Author: Breanne Clinger

What’s It Like to Use Donor Eggs? A Short Guide for Recipients

What’s It Like to Use Donor Eggs? A Short Guide for Recipients

When a woman finds out her only option to get pregnant is through donor egg IVF, the realization can be daunting. Not only is it a heavy emotional burden to bear, but trying to figure out the next best step is often overwhelming. When you […]

Little Fighter’s Journey with Anencephaly

Little Fighter’s Journey with Anencephaly

He had perfect round cheeks with beautiful long blonde eyelashes and his daddy’s mouth. I pressed his warm, small body close to my heart. I was holding him. My Bryce. He was more perfect than I could have imagined. I had dreamed this moment so […]

How to Be a Friend to Someone Experiencing Infertility

How to Be a Friend to Someone Experiencing Infertility

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How to Be a Friend to Someone Experiencing Infertility

Most people find it difficult to speak about their afflictions. We are hard wired to avoid pain like the plague, whether it is emotional or physical, ours or someone else’s. Most people would rather go about offering, “How are you?” as a form of general greeting, rather than a genuine question. Treading in safe, shallow conversation does not offer the same level of connection as striding in deeper discussion filled with authenticity and corresponding empathy. We live in a fast pace world and it is all too easy to forget relationships are what matter most. Having real conversations and being there for one another makes life meaningful.

Infertility falls in that taboo subject, a pain that is difficult topic. There is not going to be one blanket statement that is the golden ticket in making everyone feel loved and validated. But, there are some skills that can be learned to best support the person in the way that THEY need versus the way WE think that they need.

I am one to think systematically and have carried a tool I learned in nursing school termed “APIE” to different areas of my life. We will use this approach here.

A: Assess

Test out the water to see how comfortable your friend is with talking about infertility. On Mommytobeprep’s Instagram story I questioned my followers, “Do you think it is appropriate to ask someone if they want kids in the future?” 76 people responded, 63% said it was OK while 37% said it was NOT okay. This is not a huge sample size but it is fair to conclude that people do not all think on the same page regarding fertility and boundaries. Something key we can gain from this is to try not to take offense when people ask questions. It is best to assume people are truly trying their best. On the other hand, it is important for people to also be sensitive with their words.

Where to Begin?

If you suspect your friend is struggling with infertility saying something like this puts the ball in their court. “I just wanted to check in with you because our friendship means a lot to me. How are you doing? What has been on your mind?”

You cannot force someone to open up, but you can create a safe, open environment. Evaluate yourself. Do you often gossip about others? If so, people will not feel safe to share their feelings with you. Ask yourself how often you open up with this person and do you actively listen when they speak? When they do open up, do you express empathy? The ability to be open in a relationship is fueled by trustworthiness, active listening, empathy, and vulnerability.

What Empathy is by Brene Brown:

Ask Your Friend What They Need

A person’s most useful asset is not a head full of knowledge, but a heart full of love, an ear ready to listen, and a hand willing to help others.” – anonymous.

What you think your friend needs versus what they need may be dramatically different. Your friend may not know what they need or want in the moment but give them a day or so to think about it and then follow back up. Ask them what their love language is. Gary Chapman’s philosophy on love language is not just for lovers but also friends, family, and co-workers.

P: Plan

Set a part time to show your friend love in their language. Below are examples of how to show your friend love according to their specific language.

Words of service:

Attack your friend’s door with sticky notes and let them know how strong and wonderful of a person they are. Call them or shoot them a text on random days letting them know of your love, as well on big days, including tests, procedures and transfer days. If they are taking injections buy a box of alcohol swabs and write a note on each one! Some examples may be: “You are so strong!” “You are one step closer!” “You can do this!” “I’m thinking of you!”

Acts of service:

Infertility appointments are time consuming. Offering to bring dinner by, pick up groceries, walk the dog, or any other chore that may be neglected from the extra time spent away from home is very helpful.

Receiving gifts:

Send a card, flowers or a care package! My sweet sister sent me this package during the process of our In-Vetro Fertilization. It included Brazil nuts (supposedly to help with implantation), dates (helps with constipation), socks (keep the feet warm in the stirrups), alcohol swabs (for all those shots), HCG tests, propel packets (it is very important to stay hydrated with electrolytes), chocolate and a very thoughtful card. To be honest, what was in the package wasn’t what made it so meaningful- although all of it was super helpful! It was the act of her taking time out of her hectic life to put it together and ship it to me!

Some more ideas to include in an IVF care package

  • Ice pack to numb the location of the shot.
  • Over the counter stool softeners because the procedure and pain medication cause constipation and add to the abdominal pain.
  • Water bottle because it is very important to stay hydrated.
  • Heating pad because the cramping is intense.

Quality time:

Make a lunch date somewhere private enough that the person feels safe to open up, go for coffee, a picnic, or a nice walk. Show up at their house just to hang out and be with them. Invite her out for a movie night or an exercise class.

