Showing posts with label pumping. Show all posts
Showing posts with label pumping. Show all posts

Monday, February 9, 2015

Lactation in Court: Your Rights at Risk (and One Case to Watch)



Last week, I was directed to a headline that read, "Supreme Court lets stand ruling that firing woman for breastfeeding not sexist because men can lactate." I immediately thought "that doesn't sound right," and set off to investigate. The heavy partisan bias of the site and the lack of sources induced further skepticism, but I felt that such a claim must have originated somewhere, so I followed my diligently-Googling fingers to an ACLU blog post that had been heavily quoted in the first article. The headline was likewise sensational: "Firing a mom because she's breastfeeding is sex discrimination." Again, the ACLU post referenced the court's supposed claim that lactation is not unique to women (more on that in a minute), but again, no sources for this opinion were provided. What's more, the original headline of the first article has since been changed, possibly in response to a Snopes article that points out the misleading language.

What WAS certain was that a breastfeeding woman had lost her job, the circumstances pointed to possible discrimination, and a petition appealing the case had been submitted to and denied by the Supreme Court. Given the massive consequences this could have for breastfeeding mothers, really ALL mothers, I jumped down the rabbit hole to find the truth.

Don't start raging yet. Soon, I promise, I will give you a reason. Probably not the reason you think, though.

The Case: Ames v. Nationwide


First, a quick overview of the case, Ames v. Nationwide (yes, that Nationwide):

Angela Ames was a Nationwide Insurance employee who gave birth to her first child after seven months at her job, and discovered her second pregnancy five months after that. At this point, she claims she became the target of mocking and derogatory comments from her direct supervisor, Brian Brinks, and the head of her department, Karla Neel, regarding the intended length of her maternity leave, her weight and appearance, and her medical need to go on bed rest as a result of a difficult pregnancy.

Ames's second child was born prematurely, and during her maternity leave, Neel called to inform her that the length of her leave had been miscalculated, and she would need to return to work sooner than originally planned. Though further unpaid leave was available to Ames, Neel suggested this would send up "red flags," and offered a compromise of an extra week beyond paid leave. Ames, who was breastfeeding, called a disability case manager to ask about available pumping facilities, and was told that lactation rooms were available.

Upon her return to work, Ames needed to pump, and sought out the lactation room. After receiving an indifferent response from Neel, she was directed to the company nurse, who informed her that she needed to fill out paperwork that would take three days to process before she could be permitted access to the lactation rooms. Since Ames had not pumped in hours and was in considerable pain, the nurse offered an alternative room, but it was not immediately available and did not comply with federal guidelines for a suitable pumping space.

While waiting for an available room, Ames met with Brinks, and claims he told her that none of her work had been completed while she was on leave and that she was responsible for completing all of it within two weeks, even if that required overtime and at the risk of official discipline if not finished. Now fearing for her job and in even more pain because she still had not pumped, a visibly distraught Ames again sought out Neel for help. Neel then handed her a pen and paper, saying, "You know, I think it's best that you go home to be with your babies," and dictated a resignation letter to Ames, instructing her to sign it.

As a result, Ames brought suit charging sex and pregnancy discrimination, and later a claim of constructive discharge, on which much of her case depended. Constructive discharge means a forced resignation, usually because working conditions are made deliberately intolerable with the intent of causing an employee to quit rather than be terminated.

How is the Supreme Court involved?


Second, a grossly-oversimplified layperson's explanation of the case's route to the Supreme Court:

The case was initially tried in District Court in Iowa, where the events occurred. This trial court ruled against Ames, with two primary arguments: one, that she was unable to prove that she was treated at all uniquely for being a woman (particularly a mother and lactating woman), and two, that she did not adequately seek available redress prior to her resignation, as a "reasonable person" would. It was in the footnotes of this court opinion that the odd reference to lactating men was included, to support the assertion that lactation is not a sex-based condition and therefore could not prompt sex discrimination.

Next, Ames appealed the decision, taking it to the Eighth Circuit court. This appellate court affirmed the decision of the district court, but did NOT reference any of the more outrageous claims found in the original opinion, including the men-can-lactate-too argument. However, the decision of this court carries considerable weight, as its ruling is now binding for the entire Eighth Circuit, and may be referenced as precedent in cases before other circuit courts.

Now gaining the support of the ACLU (in an excellent little brief, I might add: well-worth the read), Ames petitioned the Supreme Court for a review of the case. Her attorneys sought this both for an appeal of the ruling and because several of the Eighth Circuit's opinions regarding constructive discharge conflict directly with readings by the other circuit courts, meaning only the Supreme Court can settle the dispute. The Court denied the petition, which means they will not hear arguments at all and there are no further avenues for appeal available to Ames. However, this does NOT mean that the Supreme Court has affirmed the circuit court's ruling as the Eighth Circuit did, and its denial should not be taken as approval of or agreement with any arguments made by Nationwide.

"Reasonable persons" and lactation as a choice


Is this fair? Are these bad rulings? Were Ames's rights infringed?

