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"I thought breastfeeding would be easy because it's how our species has survived for like, forever. How hard could it be if a baby's survival depended on it? It didn't take me long--a day or two--to figure out how dangerous that thinking was." Yes, breastfeeding is natural. Yes, it’s normal. But you probably had more education on getting your period than feeding a baby. You have every month to learn about your period and nobody is going to die of starvation if you don’t. And breastfeeding? You and your baby have two or three wobbly days to figure it out before doctors start pushing supplementation and using words like "no milk', ‘failure to thrive', ‘dehydration’ and ‘brain damage’. Most parents have heard about hind milk and the elusive “good latch”? But what are they and why are they important? Most importantly, "How do you get them?" Scared Mommy Many mothers stop breastfeeding in the first few months simply because they truly don't know what normal breastfeeding is like. Today's moms have all of Google and modern medicine at their fingertips, yet they still lack knowledge, experience and education in breastfeeding. Moms mostly fear not making enough milk. Because people don’t know how human milk is made, they get scared, and do things that tank their milk supply. They wait until their breasts fill up with milk before they feed which signals the body to make less milk. They supplement with formula. With each ounce of formula fed to the baby, the mom's breasts make one ounce less milk. They try pumping and because they've never pumped before, not much milk comes out. This leads to a panic, which decreases their milk flow, leading to a cranky baby. Some of these mothers start to pump a lot and then find they have too much milk, along with plugged ducts and mastitis. They are uncomfortably full all the time. Their babies gag and sputter with feeds. Babies cry for a hundred reasons  Not just because you don’t have enough milk! The sad thing is when many moms interpret all cries as "My baby is starving. I must not have enough milk." Babies cry for hunger and thirst. They cry because they are too hot or too cold. It’s too bright or too loud. They are lonely, upset or bored and more. Breastfeeding fixes everything except an overfull tummy and a dirty diaper. But, nobody explains it that way. How DO you know if your baby is starving? When do you need help? There's an easy way to really know if your baby is starving. Weigh them. If your baby is staying on their growth curve, they are getting enough milk. They are crying because they need something else. If they are not gaining enough weight, that's a solid sign that you need help with breastfeeding. You may need to supplement, but start first with figuring out why baby isn't gaining before you supplement. Moms learn through experience that breastfeeding in the first 4-6 weeks is very different from breastfeeding at 4-6 months. You might have heard it gets faster, easier or better, but in the early weeks when you are going through non-stop feeding, you may not have a way to believe that. When informed consent isn't informed. Women make choices during pregnancy and birth to use interventions that are known to make breastfeeding more difficult. Epidurals cause more difficulty breastfeeding. C-sections delay milk production and the mandated separation after a surgical birth interrupts babies' innate reflex patterns causing a cascading sequence of problems. Some decisions are carefully thought out before they are chosen. A woman with placenta previa has time to learn about and understand the risks of a C-section and prepare for additional breastfeeding support. Many parent's are not receiving the "information" part of informed consent. A c-section, whether its a true emergency, or the result of a non-progressing vaginal birth is presented at the last minute and there isn't time to plan for breastfeeding problems and extra household help at home. The cure for ignorance is education. Here are five ways to learn more about breastfeeding. Ideally, you do a bit of all of them, because just like breastmilk, even a little bit is a wonderful thing. A five step cure: 1.  Choose doctors that value breastfeeding. Plan for an unmedicated vaginal birth by taking childbirth classes and using a birth doula.  2.  Educate yourself to prepare for breastfeeding by taking a breastfeeding class and reading all you can. Schedule a prenatal appointment with a lactation consultant to ask questions. 3.  Spend time with breastfeeding mothers so that your unconscious mind starts to learn what you need to do and you can ask questions and hear what they say about breastfeeding, the challenges they face and the solutions they know. Attend La Leche League groups or other breastfeeding support groups while you are pregnant. 4.  Formula promotional packs are trojan horses that sneak into your house and whisper words of doubt into your ear. Give them away or do not accept them. In most countries, they are not distributed by healthcare professionals until needed. If you need to buy formula, you will be able to. 5.  Even if your birth goes all wonky, insist the baby be placed skin-to-skin immediately after birth and wait for the cord to stop pulsing before cutting it. Keep your baby near you and skin-to-skin as much as possible for the first two weeks. After birth, read your baby, not a book. Feed 12-16 times every 24 hours until your baby is gaining weight consistently.

You may have heard that HealthAlliance Hospital (Kingston, NY) is a Baby Friendly Hospital. You may have questions about what that means. Aren't all maternity hospitals "baby friendly?" While the health care workers, staff and executives at your nearby hospital may love babies and be friendly, "Baby Friendly" means something deeper and more important. The Baby Friendly Hospital Initiative (BFHI) was formed to increase awareness and educate parents about the importance of breastfeeding, especially in the first hour after birth; to protect parents from predatory marketing and mis-education from hospital staff; to give parents all the professional support they might need as they begin their breastfeeding relationship; and to link families to breastfeeding support systems when they return home. BFHI is founded on the ideal that all babies have the right to begin their life breastfeeding. If after educating parents and allowing babies to initiate breastfeeding, the family decides to wean, then that is absolutely fine. Nobody is forcing you to breastfeed if you don't want to. The purpose of BFHI is to ensure that you are making an educated decision about how you feed your baby. The BFHI decided on 10 principles which became "The Ten Steps To Successful Breastfeeding." and is adapted into "The Ten Steps to Successful Breastfeeding for Hospitals," as outlined by United Nations International Child Emergency Fund (UNICEF) and the World Health Organization (WHO.) The 10 Steps as interpreted in the United States are: Have a written breastfeeding policy that is routinely communicated to all health care staff. Train all health care staff in skills necessary to implement this policy. Inform all pregnant women about the benefits and management of breastfeeding. Help mothers initiate breastfeeding within one hour of birth. Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants. Give newborn infants no food or drink other than breastmilk, unless medically indicated. Practice rooming-in-- allow mothers and infants to remain together 24 hours a day. Encourage breastfeeding on demand. Give no pacifiers or artificial nipples to breastfeeding infants. