Welcome Lindsay!

Oasis Lactation Services is proud to announce our newest team member who is bringing a phenomenal service!

Why hire a postpartum doula? Get help establishing better sleep rhythms, better feeding rhythms, and learn ways to make the baby time enjoyable. Postpartum doulas are invaluable for adding a second or third baby to the family. They are able to support the older siblings as well as the mom and baby.

Lindsay Tucker is a certifying postpartum doula providing support and care to mothers who need a variety of postpartum services. Lindsay has a Bachelor of Science degree in Psychology. She’s been passionate about babies for as long as she can remember and has supported births as a trained Labor Doula and birth photographer. Lindsay breastfed her two sons for a total of 6.5 years and has personal experience with postpartum depression, colic, silent reflux, tongue and lip ties, and tandem nursing. She knows that unnecessary suffering can be prevented with proper support and education and her goal is to help new families get off to a great start.

Postpartum support services include: assistance with baby care, discussion of basic breastfeeding and bottle feeding strategies, assistance with mother care, household help, support to protect co-resting for mother and baby, assistance with older children, baby care information, postpartum stress management, developing exclusive breastfeeding plans, diapering, and more.

Contact Lindsay: lindsayTclc@gmail.com or 404.273.5366 call or text~ $75 for 3 hour session in your home, can book multiple visits

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10 Questions with a Homebirth Midwife

1) Moms planning a home birth are planning for a low intervention birth. Is the same true for their breastfeeding goals? Do women delivering at home plan to exclusively breastfeed and avoid formula intervention?

Yes. Most women who are planning natural birth also plan to exclusively breastfeed. However, there are situations where a mom chooses not to breastfeed. She may be a victim of sexual abuse or was unable to breastfeed a previous child. We ultimately want women to make the decisions they are most comfortable with after having been provided with as much education and support as possible.

2) What kind of support can a homebirth midwife provide to breastfeeding mothers that is different than a midwife in a hospital or birth center setting?

We offer a lending library that includes breastfeeding books. We offer a one hour prenatal visit so the mother has ample time to discuss her questions, goals, and fears about breastfeeding.

3) What role do you take in prenatal breastfeeding education?

In addition to the support and information provided prenatally, we also suggest the utilization of outside resources like breastfeeding classes, lactation consultants, and La Leche League meetings.

4) What aspects of homebirth uniquely facilitate breastfeeding initiation and establishment?

We are adamant about the necessity of skin to skin contact between mom and baby, with as minimal interruption as humanly possible.  Every aspect of the postpartum experience works better when you just leave them alone. Moms heal faster and babies want to nurse when they are not being poked, prodded, and taken away from mom for reasons that could, in most instances, wait.

5) Describe your breastfeeding-specific training. Does it differ from the training hospital midwives have?

I am not familiar enough to speak on the training of hospital midwives. My experience has grown through living and learning. I nursed all four of my babies at various lengths, based on my education and abilities at the time. I am learning all the time through my clients’ experiences ranging from no intervention to the necessity of an IBCLC or pediatric ENT. I also continue to learn through the support of my peers.

6) Describe the well baby care homebirth midwives give in the first 48 hours. How does this care screen for breastfeeding obstacles?

We usually stay with the mother after birth until baby has latched and is nursing well. If this doesn’t happen for some reason, we are in constant contact until it does. We listen to what moms are describing and make the call for further help based on what they are reporting. We may make another trip back to the house, or, if it seems like an issue that is out of our scope of knowledge, we will refer first to an in-home lactation consultant who is willing to assess mom and baby while maintaining the need for skin to skin contact in their own environment.

7) Do women with gestational diabetes, PCOS, or other endocrine disorders birth at home? What special feeding support do these dyads receive from a midwife?

Yes, and we don’t tend to do anything special unless we are finding it to be an issue. The premise is that it is normal and natural unless it’s not. We aren’t in the business of fixing things that aren’t broken. If we need to refer out for these things, we will.

8) Do Homebirth midwives facilitate informal milk sharing between clients? Why or why not?