It's hard to say, because lawyers are good at what they do and, with scruples or without them, they can make a case. Even as a legal-illiterate, I can follow the logic that led to this outcome. But I can also see an equally logical path to the opposite conclusion. Some context that I think was overlooked:

The courts made much of Ames's failure to report her harassment and ill treatment to HR as a "reasonable person" would, citing that as their primary reason to reject her claim of constructive discharge:

"The Court is not insensitive to the burdens and stresses associated with parenthood, particularly those experienced by new mothers. Being under stress, however, does not excuse Ames from doing what any reasonable person in her position would have done. Therefore, the Court concludes that no reasonable fact-finder would determine that the unavailability of a lactation room on July 19, 2010 would lead a reasonable employee in Ames’s position to believe that her only option was to resign."
This ignores several important points:

One, that Ames had been a victim of a sustained campaign of harassment and intimidation throughout her pregnancy, both from her direct supervisor and from the department head. As it was a physically challenging pregnancy, Ames would have been suffering from physical discomfort, fear for her unborn child, the need for constant medical care that would interfere with her work, the mockery of colleagues and superiors, and of course fear for her job. Also, she already had a baby at home, and though other stressors are not cited in the court documents, it is also possible that her health insurance and her family's financial stability depended at least in part on her job with Nationwide. Any of these factors, combined with pregnancy and postpartum hormones, could easily and understandably make Ames less reasonable than she might be otherwise.

Second, Neel demonstrated a clear pattern of manipulation in her behavior toward Ames: First came her comments that were evidently intended to make Ames feel guilty for her need to go on bed rest during her pregnancy. Then, when she called to let Ames know that her maternity leave had been miscalculated and she would need to return to work earlier than originally planned, she made threats to Ames' job should she choose to take a longer unpaid leave. After thus putting her on the defensive, she then magnanimously offered an extra week of leave to Ames, assuring that Ames would return to work both fearful for her position and indebted to Neel for her apparent graciousness. Finally, it was Neel who suggested Ames resign and who offered her the pen and paper and dictated her resignation letter to her.

Third, though there are several references to Ames's "considerable pain" or discomfort of engorgement from going so long without pumping, it is very clear that no one who ruled on this case has any idea what that feels like. While of course judges are called upon to be as objective as possible in their rulings, the physical sensations Ames was experiencing, coupled with her extreme fear for her job that had been systematically instilled by her superiors, would have seriously affected her ability to make considered decisions. Engorgement can be agonizing, tortuous even. If you were in terrible pain, and someone offered you a pen and paper that would bring you relief within the hour, would you choose that, or wait hours longer to attempt to resolve the problem "reasonably," even knowing you might be unsuccessful? Of course not: you would take whatever option would allow you to end your pain sooner, and to expect otherwise is ludicrous.

Furthermore, the courts seem unable to understand why Ames could not simply wait the three days required for her paperwork to use the lactation room. As mentioned above, it would be extremely painful and very distracting to her, making it difficult to do her job. Remember, she had just been informed that she needed to complete eight weeks worth of work in only two, after months of harassment and direct threats to her job from Neel. She knew she couldn't afford to be distracted. Moreover, having to go three days without pumping would likely lead to early breastfeeding cessation for Ames, since lactation is a supply-and-demand system. The courts surely don't care since, in the judges' minds, there's always formula, but this shows a clear bias against breastfeeding women. They expected Ames, as a "reasonable person," to simply stop breastfeeding if that was what was necessary to keep her job, even though federal pumping laws were written to prevent exactly that.

Indeed, the rulings define lactation as a "choice," and not as a medical condition associated with pregnancy. Despite the fact that lactation is a natural biological feature of pregnancy and birth, even for unfortunate women whose babies do not survive, the fact that its continuation requires effort apparently disqualifies breastfeeding as a medical condition. No protections for it are therefore recognized. In fact, the court documents even mention that because federal pumping laws include no provision for enforcement, the law is essentially invalid.

What does it mean for me?


So, that's where we've landed with this case: regardless of whether these particular rulings were correct, there is now a strong precedent in favor of employers who do not support breastfeeding mothers. Employers like Nationwide can exploit the physical and psychological condition of mothers like Ames, set unreasonable expectations for their use of lactation resources, and if they happen to overstep federal pumping laws, it's no big deal because those laws have no teeth anyway. While the headlines concerning this case are grossly misleading, it's absolutely true that the outcome of this case could have tangible negative effects on breastfeeding moms.

One last thing: there is a related case that ALL MOMS should follow for the effect that it might have on us. In Young v. United Parcel Service, a woman is suing because her doctor ordered a weight-lifting restriction during her pregnancy, but UPS did not honor it and demanded that she continue with the same duties as before. She refused, so she spent much of her pregnancy out of work, and ended up losing her insurance coverage. The Supreme Court DID take this case, and is currently deciding whether pregnancy and related conditions can be classified as temporary disabilities and accommodated accordingly, or whether mothers being treated as equals means they must perform the same work they would do if they were not pregnant. Since the status of lactation as a pregnancy-related condition is still in question, it could potentially fall under whatever ruling the Supreme Court makes. The outcome of this case will have significant consequences for working mothers, so keep an eye on it!

