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Did you know that both Harvard Pilgrim and Tufts Health Plan reimburse for our lactation services 100%? You can see us in your home or our East Greenwich office. Once you pay for the service, we provide you with the detailed receipt to submit to get reimbursed.
Call your plan directly to confirm this benefit and ask them how to request your reimbursement. Always get the name of the representative and a reference number for the call!
My brother-in-law, Greg Wind, wrote the article to share with our Dads back in 2007. There is some great information in here on how they can participate in and support your breastfeeding endeavors. Enjoy!
Dads, you just had a screaming, beautiful, pooping, sleeping miracle. Have you noticed the difference in how time passes yet? Not so much in a line as in fits and starts, right? When your baby looks at you, time can stand still, and then you make up for that golden moment trying to feed, change and bathe that child before the next chorus of “the Overtired Breakdown.” Maybe time will crawl when you try and do the math of infant feeding schedules superimposed on infant sleeping schedules and sprint again as that math goes out the window with a missed nap. Oh, and don’t forget to take time to enjoy every stage because you’ll never get it back.
The feeling probably goes double for the mother of that miracle, and if she’s getting up for night feedings and pumping on a regular basis, she’s got less of a day to accomplish everything. I’d add up the hours for you, but it might depress you and I want you to get to the happy ending below.
In our over packed lives, why would anyone go for a Stone Age strategy like breastfeeding? It hurts, it takes longer, it requires exposure of otherwise hidden skin, and on top of it all, if reinforces those nasty prejudices of the woman as primary-to-sole caregiver.
If you’ve made it to this article, you’ve probably heard about the health benefits for the mother and the baby. Even the formula people say breast milk is best. If you’re taking the time to read this, you’re likely in no danger of dropping all of the baby care in mom’s lap. Plus, there’s that bonding we hear so much about. My wife, a working mom, says of breastfeeding “you have to, but you get to, too.” The benefits are real. So why not give it a spin to see if it’ll work? Remember that no one – no one – talks about the hidden long term benefits of formula.
If you and your baby are lucky, the tike has a mother that lets you weigh in on baby care decisions – even if it’s to grunt and say “I dunno.” If you chose to support the breastfeeding decision, you are now committed to supporting the breastfeeding process. You thought you were getting off the feeding hook, right? Sorry. The actual breastfeeding will forever remain a mystery to me and most men, but there are things you can do to help. Here are just a few:
> Get over it – If you’re squeamish about feeding in public or even being around during feeding, get over this as soon as possible. Not only is America coming to the realization that breastfeeding is natural and normal, but it’s actually been legislated in many states that women are allowed to breastfeed wherever they darn well please. If breastfeeding can take place during an outing or while enjoying your company, that’s like adding time to her day. Doing two things at once = more time!
> Feed the baby pumped or “expressed” milk – Expressed is actually a good word for it because it takes less time to pump than to feed a baby. The baby will also usually take a bottle feeding faster than a breast feeding. If you give the baby a bottle, you are putting time back into the mother’s day and you get a taste of that bonding everyone talks about. Expressed = faster = more time + bonding for you.
> Wash stuff – You may have noticed that time has become a theme here. A significant amount of the time required for pumping is in washing the pump components. You can wash stuff. You’ll still be a man when you’re done. If you find this works for you, go ahead and find other stuff to take care of. Every chore you take off her plate counts double during infant care. Not that you could ever cash those brownie points in, but it might help you to know that you’re getting twice the credit.
> Keep the list of benefits top of mind – On top of being time consuming, breastfeeding will be frustrating from time to time. It’s the stuff of thousands of support groups. I’m not exaggerating. When mom reaches the end of her rope, it doesn’t always mean she wants to stop. She might just need support so she can keep going. Remind her that her options are always open, but she chose breastfeeding for very good reasons. And it will help you to remember the benefits, too when you aren’t getting the attention you’re used to. Longer, healthier life for your family = more time.
> Talk to other dads – I’m lucky enough to have a sister and three sisters-in-law going though infant care at the same time. Talking to them makes my wife feel more confident and happier. And while they discuss pumping and feeding, I hang out with the boys. Not only do we all get time out to talk about sports, but on the occasion we feel like talking about breastfeeding (yep, it happens) we’re all coming from the same point of view. Trust me – you’ll feel far more comfortable talking about it with other new dads. Try discussing a slow flow nipple with non-dads and see how far you get.
