Author: Breanne Clinger

Your Postpartum Plan

Your Postpartum Plan

A postpartum plan helps you make decisions before decision making becomes more difficult! Download the following FREE pdf template to get planning for your fourth trimester!

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

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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 many times over the last nine months wondering what it would be like, how I would feel. Now it was here, and I felt in love. I also felt fear. How long would he stay with us? His Respiratory therapist continued bagging him, helping him do what his body couldn’t do on its own with anencephaly. My husband and I were both emotional telling our son, “We love you. You are so brave. You are our little fighter.” October 29th, 2014 is the day our sweet boy came into our lives and shortly after returned back home to our loving Heavenly Father.

This is our story. It is one I have held sacred and close to my heart for a long time. This is the story of our journey with Bryce, our beautiful baby who was diagnosed with a neural tube defect called anencephaly at 21 weeks gestation.

Choices with Anencephaly

We were faced with the decision to induce labor or continue to carry our boy. We chose to carry him for as long as possible. We also decided to pursue organ donation. This brought us some peace and comfort while anticipating the loss of our son. This is the path we chose. If you find yourself in a similar situation, I want you to know that no one knows how you feel until you’ve been given the option to carry full term or not. Nobody can tell you what is best for YOU.

You are not alone. God knows you and your precious baby. God loves you and you can always turn to him for peace and help in making your decision even though you may not feel like it right now. You may be angry and upset, and it might not make sense. You are right, it does not make sense. I have been there and I have had my dark days. In the end my faith is what carried me through. Know that whatever choice you make, you are not alone, and you have a loving Savior who cares for you, and knows the exact feelings you are experiencing.

I am a Mother to an Anencephalic Baby

Photo credit: Terra Cooper

My name is Kim and my husband is Bryce. We have been married for 10 years. I feel privileged today to share our story about our little fighter.

In March 2014, we found out we were expecting our second child. We were excited to be adding another baby to our family. At 16 weeks we found out it would be a little boy. Our life seemed perfect. Our little girl would soon have a little brother to play with.

At 21 weeks gestation our lives were turned upside down. We went in for our targeted ultrasound, and received the devastating news that our son had anencephaly, which is not compatible with life outside the womb. We were given the option to induce labor, or to carry full term. After discussing our options with our doctor, for us, we knew we couldn’t induce labor. We chose to carry our sweet boy for as long as his heart was beating.

Emotions that Follow Diagnosis of Anencephaly

The next few weeks after the diagnosis of our son were some of the darkest and hardest days in our life. We were grieving the future, knowing what was to come. I felt lost, angry, confused, and numb. Nights were always the hardest. I would wake up crying in the middle of the night and go out into the living room so my husband and daughter couldn’t hear me and I would shove my face in a pillow and cry.

I became angry with our situation and at God and asked questions like “Why us?” “How could this happen?” “Why my sweet boy?” “Are we not faithful enough?” We had already had the heartache of two miscarriages. I would also question myself, wondering if I could really do this. Questioning if I was strong enough.

During my dark times I would try to focus on my blessings, such as my beautiful baby girl, my strong and loving husband, the ability to get pregnant, our health, and our wonderful family and friends, but it was hard. I honestly felt numb, but at the same time… I could feel peace. I had moments where a feeling of love would wrap around me, and that’s when I knew that we were going to be okay.

Long nights turned into mornings, and I would put on a fake smile and pretend I was okay for family and friends. I felt like I had to be strong for our family. It was an emotional rollercoaster. Sometimes all I could hold on to was that I knew, without a doubt, I would carry our son for as long as I could, no matter how hard it would to be.

Organ Donation with Anencephaly

Both my husband and I are nurses, and with our experience in health care, organ donation came to mind. As we researched, we found that health care providers had differing opinions on organ donation with a baby with anencephaly. We weren’t sure if organ donation was an option for us. At my next doctor’s appointment, we brought up this question. Our doctor was amazing. He truly embodied the role of patient advocate. He considered all of our needs throughout the entire process. He never pressured me into making a decision on carrying full term or not, and took into consideration all of our thoughts and desires throughout the process.

