My kids were born with obstructive sleep apnea

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Before I was a childbirth educator, I was a mom of a little girl. I’ve written about her birth before; I haven’t really ever thought to talk about how both of my kids were born with sleep apnea, and how it took forever to find a pediatrician who would actually believe me.

When I first brought her home from the hospital, I noticed almost immediately that my baby girl would regularly stop breathing for a couple of seconds, only to gasp for air. Initially, my new mama instinct wasn’t sure if I was just being overly paranoid, or if she really did stop breathing for a couple of seconds before the big gasps I didn’t think were normal. Her Mayo Clinic doctor (who was a total and complete ass, BTW), ignored my concerns– he told me she was just congested, and moved on to something else.

(As an aside, I should tell you some day about the nonsense “parenting education” material they would give me every visit. Knowing what I know now, there was very little actual evidence behind it. All it did was foster doubt an insecurity by creating parenting expectations that would never be biologically normal. Even better, if I could find the sheets, it’d be a total hoot to go through it with a big red marker!)

When my daughter was about 4 weeks old, after sleepless nights and too many days nodding off during the day while I fed her on the couch, a friend encouraged me to look into safe bedsharing. I found the safety guidelines online, and during one nap time, I latched her on while in the side-lying position in my bed, and we both fell asleep for a life-changing 2 hours. I was a convert from then on out. It wasn’t until much later that I realized that since she and I started sharing a safe sleep surface, I no longer noticed that she would stop breathing. Instead of sleeping next to me in her bassinet on her back (which, until very recently, was the only AAP-sanctioned sleep scenario), she spent her nights cuddled up next to me, on her side. Sometimes I’d wake up and find out that I’d been feeding her without remembering when or how the feeding started. And then, when she was 9 months old or so, she started to turn sideways in the middle of the night and stretch out as much as she possibly could. That’s when we transitioned her to a crib in her own room. And at 9 months, she would sleep in whatever position she felt like sleeping in that night. By that point, she was not only rolling and crawling, but walking on her own, too. SIDS and back-to-sleep stuff was no longer technically an issue for her.

However– she was back having very, very audible sleep apnea. We’d listen to what I now understand was the sound made when her tongue would fall into the back of her mouth, then the little “kuh” sound she’d make right before the gasp as she started breathing again. We’d joke in a moribund manner that the gasp at least told us she was breathing…eventually. Moreover, we’d started to notice that when she slept, she always slept on her stomach or he side with her head tilted back to straighten and open her airway.

When she was 2 years old–maybe?– we brought it up again with her doctor. Keep in mind, smart phones weren’t a thing yet. iPods were big and bulky and only had hard drives and were only for music. We could really only convey what we were noticing by trying to recreate it ourselves. Her family med doc was again dismissive, though he did say he could refer us for a pediatric sleep study, but that it would take 6 months before we’d be able to get in. Shortly after that, our basement flooded, my husband got a new job that required him to commute 90 minutes each way, and then I got pregnant with her little brother… and life got super chaotic.

Once my son was born, bedsharing was started from day 1. However, he didn’t really nap on his own until he was about 8 months old, and when he did, he’d do what his sister did– he’d stop breathing. As he neared the 9 month mark, when I would put them both down for a nap in the same room, I’d listen to the baby monitor as they took turns having apnea episodes (which I’m sure did NOT help my anxiety). I can’t remember if it was at a well baby visit for him or a well child visit for her, but I mentioned the apnea episodes their pediatrician, who referred us to a pediatric ENT. She got her tonsils out shortly after her 4th birthday. At that point, they had grown so large that she barely had any room to breathe while she slept. A few days after the tonsillectomy, we noticed that when she slept–there was silence.

My son had his tonsils and adenoid out when he was 3 years old. He was also able to breathe perfectly while sleeping a couple days after surgery.

So there you go. My kids had obstructive sleep apnea, and now they don’t. I do think that both of them had and have tongue ties for a BUNCH of reasons. I had recurrent mastitis, nursing was super painful at first with my daughter, she didn’t gain weight all that fast, both kids had EPIC spit-ups. One child had speech issues that have been resolved. The other one tongue-thrusts to swallow and is very sensitive to food texture.I often wonder if I had had them sleeping on their own in a room from day 1, on their backs and not near me–would we have had a different outcome? We know (and the AAP recognizes this) that babies NEED to sleep in close range to their parents for at least the first 9 months, in part to help them regulate their breathing. When humans sleep on their backs, the tongue can fall to the back of the mouth, causing snoring and apnea.