So when you add all of that time back into the day, bond with the baby and take time out to discuss the designated hitter, you’ll find that breastfeeding is a pretty good deal for you. You get a chance to be an everyday hero just by washing stuff and understanding. Mom will feel the pride of feeding her baby with her body and that will make you both happier. Everyone will be healthier. Plus (I promised a happy ending, remember?) it’s free. Take those thousands of dollars and put it toward the college fund, or better yet, reward yourselves for all of the time you gave the baby and take some time to feed the parents at the nice restaurant or sports stadium of your choice. Just remember to have a couple bottles ready for the sitter.
A few years ago I had the pleasure of attending a conference about the “Use of Human Milk and Breastfeeding Education for the Registered Nurse.” The speaker was Diane Spatz, RN PhD, an associate professor at the University of Pennsylvania and a clinical nurse specialist at the Children’s Hospital of Philadelphia. It was a fascinating day, and as usual, I learned a lot. Her most interesting lecture was her first one about the benefits of human milk. I thought I would pass this information along to all of you, as a reminder of the wonderful gift you are giving your baby!
Most women cite infection prevention as their number one reason for breastfeeding. Babies who are breastfeed have decreased incidence and severity of RSV, gastroenteritis, diarrhea, respiratory, ear and urinary tract infections. For premature babies, the benefits are life saving with a decrease in the incidence and severity of meningitis, blood infection, sepsis and necrotizing enterocolitis. ($200,000 is spent of each case of NEC alone!) These babies also have a decreased incidence of retinopathy of prematurity, SIDS, diabetes, and obesity. Their hospital stay is shorter and less expensive than formula fed preemies. Breastfeeding for these compromised babies is truly medicinal.
But do you know why that is? It is due to something called the “Enteromammary Pathway.” This is a maternal response in which anything the mom comes in contact with (microorganisms, food antigens etc.) travels thru her gut and lymphatic system causing antibodies to be produced that are then passed along thru her breast milk to protect her baby. It is for this reason that mothers of preemies are encouraged to touch everything their baby comes into contact with in the NICU. Their exposure to everything their baby is exposed to protects their baby from hospital borne illnesses.
In addition to the infection protection, breast milk has a biological specificity that is exactly what the human newborn needs. The fat content of breast milk accounts for half the calories and it adjusts throughout the feeding and the day. Amazingly, the fat content is 30% higher in mother’s who deliver preterm infants, because those babies need it! The DHA and ARA in breast milk (which have now been artificially added to formulas) enhance the babies’ visual acuity and brain maturation. Some fats are also anti-viral, anti-fungal and anti-bacterial. The lactose in breast milk enhances calcium absorption and is easily broken down to provide a constant nutrient flow to the brain. Other carbohydrates promote the growth of healthy bacteria in the gut and decrease pathogens by increasing the acidity. Protein in breast milk is low in quantity but high in quality and is primarily the easy to digest whey protein. It is also immunologic with proteins that breakdown infectious agents. Lastly, breast milk is full of antibodies, infection fighting white blood cells, hormones, vitamins and minerals that are essential for the general hydration and nutrition of your baby.
But you already knew all that didn’t you? Keep up the good work!
Mothers frequently ask me “When is the best time to give a bottle and how do we do it?” For many women, it is source of anxiety, but a necessity at some point or another. Fortunately, it is fairly easy if you do it in a controlled and timely fashion, rather than at three in the morning when you are desperate!
Obviously, my goal is to help mothers breastfeed successfully, whatever that means for them. If mothers need to give a bottle, I hope to help them give a bottle of expressed breast milk instead of formula. The most important thing to know about being able to breast and bottle feed, which many women need/want to do, is that it can be done. However, it can’t be done in the hospital, right from the get go. If you want to nurse, you have to spend the time getting breastfeeding off to a good start. This process usually takes about 3 to 4 weeks of exclusive nursing. If you do that, and nurse exclusively through the three week growth spurt, your milk supply will be well established. In addition, your baby will have learned how to nurse correctly and giving a bottle at this time will not “undo” that!
Early bottle introduction causes a host of problems for the breastfeeding family. First, these babies are usually given formula and too much of it. Babies who are nursing get only a small amount of colostrum (mother’s early milk) at each feeding, which is exactly what they need. Bottle fed babies tend to get 2-3 ounces of formula, which is much harder to digest. It prevents the meconium (baby’s first waste) from being passed quickly, suppresses their appetite and keeps them from feeding frequently, which they need to do to bring their mother’s milk in. In addition, hospital bottles have a standard size nipple, which is much smaller than a mother’s breast. Babies learn immediately to position their mouth incorrectly for breastfeeding when they are given this bottle. When they replicate that on their mom, it hurts!
