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
www.facebook.com/mother2motherlss
www.instagram.com/mother2motherdoula

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My breast feels hot and hard. Is this mastitis?

It could be. Many cases of mastitis begin with a hard knot in the breast. Often this hard spot is caused by a clogged milk duct.

What is a clogged duct?      Breast milk contains a variety of fats and proteins so that it is complete nutrition for your baby. The fats and proteins are different shapes and sizes. Sometimes they get tangled and get stuck in the milk duct. Most clogs release from the breast with frequent nursing and/or pumping. If your baby releases the clog while nursing, it is perfectly safe. Your baby will not have digestive upset from nursing out a clog.

What is mastitis?      Mastitis is inflammation of the breast tissue. It may or may not be caused by a bacterial infection. Mastitis is a relatively common condition. Women who suspect mastitis should keep nursing and seek treatment. Mastitis that is caused by infection is in the breast tissue, not in the milk. The milk is safe for the baby.

Common first aid recommendations for mothers experiencing the symptoms of clogged ducts or mastitis:

1. Keep nursing the baby. Frequent nursing is the best treatment. The milk is perfectly safe for the baby.
2. Rest. Mastitis tends to escalate more frequently in mothers who are over stressed. Staying in bed with your nursling has amazing benefits.
3. Drink plenty of clear fluids, just as you would with a cold or flu.
4. Apply heat to the affected area. Heat helps increase blood flow to the area and open the milk ducts so clogs can pass. A hot shower is a great place to hand express. Nursing directly after applying heat is beneficial as well.
5. Ibuprofen is a known anti-inflammatory that is compatible with breastfeeding. Contact your health care provider to discuss appropriate dosing.

Some mothers explore home remedies and traditional medicines. lavender

– essential oils massage oil: blend 1 part eucalyptus, 2 parts lavender, and 3 parts chamomile. Apply oil over skin, avoiding areola and nipple. Massage in. Cover with moist heat for 20 minutes. Repeat 3-5 times per day or until clog releases.

– herbal compress: chamomile is a known anti inflammatory. A chamomile tea bag can be used as a hot wet compress over the affected area.

– potatoes: grated raw white potato is said to draw out infection when placed over infected area

garlic– garlic: Garlic is considered naturally antibiotic and anti inflammatory. One study showed that babies nurse more when moms are taking a garlic supplement.

-lecithin: lecithin is a dietary supplement that is purported to keep fats smooth and flowing in the milk. A dose of 4000 mg is commonly recommended. Lecithin is derived from either soy or sunflower.
What to avoid

1. Cold. Ice or cool packs cause constricting.
2. Tight fitting bras or clothing.
3. Doing too much
4. Alcohol

Antibiotics are very effective in treating bacterial mastitis. Drugs from the penicillin family are commonly given to treat this condition. Amoxicillin and many others are very safe for breastfeeding. There is no need to wean to treat this condition, and evidence shows weaning during mastitis exacerbates the condition.

The information provided on this blog is not intended to diagnose, treat, or cure. Always contact your health care provider and LC to work as a team during illnesses while breastfeeding.

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