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24 March 2013

What I Wish I'd Known About Nursing & Pumping

I'm not sure if it's just spring or that I'm at that optimal age for our generation between having completed grad school a few years back and so actually earning more than $50K per year, and still having the physiological capability to bear children, but whatever the cause - I know a LOT of pregnant women right now, and they all plan to work after giving birth. And as we say en espanol - ?como no?! The way the world is now the vast majority of families are going to have to engage both parents in out-of-home work. So, I interrupt our discussion about paid care leave to share with you what I've learned about nursing.

A lot of the soon-to-be-new-moms are, however, giving birth for the first time, and  a few have asked me about breastfeeding. Most people cannot believe I nursed full-time for a year and that my son didn't quit nursing until he was 17 months old while I also worked full-time and hour from home. (Yes, pat on the back.) Now, I'm not crazy, I'm just irrationally tenacious when I'm committed to something. I guess some people would say that's the same thing, but the silver lining is this - you only have to be crazy to figure this stuff out... a perfectly normal person can use all my tips and remain certifiably sane.

So, here's how you do it (partners, dads, and caretakers, it's good for you to know this stuff, too)... and I'm going to state both the obvious and not so obvious:
  1. If for any reason you have a hunch that your child's latch is not right - call the lactation specialist sooner rather than later, i.e. before two weeks after birth. (Bleeding, discomfort and an insatiable baby are tick-offs.)
  2. If that still doesn't work, your baby's tongue may have a connective flap underneath that is too long. See a pediatrician ASAP, and get it snipped. This hurts about as much as having your ears pierced and used to be routine in hospital births through the 60s; it's not very painful nor is it uncommon.
  3. Cabbage leaves - before or after nursing just place a fresh leaf on each side in your bra - this eases the pain and prevents congestion - especially if you are sore or engorged. 
  4. Stay hydrated: that doesn't mean tossing back a 10 oz glass of water every 2 hours. It means a lot of sipping. If you have to make herbal tea to keep yourself sipping - do it. If you do consume large amounts of water quickly, you'll actually dehydrate when your body works overtime to achieve a correct water-electrolyte balance. Pickles also help - the B vitamins help you stay hydrated.
  5. Which leads me to coconut water. Coconut water is an insanely good natural source of electrolytes. Without them, your body will not hold onto the water you need. Bananas are also great. (Don't use Gatorade, you can't digest it and neither can your baby.) Coconut water also has some kind of magical immune boosting power, so it's good for mama and baby. In South America mothers used coconut water to wean their children.
  6. Eat well. LOTS of protein and yes, carbs! Oatmeal is great for making milk in part because it has the perfect (and I don't like that word) balance of protein and carbs for the human being. I ate it every day with nuts for extra omegas - also good for baby. And you can use instant, which is great for new mommas.
  7. Get sleep. I didn't get enough and I regret it considerably: Dad can do one feeding a night!!! Yes, he can! And you won't lose your milk! But, if you're worried, pump into a bottle right before going to bed, and let papa heat it for baby for that 3 am wake-up.
  8. Once you've kinda got the whole infant thing down (I dunno... between 6 and 8 weeks old...) start pumping a bottle a day - that's 4 oz. You can freeze it or papa can give it to start bottle feeding, say once a week. We did both. Also, it's good to have a store for "what-ifs". For me it was a clogged duct that resulted in an infection. I was on strong antibiotics for 10 days that of course killed the probiotics in my son's stomach making him very uncomfortable. We had milk frozen. I kept pumping while on the antibiotics, and was able to give him the pumped milk - spread out once a day when he was in day care months later.
  9. Pumping tips: 
  • If you're going back to work get a GOOD pump! Medela is the best in my opinion and it needs to be both sides at once, a double pump. Obama passed a law that all pumps and pumping accessories and add-ons like bags are now covered by medical flexible spending, so keep your receipts for your FSA.
  • You'll probably need to pump about every 3 hours. I fed my son at 6 am, pumped at 10am, pumped at 2pm, and then fed him at 5:30pm for bedtime (and pumped later, but I'll get to that).
  • Always pump until the milk stops - that might be 12 minutes, it might be 23. Then KEEP pumping for at least 3 minutes. I would always got a second let down. I quickly went from pumping 3 oz per pump (about 20 mins) to 6 oz (about 25 mins) after I added the extra time- capturing the second let down. This happens because the sensation of "sucking" tells your body to make milk, so while you're pumping what was already sitting there - more is being made. You want to capture that let down, too so that your body is encouraged to keep making lots of milk.
  • When you're done, make yourself that herbal Fenugreek (Yogi is good) tea and sip away, then chow a couple tablespoons of peanuts. Making milk burns 500 - 800 calories a day, so don't diet.
  • If you wanna work out - that's fine. I did starting at 8 weeks, lost all my baby weight before returning to work at 20 weeks, and never dieted. I was eating constantly - but lots of protein.
  • Like most mothers - either when mama goes back to work, or baby starts sleeping through the night, you may see a drop in your milk. This is really frustrating, but don't worry, you can get it back. Here's how:
  1. Fenugreek herbal drops. If you get them really fresh they're very good. Drops are better than the pills also, and the taste is a bit fizzy. I put half a dropper's worth right on the tongue followed with OJ, 3 times a day. And Brewers yeast - for me it was 2 pills three times a day with the Fenugreek and I saw immediate results with both. (I never found published reasons not to use either of these; they were recommended to me by moms and midwives; and have been used for centuries.)
  2. Sipping - I would sip the "Nursing Support" Yogi tea (or Celestial Seasonings Bedtime) about an hour before bed, and a couple times during the day if I was up to it.
  3. Extra pumping really helps. Add on 2 more minutes after your second let down at work. this might put you at 35 minutes of pumping time twice a day at work, but remember - it's not forever; your work life will last loooong after your infant becomes a toddler.
  4. My son went to bed at 6 or 6:30pm for the first year, so I would nurse him at bedtime, then pump immediately after putting him down to get that second let-down, and again before bed, while sipping tea. That 9pm pump got me beyond what I needed per day for him, which helped a lot when those growth spurts came along.