As always, we welcome your comments! Do you think the ruling in favor of Nationwide was fair?



Thursday, November 6, 2014

A Year in Review: Big Changes FAQ

Today, we continue our look back at a year of tips and nips (see what I did there?) from the Adventures in Breastfeeding team! Monday, Laura covered the most common questions we hear from moms at the beginning of their breastfeeding journeys, so now it's time to talk about what comes after that! Maybe you're still in the newborn phase and wondering what to expect as your nursling grows, or maybe you're a seasoned pro looking for advice on extended breastfeeding. Either way, we have plenty of great answers and personal stories for you fabulous mamas!


I'm going back to work soon and I'm so nervous! Will I still be able to breastfeed?

You can definitely keep nursing even if you work full-time! We have plenty of tips on how to establish a good pumping routine, the best pumping supplies to have on hand, and a VERY IMPORTANT overview of your legal rights as a pumping mom!
Know Your Rights: Pumping in the Workplace
Pumping Counts Too: A Working Mom's Story

Working Mamas Must-Have Pumping Supplies

I've got a handle on breastfeeding and would really like to rejoin normal society. What can I wear? What can I eat? Can I finally have a beer? Am I EVER going to drop this baby weight?!

Breathe, Mama: we've got you covered! There are plenty of cute clothes you can wear that make it easy to nurse your babe, and we have a wildly popular pumpkin spice lactation cookie recipe that even your non-nursing friends will be begging for. YES, you can have that beer, and probably another drink, as well! And definitely bookmark this great post on getting in shape while breastfeeding!
Nursing Wear for the Mama on the Go
Pumpkin Spice Lactation Cookies

Pumping it Up!

I've decided to nurse beyond a year, but I don't know anyone else who's breastfed for that long. What's it like?

What a wonderful thing to do for your child! Though it may not seem like it, you're in great company! Important things to consider if you're going to practice extended (or "biological") breastfeeding are: how to tell the difference between weaning and a nursing strike, knowing the facts so you can answer the skeptics, setting boundaries with an increasingly communicative and independent toddler, and whether to tandem nurse if another baby is on the way!

Everyone seems to have an opinion about my decision to breastfeed or nurse in public. I feel so alone sometimes....

We totally get it. That's why we talk about our first experience nursing in public (and later without a cover! GASP!), that time someone reported our beautiful nursing photo, and we highlight some of the amazing breastfeeding art and imagery out there.
5 Awesome Breastfeeding Posters
Phew! We've had a busy year with all these boobs and babies! And we have even bigger plans for next year! From the bottoms of our hearts, thank you so much for your interest, support, and incredible feedback! Please stay tuned this month for lots of fresh topics, giveaways, and more exciting changes!

And tell us what topics you'd like to see us cover on the blog, or contact us to become a regular or occasional author! Nurse on, mamas!

Saturday, September 27, 2014

Making Travel Easier for Breastfeeding Mothers

Have you traveled while breastfeeding, or more specifically, while pumping? I have a few friends who have and I give them huge props for being so organized! Having to remember to pack clothes, toiletries, and work items, in addition to a pump, storage bags, and a cooler makes my head spin just thinking about it. Wouldn't it be so nice if there was a special hotel package that took all this into account and catered to breastfeeding moms? Ladies, your prayers have been answered!

The Hard Rock Hotel in Chicago knows how difficult traveling without your nursling can be, so they created a package with you in mind. For an extra $30, the Hard Rock will provide you with everything you need to keep that liquid gold for your little one. The package includes a hospital-grade Symphony breast pump, everything you need to clean and sanitize it, nursing pads, breastmilk storage bags, ice packs, and a cooler bag. They will also make sure your room is equipped with a mini fridge and a microwave. In addition to all that, the concierge is available for anything else you might need, such as additional supplies or help shipping milk back home. The concierge team is trained on how to properly ship milk, and would be happy to help you get it back home without having to tote it through airport security.



The idea was launched on Mother's Day in 2013 and was the brainchild of Hard Rock Chicago's General Manager, Carrie Meghie. Meghie felt that this was important for breastfeeding mothers and, after doing research, was surprised to find no other hotels (at least in the US) offer a service like this. The icing on the cake? All proceeds collected from the additional fee for this package will benefit the families of local kids in the NICU. Now that's a win-win!

I think it's so great to see something like this and I would love to see more hotels follow suit! Who knows, maybe the Nursing Mother's Package will take explode in popularity and be available at hotels nationwide.

Share your thoughts with us. Do you like this idea? Would you pay extra for this package?



Information provided by The Chicago Tribune and Child Mode.

Monday, September 15, 2014

Mythbusters: Pumping Output as an Indicator of Supply

It's one of the first things a breastfeeding mother tends to worry about: "Do I have enough milk to feed my baby?"  It was only a few weeks into my now 19 month breastfeeding journey when my mom asked "Are you sure he's getting enough?  He wants to nurse all the time."  Of course I began to panic and wonder the same thing.  I was so lucky to have amazing and knowledgeable women supporting me as I pushed through those early months but, unfortunately, that's not always the case.