So, the first few weeks should be about getting a good latch and getting your supply established. If you want to give expressed breast milk in a bottle when the time comes, you can also use this time to collect some milk to give later. There may be several opportunities for this in the early weeks. If you get engorged, you can pump just enough to make yourself comfortable, which may mean only pumping a half ounce! You may also have times when the baby takes only one side, falls into a milk coma and doesn’t take the other. In that case, pump the side he doesn’t take and save that milk. You can mix the milk from several different pumping sessions to make one bottle. When you collect a total of 3 ounces, stick it in the freezer, and you have milk for your first bottle!
Develop a plan for the first time you give your baby a bottle and have someone other than you do it. I like moms to leave the house and do something for themselves. Arrange for dinner with a friend, a haircut, or shopping to get some clothes that you fit into! The reason for this is that first of all, you probably need a little alone time after three weeks of exclusive nursing. In addition, if the baby sees, hears, or smells you, the baby may protest and wonder why you are not feeding him/her. And if the baby protests at all, the person with the bottle may quickly give up and pass the baby back to you!
It is best to time it so that you leave the house right before your baby is due to eat, and pump just before heading out the door. This gives you a few hours to do what you want, and you can nurse right when you get back. This pumped milk can be used immediately, if necessary, or goes into the freezer for the next time your baby gets a bottle. When your baby gets a bottle, it should be a bottle with a wide base and nipple, not a standard size. Thaw your frozen milk, pour it in, and have it at room temperature or a little warmer for the baby.
When done this way, bottle introduction is usually pretty uneventful. Be prepared for a mix of emotions when you come home and find out everything went fine, which is after all, what you want! Then make sure that the bottle is offered every few days, especially if you will be going back to work. If you do that, though your baby will always prefer you, he will take a bottle without difficulty when he needs to!
An oldie but goodie that we first shared in 2007.
This is the one question I am asked most often! Many new parents are anxious to get their baby into some kind of a routine and restore order to the chaos a newborn creates in their home. Unfortunately, imposing any kind of structure on a newborn that suits the parents’ schedule, usually results in a tired and cranky baby. Eventually, that baby will have tired and cranky parents and your family life will be anything but peaceful!
But what if you took a different approach to trying to get your baby on a schedule? What if you simply accepted that your baby has basic needs related to hunger and sleep that are beyond your control? What if, instead, you did everything you could to accommodate your baby’s natural schedule rather than trying to force him or her to follow yours? I can guarantee that if you did that, your life would fall into a very predictable routine. It would allow you to plan your day and actually feel as if you are able to accomplish things and in control. Why not give this approach a try? What have you got to loose, other than some more sleep?
A baby’s sleeping and eating pattern really does have some predictability to it throughout the newborn period. Unfortunately, most parents of newborns are too tired to even realize it. I am certain at some point you will read this and think “That’s what my baby is doing right now!” Learning about it beforehand makes it much easier to recognize and deal with when it happens to you.
The first few days of a newborn’s life are full of sleep. The baby will usually be alert and awake for the first 4 hours after delivery, which is just one more reason to keep him with you and nurse in the delivery room! This is a great time for Mom, Dad, and baby to bond. After that, it’s lights out for days. Many parents tell me at this stage how good their baby is! I am constantly reminding them to make sure they wake the baby up every 2 to 3 hours during the day to feed him. If you don’t, he won’t eat. On or around day 4, Mom’s milk comes in and it’s a new ballgame! The baby eats all the time and is now vigorously demanding feedings. If he is doing this, you probably will not need to wake him anymore, provided he is voiding, stooling and gaining weight. Just feed him when he wakes up and asks for it! In addition, babies will start to have a fussy period that lasts a couple hours a day, usually in the evening. This fussiness usually peaks around 3-6 weeks and is almost always over by 3 months. This is a great cause of concern for mothers especially, who will begin to doubt their milk supply. It’s the perfect time to take a walk or ride in the car or break out the Snugly, swing, or vibrating infant seat. Don’t fight your baby’s fussiness! Feed him as much as he wants and do whatever else helps to make him happy. Nothing you do now is going to start bad habits and ruin him for life. You are simply giving him what he needs now, as any good parent would do.