Physical touch:

Put your arm around them as you walk. Give them a hug. Offer them a back or foot massage as you chitchat.

I: Implement

Show up for that person and carry out your plan. Just one small gesture can go a long way. For many, the most difficult thing about infertility is feeling alone.

E: Evaluate

Continue to keep tabs on your friend, circling back to the assessing what he or she may need.

Service is often referred to as the secret to happiness and benefits the giver more than the receiver. Do something for someone else today and be proud of it! Please share your thoughts in the comments below! What have you done for a friend struggling with fertility or what is something that a friend has done for you?

Motif Duo Breast Pump Review

Motif Duo Breast Pump Review

Through my experience working in L&D, postpartum, and nursery, I have read several breast pump user manuals and have learned how to operate them. But honestly, the pump that I have been most familiar with is the Medela due to having the Symphony pump available […]

Pregnancy and Skin

Pregnancy and Skin

This can be an overwhelming topic as there is A LOT of information on the Internet about skin changes during pregnancy and what products are OK and not OK to use during this 40-week period! Also, let’s not forget the stress that may accompany these […]

The Use of a Fetal Doppler at Home

The Use of a Fetal Doppler at Home

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What is a Handheld Fetal Doppler?

A handheld Doppler is a device that uses ultrasound to read your baby’s heartbeat. Your nurse or provider may use a handheld Doppler at your OB appointment after 12 weeks gestation to assess your baby’s heart rate and rhythm. Handheld Doppler monitors may also be bought for at home use, such as the “Baby Doppler.”

You may also have heard of a Doppler ultrasound to be used non-obstetrically. Doppler monitors can also be used to assess blood flow through blood vessels throughout your body in a clinic or hospital setting.

How a Doppler Works

The probe or “transducer” is placed directly on the skin with ultrasound gel. The Doppler is then turned on and conducts ultrasound or high frequency sound waves into the area that it is placed over.1 The word “ultrasonic is a combination of Latin roots of “ultra” meaning beyond and “sonic” meaning sound. Ultrasonics or ultrasound is exactly what it says, sound waves that are outside the audible range for humans. The sound waves then bounce off of a moving object (in this case the baby’s heart) and then are transmitted into a sound emitted by a speaker in real time.2

Why Use a Fetal Doppler?

When Correctly Used, a fetal Doppler Provides Imperative Information

After accurately locating the best position for the Doppler probe, the monitor should emit the audible fetal heartbeat. Depending on your specific handheld Doppler, the fetal heart rate will need to be determined by either counting the rate with a timer/second hand watch or by simply reading the rate off of the screen. For example, counting the beats for 6 seconds and multiplying by 10, or even counting the beats for a full minute to determine the rate. Even with a handheld Doppler that populates the fetal heart rate on the screen, I still recommend comparing the beats to a second hand watch to confirm the correct rate.

A normal fetal heart rate fluctuates between 110 to 160 beats per minute. A fetal heart rate that does not vary, or is too slow or too fast may signal a potential problem with the fetus.4

Psychological Benefits of The Use of a Fetal Doppler at Home

The audible evidence that you are growing a real human with a beating heart inside you can be exhilarating and provide encouragement to get through difficult days of morning sickness and fatigue. In addition, hearing your own baby’s heart beating may make the pregnancy more real to you or your family members, providing an additional way to bond with the unborn baby.

Can a Doppler Cause Harm to Mom or Baby?

Ultrasound has an “Excellent Safety Record”

The FDA claims ultrasound has had an excellent safety record and has been used for over 20 years. Ultrasound does not carry the same risks as other imaging systems that use ionizing radiation such as x-rays.

A Home Doppler should not Supersede Medical Attention

Dr. Chakladar a British Doctor shares a story in the New York Times of a mother who was full term but had experienced decreased fetal movement. She used her handheld fetal Doppler at home to find reassurance when she believed she heard her baby’s heartbeat. When she visited her Doctor’s office the next Monday there was no fetal heartbeat. Dr Chakladar states, “On their own, these monitors are harmless; it is their improper use by parents to reassure themselves which can be dangerous. These monitors can be great fun, and I would personally buy one. However, they are dangerous if they are used by untrained people as an alternative to seeking medical advice.”

More Research Data is Needed

According to a research article published in June 2017, titled “Mechanical and Biological Effects of Ultrasound: A Review of Present Knowledge” lower levels of exposed ultrasound, “such as diagnostic ultrasound” has no established evidence to cause specific harmful effect. However, due to few research data, it is difficult to draw a “firm conclusion.”

The FDA also states, “Ultrasound energy has the potential to produce biological effects on the body. Ultrasound waves can heat the tissues slightly. In some cases, it can also produce small pockets of gas in body fluids or tissues (cavitation). The long-term consequences of these effects are still unknown.”3 Because of this, the FDA strongly recommends that “keepsake” images obtained during non-medical exams should be avoided. They also recommend that baby Doppler monitors should only be “used by, or under the supervision of a health care professional.”5

How to Use Your Doppler

Baby Doppler gives an 8 step process on just how to use your doppler here.

