Healthy Pregnancy

It’s that time of year again—time when many of us resolve to lose weight, exercise more and take better care of ourselves. Taking care of yourself is even more important now that you have become a mother. Is it ok to exercise and lose weight while breastfeeding? Yes, yes and yes!

It is safe to exercise when you are breastfeeding (although I don’t recommend doing the 2 activities simultaneously!) Mothers are often concerned about lactic acid build- up with vigorous exercise but that is not a problem. Very strenuous exercise does create lactic acid but it does notmake the milk “bad” or significantly alter the taste of the milk.

What about weight loss? Will weight loss diminish your milk supply? Weight loss immediately after birth is normal and quite dramatic. In the weeks and months that follow, however, your “baby weight” will come off more slowly. It is generally recommended that breastfeeding mothers lose no more than 1 pound per week. Anything more than that may impact your milk production.

You probably have been more concerned about the foods you put in your body since you learned you were pregnant. It’s natural to extend that into your breastfeeding time and beyond. Your baby is learning about a varied, healthful diet every time he tastes your milk. Take advantage of this opportunity to teach your baby about all the nutritious foods you love.

Since we’re talking about diet, this is a good place to stress that there are no “forbidden foods” when you are breastfeeding. While there are babies who react negatively to certain foods, the vast majority do not. So, unless you have known allergies or food sensitivities in your family history, please enjoy eating your favorite foods.

A word of caution: Before beginning any exercise program, please check with your health care provider. Also remember you have just given birth and you’re probably sleep deprived so start slowly and listen to your body. And last, but not least, wear a very supportive bra!

Renee Beebe, M.Ed., IBCLC
Lactation Consultant
Postpartum Doula
206 356 7252
www.second9months.com

Breastfeeding does not require any special equipment. All you really need is a baby, and your breasts! But for a breastfeeding mother who needs to be away from her baby for work or school, a high quality professional-grade breast pump is essential! It can help maintain milk production, and allow the continuation of breastfeeding, even when mom and baby are separated.

Prior to 2011, breast pumps were considered feeding equipment and, therefore, not eligible for insurance coverage. For that reason, many individuals and organization have been fighting to change that. After much pressure from the American Academy of Pediatrics and various legislators, the IRS changed its classification of breast pumps. As of January, 2011, breast pumps are considered a medical device. It will now be easier for mothers to get insurance coverage for breast pumps.

It’s true that professional grade pumps are relatively expensive–$200-4400. Fortunately, with the new classification, your pump is eligible for insurance reimbursement. When you purchase your breast pump from a lactation consultant, she should give you a receipt in the form of a “super bill” that will include appropriate codes so you can seek insurance coverage for your breast pump.

Since your milk is important to the health of your infant, your health care provider will be happy to write a prescription for the purchase of your pump. This may increase the likelihood of insurance reimbursement. If you are denied insurance coverage the first time, consider writing a letter of appeal. Whatever you do, don’t give up. Many families have successfully received insurance coverage for breast pumps after being persistent.

If you don’t want to seek insurance coverage for your pump, the new IRS ruling also makes it possible to claim it as a medical expense. The cost of your breast pump may be added to your other deductible medical expenses if you itemize deductions on your federal tax return.

To get the most pump for your money, we recommend Hygeia. Hygeia pumps are fairly new on the scene and are a favorite of breastfeeding mothers. They are FDA approved for multiple users and have a 3-year, transferrable warranty. For more information and to shop for more information, visit Renee’s store. Please add link when clicking on “hygeia” and “Renee’s store”.

About 6 weeks postpartum, your health care provider will bring up the subject of birth control. Your doctor has your mental and physical health in mind when he talks to you about a birth control method. An unexpected pregnancy can be very difficult if you’re not ready.

There are many birth control methods that are compatible with breastfeeding. Condoms and other barrier methods are safe and effective when used appropriately. But these methods are considered “risky” to many doctors because they rely on patient compliance and errors can occur. More and more doctors, therefore, are encouraging new mothers to use an IUD for birth control.

There is a relatively new IUD on the market, that definitely can and does create problems for breastfeeding mothers. It’s called Mirena. The Mirena IUD releases small amounts of synthetic progesterone over time. Progesterone is the hormone that keeps you from lactating during pregnancy. It follows that progesterone, even a small amount, could cause a reduction in milk supply for a breastfeeding mother.

There is no research that I know of to back up this claim. I only have the experiences of many clients who have had devastating results with the Mirena. I would bet that there are many others who didn’t put 2 and 2 together and just believed that their milk ”dried up” all by itself or because they had returned to work. Since the resumption of birth control and going back to work often occur at about the same time, a mom could assume that being away from her baby most of the day is what caused the drop in milk production. So who knows how many mothers quit breastfeeding because of the Mirena?

So what should you do about birth control? Let your doctor know that breastfeeding is important to you and that you want to avoid risking your milk supply. Explore all options—including barrier methods. Remember that any birth control method is a “back up” method if you are fully breastfeeding and your baby is under 6 months old. . Avoid birth control methods that rely on hormones. Lastly, if you have already instituted birth control that includes hormones, and you are concerned about milk production, please call me for help!