I'm a member of several online breastfeeding support groups and am involved in my local breastfeeding community as well.  I cannot tell you the number of times a woman has come seeking advice, often in a panic, because she didn't think she had enough milk to feed her baby.  Often she states that she can only pump "an ounce or two at a time - even if it's been a few hours since a feeding."

I'm not sure where this idea that a pump is a good judge of milk supply came from but ladies, hear this, IT'S NOT TRUE!!!  A pump is just a device that extracts milk from your breast.


 
And while technology is good, it's not good enough to really replicate the stimulation a baby at your breast as for your milk production and extraction.  There are so many things a pump can't duplicate such as the feel of you little one at the breast, the sounds he/she makes right before and during nursing and even the scent you baby has that bonds the two of you.

Just because you're only getting an ounce or two when you pump does NOT mean that is all your baby gets when he or she nurses.

If you are really concerned about your supply because of slow or  no weight gain or not enough wet/dirty diapers please contact an IBCLC to do a few weighed feedings.  That is a much better indicator of exactly how much your little one is transferring.

Also, it's important to note that as you move further and further into your breastfeeding journey, your ability to respond to a pump my decrease significantly.  Again, this does not necessarily mean your milk is "drying up."  As before, your little one is the best measure of an adequate milk supply.  And besides, the milk you produce for a toddler is much different than the milk you produce for a newborn and they often take much less as they get older and a variety of solids are introduced.

So let's stop this myth right now:  A pump is NOT a good indicator of your supply.  Listen to your baby and not an electrical device when trying to determine if your making enough milk to feed your little one!

Friday, August 29, 2014

Swirled, Not Shaken

As a breastfeeding mom, I'm more than certain you've heard the words "don't shake breastmilk!" at some point in your nursing journey. The logic behind this is that, when shaken, the proteins in the milk can be damaged and denatured. But is this fact or just a myth that has been perpetuated by time and word of mouth?

One anthropologist decided to delve deeper into this issue and has come up with some fascinating information. Because she clearly does a better job than I ever could, I'll let her tell it. The results might surprise you. After reading her results, does it change your opinion on shaking or swirling milk?

Does Shaking Really Matter?

Photo Source


Thursday, June 5, 2014

Breastfeeding Heroes: Princess Srirasm of Thailand

If there's one drum we beat repeatedly on Adventures in Breastfeeding, it's about the need of all women to have support on their breastfeeding journey. It is this fact that has led so many women (and some men!) to become Lactivists, putting themselves out in the public sphere to promote breastfeeding, normalize it, and assure all the mothers out there who struggle with nursing that they are not alone. Among the many stories I've found of these remarkable characters, a recent favorite is that of a bonafide princess: Srirasm, Princess of Thailand and Royal Consort of Crown Prince Maha Vajiralongkorn.

Princess Srirasm was a commoner who married the heir to the Thai throne in 2001, giving birth to their first (and so far only) child in 2005, Prince Dipangkorn Rasmijoti. Once recovered from the caesarian birth, Srirasm began nursing her son, and was so moved and impressed by the experience that within a few months, she launched an extensive campaign to promote breastfeeding in Thailand. The project, titled "Love and Care from Mother to Children" received the full support of the royal family, including the written endorsement of Srirasm's husband, the Crown Prince.

Source: Breastfeeding Situation in Thailand
While much of the available data on breastfeeding rates may be inconsistent or unreliable, most sources show Thailand in the 20th Century having the lowest rate of exclusive breastfeeding [for the first six months] in Asia, and among the lowest in the world. Estimates as recent as 1998 had the number hovering just above 2%. Studies blame everything from poor education and diet in rural areas to the growing influence of the formula industry, and cite consequences like higher rates of disease and lower average IQ scores for children. The Ministry of Public Health has made a number of efforts since the 1980s to improve breastfeeding rates, but as of 2006, the number was still a paltry 5%.

Enter Princess Srirasm and her adorable little boy. From its inception, the Love and Care project centered around this pair, with interviews, photographs, pamphlets, and posters appearing all over the country, featuring the growing and healthy young prince and his pretty, doting mother. Srirasm was not shy about her experience, answering personal questions about her fears of not producing enough milk, discussing how her own diet could upset the prince's stomach when she ate the famously spicy Thai cuisine, and even sharing just how large a stash of pumped milk she had frozen (50 bags by 4 months)! Aside from the obvious fact that, as royalty, she had access to much better resources than most Thai mothers, she seemed incredibly and wonderfully NORMAL.

And IT WORKED. As of 2009, studies now show a rate of exclusive breastfeeding in Thailand of at least 15%, and some put that number at 30% or higher. Though the same problems of methodology and sample size continue to make it difficult to collect reliable data, there is agreement from a wide range of reputable sources that there has been a marked increase in rates of nursing, and these clearly coincide with the active phase of Princess Srirasm's program. The Ministry of Public Health is so encouraged by their success that they have pushed aggressive new policies to attempt to meet reach goals of +50% exclusive breastfeeding by 2025.

Of course, not all of us have access to a microphone with national or global reach, but I still find the princess' story inspiring. She used the resources with which she was blessed to reach out to fellow mothers, and she succeeded in making that connection and effecting a change in the culture. Given the well-documented positive health effects of breastfeeding, this could have a direct and powerful impact on the future of Thailand.