At around 3 weeks of age, your baby will have a growth spurt. It is usually preceded and/or followed by a lot of sleep. He will nurse constantly for days, until you think you can’t stand it anymore! But when it’s over, he will fall into another predictable pattern. He may go as long as 3 hours between feedings during the day, and start sleeping for longer stretches at night. Another growth spurt happens again at 6 weeks and by that time, your baby should be sleeping from about 10pm to 4 or 6am. They usually nurse at that morning feeding and go right back to bed for a couple more hours. Another growth spurt then occurs again at 3 months of age, and is in many ways identical to the ones that preceded it. The best part about it is that when it’s over, the fussiness tends to diminish significantly and the sleep tends to become more regular and last longer. You may get a few good daytime naps and a good 8 hours of straight sleep at night! It is at this time that I strongly recommend your baby is in his own crib in his own room (if possible of course!). I also advise parents to keep the baby in his bedroom from around 7pm to 7am, so he gets used to being in his room at night. The baby may go down at 7 and wake a few times throughout the night. But with a feeding and minimal stimulation (no TV, siblings, other adults) they usually eat and go straight back to sleep. This is usually a welcome relief to parents who have been up for hours during the night with their newborn.
Babies at 4 months of age generally are capable of and need to sleep from 7 at night to 7 in the morning. They may still wake once for a feeding anytime around 4 to 6, but they generally grow out of that rather soon. Problems at this age usually arise because your baby is now a little social being and has a pretty good idea that things are still going on in his family while he’s in his room and down for the night. At this stage, you may get some serious protesting at bedtime. But in my experience, babies who have been allowed to sleep and eat as they need to, are well accustomed to their crib and room, and have learned to fall asleep on their own, have no problem making this transition. And it is a very important one, because it now provides the parents with some quiet time in the evening for each other, other children, or additional sleep! In addition, once sleeping thru the night occurs with regularity, daytime naps start to happen with predictability as well, and your days get easier.
This routine of 12 hours of nighttime sleep and 2 daily naps in the morning and afternoon usually lasts from 4 months until about 15 months. At 15 months, your baby will start to phase out the morning nap, and tend to take one long nap in the afternoon. Many parents are happy to see that morning nap gone, as they are now free to leave the house in the morning and take the baby out for activities or errands.
Does this all sound impossible and too good to be true? I promise you it isn’t! If you think of sleep as something that your baby needs just as much as food, love, shelter and safety, it becomes something you feel the responsibility to provide for him as well. To learn more about this very important topic, I highly recommend the book Healthy Sleep Habits, Happy Child, by Marc Weissbluth M.D. He discusses this topic at considerable length and teaches you how to recognize fatigue in your baby. He also reveals many good habits to start before that 4 month mark that make the transition to a full night of sleep an easy one. He believes strongly, as I do, that a well-rested baby is a healthy, happy child, with a happy mom!
If things aren’t going this smoothly for you, we offer a sleep class and even a sleep consult if you need one. Just call our office at 401-884-8273 to let us know what we can help you with!
Through the hard work and dedication of many hospital employees throughout the state, and the gentle insistence of our Health Department, Rhode Island became the first “Bag Free” state in the nation. I realize it is old news by now, but for those who don’t know, this means “women who give birth in Rhode Island will no longer receive infant formula marketing packs when they head home from the hospital.”(www.banthebags.org) In an event held at the State House on November 28, 2012 Rhode Island’s First Lady, Stephanie Chafee, Lieutenant Governor, Elizabeth Roberts, RI Department of Health Director, Michael Fine, and Marsha Walker from the Massachusetts Breastfeeding Coalition’s Ban the Bags campaign all celebrated this achievement and “spoke of their commitment to breastfeeding families and their support of the hospitals’ efforts in this giant step forward in removing the commercial barriers to breastfeeding.”(www.banthebags.org)
I think that most everyone who heard about this knew that it was a good thing for the health of babies in our state. Some weren’t happy about it, but I really don’t think they understood what it means. And let me be clear: it does not mean that mothers will not be able to receive formula in the hospital if they choose not to breastfeed. The hospitals will still have formula, and will still provide it for your child if you want it. What they will no longer do, is routinely give out discharge packs with free formula to mothers as they leave the hospital. Dr. Melissa Bartick, a Boston MD, wrote in a very public debate with MA Governor Mitt Romney that giving formula samples to new mothers was akin to giving Big Macs to patients on a cardiac floor. As Marsha Walker has said many times, “Hospitals should market health, and nothing else.” When nurses send new mothers home with a bag of free formula, it is an implied endorsement of that product. “State health officials noted that studies link these giveaways to decreased breastfeeding rates, which is not in keeping with their efforts to promote optimal health for mothers and infants in Rhode Island.”(www.banthebags.org)
We all know the benefits of breastfeeding. This information has been well promoted among the public health community for years. But “because breastfeeding is the gold standard infant nutrition that provides optimal healt
h for both mothers and infants, lactation experts have recently shifted to describing the risks of formula feeding rather than the benefits of breastfeeding. For mothers, not breastfeeding is associated with an increased risk of post-partum blood loss, post-partum depression, and ovarian and breast cancer when compared with women who do breastfeed. For children, risks of formula feeding include an increased incidence and severity of a wide range of infectious diseases as well as chronic diseases such as diabetes mellitus and obesity.” (MacNamara et al, 2012) When framed that way, doesn’t it make sense not to promote an unhealthy behavior? Especially in a hospital, where we really have the opportunity to help mothers get off to a great start establishing healthy habits with their baby!
