The Motherwear Breastfeeding Blog

More free breastfeeding stuff

A while back I posted about a number of free breastfeeding resources.  I've since found a few more, and thought I'd share them here.

Printable breastfeeding posters from the California Department of Public Health, in English and Spanish.

A pattern to help you knit the International Symbol of Breastfeeding.

Printable breastfeeding handouts from the Massachusetts Breastfeeding Coalition in multiple languages, including my favorite, "It's my birthday, give me a hug."

Online breastfeeding training for health professionals, from the Virginia Department of Health and the University of Virginia.

"Licenses" to breastfeed from several states.  You don't need a license, obviously.

Breastfeeding management software for use with Blackberry, iPhone, and Palm operating systems, from the Massachusetts Breastfeeding Coalition.

Printable breastfeeding promotion posters from UNICEF.

Copyright free breastfeeding images on Flickr.

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You never know what you'll see in an ER.

Quite an innovative use of a Supplemental Nursing System, don't you think?  Latch looks a little too high, though.

Coffee talk.

I recently got this question* from Nola, a graduate student in my area who has a nine month old daughter:

I've realized that I need caffeine in order to effectively work otherwise I'm just trying to use too many brain cells on too little sleep.  The problem is my daughter reacts very poorly to caffeine (stays up half the night crying with a vacant look in her eyes like she really wishes she was sleeping and can't figure out why she's not).  So my new idea was to caffeinate myself right after she goes to bed.  That way I can get 2-3 hours of really focused work in.  My thought was that by morning (her next feeding) that the caffeine will have passed through me and there won't be any left in my milk.  

Now I know they say things like cow's milk proteins can be in your milk up to 7 days after the mother ingests them.  So I'm wondering if caffeine will pass through quickly or if it will linger like milk does?  Or better said - will my plan work!?

So, the general advice I usually give is that coffee in moderation is fine.  What's moderation?  A few caffeinated beverages a day is unlikely to cause any problems.

But I also say that every baby's different, and that some babies are probably more sensitive than others.  So, knowing that Nola's baby is sensitive to caffeine, will her plan to time her coffee work?

Here's what Dr. Thomas Hale says in Medications and Mother's Milk:  "While the half life (the time required for half of the dose to exit your system) in adults is 4.9 hours, the half life in neonates is 97.5 hours."

Not looking good so far. 

But wait.  Dr. Hale continues: "The half-life decreases with age to 14 hours at 3-5 months and 2.6 hours at 6 months and older...Peak levels of caffeine are found in breast milk 60-120 minutes after ingestion."

So it might work for Nola to get her fix a little before the last feeding.  That way she might be able to get a few hours of work in, and then have enough time for the caffeine to exit her system so that she can get to sleep, too! 

*Of course, this information is provided for education - and entertainment - and should not substitute for medical advice from your health care provider.

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Register your World Breastfeeding Week event.

World Breastfeeding Week is fast approaching, and you can find out about and post events in your community at this La Leche League site.

Looks like there will be walks, brunches, potlucks, and lots of stuff for kids to do in many communities.

This doesn't exactly count as a celebratory event, but our Task Force will be hosting a professor from the University of Connecticut whose research has focused on breastfeeding in the Latino/a community.  Maybe I'll make some lactation cookies for the meeting...

Do you have an online or in-person event planned, anywhere in the world? 

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Was the fix in on your breastpump?

Did you buy your Pump in Style at Babies R Us?  If so, you might be interested in this Time Magazine article on allegations of a price fixing on items including Medela pumps:

[Darcy Trzupek, a mother], an experienced coupon clipper and Web-browsing bargain hunter, searched far and wide for a deal on the Medela [Pump in Style}. But she says she noticed something odd: the pump was listed at $300 everywhere she looked. For five months, she held out for a discount. Nothing. Finally, a week before going into labor, Trzupek gave in and shelled out $300 for the pump at Babies "R" Us (BRU), the retail outlet that parent company Toys "R" Us started more than a decade ago...