Finally, I do want parents to know that if your little one stops breathing and then gasps for air, that is NOT NORMAL. If they sleep with their head always tilted back—again, not normal. Listen to your gut, and if your child’s care provider dismisses you–get a second opinion. Or a third. I know that there’s so much more to learn about this, SIDS, and other sleep issues, but I do think that parents can go a long way if we share our stories and compare notes.

On that note, Happy New Year!

Warmly,

Veronica

 

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

The Baby-Friendly Hospital initiative is perfectly safe

Last week, the American Academy of Pediatrics published a clinical report that took a look at safety practices of bed-sharing and rooming in. This wasn’t a policy paper, but instead more of a “this is what a group of Pediatricians think” sort of thing. Headlines have been all over the map on this one, though. Some wise nurse and professionals looked at the publication and took away the advice that hospitals need to have good staffing levels and well-trained competent nurses to make sure patients are safe. Sorry to sound flip, but DUH. I guess there are plenty of places that put profits before patient safety (ahem), but in 10 years of attending births, I’ve only seen poor care of a baby after birth in 2-3 cases.

And then, Elisa Strauss of Slate has her opinion: The paper proves that a Baby-Friendly designation makes a hospital inherently unsafe.

Are you kidding me?

In reality, the paper does mention that aspects of the practices outlined by the Baby Friendly Hospital Initiative need additional guidance for safety– but nothing shows that these hospitals are inherently unsafe. Strauss has a history of writing about studies in a very odd way– in January she tore apart the idea of having a doula based on the most inane logic possible. If you want to see someone hell-bent on espousing experience-based practices, she’s your writer.

How dies she even come to her conclusions?

First, she writes that, “Their [the researchers] first area of concern is the initiative’s requirement for skin-to-skin contact between mother and child directly after birth until the completion of the first feeding, and to encourage skin-to-skin contact throughout the hospital stay. The problem is not the skin-to-skin contact itself, which has documented benefits, but the fact that mother and child are often left unsupervised during this time.” Immediately postpartum, nurse coverage should be 1 to 1– a nurse should have no other patients than the baby and new mother. Yes, complications can develop quickly right after birth, and medical supervision in needed. However, the problem isn’t the skin to skin contact– it’s hospitals that profit from lean staffing levels. Further, Strauss doesn’t present any solutions– does she think these babies should be taken away from the new parents and placed in a nursery with dozens of other babies with only 1 or two nurses to take care of these babies? Or should the babies be left in the warmer in the room for a couple of hours following birth? Or…..what?

The next paragraph is a doozy. Strauss writes,

Other concerns in the JAMA paper include the encouragement for rooming-in, even when the mother is exhausted or sedated. They believe this can lead to unsafe conditions for the newborn, and that parents, thinking that such sleep-arrangements were hospital-approved, may continue sleeping in such a manner once they return home. Also, they question whether supplementation with formula should really be banned, as there is no hard evidence linking early formula use to a decreased likelihood of breastfeeding further down the line. In fact, one study suggests that early formula use might help increase breastfeeding rates by reducing stress among new moms while they wait for their milk to come in.

Where to start?

NO HOSPITAL in their right minds would EVER encourage rooming in when a mother is sedated. The hospitals I have worked at rightly and explicitly disallow rooming in if a mother is unconscious and nobody else is there to attend to the baby’s needs. I want to see proof that this is a practice any place actually follows. I’m also not sure what she means by “these sleeping arrangements”. In reality, current SIDS reduction practices actually encourage parents to have babies sleep within 15 feet of the parents– in the same room. As far as formula supplementation being banned– it’s not. Nothing about Baby Friendly designation bans formula use. It calls for hospitals to pay for the formula (rather than get an unlimited free supply from the formula companies) and it calls for guidance when mothers do supplement. That’s all. This oft-repeated myth is a great tool for formula companies who want to create public panic, but it’s simply a lie. And WHY do otherwise intelligent writers perpetuate the whole nonsense that until a mother’s “milk comes in”, there’s nothing to feed a baby. It’s called colostrum, and it works very well to feed human babies and all other mammals, thankyouverymuch.

Finally, according to Strauss,

They end the paper by arguing that the Office of the Surgeon General should reconsider its call for an acceleration of the implementation of the Baby-Friendly Hospital Initiative in the United States. “If government and accreditation agencies wish to encourage and support breastfeeding, their focus should shift from monitoring Baby-Friendly practices and breastfeeding exclusivity to monitoring breastfeeding initiation rates coupled with evidence of lactation support both during and after the hospital stay. More attention should also be placed on ensuring compliance with established safe sleep programs, emphasizing the need to integrate safe sleep practices with breastfeeding.