My son, 2 weeks old

Dads, partners and babysitters, here's what you can do:
  • When warming milk, do it slowly. First defrost in the bag or bottle in the fridge. When ready to feed baby, run the bag/bottle under warm water from the faucet to loosen all the fats and proteins stuck to the bag (you can massage it), then heat water in a pan, take the pan off the stove, and drop the bottle into the pot gently circling the bottle - loosen all the good fat from the bag or bottle with massage and warm water.
  • DO NOT HEAT MILK in a PAN OR MICROWAVE! High heat kills all the good stuff.
  • DO NOT SHAKE THE BOTTLE! That also kills all the good stuff.
  • When you bottle feed baby, hold him or her like mom would while nursing. Go ahead and put a pillow on your lap so you can make yourself and baby comfortable.
  • Please hold your lil one both on the right and the left so he/she does not come to prefer one side, which can make it harder for mama to nurse on both sides (which she needs to do).
  • Babies consume a bottle much faster than nursing; after the feeding burp your baby over your shoulder or resting over your horizontal arm or lap. Try a few methods, and either rub or pat. I found firm, massage like rubbing in a circle over the back most effective but I'm sure every child is different.
  • Remember, baby is getting comfort from nursing, so try putting the baby's main blanket or mom's shirt over your shoulder while you feed. Later, mom and dad's scents will comfort baby and this really helps at bedtime, or when baby has to be with a different caretaker. (In earlier posts I talk about how the parents' scents comfort the baby, because she or he is made of you - you smell familiar because you are family - so that blanket needs mom and dad's scent - not another loved one, to do the job of giving comfort.)
  • Dads and partners, doing that one night feeding a day will make a BIIIG difference! You'll bond with baby; s/he will go back to sleep FASTER and sleep deeper - as will you and mom; your sweet love will be better rested the next day; and you'll know you made breastfeeding more sustainable - win-win!
My son, 17 months old

For all the new moms - LOVE you lots!! Congratulations on giving birth to your very own! If you have questions, leave a comment. If I cannot answer it - I'll find one for you before you go nuts between feedings!
And, if you have tips to add, please do so in the comments. Thank you and good luck to everyone!!
TIME OFF WITH BABY IV: Western Europe, in Her Infinite Wisdom

As we now consider the effects of paid parental leave policies studied in Time Off With Baby: The Case for Paid Leave Care, let's remind ourselves what the purposes of paid care leave are:
       "The Primary motivations for providing rights to parental leave are to:

  • more easily balance the competing demands of work and child rearing,
  • to enhance the labor market position of women, and
  • to improve child health and development." pp. 112
Let's just take a moment to breathe with that sentence. 
I defy even the GOP to find anyone on God's Green Earth who believes these aims are not worth fighting for.

So, what are the policies in Europe and Canada and how do they affect children and families?
  • The nations studied offer:
  1. a minimum of 3 to 4 months of paid time off;
  2. often at least 6 months off but as much as a year or more of paid time;
  3. frequent rights to additional unpaid leave with job protection; and
  4. benefits that can be split between mothers and fathers (often giving additional supplements when fathers take a minimum of 2 weeks time).
  • For the most part parents took the full available allotment with women especially taking advantage of benefits, suggesting that policies must ameliorate the challenges of work-family balance.
  • "Short and intermediate duration" leaves have positive effects on women and employment: increases in female employment and reemployment after giving birth; and there were either no effect or small positive effects on women's wages. Fun fact: Danish researchers saw women's wages increase when leave time was increased from 14 to 20 weeks! (More women choosing to return to the same position after a period with baby rather than quit altogether?)
  • Possible effects of the "glass ceiling" were seen in employment segregation due to stymied female advancement, but only in nations where leave is extensive - over 1 yr. In the U.S. such long periods are not under consideration, so this is moot.
  • Some research showed child health benefits including reductions in infant and baby mortality, especially from 2 to 12 months when parent involvement is most crucial -- except in terms of education. However, raising a child is not building a computer. I'll wager that every parent out there who is involved in their child's life is as interested in psychological well-being, relationships, communication, self-reliance, and recently highlighted qualities like resilience of character - perhaps even more than educational achievement. It is in these developmental arenas that our children thrive due to our closeness, attention and love in the early months (see previous posts)- for we are raising human beings who feel, express, engage, enjoy, experience, and love other people, the world and themselves.*
  • However, research in Norway found that when paid care leave was, again, increased from 12 to 18 weeks, there were educational benefits, especially for girls and less educated children (the most vulnerable) suggesting that this increased bonding and support time in emotional care does contribute to a child's ability to learn - something, I think, frankly, is so obvious it's almost embarrassing to have to mention.
This is what paid care leave the world over looked like a month ago:

