Mar 30
Yesterday I saw the BEST Twin talk video which I will put at the end of this post..
But first….. I wanted you all to have a look at some luscious twin breastfeeding photos I found on Google. I am in a twin mood today.
This has had over 2 million hits on YouTube!
Mar 2
Today is IBCLC Day which is held the first Wednesday of March every year!
Ecard from ILCA
As a former IBCLC, I know how hard many work to support and protect breastfeeding moms and babies everywhere. This profession deserves our recognition today and everyday…..Thank you all for your hard work.
Happy IBCLC Day! Good job!
Feb 17
March 2011 Vanity Fair fold out cover. Olivia Wilde…. Dear Facebook, does this picture offend you? America- why is this ok and #breastfeeding in public offends??
I am continually working (baby steps- a little bit at a time) on improving what we do to care for the moms and babies in my little neck of the woods. Sometimes it feels exciting, positive and helpful….. but other times frustrating or futile.
Since I have been recently consumed with my newest career as a NICU nurse, I have seen some of my earlier successes of positive changes (on the mother baby unit and L&D)…. slowly. turn. back. to previous bad practices ….. I come over to the units and I see so many of the older traditional care models in place again which we had worked hard to place in a vault! You get new doctors, new nurses, new anesthesiologists etc… and they don’t give a crap about any guidelines or protocols for a natural process! However if the CDC changes their Hepatitis B, HIV or GBS protocols… they are all over it…. In. A. Heartbeat.
Why is it so hard for these professionals to relinquish control over all aspects of the birth process? Why can’t they look at any of that research? Why aren’t any of the recommendations for encouraging VBAC, discouraging scheduled CS’s without a TOL or keeping mother and baby together while delaying routine procedures taken as seriously?? Why?
I think I know why…I do. But that isn’t really what I wanted to talk about today.
I want to provide some encouraging – positive – inspirational ideas for my fellow nurses, practitioner or heathcare provider to do what is best for each mother and baby in their car. Even if you all pick just one… it can make a difference. So don’t feel overwhelmed. Just try to add at least one of these to YOUR daily practice. These suggestions are meant for situations without complications requiring urgent intervention of some kind.
Readers: Please ADD more in comments if you have them!
For some more ideas.. I have numerous previous posts about breastfeeding education, support and sited references such as the Coalition for Improving Maternity Services Ten Steps for example and other important issues.
Nov 2
Evolution
I love babies. I love being a nurse.
I love all the evolution of technology through which I have practiced. I love how I have had to continually evolve myself. I love helping mothers help themselves, advocating for them and their infants, facilitate when needed to support them making their own choices and watch as they evolve….. becoming the best mother they can be!
I know I haven’t blogged lately and it is because I have been having a bit of a rough transition… my latest evolution… in my new NICU job. Orientation is somewhat difficult for me. I had previously been arriving at work already at the top of my game (for the last 25 years or so) and I have now found myself a student…. every. single. day. It is almost like I have gone to a totally new facility! EVERYTHING seems new or different. All new equipment/monitors/procedures/policies/protocols/doctors/practitioners/and staff.
The babies are the same. Since some are much more preterm than we have cared for in the past… their issues are more complex. Some are the same as we have always cared for, but with neonatologists now on board, the approach to the care of these babies is evolving.
I am unlearning some of what I have always known and relearning things in new ways.
Evolution
I was able to prepare and submit the mission statement and policy on Breastfeeding for our NICU population. The neo’s are extremely awesome on breastfeeding or breastmilk feeding promotion and support! So we have a very good start for breastfeeding support in our new unit. Excellent actually! I am happy to report that since opening our unit, most of the babies thus far have had a total exclusive diet of breastmilk or fortified breastmilk! I think that is fabulous! There have been some moms who after discussion and encouragement to provide breastmilk, wished to formula feed and their choice was supported without further discussion or question. My new co-workers have been very professional about that. There were a few who provided colostrum initially and then decided not to continue. This was also supported.
Coming from my previously comfortable world of lactation in the full term nursery, I find myself on a journey to find a balance between technology and nature…… precision, absolutes and finite accuracy vs the inconsistency, variables, and imprecise intake of an infant at the breast. We are calculating daily the actual fluid and kcal energy intake of each baby and comparing that with the kcal/fluid requirement per kilogram of weight. Changes are then made accordingly. Most of the preterm population is unable to take in their required fluid and caloric needs solely by mouth. Most have parenteral nutrition in the form of a glucose/ Amino Acid protein and Lipid (fats) at first by a central line or an IV (TPN) and gradually switch over to taking all their requirement by their GI system (Enteral). They don’t have the stamina to take it by sucking/drinking and they require a nasogastric (NG) tube so the remainder of food can go in by gravity or feeding pump (gavage feeding).
