“Climb Out of the Darkness”

The emotions of having a new baby can be complicated: joy, sadness, love, anxiety. Postpartum can be a rough time for lots of families. The Dane County Perinatal Network is a great resource for parents that are looking for support with the sometimes overwhelming sadness and worry that can come with a new baby.

They have organized a local “Climb Out of the Darkness” to raise awareness of postpartum depression, anxiety, and other mental illnesses related to pregnancy and childbirth. It will be happening on Saturday, June 21 2014 at the Pheasant Branch Conservancy in Middleton. If you want to be a part of this event, they ask that you register in advance (it’s free but they need to know who’s planning to be there). There will be a potluck after the climb so that people can have time to talk and make connections.

Does breastfeeding really need to be interrupted?

It is easy to forget that breastfeeding is much more than just breastmilk. When a nursing mama is sick and needs medical care it can be super stressful to bottle feed, pump & dump – even if her baby is still getting her milk that she expressed earlier. Because of this, it’s a good idea to only interrupt breastfeeding when the baby really is going to be at risk from continuing to nurse. There are great evidence-based resources that are free and available online to help families and care providers make good choices. I have links posted on my library page. A few really useful ones are listed below:

LactMed

American College of Radiology Manual on Contrast Media

Infant Risk Center

More basic biology of milk-making

I was super excited to see this article reporting on research coming out of Cincinnati Children’s Hospital. So many women I see struggle with low milk supply and there are very few answers for them. There is just a lot of basic biology of making milk that we don’t understand. This research is trying to get at some of those answers. From the news release I followed the link to the original journal paper and got even more excited. This paper by Danielle Lemay and colleagues is awesome for several reasons:
– It is a new way to investigate how milk is made. They are looking at the genes that are active during different stages of milk production by getting RNA from milk fat globules. As I understand it, it is sort of a sampling of what’s going on inside the milk-making cells. It is a way to find out what proteins these cells are busy making at different times. Since the researchers are using expressed milk it is easy for the women that participate in the study to give samples (unlike most other ways of getting breast cells for study!).
– They find a connection between insulin and what milk-making cells are doing. I’m still working my way through the paper and don’t entirely understand what they’re saying yet but this general connection is exciting. It could lead to some practical ways to help women that are frustrated with low milk supply. It could also help explain why so many women seem to struggle with production. A quote from one of the authors : “Considering that 20 percent of women between 20 and 44 are prediabetic, it’s conceivable that up to 20 percent of new mothers in the United States are at risk for low milk supply due to insulin dysregulation.” (Laurie Nommsen-Rivers)
– They published in a peer-reviewed, open-access journal, PLOS ONE. That means that anyone can easily access their research – even people like me (or maybe you) that aren’t currently affiliated with a university library or have enough disposable income to purchase journal articles.

Hand Expression

Hand expression is so useful: engorgement, pump broken, away from baby longer than expected. It is a skill that is easier to learn by watching and doing than by reading about it. We’re lucky to have internet video now for learning by watching. Practicing in the shower can be a good way to learn by doing! I’ve got a collection of video links of hand expression on the library page of this blog. Here’s the one I just added to the list from Breastfeeding Medicine of Northeast Ohio:

The Basics of Breast Massage and Hand Expression from Maya Bolman on Vimeo.

Snuggling baby skin to skin

My fourth birth went from being a planned homebirth to a vacuum-assisted, epidural-numbed hospital birth. One of the things that worried me a lot about this transfer was how we would do with breastfeeding. My first birth and breastfeeding experience had been really challenging, at least in part because we had a rough birth and were separated for the first few days. I didn’t want the same thing to happen again. Actually I was terrified that it would happen again. The one thing that I felt I could influence was what happened after the birth. I had read Righad and Alade’s 1990 paper about how uninterrupted skin-to-skin contact after birth could help minimize the effects of labor medications on early breastfeeding. As soon as my daughter was born they handed her to me. I didn’t let go of her until she latched and nursed successfully – about 3 hours later. The staff kept suggesting that I might like to know how big she was and get her cleaned up. I just smiled and said that I wasn’t in a hurry. My husband and I kept smiling and thanking everyone for their help and ignoring any suggestions that we do anything other than keep her on my chest. We went on to have a long, and fairly trouble-free, nursing relationship.

This is just one story about skin-to-skin and of course one story doesn’t prove anything. But there a many studies now looking at how skin-to-skin time promotes infant well-being. Here are some good starting places if you want to learn more yourself or if you’d like to educate (convince?) someone else:
Massachusetts Breastfeeding Coalition handout. Cute picture of how to do it, short summaries of why it’s good. This is for when you just want the information without a lot of reading.
Cochrane Summary. This is a great resource for the statistics- and science-loving skeptics in your life. Cochrane summaries evaluate other studies and try to come to the best-supported conclusions about health care choices.
Kangaroo Mother Care. This website focuses on skin-to-skin care for preemies. There is information for parents and care providers.
Research study bibliography. This is for the geekiest of study lovers. All the peer-reviewed journal reading you could hope for!