Sunday, June 13, 2010

When the milk comes in...

In my last post on breastfeeding I talked about the early days of breastfeeding. I left off on the topic of ENGORGEMENT; the wonderfully painful experience you will have when your milk comes in!

As I mentioned in my last post, your milk will come in 2-4 days postpartum. This can be a very painful 24-48 hours, but push through because, just like labor, the pain of engorgement won't last and the reward is huge!

Engorgement is best described as a period of time in which your breasts feel very full and tender and your nipples are very sensitive. If fact, when you baby latches on, it will literally make your toes curl and you will want to scream. Don't worry, this sensation does go away after a few minutes of nursing! The absolute best treatment for engorgement is to nurse. Letting your nipples air dry and applying a nipple cream after nursing will also help. There are many old wives tales regarding things you can do to relieve engorgement, but nursing every 2-3 hours is the best and recommended solution. (It is actually the case that hot packs, warm showers and many other suggested treatments actually make engorgement worse rather than better.) I can't stress enough how important it is to make sure you are feeding baby frequently during this time. Milk production works by supply and demand and if you are not feeding baby (or pumping) every 2-3 hours during this time, your body will not produce enough milk.

During this time, your areola may be hard which makes it difficult for baby to latch on properly. If baby does not latch on properly, you will end up with traumatized nipples. If you need to express a little milk to soften the areola before feeding to make latching on easier for baby, do so! If you are experiencing pain in your nipples after the first few minutes of nursing and/or are experiencing any kind of pain in your breasts make sure you consult your doctor because there are a number of things that could be wrong (plugged milk ducts, breast infection).

Make sure you buy some breast pads before you deliver. Chances are pretty good that you are going to need them although some lucky women never d0. I used them day and night for the first few months. I was eventually able to stop using them because I no longer leaked during the day. I still occasionally leak at night, but not often enough to wear breast pads to bed. There have been nights when I have woken up and had to change my shirt, but that usually corresponded with times when my daughter went longer than normal between feedings.

I would love to be able to tell you that you are in the clear after the engorgement period is over, but that most likely will not be the case. Breastfeeding is hard work and it requires dedication on your part. I had been breastfeeding for 4 months or so before my body and daughter finally "figured it out". Mind you, I have never experienced anything like the pain of engorgement and things have definitely gotten MUCH easier, but there have still been a few bumps in the road which I will talk about in my next post.

Wednesday, June 2, 2010

Leaving My Baby for the First Time

I am only a couple of weeks away from having to leave my baby with someone other than her father for the first time. My sister is getting married, I am the matron of honor and my husband is the Master of Ceremonies which is going to leave little time for parenting. We are planning on bringing Lilah to the ceremony, but just before the dinner starts my husband is going to be taking her to her grandparent's place for the rest of the night.

I completely trust that her grandparents will take excellent care of her (after all, they did successfully raise 6 babies of their own, my husband included), but despite this, I am having a lot of trouble with the idea. Is this a struggle that every new parent goes through?

I don't know that I would be so stressed out about it if it was only going to be for a couple of hours during the day, but bedtime is a complete different story. For 5 months now, she has been getting used to our bedtime routine. I always feed her in the same place, sing her the same songs and put her down the same way. I keep wondering, is she going to fall asleep after being fed from a bottle by someone other than her father (which has also never happened before)? Will she fall asleep without her songs and in a strange place? All of these questions are floating around in my head and causing me to loose sleep.

I know that in the end, everything is going to be just fine. This is most likely going to be much harder on me than it will be on her. I expect that she will take a bottle from her Papa just fine and that she will fall soundly asleep in her playpen as if it were any other night. When she wakes up for her first night-feeding, her daddy will be there to give her a bottle and for subsequent feedings, I will be there to nurse her.

I am sure that after we have done this once, it will get easier. I don't fault myself for wanting to be there to take care of my baby and I expect that all of this is a perfectly normal stage that all loving, attached parents go through. I just wish the rational part of my brain would communicate all of this to the worry-wart mother part of my brain so I could stop stressing out about it so much!

