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Breastfeeding / MILC Moment

MILC Moment: Preventing Holiday Mastitis

Calls about mastitis tend to increase over the holidays. Changes in routine, travel, sleep disruptions, stress, and missed feedings can all contribute to getting engorged, getting a plugged duct, and/or getting mastitis. When you get a plugged duct, it may start as a little lump in the breast. It may feel a little tender, and the skin over it might look more pink or red. If it doesn’t get better, it may get bigger and the congestion may start to spread to other areas of your breast. More of the skin might look red. You might feel body aches or chills, or get a low grade fever. If the congestion still doesn’t go away, you might start feeling worse – like you have the flu, with a high fever. At that point, you should definitely be calling WBWC (or your OB care provider) – “Help! I think I have mastitis!” A round of antibiotics will usually clear up mastitis pretty quickly. But we like to avoid antibiotics if we can, and of course we like to avoid you getting sick! Could we prevent a bad case of mastitis? Sometimes, we can! First is to take care of yourself over the holidays. Keep nursing your baby frequently, don’t skimp on sleep, and do whatever you can to minimize the stress that can come along with the holiday season. If you do start to have issues, it’s good to know that very frequent nursing or pumping often does the trick. If you have a really stubborn spot that won’t clear, all you need may be just your hands – massaging to clear out those congested areas before your breasts get really inflamed. If you’re getting a plugged duct, or if you feel like your plugged duct is getting worse, check out this video for techniques on how to massage and hand express to help clear your breasts: https://vimeo.com/65196007 The Boutique also sells a “Happy Ducts” herbal tincture to help in clearing breast congestion. All the WBWC LCs, and many of the midwives and nurses, have been trained on how to do breast massage to help clear plugged ducts and breast congestion. If you feel like a plugged duct is getting worse, and you’re not able to clear it yourself, you can call for an appointment to get some hands-on help. If you believe you are getting mastitis, or have mastitis, you should always call … Read More

National Black Breastfeeding Week Celebration a Success!

  On August 31st, we had a WONDERFUL turnout for our first ever Black Breastfeeding Week Celebration! Beautiful photos were taken by Sarah Stanley of Love at First Sight Photography. Mamas made beautiful nursing necklaces, and made new friends as well. Dads got to meet other dads. We all had a wonderful time and can’t wait to do it again (even bigger) next year. THANK YOU to all who came out and made this a wonderful success. A special thanks to Sarah Stanley for the photography, and a big recognition for Tracey Jones – you know her from WBWC’s lab – for bringing so many families together by organizing this event.

National Black Breastfeeding Week

By Rebecca Costello, IBCLC Women’s Birth & Wellness Center is celebrating National Black Breastfeeding Week August 25th-August 31st. The national theme this year is #BetOnBlack and we would love for you to join us in celebrating black moms and moms-to be. Black infants have the highest mortality rates in our country, and yet many black women do not receive the support they need to breastfeed successfully. One of those challenges is visibility – most images of breastfeeding do not reflect a diverse population. Throughout the week, we’re asking black moms to please share your breastfeeding journeys with us – what makes breastfeeding a winning bet for you and your baby? During the week we’ll post questions on Facebook for you to share why you breastfeed (or plan to) and what obstacles you’re overcoming. We will post your responses on the bulletin board of our lobby. Each response gets you an entry in a drawing for a $25 Boutique gift certificate. Send us a picture of you breastfeeding your baby (or a belly shot if you’re still pregnant) for the bulletin board, and you’ll be entered again! To be entered in the drawing, e-mail photo to milc@ncbirthcenter.org – pictures must be submitted by Aug. 30th. As a celebration at the end of the week, we are having a special Black Breastfeeding Week party and photoshoot – if you don’t have an image of your baby to share for the bulletin board, or want a new one, check out our special event next Thursday! RSVP here: https://www.facebook.com/events/134126790533405/?active_tab=about Spaces for individual photos are limited so comment on the Facebook event right away if you want to reserve yours! Not a black mom, and want to help support the cause? Start learning about why Black Breastfeeding Week was started and the experiences black women have in breastfeeding: http://kindredmedia.org/2014/08/happy-black-breastfeeding-week-august-25-31/ http://theleakyboob.com/tag/why-do-we-need-black-breastfeeding-week/  