Personal Review of “Baby Doppler” Sonoline B

The Sonoline B monitor came in a perfect small package including everything needed-the actual monitor, connecting probe, batteries, and ultrasound gel. I chose this handheld fetal Doppler monitor because it most resembles the Doppler monitor we use on patients at the hospital. My favorite part is the simplicity. The monitor has three buttons-the power button, a button to control the three modes, and a button to control the backlight. The speaker is clear with adjustable volume as well as a headphone jack. The probe that came with the monitor is 3Mhz, which worked well as I was able to find the little heart rate with ease!

Resources

  1. https://www.fda.gov/radiation-emittingproducts/radiationemittingproductsandprocedures/medicalimaging/ucm115357.htm
  2. http://www.scienceclarified.com/everyday/Real-Life-Chemistry-Vol-5/Ultrasonics.html
  3. https://www.acog.org/About-ACOG/News-Room/News-Releases/2009/ACOG-Refines-Fetal-Heart-Rate-Monitoring-Guidelines
  4. https://www.fda.gov/radiation-emittingproducts/radiationemittingproductsandprocedures/medicalimaging/ucm115357.htm
  5. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm095508.htm.

 

 

Healthy Weight Gain During Pregnancy

Healthy Weight Gain During Pregnancy

Now the infamous phrase… “But, I am eating for two…” True, a pregnant woman is responsible for eating enough for both the baby and herself to survive, but sometimes that can go a little bit overboard.  In other cases, some expectant mothers become afraid of […]

Optimizing Fertility

Optimizing Fertility

As some one planning on specializing in reproductive medicine, I actually don’t like the term “infertile,” or the phrase that we often hear that some one is “struggling with infertility.” It’s very rare for a woman to be either 100% fertile, or 100% infertile, which […]

Sleep Deprivation in Mommyhood

Sleep Deprivation in Mommyhood

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Sleep Deprivation in Mommyhood

The Relationship between Breastfeeding, Sleep deprivation, and Depression

Realistic Expectations after Delivery

The idealistic expectations fed to mommy-t0-bes from the social media world can cause legitimate anxiety.  Even well meaning friends can paint unrealistic pictures of what your recovery and postpartum period “should” look like. But, each delivery is different and each baby is different. Perhaps a goal we could set for ourselves is to just give into the beautiful, unknown mess of mommyhood, with sleep deprived red eyes, a large pad in-between the legs, a recovering saggy belly, and a completely dependent but divine baby in our arms.  Although each situation is unique, general knowledge of the postpartum period including realistic expectations for your own sleep, as well as your baby’s will help set you up for success. 

One study researched ways to improve the sleep of new parents by comparing bedroom environments.  The study found that what works for some families does not necessarily work for all families. But, the study did suggest that the most helpful intervention for new parents would be accurate education regarding the postpartum period and principles to encourage parental and infant sleep.1 

Sleep Deprivation

It is recommended that adults from the ages of 18-60 years old receive seven or more hours of sleep per night for optimal health.2 In today’s contemporary rat race, sleeping as little as possible is foolishly seen as a strength or admirable. In reality, sleep plays a large part in our glucose metabolism, and neuroendorcrine function.3  It allows us to complete tasks in a changing environment,4 it helps us to stay emotionally balanced,5 and it allows us to better handle our babes. One study showed sleep deprived women view their child as more difficult than women who received adequate rest6 (no surprise there).  Now that I’ve told you just how important sleep is, I will tell you just how much sleep you can expect to miss out on… take a deep breathe.

Reproductive hormones including estrogen and progesterone have a direct influence on the quality of sleep.  After delivery of your newborn, there is a rapid decrease in these two hormones which increases your amount of sleep disturbances.  This explains why new mothers may have a difficulty falling asleep and staying asleep even when infant care is not needed! Frustrating!7

According to Okun’s study, new mammas on average experience a 20% increase in “wake time” for the first 6 weeks after delivery.8  Also, according to Health Magazine, Dr. William C. Dement, a sleep specialist, taught that parents of newborns often lose around two hours of sleep per night until the baby is five months old! Then from five months old until two years of age, parents usually lose an hour of sleep each night.9 In addition, a recent news article from “Daily Mail” claimed something similar.  “New parents lose 44 days of sleep in the first year of a child’s life.” Not too far off from Dr. Dement’s statement, the average new parent loses 2.9 hours of sleep per night.10

Coping with Sleep Loss and a Newborn

Although sleep is “highly personalized,” environmental and behavioral changes may assist your overall sleep health for you and your baby.11  Try and experiment to see what strategies work best with your personal preferences and circumstances.  You may want to try some of these changes prior to delivery to make sure they are suitable for you and your partner’s sleeping habits.

