Website

March 5, 2011

My new website is up. I am certain that I will update it and change it over time, but I would welcome feedback on it’s beginning stages. 

I also welcome beautiful photos of bellies, birth and breastfeeding that you would like to share on my website.

I am asking clients and professionals that I have worked with to share testimonials as I begin to expand my independent practice as a Lactation Consultant.

I have included a blog in the layout of my new website and plan to publish future posts on that site.

www.birthtobreastfeeding.com

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There are 10 steps required for a hospital to be considered Baby Friendly as outlined by UNICEF and The World Health Organization.

The 10 steps are as follows:

1 – Have a written breastfeeding policy that is routinely communicated to all health care staff.
2 – Train all health care staff in skills necessary to implement this policy.
3 – Inform all pregnant women about the benefits and management of breastfeeding.
4 – Help mothers initiate breastfeeding within one hour of birth.
5 – Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
6 – Give newborn infants no food or drink other than breastmilk, unless medically indicated.
7 – Practice “rooming in”– allow mothers and infants to remain together 24 hours a day.
8 – Encourage breastfeeding on demand.
9 – Give no pacifiers or artificial nipples to breastfeeding infants.
10 – Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

To many, these steps might seem logical or even easy. Surprisingly hospitals find it so difficult to assist in successful breastfeeding for mothers and babies that there are only 105 Baby Friendly birth centers in the United States and only 5 in Oregon.

The 5 Baby Friendly hospitals in Oregon are:
Three Rivers Community Hospital in Grants Pass
Providence Medical Center in Medford
PeaceHealth Nurse Midwifery Birth Center in Springfield
Kaiser Sunnyside Medical Center in Clackamas
and very recently joining the ranks of Baby Friendly Hospitals in Oregon is
Providence Medical Center in Newberg.

I recommend contacting your local hospital or birth center and asking them to become Baby Friendly to better support local moms and babies efforts to breastfeed successfully.

To find out more: The Baby Friendly Hospital Initiative

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The following information is important and relevant for breastfeeding mothers and mothers who plan to breastfeed in the future. Natural birth affects breastfeeding getting off to a good start. Many sources site that fact including Counseling the Nursing Mother, 4th edition by Judith Lauwers & Anna Swisher. “Parents can arrange for a birthing environment that promotes early, uninterrupted breastfeeding…” “They can choose to deliver their baby at home or at a birthing center to reduce unnecessary interventions.”

As a woman in Oregon you have have the right to choose who will
attend your birth. That freedom is in jeopardy! A bill recently
introduced to Oregon legislature would make virtually all forms of
serving women in pregnancy, birth and postpartum illegal
without a state license.

House Bill 2380 gives a board of non-elected officials the power to decide who can give birth outside of a hospital and who is allowed to help.

If House Bill 2380 passes:

~All midwives would be restricted from serving certain women.

~Unlicensed midwives would be illegal in Oregon.

~Some women would not be allowed to hire a midwife.

~Family and friends could be prosecuted for assisting a birthing
mother.

~Doulas could be prosecuted if they assist in a woman’s labor at
home.

~The cost of homebirth would rise.

Tell the state “Hands off my rights! Keep Oregon law the way it is.”

Visit www.OregonBirthRights.com today!
The website provides a copy of the proposed bill, contact information for your local representatives, sample letters to send the representatives to tell them you are happy with our current birth freedom and choices in our wonderful state.

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~information provided by Laura Tanner, mother of 3 & homebirth midwife in Salem, Oregon.

Colostrum

December 2, 2010

I often talk to mothers who are advised to begin pumping their breasts and/or supplementing within the first 24 hours.

I also frequently talk with mothers who are trying to get baby back to breast after weeks of pumping and bottle feeding, usually with formula supplementation as well.

After asking these moms why they began pumping in the first place, it is because they are told by hospital staff that they do not have enough milk. There are so many things wrong with this statement. I could discuss the way that the environment in which a woman gives birth and interventions affect a mother’s milk supply, her hormones, and the baby’s ability to suckle. I could go into how much more efficient a baby is than a breast pump and how supporting a mom to feed her baby at the breast would be a much more productive use of time, money, and would also build strong bonds within families. However, I won’t even go into all of these things on this post. In this post, I will try to stick to the basics of colostrum. What is it? What is the purpose of colostrum? How much does baby need in the first few hours? In the first few days?


What is Colostrum?

*Colostrum is basically your first milk & baby’s first food.
*It is thicker & stickier than your milk will be in the next stages of milk production.
*Yellow-ish in color

Why is Colostrum Important? What does it do?

