotrigine?
May 4th
After last week’s post, we received several comments regarding the use of mood stabilizers in breastfeeding women, specifically asking which is safer: lithium or lamotrigine.
Based on the available data, it is difficult to say with certainty which is “safer”. To date, there has been one report of an adverse event in a nursing infant exposed [...]
Lamotrigine and Breastfeeding: An Update
Apr 27th
Women with bipolar disorder are vulnerable to postpartum illness, and it is generally recommended that mothers continue treatment with a mood stabilizer throughout the postpartum period to reduce their risk of relapse; however, this recommendation is complicated by the all mood stabilizers are secreted into the breast milk, although their concentrations appear to vary considerably [...]
List of hospitals offering Healthy Baby Bounty Bags
Jan 15th
About 200 hospitals are now offering Healthy Baby Bounty Bags to new moms when they leave the hospital. These bags contain products, information, and coupons that support only breastfeeding. To find out if your local hospital is participating, look to see if their name is here, or give them a call.
Gymnast Shannon Miller Gives Advice to Moms
Jan 13th
Shannon Miller is the most decorated gymnast, male or female, in U.S. history with 7 Olympic and 9 World Championship medals. Now mom to 2 1/2-month-old son Rocco, this 32-year-old former Olympian is trading in her passion for the balance beam to help new moms balance their lives with a series of fitness DVDs and a prenatal cookbook.
How is motherhood so far?
"Our son was born on October 28th at 7 lbs, 11 oz. It truly is a miracle how a baby changes your life. Things that seemed so important before take a back seat to Rocco’s smile.
Everyone tells you to nap when the baby naps……yeah right! You’re too busy doing a million other chores, working or just staring at him. It’s so important to take time for yourself or you’ll go crazy."
Was choosing a baby name easy for you two? Did you know you were having a boy?
"We call him Rocco to avoid confusion and because it’s so darn cute! He is actually named “John” after his father and his paternal great grandfather and “Rocco” after his other great grandfather. He’s a 5th generation Rocco!
Choosing a name was pretty difficult. With a name like Falconetti you’ve got to have something that rolls well. We narrowed it down to three names the night before we had him. We took one look at him after he was born and knew he was a Rocco."
Looking back, do you feel the pressures of the Olympics is too much for a young person? What was it like for you?
"Truly, I think it’s up to the individual. Children don’t always get enough credit for knowing what they want and going after it. Some children can absolutely handle it and others crumble under the pressure. It certainly helps to have a strong support system around you including parents, coaches, teachers and friends. And, above all, you have to love what you are doing. You cannot fake passion.
Did you workout during your pregnancy? Did you focus on working out, or were you happy to just 'let it all go' for once? I can imagine how hard it would be to keep up with your past gymnast body!
"I did workout while I was pregnant. In fact, I was so clueless as to what I should or shouldn’t do during pregnancy that I did a ton of research. I even ended up taping a “fit pregnancy” DVD to help other women maintain a fit pregnancy. I feel better, sleep better and have more energy when I work out. And it makes it so much easier for your body to bounce back after delivery. In addition, it actually helped with my morning sickness (24/7 for 6 months)."
How are you feeling postpartum? Have the 'baby blues' reared their ugly heads?
"By the end of week three I realized I absolutely had to leave the house. I needed some fresh air and sunlight just to maintain my sanity. I started taking daily walks with Rocco in his stroller and it was perfect! John and I also try to take date nights from time to time."
What did all your friends and family 'forget' to tell you about pregnancy and childbirth? Is there anything that surprised you during your experiences?
"No one can truly prepare you for the first day you arrive home with your new baby. The nurses are gone and you realize that you are now in charge. Talk about terrifying!
I got a lot of advice and stories. Many were horror stories about the delivery process. The one thing that surprised me the most was that the delivery ended up being the easiest part. I was induced due to gestational diabetes. It was such a calm and rather painless experience."
Are you breastfeeding? If so, how is that going?
"Yes, I knew I wanted to breastfeed if at all possible. So far, so good. Rocco is a great eater! My biggest issue is trying to drink enough water to help keep my milk up. I’ve also been trying to decrease dairy and nuts in case it causes him issues. Those are huge staples in my diet so that’s difficult."
If you could make one confession - either about your years as a world-class gymnast or as a new mom (or both!) - what would it be?
"Wow, I guess what most people don’t realize is that I am nowhere near as confident or self assured as I may seem. I was never the popular girl growing up. I didn’t know how to wear makeup or fix my hair. I was intimidated by everything, except being on the balance beam. Sometimes, you have to almost trick yourself into being self confident. I learned to fake confidence once I walked onto the floor mat in a competition and realized later that I actually felt more confident.
Being a new mom, everything is terrifying. You never feel like you have things figured out. So when I get overwhelmed I “fake” being self assured. When I’m calm my son is calm."
If you are working on any other project or with any charities, please feel free to discuss.
"I have been working on so many projects I am really excited about. I filmed two DVDs Shannon Miller’s Ultimate Fit Pregnancy and Shannon Miller’s Body After Baby.
I also wrote a prenatal cookbook with my friend, and chef, Jessica Bright.
I have two other fitness books coming out in the spring. One is a yoga book. The other is an abdominal/core book. I call these “To Go” books since they are small enough to fit in your purse or gym bag. You can take them with you for great exercises to get you trim and toned. It’s been busy but it was a great way to spend this year. I have found a passion for health and wellness for women and was able to dive in and finish some of these projects I’ve been working on for years.
In addition, we’ll be holding the 2nd Annual Shannon Miller Kids Marathon on May 1st in Jacksonville, Florida. The event raises awareness for childhood obesity, the focus of my foundation."
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