And if any of you nursing mamas have ever wanted a reason to feel like a princess, well, now you have one! Well done, Your Highness!

Sunday, May 25, 2014

You get your milk from where? 3 Myths about milk-sharing

On May 10th I felt lucky to participate in the Best for Babes 1st Nation Wide Milk Walk, to bring awareness to the importance of human milk and milk banks.

Why is this such an important cause? Because there are still a lot of myths and misunderstandings about milk donation.

Myth #1 - It's Weird
Donating or recieving breast milk is no more weird than pouring milk on your morning cereal. Cow milk is for baby cows, human milk is for human babies. It's just that simple.

Myth #2 - It's not safe
There are 2 ways women share milk: either through milk banks or mother to mother. When going through a milk bank there is a screening process to even become a donor, just like there is a screening process for blood banks. I have personally donated mother to mother. I expected the mom I was donating to to ask me questions about my diet. lifestyle, etc. What she told me was "I have seen you give your daughter this milk, that's enough for me." Whatever your comfort level is, there is a safe way to get milk. The argument could also be made that formula can not be safe in certain situations either. There have been numerous recalls, and if not made properly, it can be harmful.

Myth #3 - It's not Important

The WHO recommends that when it comes to feeding an infant it should be

  1. breast milk from the breast
  2. pumped breast milk
  3. donated breast milk
  4. formula

Formula is LAST. Breast milk can not be replicated. There are over 100 ingredients in human milk that are not in formula.

Human Milk Saves Lives. 500 U.S. & Canadian preemie infants die annually, and 5000 more are sickened, from Necrotizing Enterocolitis (NEC). Feeding these fragile babies human milk has been shown to reduce the risk of NEC by 79%. NEC causes indescribable anguish to babies and parents. - See more at: http://www.bestforbabes.org/miracle-milk-stroll/#sthash.DITW1i6O.dpuf



At the end of the day, I have felt a special bond with these moms that I have been able to donate my milk to. After the walk, a friend and I decided to get lunch at a local farmers market. We were both still clad with our " I make milk" and "I donate milk" stickers when a woman stopped us and said "Thank you! Because of women like you, my son is alive." Pumping is hard work and I applaud any mother who does so. Pumping for the love of a baby not your own is a gift unlike any other. I can't wait for next year's walk.
My Friend and I half way through the walk

Thursday, April 3, 2014

3 Booby Traps That Almost Ended Our Breastfeeding Relationship

I knew nothing about breastfeeding when my son was born. The problem with that is that, since nursing is a supply-and-demand system, any mistakes or attempted shortcuts can lead to the relationship ending much sooner than the mother would prefer. While I was usually able to course-correct pretty quickly when I realized my errors, the truth is that there was a lot of luck (and, let's be honest, stubbornness) at work in our ultimately successful breastfeeding relationship, not to mention an active and well-informed support network of mamas.

Here are the 3 "Booby Traps" that tripped me up, along with a few tips to avoid them yourself!

1. Cluster Feeding? What's that?
I left the hospital with a packet of breastfeeding information that I barely skimmed before heading home to cuddle my newborn in idyllic domestic bliss.... only to discover that not only did my baby not want to eat for 30 minutes every 3 hours, but he wanted to be attached to my boob nonstop for 4 hours at a time. Any attempt to remove him was met with screaming. Sometimes he would calm for a few minutes and I would think he was finally satisfied, then he would start crying again and not calm until I put him to my breast. I didn't understand how he could still be hungry, or how I could still have milk after it appeared that he had emptied both breasts. Deciding that he must just be comfort-sucking (and needing a break for my poor aching nips), I gave him a pacifier at just 4 days old. This seemed to work, but when we learned his weight gain was much too slow, I began to doubt.

In time, I learned that my new babe was cluster-feeding, and that this non-stop need to nurse actually served the vital purpose of establishing a solid milk supply. I was also told that newborns metabolize breastmilk so fast that they need to nurse again shortly after in order to get all the calories and nutrients they need. In retrospect, it's clear that I was risking my supply by replacing the breast with a pacifier so early, and that I was hampering my child's weight gain by not offering my milk as often as he wanted it.

2. Skipping a Night Feeding
As any new parent knows (and yet, nothing can prepare you), caring for a newborn is utterly exhausting. Having that infant constantly attached to your breast? Even more so. So, it wasn't long before I felt that I needed a break. As detailed in a previous post, I found myself one night feeding my baby a bottle of formula, and going to bed: I was absolutely desperate for even one hour of sleep. This happened several times, and even after I stopped giving formula and started giving pumped milk instead, I regularly missed a night feeding and had my husband give a bottle instead.