Renee Beebe, M.Ed., IBCLC
Lactation Consultant
Postpartum Doula
206 356 7252
www.second9months.com

The holiday season is upon us! For most of us, major holidays and other big life events can mean more and less. More errands, visitors, visiting, travel, sugar. Less nutrition, cuddle time with baby, exercise and, most importantly, less sleep. You already know your body doesn’t work as well during times of stress—you are more prone to illness and you just don’t feel right. It’s no different with breastfeeding. Your breasts are part of your body and they don’t function as well during times of stress.

Stress can impact milk production because it impacts the milk ejection reflex (MER) or let down. Your brain doesn’t know the difference between a charging elephant (stress) or the stress of holiday errands in heavy traffic. What happens if you try to nurse your baby or pump in a frantic state? Possibly very little. Over time, this lack of effective MER could inhibit release of milk, leading to plugged ducts or insufficient milk production.

So what can you do?

First of all acknowledge that you have a young baby and that he will only be little for a very short time. Schedule time each day that is designated nap/cuddle time for you and baby. The younger the baby, the more times you will schedule. Make sure any guests know that you will NOT be doing all the meal preparation. If family members want traditional foods that are labor intensive, they are welcome to make them and bring them to you. Try not to have a houseful of guests; but if you do, retire to a quiet room EVERY time you pump or breastfeed. Not because of shyness or modesty, but because you want your wonderful oxytocin to flow like a river.

Here are some suggestions from moms who have been there:
Stay hydrated—a glass of water with every breastfeeding.
If you must shop, shop online
Make a photo book online featuring your baby. Then you can have the same book shipped to all your family members. Don’t forget a copy for YOU.
Forget about cleaning and decorating the house. Let it go.
If you must cook, do so ahead of time so you won’t feel stressed when company arrives.

Put you and your baby first this holiday season. Eat well. Take naps. Your family and friends will support you if you let them know what you need. They will be rewarded with a glowing, rested, happy mom and baby.

Happy Holidays!
Renee Beebe, M.Ed., RLC, IBCLC
www.second9months.com
www.facebook.com/thesecond9months

Your milk is a living thing! It is rich in antibodies that are constantly killing off bacteria. For that reason, it is very stable and remains safe even after it’s been expressed. Guidelines for human milk storage are different than formula, or even than pasteurized cow’s milk that you commonly buy at the grocery store.

You may find a wide spectrum of “rules” written about the safety of pumped breast milk at various temperatures. Why is there so much variability? The simple answer is that research is conducted in controlled situations for different purposes. Conditions for milk storage in your home are very different than in a lab. For example, pumped milk will last longer in a refrigerator that is never opened. A hospital environment with fragile, premature babies requires that milk be handled much more carefully than a home environment with a term baby.

What follows is a middle-of-the-road approach that considers the research as well as the less than perfect conditions of a home environment. The guidelines below assume that your baby is full term and healthy.

Fresh (not frozen) pumped breast milk at room temperature: 4 hours or until the next feeding. (No need to warm it up!)

Pumped breast milk in the refrigerator (not previously frozen) : 5 days

Pumped breast milk in freezer: 3 months

Pumped breast milk in deep freeze: 6 months (possibly longer if freezer rarely opened)

Whenever possible use fresh, room temperature or refrigerated pumped breast milk. Just as a freshly picked apple is more nutritious than an apple that’s been in cold storage for 3 months; your milk is most nutritious immediately after it’s been expressed. In addition, freezing destroys some of the live cells in your milk. So, if possible, store your precious milk in the fridge, leaving the frozen stash for emergencies.

If you plan to freeze your milk, make sure you use storage containers that are appropriate for a freezer. Fill the containers leaving at least ½ inch of head space. Glass containers, BPA -free plastic rigid containers and plastic storage bags are all acceptable. Be sure the bags are freezer safe, however. No one wants to find a burst bag of your precious milk in the freezer!<

If you are having a hard time figuring out a system for storing your milk for your return to work, be sure to ask for help. Renee Beebe is available for return -to -work phone consultations—perfect for helping you figure out the details of breast milk storage and establishing a routine that works for you and your baby.

Let’s assume for a moment that breastfeeding is not important. That the oral development that breastfeeding provides is inconsequential. We’ll ignore all of that so that I can give you a few other reasons to agree to have your tongue-tied baby’s frenulum clipped. Just in case the possibility of pain free, effective breastfeeding is not a good enough reason.

There are health care professionals out there who do not “believe in” freeing a tongue tied baby’s tongue “just” so he can breastfeed. “After all, you can just feed your baby pumped milk or formula from a bottle.”

You might be wondering about that yourself. You don’t want your baby to experience any pain—not even for a second! And, up until the moment your lactation consultant told you your baby is tongue tied, you’d never heard of such a thing. Why should your baby have a frenotomy (clipping the frenulum) when it’s only going to help with breastfeeding and breastfeeding? I’ll tell you why. Because freeing the tongue with a quick clip now may help your baby avoid health problems in childhood and even into adulthood.