*Colostrum functions as a natural laxative for babe. This is a wonderful way to help baby pass the first stools, meconium.
*Colostrum helps keep baby healthy by providing living cells complete with amazing antibodies that assist an infant’s immature immune system. (they certainly can’t make formula a living substance!!)
*Easy to digest. Perfect food for baby. Any supplementation is enough to change the flora of an infant’s gut for at least 2 weeks.
*aids in excretion of excess bilirubin, helping prevent jaundice
*seals gastrointestinal tract of babe, this helps prevent later issues with food sensitivities

How much Colostrum Does my Baby Need?

Baby’s stomach capacity is approximately the size of the palm of their hand. It is normal for moms to love their baby with so much intensity that they want to do everything just right. It is a powerful mothering instinct to want to make sure baby is fed. It is a great aspect of the strong bond between mothers and babies even before birth. However, it is also important to understand an infant’s stomach capacity and to realize that it is not necessary to fill up an entire baby with milk within the first day. Infants do not have hollow arms and legs and they are born to take only the precise amount of colostrum that your body is ready to feed them as you both learn about breastfeeding together.

The average stomach capacity of a newborn is:

DAY 1 ~ 5-7ml. (wow!! this means your new baby only needs about 1.5 teaspoons per feeding)
DAY 3 ~ 3/4-1oz. (2 tablespoons!! yep, that is all. you & your baby can do this!)
DAY 7 ~ 1.5-2oz (3-4 tablespoons)

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The great news is that if you have provided exclusive breastmilk throughout baby’s 1st week, it is so much easier to continue nursing for as long as you wish.

A Great Visual of Colostrum with Hand Expression

Epidurals

November 12, 2010

A lot of the breastfeeding counseling that I do is for families who have had a hospital birth. It is rare that I work with mothers who choose to have their babies at home. I do not think this is a coincidence. I believe that most breastfeeding problems, like most birth issues are caused by high intervention births. I believe that many of these barriers can be easily remedied with preventative, holistic care.

Many mothers that I talk to prenatally are planning hospital births and they are often planning an epidural. Family & friends frequently encourage epidurals, joking with mothers as they doubt their abilities to handle labor. It is not supportive for people to question a mother’s ability to birth her baby. Although well-meaning family may believe that they are saving a woman from experiencing pain, it can often feel as though they are truly questioning her parenting abilities from the very beginning. After all, what better experience to prepare a woman to parent than birth. She will encounter lows, highs, love and the amazing empowerment that comes from thinking that she can’t go any further, then going there and becoming a mother.

The epidural is a domino effect consisting of a mother losing the empowering experience of a natural birth and often followed by difficulties with breastfeeding. Epidurals do lead to many interventions including cesarean sections. Epidurals affect a mother’s ability to be able to successfully breastfeed her child and shorten the duration of the breastfeeding relationship.

I do form my opinions from anecdotal experiences of hundreds of mothers that I have talked to concerning their birth and breastfeeding experience and I am also biased as I have experienced the wonder of birthing two of my babes at home. However, the effect of epidurals on women, babies, and their breastfeeding relationship is also well-documented.

In 2006, The International Breastfeeding Journal published a study which found that women who had epidurals were less likely to breastfeed in the first few days after birth and those who did were more likely to stop nursing within the first 6 months when compared to mothers who did not receive an epidural. Other studies have also shown a link between epidurals and an infant’s ability to organize suckling properly.

Cesareans typically create barriers to breastfeeding as well. Breastfeeding after a c-section will be another post topic. Cesareans often create challenges to successful breastfeeding due to separation of mom and babe, medication, delayed mature milk (which isn’t necessarily an issue, but will be in the hospital), difficulty with comfortable positioning for breastfeeding during recovery and a variety of other reasons. I am mentioning how a cesarean can affect breastfeeding in this post as epidurals can also lead to cesarean sections which I do not feel a lot of mothers are told in an open honest discussion with their caregiver about true informed choice.

In 1993 researchers began to study the effects of epidurals on first time mothers. However, this trial had to be ceased as the cesarean rate was so great, it was considered unethical to continue. Before discontinuing the study, they found increased rates of cesarean section to be 50% at 2cm, 33% at 3cm, and 26% at 4cm dilation. Risks do appear to lower as a mother reaches 5cm dilation. However, it is important to remember that the risk of cesarean is only lowered in correlation to the epidural, not overall.

I encourage mothers who plan to breastfeed their babies to research their birth options thoroughly. If you are expecting a baby and have any questions about how your birth plan might be related to your breastfeeding goals I would be happy to answer any that I can.

