4th Trimester

Most of us know pregnancy is broken up into 3 trimesters. The first trimester is from conception to week 13. Second trimester includes weeks 14 to 26. The final trimester of pregnancy is from weeks 27-40 (or 42 allowing for babies to be baked until ready). So if pregnancy is only 3 trimesters, where does a 4th come into play? Let me explain.

The 4th trimester is based on what many mothers have known for centuries instinctively. It encompasses the first 3 months of an infants life as those months should really be spent inside the womb still making pregnancy 52 weeks. Oh my! Yes, one year is the average gestation for all other mammals but in order for humans to be upright on two legs, the female pelvis is narrower requiring an evacuation 3-4 months earlier of human babies before their heads grow too large to pass safely through the birth canal. Many scientific and evidence based facts support this theory. For instance, upon birth, our brains weigh only 25 percent of our adult brains leaving us extremely underdeveloped compared to most other mammals born with 60 to 90 percent of their adult brain size. This is the reason they are born ready to stand, run, and swim allowing them to be functional with instincts creating greater chances for survival in their environments.

Human babies on the other hand are born with minimal basic reflexes: sucking, swallowing, breathing, stepping, startle, and grasping. All of which serve a purpose but are not alone enough for survival or self soothing. For 40 weeks, give or take, they were rocked gently to sleep, soothed by rhythmic noise, nourished without an effort and kept warm and safe in the security of a snug womb. They are born with an inability to lift their head, move purposefully about, keep their temperature and breathing regulated or feed themselves. Their relaxing, soothing environment in utero has changed to bright, cold and noisy surroundings with many different sensations stimulating their immature nervous systems all at once. Imagine how scary it would be to have no control over your body, be at the mercy of those around you in a foreign environment and have only the ability to cry out for help with needs that used to be met automatically. For these reasons alone, and many more, is why babies are happiest and safest being treated as if they were in the womb until ages 3-4 months.

How can we do this? Well, lets think about what its like in the womb and how we can remedy that in the outside world.

  • It’s warm and snug: Swaddling provides warmth and security for the baby. Many parents think their baby doesn’t like to be swaddled because they wiggle around and get their arms “free”. However, babies are used to being snug and cramped in the womb but still enjoy moving and wiggling, stretching and kicking, punching and rolling. They are simply mimicking their in utero movements now that they feel safe being swaddled, reminded of the comforts of being snug and secure.
  • It’s loud and soothing: Research has revealed the volume of the womb can be compared to a 1950’s Hoover Vacuum! According to varying sources, the sound environment of the womb is very rich with various interpretations of sound levels creating range of 30-96 decibels. Just as a comparison, a whisper registers about 30 dB, a normal conversation about 60 dB and a rock concert about 115 dB. However, sounds in utero are rhythmic and buffered; moms heart beat, placental perfusion, moms stomach gurgles, moms voice and voices around her belly. The sharp, sudden noise of the outside world are startling and scary at times. Introducing white noise to an infant during sleep and soothing times can yield 1-3 more hours on average of sound sleep.
  • It’s rockin’!: Have you heard moms say, “Everytime I sit/lay down, the baby starts kicking!” This is because when mom is walking, working, climbing stairs and going about her day, she is rocking that baby to sleep. It is a constant jiggling/swaying motion and it’s extremely comforting. Wearing your infant and keeping them with you will provide the same comforts of movement they are used to and your hands free.

All of this makes one happy, healthy baby and mama!

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Breastfeeding During Early Pregnancy

So… after many questions related to this topic and tons of research it comes down to the same basic concepts, despite the source. I am happy to share with you the results of my hunt for the facts about breastfeeding an older sibling during early pregnancy of a new member!

One of the common myths is that it can induce pre-term labor or miscarriage. Although nipple stim is used in the delivery room to help get Oxytocin flowing in an effort to induce labor, that is only really true after week 38. Before that point the uterus is smart enough not to pay much attention to Oxytocin as the receptors are mostly napping and are very sparse. Once 38 weeks hit, your uterus’ Oxytocin receptors gradually increase and go to an average of 300x the amount after labor has begun! It is reported that miscarriages are usually not caused by anything mom did or didn’t do but instead something wrong with the way the baby is developing. (Things such as implantation, chromosomes, etc). So even though Oxytocin is still being released in small amounts during feeding or pumping, it has not been linked to miscarriages or early pre-term labor. In fact, the amount released during pregnancy with nipple stim is actually less than when a woman is not pregnant.