The language she quoted does not exist ANYWHERE in the cited publication, and at no point do the authors even come close to encouraging the discontinuation of the 10 steps outlined as Baby-Friendly. Further, she doesn’t even include a citation for this quote, and it could be completely made up for all we know.

In reality, the authors of the AAP paper praise the 10 steps, saying, “The Ten Steps include practices that also improve patient safety and outcomes by supporting a more physiologic transition immediately after delivery; maintaining close contact between the mother and her newborn, which decreases the risk of infection and sepsis; increasing the opportunity for the development of a protective immunologic environment; decreasing stress responses by the mother and her infant; and enhancing sleep patterns in the mother.”

For better or for worse, there will always be a backlash against the movement of hospitals towards the implementation of the 10 steps of the Baby-Friendly hospital designation. However, it would serve all of us better to see this discussion happen in a place without twisting a clinical report to serve one’s preconceived editorial slant.

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

6 ways to feel more productive while nursing your baby

 

do while nursing

One of the hardest parts once you conquer breastfeeding is that sometimes it makes you feel like you should be doing something…more productive. I mean, come ON…you ARE making sure your baby is growing and thriving, but we live in a society that eats quickly, and unfortunately, babies still haven’t been forced to adopt out weird societal norm. Throw into the mix that babies nurse not just out of hunger, but out of thirst, too, and it can be darn frustrating to be sitting on that chair, nursing your baby…again. So, I came up with some truly helpful things that you could do while feeding your baby.

1) Clean up your phone contacts- If you’re like me, you phone is full of all sorts of clutter and old info and numbers for people you really never want to talk to again. Going through and deleting bad info seems like a huge chore, but is a perfect thing to do with one hand. Think of how amazing you’ll feel when it’s all clean and organized!!!!!

2) Order hard copy prints of pictures from your phone- If you’ve ever had a phone stolen with all of your pictures on it, you know how gut-wrenching it is to no longer be able to look at the pictures you’ve been taking of your sweet kids. And the reality is, those digital pictures can’t be handed down to future generations. While it may seem quaint, actual pictures in photo albums or boxes are the answer. There are apps that let you order prints from your phone, and they all have free print offers. Future you will thank now you, I promise.

3) Learn a new language- My husband is trying to learn German through podcasts. I’ve long been interested in trying Duolingo, a free app to learn languages. Finding the time can be tricky. But if you use feeding time for baby as learning time for you–you may actually make progress!

4) Get a lower cable/internet bill- Yes, this one actually requires making a potentially frustrating phone call, but if you call, tell them you’re thinking of switching to the competitor, see if you can score a lower rate. It may work, it may not. It never hurts to ask.

5) Check you credit score- This one will make you feel like you’re really doing a great job of adulting. And to make sure you don’t go the the wrong place, here are the instructions from the State of Minnesota.

6) See if there’s money out there for you, friends, or family- Yep, this is a real thing. I’ve found money for family members. I’ve never found anything for me, but maybe you’ll get lucky and locate money you didn’t know you had. Here’s Minnesota’s program. You may want to check all the states you’ve lived in or relatives have lived in. Just makes sure you ONLY look via official state government pages.

And if you’re local and you want to meet other moms and chat with a nurse, make sure you check out Mama Cafe. It’s a free group for breastfeeding mothers held every Thursday from 10am-11:30am, held here at BabyLove.

Any other clever things you do while breastfeeding? I’d love to hear about them in the comments!

Warmly,

Veronica

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

The Problem* with Breastfeeding

Problem with breastfeeding

When I meet people for the first time and tell them that I’m a doula, Lamaze educator, lactation counselor, and car seat technician, it’s interesting how they react. Some people respond by telling me all sorts of things. I end up being told birth stories, completely unprompted, or they tell me about a friend who is also a doula, or they tell me what their breastfeeding journey was like. Sometimes, there’s an air of defensiveness to their confessions. And I get it– I really do. Breastfeeding isn’t the most cut and dry thing to wrap our arms around.

1) We have no good way to tell how much milk a mom is making- If a mom pumps milk, we assume that the pump, which is this expensive machine that’s supposed to be really good at getting milk out of human mammals, is going to do so efficiently and is a good way to determine if a mom has supply issues or not. Yeah, that’s not the case. Not everyone responds well to pumping, especially in the first week or so, and if you use pumping to see if a mom is making enough milk, there’s a good chance that her pumping output is going to be disappointingly low. Ignorant providers use this as proof that a mom’s body is broken and can’t produce enough milk. Oh, and by the way….those pumps are having major quality issues and breaking all the time.