So our tiny little state has really done a big thing for families who deliver their babies here. Next on our agenda: having Rhode Island become the first state in the nation with all birthing hospitals designated as Baby Friendly. “The Baby-Friendly Hospital Initiative (BFHI) is a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding. The BFHI assists hospitals in giving mothers the information, confidence, and skills needed to successfully initiate and continue breastfeeding their babies or feeding formula safely, and gives special recognition to hospitals that have done so.”(www.babyfriendlyusa.org) Currently in Rhode Island, Newport, South County and Westerly hospitals have all achieved this status. Throughout the world, the majority of hospitals are Baby Friendly. It is only here in the USA, which is so heavily influenced by the business of formula marketing, that Baby Friendly hospitals are in the minority. Interested in helping to make this happen? Contact your local hospital and ask that they do everything they can to achieve this designation and deliver only at a hospital that has it. Consider joining the Rhode Island Breastfeeding Coalition (RIBC) and joining our advocacy efforts. You can read more about this wonderful organization and ways to get involved at the following link: www.health.ri.gov/partners/coalitions/breastfeeding. We hope that you will join us!
Written in 2010
My three younger sisters are the only thing getting me through this phase of my life. My relationships with them help me to hold out hope that one day my children will not only be civil and kind to each other, but they may actually want to spend time together. I vaguely remember tension between my closest sister and me, as she was only 11 months younger than I was. I recall viscous fights and terrible things said to each other. But with the two younger ones, I only remember fun. Now, as we all raise our children together, there really are no other women I would rather be with. Will my kids ever feel that way? If you spent an hour in my house, you wouldn’t think so.
I am the mother of four boys. The youngest is 7 and adorable. His older brothers love him. He has not yet become annoying. The three other ones are 12, 15 and 18, so there is a lot of testosterone in my house. And with that comes trash talk, bullying, and the occasional “accidental” bat to the teeth. I wish I was kidding about that one.
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Coming from a family of girls, I am unaccustomed to the sheer physical nature of their interactions. My two oldest boys now have the bodies of men and tower over me. It seems that no one walks by the other without a nudge, flick or swat to the head. All when I have my back turned, of course. The verbal insults I can at least hear, but often wish I didn’t. I find it heartbreaking the way they speak to each other. Then I have to endure all the different versions of how things went down, who started it and how they should be punished. Invariably, someone is upset that I haven’t taken their side and I feel like I am the one beaten down in the end.
I hear from other men with brothers that this is normal behavior; that what I am experiencing is relatively tame and butting out is the best option. But don’t we have a responsibility as mothers to point out bad behavior? And to protect them from each other? Someone could get really hurt, right?
My mother-in-law stayed with us for a week once and she gave me advice that helped eliminate some volatile exchanges. She suggested that I not put the particularly combative ones together while doing chores, babysitting, on car rides etc. It really worked! My problem is that I frequently forget that advice. In my hurry to get things done, I bark out orders and put them in situations that foster the bad behavior. But I find that now that they are bigger and stronger, I really need to pay attention to what I am asking of them and determine whether they can handle it with everything else that is going on in their life. If they are having a good day and are relatively happy, they might find it fun to be with their brothers and endure a little good-natured ribbing. If not, look out. Someone else is going to bear the brunt of their difficult day.