  • The use of a white noise machine during sleep
  • Dim lighting/ use of a night light for infant care
  • Avoid reading, watching TV, or playing on cell phone while in bed
  • Avoid large meals right before bedtime12 
  • Expose yourself and your baby to daylight as it has been found to play an important role in the circadian rhythm and regulation of sleep wake patterns for both infants and adults13

Breastfeeding


A newborn should be breastfeeding every 2-3 hours or 8-12 times within 24 hours.14 
If your baby takes 30 minutes to feed that’s about 4-6 hours spent of your day breastfeeding!  Add in 6-8 hours of intermittent sleep and that equals 14 whole hours of your 24 hour day. The other time being consumed with burping, soothing, changing the baby, feeding yourself, and hopefully some self hygiene! Be realistic with yourself.  Keep your “to do list” short and simple, like real short.  Ask for help, especially if you have more small children at home! Regardless, never turn down a friend offering their time!

Exclusive Breastfeeding Moms Sleep More at Night than Formula Feeding Moms

Many women believe that formula makes an infant full for a longer period of time versus breast milk, thus helping the baby and mother gain some extra minutes for sleep!  Doan, Gay, and Newman completed a fascinating study with 120 first time mothers separated in two groups; those that used at least some formula at night and those who breastfed exclusively.  Objective and subjective data was used to see how much these mothers slept the last month of pregnancy and then at one month after delivery. 54 women used at least some formula at night and 66 were exclusively breastfeeding. Between these two groups, the amount of sleep at night during the last month of pregnancy was comparable but the one-month after delivery was significantly different! Okay, now to the good part, drumroll… The total nighttime sleep for the breastfeeding group was 386 plus or minus 66 minutes.  The total nighttime sleep for the formula group was 356 plus or minus 67 minutes. Concluding that exclusive breastfeeding moms get an average of 30 more minutes of sleep at night than formula feeding mothers!15  Breastfeed exclusively for some extra ZZZs.

Tips to Optimize Sleeping while Continuing to Breastfeed Your Infant

    • Keep the baby in their own bassinet right beside your bed so you only need to roll over to pick them up and put them next to you to breastfeed.  Place the baby back into the bassinet after the feeding is completed.
    • Ask your significant other to do the burping and changing of the diaper when necessary after feedings so you may quickly go back to sleep.
    • Sleep during the day while your baby sleeps.
    • Know your baby will soon be sleeping for longer intervals and this sleep deprivation doesn’t last forever!16

Crying

Crying is part of your baby’s development.  Every baby cries, it is their only means of communication. Babies can also cry for no reason at all and at times may be inconsolable.  You may be a great parent and make sure your baby is fed, changed, the perfect temperature, and even try the 5s taught by Harvey Karp to sooth your baby and yet your baby still continues to cry (Harvey Karp’s five S’s are a must know). These include swaddle, side lying or stomach time (stomach or tummy time should always be supervised), “Shhhhh” or “shush” sound, swinging or swaying, and lastly sucking. In addition to practicing these soothing techniques you may have even changed your diet to better suit your baby’s sensitive breast milk needs. Although a change in your diet is sometimes necessary and the knowledge of these soothing tricks is powerful, sometimes babies just cry and that is normal. Some crying can “start and stop for no apparent reason at all” and may be unrelated to anything the parent does, either to begin the crying or to bring it to an end. The acronym “PURPLE” is a great tool to understand “what the typical features of crying are in normal infants.”17 

*Permission obtained from Purple Crying to publish on mommytobeprep.com

 

Although each baby is unique, the amount of crying your newborn exhibits generally increases in the first two to three months and then gradually begins to decrease as you can see in the following graph. There is light at the end of the tunnel!


*Permission obtained from Purple Crying to publish graph on mommytobeprep.com

Baby’s Sleep 

 

Permission obtained from Sarah Ockwell-Smith Author and Parenting expert. Here is the following link where you can buy her book “Gentle Sleep.”

Maternal Feelings After Delivery

After delivery, many women experience the postpartum blues. Postpartum blues includes feelings of being upset, anxious, depressed, or angry. Moms with postpartum blues may cry for no reason, have trouble sleeping, eating, making choices and may question their ability to care for their baby. Postpartum blues usually come and and go in the first few days after delivery, typically getting better within a few days to two weeks without any treatment.18 Postpartum blues resembles a “syndrome of emotional susceptibility” versus being an authentic depression. Interestingly, postpartum blues have shown to possibly promote an “openness to emotional exchange between the mother and her infant.”19 

Postpartum Depression

Postpartum Depression affects 6.5% – 12.9% of all childbearing women. Symptoms can come as early as two weeks or even a year after delivery, but the usual peak of postpartum depression is between 6-12 weeks after delivery. A woman who has experienced depression prior to pregnancy is at a higher risk for a recurrence or postpartum depression.