NG tube
I actually love learning all this. I thrive on having a detailed clear clinical picture of my patient. I am very detail oriented which is a good thing. Because of this precision, the measurements and the calculations—> actual breastFEEDING is not often seen until much later in the game. I understand this. I do. I want so much to be very helpful at transitioning to full feeds at the breast. I have to wrap my head around it each time (all the while being a student in all other aspects of the infant’s care) researching how to best advise each mother. We range from visits every other feeding to visits once or twice a day. Skin to skin is the most powerful tool I can use when faced with limited exposure or opportunity. Sometimes when the mom is arriving for my patient, I’m involved in other things and unavailable to do anything other than providing some private skin to skin time. Encouraging any licking, suckling or other feeding behaviors at the breast during gavage feeds is also good. When the baby gets more and more ready to take oral feeds… what I’ve seen so far is that they are already preferenced to the bottle nipple. The weight gain has been established, the precision of measurement seems to have become slightly less rigid. It seems that there is adequate physician support to encourage full feeds at the breast. There are hundreds of experts out there who have gone thru this, and reorganized policy and procedure to protect breastfeeding in the NICU.
I have to evolve myself again and re-learn more about transitioning to feeds at the breast before the bottle becomes a primary feeding implement. Once I can find my footing- I hope to be strong and confident enough to start teaching moms and my co-workers.
Breastfeeding is NOT an exact science!
I need to figure out when the exact science of Neonatology can accept that….
into the feeding plan for each individual baby!
Received this email alert and thought I’d pass on thru my blog… and encourage all to take action!
It takes 5 seconds to add your name to the list!
e-CIMS Action Alert Sept. 28, 2010
CIMS Urges ACOG to Remove Additional Barriers to VBAC
Join us in asking ACOG to take steps that will increase VBAC, reduce cesareans, and ultimately avoid unnecessary harms to mothers and infants.In a Sept. 9, 2010, letter to Dr. Richard Waldman, president of the American College of Obstetricians and Gynecologists (ACOG), CIMS and 18 co-signing organizations urged ACOG to revise its current recommendation that VBACs (vaginal birth after cesarean) should take place in hospitals where emergency cesareans are “immediately available.”
CIMS will collect the names of additional organizations and individuals in support of this request through October 31, 2010, and will send the updated list of co-signers to Dr. Waldman. Add your name or your organization’s name now!
This request follows the March 2010 National Institutes of Health (NIH) Consensus Statement on VBAC, which found that VBAC is a reasonable choice for the majority of affected women. The NIH also reported that the “immediately available” recommendation was not based on strong support from high-quality evidence and had influenced about one-third of hospitals and one-half of physicians to stop providing care for women who wanted to plan a VBAC.
CIMS and the co-signing organizations also urged ACOG to revise its patient education publications and online consumer resources to include comprehensive information on the benefits and risks of cesarean section and VBAC. Without transparency about the short- and long-term benefits and risks of routine repeat cesarean and VBAC, women cannot make a truly informed choice about how they want to give birth.
Additional Information:
CIMS Press Release “CIMS Responds to Promising but Conflicting Revised VBAC Guidelines”
American College of Nurse-Midwives Responds to ACOG’s 2010 VBAC Recommendations (PDF)
Take Action: Add your name or your organization’s name now!
Jul 19
Welcome to The Breastfeeding Cafe Carnival!
This post was written as part of The Breastfeeding Cafe’s Carnival. For more info on the Breastfeeding Cafe, go to www.breastfeedingcafe.wordpress.com. For more info on the Carnival or if you want to participate, contact Claire at clindstrom2 {at} gmail {dot} com. Today’s post is about nursing in public. Please read the other blogs in today’s carnival listed below and check back for more posts July 18th through the 31st!
My first baby was born in sunny Florida during a particularly hot stretch in May 1979. Although I was an OB nurse, I knew very little about breastfeeding other than what my older co-workers had taught me—which was not all that correct or very helpful information. Luckily, I had a great friend who was nursing her 3 month old at the time my son was born. She really showed me the ropes. It just so happened that she was the one who took me home from the hospital. We had to stop at the store for a few items so we went in to a “Publix” supermarket with both babies in our arms. My newborn son began fussing to nurse soon after we hit the air conditioning.
I said.. “I’m going to have to go back out to the car and nurse him.”
My friend says “Oh..You’ll do no such thing.. You’ll die in that heat.. Just hook him up and keep shopping so we can get finished and out of here!”
Me- “Nurse him in here?”
Friend- “Well if he’s hungry.. yeah!.. (after looking at my face) Oh stop worrying about it..go over to a deserted aisle, get him hooked on and put your receiving blanket up near his face… nobody will know!”
Me- timidly…above the louder howls.. “Alright, be right back..”