I’ve tried to put some thought into what each child seeks from another. The older ones really want respect. They want the younger ones to take what they say to heart, to do what they ask the first time, to have their privacy, and their possessions left alone. The younger ones just want to be with the older ones and to be an important part of their lives. None of them need additional parents. I keep saying things like “Just be the cool big brother” or “Be what you want him to become.” Let the parents actually engage in the parental behavior.
Sometimes, I feel their bad behavior is an attempt to get some attention from me. I might be flattering myself, but I do know that if I make the effort to spend time alone with each one, things tend to be better at home. So when I can, I take a boy with me. Whether it is to the grocery store, bank or post office, you can learn a lot when alone for a half hour with a boy. In addition, almost
every day each of them wants/needs something from me- a permission slip signed, form filled out, a button sewn back on their pants. Silly little stuff, but important to them. And when I take care of it, they are more inclined to take care of each other. Sometimes I really have to stop myself and pay attention to what is important to them. I think that is important advice for mothers of children of any age. When we look them in the eye and take their requests to heart, it validates them and lets them know we think they are important.
So in a nutshell, here is what I have found works:
Don’t take sides. If you didn’t see it, you cannot make a judgment about it. Listening to all sides of the story makes you pick sides and someone will be unhappy. My husband came up with a grand plan of punishing all involved equally, regardless of who started it or did what. This has made them think long and hard before coming to us, and they tend to resolve things amicably themselves.
Physical and verbal abuse/ bullying is never acceptable. There is no excuse for it regardless of the behavior that provoked it. When you see or hear it, stop it immediately and remove the offender from the situation. Take away a privilege if the behavior continues.
Don’t put kids who are combative in a situation where they are forced to work together without adult supervision. I have learned who works well together and when I need to, I am involved in supervising the activity. My presence usually keeps the situation under control, without them realizing that is my intention. Sometimes they even have fun together!
Give each child some one-on-one time with a parent as often as you can, especially if they seem to be having a hard time within the family. Reinforcing your unconditional love and letting them know they have you to protect them does wonders for their self esteem and gives them the strength to stand up for themselves.
For the younger kids, teach and model empathy every chance you get. This has been reported to be a critical developmental milestone. If they are able to put themselves in another’s shoes and understand how they feel, it goes a long way in keeping them from treating others badly. And it can be the basis for everything ~sharing, taking turns, manners and respect.
And maybe someday, they will look back on this time fondly, while hanging out with their siblings and their own children. At least we can hope for that, right? I know I do, every day.
I used to hate nipple shields and never used them. My bias was based on literature that came out many years ago that indicated they caused nipple damage, usually because they were used incorrectly. They also contributed to lazy latches with ineffective drainage of the breast leading to a subsequent decreased milk production and infant weight loss. So I basically just steered clear of them, thinking that no good could come from using them.
Then in the fall of 2007, I attended a conference hosted by the Rhode Island Breastfeeding Coalition (RIBC) on “The Challenges of Breastfeeding the Near Term Infant.” The speaker was Molly Pessl, RN BSN IBCLC, and she changed my mind about nipple shields. She taught us all how they really get the baby who isn’t quite term in their development nursing at the breast. These babies look like they should be able to nurse without difficulty, but developmentally, they are not quite there and the shield makes all the difference. Many of them were bottle fed and were used to plastic. The plastic shield tricks them into getting on the breast and its firmness makes it easier for them to drain the breast when used correctly. I started using them in these circumstances and found that she was absolutely right! Christina Smillie MD, FAAP FABM, who spoke at the 2009 RIBC conference on “Baby Led Breastfeeding” agreed with this use of the nipple shield, and supported anything that gets the baby nursing directly from the breast.
Now I sometimes feel as if I am passing nipple shields out like candy. I don’t leave home without them. They are always the last resort, after first assessing the situation and trying to get the baby to nurse without it. I make sure the family is aware of all the contradictions and side effects of improper use, and agrees to frequent weight checks and follow up with me. I explain that use of the shield is a temporary thing. I find that usually after about 2-3 weeks of good nursing and weight gain, the baby doesn’t need it any more. They wean easily and all those difficulties in the beginning are a distant memory. Once they understand all that, we give it a try….
I have had many moms burst into tears when I help them latch their baby on the breast with the shield. They are thrilled to see milk in the shield and so proud of the intake we are able to measure on my scale. The swallowing they witness is much stronger than what had been happening without the shield, if they were ever even able to get the baby on the breast! The family is happy, and then so am I.
