10 Questions with a Doula

1) What is a doula?
         A doula, also known as a birth companion, is a nonmedical person who is trained to assist women before, during, and/or after childbirth as well as her spouse and/or family, by   providing physical assistance and emotional support.
2) Why hire a doula?
        There have been numerous studies that show the benefits of hiring a doula include a decrease in the chance of C-section, decrease in the amount of time a woman spends in labor, decrease in the use of interventions like forceps and vacuum, decrease in the use of epidurals or need for pain medication, decrease the chance of postpartum depression, and increase the satisfaction a woman feels about her birth experience.
 
3) How does having a doula impact initiation of breastfeeding at birth?
        All doulas should be equipped to assist moms with the initiation of breastfeeding after birth. Often times in a hospital setting, nurses might have to leave to attend to another patient leaving the new mom to figure it out on her own. Some hospitals do not have on-site lactation consultants on call around the clock. Having a doula ensures that a knowledgeable person will be there to help if/when needed. 
4) What barriers to breastfeeding does a doula help reduce or eliminate?
    1. Educational barriers: misinformation about breastfeeding, milk production/supply
        2. Emotional barriers: lack of confidence in ability to breastfeed, embarrassment of feeding in public. A doula provides support if the mom is lacking support from family/friends.
        3. Physical barriers: learning how to prepare for breastfeeding, postioning mom and baby for comfortable and sufficient nursing/bonding time.
        4. Medical barriers: Breastfeeding while recovering from c-section, helping to identify potential medical issues such as tongue ties and lip ties and refer to specialists
5) Does a doula come in handy after birth?
        Yes. Doulas routinely remain in close proximity to moms immediately after the birth of their baby. This is to help facilitate the mother’s wishes for skin-to-skin care, breastfeeding initiation as soon as possible, and to answer any questions about newborn care and postpartum care. Many moms also benefit from the services of postpartum doulas. Postpartum doulas contract with the mother and her family for a specified amount of time (hours/weeks) once the family is settled at home after the birth. Postpartum doulas assist with baby care, sibling care, light household chores, and meal prep to help parents acclimate to having a new baby in the home. It can be a great help to have someone onsite those first days/weeks after birth to help with breastfeeding issues among other things, when needed.
6) What do you think are the 3 biggest factors in a birth that impact breastfeeding?
        1. Medications administered during labor and their effects on the mother and the newborn.
        2. Type of birth. If mom has interventions such as forceps, vacuum, or caesarean and baby has a medical issue due to this and they must be separated for an extended amount of time after birth.
        3. The length of the birth. A mom who has a lengthy labor may be extremely fatigued and unable to breastfeed right away.
7) How can moms find a doula friendly care provider?
        1. Moms can ask their care providers how they feel about having a doula in attendance at the birth. Most providers will have a definite opinion one way or the other.
        2. ICAN of Atlanta has a provider review section on their website. Anyone can join ICAN. You do not have to have experienced a c-section. The forums provide excellent information for all expectant moms.
        3. Word of mouth. Ask your friends,  who have used a doula, who their provider was and what the experience was like. If you have already hired a doula, most can tell you of the more popular doula-friendly practices in the area.
8) How can moms find a doula in their area?
        Resources for finding a doula in your area include www.doulamatch.net, www.gabirthnetwork.com, (or local birth networks) asking your provider if they have a list of doulas that they work with, websites of doula certifying organizations such as DONA, CAPPA, and ProDoula, and again referrals from friends/family/mom’s group members who have used a doula’s services before.
9) What skills does a doula have to help with long term breastfeeding success?
       Many doulas have taken breastfeeding classes to assist their clients in the early stages of breastfeeding. For long term breastfeeding success, doulas assist moms through emotional support and encouragement. Many moms give up just because they do not have the support needed to continue. Doulas provide practical information and solutions to assist with challenges associated with breastfeeding. We are knowledgeable about common problems like engorgement, symptoms of clogged milk ducts, mastitis and can refer you back to your care provider or a lactation consultant for added assistance.
10) Do moms need a doula for birth center or home births?
         I believe all moms could benefit from the support of a doula no matter where they choose to give birth. Birth is a very beautiful, but physically and emotionally draining experience. Having a person who has walked the journey before can make it easier by helping to reduce or eliminate the obstacles of fear, anxiety, lack of information, and more because they are a trusted, trained and experienced individual who is there just for the mom.
Bonus Question! 11) Share your favorite nursing moment?

My favorite nursing moment was probably the first time my daughter latched properly. I was unable to successfully breastfeed my older son due to lack of education and support. I became engorged and had painful, cracked, and bleeding nipples. After 3 days of crying (both of us) I gave up. After I had my daughter, I was able to get help from the buses at the hospital. They explained what a good latch looked like and should feel like. They gave me tips for sore nipples, too. So once at home, when she latched with little help from me and with no pain to me, I was very excited. I went on to breastfeed her for 14 months.