2) Since there’s no gauge on the side of the breast, we have to guess how much milk a baby is taking in- There’s an elaborate method of weighing a baby before and after a feeding to estimate how many ounces of milk a baby took in, but that’s still not bullet proof. It’s not an uncommon impulse to have so little confidence in the breastfeeding process that providers will make mothers bottle feed babies just to verify input. Even when bottle feeding pumped human milk, the message is strong–you can’t be trusted, your body can’t be trusted, and only the bottle can be trusted.

3) The nutritional content isn’t static, so it’s really hard to know what the caloric content is- The more we understand breastfeeding and the production of breast milk, it’s become startlingly clear that the milk a mom makes for her baby changes hour by hour, day by day, month by month. It changes depending on which child you’re feeding. If you have a preemie, we’ve just realized your milk is really a lot more calorically dense than we ever thought. We do know that on average, breast milk is a lot more calorically dense than formula, so it does take a higher volume of formula to approach the nutritional needs of a baby. At least, though, health care providers know exactly what is in it, unlike breastmilk, which changes if baby is getting sick, or needs more calories, or based on the time of the day.

4) It’s really hard to trust that you’re breastfeeding the baby as much as you say you are- When we talk about breastfeeding, we tell moms to watch for cues. We call them hunger cues, but babies also cue out of thirst. News flash– babies are human and get thirsty, even when they aren’t hungry. Expecting a baby to get hungry and thirsty on a set, quantifiable schedule is about as crazy as expecting you to only be thirsty every 3 hours. So with breastfeeding, every time you sit down to nurse baby can be different in length and frequency, which is maddeningly hard to plan out and account for.

5) Only a few people are qualified to help you- Breastfeeding has a learning curve. It’s not easy for most moms and babies at first, but if they can make it past the 2-3 week mark, it usually gets much easier. However, getting past that hump can be really, really %@$*!#* hard. If you had a baby 100 or 200 years ago, by the time you had your own kids you would have watched lots and lots of babies be breastfed, and most women knew enough about breastfeeding that they could help each other. Now, we not only have so few people (including medical professionals) that are appropriately and accurately trained to help with breastfeeding, but we wall them off and only make them available during banking hours. It can take a lot of dedication, perseverance, and tenacity to get through the early breastfeeding struggles, but there’s a huge role that luck plays. If you find the right lactation specialist, you’re good. If you have a bunch of lactation specialists who don’t really care…you’re probably screwed.

6) Your mom didn’t breastfeed, and her mom didn’t either- Breastfeeding rates have risen since the 1950s, when only about 5% of moms ever breastfed their babies, but the 6 week breastfeeding rates in the US are still pretty low. Initiation rates are high, but almost 70% of moms give up breastfeeding before they initially planned to. There are a lot of moms out there who had bad breastfeeding experiences. This makes breastfeeding seem impossible; more tragically, it can unintentionally undermine a mom’s desires for feeding if she’s hearing from others that it’s just not important. And this one is the trickiest thing about breastfeeding. We know there’s a sociological component to breastfeeding. The barriers aren’t just biological. The biological barriers can be real, but we still struggle to have good, healthy conversations about breastfeeding within the larger construct of motherhood.

As is the case with most medicine, we’re realizing more an more that there’s a whole hell of a lot of nuance with breastfeeding that we have to get used to. Pumping and bottle feeding human milk can seem like a good solution, but most people who suggest it completely ignore how draining the process of pumping for every feeding or after every feeding becomes. They suggest pumping and make it seem that it’s as easy as brushing your teeth. Constant pumping sucks. I don’t have anything super simple to offer as a solution to any of these things, other than education. Humans are mammals. We are mammals with young that need fed. Rather than think that the process is broken, I’d posit that breastfeeding usually works– but we are the ones who are making it not work with our bad information, lack of trust, and unrealistic expectations.

*I decided to couch it in these terms. It’s kind of tongue in cheek.

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

When your breastfed baby won’t accept a bottle

baby wont take bottle

One of the biggest questions I get during breastfeeding class is, “when can I introduce my baby to the bottle?’ And while the answer is different for everyone depending on their situations, there’s one thing that doesn’t come up enough: When breastfed babies reject a bottle. When that happens, it’s frustrating for moms because they feel like they can’t leave their babies, and it’s frustrating for dads and other caregivers because the bottle rejection can feel so personal. So, here are some things you can try if you’re in this situation.