There are two other situations in which I use nipple shields. One is for the mother with flat or inverted nipples. That is probably not a surprise to anyone. It provides the baby with something to latch onto without causing the mother any pain. I also use them for babies who latch without incident, look absolutely perfect on the outside, and despite numerous suggestions on positioning and support , still cause their mother pain. I never am really sure why this happens and nothing fixes it. But the shield does. Mom nurses pain free, and like the other situations, the baby eventually weans off it.
So this is all good, right? When used in these situations and while working with someone knowledgeable about breastfeeding and infant growth and development, it really does fix problems and get the baby nursing. However, now I am running into a much bigger problem.
You can get a nipple shield anywhere. Target, Babies-R -Us, and Walmart all sell them. As a result, I am seeing moms at 3 weeks post partum, who brought a shield to the hospital after buying it in the store and started nursing with it immediately after birth. They never even tried to latch on their own. They assumed that since it was in the store, it was just one more thing they had to have to breastfeed. I am called in because the baby isn’t gaining weight, mom reports she has no milk and had to start supplementation. And at this point, there is not a lot I can do. The hormonal response that establishes and maintains a woman’s milk supply has come and gone. The window of opportunity to get things off to a good start has been missed. It is heartbreaking to have to tell a mom this and have her realize she probably never needed to use the shield in the first place.
What has typically been happening in situations like this is that the baby has spent a tremendous amount of time at the breast, using the nipple shield as a pacifier. The shield slides in and out of the baby’s mouth, and the breast is not drained. I see this immediately when I ask the mom to show me what she has been doing. The only milk the baby gets is from the mom’s letdown. Mom interprets the length of time at the breast as a good thing, not realizing that the baby is wasting calories with all the ineffective sucking, and not gaining weight. The ineffective draining of the breast then causes her milk to dry up, as you have to remove the milk in order for it to be replaced.
The key to all this is that these feeding devices are intended to be used under medical supervision. While it clearly states that on the packaging, it is on the back and the last thing mentioned, after stating all the things a nipple shield is good for. I have complained to the manufacturer about this, and have been told that they are working to make that statement more noticeable, but will continue selling them in retail stores.
At HBHM Inc., we have a very specific protocol that we follow when using shields with a family that involves frequent follow up and weight checks. I am planning to revise that protocol with our new website launch to include not selling these shields to moms unless they are working with us or I can confirm they are working with another healthcare provider. I am sure many mothers will not appreciate that extra requirement. But I don’t want to be responsible for providing someone with something, that when used incorrectly and without guidance, can have such grave consequences. I will let the manufacturers and retailers get the credit for that!
We are incredibly lucky to spend our day with such wonderful moms and their precious babies. There is no question – the newborn phase goes by fast! Cherish those sweet snuggles, enjoy this special time with your little one, and take lots of photos!
In our guest post today, we share with you some great tips and ideas for newborn portraits from Rhode Island & Massachusetts Photographer and Artist – Jean Monti. Enjoy!
NEWBORN PHOTOGRAPHY PORTRAITS
http://www.jeanmontiphotography.com
TOP QUALITY NEWBORN PHOTOS: HOW JEAN MONTI PUTS HER HEART INTO NEWBORN PHOTOGRAPHY PORTRAITS.
I love newborn photography and look forward to every newborn photography session with excitement and enthusiasm. Imagine welcoming new babies into your family every month! I have the honor of this experience every time I welcome a new family into my home studio. Can you image the joy and love I am surrounded with during every session? Newborns represent innocence, purity, goodness, and so much hope for our future. I always try and photograph them in a wide variety of poses to be sure I capture the present newness that will change so quickly with each and every passing day. I love how cozy they look swaddled in a soft wrap on a fur blanket, and how beautiful they are in a basket bathed in sunlight in a creative and natural setting, or how secure and loved they are when in the arms of their adoring parents. The details of their rosebud lips, and their tiny little toes are important because we never want to forget how sweet and little they are.
Sunlight cascading through a window on a newborn is photographed by Jean Monti Photography in her Cumberland RI studio
It is best to photograph newborns during the first 14 days of their life. I understand how exhausted parents feel during this time, but I have never had a parent regret scheduling time to have professional photographs of their newborn. I highly recommend capturing this fleeting and special time in your life with a professional, but if you would like to try it on your own, here is what I suggest for ideas and tips.