Postpartum Depression & Sleep Deprivation

There is not one specific cause for postpartum depression, but there are proven contributors such as the quality and amount of sleep.  Sleep deprivation and depression have a two-way relationship. Women with significant sleep disturbances are more likely to report an increase in symptoms of depression as well as postpartum depression. In addition, women with depression are at an increased risk for developing sleep disturbances creating this relentless, overwhelming cycle.

The Diagnosis of Postpartum Depression

The diagnosis of postpartum depression is made when a woman has a persistent sad mood or decreased interest in the things that used to bring her joy as well as five or more symptoms. These symptoms include, “changes in weight or appetite, sleep disturbance, feelings of anxiety, irritability, altered psychomotor activity, decreased energy, poor concentration, poor self-worth, or suicidal or homicidal ideation (including recurrent thoughts about harming themselves or their infants).”20 If you have postpartum depression, seek help from your OB or hospital immediately.

Breastfeeding and Depression

Although there needs to be further research regarding postpartum depression and breastfeeding, breastfeeding is suggested to enhance maternal mood due to the release of oxytocin and prolactin. Oxytocin in particular is known to promote feelings of nurturing and relaxation. Lactation is suggested to decrease stress hormones especially cortisol which would enhance sleep.21 According to Pope and Mazmanian, there can be no clear conclusions drawn at this time regarding the direct relationship breastfeeding has on postpartum depression. However, postpartum depression has shown to reduce the practice of exclusive breastfeeding.22 

Sleep Deprivation All in All…

It is impossible to be completely ready for a baby as each babe is unique. But knowing baby norms will help.

  • Sleep is important and not overrated. New moms can expect to lose 2-3 hours of sleep a night, this adds up quickly. You will get through this and it does get better. Exclusively breastfeed if possible, as it is shown to give you more minutes of ZZZs each night.
  • You can expect your newborn baby to be suckling on your breast around 4-6 total hours a day. The rest of the day may seem to slip by due to the baby’s demands.
  • At two months your baby could cry up to 6 hours a day, but crying generally decreases at 4-5 months of age. Remember, there is light at the end of the tunnel!
  • As a newborn your baby will not know the difference between night and day and their sleep cycles are short due to small tummies and frequent feeds.
  • Postpartum blues are actually normal and common, but do not mistake them for postpartum depression.
  • Don’t forget to ask for help, take care of yourself, and know that your babe is only little once.

Share in the comments below with what tips or tricks helped you to cope with sleep deprivation, or any stories! I love to hear from you!

 

Resources:

1. Lee, Kathryn A., and Caryl L. Gay. “Can modifications to the bedroom environment improve the sleep of new parents? Two randomized controlled trials.” Research in Nursing & Health 34.1 (2010): 7-19. Web.

2. “Recommended Amount of Sleep for a Healthy Adult – American ….” https://www.aasmnet.org/resources/pdf/pressroom/Adult-sleep-duration-consensus.pdf.

3. Loche S, Cappa M, Ghizzoni L, Maghnie M, Savage MO (eds): Pediatric Neuroendocrinology. Endocr Dev. Basel, Karger, 2010, vol 17, pp 11–21

4. https://doi.org/10.1159/0002625244. “Chronic sleep curtailment impairs the flexible … – Wiley Online Library.” http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2869.2010.00878.x/abstract.

5. Okun M. Sleep and postpartum depression. Current Opinion In Psychiatry [serial online]. November 2015;28(6):490-496. Available from: PsycINFO, Ipswich, MA.

6. DELEÓN C. A Pilot Study on Perceptions of Sleep Deprivation and Mother-Infant Interaction. Journal Of The Indiana Academy Of The Social Sciences [serial online]. October 2012;15:74-85. Available from: Academic Search Complete, Ipswich, MA.

7. Okun M. Sleep and postpartum depression. Current Opinion In Psychiatry [serial online]. November 2015;28(6):490-496. Available from: PsycINFO, Ipswich, MA.

8. Okun M. Sleep and postpartum depression. Current Opinion In Psychiatry [serial online]. November 2015;28(6):490-496. Available from: PsycINFO, Ipswich, MA.

9.”In Desperate Need of Sleep – Health Magazine.” http://www.healthmagazine.ae/health-us/childrens-health/in-desperate-need-of-sleep/.

10. “New parents lose 44 days of sleep in the first year of child’s life | Daily ….” 17 Sep. 2013, http://www.dailymail.co.uk/femail/article-2423615/New-parents-lose-44-days-sleep-year-childs-life.html.

11. Holtzman, Nancy. “Helping New Mothers and Newborns Sleep: An Innovative Sleep Support Program.” Journal of Obstetric, Gynecologic & Neonatal Nursing 42 (2013).

12.”CDC – Sleep Hygiene Tips – Sleep and Sleep Disorders.” 10 Dec. 2014, http://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html.

13. Lee, Kathryn A., and Caryl L. Gay. “Can modifications to the bedroom environment improve the sleep of new parents? Two randomized controlled trials.” Research in Nursing & Health 34.1 (2010): 7-19. Web.