Elysia Douglas is a wife, mother of 4, and a professional, certified birth doula in the Metro Atlanta area. In her first 3 years as a doula, she has assisted over 50 families as they prepared for and welcomed their little ones into the world.  She offers attentive, nurturing, and compassionate support during pregnancy, labor, birth, and beyond. Elysia is passionate about equipping, encouraging, and empowering women to achieve their birth goals by providing unbiased, evidence-based information, emotional, and physical support throughout their pregnancy journey. She fully believes in your right to know your options and make decisions that are best for you and your baby. When Elysia is not at prenatal visits, facilitating a childbirth education class, or attending a birth, she enjoys sewing, painting, volunteering in children’s ministry at her church, and spending time with her family and friends.

www.mother2motherlaborsupport.com
http://doulamatch.net/profile/6020/elysia-douglas
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What is a Normal Feeding Routine? How Does it Change with Age?

The one thing that is certain with babies is they change every day. Knowing what the range of normal is for infant feeding can help parents make better decisions about the family rhythm.

Exclusive Breastfeeding and Human Milk Feeding

0-6 weeks: This is the time when babies nurse constantly. Their tiny tummies want a constant and steady fuel supply, just like they were accustomed to in utero. The placenta nourished the baby so well, hunger is something completely new after being born. It’s easiest to feed babies before they show signs of agitation. Nursing in clusters is common. Nursing every 1-3 hours day and night is normal. Nursing sessions may last 5-35 minutes at a time. Babies frequently fall asleep at the breast and nurse in their sleep. Expect 10-15 nursing sessions per 24 hours. Babies should be fed on cue or on demand. No medical organization endorses scheduled feeds for breastfeeding infants.

6-12 weeks: This period is usually full of what most people call growth spurts. Babies this age are still nursing around the clock. Remember, human milk is digested in about 90 minutes. The tummy is still small, maybe as little as 2 or as many as 5 ounces. Some babies will have a “witching hour” in the early evening where they feed in a cluster of sessions. Babies who have been separated from mom during the day may be particularly interested in a marathon evening nursing session. Nursing and bottle feeding human milk should continue on cue or on demand.

3-6 months: The World Health Organization and the American Academy of Pediatrics recommend that babies continue to receive only human milk at this time. Babies in this age range have a variety of sleep patterns and growth patterns. Teething may begin during this stage which may disrupt feeding or increase night wakings. All of this is normal. The stomach size is 3-5 ounces. Babies in this age range may increase their nursing or cluster feed just as newborns do. On cue feeding should continue at this age.

Breastfeeding with Complimentary Solids

6-9 months: Most babies will have a first tooth appear at this point. Babies who have a tooth, can sit well unsupported, and have lost the tongue thrust reflex are ready to begin solids in compliment to human milk. Human milk is still recommended as a primary source of nutrition. Ideally, the baby is nursed first then solids are offered as “dessert.” You may have heard “food before 1 is just for fun.” Small amounts of complimentary solids are important for iron and other minerals as stores from birth are utilized by this age. Human milk should be offered on cue. Solid foods can be offered at scheduled meal times.

9-12 months: Most babies are interested in self-feeding. They have mastered the pincer grasp and can put bits of food into their own mouths. Human milk is still the bulk of their nutrition. Some babies may not have had a tooth erupt yet. Nursing through the night is very common.

Nursing a Toddler

12- 15 months: The American Academy of Pediatrics feels this is a safe time to replace human milk with other foods including the milks of other mammals. Many mothers continue to nurse their toddlers for nutrition. Toddlers at this age are busy and may have nutritional gaps because they are out exploring the world instead of eating. Their stomachs may only be a few ounces bigger than they were a year ago. Continuing to breastfeed at this age can help a growing toddler meet nutritional needs during a “picky” phase.

15-18 months: Children who are still nursing may continue to do so at night as well. Mothers commonly explore night weaning around this age. Other mothers are glad to nurse through the night to help with the pain and wakings associated with eruption of molars.

18-24 months: By this age, most children are well established on solids interested in eating with the family at more regular times. Self feeding has been mastered. Many children can drink out of a small cup unassisted. Toddlers who are nursing may nurse frequently or only once a day. The range of normal is very wide.

Full Term Nursing

2 years and beyond: The World Health Organization recommends that children breastfeed for a minimum of 2 years with nursing continuing if both mother and child so desire. Children often self-wean some time after the second birthday. Pregnancy or extended separation may motivate a child to wean faster from nursing.

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