Please note: If your baby is simply not eating anything in any form for a length of time, please seek immediate, appropriate medical care.

  • Is the milk yucky?–Sometimes I forget to ask moms if they’ve had a chance to taste the milk that they have pumped. Sometimes, the pumped milk, due to an excess of lipase (which we dont really understand why this is the case for some moms), can end up tasting or smelly soapy. Kellymom.com has a great set of instructions to help you make your milk more palatable if this is what you’re dealing with.
  • Try a different bottle–Not all bottle are created equal, and even the (unfounded) marketing claims make it hard to figure out what kind of bottle to use for your baby. What I usually tell moms is that usually simpler is better, and a wider bottle is better. No matter what, I’d discourage any mom from making the choice for kind of bottles without baby’s input. He or she will let you know what he likes. One note: It may seem like a faster flow nipple will be better, but if your baby is already leery of bottles, a fast flow can end up coming out too fast and result in scaring your baby, compounding the issue.
  • Try movement– some babies need to be distracted into taking a bottle. the person giving baby a bottle may need to walk, swing, bounce, or sway while trying to feed baby. Some babies need to be sung to while being fed. Some babies prefer to look out of a window, while others may prefer to sit in the dark. Try all of these things– you never know what will work.
  • Try different temperatures of milk– it may seem like the best choice is to heat up the breastmilk to body temperature, but some babies get very upset when the milk is the right temp– but there’s no mom attached to the milk. If this is the case, try cold milk, try milk that’s warmer than body temp (but not hot), and see if any of those changes help.
  • Try something other than a bottle– Bottles are relatively new inventions in the scheme of things. Sometimes the best way to feed a baby who won’t take a bottle is to use something else to feed baby. Cups and spoons are two common things used to feed babies. And rather than me try to explain how to do it here or to send you out to the great web to find information, here’s a great playlist someone already put together of some really great videos:  Again, patience is the key.

If you find yourself in the predicament, it can be helpful to seek good lactation help, too. Sometimes having another brain in the mix can help you figure out what’s going on.

Have you dealt with this? Do you have any ideas? Share below!

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Summer Baby Safety

Summer Baby Safety

Today is our very first 90 degree day of the year, so it’s time to get everyone up to date on the things you need to know to keep your baby safe.

No water for newborns 

Your baby should ONLY be given breastmilk or formula for the first 6 months. Nothing else. Water can actually be dangerous; their kidneys aren’t able to get rid of the excess water and it can make babies very ill. And really, we take access to safe water for granted (BIG TIME). Even some things in the water supply that an adult body can handle, a newborn’s body can’t.

Nurse that baby!

When the weather gets warmer, don’t be surprised if your little one has more frequent feedings. We get thirsty more often, and your baby does too. So watch your baby for cues and listen to what he’s trying to tell you: It’s hot and he’s thirsty. It’s OK. It won’t spoil your baby.

Stay in the shade

The AAP cautions against using sunscreen on babies under the age of 6 months. Their skin isn’t mature enough to handle it. Get a hat that allows for decent ventilation with an SPF and use an umbrella or anything else to make sure you avoid prolonged sun exposure.

Cover that car seat

If you’ve been through at least one summer with kids, you’ll know this, but it’s still important to repeat: Car seats get very hot in the sun. Kids and babies alike try to avoid getting burned (smart kids!). While your car is sitting out in the sun, cover the car seat with a thick blanket to keep it from getting too hot.

Rethink the beach

Here in Minnesota, in the land of lots of lakes, going to the beach in the summer seems like a birthright. Yeah, not so fast. While nobody is claiming that lakes should be squeaky-clean, the reality is that our lakes aren’t very clean. The Minnesota Department of Health has a wonderful set of resources to help you figure out if your favorite spot is safe, but again– what we can tolerate as adults can easily make babies and toddlers sick. Stick to the pool instead.

Nobody wants to miss out on our precious summer days because of injury or illness. Any other summer safety concerns? Let me know!

Warmly,

Veronica

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Breastfeeding Help…And Why You Can’t Get Any

Minnesota Breastfeeding Help

I’ve been thinking about this for a long time, and I need to get this off of my chest. I’ve written a little bit previously about some of the issues moms face in getting competent breastfeeding help, but after having this conversation with many providers recently, I think it’s time to have a little bit of a discussion about the state of lactation support in Minnesota.