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic A hospital goes through a several-year process of adopting the "Ten Steps" in coordination with BFHI. This involves changing the organization of the hospital and the hospital policy. It's not an easy task to make institutional change. When an institution has been doing things one way for a while, there can be a lot of pushback to keep things the way they always have been. One major difference is that Baby Friendly hospitals no longer receive promotional products such as formula, pacifiers and discharge bags. Formula is purchased in the same way every other hospital food is. Pacifiers are now purchased medical supplies and discharge bags are funded through the hospital marketing department. Becoming Baby Friendly often involves making physical changes to the layout of the labor, delivery and postpartum ward. In a Baby Friendly hospital, there is no need for a traditional nursery and patient rooms may be reconfigured to be more comfortable under the new policies. The biggest change is in the training that the staff receives. Every employee of a Baby Friendly Hospital is trained in the the Ten Steps. Training is adapted for each of the levels of service from Custodial to Food Service to Labor & Delivery to Lactation. The training focuses on breastfeeding as a normal process that is unremarkable and ordinary. It's how humans feed their babies. When a hospital has made all the organizational and structural changes needed to adopt these principles, they are inspected and accredited. They become a "Baby Friendly Hospital." In New York State, these hospitals have earned the Baby Friendly designation: Bellevue Hospital Center 462 1st Ave & 27th Street New York, NY 10016 (06/16) Brooklyn Birthing Center 2183 Ocean Avenue Brooklyn, NY 11229 (07/16) Coney Island Hospital 2601 Ocean Parkway Brooklyn, NY 11235 (01/18) Elmhurst Hospital Center 79-01 Broadway Elmhurst, NY 11373 (02/19) Flushing Hospital Medical Center 4500 Parsons Blvd. Flushing, NY 11355 (07/18) Harlem Hospital Center 506 Lenox Avenue New York, NY 10037-1802 (2008) Re-Designated 2018-2023 HealthAlliance Hospital – Broadway Campus 396 Broadway Kingston, NY 12401 (12/17) Jacobi Medical Center 1400 Pelham Parkway South Bronx, NY 10461 (06/16) Jamaica Hospital Medical Center 8900 Van Wyck Expressway Jamaica, NY 11418 (05/17) John R. Oishei Children’s Hospital 818 Ellicott Street Buffalo, NY 14203 (12/19) Lincoln Medical and Mental Health Center 234 East 149th Street Bronx, NY 10451 (02/15) Long Island Jewish Forest Hills 102-01 66th Road Forest Hills, NY 11375 (03/17) Long Island Jewish Medical Center 270-05 76th Avenue New Hyde Park, NY 11040 (07/19) Metropolitan Hospital Center 1901 First Avenue New York, NY 10029 (08/17) Montefiore Jack D. Weiler Hospital – Einstein Campus 1825 Eastchester Road Bronx, NY 10461 (06/17) Montefiore Medical Center – Wakefield Hospital 600 East 233rd Street Bronx, NY 10466 (06/17) Mount Sinai South Nassau One Healthy Way Oceanside, NY 11572 (03/16) New York Presbyterian/Queens 56-45 Main Street Flushing, NY 11355 (1/20) New York-Presbyterian/Hudson Valley Hospital 1980 Crompond Road Cortlandt Manor, NY 10567 (01/13) Re-designated 2018-2023 Newark Wayne Community Hospital 1200 Driving Park Avenue Newark, NY 14513-0111 (01/15) NYC Health + Hospitals/North Central Bronx 3424 Kossuth Avenue Bronx, NY 10467 (04/16) NYU Langone Hospital 550 First Avenue New York, NY 10016 (01/11) NYU Winthrop Hospital 259 First Street Mineola, NY 11501 (12/14) Re-Designation Pending Phelps Hospital 701 N. Broadway Sleepy Hollow, NY 10591 (10/16) Queens Hospital Center 82-68 164th Street Jamaica, NY 11432 (05/14) Re-Designated 2019-2024 Richmond University Medical Center 355 Bard Avenue Staten Island, NY 10310 (05/16) Rochester General Hospital 1425 Portland Ave Rochester, NY 14621-3001 (2000) Re-Designated 2015-2020 St. Catherine of Siena Medical Center 50 Rte 25-A Smithtown, NY 11787 (08/17) St. Joseph’s Hospital Health Center 301 Prospect Ave Syracuse, NY 13203 (2009) Re-Designated 2019-2024 St. Peter’s Hospital 315 South Manning Blvd. Albany, NY 12208 (10/16) United Memorial Medical Center 127 North Street Batavia, NY 14020 (01/19) Unity Hospital 1555 Long Pond Road Rochester, NY 14626 (12/19) Woodhull Medical & Mental Health Center 760 Broadway Brooklyn, NY 11206 (05/17) https://www.babyfriendlyusa.org What to Expect at a Baby Friendly Hospital About HealthAlliance Hospital's Family Birth Place HealthAlliance Hospital’s Family Birth Place

"I spent most of my pregnancy studying pregnancy, labor and birthing. There was a page on latching your baby for breastfeeding, but I didn't really pay attention because I was worried about handling contractions during labor. I didn't even think about breastfeeding, because I figured it was natural, and it would just happen naturally." You wouldn't plan a wedding without planning a honeymoon. A honeymoon is a time of celebration, rest, and exploration in your new life together. It involves research. You reserve your accommodations, restaurants, recreation and beautiful, romantic spots to enjoy each other's company in. You may buy lingerie, special outfits and gear. You probably spend hours packing and repacking your bags. And you will definitely search blogs and reviews for places to avoid and potential pitfalls in your plan. A honeymoon is supposed to memorable in a good way and most people understand that honeymoons require a fair amount of planning. Parents enjoy Babymoons while they are pregnant-- massages, luxurious meals, easy walks, shopping, dreaming and cuddling. Many are figuring, "This is our last chance for many years!" Yet, most new parents don't plan for a "honeymoon" after welcoming their new baby. As a result, the Fourth Trimester is an exhausting Pandora's Box of opened gifts, last-minute meals, naïveté and tears. Why would you spend months preparing just the right layette, picking the perfect name, interviewing pediatricians and obstetricians, researching the perfect birth, and assume your baby will just naturally and magically feed and sleep like they do on TV? "Breastfeeding is natural, isn't it? How did humans survive in the past? We aren't worried, we'll figure it out!" For some, there is a cultural belief that investing oneself in the birthed baby may cause harm. No purchases or planning can happen until the healthy baby arrives. That may work in your native culture with abundant, close-knit family support. But it does not work in your average American suburban, or urban, single family home with both parents working right up until birth. Listen! Breastfeeding is part of the birthing process, not a separate, nor even a different event. Babies who birth vaginally without medication, placed on their mother's belly and observed, crawl to the nipple and are usually feeding themselves within an hour after they are born! This stimulates the release of your placenta, which starts your breasts making milk. The process of breastfeeding contracts and heals your uterus. It continues the immune protection given in-utero along with the protection, comfort and closeness of your body. Your baby needs this! But many birth practices will affect breastfeeding: Medications pass through the placenta during labor.  They can make babies sleepy and disoriented and impair breastfeeding reflexes. They also affect you. Delivering via C-section means milk production may be delayed by 12 or more hours. This is not a debate on necessary Caesareans. It's a head's up! Mothers who experience rough handling or injury during birth, often find even small challenges in breastfeeding, upsetting and overwhelming. Babies separated from you at birth for treatment in the Neonatal Intensive Care Unit (NICU) need extra support if breastfeeding is going to happen. You may need to be treated for high blood pressure, hemorrhaging, or illness. and may be separated from your baby. Doctor-caused injuries do occur during birth, or after. Common examples is an episiotomy, which makes sitting uncomfortable and suctioning a baby, which can lead to feeding aversion.  