I now know that missing feedings so early or at all is to seriously jeopardize the breastfeeding relationship, but I didn't learn until recently that night feedings in particular are especially important. Not only does night feeding promote milk production, but nighttime milk is actually much richer and denser in nutrients than daytime milk. Even though I was replacing the missed feeding with an earlier pump to counteract negative effects to my supply, by skipping the nighttime feeding, I was withholding from my baby much-needed nutrients and fat that would help him grow and be healthy. Furthermore, since a pump is not as effective as a suckling babe at removing milk from the breast, the replaced feeding was probably still impacting my supply. Worst of all, the whole reason I was missing the feed-time was to get some sleep, but studies show that cosleeping moms actually get more sleep than non-cosleepers! I could have fed my baby more and gotten more rest!

3. No Paced Bottle-Feeding
It started harmless enough: I was pumping more than my 2-month-old was eating in a day, so when our daycare provider told us he was eating more, I thought "No problem" and started sending extra ounces with him. Then they kept asking for more, and more, and more, until I was sending at least 20 ounces of pumped milk for a 10-hour separation. I could only pump 16 or so ounces a day, so I was having to fit in extra pumps at night and dip into my meager frozen stash to make up the difference. It was stressful and exhausting, and still it seemed he wanted more. Before long, we decided to move up to a faster-flow nipple on the bottles. One day, I learned that he had had 25 ounces that day. I felt the end was near.... I would never be able to keep up with that pace.

Then, disaster struck: I got laid off. My mostly bottle-fed baby suddenly became an exclusively breastfed baby, and his fury at and rejection of the "slow flow" of my breast made me suspect that he had developed a bottle preference. Someone recommended this Expressed Milk Calculator on Kellymom, and I learned that we had been WAY overfeeding our kid.

A breastfed infant needs an average of 25 ounces of breastmilk in a 24-hour period..... and that's what we were feeding in only 10 hours! A baby does not have to work as hard for milk from a silicone nipple as he does from a breast, so many of them also develop a preference for the bottle, as ours clearly had. While I'm certain they meant well and it was my responsibility to be informed, clearly the daycare had been using feeding as a pacifier, and had I not lost my job, we probably would have needed to start supplementing, which could have led to our nursing relationship ending much sooner than either of us wanted. My layoff was a blessing in disguise, but many mothers remain unaware of the effects of overfeeding, as do well-meaning caregivers.

And Yet....
In spite of all these Booby Traps and the many other trials we have faced on our breastfeeding journey, we recently passed a full year of breastfeeding and are still going strong! If you've fallen victim to a Booby Trap, don't give up! Your body and baby are designed to do this, and with the right information, you can still have a healthy and rewarding breastfeeding relationship!

Monday, March 17, 2014

You Can Drink That?!

March is the month of one of the "booziest" holidays of the year, St. Patrick's Day.  It also ushers in spring and summer, which are great months for sitting on the porch and having a glass of wine with a neighbor or your significant other.

But you're a breastfeeding mom so the only thing green you'll be drinking is your kid's Kool-Aid and you'll have to get your grapes from grape juice, and not the fun kind, right?!

Or, even worse, you'll have to hook yourself up to that torture contraption known as a breast pump and at the end of your 15 minutes of pumping dump all that liquid gold down the drain.

WRONG!

Now, we're not advocating on behalf of the alcohol companies and we're not saying you should go out and get extremely intoxicated and then go home and nurse your baby.  What we are saying, is that you don't have to give up that glass of wine and you can certainly enjoy a green beer without concern.  We are also saying that you absolutely do NOT need to dump your pumped breastmilk after a drink, or even two.



The rule of thumb is that if you are sober enough to drive a car, you are sober enough to feed a baby and the amount of alcohol in breastmilk peaks at 1/2 hour after drinking.  According to kellymom.com, less than 2% of the alcohol a mother consumes actually gets into her blood stream and milk supply. Alcohol leaves the milk as it leaves the blood - so when your blood alcohol levels are back down, so is the level of alcohol in your milk.

And who doesn't love the Jack Newman Facebook post that has gone all sorts of viral that talks about a study a mother did in a toxicology laboratory regarding alcohol levels in breastmilk.  You can find the whole post here, but the end conclusion is that percentage of alcohol she found in breast milk after consuming one mixed drink OR half a beer and two 6oz glasses of wine is so negligible that it is unlikely to have any adverse affects on a baby.

Now, you should keep in mind the age of the child when making the decision to drink or not.  An older infant or a toddler will be able to process any alcohol that does enter their system via breast milk much easier and faster than a baby that is only a few weeks old.  

Also, please remember that while the amount alcohol that may pass to your child is small and will most likely not hurt them, it could effect your judgement and ability to properly care for your baby.  Keep in mind that if you are co-sleeping and breastfeeding it is advised that you not drink before putting a child in bed with you.  And while I've never experienced this, I can't imagine a hangover and a baby go very well together!



So today I raise a glass to you, fellow breastfeeders. Now go and enjoy that green beer guilt free!

Tuesday, March 11, 2014

Breastfeeding and Jury Duty

 
a few months old

Literally the day I came home from the hospital with my daughter I had a summons in the mail for jury duty.  Insert freak out.  I immediately called and got it delayed as long as I could because I knew I wasn't ready to leave my days old baby.

Fast forward a year and it was my time to serve.  I was pretty nervous about being able to pump- would they tell me tough luck, would they make me pump in the bathroom, would I be allowed breaks at all?
a year later

Some states will allow you to get out of jury duty if you are a breastfeeding mother (check out if your state is one of them here).  New York is not one of those states, so I showed up at the courthouse with my pump in hand, ready to serve my civic duty.