So, first of all, the advice that ONLY IBCLCs are qualified to help moms with lactation issues is ludicrous. When we’re talking about something that about 90% of moms start doing right after giving birth, there’s no need for stupid turf wars. There are a number of breastfeeding trainings and certifications, some with more rigorous standards than others, but just as Minnesota doesn’t mandate one specific type of training or certification for midwives who want to attend homebirths, a rational breastfeeding supporter would acknowledge that there are a few different ways that professionals can gain the information that they need to help moms figure out how to make breastfeeding work. Even the CDC, when they issue their annual breastfeeding report card, reports not only how many IBCLCs there are in a state, but also how many CLCs there are.

Second, it’s time to acknowledge that hospitals don’t have enough inpatient resources to help every mom get breastfeeding well established before being discharged. Although I don’t have any hard evidence to prove this, but anecdotally I’ve heard from families who gave birth in Baby-Friendly hospitals got absolutely no one-on-one support, perhaps because the dedicated lactation staff was either reduced or eliminated completely. Sometimes administrators think that by paying for 20 hours of trainings for all of the nursing staff, they need to recoup that money by getting rid of the experts. Or something. Whatever it is, the access to help is not improving.

Third, once moms get discharged, finding outpatient help can be nearly impossible. One health system makes everyone in their system go to one clinic in St. Paul, which may or may not have more than one IBCLC on staff. Visits from a public health nurse can help, but visits are not universally done, and not all nurses have the time to properly assist moms with breastfeeding. Many outpatient clinics report waiting lists of up to a week. And while there are LCs in private practice, most of them require moms to pay out of pocket upwards of $200 per visit, despite the fact that the Affordable Care Act mandates that insurers cover breastfeeding help at 100%. Now, there are some barriers to becoming an in-network provider, but those hurdles can be overcome. The larger issue is getting providers to understand reality versus the whispered lies and half-truths about insurance reimbursement they’ve heard in the past.

My point? Fixing our broken breastfeeding system in Minnesota is going to require that the IBCLC turf war goes away. It’s going to require that hospitals hire more lactation staff. Private practice lactation specialists need to to think outside the box (rather than only trying to build one box) to make sure families don’t have to pay out of pocket for services they shouldn’t be asked to pay for. After all, for every mother that gives up on breastfeeding sooner than desired, I’ll show you a mom who had little or no competent support. That’s just not fair to moms or babies. They deserve better.

Two things we’re doing at BabyLove to address these issues: First, Mama Cafe, free breastfeeding support on Tuesday mornings, has been around since day 1. Second, you can get one-on-one breastfeeding help in our office or in your home, with some insurances accepted, and more being added. It’s my way of not just talking the talk, but walking the walk.

Warmly,

Veronica

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Am I biased? You bet.

BiasedBiased

Recently, although I’ve heard it before, the charge was leveled at me that I am biased in my classes. I was called, “Pro-breastfeeding, anti-drugs.” I spoke with a few other Lamaze Certified Childbirth Educators, and it seems that this charge is something that we’ve all heard. So, I think it’s time that I out myself for all of my biases.

First of all, I teach what’s best practice, what’s evidence-based, and what’s biologically normal. Now, keep in mind that it takes, on average, 17 years from the time something is deemed best practice (ie. safest) in maternity care before it used on a regular basis. 17 years. When new practice bulletins come out from ACOG, when the American College of Nurse Midwives issue statements, when the AAP put out new guidelines, guess what? That’s what I’m teaching. If I only taught what was being done by doctors and midwives– well, I have major ethical concerns with that. In an environment of “shared responsibility,” there’s a moral imperative to give families the information that they need to know if they are getting safe and competent care.

As for the “pro-breastfeeding” charge; I’m always interested to know why someone’s motivated to make that charge. Yes, I am a Certified Lactation Counselor. So? In classes, I teach the American Academy of Pediatric’s guidelines on infant feeding and mention what the World Health Organization’s stance is on the issue. Maybe the issue is that my classes meet the standards as set forth in the Baby Friendly Hospital Initiative. Again…so? We have 6 hospitals in the Twin Cities that are certified as meeting the Baby-Friendly requirements, all of the Healtheast system, one HealthPartners hospital, HCMC, and the U of M hospital, I hardly think I hold a renegade position. If those hospitals want to maintain Baby-Friendly status, they need to make sure their childbirth education classes have the same content as mine do. With almost 90% of moms initiating breastfeeding, I’ll stand with and support them. This is not about condemning one feeding choice, it’s about helping moms reach the goals they have for themselves.

What else?

I believe that it’s important to teach an understanding of the processes that are the biological norm.

I believe in maternity care transparency.