Education is the key to good decisions. Before you decide on giving birth with pain medication, or schedule an elective C-section, take time to educate yourself on risks and side effects. You need to be knowledgeable to make an informed decision. During labor, you will not get full risk factors from the anesthesiologist, much less be in a headspace to take in the necessary information. If they could, babies would say "No thank you." to these. Post birth procedures such as bathing, eye drops, and mother-baby separation can disrupt, upset, and even repattern innate reflexes and cause your baby difficulties in latching and transferring milk. Nipple shields, pacifiers and bottle nipples can also confuse babies who are learning to breastfeed. And nobody wants their head grabbed and forcibly jammed into their mom's breast. Insist that your nurse or lactation consultant use "hand's off" or "hand's over" techniques. You can only ask for what you know about. Read as much as you can about breastfeeding. If you don’t know what is important, or even what questions to ask, take a class and make an appointment for a prenatal consultation with a lactation consultant. Breastfeeding happens best with full support. Birth and caring for yourself after birth, is challenging. And caring for a newborn is Uber-challenging. It has brought stronger women than you to tears, even when breastfeeding happens as planned, which it usually does. But, all that stuff you do now without even thinking about it? That won't be possible for a while. Chores like grocery shopping, meal prep, cleaning the kitchen and the bathroom, changing your sheets and washing your clothes will end up at the bottom of your daily list. You will need someone to do these for you because there is a limited amount you and your partner will be able to do by yourselves. The first weeks are about basics like sleeping, eating and hopefully, showering once a day. If you plan your Babymoon, you will have a stocked pantry and a freezer full of ready to eat meals. You will have clean sheets. You will have a pile of comfy cleans clothes and bras. You will have someone to clean your kitchen and bathroom while you recover from birth in bed or on the couch. You will have someone to soothe your sweet one while you take a shower. You will be gazing dreamily at your partner and your newborn while munching down a bowl of fragrant curry, made by your (new) best friend. Give yourself the space and time to learn how you and your baby breastfeed together. Learning breastfeeding can take some extra time because of birth experiences, recovery time and individual needs. You may need the expertise of a lactation consultant. You will need a breastfeeding community and support from peers. All this takes time. You will have a few trips to your pediatrician in the first weeks. You may need to see other health care professionals, like a cardiologist, pediatric dentist, ENT and lactation consultant. There is probably nothing wrong with your baby, but many times, your doctor will want a second opinion, just to make sure. All this takes time, at a time when you are roller coasting between bliss and overwhelm, and physically, not feeling that great. More overwhelmed than ever? Here is a Quick List for taking action: Join the Breastfeeding Café for peer support. Start to stockpile freezer meals, groceries and supplies Put my number into your phone: Donna Bruschi, IBCLC 845-750-4402 Happy Babymoon Planning!

"I had never seen a mom breastfeed her baby in real life. I babysat and bottlefed when I was a teen. I have several nieces and nephews but my sisters didn't breastfeed. So there was my son and me, with no idea how it all worked. I wasn't just scared. I was terrified." Our brains learn best by watching and with mentoring yet many American mothers have never actually seen a woman breastfeed, let alone learned from her. In cultures where everyone breastfeeds, women still have difficulty learning, but because everyone around them helps them and encourages them, they work through their challenges and keep breastfeeding. Our culture boasts of family values, yet there is little cultural support, let alone celebration, for the breastfed baby. Instead, bottles and pacifiers go hand-in hand with babies. They are visible everywhere: in babies’ mouths, on t-shirts, gift bags, party decorations, baby gifts, advertisements, health insurance brochures and doctor’s offices. The result is that at 6 months, only 13% of our babies are exclusively breastfed. Here's a bag, just-in-case breastfeeding doesn't work. Many hospitals still give new moms a promotional bag with bottles of formula and pacifiers. Americans are targeted by corporations interested in selling their product at nearly any cost. And we are accustomed to doing their marketing for them by accepting and using branded gifts and products. This is fine if you are freely choosing to do this. Many people enthusiastically wear their favorite sports team on their shirt or hat. We buy sneakers and food with certain logos and tell everyone we know how much we love the product. But we generally are not under duress when we choose to do this. Have you heard about "The Code?" The USA has not adopted the The International Code of Marketing of Breastmilk Substitutes (The Code).  The Code helps to protect vulnerable parents and innocent babies from predatory marketing. Predatory marketing in this case, is marketing a product (formula and teats/nipples) to a vulnerable market (new parents) using untrue statements. Claims that may seem plausible to someone who is in distress, such as a new mother who is tired and worried about her baby being hungry. Predatory marketing is the opposite of informed consent. In America, your doctor is a salesman for pharmaceutical companies. Health care workers are rewarded for promoting formula and that leads to you getting misleading information and making choices that you later regret. How do you get around this? The secret is in communities. When women are with other women who breastfeed, they talk. They share information, learn, troubleshoot, enjoy and keep breastfeeding. All over America, there are sub-cultures of breastfeeding families everywhere for you to discover.  Don’t follow the example of the pioneer woman living alone on the prairie. There is a new wonderful world awaiting when you join or create a breastfeeding community. Where is my local breastfeeding community? While you are pregnant or when you are out with your baby, scope out breastfeeding-friendly resources in your community. Places like playgrounds, libraries, public spaces, play spaces, cafés and stores are hubs where breastfeeding women gather. Look for breastfeeding support groups at hospitals, WIC offices, baby stores, community centers, on Meetup.com, in OB/GYN’s, midwives’ and lactation consultants’ offices.  Join La Leche League or another breastfeeding support group and attend meetings starting in your first or second trimester. If there are none, start one. Become an advocate for breastfeeding in your life and community. Host a 'Big Latch On' or participate in a 'Live Love Latch' event during World Breastfeeding Week to raise awareness in your community. If you can’t find a breastfeeding support group, start one. Join Meetup.com, or put up a flyer at your local doctor’s office, church, library children’s room or preschool.