But was that breast pump part of a widespread price-fixing conspiracy that protected the profits of Babies "R" Us, the country's dominant big-box baby retailer? According to a federal judge, it appears that could be the case. On July 15, the U.S. District Court in Philadelphia granted class-action status to a complaint that Babies "R" Us coerced manufacturers of high-end strollers, car seats, high chairs, strap carriers and breast pumps into preventing Internet retailers from discounting their products.

The dirty deal, according to the suit, was simple. From 2001 to 2006, Babies "R" Us told companies like Medela that they had to enforce resale-price maintenance — i.e., tell the Web retailers, who can more easily discount products since they avoid brick-and-mortar costs, to sell your products at X, or you'll cut off the supply. If they resisted, Babies "R" Us threatened to cut off the manufacturers, according to the suit, and refuse to sell their products in Babies "R" Us stores. Since Babies "R" Us sold 30% to 50% of these companies' products, Medela, which is based in Switzerland, and other brands like BabyBjörn, the Swedish strapmaker, and Maclaren, the strollermaker based in the U.K., had no real choice but to go along.

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A few things I've been wondering about.

I've been mulling over a few things recently:

• Why did we never see Claire nursing Aaron on Lost?  Or did I miss it?
• Do nipple shields really need to stick out that far?  And why don't they make a size larger than "standard?"
• Will someone ever invent a pacifier with the exact look and feel of a human finger?
• Should I increase the font size of the blog from this to this?  Do I need glasses?

Feel free to answer any and all.

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Do nipple piercings impact breastfeeding after all?

Whenever anyone asks me about nipple piercings affecting breastfeeding, I tell them that it doesn't - and that they should take the ring or post out before nursing!

But a recent study has me re-thinking this a little bit.

A study from Australia reported on:

three cases...in which women were unable to express milk from a breast they had pierced five to seven years earlier.

The women, ranging in age from 25 to 37, produced minimal amounts of milk from their pierced breasts despite frequent breast pumping and help from a lactation consultant. The medical team at the University of Western Australia used ultrasound to study mammary blood flow, breast anatomy and milk ejection in the women.

Researchers concluded that the most likely explanation was that the piercings caused milk duct obstructions, although only one blockage stood out in ultrasound images. That patient had obvious scarring from accidental tear-out of a nipple ring. Another patient had had an allergic reaction to her piercing. The third had no previous complications.

They conclude:  “These cases indicate that nipple piercing may cause complications leading to duct obstruction so that only minimal amounts of milk can be removed from the breast during lactation.”  They also note that "Women with piercings typically have no trouble breastfeeding, so the risk of lactation complications is probably small."

My advice has reflected La Leche League's conclusion:  "There is no evidence to suggest that a woman's pierced nipples will have any effect on her ability to breastfeed."  But this study makes me think that these situations may require a little more attention, especially when infection or scarring has occurred. 

It does make sense to me that some scarring or severing of milk ducts could occur when the place of piercing is also the terminus of all of the milk ducts, and that that could inhibit milk flow.  I also wonder if nerve damage could have occurred, since nerves in the breast are responsible for sending the message to the brain to release the milk-making hormones.  That said, I've worked with many moms who had had piercings, and it didn't seem to affect breastfeeding at all.

Have you nursed after piercings?  Any experience to share?

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The contest entries that made me smile.

These are some of my favorite stories from Motherwear's recent contest (see the winning entry here).  You can also read the ones that cracked me up from the last contest, and read all of the entries, too.