14. “POCKET GUIDE – Bright Futures – American Academy of Pediatrics.” https://brightfutures.aap.org/Bright%20Futures%20Documents/BFNutrition3rdEdPocketGuide.pdf.

15. Doan T, Gay C, Kennedy H, Newman J, Lee K. Nighttime breastfeeding behavior is associated with more nocturnal sleep among first-time mothers at one month postpartum. Journal Of Clinical Sleep Medicine: JCSM: Official Publication Ofv The American Academy Of Sleep Medicine [serial online]. March 15, 2014;10(3):313-319. Available from: MEDLINE, Ipswich, MA.

16. “Sleep Deprivation and Breastfeeding – HealthyChildren.org.” 21 Nov. 2015, https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Sleep-Deprivation-and-Breastfeeding.aspx.

17. “Why Does My Baby Cry So Much | PURPLECrying.info.” http://purplecrying.info/sub-pages/crying/why-does-my-baby-cry-so-much.php.

18. “Postpartum Depression – ACOG.” http://www.acog.org/Patients/FAQs/Postpartum-Depression.

19.”POSTPARTUM BLUES: A MARKER OF EARLY … – Wiley Online Library.” http://onlinelibrary.wiley.com/doi/10.1002/imhj.21410/pdf.

20. Okun M. Sleep and postpartum depression. Current Opinion In Psychiatry [serial online]. November 2015;28(6):490-496. Available from: PsycINFO, Ipswich, MA.

21.”Breastfeeding and Postpartum Depression: An Overview … – NCBI – NIH.” 11 Apr. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842365/.

22.”Association between postpartum depression and the … – Science Direct.” 26 Dec. 2016, http://www.sciencedirect.com/science/article/pii/S0021755716303941.

 

Breastfeeding a Preterm Baby

Breastfeeding a Preterm Baby

Breastfeeding a Preterm Baby What is Considered Premature? Labor after 20 weeks and prior to 37 weeks is considered preterm.1 One in every ten babies is born premature.2 Further categories of prematurity are based on gestational age as listed below.3 – Less than 28 weeks […]

Breastfeeding a Sleepy Baby

Breastfeeding a Sleepy Baby

With each stage of your newborn’s life you may need to adjust your nursing techniques. Newborns tend to be lazy or sleepy, while infants tend to be distracted by noises and movements. Both create a unique challenge for breastfeeding. How Do I get My Newborn […]

Sore & Cracked Nipples

Sore & Cracked Nipples

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Nipples are Like Feet

Nipples are like feet. Besides the fact that they like to be covered in the day and free in the bed, they come in many shapes and forms; large, small, flat, pointy, and even inverted. They both serve fundamental purposes– walking and feeding. Feet can get sore, cracked, and blistered from an improper fitting shoe and excessive walking. Nipples can get sore, cracked, and blistered from an improper latch and excessive suckling. Just like a good pair of shoes need to be broken in with some time and some practice, you and your baby will also benefit from some time and practice.

It is normal for women to have a small amount of soreness and discomfort when first starting to breastfeed. This pain should be eased within the first week. Any nipple soreness that continues after the first week is abnormal. If you are having nipple pain, continue to breastfeed. But do not soldier through the pain ignoring it, TREAT IT! The best thing to do is to fix the underlying problem.

The Underlying Problems of Cracked & Sore Nipples

Baby’s Latch

 The most common cause of nipple pain is due to a shallow latch. If you put your index finger in your mouth (do this exercise after eating Doritos and it will be much more enjoyable) just far back enough so your lips cover your first knuckle and then suck on that finger. You will feel how your tongue rubs the top of your finger. Now go ahead and stick your finger a little further in your mouth (between the first knuckle and second joint- hopefully you were real messy with those Doritos). As you suck on your finger deeper in your mouth, you should no longer feel your tongue rub on the tip of your finger. When your baby has a deeper latch, your nipple will not be pinched or rubbed. Thus the depth of the latch can make the difference between sore nipples and comfortable breastfeeding.  (La Leche League International, 2003, p.76)

To learn how to get the perfect latch, head over to my post The Post 5 Ps of Successful Breastfeeding under “Position Your Baby”. And remember, just as you may go to a specialized running store to get fitted for the proper shoe, lactation consultants are there for you to help you get that proper latch. 

Pulling Baby Off

If you need to pull your baby off your nipple before he or she becomes unlatched for any reason, such as your baby biting youfirst break the suction! You can do this by placing your finger in the corner of the baby’s mouth and then gently pulling down on the baby’s chin pulling your baby off the breast. Never pull your baby off your breast without first breaking your baby’s seal. 

Infection

If you have thoroughly assessed your baby’s latch and cannot find any issues, see your Doctor.  Breast infections such as mastitis and thrush can cause awful nipple pain.