Yes. However, not all moms are comfortable with that and we support that, too.

9) What signs or symptoms of feeding challenges do you refer out to an LC?

Baby not gaining weight, latch that just isn’t getting better despite our suggestions of different feeding positions,  mom in extreme pain with cracked, blistered, and bleeding nipples.

10) If a client chooses not to breastfeed, what alternative feeding do you recommend and why?

I usually don’t do much recommending of formula, but I suppose an organic formula of some type if they must. It is extremely rare that a client of ours comes to their six week postpartum visit and is not still exclusively breastfeeding. If they are supplementing with formula, they have already been working with a lactation specialist and have made those decisions together.

Bonus question 11) Share your favorite nursing memory.

I remember a moment nursing my last baby. I nursed all four, but I think I was in a hurry for a lot of that time. Hurry up and quit nursing. Hurry up and walk. Hurry up and potty train. With number four, I knew she was my last and I was thankfully in a place in my life where I didn’t want to hurry anymore. I wanted everything to slow down. I am grateful that I was able to have the awareness to enjoy every single stage with her. I squeezed every last drop. Nursing her one afternoon, she was holding my finger and resting her hand on my chest, while staring into my eyes. I felt in the depths of my being, at that very moment, what an amazing gift to be given the ability to nurse my baby, and I wasn’t going to hurry.

 

Rachel Hart I am a traditional midwife and CPM. I moved to Atlanta from Las Vegas with my husband and four children in 2008. I am a graduate of the University of Nevada, Las Vegas with a Bachelor’s degree in English. I began my midwifery journey through an apprenticeship training program in 2005 and began my own practice in 2007.  All four of my children were born at home, the last birth unassisted. I joined Beth at Birthing Way in 2010.

Helping women realize their true power and potential as a woman and mother through the birthing process has been a privilege. I have really enjoyed attending births with the lovely families here in Georgia. I also support the birth community as Secretary of the Georgia Midwifery Association and as Membership Director of the Georgia Birth Network.

 

www.birthingway.com
rachel@birthingway.com
770-597-4478

Thrush – Yeast – Candida

Thrush is a common diagnosis when mom is experiencing nipple pain. Thrush is an overgrowth of a yeast that lives on the skin and in the gut of healthy humans. Thrush may also be referred to as candida albicans.

How Common is Nipple Thrush?

If you ask a group of moms, they’ll tell you thrush or yeast is very common. If you look at the research, a very different picture emerges. Mothers frequently complain of burning nipple pain, nipple damage, yellow or white discoloration in damaged areas of the nipple, sensations of heat or itching, and pain that radiates into the breast. These symptoms are then lumped together as thrush and treatment is prescribed often without a culture. Frequently, mom’s symptoms improve then return. Frequently, another round of anti-microbial treatment is begun.

The latest research on candida and breast yeast informs us that thrush is often the incorrect diagnosis. More women are shown to have staphylococcus aureus than candida, and not all women with one or both positive cultures have pain. In fact, only 15% of the study group experiencing nipple pain had yeast in the culture from swabbing the nipple. Even fewer, 9% had candida in the milk sample (Amir et al). Does ductal thrush even exist? Could it be something else?

Staph aureus has a white to golden color when present on the breast nipple. The common prescribed treatment for candida is miconazole or clotrimazole. Both of these drugs are effective in treating staph aureus as well as candida.

The largest common denominator in these studies on mothers experiencing nipple pain was nipple damage. Nipple damage is caused by a sub-optimal latch.

How Sub-optimal Latch is Misdiagnosed as Thrush

When a baby latches shallow to the breast and does not draw plenty of the areola into the mouth, the nipple is often exposed to inappropriate friction. The baby then must use the jaw and a clamping motion or bite to hold the nipple in the mouth. This can cause a very common condition called a vasospasm. The pressure from the poor latch causes an interruption of blood flow around the nipple. When blood flow returns to normal, a pain called a vasospam may occur. This pain can feel like shooting or burning pain in or around the nipple or deep into the breast. This pain can happen during, after, or between feeds. The solution for this pain is to fix the latch.