While I believe the U.S. can learn a lot from our brother and sister nations on Earth (and use a dose of healthy competition), I also know each nation has its own challenges, and the governmental policies of each nation reflect the culture of its peoples. So next week we'll take a closer look at our homeland through the policies of California answering what we tried and how it went down.

See you next week!

For more on character development I recommend The Social Animal by David Brooks or The Soul's Code by James Hillman, not to mention the poetry of Joy Harjo.

12 March 2013

TIME OFF WITH BABY III: Corporate Interests

After last week's poetic break from Time of with Baby: The Case for Paid Care Leave, I hope you're ready to sink your teeth into some real meat! We've talked about why parental leave for infants and babies is so important, for both families and society; what it means developmentally - emotionally and cognitively - for babies; and the societal economics in support of paid leave. Lets bite the bullet and deal with the primary enemy of paid care leave in the U.S.

Corporate lobbyists would have you believe the entire economic structure of this nation would fall under the burden of paid leave care costs. But, according to both California and our authors, Zigler, Muenchow, and Ruhm, things don't fall apart:
  • Employers benefit from paid parental leave: hiring and training costs for a new employee can be as much as 150% of the departing parent's salary.
  • Other employee costs are also lowered. For example, better maternal and child health reduce sick days and lower insurance costs (breastfed babies, for example, experience fewer infections; most day cares do not allow a child with a fever to come in).
  • Since California enacted its paid leave policies it has been found that most companies do not hire temporary workers, but divy up responsibilities between other members of the new parent's team.   Not only does this mean lower costs, but it utilizes the very reason most employees stay in a job - loyalty to supervisor and co-workers, who by the same token care about their friend who is out on leave, and know they, too, may need the support of co-workers in the future.
  • Further, it is a myth that companies will absorb all of the cost of paid parental leave. In many nations, as in California, employers' and employees', as well as state or federal funds, are aggregated to create pools from which benefits are paid, as with disability leave.
  • It's important also to mention that because of unpaid leave many women are forced into a slowed rate of career advancement and stymied earnings. Some women leave good positions because they wish to remain home with a child and find reentry to be a set-back in both position and earnings. Others are in effect, punished for having a child by lost wages, slower rate of promotions, and other ill effects.
  • Over half the nation's population earning less than they deserve and providing less than America needs slows the economy.
  • Every workplace benefits from greater diversity if only because it increases a company's chance of finding the right person for a job, creating greater stability and better productivity.
These findings paint a clear picture for me - everyone wins when families win. Which leads me to ask why so many in the United States are so fundamentally against paid care leave. Let's just try this out: is it ultimately not about our children, but about the mothers? 

The firestorm that erupted in the 2012 campaign season brought to bear a few major women's issues: 
  1. What's up with "legitimate rape"?
  2. Why did it take sooooo long to pass VAWA?
  3. And why did the GOP so vehemently oppose insurance coverage for oral contraceptives?
While these examples barely scrape the surface of the "war on women" they do point specifically to our power as creators... And to our vulnerability as creators.

I've talked about this issue before: only women can bring children into this world, but in many societies for far too long this has made us beholden to men and vulnerable to their insecurities, frustrations and need for control - over us, and what we bring forth.

Paid care leave is not only a family issue, but a women's issue. And a men's issue. When we as a society make the choice to uphold the family, we will acknowledge the essential roles of each member of the family, as well as the strengths and frailties of each member. It is in that light that we can see what a family truly is, and that we are at our best as individuals, families, coworkers, and government protectors when we accept and build on both strength and vulnerability: for that duality is our humanity.

Please leave your comments below! We'd love to hear what YOU think!

04 March 2013

Love Song to Sleep

Many moons ago I also promised you poetry. So let me honor that promise tonight.
I hope you enjoy...

The whole world is asleep
In the room next to mine –
His little fists curled around
A sweaty receiving blanket.

Eyes closed so gently to the night
And day alike,
To my steps over the floor,
And the 30-somethings’ party across the backyard,
To military jets overhead,
And the prostitutes
Under our front steps,
Their johns all unzipped and unaware…

That above their heads
The peace of sleep is ever pervasive,
blessing us all.