Labor Medication and Breastfeeding

Making a birth and postpartum plan can be overwhelming. So many choices, options, and consequences. You ask yourself, "will all this research and planning really have a tangible outcome?" If breastfeeding is a goal, there is a recent observational study that says "yes" it may indeed make a difference. 

Kajsa Brimdyr, PhD, CLC has recently published a study showing the association between Fentanyl epidurals and suckling challenges in infants in the first hour after birth. There are many medications that can be in an epidural, but fentanyl is one that specifically hinders the newborn infant's ability to suckle at the breast immediately after birth. Fentanyl is a highly lipid soluble opioid which easily crosses the placenta to the baby. Infants go through 9 distinct stages after birth leading up to breastfeeding which can have some really important implications if those stages are hindered.

Brimdyr observed the 9 stages of infant behavior in babies who were exposed to fentanyl via epidural. She noticed that infants exposed to fentanyl were less likely to suckle and breastfeed one hour after birth. 

So...

"We have known for some time that early initiation helps to establish exclusive breastfeeding – a life-saving practice. These new findings also confirm that getting an early start to breastfeeding boosts child survival in its own right and that the protective benefit extends well beyond the first month, until the age of 6 months."  UNICEF 2016

This study demonstrates that an epidural that contains fentanyl could very well effect long term goals of breastfeeding.

 Here is a video that summarized Brimdyr's findings:

What does this mean for you?

• Plan what type of birth you want to have taking into consideration your breastfeeding goals.
• Be informed about what type of medication is typically used in your hospital's epidurals.
• Advocate for yourself and your birth medication if you plan on an epidural (or are open to one).

Organizing for Mom-Guest Post

You’ve finally taken the time to get organized, but what can you do to maintain the systems you’ve put in place? Here are some tips to make sure your efforts aren't wasted!

#1 Think before you shop. (This pertains to anything bought or acquired that makes its way into your home) Before you acquire an item, ask yourself the following questions:

-Do I need this?

-Do I really like/love this?

-Do I already have one or something that serves the same or similar purpose?

-Do I have a place to put it?

Finally, resist the urge to buy or take items you did not answer “yes” about. Try writing the items in question on a list. After a few days, see if the items are still something you want or need. Chances are the answer is no.

#2 If you find yourself answering yes to the above, try to always use the “one in, one out” rule. Swap an old item that you no longer need, love or have a place for with the new item.

#3 Set up a “donation can.” I recommend setting one up on each floor of your home. Like a trash can, these “donation cans” should be used to collect items that no longer serve a purpose for you or your family. “Donation cans” allow items to be immediately collected to ensure unwanted things don't make their way back into your home. When the can is full it’s time to take a trip to your local charitable drop off location.

#4 Schedule a weekly day to purge the house of unwanted items and to put things back in their places. You should also use this time to take inventory of items you may have run out of or need for the week(food for lunches/dinners, supplies for upcoming school projects, etc...) This cuts down on last minute shopping trips that encourage “impulse buys” as well as helps to avoid purchasing duplicates. I like doing this on Sunday night to give the week a fresh, organized start. Remember, establishing routines is key to staying organized.

#5 Remember that YOU control what comes in to your home! Practice saying “No Thank You.” When you are offered free-bees, informational brochures, unnecessary receipts or items that do not serve a purpose-JUST SAY NO☺.

Unsubscribe from magazines or coupon lists that you do not use or wish to receive.

Just because something is free or discounted does not mean that you need it. Although harmless in small quantities, continuing to aimlessly acquire these items can sabotage your efforts to get organized.

#6 Lastly, try your best to treat each one of your “to-dos” like an appointment. Scheduling tasks to be completed on a specific date and time is the best way ensure that your goals are being accomplished!


Back to Basics Organizing, LLC
Rachel Kowitz, Owner & Professional Organizer
rachel@backtobasicsorganizing.net
www.backtobasicsorganizing.net

410-404-4371

Upcoming IBC Events

What's even better than being a doula? Being a doula and working with a great organization called Informed Birth Choices. Check out my profile at IBC.