After waiting in line, going through a metal detector and watching a video my name was called to be a potential juror.  I was escorted to the building next door where a judge informed us that we were being interviewed for a 3 month long trial.  THREE MONTHS??  My heart started pounding.  Technically there was nothing preventing me from serving, and I raised my right hand and promised I would be honest during the selection process.

I was brought back into the judge's chambers where about ten different lawyers surrounded me.  The judge said he'd heard every excuse in the book at this point (he'd already met with over 200 jurors) and wanted to know what mine was.  I told him I had none and I was fit to serve.  I just asked that I could have two breaks a day to pump.

He told me that wouldn't be an issue at all, by law I was allowed to pump.  And get this- he even told me by law I was allowed to bring my daughter and breastfeed her in the court room.  How cool is that??

It turns out I wasn't chosen for that case for other reasons, and was sent back across the street to sit in the jury waiting room again.  By this point it was time for my first pump of the day, so I went to the front of the room and asked where I could pump.  I was taken into an office where they let me pump, no issues at all.

Lunch time came, I went outside and got some food and fresh air and resumed my waiting in the juror's area.  I pumped again in the afternoon with no issues.

Honestly, the only bad part was I had forgotten an ice pack and didn't want to dump that precious milk.  So I got creative and bought sodas throughout the day from the vending machine and stuck it in the cooler bag with my milk.  Did an impressive job of keeping my milk chilled!
back home after jury duty with a milk drunk baby

Overall it was easy peasy, and I had worked myself up to think I'd have all kinds of issues.  I actually quite enjoyed my time sitting in the juror's waiting lounge.  I had no one at work expecting me to get back to their emails and I didn't have a little one pulling at my computer plug or trying to snatch my phone.  I feel good that I performed my civic duty even though I wasn't chosen for a case.

See ya next time, jury duty!

Milestones and The Top Five

A few weeks ago, we hit the goal we had been working toward for the last year. That's right, we made it! One year. Slow weight gain. Working twelve hour shifts. We made it. No formula, just mama's lovely, albeit skim, milk. I posted previously about my son starting to wean and that has progressed a bit but there are still days that he wants to nurse all day long and I'm totally fine with that. I told my husband today that I thought he would nurse til he turns two, to which he replied, "Are you surprised?". This leads me to my favorite top-five ever. The answers to the question I have been getting since we reached that year mark:

How did you do it?

5. Find a breast-friendly pediatrician

     While this is not number one on my list, I cannot stress how important this is. I've probably mentioned
     a handful of times now how big of a role our pediatrician played in our breastfeeding success. Find a
     pediatrician that you trust. Find a pediatrician who has positive feedback from breastfeeding mothers
     in your area. There are pediatricians in my are who are wonderful and sweet, maybe have shorter wait
     times in the office, but who would have encouraged supplementing in a heartbeat with my son. We
     went for my son's one year check up last week and the pediatrician laughed at the growth chart. Literally
     LOL'd. Maybe it's because it resembles a stock graph or something totally unrelated to infant growth or
     maybe because he was right. Remember I mentioned that our pediatrician, while my son was hovering in
    the second percentile for months, told me not to sweat it and around 6 months he would shoot up? He
    did. He jumped from the 2nd to the 23rd then at a year, he jumped to the 64th percentile for weight. We
    never supplemented with formula and we started solids slowly at 6 months, per the recommendation of the
    AAP. I trusted him and he trusted my body and my choice to EBF. He was a great fit for our family. At
    the end of our appointment, he asked if C was still a breast guy and I said yes. He said that was great and
    that we were in no hurry to wean. Swoon.

4. Don't be afraid to ask questions.

     No one expects you to know all of the answers. I tell first time moms in the hospital all the time: You
     have never done this before and neither has your baby. It is a learning process for both of you and every
     time you sit down to feed, you will both learn something about feeding and each other.

     There is no shame in asking questions. Reach out. Reach out to moms who have done this before you.
     Reach out to moms who will keep it real with you. Positive feedback is great, but if you are doing
     something that will be detrimental to your nursing relationship, it helps to have someone you can count
     on to help bring you back to center. One day, it will be your favor to return and you'll be grateful that
     you asked questions so that you can pass on the wealth of knowledge you have acquired.

     Asking your gal pals is a great idea but these gems will become your best friends:


     Kelly Mom also has a Facebook page and there are many other social media pages that serve as great
     and informal resources on lactation. Please remember that advice given by friends, bloggers, etc. is 
     wonderful and generally accurate, but it does not replace that of an IBCLC, MD or other professionals
     trained in lactation. 

3. Stand your ground

     You know your baby and your body best. If you aren't comfortable giving your baby a pacifier, don't
     If you aren't comfortable leaving your baby with grandma to take a bottle so you can get some sleep,
     don't. Are you keeping track of wets, dirties and temperament and know that your baby is getting
     enough despite what feels like the rest of the world telling you otherwise? Tell them to shut it! Are
     there times you are going to want more sleep and that bottle will sound tempting? Absolutely. Just
     remember that you made this choice and you are the only one who can decide to go the other route.
     