One contributing factor to shallow or clamp-down latch is a high arched palate in the nursing baby. These babies often have milk stains on the tongue because the tongue doesn’t rest against the hard palate and clear itself of milk. The milky tongue may look like thrush. Tongue-tie or ankyloglossia is another risk factor.

Sources:
Amir LH, Garland SM, Dennerstein L, Farish SJ: Candida albicans: is it associated
with nipple pain in lactating women? Gynecol ObstetInvest 41:30-34, 1995
Hale TW, Bateman TL, Finkelman MA, Berens PD. The absence of Candida albicans in milk samples of women with clinical symptoms of ductal candidiasis. Breastfeed Med 2009;4:57-61.
http://www.placerconferences.com/wp-content/uploads/2014/05/G.Why-Does-it-Hurt.pdf

What to Do if Your Culture Came Back Positive for Yeast

Medications: Your health care provider can prescribe medications for both you and your baby that are compatible with breastfeeding. Many mothers feel anxiety about medications and breastfeeding. Remember, your doctor prescribes medications because they have more benefits than risks. If you are interested in reading study data on breastfeeding and taking your prescriptions, contact the Infant Risk Center.
Pumping Guidelines: If your baby depends on pumped milk, keep feeding the pumped milk. If you engage in informal milk sharing, it is wise to take a break from donating until the yeast is cured. If you donate to a milk bank, contact the bank about the medications you are using to clear the infection. If you have an open system pump, be careful. Change the tubing completely. The tubing can’t be sterilized well and should be changed if there is thrush. If you have a closed system pump that is functioning properly, just sterilize the pump parts correctly after each time you pump.

Nursing Guidelines: It’s perfectly safe and beneficial to nurse through thrush. The direct mouth-to-breast nursing is a closed system and transfers antibodies and biochemicals back and forth. Infant saliva on the nipple actually helps change the make up of the milk to meet a babies unique immune needs. The living cells in the milk help fight the infection during the nursing process. The sucking also can help relieve some of the discomfort babies experience when baby also has thrush.

Nipple Care: Your health care provider will probably provide a nipple ointment that is anti-fungal. There are many on the market that are perfectly safe for your baby’s mouth. You may want to consider saline nipple soaks to ease the discomfort and facilitate healing any damage. Using disposable breast pads can reduce staining in your nursing bras and clothing from the ointment.

Laundry and Dishes: Many moms are worried their bras, cloth breast pads, and cloth diapers are harboring yeast. Contact your cloth diaper manufacturer for instructions on how to strip your diapers. Other fabrics can be soaked in vinegar for 24 hours then laundered normally. Pacifiers and bottle nipples can be sterilized daily.

This blog post is informational only and does not serve to diagnose or treat any condition. See your healthcare provider if you suspect a nipple infection.

 

Breastfeeding is MORE than Milk

 Breastfeeding provides perfect nutrition for infants, but it also does much more! Direct nursing at the breast has a whole host of benefits that are easily overlooked in a culture so focused on the milk. Nutrition is only one aspect of infant feeding that leads to growth and development.

Muscle Mechanics:

  The muscle mechanics involved with nursing facilitate optimal cranial-facial development. You’ve probably heard about importance of “tummy time” for the development of head control. Nursing your baby in a laid back position is tummy time made easy! Breastfeeding also coordinated the right and left hemispheres of the brain because the baby is moved from left to right on the mother’s body. This brain development is critical to other developmental milestones like crawling, walking, and later reading. The developing infant palate, mouth, and skull are shaped by feeding. Feeding at the breast helps the baby achieve normal oral motor function and growth.

Skin to Skin:

    Breastfeeding inherently provides the skin to skin contact newborns need for early neurological development, body temperature regulation, and blood sugar regulation. The mother-baby bonding that occurs while a baby is at the breast is unparalleled. Studies show held babies have lower stress hormones.