How To Deal With Sore, Cracked Nipples

  • Bath with plain water and pat dry unless directed by your Doctor.
  • After breastfeeding, leave a little breast milk on your nipple and let air dry. The fresh expressed breastmilk will help to reduce the chances of infection due to the antibacterial properties of the breast milk. If you have thrush (a yeast infection) do not do this and keep your breasts as dry as possible.
  • Get a nipple cream. Lanolin is a great basic cream to start with and is hypoallergenic.  You usually will be able to get a free sample of lanolin at your Dr.’s office or at your hospital (I carry a sample in my pocket to put on my chapped lips!) Some of my patients have also used coconut oil and say that has worked well for them. Triple Nipple cream or APNO (All Purpose Nipple Ointment),  is three creams mixed in one with different purposes, an anti-fungal, a steroid to decrease inflammation, and an antibiotic. You will need a prescription for this and it is best to get at a compound pharmacy.
  • Feed your baby often to prevent your baby from using a vigorous suck. Breastfeed from the breast that is the least sore first if possible.
  • Use Hydrogel pads and glycerin gel pads such as Lansinoh Soothies for calming nipple pain. My patients LOVE these, especially after being in the fridge!
  • DO NOT use moist tea bags, hair dryers, or sun lamps on your nipples. These are all tips that may come from your great aunt Ruth that have been proven to make your little lady friends worse.

*If your nipples are bleeding, any blood that your baby swallows from the damaged nipple will not be harmful.

Remember, sore nipples DO heal! You and your baby will be able to go on both benefiting from all the advantages that breastfeeding has to offer! Seek help and stay with it!

 

Resources:

How do I heal sore nipples? Obtained from http://www.lalecheleague.org/faq/heal.html

Mohrbacher, N., & Stock, J. (2003). The breastfeeding answer book. Schaumburg, IL: La Leche League International.

 

Engorgement & Acute Mastitis: How to Prevent & Treat

Engorgement & Acute Mastitis: How to Prevent & Treat

Engorgement It is normal for your breasts to become more full during the second to sixth day after delivery due to your mature milk coming in. The increase in volume of milk, as well as the additional blood and fluid traveling to your breasts will give you a full sensation. Some women hardly […]

Too Little Breast Milk Supply

Too Little Breast Milk Supply

Most Mamas can make plenty of milk for their baby or babies. Make sure low milk supply is in fact something you are experiencing before you start treating it! Milk supply is a balancing act and overcorrecting a low supply can land you in the […]

Spitty & Gassy Baby

Spitty & Gassy Baby

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Spitty and Gassy Baby
The down side of having a spitty and gassy baby is that the laundry load increases exponentially and you may indefinitely smell of sour milk. On the plus side, you always have a baby to blame postpartum toots on (I mean flatulence). In all reality, having a spitty and gassy baby is pretty normal.

Why do babies spit up so much?

Why Do Babies Spit Up So Much

There is something called the Lower Esophageal Sphincter (LES), this LES sits right at the end of your Esophagus leading into the stomach. Think of the LES as a round doorway into your stomach. Usually this doorway muscle is closed unless the person is eating. In babies, the LES muscle is not yet fully mature. Instead of the doorway being tightly closed and keeping food from coming back up, it is weak and milk can easily come back up from the stomach. The LES is normally developed by 12-14 months. This is why it is considered unusual if your baby’s reflux continues past 18 months. (www.nhs.uk)

5 Tricks to Help Your Baby Avoid Spitting Up

5 Tricks to Help Your BabyAvoid Spitting Up:

  1.  Feed your baby smaller amounts more frequently.
  2. Try burping your baby not just after the breastfeeding session, but also a couple times throughout the feeding.
  3. Keep your baby upright for 20-30 minutes after their feeding and avoid rocking or tummy time for a half hour after feeds.
  4. Raise the head of your baby’s crib when they are sleeping. DO NOT put any pillows inside the crib. Instead, you may put the pillow under the mattress at the head end of the bed. Your baby should always be laid down on their back to sleep.
  5. Use a pacifier to give your baby non-nutritive sucking after feeds if he or she will take it (there is debate about this as non-nutritive sucking can also cause extra air to enter the stomach and cause gas). Womenshealth.gov also states that it is “best to wait until the baby is one month old to introduce a pacifier. This allows the baby to learn how to latch well on the breast and get enough to eat.” Do what works best for your baby.

You can read more in detail about some of these tricks at healthychildren.org 

When Does a Spitty Baby Become a Bigger Problem?

The following are all reasons to visit with your Pediatrician.

  • Your baby is spitting up after every feeding, even sometimes hours after feeding.
  • Your baby looks like he or she is in pain after spitting up.
  • Your baby isn’t having enough wet or dirty diapers a day.
  • Your baby isn’t gaining adequate weight or is loosing weight.
  • Your baby has frequent projectile vomiting.
  • Your baby is being irritable and has persistent crying.
  • Your baby is refusing to eat or pulling away at the breast.

