MAYD to Birth: At Your Doorstep

Promoting gentle, empowering mother journies…

Tongue- Tie Tale

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True Story:
this was this week
Mother’s nipples hurt during latch of newborn and ended up pointy like a lipstick.
Nurses told mother that the baby looked tongue-tied. They recommended checking with the IBCLC.  ((Yay, for the nurses!))

IBCLC confirmed the tongue-tie. Referred her to me. ((Right-on!))
PEDIATRICIAN even confirmed it was tongue-tie!! He referred to ENT!
ENT AGREED!!

ENT scheduled baby to have frenotomy relaeased in out-patient center. :(
Mom’s nipples still hurt.
Out-patient surgery center notified parents that they don’t take newborns. Either they can re-schedule at 6 months or go to the operating room.

Waiting won’t help breastfeeding TODAY.
Anesthesia is not necessary.

Mom came to me. Determined to breastfeed.
She explained all this to me. Showed me the baby’s tongue and her lipstick shaped nipple after latching.

A very simple snip in the office released the frenulum.
The baby went to breast.
No pain.
No lipstick shape to the nipple.
Everyone Lived Happily Ever After.
The end.

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Happy Birth Day to Me

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Today is my birthday, and I have a lot planned for ugly number 39:

  • Walmart for baby proofing (see photo below) and crafting stuff
  • Finish G’s birth story since she turned 6 months old yesterday
  • Meet a friend and hike “the M” today before the weather turns (hooray, snow!)
  • Bake me a cake (no I don’t mind pampering myself on my birthday)
  • Go to one of my BF’s to celebrate avec family (it may even turn into an overnight par-tay)

    Happy Birthday to Me (aka thank you for not killing yourselves)

My good friend from Birth After Cesarean posted this yesterday on my wall:

Well, who would have thought this past year would bring so much difference for you, woman!

Seriously, this has been an epic year for me.  I happily and healthily grew another blessing.  Against all odds, really . . . I had a successful hospital VBA2C.  I held my ground and refused a cesarean.  I achieved tenure and was promoted at my University.  I performed a solo faculty recital (my recital partner backed out on me a week prior) a mere 2 months post partum!  My hubby and I drove to and from Denver for the holidays with our four young kids (which I consider a HUGE success).  My Dad flew me to Houston to check on my ailing aunt, and I was able to see my mom, brother, SIL, niece, and meet my nephew!  And we ended our childbearing years yesterday with a vasectomy.

It’s crazy to think that my childbearing years are over.  I love pregnancy.  I might even be addicted to pregnancy.  I am jealous of every pregnant woman I see.  And thankfully a part of me is at peace with being done.  But, now I have to face raising these beautiful children that my husband and I conceived.  Some days it’s really really hard to be a good parent . . . to be a minimally acceptable parent.  I never feel like I’m a spectacular parent.  But maybe now that I’m done making, baking, and birthing babies, I can focus on being a better parent?

So, what’s next?  I think I’ll eat a little something and go for my hike.  Guess I’ll have to postpone finishing my birth story until this afternoon while my birthday cake is baking.

After that I’ll continue herding my little flock of kids and herding my big flock of students and loving my husband and my home!

Milk Sharing (My Statement)

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Addendum1/22/12 : I have been sent updated links and comments in response to this post.  My post is outdated. Until I can update, read through the comments. As I have found out there ARE guidelines from LLL. Not too many people are aware that leaders can discuss the pros and cons of milk-sharing when it is brought up. Per the guidelines it is very appropriate for a leader to refer to a health care professional for a discussion of medical pros/cons of informal milk sharing. That is where I would come in. I want to evaluate why the mother can not meet the needs of her baby (low supply or medication exposure or other reason), can it be corrected and if not discuss the options of what to supplement with (donated milk, home-made formula, commercial formula, cow’s milk, goat’s milk, or vegan mylks with and how to supplement it (bottle vs supplemental system, etc..). Human Milk 4 Human Babies is a commerce free site on facebook to offer your extra milk or seek potential donors. Look for the global network and your regional group.

From my attendance at the recent conferences it is apparent that even some of the breastfeeding doctors can be adamantly opposed to milk sharing. La Leche League does not support informal milk sharing either.

It would be very reasonable to support milk sharing amongst friends who have known blood tests and are obviously healthy.

If the mother is feeding milk to their own baby, and recipient knows both the donor mother and the baby, it sounds responsible for a breastfeeding group to support informal milk sharing. Then go on to clarify if you must that if you don’t know the mother and the baby that carries risks of the unknown.

There is VERY little that makes milk bad. I’d be afraid of the risks of formula and increased illness.

 If you don’t know the donor you can get to know them.

The only reason I once heard for La Leche League not supporting the use of donor milk was desiring credibility to new-comers and the public.

There is much more awareness now on the benefits of milk-sharing, it is time to update policy and make a huge positive impact.