Increased Maternal Rest:

    Exclusively breastfed infants who sleep in close proximity to their mother replicate their mother’s REM cycles.  Since their sleep is in sync, the baby is more likely to wake for nursing when the mother is not in a deep sleep state.  Maternal sleep is a crucial part of postpartum recovery. Studies show that breastfeeding moms actually sleep about 45 minutes more per night than formula feeding moms.

Better Maternal and Infant Mood:

    Breastfeeding facilitates the release of the “feel good” hormone oxytocin in the mother during “let down” or milk ejection reflex. Mothers of breastfed babies experience less postpartum depression.  Breastmilk contains multiple hormones that promote happiness and relaxation in infants. Breastfed babies also are less likely to have colic.

Infant Sleep/Wake Cycle Regulation:

    When babies are first born they do not make their own sleep hormones. The newborn receives the sleep hormone melatonin directly from breastmilk. The act of suckling at the breast releases a hormone in the baby called CCK, which makes him or her feel full and sleepy. Nursing to sleep is good for babies!

Protection from Sudden Infant Death Syndrome:

    Frequent night wakings to nurse are a large part of normal infant sleep, and serve as nature’s protection against SIDS. Bottle feeding human milk through the night has not shown to be as protective in preventing SIDS as direct nursing at the breast.

The American Association of Pediatrics recommends exclusive breastfeeding for the first six months of life, and continued breastfeeding with complementary solids until at least age 1. Continued support is a huge factor in long term EBF success. A prenatal visit with a lactation consultant or lactation counselor is the first step. An LC can answer your questions and assist you with formulating a breastfeeding friendly birth plan.  If you have already had your baby, schedule a home visit or clinic visit with your LC for an in depth consult that can help your family realize all the benefits of breastfeeding.

Bringing Your Newborn Home

Bringing your infant home can be both exciting and scary. You may wonder what your family’s new normal will look like. Many refer to this period of time as the “fourth trimester,” or the period of time when mom and baby both adjust to their new physically separate states. This adjustment takes place over the course of several months. When your baby is first born he or she has no experience with the world beyond the womb. Certain things can facilitate the ease of this transition from the womb to your arms. Bonding is the name of the game during the first days home. “Eat, bond, sleep, repeat” becomes the new mother’s mantra.

    The natural habitat of the human infant is mother’s breast. Your baby will likely spend most of his or her time there for the first few months. Since newborn nutrition is such a large part of life with a new baby, taking a prenatal breastfeeding class is essential. You may wish to speak to an LC one on one to discuss your questions or concerns specific to your family prior to your baby’s arrival.  A prenatal breastfeeding consult is a helpful tool for preparing you with information about establishing the nursing relationship. Most of the time in Atlanta area hospitals, you will have the opportunity to receive a quick consult from a hospital lactation consultant prior to your discharge. This consult is generally brief. Many families still have questions and concerns regarding breastfeeding after returning home. Many new moms prefer to schedule home visits with their LC to stay in the comfort of  home during the recovery period.

 Breastmilk is digested in 90 minutes. Expect to nurse your baby 10-15 times per 24 hours. Many first time mothers worry that their baby nursing frequently is a sign that they do not make enough milk. This is usually not the case. Colostrum, or newborn milk, is present in your breasts starting early in the third trimester. It is nutritionally rich and very little is required to fill a new baby’s tiny stomach. If your baby experiences the common condition “jaundice” also called hyperbilirubinemia, colostrum is a powerful laxative that will help resolve it. Within the first few days your milk will transition to “mature milk.” Each time your baby nurses, it signals your body to make more milk. Frequent on-cue nursing during the newborn period generally equates to a robust milk supply in the long term. Exclusive breastfeeding or “EBF” and avoiding formula are common goals for many mothers. This goal is attainable with access to breastfeeding education and breastfeeding help if necessary.

    The best indicator of adequate intake is output. Normal diaper count is 6-10 wet or dirty diapers daily. In the first week, counting diapers can give you reassurance that your baby is indeed eating enough. Your baby should have at least one stool per each day of life. Day one- 1 poop, Day two- 2 poops, Day three- three poops, and so on. “Cluster feeding” or blocks of frequent nursing are common. Although nursing is frequent, it should never feel painful. Your baby will likely love to be held on your chest close to your breasts even when he or she is not nursing.

