Archive for July, 2011

Breastfeeding and Work: New Research

July 27, 2011

Important notice:  This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

It is commonly understood that breastfeeding mothers returning to work face multiple challenges. Balancing work and motherhood, carving out time to pump at work and maintaining adequate milk production are all topics that any employed, lactating mother can discuss at length. Studies have shown over and over again that employment outside the home reduces breastfeeding duration.

A new study just published in the Journal of Human Lactation (August, 2011) has shed some new light on this topic. It sought to understand the relationship between breastfeeding and occupational type (professional, administrative, service, sales, etc.) and postpartum employment status. The researchers asked about initiation of breastfeeding as well as duration of breastfeeding. The subjects in the study included thousands of women in the U.S. from all walks of life.

Instead of boring you with all the statistics and methodology, I’ll just summarize the results. This study found that neither postpartum employment status or occupational type was a significant predictor of duration of predominant (mostly) breastfeeding. However, and this is big, full time workers were less likely to initiate breastfeeding in the first place! There was no significant difference in breastfeeding initiation between part time workers and mothers with no postpartum employment.

Mothers who were employed full time and chose to continue breastfeeding were also less likely to continue breastfeeding beyond 6 months compared to part time workers and “stay at home” mothers. Again, there was no difference in breastfeeding duration between part time workers and non-employed mothers.

Even when mothers have part time jobs that enable pumping breaks, access to lactation consultants, and other amenities, milk production can still be a problem when relying on a breast pump for a large part of the day. Other research has demonstrated that the strategy associated with the longest duration of breastfeeding after returning to work was breastfeeding the baby during the work day. Access to the baby is the number one strategy for maintaining breastfeeding for the longest amount of time.

How does all this relate to you? If you’re breastfeeding and plan to return to work, the following strategies will help you continue your breastfeeding relationship until you and your baby are ready to wean.

  • Don’t go back to work for as long as possible.
  • When you start back to work, just work part time if possible. Even if it’s only for the first year. Consider job sharing.
  • If you must go back full time, find a way to work from home part of the day or a day or two per week.
  • Does your employer offer onsite day care? If so, go for it!
  • Get childcare close to your job so you can have access to your baby.
  • Find a care provider who will bring your baby to you at lunch so you can breastfeed.
Obviously not every mom can enjoy all of the above options.  You can only do what you can do! But if you apply some creativity to your work situation, you may be able to improve your situation somewhat–which may be just enough to make long-term breastfeeding easier!
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Breast Engorgement and Cabbage Leaves?

July 25, 2011

Important notice:  This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

Let’s be honest. Overly full, engorged breasts are uncomfortable and sometimes downright painful. Fortunately, under normal circumstances true engorgement can be prevented with frequent breastfeeding in the first few days/weeks after the birth of your baby. Some breast fullness and tenderness is to be expected in the first week postpartum as your breasts prepare to provide nourishment for your baby or babies. It may feel like you have enough milk to feed the entire neighborhood, but keep in mind that much of the swelling you are experiencing is simply that—swelling. It’s not just milk “coming in” that is making your breasts feel so full. After the birth of your baby; water, blood and lymphatic fluid rush to your breasts in preparation for breastfeeding. With adequate breastfeeding, the discomfort usually passes in a day or 2. Many mothers don’t experience anything but mild fullness.

Currently, however, many mothers in the U.S. experience births that are anything but “normal.” Epidural anesthesia requires that mother receive an IV of fluids. Inducing labor with pitocin requires extra fluid. C-sections require IV’s. If a mother receives any extra fluids via IV, she will continue to retain the fluid for some time even after the birth of her baby. That extra fluid often results in swollen ankles, fingers and even breasts!

The edema in the limbs may be noticeable right away; but the breast swelling will probably not be apparent until day 3-5. When breasts are full in a normal way as the milk “comes in,” your baby will still be able to latch on and breastfeed. The breasts will feel full, but the areola will be soft and compressible. True engorgement is very different. Your breasts are hard. The skin is stretched and shiny. The areola is hard and taut. There is no way a baby can latch on to your breast. Pumping is usually ineffective since the tissue is not malleable. It’s like trying to use a pump on a wall!