I believe that moms need to be responsible for finding competent care. They need to learn what that looks like and how to find it.

I believe that infant car seats are usually a waste of money and, since they are more often recalled and used incorrectly, can quickly become not as safe as convertible car seats. I also hate that parents aren’t taking their babies out and more than half of kids now have flat heads by age 1.

I believe in teaching about healthy choices and safe choices.

I believe in judging a hospital and birth center by their outcomes, not their wallpaper.

Are these things really that bad? Is it wrong to make sure parents aren’t being lied to? Is it wrong to be critical of those “educators” who are giving parents unsafe information because it’s the cultural norm? Is it wrong to help parents seek out safe care? Is it bad that I advocate for the right of a mother to be listened to? I hope not.

Every day, I hear birth stories and breastfeeding stories from moms who didn’t get the education or support that they needed and either they ended up with poor outcomes or their babies did. And you know what? I’m going to stay the course, because moms, babies, and families deserve it.

-Veronica

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Refresh Wednesday: Breastfeeding Myths

Today I’m reposting a blog that I wrote a couple of years ago. The post is old enough to go to preschool now, so I figured putting it up again wouldn’t be too much of a rehash. Enjoy!

Veronica

Breastfeeding myths amaze me.  Some myths are super persistent and are hard to make go away.  Others go away, only to rear their ugly little heads at random.  Two steps forward, one step back, I suppose.

So, let’s start on the most irritating ones:

  • You need to toughen up your nipples- ARGH!  This one MUST go away!  Moms, you do not need to do anything extra to get your nipple toughened up.  This awful little gem, in my opinion, was stupid advice doled out in an attempt to get pregnant moms so freaked out by the though of taking a hairbrush to their tender pregnancy nipples that they gave up on the idea of breastfeeding before baby was even born.  Leave your nipples alone.
  • If you have a drink or two, you need to pump and dump*- It’s a complete myth that if you have any alcohol, you have to pump out the “bad” milk until you get every trace of it out of your breastmilk.  Breast milk is a blood product.  The concentration of alcohol is never higher in breastmilk than it is in your blood, and as the levels fall in your bloodstream, the levels fall in your milk.  Generally, the bigger danger from drinking alcohol won’t be from having it in your milk, but instead you will be dangerous as a mother and will not be sober enough to care for your baby safely.  Not sure? Read some more guidelines here.      (*Now, pumping and dumping might have to happen if you are away from your baby for a long period of time while you are out imbibing, but mostly for mom’s comfort, not to keep baby from ingesting alcohol in the milk. If you’re undergoing radiation treatments, you will have to pump and dump.)
  • You can’t take the medication _____ while breastfeeding- Recently, it was estimated that ONE MILLION mothers quit or never started breastfeeding their babies because of incorrect advice about medication.  When I was breastfeeding and needed to take a medication, I would always test my provider to see if he or she knew how to answer the question (even though I usually knew the answer because I had done my research).  And sadly, often I had to teach THEM how to find the correct answer.  Online, you can find some really good information on LactMed, You can call the VERY amazing InfantRisk Center, and you can also download apps for both on your smartphone.  There is no excuse for care providers to not have this information literally at their fingertips.  However, you know now, too, so spread the word that the answers to breastfeeding and medication questions are easy to find.
  • If you exercise, it will make your milk “bad”- This is a complete, total, and utter falsehood.  Truthfully? The last time I read it was in a book on breastfeeding published by a formula company.  But, as always, stay hydrated (and this piece of advice is true even if you aren’t nursing!)
  • What you eat or drink will help your supply- This is a holy grail for some, BUT THIS IS NOT TRUE!  Even mother facing plague and famine are able to make plenty of milk for their babies, as are women who eat nothing but chips and drink soda all day.  And for the most part, their milk will provide plenty of nutrition for their babies.  Only a couple of things, such as vitamin K, won’t be in mom’s milk if she doesn’t have it in her diet.  What will happen if mom has a poor diet?  It will take a toll on how she feels, but that’s pretty much it.  So mom will less able to cope with the demands of her baby, but the quantity and quality of milk will be largely unchanged. For more info, check this out.
  • Fenugreek is totally fine to take to up supply- First of all, too many moms falsely think they don’t make enough milk for their babies.  Some times, it’s more of an issue of mom not having a realistic idea of what a newborn’s needs are.  So first, find out if you really might have a low supply. If you do, the best thing to do is to give baby more of a chance to breastfeed.  But when it comes to herbs to increase supply, realize that they have potential side affects. And if you have peanut allergies in the family, do not take fenugreek. But really you could take all the herbs in the world and if you aren’t letting baby nurse often enough, your supply won’t go up.  It’s supply equals demand, not supply equals Fenugreek.