Our doctor contacted Intermountain Donor, and got us in touch with a specialist. As we met with our specialist we found that it was possible, but uncommon to donate organs from a baby who is anencephalic. This news gave us hope. Our donor specialist was incredible and helped us tremendously. Throughout the entire process, we never felt pressure. It was always our choice to choose organ donation or not.

Meeting Our Little Fighter

October 29, 2014 at 39 weeks gestation we chose to deliver by c-section to give ourselves the best odds of holding our baby boy alive, as the birth canal would have been to traumatic for him. At 8:25 am our sweet boy was brought into this world. The nurse placed baby Bryce into his father’s arms- the man he was named after. Bryce then placed him on my chest. My life was forever changed in that moment. Holding my precious baby, knowing we had little time with him and trying to memorize every little detail of our beautiful boy.

While waiting for his arrival, there had been many emotions. I was excited to meet him, nervous of the unknown, fear of little time, and everything else in between. When I finally held Bryce in my arms, I was overcome with the feeling of LOVE, deep unconditional love and peace. I was holding a perfect child of God. Shortly after baby Bryce was placed in my arms he squeezed my hand letting me know he was aware of me. I felt like that was a tender mercy from God, letting me know that little Bryce was acknowledging that I am his mother. Bryce had perfect round cheeks with beautiful long blond eyelashes with his daddy’s mouth. He had dark curly hair with the sweetest little nose. Little Bryce was perfect. The love in the room was tangible.

Saying Goodbye to Our Little Fighter

Baby Bryce’s color was quickly changing, and I could tell he wasn’t doing well. I gave him to the nurses so they could care for him and help him breathe as we had discussed earlier. Bryce went along, to be with his son in the Neonatal Intensive Care Unit (NICU). Shortly after, a nurse came back and told me that little Bryce was having a hard time and they were currently giving him CPR. My doctor stapled me up to quickly get me out of the OR and into the NICU to be with our boy.

As we reached the NICU, I found out they had been unsuccessful in trying to intubate our son. This was because his airway was not fully developed. To get air into his lungs, they began to “bag” him. My heart broke seeing my little fighter like that. They gave me little Bryce to hold while they were bagging him. Our daughter was able to come into the room and meet her little brother. She was 22 months at the time and she was so sweet and tender with him. She kept giving him kisses and hugs. All of our immediate family was able meet little Bryce. After our families got to meet our son, we decided it was time to let him return back home. It was one of the hardest decisions, but we knew it was the right time.

………………………………………………..

I am a Father to an Anencephalic Baby

Photo Credit: Terra Cooper

Little Bryce’s Father’s words….

We knew that our time with our son was going to be short. We had to try and soak up every second we had with our son before he was taken for organ donation. As he was bag-masked for ventilation, we got to hold and love our sweet boy for what we knew would be a short time. As attempts to intubate failed, we knew that our time would be even shorter. We took turns holding him and expressing our love for him.

He had full cheeks that received many kisses from Mom, Dad, and his big sister. As he came into my arms, his dwindling heart rate picked up some. It seemed a sign given to me that he was expressing his excitement to be held by his father. When the time was right, 1 hour and 38 minutes after being delivered, we chose to stop breathing for him. I continued to hold him and slowly watch his vitals trend down. We expressed our last sentiments at that time, and when his heart rate ceased, he was taken directly for organ donation, in hopes that his short life and precious organs would provide life and vitality to another individual. It was a tear-filled, heart wrenching short time that we had with our son, but we were so thankful for that time.

……………………………………………………

Our Baby Continues to Live

Artist: Tessa Brown

Our faith brings us comfort in knowing that we will be reunited with our son again. I have no doubt about it. I know that we will be reunited with our sweet boy. That faith and knowledge has helped time and time again to soften the ache in our hearts. We will never stop thinking of our son. We love and miss him with every bit of our hearts. I can’t wait for the day that I get to kiss those big round cheeks again and let my little fighter know how much we’ve missed him.

