New Blog URL for The Sanity Spot

The Sanity Spot has a new URL. I have finally switched over to Square Space to host my beautiful new web site and blog. Now you will be able to find out about all of our fabulous breastfeeding and parenting classes, support groups, and consultations, as well as follow our weekly blog! Please join us at our new home: sdbfc.com/blog.

I look forward to reading your comments on our upcoming blog post!

Happy Mother's Day!

Warmly,
Robin

Hi Ho, Hi Ho, It's Off to Work We Go: Part 3

Your First Week Back at Work

After weeks of pumping and storing breast milk, making plans with your employer for pumping breaks while at work, and preparing yourself to leave your little one behind, the day has finally come: You are going back to work! Yowza!

I remember crying during the entire drive to work that first day (actually, who are we kidding...the first WEEK back at work), wondering how I was going to make it through the day without my sweet little Ben. How was our caregiver going to meet his every need? Would I make enough milk while I was away from him? Was it time to go home yet????

Well, ladies, the emotional part of going back to work can be quite stressful.... I can definitely empathize. I have been there and ,initially, it can be difficult. So, let me help you the logistics of getting through your first week back at work....let's make that a no-brainer.

Start in the Middle of the Week

There is nothing that says that you have to start back to work on a Monday. Who needs a double case of the 'Mondays?' Not you, that's for sure. Instead, set yourself up for success. For your first week back, start on a Wednesday or Thursday. This way, you can ease yourself in to your work schedule, without it being completely overwhelming. Those few days closer to the weekend (and uninterrupted time with your baby) will make this transition so much smoother and less daunting.

Pack Your Bag the Night Before

Rather than scrambling in the morning, which only adds to your stress, pack your bag the night before so that you will feel even more prepared in the morning. Wondering what to pack? Here's a short list of some items you might want to include:

• Pump and pump pieces


• Freezer packs to hold your pumped milk (unless you have a fridge in your office)


• Extra batteries for your pump or a plug to connect it to the wall


• Photos of your baby


• Extra breast pads, just in case you leak while at work


• Diaper bag for your baby (if he/she is not being taken care of at home) - full of bottles, extra clothing, diapers/wipes, etc.

For even more ideas about what to pack the night before and the day of, check out the list at workandpump.com

When Should I Pump?

Ideally, you want to pump at work as often as your baby is getting a bottle while you are away from him/her. I tried to breastfeed my son before I left for work every morning. Then, he usually took a bottle around 11am and 2pm while I was at work. I always had an extra bottle, just in case I didn't make it home in time before the late afternoon feeding. My goal was to get home just in time to breastfeed my son around 5pm. If I got stuck in traffic, I would sometimes have to pump when I got home, which was always a bit of a bummer. Best case scenario, I pumped twice at work, using a double electric pump, for about 15 minutes each time. This gave me enough breast milk for the next day, plus a little extra sometimes. I also pumped once or twice over the weekend, just to have a little surplus for the following week.

I hope that this series of posts was helpful for all of you brave, dedicated mamas who are breastfeeding and going back to work. If you have other tidbits of advice, please add them to the comments so that other moms can benefit from your wisdom!

Hi Ho, Hi Ho, It’s Off to Work We Go…. Part 2

Making Plans with your Employer

So, now you should have mastered the pump, built a small supply of milk in your freezer, and introduced a bottle to your little one. No problem, right? Next step, get your employer on board for giving you your well-earned break to pump while at work. Sometimes, this is a no-brainer. If you live in a state like California, businesses with more than 50 employees are mandated to give breastfeeding moms pumping breaks and supply a clean, private space to pump (which cannot be a bathroom stall.) Other states do not have such laws in place, so you might be paving the way in your business for you and future breastfeeding moms. Either way, it is helpful to know your rights and how to be proactive to get what you deserve: time to pump so that you have something to feed your breastfeeding baby. Let’s get all of your ducks in a row so that this is an easy process for you.

Reasons Why Pumping at Work is Good for Your Employer

Sometimes it is helpful to have a list of reasons why allowing a mom time to pump at work is beneficial for her employer. Bosses like to look at the bottom line. Here’s a handy-dandy list of reasons to share with your boss:

• A study of multiple companies with lactation support programs found an average retention rate of 94.2%

• One-day absences to care for sick children occur more than twice as often for mothers of formula feeding infants.

• Businesses with lactation support have lower turnover rates, higher employee satisfaction, and additional health care savings.

