Thursday, October 16, 2014

Milk Expression - It’s a Hands-On Job

by Miriam Valdez, CLC, Membership Director Mom2Mom KMC

You heard right, milk removal from your breasts with your own hand is a skill every lactating woman would benefit from learning. In fact, hand expression in conjunction with pumping can increase output for pumping moms, yet teaching the skill is neglected on many maternity wards.

I’m not sure when we started to assume that our own handy work wouldn’t be sufficient and obsessed about finding the right pump for milk expression. It seems that a first-time mom is required to add an electric breast pump to her baby registry if she decided on breastfeeding, along with the starter bottle set just in case.

Just in case of…Can you think of a few reasons that require you to have an electric breast pump? I can too, but except for the case of a working mom most of them are very unlikely, like a very premature baby, being separated from baby for a longer period of time, or feeding issues that prevent latching. For most of those rare events, a mom would be able to rent or borrow a hospital grade pump, the most efficient, multi-user, and pricey item on the product list of manufacturers. Working moms and exclusive pumping moms may benefit from the use of a good electric pump, but being efficient in hand expression can only be of advantage to pumping moms as well. Yes, it’s work and you won’t be able to check Facebook while doing it, but I can come up with one advantage for every digit on my hands that may persuade you to give hand expression a try.

2 x 5 advantages of learning hand expression over buying an electric breast pump:
  1.  Hand expression is cheap – it costs you only the soap and water you use to wash your hands.
  2. Hand expression is always available provided you have a free hand or someone to lend you a hand. Imagine you pumped a bottle for baby and went to an event without lugging the pump because the carrying tote didn’t coordinate with your gorgeous dress and there’s no place to store it. You start to feel painfully engorged and need to remove some milk for comfort. Thank goodness you know how to hand express and the ladies’ room is just around the corner! Five minutes, and you’re back at the party!
  3. Hand expression doesn’t require electricity  - even better, you increase your own energy expenditure. I certainly wouldn’t mind burning some extra calories. You can express anywhere, no need to look for an outlet and chair.
  4.  Hand expression, more specifically breast compression, can help pumping moms to effectively drain the breast and increase output, especially if practiced in the early days.
  5. Supplies are minimal and cleaning is fast. You need a dish to catch the milk if desired, otherwise the sink, ground, or a towel will do. No extra aftercare is required.

  1. You learn the technique you respond best to and get to know your breasts – it’s not a one-fits-all approach, like the suction of a pump, ­-- and  if there are issues or lumps you will know.
  2.     It’s faster than a pump once you are proficient. More mommy time? Why, thank you!
  3. Hand expression can help while nursing to remove plugged ducts and aids in treatment of mastitis much better than a pump, second only to baby.
  4. In NOT buying an affordable, single user pump (which can’t be resold) for occasional use, you reduce electric waste and preserve resources. Breastfeeding rates are increasing and at this rate we may have underused pumps orbiting the earth as space trash soon. You get my point.
  5. Working with your hands increases confidence in your body and yourself. Much more so than comparing yourself to a dairy cow.

Now that you are intrigued to try, check out this video to get some pointers on technique and start practicing. It will take time to learn, so don’t be discouraged.

Do you see some results? High five!

Please share your experience with hand expression, special tricks, or situations where it helped you in a comment below.

Sunday, September 28, 2014

Breastmilk Movie Review

by Carrie DiStefano, CLEC, Mom2Mom KMC Education Director 

I will admit that I had a slightly skewed view before I even saw this movie.  A couple of friends had posted that they had seen it and were both disappointed.   Always one to keep an open mind, I thought to myself, “it can’t be THAT bad”.  I was hoping that my friends were wrong and that once I saw it I would be excited and think that we could save the world with breastfeeding and then chest bump all of my breastfeeding  girlfriends.  