The Gift of Medical Research and Organ Donation

Although his life was short, baby Bryce continues to give the gift of life and furthering medical research through organ donation. Baby Bryce’s kidneys were successfully transplanted into a woman from California. The transplantation of his kidneys was just the second successful kidney transplant with Intermountain Organ Donation from an infant with anencephaly. His heart valves being too small for a recipient, went to research along with his liver and pancreas. His lungs went to a facility that is doing great things in advancing care in Cystic Fibrosis patients. Baby Bryce’s brown fat went to a doctor who has been able to successfully regenerate his brown fat which he has been able to do only one other time. I was able to meet this doctor at a conference, who told me he receives many calls from people asking to use the brown fat from baby Bryce for their research. Although we would rather have our baby boy with us, it brings us comfort knowing he has had a huge impact on so many lives. Even though Bryce’s life was short, he touched the hearts of many. He inspired us to be a little softer, kinder, and gentler.

Our Support Team

We have been blessed with the love and kindness of others through the act of service. Our doctor was amazing and never left our side throughout the birth of our son. He took the morning off to be with us and comfort us as needed. The Labor and Delivery and NICU staff were phenomenal. The respiratory therapist was an angel. She bag-masked our sweet boy for 1 hour and 38 minutes. The members of the organ transplant team were truly genuine and kin. The hospital was amazing and made sure all of our wishes and desires were met. The amazing photographer captured all of our sweet moments with our beautiful family. We are thankful for our amazing family, friends, and church members who supported us throughout the entire process and showed us unconditional love. Our hearts have been forever changed and touched through the love and countless acts of service that were given to our family. We truly will never be the same and have learned a great deal about life throughout our journey with our little fighter.

The Grieving Process

Photo Credit: Terra Cooper

“Grief is like the ocean; it comes in waves, ebbing and flowing. Sometimes the water is calm, and sometimes it is overwhelming. All we can do is learn to swim.” –Vicki Harrison. I can tell you that it is not easy to learn to swim. I have learned that everyone does it differently and that’s okay. My husband and I grieve in our own ways and have different coping mechanisms for processing and dealing with our emotions.

Grief is a roller coaster of emotions. You will have your good days and your bad days. You could be having a great day, then all of a sudden a smell, a sound, a thought, or an image of a sweet baby, or an expecting mom passes by and just like that you are spiraling down into heartache and despair. It takes all your energy to work your way back up to feeling okay with the world again. I learned that others have good intentions, but sometimes say things that can be hurtful. I’ve learned to think to myself, “bless their heart” and “at least they are trying” with a smile on my face. I loved when people would come up to me and just say, “I’m sorry, this is hard and we love you.”

Anniversary dates and holidays are hard. I find myself on edge and emotional, constantly fighting back tears. It can be hard for a friend or family member to understand. I remember having feelings of being all over the place emotionally and getting upset with family. They were damned if they do or damned if they don’t do something. It’s a tricky state of mind, I wanted people to be around and to be there, but I also wanted my space and to be left alone. See… tricky… I didn’t even know what I wanted. It is hard processing all of these emotions. If you have a loved one suffering the loss of a child just be there for them. They will have their bad days. Let them know you love them. Be understanding and be forgiving of them. Grief is a vicious cycle. Again, just be there for your loved ones. They are trying to process all of their emotions, which can be lonely and confusing. They are “learning to swim.” Be patient and loving.

Pain Can Nurture Personal Growth

I have learned that service can help ease the pain. Try to help those in need. Go outside and feel the sun on your face. Pray for strength and guidance. The pain deepened my relationship with my Savior and solidified my testimony that he is aware of our exact circumstances. You will have your hard and dark days, and sometimes you feel like you can’t go on, but I promise you this, YOU can. He knows our pain and he is always there to comfort us, even when we feel alone. A lot of times our prayers are answered through the service of others. With the little time we had with Bryce, he has taught us a lifetime of lessons. I have learned to have peace with the unknown and the “why’s” in life, living my life in a way that would make our sweet Bryce proud. Until we meet again Bryce. I’d like to end with a poem that was written for our Bryce by my cousin.

 

Little Fighter

for Bryce

We were right

to think you’d fight.

It wasn’t because you kicked,

made us so aware you were

there inside, on your way here.

You fought for life

as much as you

were filled with it.