Breastfeeding Life Lessons

By Claire Caprioli I was holding back tears as I tried unsuccessfully to get my newborn daughter to nurse. I was sitting on a futon with Nancy Albrecht and my husband. My angelic baby latched on eagerly, but after 20 minutes of “nursing”, she wasn’t gaining an ounce and my breast had not softened. This simply couldn’t be happening. I knew how to nurse; after all, this was not my first baby: she was my fourth! Nancy looked at me reassuringly and stated matter-of-factly: “Every baby has something new to teach you.” The magical combination of her tone, my husband by my side, and the innocent sweetness of my newborn nuzzled against me, had an immediate relaxing effect. Nancy’s words wafted past me like a warm, gentle breeze. I was ready to look past my emotional state and tune into the methods we would need to correct the baby’s tongue-thrusting habit. This included tongue exercises, and lacing a tube through a nipple guard to squirt expressed breast milk into the baby’s mouth while she was latched on. The latter would ensure she received enough milk while she was still learning to nurse properly. I can’t say I wasn’t in tears over this awkward and unnatural set up, but the problem was corrected within two weeks. We soon became the relaxed nursing duo that I hoped, and knew, we would be. Nancy’s words, however, stayed curiously and contemplatively in my mind. It was true: each of my nursing experiences had been different, yet with time, effort, and faith in my baby and myself, they had all been successful and enjoyable. My first baby had been a natural, nursing before her umbilical cord was even cut. Her latch-on was perfect and she nursed contentedly. I was not prepared, however, for the colic that kept her screaming in distress for hours every evening. The only time she stopped was when she was nursing, which she did with great frequency. This, somewhat predictably, led to dry, cracked, sore, and bleeding nipples. I dubbed her the vampire baby and sheer determination drove me on. When the colic subsided within a couple of months, the two of us were left with breastfeeding times that were blissfully quiet and precious. She nursed for a total of 14 months.  My firstborn taught me that the true beauty of a rainbow can only be appreciated after a storm. Nearly … Read More

MILC Moment: World Breastfeeding Week

WBWC is excited to celebrate World Breastfeeding Week 2017! In keeping with this year’s theme of “Sustaining Breastfeeding Together”, we will be holding an extra, and extra-special, breastfeeding café on the morning of Friday August 4th from 10:30a-12p. If you can, please join us for for treats, activities, and fun! If you can’t, keep an eye out on our Facebook page – we will be posting questions and links all week to hear your stories of how breastfeeding is supported by your community.  

MILC Moment: The Growth Chart Puzzle

By Rebecca Costello, IBCLC We sometimes hear from parents concerned that their breastfed children’s growth “slowing down” around 4 months – the baby’s weight percentile dropping and the baby slipping down the growth curve. Sometimes these concerns are accurate – but sometimes they are not! Why?? The fact is, some medical offices still use growth charts developed in 1977, based on a small sample of babies in Ohio who were primarily formula fed. Similarly, even the 2000 Centers for Disease Control (CDC) growth charts are based on a sample of mixed breast/formula feeders. Formula fed babies grow more slowly than breastfed babies in their first few months of life, then begin to grow more quickly than breastfed babies. When we chart breastfed babies on the formula fed growth chart, it makes breastfed babies look nice and high on the chart for the first few months, and then start to look like they are faltering. What does it look like when breastfed babies are tracked on charts that accurately reflect their growth? To do that, the newest World Health Organization (WHO) growth charts are a far better choice than any of he CDC charts. The WHO charts are based on a worldwide sample of infants who received optimal breastfeeding and complementary feeding. This article from the Journal of Nutrition does an excellent job of discussing some of the differences between the CDC and WHO growth charts. They have several great illustrations as well to help you visualize how the growth charts differ: This chart shows the difference between weight-for-age curves in boys ages 0-60 months. You can see how around 4-6 months, the CDC chart line crosses over the WHO line and generally stays above – sometimes quite high above – the WHO line up through age 5. This chart is even better, which shows how an average infant from the WHO sample would track on each chart. A baby who tracks normally on the WHO chart (staying fairly even in growth after an initial drop) looks very different on the CDC chart: after an initial rise the baby appears to slowly fall down the growth curve from the age of 2 months on. The CDC formally recommends that all clinicians switch to the new WHO growth charts for ALL infants and toddlers up to 2 years of age. (Note that this means not just breastfed babies – the CDC recognizes … Read More