My nursing tip comes from when I was home on maternity leave with my first child (I am now at home with my 3rd!). If you are dialing in for a conference call (especially one with clients on the phone line), be sure you know how to "mute" your end of the line! I thought I could just follow along with the conference call using my notes, while nursing. A friend later told me that everybody on the call could hear the happy slurping noises from my new baby! How embarrassing! Thankfully, I didn't hear about it until I returned to work a few weeks later, and everybody got a good laugh (nobody was upset, they were just happy for me!).  -Becky R., VA 

As a mother of 4 boys one can only imagine the hilarious comments the kids say on a day to day basis. One that makes me smile is when I had just sat down to nurse my 2 1/2 month old, who had been screaming due to the fact he had to wait for me to finish the sandwiches for lunch and help my 2 year old to the bathroom. Just as I began to snuggle with my baby, my son Jonah (5 years) asks, "mommy can you go downstairs and help me turn on the computer?" I said, "No, I just sat down and Mateo has been waiting to eat. Let me feed him first." Jonah replies, "Mommy you can do anything nursing. You empty the dishwasher, take Luca to the potty, why can you not walk downstairs? You know you can use your 'nurses' to do that too! Now can you help me? You can still feed Mateo! I smiled as I reflected on his comments. As woman it really is amazing the things 'Mommy' can do! It just makes it that much more special when someone else recognizes it too! Here is to "multi-task nursing!"  -Heather B., MA

I have only ever gotten positive comments when nursing in public (thanks to your comfortable and easy-to-nurse-in attire!) and after working through the uncomfortable feelings of nursing in front of others with my first, I confidently nursed in public frequently with my second. He was about 4 or 5 months old when I was shopping in a store that had a small cafe with tables inside. My son got hungry so I sat in the cafe to feed him, watching the other shoppers as he ate. One shopper walked by, saw us nursing, and said "Oh, look, he's having his latte, too!" What a sweet comment!  -Allison M., AZ

My son likes to stretch out and move while nursing so it is easiest and most comfortable for us if I nurse him while lying on my side. When we were visiting my parents one weekend, my youngest nephew (4 years old) happened to walk by the bedroom where I was nursing my son. He stopped, looked, and exclaimed loudly, "You're laying on his face!" and insisted that I move. It was all I could do not to laugh out loud; he was so sincerely concerned that I was hurting his little cousin! After a carefully-worded explanation I was eventually able to convince him that his cousin was simply eating and could breathe just fine during the process. It's something we'll laugh about for a long time to come.  -Kristen H., SD

I wanted to share my tip: enjoy the time that you have nursing with your little one because they grow up so quickly. My nursing story: When my daughter was 6 months old she started popping her head up from nursing everytime her Daddy would enter the room. She would give him this really serious look like he was interrupting her. Now that she is 15 months old he can be in the room again, but he better not speak too loudly or she waves at him.   -Rachel C., PA

We were on vacation on my 34th birthday. My family had arranged with the waiter to sing "happy birthday"... the entire dining room turned to sing "happy birthday" to me... as I was nursing my daughter. Clearly, a birthday I will never forget!  -Hollie T.E., NY

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How breastfeeding helps you, too.

While the importance of breastfeeding to babies' health is widely recognized, the effects on mothers' health is less well known.  So, I thought I'd point out some of the ways that breastfeeding protects moms, too.*

Physical health:

Faster weight loss.  There's a reason why your body puts on extra weight (that isn't the baby and requisite fluids) during pregnancy.  Our extra fat is there to be used as a fuel source for breastfeeding.  You can burn up to 500 calories per day just making milk (though the amounts vary by individual), and that's where those stores go.

Shrinking of the uterus after birth.  The oxytocin released when a baby nurses contracts the uterus, protecting mothers against postpartum hemorrhage.

Lowered breast cancer and ovarian cancer risk.  As discussed in more detail in this interview with breast cancer researcher Dr. Kathleen Arcaro, breastfeeding is protective against breast cancer.  A recent federal meta-analysis suggests that breast cancer risk can be reduced by up to 28%, and ovarian cancer by up to 21%.

Lowered risk of heart disease, diabetes, and metabolic syndrome.  Newer research investigating the effects of breastfeeding on heart health, insulin control, cholesterol, blood pressure, and diabetes are finding strong associations between breastfeeding and lowered risk for these serious health problems.