You wanted to arrive

as much as we wanted

you here.

Thank you for fighting,

for struggling to meet us,

for saying hello, for

allowing a goodbye.

You are our newest memory,

one we get to save

all the rest

of our days.

Our little boy.

Our sweet boy.

Our joy.

-Dainon Moody

If you would like to contact Kim regarding her story please do so at littlefighterb@gmail.com

How to Be a Friend to Someone Experiencing Infertility

How to Be a Friend to Someone Experiencing Infertility

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 […]

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

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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 hormonal changes and possible new insecurities.

Skin Changes During Pregnancy

The most common skin changes include; acne, spider and varicose veins, stretch marks, dark spots on your breasts, nipples or inner thighs, brown patches on the face (melasma), linea nigra (a dark vertical line on the belly), and changes in your hair and nail growth.¹ Did I just describe a “glowing” expecting mommy-to-be or a bursting beast? These possibly uncomfortable changes are just the beginnings of a mother’s sacrifice.

Pregnancy Glow

The “pregnancy glow” is something most women look forward to and like the other skin changes in pregnancy, is attributed to a change in the hormones. The hormones cause our glands to produce more oil giving the face a glowing look, or in some cases, more acne. Another factor attributing to the pregnancy glow is an increase in blood flow (approximately by 50%). The theory is, the increase in blood flow and circulation leads to a more full, brighter face.²

 From the pregnancy glow to the pimply discolored face in the mirror, expecting women are doing an INCREDIBLE, GLORIOUS task. YOU ARE GROWING A HUMAN BEING! Thank you for contributing to society and being selfless in sharing your body with your developing babe. Maybe there is more to the skin changes then just a biological change in hormones. Maybe these changes, along with the other body transformations during pregnancy are there to also emotionally prepare us to be better mothers and even human beings. I think the pregnancy glow is more then an influx in oil and blood to the face, even more so, an increase in acute awareness to what a beautiful gift we have been given and just how influential we can be in our unborn child’s life.

Help with Skin Changes During Pregnancy

Still, there are some tricks we can do to help ease the discomforts of these changes! Find your largest skin change during pregnancy below and do not hesitate to discuss your concerns with your healthcare provider.

Mommy To Be Prep’s Review of Pretty Mommies Three- Step Skin Care System

Pretty Mommies sent me their Three-Step Skin Care System to use throughout my pregnancy! I was absolutely thrilled! All of their products are estrogenic free, vegan, gluten free, soy free, and toxin free (very baby friendly)! I have struggled my whole life with acne and when I became pregnant my first concern was my baby. The product has helped my acne, yet is gentle enough, it never caused irritation. The scent is citrusy which is rather refreshing when so nauseated. Overall, I do consider it pricey, but would recommend this product to any friend wanting to improve their skin especially when looking for a all natural way. Click below if interested and wanting 20% off your order! The code will be automatically included at checkout! xoxo! Pretty Mommies - #1 Physician Recommended Pregnancy Skin Care

 

Resources

  1. https://www.acog.org/Patients/FAQs/Skin-Conditions-During-Pregnancy
  2. http://americanpregnancy.org/your-pregnancy/pregnancy-glow/

Resources used in Picktochart

  1. https://www.aad.org/public/diseases/acne-and-rosacea/pregnancy-acne-treatments
  2. https://www.aad.org/media/news-releases/acne-can-put-a-damper-on-hopes-of-glowing-skin-during-pregnancy
  3. https://nationaleczema.org/basic-skin-care-eczema/
  4. https://www.aad.org/media/news-releases/medication-for-moms-to-be
  5. https://www.aad.org/media/news-releases/melasma-tips-to-make-it-less-noticeable
  6. http://americanpregnancy.org/naturally/treating-varicose-veins-naturally-during-pregnancy/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1913631/
  8. http://americanpregnancy.org/your-pregnancy/prevent-pregnancy-stretchmarks/
  9. https://www.aad.org/public/skin-hair-nails/skin-care/stretch-marks
The Use of a Fetal Doppler at Home

The Use of a Fetal Doppler at Home

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. […]

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

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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 those bipolar terms imply. I think we would be better informed speaking of fertility on a sliding scale (with most couples falling somewhere between 0-100% fertility), with the intention of optimizing wherever your set point of fertility happens to be.