    Skin to skin contact is crucial for your newborn.  Skin to skin regulates the infant’s body temperature and blood sugar. It also facilitates important early neurological development. The simple act of holding your baby skin to skin stimulates production of hormones in both the mother and baby that keep everyone feeling relaxed and calm.  Your partner can help you with this important bonding process by doing things like screening phone calls, entertaining visitors, bringing you food and drinks, changing diapers, and caring for older children. Your partner should encourage you to rest as much as possible while your baby sleeps.

Newborn sleep gets a lot of publicity. When babies are born, they do not make their own sleep hormones. They receive their sleep hormones from their mother via breastmilk and suckling. This is why many babies nurse to sleep. Nursing to sleep is biologically normal and natural. Many people refer to babies “having their days and nights confused.” This is not the case. Babies are not born with a light/dark cycle. One will eventually develop with time, but during the newborn period frequent night wakings are to be expected.  Frequent waking to nurse is part of nature’s protection against SIDS. The American Academy of Pediatrics recommends a form of co-sleeping that is referred to as “rooming in” for the first six months of life as a measure of SIDS risk reduction. Sleeping in close proximity to your baby also allows to have a heightened awareness of your baby’s hunger cues throughout the night.

Your new baby’s first days at home will likely seem like more of a whirlwind than pregnancy.  Prenatal breastfeeding education and accurate expectations of the newborn period can make this transition much more manageable for families. However, there will be times that you don’t know what to do. When in doubt just do less, nurse more, and call your LC!

How Do Moms Pump Enough to Return to Work?

Many moms want a safety net of pumped milk in the freezer for their return to work away from their babies. While it’s only necessary to have enough milk saved for the first two days back at work, many moms want to save several days or even weeks worth of feedings during their maternity leave.

Please read What to Expect When Pumping to trouble shoot and get the most out of your pumping experience. This article addresses how to juggle pumping during your maternity leave and during the working day.

When to start building a “stash”

Most women start with over production. The first 10 weeks of breastfeeding are the easiest for milk collection. This is also a critical time for conditioning the body to respond to a pump. Ideally, moms should nurse on cue and spend a great deal of time resting skin to skin with their babies for the first 2 weeks. Once baby has regained birth weight, around day 10-15, it’s time to try pumping.

Milk collection is easiest in the morning hours when the milk making hormones are highest. Beginning at this favorable time will help make pumping a more positive experience. After nursing the baby, pump either one or both sides for 20 minutes each. Even if the milk stops flowing, continue pumping for 20 minutes per side.

Weeks 2-4, pump one time per day in the morning after nursing. Expect to collect 1-2 ounces each day. Remember: 20 ounces is enough milk for about 16 hours of mother-baby separation.

If you wish to increase your daily milk collection, add a second daily pumping session weeks 4-6. Pumping only twice a day will help you collect several days worth of milk before returning to work.

If your baby cues to nurse after pumping, just nurse. The breasts are never truly empty until you wean. The more milk removed, the faster the glands work to produce more milk. No pump is as efficient as a baby who is properly latched. There is no need to feed the baby the pumped milk in place of nursing.

If your maternity leave is longer than 6 weeks, continuing pumping 1-2 times per day as is possible for the duration of your leave. This helps maintain a conditioned response for more efficient pumping in the future.

When to Pump at Work
No two work environments are the same. No two work days are the same. Not every work environment allows for predictable or scheduled pumping sessions. Things to consider:
– aim to pump every 1-3 hours. This is a range. Babies and breasts are flexible.
– don’t feel trapped on a schedule
– if you anticipate a long meeting or event you cannot break out of, consider pumping once an hour for 2-3 hours beforehand and/or afterward
– your body does not require you to pump on a set schedule just as your baby does not feed at set time
– a hands free pumping bra can help you pump during your drive to and from your work location
– hand expression may help moms who have a short break but can’t make it to the pumping room
– taking a lunch break to nurse your baby may be easier than pumping as frequently at work

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