2. Trust your body.

     Yes, there are women who, for various physiologic reasons, are unable to produce breast milk. The
     odds that you are one of them? Slim. Women tend to start doubting themselves when babies don't
     latch right away, aren't sleeping through the night when other babies of the same age are or may not
     have regular dirty diapers....or a plethora of other reasons. Remember: You were made for this! 
     Women are designed to lactate for our young. Am I saying there won't be stumbling blocks or that
     this beautiful and natural thing will come as easy as your natural labor - oh, wait...just keeping you on
     your toes! There will be times you will doubt your ability to produce wonder food for your baby and
     you will question the strength of your body and mind - nurse on. You've got this!        

1. Surround yourself with people who are supportive of your choice to exclusively breast feed.

    I tell moms in the hospital all the time: You will get a ton of feedback and advice about breastfeeding -           mostly from women who have never breastfed. There are so many support resources available:

    Adventures in Breastfeeding (ofcourse!)
...as well as local hospital and community
based support groups.

     Becoming socially accountable for reaching breastfeeding goals goes far. I refer to it as positive peer
     pressure. Of course, there is nothing wrong with giving medically indicated formula, but there is something
     about knowing how your friends will react if you were to bring a bottle of ready-to-feed to a play date
     that keeps a breastfeeding mom motivated to trudge forward, even in the hardest growth spurts or
     sleepless nights.

I am so thankful to have come this far in our nursing journey and cherish each session now. The hardest thing is knowing that any day now I could nurse my sweet boy for the last time but the best thing is knowing how far we have come. When you doubt yourself, remember that you can do this. 

Til next time, mamas...

Keep calm and nurse on.



Thursday, February 13, 2014

Top 8 Apps for Breastfeeding Mamas


Wether you're a brand new breastfeeding mama or a veteran with a gymnurst swinging from your boob, everyone needs something to pass the time every now and again during a nursing session. Here are our top rated, breastfeeding mom approved apps for 2014.


Facebook
#8 Facebook- I know, you most likely already have this one, but it warrants a spot. I've been able to catch up on a few of my favorite blogs, get some much needed advice from my breastfeeding support group, and find some encouragement at 3 AM thru Facebook chat. This one is an oldie, but a goodie (isn't it weird that Facebook is now considered kind of old…they just celebrated their 10 year anniversary).

Kindle
#7 Kindle- Have you ever tried holding a paperback over your head with an attached nursling? I have, for about 5 seconds. Have you tried pumping and holding a paperback above your double-electric pump? I have, (wait for it…) for about 5 seconds. It's just not comfortable and turning pages is like a circus act! I've devoured the entire Hunger Games Trilogy, numerous parenting books, and a few self-help books via my Kindle app. This one is a no brainer!

Pinterest
#6 Pinterest- Who doesn't love Pinterest? Pinterest is a bit like Narnia. Once you're in you never want to leave. If you're not already an avid pinner, I recommend it for finding lactation recipes, family meal planning ideas, and preparing for our little one's birthday parties. This one isn't some big revelation, but certainly worth considering during a Midnight feeding. 


Amazon

#5 Amazon- This one just might be my absolute favorite. It is not, however my bank account's favorite! It sometimes feels as if I'm playing a video game named "Buy All the Things". I've since found that the "save for later" feature is my friend so I can "shop" without actually buying. Then again… it is really fun to have presents delivered on the daily :) Seriously though, Amazon can really save you in a pinch if you need a new set of Bamboobies, a nursing bra, or pump parts and don't have time to get to a store.


#4 Feed Finder- Ah ha! A new one, folks. This app was created in the UK for nursing mums to find and share suitable breastfeeding locations. It's made it's way to the United States, but will take a little effort from all of us to get it going here. Once you've found a breastfeeding friendly location you can add it and rate it. It's sort of like Yelp, only for breastfeeding. Love it! 





#3 LactMed- Have you wondered if Robitussin is safe while breastfeeding? Or if Robitussin isn't safe, then what can you take? Most of us have had some medical situation arise where we just don't know and truthfully our average doctor doesn't always either. LactMed is the answer. It's a database of drugs and supplements that may affect breastfeeding and is part of the National Library of Medicines Toxicology Data Network. Basically, it's totally legit and you should use it instead of asking everyone you know on Facebook.





#2 iBreastfeed2 by Medela- Finally, a one-stop-shop for all things breastfeeding! If you're looking for an app that provides quick links to resources, an activity tracker, storage and feeding recommendations, breastfeeding friendly location finder (it should be noted that this is also in the early stages, just as the other app is), breast pump recommendations, and more… Look no further! This app has it all!

                                                   

#1 Netflix- Perhaps you're resting from a nasty case of mastitis or you're pumping at work and in great need of mindless activity. Netflix is your friend. Why not watch every episode of Gossip Girl or Scandal or Breaking Bad or Downton Abbey? Not that I've done that or anything. I'm busy. You could though…






What did I miss? What's your favorite app that helps you get thru the day?