Optimizing fertility requires awareness of one’s health, a little bit of basic science education, and in some cases, reproductive specialists.

Health & Wellness

This is the first box to check before thinking of conceiving!

Nutrition

Your diet should be the foundation from which you receive all nutrients necessary to sustain a pregnancy, and any supplementation should be the insurance policy that you have to make sure you get any vitamins and minerals missed in your diet

  • I’m an advocate for real food when preparing to conceive (or afterwards), which basically means that you eat whole vegetables and fruits, whole grains, and whole-fat dairy, grass-fed meat, and pastured poultry and eggs.
  • Fertility foods: adding these nutrient-dense foods to your weekly diet are thought have fertility-boosting benefits:
    • Wild-caught fish and fish-roe
    • Oysters, clams, mussels
    • Liver (although, admittedly, I was never able to incorporate this one into my diet)
    • Butter & full-fat dairy
    • Limiting, or eliminating, these substances can help to increase fertility: caffeine, alcohol, smoking, and sugary drinks and foods.

Supplementation

  • Prenatal vitamins – any prenatal vitamin with at least 600 mcg of folic acid (vitamin B9) is recommended.
  • Cod liver oil – I made sure to take this supplement every day for at least two months before I became pregnant, and every day throughout my pregnancy to ensure that I was getting enough omega-3 fatty acids, EPA, and DHA. It also contains high amounts of vitamins A and D.

Weight

The extremes of weight (being too thin, or too overweight) can cause fertility issues; and it is unsafe to try to diet during pregnancy, so the best time to reach an optimal weight is prior to conceiving.

Exercise

Any type of exercise that is not overly strenuous or requiring too much balance can (and should) be safely continued throughout pregnancy. Exercise and has many benefits like promoting faster post-pregnancy weight loss and shorter labor-times.1,2 However, pregnancy is not the time to start a new exercise regimen, so it would be best to have a regular exercise regimen established pre-conception. Exercises like yoga, pilates, jogging, and swimming are great options.

Stress

Stress reduction can help to optimize fertility, and is usually achieved by activities that promote overall wellness as an added benefit. Consider adding in activities like meditation, exercise, acupuncture, and massage.

Science

Understanding when ovulation occurs during a typical female cycle can make your initial attempts at conceiving more successful.

For some background: female cycle lengths can vary, anywhere from 21 – 45 days; and it doesn’t really matter how long they are, as long as they occur consistently. I will choose 30 days as an example here.

The three most important hormones to discuss: estrogen, progesterone, and luteinizing hormone (LH).

optimizing fertility

Estrogen dominates the first half (follicular phase – days 1 – 15) of the cycle and builds up the lining of your uterus. Progesterone dominates during the latter half (luteal phase – days 16-30) of the cycle, and make the uterine lining more hospitable for implantation. The luteinizing hormone (LH) spike occurs around two weeks before the last day of your cycle, and stimulates the ovary to release an egg. Ovulation will occur ~12-36 hours after the LH surge. Your most fertile days are the 2-3 days prior to ovulation.

My advice:

  • Discover when you ovulate – take one to two months to simply record when ovulation occurs during your cycle. How?
    • Use a calendar to mark when the first day of your period occurs every month. This is day 1. Count how many days until the next cycle begins: this will be your total cycle length. Take the total cycle length and minus 14 days: this day is approximately when ovulation occurs (the majority of females consistently begin their period 14 days after ovulation)
  • Use a digital basal thermometer to track your body temperature and log these tiny changes every day (ideally before you get out of bed, at the same time every day). There are plenty of apps that help you graph this. If ovulation occurs, your body temperature will rise by ~1°F and stay elevated through the latter half of your cycle. Ovulation occurs just prior to the steep rise in temperature, as in the graph below:

Optimizing Fertility

  • Use LH urine strips (ovulation predictor strips), once a day, at the same time every day, beginning 18 days before your next cycle (total cycle length – 18 days) and continue for a week.
  • Attempt to conceive during your most fertile days
    • Have sex every other day, which preserves sperm count, as opposed to every day. Sperm can survive in the female reproductive tract for 24-48 hours (or some studies have shown up to a week).
    • Begin four days before your steep rise in temperature from your basal body temperature chart, or three days before your LH strip becomes dark.