I know more myths are out there.  These were my easy ones.  Truthfully, this is a hard thing to tackle, because some of them are so closely held by even strong breastfeeding supporters.  Evidence on breastfeeding best practices have changed a lot in the last couple of years, which is why it’s VERY important to find someone who has extensive breastfeeding and lactation training (at least 45 hours) and has been staying current to help you if you have any problems.  What other myths did I miss? Maybe I can tackle them in a future post.

Warmly,

Veronica

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

3 Things the Tongue Tie Skeptics Get Wrong

I’ve been writing about tongue ties and lip ties for a couple of years, and have been involved in some grassroots efforts to expand awareness and access to providers. Things had been going at a slow, yet calm pace until….until the skeptics and adversaries started speaking up. The first time this really hit our radar, I think, was this blog post from Nancy Mohrbacher. Now, I have a lot of respect for Ms. Mohrbacher, but I think there are a few things that were misleading in her portrayal of the issues. Reaction to her post was swift and divisive. Interestingly enough, comments on her post were removed and the ability to comment was turned off. Other posts have surfaced, but it was this post that prompted me to clarify a few things.

Myth #1: ______ are diagnosing tongue ties and lip ties

From Nancy Mohrbacher’s post:

I appreciate the growing awareness of tongue- and lip-tie issues and health providers willing to do interventions. Yet often the diagnosis is coming from friends, Dr. Google, and Facebook discussions.

OK, so major point of clarification: Medical Doctors can diagnose. Chiropractors (in some states) can diagnose. Advance Practice Nurses can diagnose. Physician Assistants can diagnose. Dentists can diagnose. Unless they hold any of these other licenses, guess who can’t diagnose?

IBCLCs (unless they are also MDs, DOs, etc.) can not diagnose. The internet isn’t diagnosing. Friends aren’t diagnosing. Facebook groups aren’t diagnosing. Once a parent is referred by whatever source to a provider who can do frenectomies, that provider then can diagnose and treat. Period. So let’s stop saying otherwise, OK? Thanks.

Myth #2: Moms aren’t getting help from IBCLCs before wondering if tongue ties or lip ties are an issue

In the 2nd blog post I referenced above, “Revise the Ties, Keep the LC,” she lays out 7 reasons why IBCLCs need to be involved with sorting out breastfeeding issues. I don’t think anyone disagrees with this at face value. But what isn’t really addressed is, if you read many accounts written by moms who have ended up getting frenectomies done on their little ones, most of the time at least one IBCLC, if not 3 or 4, have been involved with working with a mom. And while the author gives the advice that,

Every lactation consultant is an expert on breastfeeding, but not every lactation consultant is an expert on tethered oral tissues, structural issues as they affect breastfeeding,  and recovery after frenectomy.  Many of us have invested considerable amounts of time and money to acquire knowledge and information that is more advanced than the basic training required by the International Board of Lactation Consultant Examiners (the certifying board for IBCLC’s).  If you are not sure whether the lactation consultant you have contacted is an expert in this area, just ask.  Ask if they are knowledgeable on complete tongue function, if they have a good working relationship with local providers that release tongue/lip ties.

I can say, in my year and a half of advocacy work, this is hard for me, someone not even in crisis mode with a tiny, hungry baby, to figure out. How on earth are new moms supposed to suss all of this out? They get told that an IBCLC is the person to see for help with breastfeeding, and when they don’t get that help from the IBCLC that actually helps….I don’t know what to say to them.

Myth #3: This issue only affects breastfeeding

There are lots of studies that exist that show links to tongue ties and lip ties and things like sleep apnea, TMJ, speech issues, torticollis, overbites, crowded teeth, etc. (And of course, as I type this, PubMed isn’t working.) You can find lots and lots of info on these various issues over on Dr. Ghareti, ENT’s blog, including a link to the video interview I did with him a year ago. Since teeth, speech, etc are so easily affected, that’s often why dentists are more likely to be receptive to diagnosing and treating lip ties and tongue ties than other providers.

I do realize this is an evolving issue, but it’s easier to have a conversation as professionals if you at least keep the three points I made in mind. It’s easily to vilify, oversimplify, and misrepresent the issue, but that’s not fair to anyone. We’ll all do much better if the dialogue is respectful, open, and there’s no more name calling.

Warmly,

Veronica

 

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.