Something that does tend to happen at different times in the new pregnancy is a possible decrease in milk supply or a different taste in the milk itself. Some babies don’t skip a beat and keep right on schedule. Others however, esp if over a year old, can start to self wean. It is not necessary to wean your baby if you wish to continue breastfeeding. In fact, there are some astonishing numbers for moms who not only choose to continue feeding their babe in early pregnancy but, continue all the way to tandem feeding with the new baby! Experts of all kinds say it is a great way to introduce the new addition and keep your older sweetie feeling loved and cared for as well. It is a great way to continue to bond as well as bonding with the newborn.

Although weaning for the health of the pregnancy may be advisable for some women’s individual situations, during most pregnancies however, continuing to nurse or deciding how long to nurse is a parenting decision, not a medical question.

A great resource for a one stop shop would be www.kellymom.com which I recommend for all breastfeeding and lactation issues. They are a great place to start as well as talking to your local LC, Pedi office and even OB or midwife. The LeLeche League is a great community support as well.

Leave your questions here if you have other questions or topics you want to hear about!

Latch-on 1, 2, 3…

Despite the rumors and myths, it is actually the minority that mom and baby form a perfect breastfeeding partnership right away. The baby has their natural instincts and mom has some as well but it does still take practice. For whatever reason or another, we try to make things more complicated than they need to be at times. When you take away all of the variables of medical issues, mom and baby have what it takes to breastfeed with all of nature’s instincts guiding them. Although it may be awkward at first with knowing where to put your hands, how to hold your newborn and how to use your breasts for breastfeeding…it is still natural. Sometimes we forget this by trying too many of what I like to call “textbook techniques”. What I mean by that is every nurse on the floor or cousin in the hospital room or lactation consultant coming in and trying to shove your baby on the breast and get a “quick fix” magical latch. Sometimes baby and mom know better than that when it gets too overwhelming.

Please allow me to introduce the idea of “self attachment”

A great LC I worked with on the Mother/Baby Unit had a video on it from Sweden done in the 1980’s. Here is the overview:

The baby was born and placed immediately on mom’s tummy, skin to skin. That is where the baby stayed while the umbilical cord was clamped and cut, placenta was birthed, and baby was dried and cared for. During the first hour after birth the baby is in their most alert state. From being belly to belly with mom, baby used their “stepping reflex” along with rooting and incredible sense of smell and instinct, made its way up moms belly, bobbed their head around mom’s chest and found her breast. At that point, baby began making mouthing movements as well as gaping and rooting and latched themselves on the breast! That’s right! No nurse. No doctor. No LC there to position the baby with 20 pillows or pull down on their chin…just mom guiding baby and keeping their head and neck safe and supported. This process took approx 35 minutes and was the start to a very successful and more importantly stress free way of self attachment breastfeeding. What an awesome start for the duo!

I found a wonderful video demonstrating some key concepts with latching and allowing your baby to self attach as well. Here is the link:

http://www.youtube.com/watch?v=Zln0LTkejIs

Enjoy!

PS: Feel free to watch more videos on self attachment breastfeeding but I must warn you…keep your tissues handy because it is AMAZING!!! Go NATURE 🙂

Safe Sleep Reminders

Now that winter is fast approaching, we still need to be SIDS Prevention savvy while keeping our peanuts warm and cozy at night. SIDS Prevention Guidelines state this:

A firm mattress, tight fitted sheet and a swaddled baby are all that need to be in a crib. PERIOD.

If your baby is older and is rolling around, placing a blanket in the crib with them can be especially dangerous. Babies have died from getting wrapped up in blanket and not being able to cry loud enough to get their parents attention to come and unwrap them from their beehive they created unknowingly. Or, even scarier, are not able to breathe as they have the blanket wound up so tight they can’t get their face out for fresh air. We need to keep our kids safe but also warm at the same time. Over bundling and overheating your baby are listed as SIDS Risks. They have options such as “Sleep Sacks” that are a great alternative to a loose blanket in the crib. This way you achieve the overall goal of creating a comfy sleep but safe environment for your infant.