Sunday, May 30, 2010

Poor Bumper Pads

As many people know, bumper pads are not recommended. The main reason is that they are thought to increase the risk of SIDS. They can also lead to entanglement, entrapment, strangulation, and suffocation. Historically bumper pads were used because the slats on cribs were wide enough for infants to stick their heads through. Crib design standards have changed dramatically since then, but the traditional bumper pads have stuck around.

Clearly the risks of bumper pads outweigh the benefits and, therefore, I do not have bumper pads in my daughter's crib even though her bedding set did come with them. The biggest problem I am currently having due to the absence of bumper pads, however, is my daughter very regularly sticks her arms and legs through the slats and gets stuck. She is still too young to be able to get out on her own so she screams until we come and rescue her. I can't tell you how scary it is to be woken in the night by a baby who is screaming because there is genuinely something wrong! My heart practically leaps out of my chest and one of these days I am going to seriously injure myself dashing to her room in the dark!

Health Canada reports that "serious injury is not likely when a child puts his or her arms and legs through the crib slats. The baby will either remove their arm or leg from the slats if possible, or make enough noise to alert a parent for help."

This is good to know, but does nothing to solve the problem. Apparently there are new mesh bumper pads on the market that are much safer. They are not nearly as nice looking, but they are safe. Had I known this arm/leg getting stuck thing was going to be an issue and of the existence of such a product, I may have considered purchasing mesh bumper pads in the first place. If you are in the process of setting up a nursery, this might be something to consider.

By the way, I am still searching for a creative way to make use of the bumper pads that came with my daughter's bedding. One cute idea that I came across was to cut the sections apart and sew them together into a soft book. I might give this a try and I will post pictures if it is a success.

Pacifier Use vs. Thumb Sucking

There are several very hotly debated parenting issues out there, one of them being the thumb-sucking vs. pacifier use debate. I personally chose to go the thumb-sucking route and, therefore, this post will come across as biased toward thumb-sucking. That being said, if you have decided to go the pacifier route, I don't think that you made the wrong decision and by posting on this topic I am by no means trying to suggest that.

The Research

Both the World Health Organization and the United Nation's Children's Fund are but two organizations that strongly discourage the use of pacifiers because it is perceived that their use leads to early weaning in breastfed babies. There are numerous studies that support this perception which suggest that pacifier use is associated with fewer and shorter feeds and a shorter duration of breastfeeding, but that the same correlations are not found for thumb-sucking.

More recently, research has begun to suggest that rather than pacifier use being the cause of early weaning, it is a marker for breastfeeding problems or a reduced motivation to breastfeed. Generally speaking, mothers who introduce pacifiers tended to be those that breastfeed less often and experienced breastfeeding problems rather than pacifier use being the cause.

Although research now suggests that pacifier use does not cause early weaning, there are a number of other factors to consider when making the decision of which to use.

Which is easier to give up?

There are those that believe getting rid of the pacifier is easier because you are in control and can simply throw the pacifier away whereas the same can not be done with a thumb which is in the baby's control.

There are others (like myself) that believe giving up the thumb will naturally occur as long as a baby's sucking needs are appropriately met during early infancy.

Being a new mom, I have no experience with either situation. It will be interesting to see if and when my daughter naturally gives up her thumb.

The Pros and Cons (Okay, so there are only cons for the pacifier...LOL!)

Pacifiers

Pacifiers can be beneficial for getting through the period of time when babies experience an intense need to suck. Around the 2 month mark, my daughter had a week where she seemed to want to suck around the clock. I tried to nurse her as often as she wanted, but I started to feel like a human pacifier. It was pretty intense and my husband and I debated giving her a pacifier at this time. It was tough to get though the week without it, but when the week was over, the intense need to suck seemed to disappear.

Pacifiers can also be a sanity saver with very colicky babies when you need a break from the crying or when flying to help baby's ears to pop.

But...

Pacifiers used at bedtime to put baby to sleep can interfere with baby learning to fall asleep on his/her own. In addition, sleep could be interrupted if the pacifier falls out in the night and baby can't fall back asleep without it (unless you are planning on getting up to put it back in).