After having unprotected intercourse:

  • 30% of couples will conceive within a month
  • 59% in 3 months
  • 80% in 6 months
  • 85% in 12 months

Reproductive Medicine

10-15% of couples will not conceive after 12 months of unprotected sex. Most physicians will tell you to wait to see a specialist (reproductive endocrinology and infertility specialist) until after you and your partner have been trying for 12 months (or 6 months if you are > 35 years of age). This advice is for typical couples with no signs of decreased fertility. Do not wait this long if you have any of the following concerns:

  • Irregular cycles lengths, or no cycles
  • Cycles are consistent, but on the shorter side (<25 days) or longer-side (>35 days)
  • Severe pain with menstruation or intercourse
  • Previous STDs or infection of the pelvis (pelvic inflammatory disorder)
  • Surgery of the reproductive tract
  • Partner has tried to conceive unsuccessfully in the past

If you have any of these concerns, a reproductive specialist will be happy to see you after trying for any length of time.

If you and your partner do not have these concerns, but have been trying with the above “optimizing fertility” methods for 9-12 months, my advice would be that it is time to see a reproductive specialist.

References:

  1. Clapp JF. The course of labor after endurance exercise during pregnancy. Am J Obstet Gynecol. 1990;163:1799-1805. doi:10.1016/0002-9378(90)90753-T.
  2. Hall DC, Kaufmann DA. Effects of aerobic and strength conditioning on pregnancy outcomes. Am J Obstet Gynecol. 1987;157:1199-1203. http://www.ncbi.nlm.nih.gov/pubmed/3688075.
  3. University of California, Santa Barbara, SexInfo Online: “How Long Can Sperm Live in Air? In a Bath?” “Semen;” and “Making Strong Sperm.”

SusanDalton

Dr. Dalton graduated from The University of Florida College of Medicine, class of 2016. She struggled with decreased fertility issues herself and is thus inspired to share her personal knowledge, paired with her medical and clinical training to serve women. She now has an adorable 11-month-old son and is waiting to start her OBGYN residency shortly. Mommytobeprep is honored to have her as a guest writer!

Sleep Deprivation in Mommyhood

Sleep Deprivation in Mommyhood

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 […]

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

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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 Baby to Stay Awake to Breastfeed?

Babies are usually wide eyed and alert right after delivery for a couple of hours. This is why we healthcare workers call the first hour of delivery “The Golden Hour.” After this time of alertness, your baby will usually undergo a deep sleep, and sleep a lot for the next couple of days! It is important for parents to understand a newborn’s sleeping cycle and feeding cues to best support the baby’s needs and to prevent frustration of the mom and baby.

Newborns Sleeping Cycle

Expect your baby to sleep a lot in the first few days of life! One study looked at 75 full term newborns and the amount of sleep they obtained within their first three days of life. The total average hours of sleep obtained on the first day was 17 hours, 16.5 hours on the second, and 16.2 on the third!Other than being able to predict that your baby will sleep a lot and go through different types of sleep (active sleep, light sleep, and quiet sleep).2 There is no set schedule for when and how long each nap will be, each baby is different.3 Although, it is recommended that you do not let your baby sleep a stretch longer than 4-5 hours in the first early week.

Recommended Frequency of Feeding Your Newborn

Although each newborn is different, the golden rule is to feed your newborn is 8-12 times within 24 hours, which equates to a feeding every 2-3 hours. Be attentive to your baby. Look for feeding cues. Feedings are timed from the beginning of one, to the start of the next feeding.6

Feeding Cues

  • Increased alertness (fluttering or opening eyes)
  • Turning head
  • Opening mouth
  • Putting hands to mouth

*Crying is a sign of late hunger. Place your baby on your chest at the first sign of hunger.