Are you a fourth-time breastfeeding pro or a first-time breastfeeder in a bottle feeding family? No matter what your skill level in breastfeeding, it is especially important to surround yourself with people who believe in you breastfeeding your baby. Praise and support are vital in the early months, when you are learning, and you doubt everything! You need people who will encourage you to keep going, find you professional support, and remind you to see the bigger picture when it seems easier to quit. Where can I find these people? Life changes. That is the only constant in life. So it's good to have a large contact list of people who are supportive of your endeavors in breastfeeding. 1. Make a list of your friends and family who have breastfed. While you are pregnant, ask them what their early weeks were like, and what was helpful, and what was not. You will get a better sense of who you feel comfortable talking to, when it’s your turn to breastfeed. If you already have a baby, they may be contacting you, which can be overwhelming. Start a list of supporters in your phone or on a notepad, so you can return their call when you actually need their help. If they haven't called you, contact them and tell them your baby has arrived and you are trying to breastfeed, and how it's really going. 2. Look up breastfeeding support groups in your area. You don’t have to have a baby to attend--just come as you are--pregnant. Most moms will tell you they wish they had taken the time to actually meet real live moms and babies before they gave birth. Support groups are a good way to meet other moms, and make new friends with babies the same age as yours. If you have a baby, definitely go to a local breastfeeding support group, or a ‘mommy and me’ support group. It can be overwhelming to pack up and get out of the house with your baby to face a roomful of strangers. I can assure you that most likely your discomfort will be short lived. I can't promise you, but the odds are that you will be happy you went. If you are unhappy, then ask yourself. Is it you, or was it the group? There are all kinds of groups, so don't give up if your first one or two aren't quite right. La Leche League, Breastfeeding USA, Baby Café and WIC all have active support groups all over the USA. Most hospitals and baby stores have baby groups, and you will find more on Meetup.com. Online groups can be a lifesaver, especially if you are housebound with the pandemic, weather, a premature baby, or illness. An advantage of online groups is specialization. No matter what challenge you find yourself facing, there is a group focusing on supporting people with that challenge. Search on Instagram and Facebook, or Google using specific words of what you want, like "Poughkeepsie mom group" or "Rhinebeck Twins Mom Group" 3. Find an IBCLC who will come to your house. Make a list of lactation specialists who help moms in your area. International Board Certified Lactation Consultants (IBCLC) have the most expertise, training and experience. Schedule a 10 or 15 minute prenatal conversation to see if you feel comfortable asking them for help, should you need to. The Breastfeeding Café is my online support community filled with expectant and breastfeeding and moms. It’s a friendly place where you can grab a cup of coffee, login and chat. Come join us! 4. Build a list of trusted resources. Search first with these trusted online resources. You can google a breastfeeding question and come up with some surprising (and embarrassing) results and some stomach churning photos. 1. KellyMom.com Kelly Bonata is an IBCLC who writes evidence-based articles clearly explaining every aspect of breastfeeding. https://kellymom.com 2. La Leche League - For over 60 years, this organization and its Leaders have supported, encouraged and empowered women to breastfeed. Small groups meet all over the world and trained group Leaders provide phone support and in-person support at group meetings. https://llli.org 3. Breastfeeding USA is a nationwide network of breastfeeding counselors who provide evidence-based breastfeeding information and support and promote breastfeeding as the biological and cultural norm. https://breastfeedingusa.org 4. WIC (Women, Infant and Children Nutrition) WIC equips WIC moms with the information, resources and support they need to successfully breastfeed through the use of incentives, support groups, IBCLCs and WIC Breastfeeding Peer Counselors. https://wicbreastfeeding.fns.usda.gov 5. BabyCafe USA -- Baby Cafés are free groups for pregnant and breastfeeding mothers offering support from trained staff, and opportunities to share experiences and make friends. http://www.babycafeusa.org 6. USLCA is the professional association for American lactation consultants. Check certification, and and look for an IBCLC lactation consultant near you. https://uslca.org/resources/find-an-ibclc 7. Donna Bruschi, IBCLC -- Call or text (845) 750-4402 with your questions. And don’t worry, you are not “bothering me!” Answering breastfeeding questions is what I do, and how I work with all mothers. Happy breastfeeding!

In this post, we'll explore the topic of tummy time for new babies. I hope to provide easy strategies so you both have positive and beneficial tummy times. These tips and techniques help you and your little baby adjust to tummy time and this supports their physical and sensory development. Tummy time is an essential developmental milestone for all babies, including those born prematurely. To make this activity more enjoyable, I recommend the following evidence-based approaches: Keep baby close: When starting tummy time with new babies, it's important to keep them in close proximity or on your body. Physical closeness creates feelings of security and attachment, which allows your baby to relax. By maintaining this connection, tummy time can be a supportive and reassuring time of growth, rather than a stressful burden. Select optimal windows: Observe your baby's behavior and cues to help you find good times for tummy time practice. When they are most alert and content? By selecting favorable moments, you create an environment conducive to calm and beneficial tummy time sessions. Piggyback with the Contact Nap: This popular napping position involves placing your baby on their tummy so they are lying on your chest. They can see you, smell you, feel your warmth, breath and heartbeat. This physical closeness and gentle support keeps your baby calm while promoting the head-up and back strengthening needed for rolling and crawling. Gradual progression: When initiating tummy time, it's important to start with short durations and gradually increase the length of each session. Starting in small increments of 30 or 45 seconds initially, contributes to your baby's muscle development and motor skills. By gradually extending the duration as your baby becomes more comfortable, you create a foundation for continuous progress and improvement. By age two or three months, your baby will be happy to lie on their stomach, reaching, stretching and learning to roll over. Get down on the floor with your baby: Make funny faces, blow raspberries, sing and talk with them. Involving siblings in the process promotes friendship and bonding. Encourage older kids to interact by making funny faces, offering toys, talking and singing with the baby, while you supervise. Establish a consistent practice: Add tummy time into each part of baby's daily routine. For example, integrate a tummy time session into each diaper change, waking from naps, play time, and breastfeeding. Spending a minute or two on their tummy every 1/2 hour throughout the day helps your baby become comfortable with the activity. It builds their muscles and flexibility in baby steps, over time. Incorporate toys: Make tummy time more engaging by incorporating age-appropriate toys like rattles, bells, mirrors, textures and picture books that grab your baby's attention and engage all their senses. Individualized adaptations: Every baby is unique, and certain circumstances may require adaptations for comfortable tummy time. For babies with reflux, practicing tummy time in an inclined position can alleviate discomfort. Placing them on a rolled-up receiving blanket or a Boppy pillow under their arms creates a gentle incline that reduces potential reflux symptoms. For a baby with torticollis or a large head: These babies may need a gradual introduction to tummy time to accommodate their unique physical characteristics. Try placing them on their side or propping them up with a small rolled-up towel to help them gradually build up neck flexibility and back muscle strength. As they develop, you can progressively transition them to traditional tummy time positions. Delicate approaches for special cases: Babies with G tubes or sensitive abdominal areas require special consideration during tummy time. Utilizing a cross-lap soothe position or a Boppy pillow under their arms can help create a gap around the sensitive area, ensuring their comfort and safety during the exercise. This approach enables babies with specific needs to experience the benefits of tummy time while minimizing potential discomfort. Initiating tummy time from is crucial to baby's reflexive development. Humans are a "Carrying Species." We are meant to be on our tummy or in an upright position, not on our backs. With "Back to Sleep" in cribs and bassinets, car seats, bouncy seats and swings, a baby will spend nearly all their day on their back. Incorporating tummy time early on allows babies to enjoy the position. It initiates the strengthening of their back and neck muscles and promotes the development of motor skills like rolling and crawling. As you embark on the journey of tummy time with your new baby, remember that each effort contributes to their overall growth and development. By following evidence-based practices and incorporating these strategies, you create an environment that supports our baby's strength and body development. Celebrate each milestone, regardless of its size, as it signifies progress in their journey. If you have any concerns or specific needs, I encourage you to consult your healthcare provider for additional guidance and/or referrals for physical or occupational therapy for your infant.