All of this information, and more, can be found in the Business Case for Breastfeeding: For Business Managers

What You Would Like for Your Employer to Provide

A pumping mom needs very few things from her employer to continue making milk for her baby. Really, all you are looking for is a private, clean space (that is not in a bathroom) with outlets, a comfy chair, and a lock. An optimal break time is about 20 minutes: 15 minutes to pump, 5 minutes for set-up/clean-up. You should be able to take a break every few hours, since you will need to pump as many times as you are missing that breastfeeding session with your baby. It is amazing how efficient you will become in your pumping space. The supplies you will probably have to provide will be a pump/pump pieces and freezer bags (in which to keep your pumped milk.) Some savvy employers may provide a small fridge to keep your milk in and a super comfy space. Others may provide the bare minimum. Regardless, it is your right and you can make it happen!

What Should You Do if Your Employer Does Not Provide Pumping Breaks for You?

Check out your federal rights at the Workplace Support in Federal Law web site. All of your rights are there in front of you. You can make it happen!

Next time: Your First Week Back to Work

Hi Ho, Hi Ho, It’s Off to Work We Go…. Part 1

The time has come. Your maternity leave is slowly coming to an end. Whether you are sad to be leaving your little one for a portion of the day, excited to have some adult interaction, or a combination of the two, it is now time to consider how and what you will feed your baby during this time of separation. I remember feeling somewhat overwhelmed about this whole process. What was my son going to eat when he was away from me? How was I going to stockpile enough breastmilk before my first day back to work? Where was I going to pump while at work? The list went on and on in my mind and made me a little crazy. Yet, once I sat down and made a plan for myself, everything seemed less daunting and more feasible.

Well, ladies, my plan for the next few blog postings is to help make your 'back to work transition' easy and manageable. Are you ready? Here we go:

Starting the Pumping Process

As soon as your baby has gone through his/her growth spurt (around 2-3 weeks old) and if breastfeeding is going well, you can start pumping to get breast milk for bottles and your stock pile. Now you may ask, if I am exclusively breastfeeding, how I am going to have extra breast milk to pump? Well, usually your baby will remove about 75%-80% of your breast milk during a feeding, so there should still be some milk in there to pump out. Also, you may find that there are certain times of the day where you feel fuller, even after your baby has had a full feeding. I found that this time for me was in the morning. Even though I wasn't sleeping THAT much at night, my body was resting and replenishing while I was sleeping.

After our first mid-morning breastfeeding session, I would pump afterwards and save the little I got (usually .5-1oz) in the fridge in a milk storage bag. After pumping at this time for a few days in a row, I had about 3oz in the fridge….a perfect amount of breast milk for my 3 week-old son.

Introducing the Bottle

So, mamas, how do we introduce this first bottle of liquid gold???? Have someone else do it! Yes, you read correctly. Your baby can smell you from practically a mile away (well, maybe not that much!) and will probably have no interest in a bottle if he can have the real boob. Instead, hand your bundle of joy to dad, grandma, etc and immediately leave the room. And wait. And wait. Caution: Do not pump in place of this feeding session until you receive the 'All Clear' that your baby happily drank the bottle of milk and is as happy as a clam. I made the HUGE mistake of pumping as I THOUGHT my hubby was giving our son the bottle. Long story short, my son didn't take the bottle the first day. I had pumped because I thought he was drinking from the bottle. We ended up with a screaming little boy, empty breasts, and a frustrated mama. Moral of the Story: Wait until your baby takes the bottle and then pump in place of the breast feeding session. Now baby is full, mom has empty breasts, and now you have breast milk for your next bottle.

How Often Should I Give a Bottle?

If you are going back to work, I would recommend giving your baby a bottle a few times a week. That way, she/he gets used to going back and forth between bottle and breast and will continue to take a bottle once you return to work.

For a great resource about the different types of pumps and which ones are best for moms going back to work, check out one of my favorite web site: Breastfeeding for Working Mothers. As for bottles, always choose a slow flow nipple that looks most like your own anatomy.

If breastfeeding is still a challenge by 2-3 weeks, please see a lactation consultant before starting this process, as it could cause more difficulties if breastfeeding is not going well.

Next Time: Making Plans with Your Employer

How Your Breastfeeding Life Changes from 1mo - 6mos

As your baby transitions from a sleepy few-week old to a more alert few-month old infant, you may notice that your baby's feeding patterns and behaviors change. You might be introducing a bottle and watching a family member enjoy taking part in the feeding routine. You may be going through growth spurts at 6 weeks and 3 months that throw you for a loop. You might also notice that your baby has inconsistent sleeping patterns and may sleep 6 hours/night one week and then go back to every two hours the next.