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Resources
Midwifery and Childbirth in America by Judith Rooks
International Breastfeeding Journal
http://www.childbirth.org/articles/episec.html
http://www.sciencedaily.com/releases/2006/12/061211092622.htm
http://aamishop.com/index.php?main_page=product_info&cPath=17&products_id=256

The First Few Weeks

October 25, 2010

As this is the beginning of a new blog, I thought a great place to start would be the beginning phase of milk production. I am passionate about mamas learning how to get breastfeeding off to a good start. I am also passionate in my frustration with the negative messages mothers are hearing about their body’s ability to sustain their babes during the first phase of milk production. It is very uncommon for a mother to experience breast fullness or leak any whitish colored milk for 40-70 hours or 2-3 days. Many hospitals are giving mothers the message that as they have ‘no milk’ during this time. Families are often told that they will need to pump and/or supplement with formula. I am certain that the human race has not typically gone without nourishment during the first 3 days of life since the dawn of time. Historically, mothers were able to feed their babes before hospitals swooped in to save us bearing gifts of funnels and tubes attached to our breasts.

Although mature milk typically arrives around the 2nd or 3rd day after birth, variations of normal do exist. As birth intervention rates go up, so do the rates of breastfeeding interventions. Many moms who experience a cesarean birth often experience the second stage of milk production between 4-6 days postpartum. This does not mean a mother has colostrum for 2-3 days followed by empty breasts for another couple days and then her mature milk comes in. What it does mean is that your body has to work extra hard to interpret all of the different hormonal and chemical messages it has received or failed to receive during a medicated and surgical process. For this reason, it is all the more important to put baby to breast often. Colostrum will be available until the next phase of milk production begins. Whatever a pump can do, a baby can do better! 😉

I am going to explain the basics of milk production because I want mamas to feel assured that this WILL work. Your amazing body that grew such a perfect baby knows just how to continue to nourish her. When or if you start leaking colostrum during pregnancy does not determine breastfeeding success. Some moms leak colostrum when they are 4 months pregnant. Some never leak a drop. It is all well within the ranges of normal. Colostrum will be present and available when you first put your newborn to your breast. The stomach capacity of a newborn on day 1 is 5-7 milliliters. That is about 1/5 of an ounce. By day 3 it is approximately 25 milliliters, that is still not even 1 full ounce. As certain hormonal levels change within your body you will experience the next phase of milk production. During this time moms typically experience breasts feeling full, sometimes leaking, and sometimes engorgement. This phase of breastfeeding is so important! This is when it is up to you and your baby to establish how milk production will work for you. Breastmilk will now be available utilizing a supply and demand method. This means that the more your baby is at the breast, the more milk your body will continue to make. During these days of fullness it can feel like your body overcompensates, I joke that our body needs to be ready in case we have triplets or a 20 pound baby. It can be really surprising to new moms when a week or two later their breasts begin feeling empty. This is a time when some moms begin supplemental feedings. However, when you begin experiencing occasional feelings of emptiness in your breasts (most typically in the evening) it is a wonderful sign. This means that your body is now in the third and final phase of milk production. You have done such an amazing job of paying attention to your infant’s feeding cues and instinctively putting your baby to breast that your body is now totally in sync with your baby’s needs. You are now making the perfect amount of milk for your baby, no more and no less. As the needs of your babe change, your breastmilk will adjust to meet those needs.

I have briefly addressed many topics in this post that I cannot wait to go into more detail on. I plan to discuss these subjects in depth complete with resources in future posts.

Welcome

October 24, 2010

My name is Karinda Woodward. I am a midwifery student, doula and breastfeeding counselor. I have been working as a breastfeeding counselor for approximately 4 years. I am creating this blog to dispel breastfeeding myths, answer breastfeeding questions, and create local support.

I am also writing this blog to tell the truth. I will not pretend that formula is simply another feeding choice and is similar in any way to breastmilk. Formula is not a safe choice for babies and should only be used when the benefit outweighs the risk. Between 9,000-10,000 infants die each year in the United States due to withholding breastmilk.*  I also plan to discuss how birth choices affect breastfeeding. Having an epidural or a cesarean does affect getting breastfeeding off to a good start. Many pregnant mothers report that they are planning a natural birth and these interventions should not be a problem for them. Michael Rosenthal, OB/GYN states, “the first intervention in natural childbirth is the one that a healthy woman does herself when she walks out the front door of her own home in labor. It is from that first intervention that all others follow.” I strongly agree with this statement and for that reason I am an advocate of families giving birth in the safe, secure, relaxing environments of their own homes. The cesarean rate in the United States is currently 32.3%. I do not believe that 1 in 3 women are incapable of vaginal birth. I do, however, believe that at least 1 in 3 doctors are incapable of believing in the ability and strength of a woman’s body.

Other subjects that I hope to address in this blog will be the importance of colostrum, how milk supply works, the necessity of skin to skin breastfeeding, and many other valuable topics. I want this information to be available based on supply & demand, just like your milk! For that reason I welcome comments and questions. I will decide on topics based on feedback that I get from this blog, questions from mothers that I have worked with throughout the week, and personal frustrations concerning things that create barriers for women being able to successfully nurse their children. Read the rest of this entry »