Newborn Photographer, Jean Monti, photographs newborn at the Jean Monti Photography studio located in Cumberland, RI
Detail of a newborn’s head being held by the hands of her father and mother.
Detail image of a newborns tiny feet was captured in the photo studio of Jean Monti
Jean Monti loves to document the smallest details of a newborns lips during a newborn photography session
NEWBORN PHOTO IDEAS AND TIPS BY JEAN MONTI
PHOTOGRAPHING A NEWBORN BABY
Use a really good camera! I too think the mobile device cameras have come a long way for fun candid shots, but they are absolutely no substitute for a DSLR with a really good lens when capturing fine art portraits. You cannot control aperture, speed, or ISO with a mobile device.
Have a plan! I always go over color schemes, where the clients want to hang the finished portraits, do they want to fill an album, do they want 50% or 90% of the images to be just the newborn and the rest to be with the parents, etc. It is best to photograph a newborn just after they eat and when they are asleep. Mom should avoid certain foods if nursing because the baby will be moved around more than usual and certain foods will make them more upset than usual. Within the first 15 minutes and while sound asleep, photograph them swaddled and wrapped lying down on a bed or a covered beanbag. This way you are guaranteed to have something great before moving on to more difficult poses where their body is exposed. Also, make sure the room and your hands are very warm. Babies love to be in constant contact, so I stay very close, hold their hands and legs close to their body, and always move them gently and slowly so as to not startle them. Whatever you do, don’t change them on a cold plastic changing pad! Imagine someone lifting you out of bed in the morning, undressing you, and then placing your warm body on a cold plastic pad! Next, you can try to place them in a basket, but always have someone close by to make sure baby is safe and nothing in the basket is poking or hurting them in any way. Make the bed of the basket soft with blankets and/or fur and softly cushion their head. At this time you can swap out hats, or headbands, and slowly try and remove the wrap.
A throwback from 2007 that many of you can relate to as your children start a new school year.
I am a woman on the verge of freedom. After sixteen years at home, the youngest of my four sons is off to a full day of Kindergarten in the fall. I am at the same time, elated and depressed. I alternate between euphoria at the possibilities that are opening up for me, and hysterical tears as I experience each last milestone with my baby. Preschool is over. We sat together for the last time at First Friday Mass, waving at his big brothers. Next time I go, he will be sitting with his classmates. He is done with Eager Beavers at the YMCA. I no longer have a child to take to the playgroup I have been attending weekly for 8 years. Even as we go shopping at the grocery store, I am reminded that come fall, I can do this by myself. Think of the money I will save! And how quickly I will get it done! Then the tears start, as I realize my constant companion will be otherwise occupied come September.
I should be happy, right? Everywhere I go, I see mothers with young children. I remember how tiring it is to carry a car seat, reason with a 2 year old, nurse a baby for the third time in 2 hours, race home before naptime, and beg a six year old to run and get me a diaper, again. I vividly remember the energy it took to take care of all of them and their needs, while mine forever took a back seat. I see the fatigue in my friends’ faces whose schedules still revolve around their little ones. I hear it in my clients’ voices when I try to reassure them that this particular phase won’t last forever. I am frequently reminded of a quote from one of my favorite authors, Kathleen Huggins. “If you find it hard, it’s because it is hard.” And it was.
But it has also been one of the best things I have ever done. And if I had more money and energy, and was a little bit younger, I would do it all over again. I’d love the chance to get another marriage proposal from a 3 year old or have a 5 year old tell me, “Mom, you’re my whole world.” I want to have a newborn stop crying immediately when I pick him up and feel a little hand grab a hold of mine while walking through a crowd. I’d even love to rock my sick toddler in my arms in the middle of the night. These are the memories that I cherish, and long for.
And yet, this phase of my life is almost over. And in so many ways, the new phase is terrific. I have built-in babysitters and can go out to dinner with my husband, or for a run in the morning before anyone wakes up. We actually get where we are going mostly on time now and my youngest prides himself on helping me. My 9 year old will still talk to me when no one else in the family wants to. I love nothing more than sitting on the couch with my two teenagers, rehashing the day, and laughing till I cry when I hear of their escapades. I am amazed at the men they are all becoming, and excited for their futures.
So, what is a woman to do in this situation? I have agonized about it, and finally decided. I am getting a puppy. It’s a boy and he’s coming home Labor Day Weekend. But don’t tell my kids! It’s a surprise, and we are on to our next phase.