So what can you do if your breasts become so engorged that you feel like you have 2 bowling balls on your chest? Try using cabbage leaves to relieve the swelling so that milk can be removed by the baby or a pump. Cabbage? Really? Yes! This is one of those times when folk wisdom can be helpful.

Green cabbage contains sulfa compounds which pass through the skin, and constrict vessels–relieving inflammation. This reduction of inflammation and swelling allows the milk to flow. To use the cabbage to relieve engorgement, rinse the leaves thoroughly in cold water (leaves should not be cooked). Place a leaf or two on your breasts under your bra. Change the leaves as they wilt. Most mothers notice immediate relief using this method.

A couple words of caution: This technique is not recommended for women who are allergic to sulfa or cabbage. It’s also important to not over-do the cabbage cure. There are reports of decreased milk supply with excessive cabbage use.

If you find yourself in the difficult situation of clinical engorgement, you need help! Contact an experienced lactation consultant right away. In the meantime…try some cabbage!

Alcohol and Breastfeeding

July 3, 2011

It is well known that alcohol consumption during pregnancy can harm the developing fetus. The placenta is not a barrier for toxic substances and even moderate drinking can cause devastating brain damage. But what about breastfeeding? Does that glass of wine you enjoyed with dinner pass into your breast milk? Do you need to be cautious about drinking alcohol?

The short answer is “yes.” The alcohol you consume enters your bloodstream almost immediately and, therefore, is in your milk rather quickly. Even though the alcohol does transfer to your milk, the amount of alcohol your baby experiences is much less than the amount you drink. Unlike the placenta, the breast provides some protection from most toxins in your bloodstream. According to Dr. Thomas Hale, the dose of alcohol in milk is less than 16% of the mother’s milk.

The amount of alcohol in your milk will peak 30 to 60 minutes after you enjoy your drink. After that time, the milk alcohol level decrease rapidly as long as you don’t have another drink. Alcohol is not stored in your milk. It quickly dissipates as your blood-alcohol level decreases.

There is no need to “pump and dump” (how I hate that phrase!) if you enjoy an occasional alcoholic beverage. But it is a good idea to time your drink for just after a breastfeeding session. That way most of the alcohol will be out of your bloodstream by the time your baby wants to breastfeed again.

After 40 weeks of abstaining, you may be excited about that first glass of wine. A note of caution from someone who has been there. Be careful! Many sleep-deprived mothers find alcohol packs a much bigger punch than before the pregnancy. If you choose to imbibe, take it slowly. Start with 1/3 to ½ of what you used to drink.

What about alcohol and milk supply? Some mothers are told to drink a beer so their milk will “come in” faster. Perhaps your wise, old grandmother advised you that beer would increase your supply. On the contrary, research has demonstrated that alcohol inhibits oxytocin release. Since oxytocin is responsible for your milk ejection reflex or let down, alcohol consumption actually decreases the amount of milk released from the breast during a feeding. Over time this can lead to a reduction in your milk supply.

Drinking during breastfeeding is a personal choice—one of many decisions that you will make as a mother. The bottom line is that alcohol in moderation, keeping in mind the timing of your drink, is probably not harmful. The American Academy of Pediatrics lists alcohol as “usually compatible” with breastfeeding. Excessive drinking while breastfeeding can, however, lead to developmental delays.

In summary:

    • Alcohol enters milk freely, but in lesser amounts than is in your bloodstream.
    • The peak level of alcohol in breast milk is 1/2-1 hour after it’s consumed.
    • If you choose to drink alcohol, time your drink for right after the baby nurses.
    • There is no need to pump and dump.
    • Waiting about 2 hours after having a drink is a general guideline to ensure complete metabolism of alcohol. (Based on a 180 lb. female)
    • Your milk is the best thing for your baby. Planning your alcohol consumption is advised over using formula to replace milk that may contain a small amount of alcohol.

If you’re too tipsy to safely hold your baby, you’re probably too tipsy to breastfeed! Use some previously pumped, alcohol-free milk instead.Important notice:  

This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

 


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