The following article, written by one of my favorite lactation consultants, Denise Altman, describes some common patterns you may notice in your 1mo - 6mo old baby. I love this article because it really helped normalize my son's behaviors at this age.

Enjoy!

Milk Supply and Intake / The First Six Months by Denise Altman RN, IBCLC, LCCE/All The Best

Why Does My Baby Cry while Feeding? - Part 2

Last week we wrote about thrush, which may be one reason why babies cry while breastfeeding. This week we will discuss two more reasons that can cause babies to cry while breastfeeding: reflux and fast let-down.

Laid-back Breastfeeding - The Ultimate Position!

Reflux: Heartburn! How many of you had heartburn while you were pregnant? If you have ever felt this burning in your esophagus and chest, you know how absolutely uncomfortable this is. Most babies have some sort of reflux, as their digestive systems are still immature until they are about 3 months old. Babies with reflux often feel this pain in their chests while feeding, which may cause them to arch their backs, pull off and on, or just pull off and start crying. It is important to work with a lactation consultant if your baby is exhibiting these symptoms. Sometimes reflux can be managed with feeding your baby in a more laid-back position and keeping him/her upright for 20 minutes after feeding. Sometimes reflux can actually be a symptom of a food intolerance, which will drastically improve once the food is removed from the mom's diet. Other times, reflux can be a sign of a more challenging condition called gastro-esophageal reflux (GER), which sometimes needs to be treated with medication. A certified lactation consultant should be able to watch your baby feed and help you solve this issue based on your baby's symptoms and your medical history. You may also need to meet with your pediatrician. Whether it is reflux or food intolerance, formula is not the answer, so keep on breastfeeding and seek the help of a lactation consultant.

Fast let-down: Picture turning on the garden hose and trying to manage swallowing the liquid while dealing with the fast flow. This is the best way I can describe to a mom what it feels like when she has a fast let-down. Sometimes a baby will clamp down on the nipple to slow down her/his mom's flow. (Like kinking the hose to stop the flow) Other times, a baby will pull off and gasp for air. You may also hear your baby gulping super-fast and seem to sputter a little, which may lead to him/her swallowing a lot of air and becoming gassy later after the feeding session is over. Or, your baby might just pull off and cry if he/she sucked in a lot of air. Dealing with a fast flow can be fairly simple with just some small positional changes. Mom can lean back so that gravity can help to hold the milk in her breasts, rather than pouring into her baby's mouth. Also, a baby placed in a more upright position, either sitting on her/his mom's lap or lying on her chest, often can tolerate a fast flow a little better, as gravity will assist her/him in swallowing mom's milk at a more comfortable pace. Check out more information about this positioning at Biological Nurturing.

I cannot stress enough the importance of working with a certified lactation consultant if your baby is crying while breastfeeding. The stress on you, as the mom, can become overwhelming….and it doesn't have to be. Use your community resources and get the support you need so that you can continue to meet your own personal breastfeeding goals.

Why Does My Baby Cry While Feeding?

Babies have this amazing ability to let you know when things just aren't right….they wail like a fire engine! Yes, they sure know how to get our attention. So, when a baby consistently cries while breastfeeding, a mom's maternal instinct kicks in and starts to hypothesize a thousand reasons why her baby is crying at breast. Could it be that my baby doesn't like the taste of my milk? Does my baby not enjoy breastfeeding? Do I not have enough milk? And the list goes on and on….. It is enough to drive a mom crazy, which often exacerbates the initial issue.

So what is a mom to do if her baby is consistently crying while feeding?

First of all, I would recommend meeting with a lactation consultant. Sometimes it is the position that is causing the baby to cry while feeding. Sometimes it could be thrush in the baby's mouth. A lactation consultant will watch your baby feed and should be able to figure out what is going on. In the meantime, here are a few reasons why a baby will cry while breastfeeding and a few quick ways to remedy the situation. This is in no way an exhaustive list, nor should it be taken as a substitute for professional lactation assistance from a lactation consultant or pediatrician….it is just a little glimpse into why your baby might be crying while breast feeding.

Thrush: The beasty-yeasty! Oh, the amount of thrush I saw this past summer could last me a lifetime. Sometimes when a baby has thrush, s/he will have white patches in her/his mouth which may itch or burn. Ouch! Look for white patches on your baby's tongue, inside cheeks, roof of his/her mouth, or on her/his gums. If it cannot be rubbed off, like milk tongue, it is probably thrush. Sometimes a baby will have a diaper rash. Sometimes there is no visible yeast at all. Check your nipples to see if they are pink and/or burning while feeding. A yeast infection can make it very uncomfortable to feed, which can explain lots of crying at breast. If your baby has thrush, you can start taking probiotics to fight off the 'bad' yeast and get your body back in check. Definitely make an appointment with an LC or your baby's pediatrician as a follow-up. Babies usually don't need to be placed on medication when they have thrush, as there are many herbal remedies that can take care of the yeast situation.