In addition to birth doula and postpartum doula services, IBC offers childbirth classes, comfort measure classes, infant care and breastfeeding classes. I have the privilege of teaching at IBC and I love it. 

Here are some of their upcoming classes:

• Informed Childbirth Weekend 
• February 20-21: 9:30 am-3:30 pm
• April 16-17: 9:30 am-3:30 pm
• Comfort Measures Workshop
• February 21: 4:30-7:00 pm
• April 21: 6:30-9:00 pm
• Baby Basics (infant care and breastfeeding)
• March 26: 1:00-5:00 pm
• May 14: 1:00-5:00 pm

Also, IBC is offering a FREE comfort measures class with the purchase of birth doula services for all of 2016!!

Thinking about becoming a doula? Well, IBC has you covered there too. IBC is hosting both a postpartum and birth doula workshop (DONA approved) in the upcoming months. In addition, IBC offers the 3 hour DONA approved Breastfeeding for Professionals, which is a prerequisite for becoming a doula

• Postpartum Doula Training 
• March 18-20: 8:00 am-6:15 pm
• Birth Doula Training 
• April 23-24: 8:00 am-6:30 pm
• August 20-21: 8:00 am-6:30 pm
• Breastfeeding for Professionals
• June 4: 1:00 pm-4:00 pm
• September 24: 1:00 pm-4:00 pm

Sign up for any of these classes here.

Want to meet IBC in person? Then check out the Columbia Baby Expo on March 12. 

Hope to see you at IBC!

Journey in Adoptive Breastfeeding: Part 5

This may be the hardest blog post that I write.

The journey in adoptive breastfeeding has been a long and trying one of waiting, praying and pumping. Around September, my husband and I felt that maybe we had been waiting long enough and that if we didn't get matched by December that we would come off the adoption list. We planned a trip to Hawaii with my sister and her husband (and no kids) and kind of prepared ourselves for the end of our journey. Well, sure enough, we got a call  that we were matched with a baby girl who was due on late October. "Over the moon" doesn't begin to describe how we felt! We were so thrilled that our dream of a third child, a daughter, was about to come true. We were so over Hawaii and ready to be parents again. She was perfect and right on time (on her due date).

Now there was the "small" decision to make: do we take direct placement of her knowing that the birth parents have 30 days to change their minds or should we just wait out the 30 days with her in transition care through our adoption agency. It seemed simple to us. We want to care for her and love her as soon as possible. So with some negotiating, we were able to take placement of her 8 days after her birth. We named her Mychelle Sydney Byrd. And she was with us for two weeks...

She was such a lovely, sweet baby, who had no problem going back and forth from nursing and bottle feeding. Breastfeeding was such a sweet time for me and she loved it too. I am so blessed that I got to experience that. I know for many women it is hard and doesn't go as planned, but for Mychelle and I, it was magical!

After two blissful weeks, our adoption agency called us and told us that her birth parents decided to parent her. We were completely devastated. We cried with each other and with our friends and family who showed us great love and compassion during the process of returning Mychelle to her birth family. It was the hardest and saddest thing that we ever had, and I hope ever will have, to do. I hold on tightly to the memories I have of her and miss her.

Ok, so what about the pumping? I stopped pumping gradually. Since we weren't sure if we were going to continue on the adoption list or not, we decided to stop pumping. It was important not to stop all at once so that I didn't get blocked ducts or mastitis. It took about two full weeks for my body to stop lactating. During this process, I had to not only mourn the loss of a baby, but also my breastfeeding experience.  I was able to find some families who could use my frozen breastmilk, which is some consolation.

We did end up going to Hawaii to get away for a while, but Hawaii ended and we were thrust back into the reality of our loss. We are at a great crossroads. Should we keep waiting for another baby or move on to see what life brings us? More to come...I hope.