Coercing Your Sleepy Newborn to Feed

Breastfeeding encourages your milk supply to grow and meet your baby’s needs. This is why attempting to breastfeed every three hours is not only important for your baby’s caloric needs, but also for your breastmilk supply. Observe your newborn. If your baby has not fed for more than three hours and is still sleeping, there are some tricks to get your baby to latch and suckle.7

-Dim Lights so baby does not have to squint

-Un-swaddle

-Place baby skin to skin

-Talk to your baby

-Massage your baby’s hands and toes

-Stroke your baby’s tummy and back

-Self-express breast milk on your baby’s lips

If your baby does not show any signs of increased alertness after these steps, your baby is probably in “quiet sleep” which is the deepest level of sleep. You may want to let your baby continue to sleep and watch for your baby to shift into a lighter stage of sleep. Any twitching of limbs or eye movement under closed eyelids can be a sign of active sleep, an easier sleeping stage to arouse the baby.8

How do I know my newborn is getting enough?

By day four you should notice your breasts being a little larger and more full. Also by day four your baby should have four poopy/dirty diapers.9 Weight measurement is one of the best tools to measure breastfeeding adequacy. For more information see heading “Is My Baby Getting Enough Breast Milk?”

Newborn Weight Loss

Weight loss is absolutely normal for a newborn but the amount can be controversial. The newborn’s second and third days of life are usually the days of maximum weight loss. Usually the baby regains their birth weight back within the first two weeks postpartum. A weight loss of more than 7% of baby’s birth weight is “cause for further assessment and possible intervention.”10 Other sources identify “breastfeeding inadequacy” as 10% weight loss or more in the newborn.11

*If you have any concerns about how your baby is doing, contact your lactation consultant or healthcare provider.

 

References:

Parmalee, A. H., Schulz, H. R., & Disbrow, M. A. (1961). Sleep patterns of the newborn [Abstract]. The Journal of Pediatrics,58(2), 241-250. doi:10.1097/00006199-196101030-00064

2“Stages of Newborn Sleep – HealthyChildren.org.” 21 Nov. 2015, https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/Phases-of-Sleep.aspx.

3″Baby – Sleep – HealthyChildren.org.” https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/default.aspx.

4 Moran, Dianne E. , RN, LCCE, ICD, and G. Byron Kallam, MD, FACOG. “How Do I Know The Baby is Getting Enough To Eat?” Gift of Motherhood Nov. 2013: 102. Print.

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

Moran, Diane E., RN, LCCE, ICD, and G. Byron Kallam, MD, FACOG. A New Beginning Oct. 2013: 21-24.

Waking a Sleepy Newborn – La Leche League.” https://www.llli.org/docs/0000000000000001WAB/WAB_Tear_sheet_Toolkit/03_waking_a_sleepy_newborn.pdf.

8″Stages of Newborn Sleep – HealthyChildren.org.” 21 Nov. 2015, https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/Phases-of-Sleep.aspx.

9 Nommsen-Rivers, L. A., Heinig, M. J., Cohen, R. J., & Dewey, K. G. (2008). Newborn wet and soiled diaper counts and timing of onset of lactation as indicators of breastfeeding inadequacy. J Hum Lact, 24(1), 27-33.

10 Noel-Weiss, Joy, Genevieve Courant, and A Kirsten Woodend. “Physiological Weight Loss in the Breastfed Neonate: A Systematic Review.” Open Medicine 2.4 (2008): e99–e110. Print.

11 Nommsen-Rivers, L. A., Heinig, M. J., Cohen, R. J., & Dewey, K. G. (2008). Newborn wet and soiled diaper counts and timing of onset of lactation as indicators of breastfeeding inadequacy. J Hum Lact, 24(1), 27-33.

 

Sore & Cracked Nipples

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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 […]

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

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Low 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 opposite problem of oversupply! Here are a few common false alarms.