MILC Moment: Breastfeeding Update 2017

By Rebecca Costello, IBCLC Twice a year, the WBWC lactation consultants organize a “Breastfeeding Update” for all our midwives, nurse practitioners, and nurses. This spring we covered several topics, one of which was a quality improvement project by our UNC intern, Anna Caudill. Anna pulled data from charts for 6 months of WBWC births, looking at breastfeeding outcomes, specifically whether a baby is at or above birth weight at 2 weeks of age, which is an indicator of whether baby is breastfeeding well/getting enough milk. Her work was an update to a similar assessment conducted 2 years ago, which had enabled us to identify possible early warning signs of breastfeeding issues. As a result of the previous study, WBWC implemented several additional screening measures as part of our routine postpartum care. Anna’s research showed that over the past 2 years, we cut our rate of babies who were not back to birth weight by 50%! Because our rate 2 years ago was already similar to other comparable populations, this result now means we are doing much better than average. We credit this progress to our focus on early intervention – noticing breastfeeding problems in the first few days of life, and helping fix them quickly. We want to thank the entire WBWC team for making this progress possible, and of course you, our WBWC families, for working so hard with us to make breastfeeding successful for you and your babies. Anna also looked at the percentage of babies who lost more than 10% of their birth weight in the early days after birth (another sign that breastfeeding is not going well). We found that our rate is consistent with other comparable populations. Our next step is to see whether we can reduce that number as well. We have been in touch with another birth center that successfully reduced its numbers with some baby-friendly changes, like continuous skin-to-skin for 48 hours postpartum. We are interested to pilot some new ideas in the service of happy, healthy moms and babies. Stay tuned! Image courtesy of Heart in Hands Photography

Breastfeeding for Doulas and Birth Professionals

Are you a birth or postpartum doula? A childbirth educator or other birth professional? In this class, you’ll supercharge your breastfeeding support skills! Whether you’re starting from scratch or have helped hundreds of babies, you’ll get a grounding in the latest breastfeeding information and learn something new (and customized to the Triangle area!). We’ll be covering topics including: Preparing your clients for breastfeeding success The anatomy and physiology (making milk, letdown, suck) Baby reflexes, abilities, and cues Optimal latch and positioning, and helping parents get comfortable “Protecting the space” immediately postpartum and navigating local hospital protocols Helping parents catch early signs that something isn’t going right, and navigate to the help they need Breastfeeding gear: pumping, bottles, and milk storage Overcoming common obstacles including engorgement, sore nipples, and worries about weight loss and milk supply Hot topics: understanding tongue tie, and bodywork for breastfeeding challenges The class will be taught by Rebecca Costello IBCLC CD MPH. Rebecca sees patients full time at Women’s Birth and Wellness Center where she’s the Director of Lactation Services. Before coming to WBWC, she worked at UNC Women’s Hospital as an LC, and was a birth doula for many years prior. She knows the importance of doulas to breastfeeding success, and how helpful it was to have breastfeeding education in her doula role. Cost: $50 To register call (919)933-3301 http://ncbirthcenter.org/event/breastfeeding-for-doulas/