Check back next week when we discuss reflux and fast let-down.

10 Steps for Effective Pumping

Whether you are going back to work, trying to increase your milk supply, or just need a little break from your baby, there are some great strategies for ways to maximize your pumping session(s). While your baby is usually your most efficient 'milk extractor', there are some definite tricks to help get your milk out with a pump. Denise Altman offers some amazing tips for pumping in this article. Hopefully these tips will help to make your pumping session(s) quick, easy, and painless!

Enjoy the article: Ten Steps for Effective Pumping

I’m Sick! Should I Continue to Breastfeed?

Many moms will ask me if they should continue to breastfeed when they have a cold or the flu. The answer is: ABSOLUTELY! Whether it be a mild virus, a bacterial infection, the flu, mastistis, you name it, the best thing you can do for your baby is to continue to breastfeed.

By the time your symptoms begin to appear, you have already been contagious for several days, therefore your baby has already been exposed to your illness. Since you started to come down with your illness, your body has been creating antibodies to fight off this illness. These antibodies, which are specific to your illness, have been transmitted to your baby through your breast milk and will continue to protect your baby throughout the entire time your body is fighting your illness. If your baby does happen to catch what you have, most likely it will not be nearly as severe as what you are dealing with. How amazing is that?

So if you find yourself feeling under the weather, wash your hands often, stay hydrated, breastfeed often, and stay away from medications (such as antihistamines) that may increase your risk for lowering your milk supply.

For more information about medications that are safe to take while breastfeeding, check out LactMed or call your local Lactation Consultant.

The Breastfeeding Mom’s Most Important Cheerleader

When I teach my prenatal breastfeeding classes, I often rate my success as a teacher by how well I am perceived by the significant other who attends the class with the pregnant mom. If a dad comes up to me and thanks me for the great class, I know that I have done my job. You see, if the pregnant mom signed up for the prenatal breastfeeding class, she has already made up her mind that she plans to breastfeed her child(ren). The significant other usually attends the class to show his/her support for the pregnant soon-to-be mom. This support is absolutely imperative in the mom's success to reach her breastfeeding goals. A mom needs her cheerleaders….significant others, friends, family members, yahoo-group friends, etc. …. to help her feel successful as a mother. Motherhood if challenging, especially the first time around; which is why we need our cheerleaders. If breastfeeding poses some challenges, it is this cheerleader who can either provide support and build confidence or slowly begin to offer that the mom give up.

This is why my prenatal breastfeeding class focuses more on creating support systems than positioning and latch. Lactation consultants can help to fix positioning and latch, but the cheerleaders are the ones who give the mom strength to meet her personal breastfeeding goals. It is the cheerleader who brings the mom water during the night and makes sure she eats enough healthy food throughout the day. It is the cheerleader who rubs mom's back and massages her shoulders as she feeds her baby 8 or more times in a 24 hr. period for the first few months of life. Again, it is the cheerleader who makes all the difference.

Wondering how to be the best cheerleader for a new mom? Here's your list to follow:

1. Before breastfeeding challenges arise, have a list of lactation consultants, La Leche League leaders, and breastfeeding support groups that you can contact to get help, if needed.
2. Breastfeeding a baby can take up a large portion of the day and night. Offer to help make dinner and take care of the home so mom can focus on getting breastfeeding off to a great start.
3. Find your own special ways to bond with the baby: snuggle after feedings to help the baby's milk digest more easily, hold the baby skin-to-skin, sing to the baby….these are just a few.
4. Discuss with mom what her breastfeeding goals are and do everything you can to support her and these goals.
5. Be proud to be a cheerleader! You role is irreplaceable!

The Surgeon General’s Call to Action to Support Breastfeeding

FACT SHEET

The Surgeon General's Call to Action to Support Breastfeeding outlines steps that can be taken to remove some of the obstacles faced by women who want to breastfeed their babies.

How many American women breastfeed their babies?

• Three out of four mothers (75%) in the U.S. start out breastfeeding, according to the Centers for Disease Control and Prevention's 2010 Breastfeeding Report Card.
  
• At the end of six months, breastfeeding rates fall to 43%, and only 13% of babies are exclusively breastfed.
  
• Among African-American babies, the rates are significantly lower, 58% start out breastfeeding, and 28% breastfeed at six months, with 8% exclusively breastfed at six months.
  