I put the DVD in my laptop and tell my husband that I am doing “school work” and need to be left alone.  I start the movie, and the scene opens to a woman at her baby shower opening gifts of breastfeeding related paraphernalia.  Not exactly attention-grabbing as a high speed chase, but I keep watching.   The film follows 6-7 women on their breastfeeding journeys.   Following them from about the time they are 7 months pregnant through the first year of the baby’s life, each woman has a unique, yet often similar story of breastfeeding.     Almost all of the women face hurdles that are, unfortunately, all too commonly found in America.    Some of the challenges these women face include:  a late-term preemie, an unexpected c-section, a baby that has problems latching, and a tongue and lip tie.   One thing that all of these women have in common was that they all said they wanted to breastfeed when they were pregnant.    All of these issues, if addressed by a knowledgeable professional with lactation training, can be remedied and breastfeeding goals can be met. 

Women often have ingrained in them that breastfeeding is “natural”, “instinctive”, and “what the breasts were made for”.  While all of this is, in fact, true many women still decide breastfeeding is not for them and switch to artificial baby milk.   Why are so many women starting out saying they want to breastfeed and then not following through?   Breastmilk provides a great insight into the perceptions that women have about breastfeeding and why they switch.   What this movie had the capacity to do, but failed miserably, is to educate people about breastfeeding.   Breastmilk essentially educates people about the challenges of breastfeeding, not the success stories and how challenges can be overcome.  In fact, only one of the moms was still breastfeeding when her baby turned a year old.  Almost all of the others started some type of supplementation, if not a full transition to formula, prior to the baby turning 6 months.   I want to take this opportunity to dispel some of the myths and misinformation presented in the movie. 

Karin was told that her 36 weeker, born just a few weeks early and weighing in at nearly 6 pounds needed human milk fortifier.   FACT:   Preemies can latch on to the breast and get what they need VERY early on – even prior to 36 weeks.    There’s no need for any sort of fortifier (read:  formula) unless it’s medically necessary, for example, galactosemia which is a rare condition, or very low birth weight preemies under approximately 3 pounds, or infants with phenylketonuria.  In fact, introducing foreign substances to a baby (including formula) can sometimes harm the baby as it increases the risk for necrotizing enterocolitis (one of the most common and serious intestinal diseases among preemies) versus breastmilk which contains immunological properties that can help protect preterm infants. 

Karin also believed that breastfed babies gain weight more slowly in the beginning and then speed up their weight gain as they are older.   FACT:  The opposite is true.  Breastfed babies often gain weight quickly in the first 3-4 months and then slow down.  

Colleen is a biologist and she wants her baby to latch on his own as it’s an instinctive, innate behavior that he can do without any assistance.  Yes!  This is true – thank you, Colleen!   Unfortunately what happens with Colleen is that she has a bit of an impatient and assertive nurse who wants the crying baby to hurry up and latch on.  So while Colleen watches her baby grab on to her breast, even though he’s not sucking, the nurse insists on helping her and takes the baby’s head and tries to help position him to latch on.   FACT:   Babies can and will latch on without any help from anyone.   Skin-to-skin immediately after birth will help facilitate this instinct known as the breast crawl, where the baby is searching for the breast and is able to find it and begin nursing.  It may not necessarily be a perfect latch as baby has to learn how to perfect his or her technique, but he can latch on and suck – two instincts that babies are born with.     

Colleen’s baby is also diagnosed with a lip and tongue tie.  Ties are common in breastfeeding and can cause a lot of barriers to breastfeeding success if not diagnosed and corrected.   They restrict movement which creates problems with breastfeeding as the baby’s tongue cannot reach the top of his or her mouth.   The baby cannot get a good latch at the breast and causes pain to the mother.   Babies who have ties also sometimes do not gain weight as well due to their inefficient sucking ability.   The movie actually does a good explanation of a tongue and lip tie and how they affect breastfeeding.  If only they had included more of these teaching moments, the movie would have been much better.  