It has been found that infants that use a pacifier long-term (into toddler hood) are more likely to have ear infections and develop misaligned teeth than those that are not given one.

I also personally dislike the way a pacifier looks in a baby's mouth. When we do give my daughter a pacifier when we fly, she doesn't even look like my baby.

The Thumb

The thumb is always there when baby needs it and can easily be taken out when baby wants to communicate. Enough said, I honestly can't think of any disadvantages.

I don't think using a pacifier occasionally is a bad thing. If you do go the pacifier route, make sure you use it in moderation, only when baby really seems to need it and don't offer it past the 6 month mark to prevent dependence. Please don't become one of those parents that puts in the pacifier at the slightest hint of fussiness rather than consoling and trying to figure out what is actually wrong with baby and don't use it to put baby to sleep instead of cuddling. Your baby needs you, not a substitute.

Saturday, May 29, 2010

The Early Days of Breastfeeding

There a several myths out there regarding things you can do to get your nipples ready for breastfeeding. Myths are exactly what they are. There is nothing you can or need to do to get your nipples ready for breastfeeding. The only recommended steps are:

1) Wear a supportive bra (nursing or otherwise) without underwire. Bras with underwire have been known to lead to plugged milk ducts and breast infections. I personally found any bra with underwire to be very uncomfortable in the last months of pregnancy anyway and could not imagine having worn one in the early weeks of breastfeeding. I found cotton nursing bras without any bells and whistles to be the most comfortable. As I mentioned in an earlier post, you may want to buy at least one nursing bra ahead of time. It is generally safe to buy one towards the end of your pregnancy because your breast size will not significantly change any more. You will eventually need more than one, but you can hold off buying more until you decided which ones you like.

2) Avoid washing your nipples with soap when you are in the shower as this can dry them out.

That's it! There isn't anything else you can/should do.

One of the most important things you can do to get ready for breastfeeding is educate yourself about what to expect and what is normal and abnormal. The more educated you are, the more enjoyable your breastfeeding experience will be. I highly recommend the book The Nursing Mother's Companion by Kathleen Huggins.

It is also a good idea to attend a prenatal breastfeeding class. I did a lot of reading beforehand so I didn't really learn anything new from the class, but they provide you will a ton of resources in your community that you can access of you have any questions or problems.

Breastfeeding can be one the most amazing experiences of your life. The bond that it creates between you and your baby is incredibly rewarding. I have had a wonderful experience and absolutely love it. That being said, breastfeeding is by no means easy and it requires a huge commitment on your part.

The first few days are particularly hard. Initially, just getting baby to latch on properly is a big challenge. Although babies are born with the rooting reflex, both you and your baby have to learn how to breastfeed. The nurses in the hospital should help you with this because it is really difficult to manage holding your newborn baby and getting him or her to latch on to your nipple all at the same time (I would recommend a Boppy pillow). Don't get frustrated because after only a few nursing, things start to get easier.

As a side note, make sure you let the nurses know that you want to breastfeed for the first time as soon as possible after giving birth. Infants are usually incredibly eager to suck within the first two hours after birth and this is a perfect time to get the learning ball rolling. Studies have shown that the longer you wait, the less successful breastfeeding will be. Also be sure to avoid giving your baby a pacifier in the early days of nursing. This can lead to all kinds of nursing problems such as latching problems and early weaning and ear infections down the road (more on pacifier use later).

Until your milk comes in (generally 3-4 days postpartum), your baby will be drinking colostrum. This is thick and yellow and it is the most important substance you will ever feed your baby. It provides your newborn with all kinds of antibodies, prevents bacteria from entering baby's intestines, stimulates baby's bowels and can reduce jaundice just to name a few of the benefits. It may not seem like your newborn is eating very much, but know that a newborn's stomach is very small and they are getting what they need.