Here is one example: http://www.amazon.com/SleepSack-Cotton-Applique-Wearable-Blanket/dp/B004G8QN58/ref=sr_1_1?s=baby-products&ie=UTF8&qid=1352921390&sr=1-1&keywords=sleep+sack

If you want to opt out of the sleep sack, there are other ways to keep your baby warm without one. Choose pj’s that are warm and fuzzy and fit properly (They are able to stretch out and not have their toes cramped from feet that don’t fit!) Under warm pj’s you can always layer. Place a long sleeve onesie on underneath as well as warm socks that have a chance at staying in place overnight.

However you bundle just remember this: Although we teach to dress your baby as warmly as you are, keep in mind that you have blankets and they don’t. This is the time when you safely add an extra layer all around so they stay just as comfy as you do, but safe.

10 Tips On: Pumping in Public

There are so many different circumstances that may require you to pump outside your home. Pumping in public is a whole lot different than pumping with boobies out from the comfort of your couch. People tend to look a lot closer at what your doing to your breasts in public when they don’t see little feet out from your coverall. Here are some tips that may help make it more discreet making it more comfortable:

  1. Wear Layers- Wearing a tank top under a larger shirt is an inexpensive way to keep your midsection covered while still accessing the necessary equipment up top, therefore leaving you less revealed. By doing this, you have a built-in “cover-all” and won’t have to drape yourself (depending on how big the top layer shirt is).
  2. Put Your Pump in a Cute Bag- This disguises the loud, obnoxious pump you may have leaving only the cord and tubing showing.
  3. Go For Comfort- The more relaxed you look, the less conspicuous you look.
  4. Hunt for the Perfect Outlet- Pumping takes some time as you know. Finding the ideal outlet not in a nasty bathroom is key. Look around for a corner spot where you can either face the wall privately or sit in comfort on a piece of furniture (imagine that!)
  5. Go Low- Wear a low cut blouse with a zip up hoodie or sweater. Doing this still leaves your midsection covered, like with the layering trick, as you only need to pull your shirt down past your breasts. Having a zip up or button up sweater makes it so you can cover a bit with just the clothing you have on.
  6. Go Hands Free- Yes they sell get-ups that you can wear your pumping equipment and not need hands at all. You can get the same concept accomplished if need be by wearing a snug, stretchy tank and placing them underneath allowing the tank to hold them in place.
  7. Look Like Your Breastfeeding- Throw on your most stylish breastfeeding coverall and just go for it!
  8. Keep it Simple- Have everything you need while pumping at half an arms length (since that is probably all you have to spare). Keep your extra equipment in your bag that the pump is in so you have it handy at a moments notice.
  9. Quick Clean Up- Instead of needing to get to a sink after pumping to clean up all the parts and bag up the milk, etc, I suggest looking into the waterless options for safely cleaning bottles and pumping parts. Medela makes wipes that are extremely handy as an example: http://www.amazon.com/Quick-Clean-Breastpump-Accessory-Wipes/dp/B000CCXLNE
  10. GO BOLD- When all else fails, draw up a sign that says: YES I AM PUMPING IN PUBLIC! I AM DOING WHAT IS BEST FOR MY BABY, EVEN WHEN THEY AREN’T WITH ME. HAVE A NICE DAY 🙂

Be sure to post up comments if you found other tips that are helpful for our mama’s out there!

Travel Pumping Adventures: Pt 2

So in Travel Pumping Adventures: Pt 1 I told you all about my experience of breezing through customs and TSA agents with international air travel…NOT!

If you thought the traveling with the boobie milk was tough, try collecting it all! I had to become a pro pumper in public, an outlet spy and a “how to keep things cold” wiz.

Although I was on vacation and away from my infant, I knew it wouldn’t be as carefree as one would think Mexico to be. Unlike most vacation goers who are away from their kiddo’s, I was thinking of my peanut every 3-4 hours and sticking right to our usual schedule 🙂 I made my day in the sun revolve around being near an outlet and freezer every 3-4 hours in order to maintain my milk supply by pumping. My husband, who was back on the home front holding down the clan, was giving me a daily report of how many ounces my son had and at what times so I could trick my body into thinking he was still with me. My plastic pump was my plastic baby! I won’t let Mexico get in the way of my breastfeeding goals!