Only one mom was still breastfeeding at one year.  She had attended a breastfeeding support group meeting with her baby to get reassurance from other moms (it’s unclear from the movie if she attended more than one meeting).  However, this mom did start pumping prior to her baby being born as she was concerned about her milk supply.  Her pumping likely caused her to have contractions and she went into labor that night.   A lot of moms believe that nipple stimulation can help with supply and/or to prepare the breasts for breastfeeding.   FACT:   This is absolutely not true and as shown in the movie may cause a mom to start contracting and go into labor.   A mom-to-be does not need to prepare her breasts for breastfeeding and any sort of artificial nipple stimulation is discouraged.
One of the mothers in the movie also was faced with an unexpected c-section delivery.   After the delivery, she says she felt very out of it and was not comfortable holding or feeding her baby.    What many women don’t realize, especially first time moms, is that the delivery can affect breastfeeding.   In the movie, it’s obvious how the delivery affected the young mother, but moms who have long labors and/or may have received extra fluids can also be very much affected when it comes to latching their baby to the breast.  Extra fluids may cause water retention which in turn may cause issues with a baby being able to latch on.    The extra fluids may also cause a delay from the transition of colostrum to mature milk.   A procedure known as reverse pressure softening can help with extra water retention in order to help the baby latch on.  And regarding the mature milk, the mom just needs to understand that a couple of extra days may be needed before she has her mature milk.  

The movie went on to interview a family who many breastfeeding moms likely would not be able to relate to.  It is this family that was used as an example of what full-term breastfeeding looks like.  That is, the mom was still nursing her toddler who was probably between 2 and 3 years old.   The American Academy of Pediatrics recommendation is that “exclusive breastfeeding for about the first six months of a baby's life, followed by breastfeeding in combination with the introduction of complementary foods until at least 12 months of age, and continuation of breastfeeding for as long as mutually desired by mother and baby”.  The World Health Organization’s recommendation on breastfeeding duration is, “Exclusive breastfeeding is recommended up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond”. 

There are a lot of moms that nurse past one year and to use a couple who most viewers would not be able to connect with is doing a disservice to the idea of breastfeeding into toddlerhood. 
While this movie IS an accurate representation of a typical American mom’s breastfeeding journey, it leaves much to be desired in educating the audience on breastfeeding.     Not only is it missing an opportunity to educate moms, but it also lacks focus and a purpose.   I turned off my laptop feeling a bit confused and disappointed in a movie that I had such high hopes for.    


Tuesday, September 23, 2014

Mommy Wars

A few months ago as the board of directors were tossing around the idea of a Mom2Mom blog, we unanimously decided to write our first post about mommy wars. What better way to engage with the community than by addressing a universal challenge we all have faced? Well, a few of the board members, including myself, have sat down to write that post and each of us have come up blank! None of us have been able to put together the right collection of words to express how we feel.
The inability to write about mommy wars from the perspective of a Mom2Mom member is not due to a lack of experience with this thing. Tell me who can become a mother and wholly escape it? I think our silence comes instead from a desire to stay clear of the competition and judgement that define this "war". In Mom2Mom we have a hugely diverse community of women and families. Some of us are active duty, some work part time, and others stay at home. Some of us have breastfed for days and others years. Some of us pump, some supplement, others sns feed, and some tandem nurse! What makes our community rich, vibrant, and unique is this very set of differences. And I believe that it is through these differences that we are able to help each other see the other side of issues and pull through our toughest challenges.
I hate to sound trite or aggressively sing the virtues of Mom2Mom but the fact of the matter is that I am so proud of this community and it's members. Breastfeeding is an inherently hot topic but in our Facebook group and at our Breastfeeding Cafe discussions there is rarely a hostile moment. It seems that there is a breastfeeding paradise of knowledge and experience right here in the KMC and we are all invited to take part!
So instead of writing about how much mommy wars frustrate me or how it's ruining my life, I'd like to take this post in a different direction. I'd like to invite you - our members, readers, and supporters - to tell us one thing you've learned from another mother. Please leave us a comment below with your story and perhaps you will inspire someone else today!
Thanks for reading and boob on!

Written by Lauren Foley
Community Outreach Director