 You may wonder if you need a class for breastfeeding? A breastfeeding class prepares parents for the fundamentals of breastfeeding. In an ideal world, you would have breastfed, watched your siblings breastfeed and all your sisters, aunties, co-workers and friends would have taught you a bit about normal breastfeeding throughout your life. In a traditional culture, your mother, or mother-in-law, would move in after your birth for a month or two, bringing her knowledge about breastfeeding. She would prepare traditional foods to support lactation and provide plenty of mompower to keep your little household running smoothly during your recovery. In lieu of that, a two-hour course will cover the fundamentals of breastfeeding. It will help give you a good start, even if your mother is coming to live with you. Prepare during pregnancy for breastfeeding. You will learn how to receive a breast pump through insurance and what you need to do, so it's ready to go if you need it. Pregnancy is also the time to talk to your employer about your plans to return to work and what kind of accommodations you will need if you're pumping. In New York State, the law protects your right to pump at work until your child is three years old. Somebody probably told you how to toughen your nipples by rubbing them with a washcloth. Rather than doing this, learn to massage your breasts to wake them up. In a breastfeeding class, you will learn about expressing your colostrum prenatally so you have supplemental food, should your baby need it in the hospital.  And you will hear about how wonderful and awful, breastfeeding can be. Beginning breastfeeding The first five days are challenging and many parents are overwhelmed by their new responsibilities. You will learn how to negotiate the first hour of your baby's life and why it's important to keep your baby on you skin-to-skin, even though not every hospital allows it. The law protects your rights to have this time, and you will learn how to advocate for it. In addition, you may not have access to a Lactation Consultant in the hospital because either your schedule and hers don't line up. You will watch and receive a short list of excellent videos that can help you through this time.  Common problems In the first five days, there are four common problems: sore nipples, engorgement, baby not latching well, and worrying that you don't have enough milk. All of these problems have simple solutions that are not commonly taught by hospital staff but are covered in a breastfeeding class. For instance, simply leaning back into a reclining position can make sore nipples vanish, and cause babies to open their mouth wide.  Solving breastfeeding problems in a hospital often takes breastfeeding away from mothers and substitutes it with pumping and formula. Breastfeeding classes not only offers you simple solutions that keep you breastfeeding, but also teach how to advocate for your baby's needs. How to know when you need help There are four barriers that keep women from getting the help they need. Stubbornness and the belief that they can power through it. Not knowing where to get help, or what kind is needed. People or places where you might get help don't actually exist in your community. Not knowing common warning signs and red flags for impending doom. Weaning will happen whether you want it or not. It may seem strange to talk about ending breastfeeding before it's even begun, but it's important.  Weaning always takes time -- weeks or months, not days. Sudden weaning can make you painfully miserable, or even sick. You will learn strategies for every age that weaning might happen. Support groups are an important part of success. A breastfeeding class gives you information on local and online support groups. The easiest way to prepare yourself for breastfeeding is to attend breastfeeding support groups while you are still pregnant. It's also important is to talk on the phone or meet with at least one International Board Certified Lactation Consultant (IBCLC.) Many IBCLCs facilitate their own breastfeeding support group. When you are surrounded by women who breastfeed, they can cheer you on and model what's coming up in your future. When you don't have a perspective from hearing shared experiences, its easy to magnify your problems in your head. And that leads to anxiety, stress, feeling discouraged and not meeting your breastfeeding goals. How do Partners and Grandparents fit into breastfeeding? While you might be the rebel of the family already, it's a lot easier if your significant-other and parents support your breastfeeding. Breastfeeding involves some bare breasts in the beginning. You will probably feel self-conscious, and the last thing you need is family members acting all judgmental, self-righteous and shocked. Or making snarky comments about boobs. Or trying to be "helpful" by suggesting the baby needs a bottle. A class prepares you to tell them and you can bring them to your breastfeeding class to help make sure you are all on the same page.  Remember, this is your baby. You are the parents, and Gramma is not. She may have some feelings about this, but she had her baby in her day, and now, she can show you some respect! Selecting a breast pump and essentials if you are returning to work. Search your insurance company website to see what they offer in breast pumps and how to receive one. Insurance companies and pumps all work a little differently and it can take some time, so don't leave it to the last minute. If you need a pump in the hospital, a hospital grade pump will be provided for you. The class gives you reviews about different pumps and how to select the right one for you. Pacifiers, safe bottle feeding, & suckling When a person of authority insists that you stop breastfeeding while you are just learning how to breastfeed, and you aren't ready, you need a solution. There is a time and a place for pacifiers and bottle feeding, and there is almost always a breastfeeding solution, if you want to keep breastfeeding. Pain can be reduced greatly with excellent positioning. Breast compressions can replace pumping and keep babies swallowing even while they doze. A spoon can replace a bottle. Breastfeeding can replace a pacifier.  A good breastfeeding class gives you a foundation for what to expect. It starts to prepare you for how beginning breastfeeding will be wonderful, amazing, empowering and challenging. And it gives you resources, so that when you need help, it's already in your phone.

Created: Saturday, 04 April 2020 02:10 Hits: 743 I am frustrated because my dad is totally conscious of what we are all saying and doing.   He tries, but can no longer join in, and this makes him incredibly sad. He tries to talk and inevitably someone laughs at him, or at themselves, for losing patience with him. His words are substituted, inarticulate, whispered, told in analogies. He loses his train of thought. A conversation with him is a series of jokes, missing a punch line; shaggy dog stories without a central character, or action. We know all the stories, so we laugh at the appropriate times, and remind him of the names and places. It is agonizing and frustrating. And still, I soak them in, because I know there won't be any more. He walks, until the day he lays down, and starts to let go of life.  He has Parkinson's Disease and he is always cold. He starts to hate going outside, and it is just too hard to put all those clothes on him. I flash back to my three small children lined up by the door, finally in snowsuits, boots, hats, scarves, mittens, while the prickling heat and sweat are running down my face and back. Twice or more a day, we are undressing him, then dressing him. We call his diapers, depends. There are bed pads, wet sheets, and wet pants. There are wet shirts from constant drooling. He hates when the aide pins a towel over his shirt, so I cut the backs off some of his old shirts and make bibs. I jest that I am going to upcycle a line of adult bibs made from real clothes, and call it "Clean Clothes." We all try to do everything we can to dignify his experience. The amount of laundry is insane, so is his appetite. He still loves to eat, but his swallowing is only 50% effective, which we know, because he goes for swallowing ultrasounds where they measure these things. He is supposed to be eating purees and drinking thickened drinks. He refuses to eat slurpy slop. So we cook his favorites, we dice his food, remind him to chew, and watch helplessly when he gags.I remember my babies cheerfully jamming handfuls of food into their mouths, before coughing it back onto the table. I get to know him on a physical level.  