Traveling to and from Mexico and having layovers posed an unusual issue…Where the heck do I plug this thing in? I quickly found out there are almost no outlets in the public restrooms, except for the co-ed space before you enter your gender designated restroom. So…there I sat, plugged in and facing the wall, sitting on the floor pumping away. I needed to time it out so that 45 minutes before my scheduled flight I had to pump. It takes about 10 minutes to pump and 5 minutes to clean the equipment and bag up the milk. The other 30 minutes accounts for the boarding time on the flight.

After we landed it was always a mad rush to get to an outlet. Again, I get the bathroom or, my alternative, scouring the terminals looking for vacant airline desks or wall outlets. Not easy to come by may I add…especially when every single person in the airport has something that needs to be plugged in! Needless to say I now know how to charge my electronics in peace going forward.

As much work as it honestly was, it was so empowering to know that I was still providing for my baby while I was away and it only helped me feel more connected to him. I am extremely proud that I am working towards my personal breastfeeding goals and not letting anything get in the way! It’s easy to stay motivated if the passion is there.

Travel Pumping Adventures: Pt 1

I recently traveled internationally and wanted to share my new found wisdom of transporting breastmilk through the many loops of customs.

Before I booked my vacation I was sure to call TSA and ask them directly their policies on air travel with breastmilk. This is what I was told by the agent on the phone:

  • There is no limit to quantity
  • It can be checked-in or carry on
  • You are allowed frozen ice packs (if they thaw you could run into trouble)
  • They can be transported frozen or fresh
  • They will not need to open any of the containers to test them
  • They process of testing the unopened containers will not harm the breastmilk in any way
  • You can travel with breastmilk, with or without your child

They told me since I was traveling to Mexico that I need to talk to customs to find out their policy. This is what I was told by the customs agent:

  • There is no limit to quantity
  • It is better if you travel with them frozen
  • You are allowed frozen ice packs
  • They will not harm any of the milk during testing
  • You may get held up in customs so expect to be at the airport earlier than recommended
  • You can travel with breastmilk, with or without your child

This is what actually happened with customs leaving Mexico:

  • Going through the X-Ray and getting an astonished “Oh My” look from the woman agent
  • Another agent with better English speaking abilities came over and asked, “Where is your baby?…You can’t bring this without your baby.”
  • Me asking for a Supervisor since I did all my research prior and that is not the protocol.
  • Supervisor coming over and saying, “We will need to talk to the Supervisor of your airline. They need to take on all liability for this liquid on the aircraft or you need to check it on the flight.” (Since bags get lost all the time and frozen breastmilk is only good for 24 hours after thawing I figured he was smoking crack with me taking a chance on loosing 156 ounces worth of liquid gold!)
  • I got the Supervisor of United Airlines (Thank You!) to agree and I went on my way, not without them testing the breastmilk a 3rd time through the X-Ray machine (Sure…radiate my precious boobie milk a little more why don’t you Mexico?)

After that I try to relax and enjoy the flight and just ensure that the milk remains frozen. We find out our flight is delayed 4 hours! I did not account for 17 hour of frozen milk in a cooler so now I go into MacGyver mode and start asking the flight attendants for ice in a barf bag to continue my journey on the plane.

This is what actually happened at customs getting into the U.S.:

  • BEFORE going through the X-Ray machine, I tell the female agent I have a large quantity of frozen breastmilk with me.
  • She asks, “Where is your baby? You can’t bring this in without your child present.” (What the HECK is with you people? If I had my infant with me why the HECK would I need 156 ounces of BREASTMILK?) I digress…
  • I explain all of my research and what I was told from both customs and TSA. She tells me they are going to have to test every single bag of breastmilk and I tell her no way, so she gets her Supervisor.
  • Her Supervisor says take 2 bags and test the outside of them, test the ice packs and let her go.
  • PHEW!
  • I stop at McDonalds (Thank You, too!) for a large bag filled with ice to help my poor melting bags and wait for our flights.

THE BEST PART!:

Our bags got lost and got delivered to us 2 DAYS AFTER! Thankfully I stuck to my guns and did my research!

PART 2 to follow: Travel Pumping Adventures: How did she get all that milk?

PS: I am now a PRO at pumping in airports and finding those precious outlets! Look for them on the floor under the wall behind the empty airline stations at the gate terminals, they will be there 🙂