Delayed return to fertility.  This is most relevant in areas of the world where access to other forms of contraception is limited, but exclusive breastfeeding (among other criteria) delays the return to fertility.  In many parts of the world this is critical in spacing of pregnancies.  Of course, you can become pregnant while breastfeeding, so be sure to get more information before using breastfeeding as a form of contraception. 

Emotional health:

Protection against postpartum depression.  Breastfeeding, through the hormones released when a baby nurses, protects against postpartum depression.  It's also true, though, that breastfeeding difficulty can be a potent trigger of depression.  The good news is that when breastfeeding is the cause of depression, depression lifts when breastfeeding problems are fixed.  That's why it's so important to get good help with breastfeeding as soon as possible.  There's far more information on this topic in this podcast interview with Dr. Kathleen Kendall-Tackett.

Increased maternal self confidence.  Research has shown that breastfeeding increases women's feelings of self confidence as mothers.

Ease of bonding.  Of course, mothers who bottle feed bond with their babies, too, but breastfeeding provides a particularly powerful, hormonally mediated means of bonding.

*This post is part of the carnival of the Women's Health Blogfest.  Check out these other posts on the topic of women's health below:

Angela White at Blisstree's Breastfeeding 1-2-3 - Helpful Skills of Breastfeeding Counselors
Angie Tillman, RD, LDN, CDE - You Are Beautiful Today
Anthony J. Sepe - Women's Health and Migraines
Ashley Colpaart - Women's health through women
Charisse McElwaine - Spending too much time on the "throne?"
Danielle Omar - Yoga, Mindful Eating and Food Confidence
Diane Preves M.S.,R.D - Balance for Health
Joan Sather - A Woman's Healthy Choices Affect More Than Herself
Laura Wittke - Fibro Study Recruits Participants
Liz Marr, MS, RD - Reflecting on Family Food Ways and Women's Work
Marjorie Geiser, MBA, RD, NSCA-CPT - Healthy Women, Healthy Business: How Your Health Impacts a Powerful Business
Marsha Hudnall - Breakfast Protein Helps Light Eaters Feel Full
Michelle Loy, MPH, MS, RD - A Nutritionista's Super Foods for Super Skin
Monika Woolsey, MS, RD - To effectively work with PCOS is to understand a woman's health issues throughout her life
Rebecca Scritchfield, MA, RD, LD - Four Keys to Wellness, Just for Women
Renata Mangrum, MPH, RD - The busy busy woman
Robin Plotkin, RD, LD - Feeding the Appetites of the Culinary, Epicurious and Nutrition Worlds-One Bite at a Time
Sharon Solomon - Calories, longevity and do I care
Terri L Mozingo, RD, CDN & D. Milton Stokes, MPH, RD, CDN of One Source Nutrition, LLC - Crossing the Line: From Health to Hurt
Wendy Jo Peterson, RD - Watch Your Garden Grow

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Another casualty of the economic downturn: breastfeeding support

I guess that this was inevitable, but the I've been noticing an increasing number of stories about breastfeeding support programs being cut or eliminated.

Breastfeeding support in San Luis Obispo, California, a hospital lactation program and a community breastfeeding support group in Ontario, Canada have all been on the chopping block in recent weeks.

Recent cuts at our local hospital led to a mom-driven push for our hospitals to become Baby Friendly.

There will surely be more stories of breastfeeding services being cut as hospitals and community health programs look for ways to reduce costs.  Breastfeeding saves families, taxpayers, and our health care system a lot in reduced health care costs, but these days few people are taking the long view.

If there's a lesson here, it's that being a squeaky wheel works.  No one likes bad publicity, and in some communities there is significant competition to become your provider.  If the breastfeeding support program in your area has been important to you and it's now threatened, get together with other moms and speak up.  You might be surprised by the response.

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