A Story of Strength

By Lindsey B. Bickers Bock On the fourth day after our daughter was born, my husband and I were struggling. We had a distressingly sleepy, jaundiced baby, and we were concerned that my milk wasn’t coming in after dealing with a retained placenta after her delivery. We were exhausted from someone being up with her 24 hours/day to keep her on the biliblanket that was provided as treatment for her jaundice. We were overwhelmed when a suggestion was made that she might need to go to the hospital if we couldn’t get her feeding and regaining weight better. Thankfully, the midwife on call at the Women’s Birth & Wellness Center suggested that we could at least try an appointment with an LC before heading to the hospital. Then, if we still felt like we needed to go, they could at least facilitate our admission, instead of having to go through the ER. That afternoon, we spent nearly two hours talking with the LC, learning more about ways to keep a tired baby awake to feed, strategies to maximize the energy our daughter did have, and a game plan until we met again. We walked away with clear written notes about what to do, what to be concerned about, and when to come back again. Over the next ten days, we returned to the Birth Center 5 or 6 times for additional LC visits and weight checks. When our daughter checked in at her birth weight after 15 days and we got the okay to stop an exhausting schedule of pumping and feeding every two hours, we cheered…but only long enough to gear up for outpatient surgery that I had to put off while being pregnant. Again, the LCs were an amazing help, assisting us with putting together a new game plan that would ensure our little one continued to be fed breastmilk on demand around my surgery and follow-up care. Five weeks after she was born, I was delighted to “graduate” up to the local La Leche League meeting, where I was able to share and troubleshoot more routine challenges of breastfeeding with other mothers, as well as celebrate milestones along our nursing journey. After those difficult early weeks, I knew how valuable the support of others could be in reaching my breastfeeding and parenting goals. I have been exceedingly thankful to have an awesome local evening meeting with lots of other … Read More

March 1 is IBCLC Day!

In honor of IBCLC Day, we’re celebrating our wonderful Lactation Consultants! Nancy Albrecht, Ellen Chetwynd, Rebecca Costello, Elley Schopler, and Deborah Adler work tirelessly to make sure every mother has the best available breastfeeding assitance.  Here are some of the ways they’ve helped women navigate the sometimes difficult world of breastfeeding: “We are a few days away from our 6-month nursing anniversary. We would not be here without Ellen. By the time I saw Ellen, my daughter was one month old and the nursing struggles had left me an emotional mess. Ellen was so kind and invested so much time into figuring out what was going on – after a few visits and a tongue tie clip, we have not looked back and breastfeeding became a wonderful, pain-free experience. I treasure my time nursing Zoya, because it helps me connect with her, and I would not have this opportunity if we hadn’t met Ellen. Her attentiveness and thoughtfulness are something I will always remember.” – Haniya Mir      “The wonderful IBCLCs, especially Rebecca since that’s who I saw mostly, always helped to ease my worries. They made me feel like I was doing an awesome job nourishing my baby, as I pushed my way through diet restrictions, constant nursing, pumping at work, and low supply. The best advice I got from Rebecca was that breastfeeding is not all or nothing. That statement helped to normalize how hard breastfeeding was for me at times and made me feel better about having to use donor milk.” – Sarah Jackson  “Sometimes I worry Rebecca will think I’m a total creep for the amount of praise I give her. I was probably at my most vulnerable after Rowan’s birth when I went to see her. He was born at 31 weeks due to severe pre-eclampsia. Nothing had gone right, or even right-adjacent. We were finally home from the hospital (I was inpatient for three weeks, owan for almost six), and he was really struggling to nurse. He was not transferring much milk and was choking every time he ate. I was falling apart emotionally from the trauma mixed with sleep deprivation from trying to pump, nurse, and bottle feed. The first thing Rebecca did was give me permission to skip the nursing part during the middle of the night. She spotted the same tongue and lip ties that I had suspected, but been told not to worry about … Read More