I found the most private place I could. I started cursing that complicated “wonderful nursing bra” I just had to have. (Remember..this is 30 years ago… this bra is now an antique!) My skills handling newborns allowed me some grace as I attempted to multitask by stooping down, prop my loudly crying baby on my partial lap, use 2 hands to fiddle with the damn nursing bra, then get him back up near my finally free boob and latched on.
Ahhhh~ quiet, happy, drinking baby!
Still stooped down, I peered slowly behind me — expecting that a large crowd must have assembled. Somewhat surprisingly, everybody was just going about their business and I happily realized that noone was looking at me! I stood up, made sure I wasn’t showing anything, and walked off with my happily nursing baby to find my friend.
It’s amazing how many people want to see a quiet baby as opposed to a screaming infant!
A sweet little old man stopped me first and asked me how old my baby was….”3 days”, I replied. He peeked in for a closer look and he actually didn’t get it right away.. “I can’t really see his face.”.. I said “Well- he’s feeding right now.”.. He just said..”OOPS….sorry about that! Well he’s a cute one!” then walked off.
The next person who stopped me was again.. a sweet little old man. He was very smiley and jolly. He asked all about the baby but didn’t lean over to look like the other man. I quickly said he’s nursing now and then answered all the small talk. He never seemed uncomfortable about it at all! That probably gave me a lot more confidence. We parted ways and I finally found my friend. She gave me an approving thumbs up, asked me to hold a basket with my other hand and said we were almost done.
Another little old man stopped us by the register to ask about both babies. We gave him all the small talk answers and let him know my son was nursing. This guy was a real sweetie, commenting on how lucky kids were that moms were starting to “nurse their young” again and ‘good for you.” He never tried to look in at my son. He didn’t seem embarrassed by the process at all. He was the coolest guy!
I left the Publix Supermarket on my way home to begin my life as a mommy…. with a little public education bonus. Encountering those sweet little old men while feeding my baby and receiving their positive type feedback was the gentle support I needed. I went on to feel empowered to nurse in public for all three of my babies… Those little old men were just so supportive! ~ When my baby was hungry, he needed to feed and it really didn’t matter where I was at the time. Thank goodness for my friend’s wisdom and support to go for it!
I became a lactation professional while nursing my last baby. It was then, only after I really became more aware of issues surrounding nursing in public that I actually took any kind of public action to empower other moms. I’ve done lots of different little things as the years have gone by. I want to mention one fun way that I thought I could help gently re-educate some of the “new” sweet little old men of this day and age. Our local paper has a lot of little retired guys commenting back and forth on various local articles. I’m guessing their age and status by all the things they say. I took this opportunity to possibly educate some of these forum readers about breastfeeding rights in public. Every once in a while, on the forum, I put out a little snippet on nursing in public… and sit back and watch what they have to say in reply! It’s quite fun!
Here’s an example I wrote on a long forum discussion a couple years ago on a breastfeeding article:
On another note, regarding a reader reaction in the forum, a skimpy bikini or the bathing-suit issue of a favorite sports magazine show more skin in a provocative, sexy way than any mom breast-feeding. Even the movie stars in their gowns with plunging necklines are showing almost the entire breast! Somehow, that is OK. It is sad that the public opinion of a baby breast-feeding (the most natural way for him to eat) is something that should be done in private … yet young girls are encouraged by media to bare more and more skin. Of course being discreet while feeding is important, but I can assure you, most girls in a tiny bikini are thinking more about “tacky exhibitionist behavior” than a mother breast-feeding her baby. August 1-7 is always World Breast Feeding Week. The theme this year is “Welcome Baby Softly,” focusing on the importance of the first hour or two after birth. Learn more about it. I would love to see the paper do an article on that.
This one provoked a few responses in both directions and sometimes there were a few people who actually thought out loud that …gosh maybe I was right… never thought about it that way…etc..
Here’s an example I wrote on a recent article about the appropriate % amount for tipping :
I have never left an establishment without tipping– however, I also tip according to service up to 20%. If there are unkind reactions to small children in a FAMILY establishment, they will be getting a bare minimal tip for sure!! I do my best to keep my children behaved with table manners AND respect other patrons… but fact remains, they are children! I cannot possibly be prepared for every behavior or an accidental spill. In addition, my breastfeeding baby may be hungry.. By PA law, I have the right to nurse my baby in a public place wherever he and I are allowed to be. I am discreet.. I am protected by law… I don’t need an unkind comment from servers. They do not get a 15-20% tip if nasty, unkind or disrespectful comments have been made about my children or my breastfeeding baby!
This provoked a foray of comments ranging from ‘good for you’ to ‘you should be in the back booth…controlling kids etc..’ Sometimes the opportunities to educate others come at unexpected times but produce amazing results!
On a few occasions, other readers were supporting my comments and
helping to educate those sweet little old guys with me!
😉
Here are more posts by the Breastfeeding Cafe Carnival participants! Check back because more will be added throughout the day.
Jun 29
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