The tongue is a strong muscle and that frenulum is a tight cord that is constantly pulling on the floor of the mouth and/or the lower gum ridge (called the alveolar ridge) with movement of the tongue. Without normal tongue movements the oral cavity does not develop properly and since one body part is connected to the other, problems can occur in the rest of the body also. Here are some effects of tongue tie that are not breastfeeding related.

• Ineffective oral hygiene
• Tooth decay
• Excess saliva production—frenulum pulls salivary glands to an abnormal position.
• Crowding of teeth—especially lower teeth
• Lisps and other speech impairments
• High, arched or “bubble” palate
• Choking
• Reflux
• Snoring
• Sleep apnea
• Headaches

So now you know. Perhaps that frenotomy doesn’t sound so bad after all!

Written by Renee Beebe, M.Ed., IBCLC. Renee is a lactation consultant in private practice in Seattle, Washington. She is available for home/hospital visits and phone consultations. Renee can be reached at www.second9months.com

The term “tongue tied” refers to a tongue that is quite literally “tied” by a frenulum. The frenulum is a (usually) thin, fibrous band that connects the underside of the tongue to the floor of the mouth. The mere existence of a lingual (tongue) frenulum is not an indicator of a problem. The important thing is whether the frenulum restricts the movement of the tongue to impact function.

One of the vital roles of the tongue for a baby is for feeding. Your baby depends on her tongue for sustaining a vacuum, moving the milk to the back of her mouth and swallowing. These things are important whether a baby is breastfeeding or bottle feeding. But when a baby is breastfeeding, the function of the tongue is more critical because incorrect tongue movement/placement equals sore nipples for mommy!

How do you know if your baby is tongue tied? Take a minute to observe your baby with these questions in mind:

Do your nipples looked creased or flattened after breastfeeding?

Does your baby have a hard time latching?

When your baby cries, does the center of his tongue look “’stuck” to the floor of his mouth with just the edges curling up?

When your baby sucks on your finger, do you feel the lower gums?

Does your baby seemed stressed with a fast flow of milk?

Do feedings take a long time? Or is baby feeding very frequently?

If the answer to any of these questions is yes, Your baby may be tongue tied! Check with an experienced lactation consultant to be sure. She will examine the baby—paying close attention to tongue movement. She will also observe the baby feeding. After a thorough evaluation, the lactation consultant may recommend that the baby have his frenulum clipped. After this very brief procedure (it literally takes about 1 second!) most mothers and babies notice an immediate difference in breastfeeding.

Written by Renee Beebe, M.Ed., IBCLC. Renee is a lactation consultant in private practice in Seattle, Washington. She is available for home/hospital visits and phone consultations. Renee can be reached at www.second9months.com

The simple answer is yes. And to prove that longtime brands like Walmart, Dole and Kraft and increasing their focus on organic products to meet the growing demand for what is considered “the fastest growing sector in agriculture” at “1 billion in sales in 2006.” It is important to note that natural does not necessarily mean organic, but is rather a broad statement that implies the product has not significantly been altered physically, chemically or biologically. For a product to be labeled organic: 95% of the ingredients must be organic. To qualify for a label of “made with organic ingredients”, 75% of the ingredients must comply.

The benefits of organic are countless from the higher level of disease fighting phytochemicals, increased vitamin C levels and the your ability, as a consumer, to avoid the harmful effects of chemicals, pesticides and antibiotics. Some researchers theorize that young girls may be going into puberty early due to these unnatural hormones being delivered by the food they are eating, specifically hormones and antibiotics that are injected into animals. Pesticides are known hormone disruptors and can interfere with your natural hormone levels, contributing to the increase in estrogen dominant conditions like endometriosis, cysts and fibroids. With infertility on the rise, paying special attention to avoiding hormone disruptors is important when wanting to conceive and for a healthy pregnancy.

The downside to organic is often the price, which can be around 30% more than non-organic foods. Is it worth it to have no chemicals, pesticides and hormones? Sometimes it’s helpful to know where to splurge and where pesticide residue is minimal. As a rule of thumb, always choose organic animal products (dairy, eggs, meats) to be safe.

Below is a list from Today’s Parent Magazine or the lowest vs. highest residue fruits and vegetables:

Safest:
Onion, avocado, sweet corn (frozen), pineapple, mango, asparagus, sweet pea (frozen), banana, kiwi, cabbage, broccoli, papaya.

Splurge worthy:
Peaches, apples, sweet bell peppers, celery, nectarines, strawberry, cherry, lettuce, grapes, pears, spinach, potatoes.

Resources:

Today’s Parent Magazine: A Brand You Can Trust July 2006 95-100

Baby Love: Healthy, Easy, Delicious Meals for Your Baby and Toddler by Norah O’Donnell and Chef Geoff Tracy

Kathryn Flynn is the author of Cooking for Fertility: Foods to Nourish Your Fertile Soul. Kathryn supports men and women worldwide in achieving a healthy pregnancy through nutrition and lifestyle changes in her individual fertility nutrition consultations. For additional information, please feel free to email Kathryn.