I could also accept if a new policy stated that both mothers and both babies be monitored for good health through out the donation period. The donor mother’s prenatal labs with HIV should suffice (HIV is a topic for another post). A donor baby who is healthy and growing, labs are not necessary. We just want to see that the baby won’t be compromised if mother shares milk. The recipient mother should have an evaluation on why she can’t produce enough milk and optimize her own production.

Doctors get blamed for making decisions based on pharmaceutical and financial interest. I have wondered if the hold out for breastfeeding groups to accept donor milk has something to do with collaboration and survival of milk banks.  I don’t know if this is fact, so don’t quote me. It’s just a thought.

Pasteurized milk serve a special community: the preemie babies and research. It is not easy to get pasteurized milk out to the communities healthy babies.

I will take this one step furthur. I have been a Raw food advocate. The same principle applies to breastmilk. While pasteurized breastmilk is much better than formula. Minimally processed breastmilk has the  LIVE enzymes. I also support the use of minimizing the handling of fresh milk.

If anyone has milk to share at this time, I can probably find a home for it.

Finally,

I do not support buying milk from Craig’s List and Social Media.

Permission to Mother now available on Kindle!

Should We Care How Beyoncé Gave Birth?

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Update: after posting this, Beyoncé released a statement saying that she had a “natural” birth. Right now, the blogosphere, facebook, and apparently the entire internet, are all on fire about how Beyoncé gave birth to her baby. Does it matter? Should we care? My answer is, yes… and no. Celebrity is a two-edged sword. The [...]

Miami Physician’s Breastfeeding Summit

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 Like a geek, I sat in the front row of this physician’s meeting on breastfeeding in Miami. I wanted to make sure I heard EVERYTHING. I didn’t even know about this conference til about a week ago. 
I get patients from Miami and when I heard about the meeting, I felt like I should now what is going on there. 
Who’s at the table:
Grisel Garcia MD from Miami
Joan Meek MD from Orlando
Julie Kelogg MD from Jacksonville
Liz Westwater from Baby Friendly
Lourdes Forester MD from Miami
Alberto Dominguez-Bali MD from Miami
So Miami has 14 hospitals and 12 are working towards Baby Friendly! Part of becoming Baby Friendly is that your physicians must have 3 hours of formal training in breastfeeding. Attending this meeting was physicians and other staff trying to meet this requirement. How do you get a physician at a meeting on a Saturday morning, on breastfeeding.  FREE CME, FREE breakfast and lunch, and a mug…. the good view of the harbor was a bonus. It got me there!
This was not a lecture to the choir!
Joint Commission a group that hospital quality control has a campaign directed towards mothers to “Speak Up”.
That’s how the meeting started– by showing the brochure. What does it mean when your mother speaks up and asks for skin-to-skin. ((It never entered my mind that a physician might not know what skin-to-skin was.)) This was a good non-threatening starting place to reach the participants. Dr. Bali showed a video of attachment after birth and the phases in detail. He emphasized touch, touch, touch… and he was quite passionate about it. He said, if the mother couldn’t do skin-to-skin immediately, partner or grandma should. 
He said we forgot something very basic– WE ARE MAMMALS! No other species survives without breastfeeding. 
We talked about removing warmers from the delivery room
Talked about how damaging suctioning is because it cause aversions, stresses baby, changes the flora.
We talked about how WE interfere with breastfeeding. We ((doctors)) and our policies interfere. 
But the good news is how a little education and a little encouragement form the physician GOES a long way.
The speakers told the other doctors to tell their patients:
“As your doctor, “I want you to know I support your breastfeeding.”
A point was made that if you tell mothers this, you should remove the formula display from your waiting room which undermines a mother’s confidence in herself and you.
In the hospital, anticpate the baby will be up all night.  The hospitals are implementing a no procedure, restful period from 1-3 o’clock in the afternoon. We talked about how society prepares mother that everything will go back to normal. We need to support mother better.
It was noted that in one area no one came to the breastfeeding support group, but they changed the name and  many came to massage class (and they spoke about breastfeeding).
When the hospital got an estimate to purchase formula, the formula company inflated the estimate.  There was several reasons that actual usage didn’t meet the estimated purchase cost. For example- staff passed out extra formula because it was free. As time went on and they used less formula, they purchased less.
We talked about delaying procedures, growth curve, reflux, hepatitis, glucose, jaundice, starting solids. 
The participants got to ask Questions at the end. I thought this three hours was excellent for Physician Breastfeeding 101.
The AAP is coming out with a new breastfeeding statement this year emphasizing the physicians role in management.
At the end Liz from Baby Friendly encouraged the doctors and said that surveys use to come back with negative about the doctors being the barrier, but in more recent years, the surveys come back as the doctors being the one who moved it forward!
I see mothers from Miami for tongue-tie (frenotomy was not discussed) and alternative vaccine schedules (discussed briefly, if any of the speakers supported an alternative schedule I didn’t here it). Also, most of my Miami consults have had out-of-hospital births. This meeting should have a positive impact on what is going on in the hospital! A good start has lasting effects!!
Permission to Mother now available on Kindle!