I realize we haven't always been at arm's length. I remember cuddling with him as a little girl, and being replaced by a guitar, or a book. I remember his plaintive query, "Can we do something as a family?" And either dismissing it outright, because I have my own life to live or humoring him with a family dinner, or a weekend at the family camp. I understand my own longing for my kids, and their behavior that hurts. I remind myself they have their own lives to live, and their own lessons to learn. But now, I comb his hair, wipe his face and nose. I massage his hands, shoulders and back. I touch his arm when we talk.  Though my dad is only able to peek out at the world, his mind is going a mile a minute. He tries to decipher the code of the Persian rug--the hidden messages it is offering up. A Hospice volunteer reads science articles to him, and they talk about galaxies and evolution. He still studies his disease. He resents his illness and blames doctors for not curing him. I remind him that at least he is still home and we love him. We care for him willingly and with love. And he is not going for chemotherapy, or living in chronic pain, or in a nursing home. Hospice arrives. Someone told me to call hospice early, because he has a terminal illness. We do need more help caring for him, and I am curious. He meets the threshold of need, and Medicare pays for it. Medicare and Medicaid will pay for 6 months of hospice care, but they will not pay for 6 months of similar care for babies! I keep wondering, "What if every new mom had a visiting nurse once a week, and someone checking in three times a week for bathing, and a social worker every 2 weeks? What if they sent volunteers to babysit so new moms had a respite?For crying out loud, what if new families had a Music Therapist? Everyone at Hospice is caring and sweet. They walk us through dying step-by-step. I remember my midwife doing this. In fact, we now have a Hospice Doula who is helping us navigate the hard parts. My dad hallucinates, and each time I have to decide if I should tell him what reality is. I wonder, "What is reality, anyway?" He insists there are three of my mom, and the one sitting next to him is an imposter. He gets angry and my mom cries. Over time, we figure out that there is his Blushing Bride, Mean Mom and Gentle Mom. He only likes Gentle Mom and Blushing Bride.  I don't blame him. I mean, nobody else wants Mean Mom around, either. My mom loses track of time and reality.  Dealing with my dad 24-7 has exhausted her. She is angry, frustrated, blamed and blaming, incapable of caring for him, because she is old and tired too. She snaps at me and I cry. I am doing the best I can. The aides are doing the best they can. My dad is doing the best he can. She is doing the best she can, and it all mostly just sucks.  I bring up memories of happier times, and pull out boxes of old photos for a diversion. This helps. We tell each other stories of when she was little, when I was little, and when my kids were little. We laugh and cry. We hug and I notice how small she is getting. Home death looks a lot like home birth. Two weeks before he passes, my dad has his final meal of pea soup and baguette. He eats eagerly and enjoys it very much. The aide and I put his pajamas on and he goes to bed. He never gets back up. The next day he sleeps all day. He eats tiny bites of applesauce. The aide gives him spoonfuls of water and puts vaseline on his dry lips. The following day she makes him puree that he won't eat. I call my kids and siblings, and our family begins our wait. We know he will die. We have everything ready, his trust, his will, his succession. We have his request to not resuscitate him.  Two of my babies were born at home. The last two weeks before birth were much like this. Watching for signs of progress, and on edge, guessing if this was the real start, or only another baby step, of the process. And in-between, the day-to-day routine of eating, cleaning and resting--normal family life at home. We are ready, but he is not. He continues hallucinating, rambling on and on, in delirium. Our pastor comes one night and we pray. He asks God to show my dad His love and that night my dad settles down. His face has changed. He is at peace and he looks like he is letting go of this world. He recognizes me as I sit with him, but quickly drifts off again. I play banjo and dulcimer for him. I can't tell any more if he likes it or not but I am doing it un-self-consciously, just like he taught me. May the circle be unbroken My dad loved to play guitar and sing, and he inspired countless sing-a-longs as far back as I can remember. He was a mediocre guitar player and a terrible singer. But there are a lot of terrible singers this world and it didn't stop him. The Sunday before he passes, we all gather around his bed. My brother plays guitar. We sing, using his song sheets and he tries to join in. It's hard to say if he wants us to sing, or to stop, but that train has left the station. We sing This Land is Your Land, Michael Row the Boat Ashore, Amazing Grace, Traveling Man, Erie Canal, and so many more.  I remember laying in bed, listening to my dad play,  I remember dreading him singing and playing his guitar, I remember the time he came to one of my parties dressed as Elvis. I remember my kids hanging on him as he played. I remember when he tried to play a couple of years ago, couldn't, and sadly put away his guitar.  I look around the room at my brother, who started learning to play the guitar when my dad stopped, my sister doing the hand signs for Kum-Bah-Yah, my mom holding my dad's hand. I feel Michael's hands on my shoulders. I see my dad, shrunken and pale, tears in his eyes. This is my family and I love them so much. Each day I go to my parent's house. And each night I say, "I'm going home and will be back tomorrow. If you need to go, then go, and if you are still here, I will see you."  It's a sunny Saturday morning and I am on my way to see him. He waits until my mom leaves the room, and dies in his bed, with an aide by his side, before I get there. I call my brother and sister. A hospice nurse comes an hour later and pronounces him dead. She will make all the other phone calls to his doctors, to the funeral home, and to the state. She destroys the rest of the morphine, talks with us for a while, and leaves. My mom and I are relieved, more than any other feeling. She strokes his hair and I feel the deep love she has always had for him. My sister and her husband arrive, and we bath and dress him. It's weird and a little uncomfortable, but also feels completely normal. I acknowledge I am having a life experience with roots as old as mankind.  We work side by side. His body is stiff and we puzzle how to get his clothes on him. We figure it out and in the end, he looks like he is resting, before leaving on a Hawaiian vacation. Our mom wants to keep the shirt we have chosen, but we hold firm. It's his favorite shirt, he's entitled to take it to the grave. In memento mori. I use my sister's camera, her staging, and my skills and in the end, we have a good portrait. My mom kisses him tenderly and says goodbye. We take a picture of that, too. I give his cold hand a squeeze and thank him for being such a good dad. I'm crying. The funeral director comes with a black bag and a gurney.  We talk about the house. He had looked at buying it before my parents bought it. He comments that the former owner died yesterday. Then, I gently lead my mom out of the room. This sun is streaming through the living room window and sitting on the couch, we will not see my dad zipped into a black bag, being bundled into the black Chevy Suburban parked in front of the house. We don't know that in a couple of weeks, our family will go into self-isolation from COVID-19. His memorial is March 7, a warm sunny day, and it is a fine, large celebration of his life with family and friends, from all parts of his life. We sing Amazing Grace, Country Roads, This Land is Your Land, and of course, Kum-Bah-Yah, with my sister doing the hand signs.