False Alarms of Low Milk Supply

  • Generally, around “two to three weeks, six weeks and three months of age” your baby will want to nurse longer and more frequent due to growth spurts. Allow your baby to eat as much as he or she wants. This will tell your body to create more milk, and once it does, your baby will return to his or her normal breastfeeding schedule.
  • Around 6 weeks, you may notice your baby’s bowel movements decrease back to once every day, or to even to a few times each week due to the colostrum no longer being in your milk. This is also O.K.
  • By 6 weeks to 2 months you may notice your breasts may no longer feel full or your baby is only breastfeeding for 5 minutes or so. This is okay and it just means your body has become more proficient at removing the milk!

The best way to tell if you are producing enough breast milk is by checking your baby’s weight gain regularly. You may also want to check out my post The 5 Ps of Breastfeeding under “How do you know your baby is getting enough?”  If you do find that you are not producing enough milk for your baby, or that your baby is loosing weight, get in contact with your Pediatrician immediately.

6 Steps To Increase Your Breast Milk Production

  1. Offer the breast to your baby at least every three hours and let he or she feed for as long as they want.
  2. Do not switch breasts until the baby slows down or stops and then offer the second breast (this way your baby can get the hindmilk).
  3. Avoid or limit the use of a pacifier.
  4. Do not give your baby anything other than breast milk until 6 months old unless advised by a Doctor. If you do need to supplement, use a spoon, cup, or dropper.
  5. Take care of yourself, drink enough water and give yourself enough time to rest.
  6. Speak to your Pediatrician about the use of herbs and medication to increase your milk supply. You may also find a list of these on my post “Breastfeeding a Preterm Baby” under “Maintaining a Milk Supply.”

Information obtained from A Leche League International  

Spitty & Gassy Baby

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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, […]

Baby Chooses to go on Strike From Breastfeeding

Baby Chooses to go on Strike From Breastfeeding

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Over Production of Breast Milk: How To Prevent & Manage

Over Production of Breast Milk: How To Prevent & Manage

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Over Production of Breast Milk
Photograph by Ryan McGuire

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). Okay, I know it sounds a bit funny, but it’s not when your breasts are sore and you have an extra spitty and gassy baby. And Ironically, your baby may not be actually getting enough breast milk due to him or her not being able to handle the strong flow. (La Leche League International)

Additional Signs that You are Producing Too Much Breast Milk

  • Your baby may be extra restless and may “gulp, choke, sputter, or cough during feedings at the breast.”
  • Breastfeeding sessions may only last 5-10 minutes and may seem like battles with the baby arching their body back away from the breast.
  • Your breast may act like an uncontrolled sprinkler system and spray out more milk when the baby comes unlatched.
  • The baby’s bowel movements may be “green, watery, or foamy, explosive stools.”– Watch out! 

For the inquiring mind: Why “green, watery, or foamy, explosive stools?” This is due to the baby getting too much lactose from too much foremilk and not enough hindmilk. Foremilk comes at the beginning of a breastfeeding session and hindmilk comes towards the end of the feeding and is higher in fat. It is important to know, if a baby is switched from one breast to the other too soon, the baby will get an excess of foremilk but will miss out on the hindmilk. (La Leche League International)

How To Prevent Over Production of Breast Milk?

Your breast milk production works as a “supply and demand” system that is unique to you and your baby (pretty amazing). The more you breastfeed or pump, the more milk your body will make. Unfortunately, a mother may become engorged due to listening to advice coming from well-meaning friends or family. Remember this, (screen shot it, print it, whatever you have to do) a mother does not need to nurse a certain number of minutes on each breast and a baby does not need to feed from both breasts for a full feeding. Feed your baby until he or she is satisfied. This is unique to your breast milk supply and your baby.

How To Manage Over Production of Breast Milk?

Mothers with an oversupply of milk can usually produce enough milk from one breast for a full feeding. Try only offering one breast for three-hour increments. For example 6:00am you put your baby to the right breast to feed and do not offer the left breast until 9:00am. If your baby acts hungry between 6:00am and 9:00am, only offer the right breast. This technique should help your milk supply decrease to match your baby’s needs and allow your baby to more fully drain your breast to access the hindmilk (La Leche League International)

For a more in depth description about over production of breast milk visit http://www.llli.org/faq/oversupply.html, they have GREAT breastfeeding resources!

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The 5 Ps of Successful Breastfeeding

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  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 […]