Your Pediatrician will be able to further evaluate if your baby is experiencing something termed Gastroesophageal Reflux Disease (GERD), also known as GORD depending where you live in the world. GERD/GORD is a more serious, long-term type of reflux. If your baby is diagnosed with GERD, it is important to continue breastfeeding as it is more easily digested than formula. (Womenshealth.gov)  Your pediatrician may also evaluate to see if your baby has an allergy to cows milk, or has a blockage in their digestive track.

If you want more information on reflux, read here. This is an entertaining, education article written by Katie Madden, a well known lactation consultant.

Just like reflux is usually just a laundry annoyance, gas is also a minor issue unless excessive and accompanied by other symptoms.

5 Steps to Decrease & Ease Your Baby’s Gas Pains

Gas Pains

1. Adjust Feedings

  • Feed your baby before he or she becomes frantic (swallowing air from crying can increase gas).
  • Try breastfeeding in an upright position.
  • Burp your baby throughout the breastfeeding session and not just at the end.

2. Goodbye Dairy Products

Consider cutting out all dairy products from your diet for a week. And then assess to see if any of your baby’s symptoms have decreased. If so, keep on doing what’s working!

3. Eliminate Foods that Make You Gassy

The most common gas creating foods are “beans, cabbage, brussel sprouts, broccoli, asparagus.” (sw.org)

4. Baby Massage and Movement

Giving your baby some supervised tummy time and gently stroking or massaging your baby’s back may help release air bubbles. Also, light belly massages and regularly moving your baby’s legs in a bicycle motion can help get things moving. Babycenter.com recommends that diaper changes are a perfect time to do this.

5. Medications

It is best to treat the gas by fixing the underlying cause, but medications can help with the symptoms. Speak to your Pediatrician about trying over the counter medications such as simethicone, probiotics, or gripe water. (Babycenter.com)

Baby Chooses to go on Strike From Breastfeeding

Baby Chooses to go on Strike From Breastfeeding

This is when you and your baby have been breastfeeding for a while, but now your baby is getting fussy at the breast or refusing the breast all together. FRUSTRATION would be a normal emotion at this point! It is important to know that this […]

Over Production of Breast Milk: How To Prevent & Manage

Over Production of Breast Milk: How To Prevent & Manage

Over Production of Breast Milk Say what? The more milk the better right? Not right. Too much breast milk can cause an overactive let-down, or in other words, a forceful milk ejection (picture a dog trying to drink from the garden hose on full blast). […]

Real Life Breastfeeding Obstacles

Real Life Breastfeeding Obstacles

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Breastfeeding moms may face a couple road bumps on their breastfeeding voyage. Breastfeeding can be difficult, awkward, messy, tiring, and not as simplistic and flawless as some pictures portray. Yet, the way a woman’s body is made to sustain another life is GLORIOUS! Not to mention all the benefits breastfeeding holds for the mom and baby! Suzie Blake‘s project “What Does Breastfeeding Look Like?” inspired me to gather photos and captions of what “Real Life Breastfeeding” is like for many of my Mommytobeprep Instagram followers. And a huge “THANK YOU” to those brave women who participated! I am SO appreciative for these authentic pictures.

I loved the outcome of the collage; a little chaotic, messy, yet beautiful, just like breastfeeding! These are real women with their “Real Life Breastfeeding Obstacles”. I dug to the root of these obstacles and clustered them into a mnemonic that I thought very appropriate!

REAL LIFE BREASTFEEDING OBSTACLES. MOMMYTOBEPREP.COM

Over Production of Breast Milk

Baby Chooses to go on Strike from Breastfeeding

Spitty and Gassy Baby

Too Little Breast Milk Supply

Acute Mastitis & Engorgement 

Cracked and Sore Nipples 

Lazy or Too Sleepy of a Baby to Breastfeed 

Early Delivery of Baby

Sleep Deprived Mother

For the next while, each subject will be posted in order so stay tuned to Mommytobeprep.com! I have pulled information together from reliable resources for you to have at your fingertips when experiencing these rocky times! And of course, always discuss any problems with your Pediatrician and Obstetrician, as they know what is best for you and your babe!

A breastfeeding obstacle may be probable. But remember, breastfeeding is both possible and profitable! With some education and work, the obstacle can be solvable. Listen to your pediatrician and be logical (I hope my rhyming is somewhat comical) 😉

The 5 Ps of Successful Breastfeeding

The 5 Ps of Successful Breastfeeding

  Plan, Position, Practice, Patience and Persistence. 1. Plan and Decide if Breastfeeding is For You. The pros and cons of breastfeeding should be understood when deciding if breastfeeding is for you and your baby. It is a good idea to discuss these with your […]

What You Should Know About GBS

What You Should Know About GBS

What is GBS? Global Business Services (GBS) are providing ample opportunities… just teasing! The GBS I will be speaking of today is Group B. Streptoccus, also referred to as Group. B. Strep or Baby Strep. GBS is a bacterium that may come and go in […]