"I've thought about breastfeeding. I have to go back to work 6 weeks after my baby is born. It just doesn't seem worth all the aggravation that I've heard about. I want to spend the few short weeks I have, recuperating and enjoying my baby." Just the idea of going back to work in the first few weeks or months, causes some women to rule out breastfeeding. Research shows that ANY amount of breastfeeding is beneficial, and women should breastfeed at least until they return to work. However, even after breastfeeding is going well, going back to work increases the risks of early weaning. And all mothers acknowledge that working and breastfeeding is challenging. So, why bother? The United States is last in the world in how much maternity leave mothers receive.  This means that women are returning to work soon after birth, which also means they are working before breastfeeding is securely established. You aren't the only one going through this and many women have done it before you. You don't need to solve every problem yourself but going back to work before you are comfortable breastfeeding adds an extra layer of stress into your family. Women often lack the support of their employer to pump at work. Employers are sometimes surprised when you let them know you will need a place to pump when you are working. Even though studies show that mothers who breastfeed take fewer sick days. Even though employers who accommodate nursing mothers have lower employee turnover, because women are happier. Even though there are laws that protect your right to express your milk for as long as three years postpartum. Things are changing, but you may find your employer is pushing back in major or minor ways, and it may not be worth the fight. How might breastfeeding and employment work out? 1.  First, do a cost analysis and see if it even makes sense to return to work. Add up your costs of daycare, transportation, work clothes, convenience foods and the likelihood needing to supplement with, or switch to, formula feeding. You may find you are eligible for Medicaid health insurance or a low-cost Marketplace plan if you aren't working. Some moms offer part-time child care for older children while they are at home or find another home-based business to close the gap. 2.  Talk to your employer while you are pregnant about pumping schedules and a clean, private place to pump. Share “ The Business Case for Breastfeeding ” with them. Expect to pump 2-4 times a day at work, or about every 3 hours. Experienced pumpers block out 20 minutes, but you may need longer in the beginning. Not all pumping breaks will be paid. Employers must provide you with a clean, private room with a locking door and access to washing facilities. Laws specifically prohibit bathrooms as workplace pumping stations. Some large workplaces have dedicated pumping rooms with amenities such as refrigerators, hospital grade breast pumps and comfortable chairs. 3. Try breastfeeding and see how it goes. You might be pleasantly surprised. Women who never intended to breastfeed are often shocked when their baby finds their breast and begins nursing. Many times, their reluctance to breastfeed fades. They find they enjoy it. You really can’t predict how breastfeeding will go, or how you will like it, until you try it. 4. Don’t be afraid to combine breastfeeding and formula feeding after you go back to work. Some breastmilk is always better than none. Breastfeeding is a wonderful way for you and your baby to reconnect after being separated. Accepting that you may need to use formula takes the pressure off pumping enough milk every day. After surrendering to this idea, you may find that you actually are able to pump more milk because you aren’t anxious about "starving your baby". Talk to other mothers who are back at work. Before you make a final decision, find out what it's really like from moms who have breastfed and gone back to work. There is no need to solve all the challenges yourself. When you listen to moms who have done it, you will learn how to express milk, what you need in equipment, how to handle emergencies, how to handle separation and things you can't even imagine, before you are actually in the situation. Talk to moms who formula-fed and worked. It's not always an easier choice-- it has its own unique challenges. You will learn how to handle regrets and jealousy that arise as your baby attaches to other caregivers. You will find out about planning amounts and not wasting money dumping out half full bottles. They will have ideas about handling rashes and upset tummies and things you can't possibly know unless you've been through it yourself. Take your time and really think about what's important to you. You know yourself best and what you need. You've had your whole life to learn what challenges you have relished, and which ones sent you into overwhelming self-pity and regret. This is a big decision and how you feel in a few months may surprise you. A baby would always choose to breastfeed but breastfeeding is not always the right choice for a mother who works. It requires some problem solving, time sacrifice and equipment, and that may not be the healthiest choice for you.

"Maid of Honor while breastfeeding! It can be done." Prepping for an occasion such as a wedding, holiday party, or a vacation when you are breastfeeding, can be daunting, when normally you would be full of anticipation and excitement. One of the features of a big event is the planning, and.... the long roll out... with details emerging as the party comes nearer. You may have been invited to this event before you were even pregnant. “We are getting engaged!” “We are engaged!” At the time, you weren’t pregnant. You and your husband went to the party and stayed up all night with your friends. You had a great time! “We set a wedding date!” “We booked a venue!” You are pregnant when you get the news. You assume you will get a babysitter, and have a blast, just like you did at their engagement party. “We picked the dresses!” You look at the pictures. It’s six months after you give birth. Surely, you will have lost the baby weight by then… “We booked the photo shoot!” “We booked the hotel.” Now you are thinking, maybe the baby should come with you. Your life has changed so much. And so on! Whether you are including the baby or not. About two months before the event. is when the big day comes onto your timeline. It’s time to do your part. And, your breastfeeding baby is front and center when you are planning for the occasion. You are probably anxious and imagining all kinds of scenarios. That’s a normal way to prepare, and be prepared. The Countdown: The very first thing to do is find a babysitter- If the event specifies that no babies can attend, then you will definitely need a babysitter. If you are traveling, think about a suite accommodation near the event, with two bedrooms, living room and kitchenette, or a short stay home rental, where everyone can stay. Even if your baby is invited, a baby handler will help you and your baby enjoy the party more. Baby’s have their own needs which don’t often include loud, long parties, or sitting through religious services. Two months before the event, plan for yourself. Where can you pump? All events are longer than your breastfeeding intervals, so you will need a place to pump during the event. Do not try to power through without removing milk. It can lead to plugged ducts and mastitis. Many party venues have a ladies lounge adjacent to the bathroom, which might work for you. If not, ask about access to a dressing or changing room. Your hotel room may also be close enough. Will your pump work for the event? If there is a dressing or hotel room, you can use your regular plug-in pump. If not, now is the time to buy a wearable pump or a hand pump, and spend some time getting used to it. How many outfits will you need, and what kind? What kind of clothing will you be wearing? Are the outfits breastfeeding friendly? If you can’t breastfeed, you will need to express milk. Can you pump in every outfit? You may need to buy, rent, or borrow some specific kinds of clothing for the occasion. You may need to have clothing tailored. Do it now. Evaluate your baby gear. You may love your SUV stroller, but trying to gate-check it might be more trouble than it’s worth. Consider your car seat and think about a travel bag for it. Can you rent (or borrow) a crib or pack and play where you are staying? If you are in a city, research baby equipment rental. These are popular in many tourist destinations. While you are shopping, pick up some extra supplies like a cooler, ice packs. microwave sanitizing bags, cleaning wipes, storage bags and bottles. If your baby will be far away, you have to decide if you are shipping your milk, or discarding it. Research your milk shipping options now, if you want to do that. Where are you staying? Hotels are in the business of providing things for guests. Call in advance for things you need, like a crib or min-fridge. If you are staying with a friend or relative, or short stay rental house, check with them about a crib, refrigerator and freezer space, a chair in your room, or any other thing that you use in your day-to-day breastfeeding/pumping routine. Purchase a card and gift for the hosts. If you are giving money, then go to the bank and ask for new bills. If you are writing a check, take a deep breath, and write it with your best penmanship. Wrap the gift and put it in a bag or box so it doesn’t get (as) crushed. Remember where you put it! Transportation and lodging plans, gifts, gear purchases and clothing fitting should be completed well in advance of (at least two months) the event. About a