Mom on a Mission

I was recently interviewed by a friend for her blog. She is doing a spotlight on "women on mission".

"Doula Annie Byrd is passionate about missions. She also loves crafting. A mother of two young children, she donates her precious free time to sew treasures for Mama and Baby that she sells to raise money for the Fistula Foundation.

"Fistula is a life-altering injury caused by childbirth. Women in third-world countries who lack proper obstetrical care can be particularly vulnerable. Maybe fistula awareness is a cause near-and-dear to your own heart. Or maybe, like me, you’re just learning about it. Annie suggests checking out the Fistula Foundation website for more information. You can also check out posts on her own blog, Baby Byrd Doula.


Annie first became aware of the fistula problem when she read a book called Half the Sky: Turning Oppression into Opportunity for Women Worldwide..."

Click here to read the rest of the interview.

Journey in Adoptive Breastfeeding: Part 4

13 months...that's how long I have been pumping. The year really flew by. There were many times I just felt like giving up, mostly on trips when finding time to pump was harder and storing pumped milk was nearly impossible. But I haven't given up yet, in fact it has been so incorporated into my lifestyle that it feels almost like brushing my teeth or eating breakfast. It is just something that I do everyday...6 times a day.

Here is an update on our adoption process...
(Click here to catch up if you don't know what is going on: Part 3)

The summer has been really hard. I felt like I was holding my breath, waiting for Miles' birthmother to call and let us know what was going on. The last time the social worker spoke with her was early April. She hadn't been to the doctor but thought she was 6ish months pregnant. She scheduled her first prenatal appointment shortly after the social worker's visit. Then, well, she fell off the face of the earth. Radio silence. The adoption agency tried to contact her several times with no returned call. Lance and I decided to just wait through July and maybe she would contact us after the baby was born. July has come and gone with no word from her. So, we have moved on (as much as you can) and we are back on the waiting list.

It has been so emotional to go through two missed adoptions. Much harder than I could have imagined. But the pumping must go on...

There have been blessing as I have waited.

I've had to rely on others more emotionally theses past months, which is harder for me. I am usually the one who people can rely on.

I've had to take a break from doula-ing because of the uncertainty of the adoption. This allowed me to enjoy my summer fully with my kids and husband without being distracted.

I was able to donate milk to several mothers who either adopted a baby or didn't produce enough milk on their own. That was really rewarding to know that my milk is helping another baby and momma.

I have been able to normalize pumping/breastfeeding for my children. My hope and prayer for my boys is that for the rest of their lives they view breasts differently than the typical American culture.

So the journey continues...still...

A Doula: Picture It!

Recently I attended a birth of a client who had a birth photographer.  Many people may ask, "why have a photographer take pictures of you in pain or when you are most vulnerable?" My answer is that the most vulnerable pictures are sometimes the most powerful, capturing the struggle and essence of life. Birth is painful and messy, but it also moving and beautiful.

As a doula, it is my role to be that the person working in the background, so it is not often that my role is captured. A lot of times, I am taking the pictures for the family so that they can focus on their birth and baby. Maybe you've never seen a doula in "action". As a doula I...

Come to your home when your labor starts...even at 3:00 in the morning...

Offer comfort measures like message...

And the TENS unit...

Help you to know when it's time to head to the hospital or birthing center...

Work closely with medical staff, in a non-medical way, to help you have the birth you want...

Bring you anything you need...

Talk and laugh with you in between contractions...

Reach out when you need a hand...

Support your partner and help him support you...

Support your breastfeeding efforts...

And celebrate new life with you!

I am your constant physical, emotional and information support through YOUR birth and it is such a joy! Thank you!

Special thanks to Marcella, Alex and Jade Vinson for allowing me to blog their photos. Also, all photo credit to goes to Lindsay (http://www.labirdiephotography.com/about-contact/). Thanks!