Newborn babies need anywhere from 10 to 45 minutes to complete a feeding. There is a lot of misinformation out there about this topic. Do not restrict your nursing time. Many people believe this helps to reduce nipple soreness, but that is not the case. Sore nipples are caused by improper positioning. There is no truth to the myth that it takes the a certain amount of time for the breast to empty either. You should let your baby nurse for as long as he/she wants. Not doing so will frustrate your baby and can lead to more engorgement down the road. When your baby is finished, he or she will let you know by letting go of your nipple. This is the absolute best way to end a feeding. If you do need to break the suction for some reason, make sure you do it properly by sliding your baby finger into the corner of your baby's mouth until you hear the release. You will be amazed at how strong the latch can be and if you don't break suction properly it will hurt!

Until your milk comes, your newborn will be nursing very frequently. At a minimum you should make sure you are nursing at least 8 times in a 24 hour period. The general rule of thumb is don't let your baby go more than 3 hours between feedings during the day and more than 4 hours during the night. This means you may have to wake your baby if he or she is very sleepy which newborns tend to be in the early days. When your milk comes in it is very important to make sure you are nursing every couple of hours to ensure a good milk supply. When your milk comes in, be prepared. This can be an rough 24-48 hour period. More on that in my next post!

Friday, May 28, 2010

The Challenge: Finding time to have a shower!

I am sure that all new moms will agree that finding time to have a shower is a challenge.

In the early months, I didn't feel comfortable jumping in the shower while my daughter was sleeping because I never really knew how long she was going to sleep for and I didn't want her lying there crying until I got out. Our bathroom is right beside my daughter's nursery and I was also worried that the noise would wake her up after I had finally got her to sleep.

When I asked for advice, almost every single mom that I talked to told me to just put her in her bouncy chair outside of the bathroom door where I could still see her. What a great idea! Now my advice to every new mom is - invest in a bouncy chair and turn shower time into a fun game of Peek-A-Boo.

BUT...

The bouncy chair worked great until recently because now my 5 month old daughter is too big and strong for her bouncy chair. Now what?

She can't crawl yet so my new plan is to put her on her playmat within sight while I take a shower. This might work for a few months, but when she starts to crawl I have no idea what I am going to do with her!

She is a much more consistent napper and I know roughly how long she is going to sleep for so I suppose I could start to take showers while she is sleeping. I am also far less worried about her lying there crying because she doesn't usually wake up that way anymore. For the most part, she is perfectly content lying in her crib awake for a short time.

I guess this is where a playpen or pack-and-play comes in handy. We never invested in one because they are incredibly expensive and I didn't think we would get enough use out of it to make it worth the money. I don't think having it just for the purpose of taking a shower justifies the expense.

Anyway, I guess I will just have to continue to come up with creative ideas for taking a shower!

Happy Showering!

Wednesday, May 26, 2010

Getting ready to start solid food!

The countdown is on! We are only a few short weeks away from the big day...the day Lilah starts solid food! I am very excited about the big event.

This past weekend, I did some on-line shopping for the supplies that we are going to need. Any day now, infant spoons, bowls, sippy cups, ice cube trays with lids, and snack containers will be arriving at my door! Yes, I do get excited about the little things in life.

I plan on making all of Lilah's baby food and I can't wait to get started. My mom gave me a great book, The Healthy Baby Meal Planner - Mom-Tested, Child-Approved Recipes for Your Baby and Toddler. It was written by a woman named Annabel Karmel. She is a mother of 3 and has written 16 bestselling books on cooking for babies so she knows what she is talking about (www.annabelkarmel.com). The book has a very thorough introduction that talks about the best first foods, nutritional requirements, allergies, and preparing baby foods. Chapters on first-stage weaning (the 6th month), second-stage weaning (7-9 months), feeding your 9-12 month old, and feeding your toddler follow. There are over 200 recipes in the book as well. The thing I love about the book the most is that it includes meal planners (The First Tastes Meal Planner and The First Tastes Accepted Meal Planner). Our debut foods are going to include rice cereal, carrots, sweet potatoes, pears, apples, and butternut squash! SO EXCITING!

Now, if only Lilah could be as excited about this as I am!