• The Healthy People 2020 objectives for breastfeeding are: 82% ever breastfed, 61% at 6 months, and 34% at 1 year.
  

What are the health benefits of breastfeeding?

• Breastfeeding protects babies from infections and illnesses that include diarrhea, ear infections and pneumonia.
  
• Breastfed babies are less likely to develop asthma.
  
• Children who are breastfed for six months are less likely to become obese.
  
• Breastfeeding also reduces the risk of sudden infant death syndrome (SIDS).
  
• Mothers who breastfeed have a decreased risk of breast and ovarian cancers.
  

What are the economic benefits of breastfeeding?

• Families who follow optimal breastfeeding practices can save between $1,200–$1,500 in expenditures on infant formula in the first year alone.
  
• A study published last year in the journal Pediatrics estimated that if 90% of U.S. families followed guidelines to breastfeed exclusively for six months, the U.S. would annually save $13 billion from reduced medical and other costs.
  
• For both employers and employees, better infant health means fewer health insurance claims, less employee time off to care for sick children, and higher productivity.
  
• Mutual of Omaha found that health care costs for newborns are three times lower for babies whose mothers participate in the company's employee maternity and lactation program.
  

What obstacles do mothers encounter when they attempt to breastfeed?

• Lack of experience or understanding among family members of how best to support mothers and babies.
  
• Not enough opportunities to communicate with other breastfeeding mothers.
  
• Lack of up-to-date instruction and information from health care professionals.
  
• Hospital practices that make it hard to get started with successful breastfeeding.
  
• Lack of accommodation to breastfeed or express milk at the workplace.
  

What can the health care community do?

• More hospitals can incorporate the recommendations of UNICEF/WHO's Baby-Friendly Hospital Initiative.
  
• Provide breastfeeding education for health clinicians who care for women and children.
  
• Ensure access to International Board Certified Lactation Consultants.
  

What can employers do?

• Start and maintain high-quality lactation support programs for employees.
  
• Provide clean places for mothers to breastfeed.
  
• Work toward establishing paid maternity leave for employed mothers.
  

What can community leaders do?

• Strengthen programs that provide mother-to-mother support and peer counseling.
  
• Use community organizations to promote and support breastfeeding.
  

What can families and friends of mothers do?

• Give mothers the support and encouragement they need to breastfeed.
  
• Take advantage of programs to educate fathers and grandmothers about breastfeeding.
  

What can policymakers do?

• Support small nonprofit organizations that promote breastfeeding in African-American communities.
  
• Support compliance with the International Code of Marketing of Breast-milk Substitutes.
  
• Increase funding of high-quality research on breastfeeding.
  
• Support better tracking of breastfeeding rates as well as factors that affect breastfeeding.
  

To order a printed copy of The Surgeon General's Call to Action to Support Breastfeeding, call 1-800-CDC-INFO begin_of_the_skype_highlighting or email cdcinfo@cdc.gov and reference the publication title. For a downloadable copy, visit www.surgeongeneral.gov.

Supporting the Sisterhood Part 2

In my quest to provide healthy, quick, and easy recipes to new mamas, here is the second installment with a fabulous easy recipe for homemade pizza dough. I love this recipe because it is so easy to include a plethora of vegetables to spice up the flavor and add to the health benefits. Think broccoli, red peppers, spinach, etc. Prepare the dough in the morning (when babies like to sleep the most) and roll, add toppings, and bake for dinner (when babies tend to be the most fussy). Add a salad and you have a full, healthy meal! Enjoy!

Ashley Treadwell's Easiest Pizza Dough Ever:

4 cups of flour (I use 1 c whole wheat and 3 cup white)
2 1/4 tsp (or one packet) yeast
1 Tbsp kosher salt
2 Tbsp olive oil
1 3/4 cup warm water

Add all dry ingredients to food processor and pulse to mix. Turn processor on and add olive oil. Add water slowly until dough forms a ball (you may not use all the water)
Let rest for 2 minutes.
Process for an additional 30 seconds.
Turn dough out onto floured surface and knead until elastic and smooth (1-5 min). Put into oiled bowl and cover with saran wrap and leave to rise - 1-2 hours (or all day).

When you are ready to cook the pizza, divide the dough into 2 balls. Roll the dough, on a floured surface, into a circle. Add jarred sauce and pre-shredded cheese.

To cook: place pizza dough of a floured cookie sheet or pizza stone. Precook dough at 425 for 5-10 minutes. Then add the toppings and bane for an additional 10 minutes or so.