month before the event: How long your stay? That will determine how much you need to pack. Is your suitcase or duffle bag appropriate, or do you need to borrow, or buy, more suitable luggage? What other clothing do you need, that you might not think of? Is there a pre-event dinner? Do you like wearing a robe and slippers? Will you want a bathing suit for a pool, lake, or hot tubs? Sneakers and casual shoes for walking and sightseeing? Are you wearing flats or heels to the event? Are they comfortable? Remember that your feet may have changed sizes since you were pregnant. Two weeks before the event: Now is the time to go through your toiletries, makeup and meds. Check your inventory and purchase travel sizes, or plastic travel containers. Check your makeup for color and skin sensitivity. You are different than before! Pack enough medicine and your insurance card, if you are dependent on a medication. Plan for transportation. Obviously airline tickets are purchased in advance for the best deal, but how are you getting to the airport, and then to the hotel? What are the current TSA rules on traveling with breastmilk? Do you need a pillow or snack? Do you have KN95 or N95 masks in your bag? Nobody picks to sit in front of someone who’s coughing, but it happens, and you can protect yourself. Plan for your hosts: If you are staying at someone’s house, bringing a hostess gift is a nice touch. It can be something small like a fancy dish towel, a box of chocolates, a candle, or something larger. Don’t overthink it. It’s a social grace, not a final exam. One week before the event: What snacks and meals are you responsible for? When you are a guest, you know your host will feed you, but it might not be exactly when you are starving. Purchase some substantial packaged foods for hunger pangs and midnight snacks. Driving your car: If you are driving, then your car can become your default ’staging area’ Stash your event gear in its own bags and keep them on the top. If you are driving to the airport and flying, then remove everything from of your care that might get stolen. Plan for your apartment or house If you re away overnight, run through things that your house or apartment might need. Lock your windows, check your thermostat, arrange for your mail to be picked up, or held. Water your plants, make a pet care plan, take out the garbage, do the dishes, or at least rinse them. Clear your bed, so you can just fall into it when you return. Plan for baby Write down their routine- it can be loose if your baby is unpredictable. Observe your baby and write down all their details and preferences with feeding, soothing, and diapers. You may know that your baby always fusses when they are wet, but their caregiver might not immediately think of this. Drinking or not? You may be wondering about alcohol and breastfeeding. Yes, you can drink and breastfeed or pump. If you are sober enough to drive, then your baby can have your milk. If you aren’t sober enough, then wait until you are to feed or pump. Alcohol metabolizes out of your milk just like it does out of your blood. If you pump while drunk, either dilute that milk or dump it. Pick out and pack baby’s clothing. If they are expected to wear a special outfits, do you have an alternative in case of a blowout, spit up or other incident? Diapers can be shipped to your destination if you are going for any length of time. Pack a baby carrier and a few teethers and toys. If your baby is eating food, pack a few items for travel, and plan on a grocery run when you are there. Consider your partner.—you know them best. If they always forget something, then covering for them makes your event less stressful, rather than criticizing them for forgetting it, “Again!” But seriously, they are an adult and can pack their own bag. Is your hosts more their friends, or yours? They may want some time off to spend with their friend, rest or sightsee. Obviously, if bringing baby, they should spend time with their baby. It’s 2023, you don’t have to do everything as a couple. The week of: Pull out your bag and start to fill it . Keep a running list of items that you can pick up locally like snacks and phone chargers Baby’s bag may be their everyday diaper bag, with another bag for toys, diapers and outfits. Remember, they also sell diapers at most destinations! Make your deadline two nights before you are leaving. This way, you have the possibility of relaxing the day before instead of frantically running around shoving things into bags. The night before: Eat a good dinner and go to bed early—when your baby does. That way, you will have enough time to get enough sleep. Set your alarm, drink some water and settle in. You did a good job and you are going to have a great adventure!

Happy Traveling! Read More.
Warmly, Donna


Donna Bruschi, IBCLC

Created: Wednesday, 15 April 2020 18:31 Hits: 826 Amanda didn’t plan for any of the traumatic stuff that happened to her. There was no way to prepare for it. She planned on a natural birth without drugs. She planned to have her baby placed on her chest, and together they would begin breastfeeding, in the “golden hour.” Instead, she felt rushed and pressured during labor. She couldn’t get comfortable with a fetal monitor around her belly. It kept slipping and giving false alarms, as she tried to get comfortable on the bed. And, after 12 hours, the alarm was real, and baby Jade was born via c-section. Amanda and Jade were separated and then reunited a few hours later, and they started breastfeeding.   It was magical!  Jade knew what to do, and they did it together. They nursed and dozed, blissfully connected. Amanda had no pain. Jade was drinking first colostrum, then milk and making lots of diapers. After two days home, Amanda's incision turned bright red and started oozing. She went to her doctor who put her back to the hospital, for a week. She pumped as best she could, drifting in and out of drugs, and fever. Her husband, Rick, held the flanges and comforted her. Her mother fed the milk to Jade at home. Back at home again, Amanda tried to start breastfeeding again, and Jade refused to nurse. Amanda cried, both in pain from her incision, and the heartache of not breastfeeding. She held Jade skin-to-skin and tried to pump. She was not yet making enough milk.  Her first two months postpartum were painful and messy. A visiting nurse came to her home to check on her, and to change her dressings, every other day. She encouraged Amanda to try to breastfeed, and taught her better pumping techniques. But, over the next few weeks, Jade was receiving more, and more, formula.  Amanda was spending nearly 3 hours a day plugged into the pump. Her mom was bottle feeding Jade. She was discouraged and angry. She cried because she missed her baby and one day decided to stop pumping. She got even angrier when her milk just “stopped” the next day. There was no swelling, no pain. She felt like her body had failed at everything it was supposed to be able to do naturally. It couldn’t birth, and it didn’t make milk.  She had slammed into an immovable object—an uncommon situation that is nearly insurmountable once it starts: a new mother with a life threatening illness or complication from birth. How could she have prevented this? Was there a way of reducing her risk? These are always two paths, and there are no guarantees, because breastfeeding is unpredictable.  1. You can choose the path of education and advocating, and you are more likely to have a good outcome because you are empowered to make good choices. 2. You can choose the path of ignorance and hoping, and you probably will have a good outcome. Because you are not educated, your health care providers will make all the decisions for you, so your outcome is dependent on their philosophy and training. In Amanda's case, trouble started when her labor was restricted, and she was not able to move around. The constant alarms on the monitor scared her. These increased her risk of a c-section, which is how she gave birth. If you are healthy and have no medical complications, using a midwife is the best option in having a natural birth, free of interventions. This generally leads into a good start to breastfeeding. Many childbirth interventions can delay or complicate breastfeeding.  If that is not an option, reducing risk with a childbirth class, a breastfeeding class, a birth doula and a breastfeeding plan always is. Using a pro-breastfeeding doctor, who trusts your birth process, is vital to mother and baby heath.  It’s all about reducing risk and making peace with what happens.  In Amanda's case, her body’s reaction to the c-section started a chain reaction, that ended her breastfeeding. Some women hit one setback, others hit many in rapid fire succession. In the beginning, even one setback can feel overwhelming, and cause you to quit. Setbacks grind away at your resolve. It’s easy to forget why you wanted to breastfeed, especially if you are isolated, or never breastfed before. Amanda stuck with it, until she couldn’t anymore. When anyone doesn’t get what they want, they feel frustrated, sad, or even angry. Some people will quit as soon as the feelings become unbearable, others will keep searching for a way.  There is not one right way to move through problems. There is only your way.  It’s OK to be angry and sad, but it’s not ok to hurt yourself, and beat yourself up. Once you get through the crisis and get your strength back, it’s easy to look back and regret your decisions. You may feel depressed, angry at yourself, or even suicidal. It’s easy to think you are a bad mom for failing at breastfeeding. The data supports breastfeeding as the optimal way to feed your baby, but it’s not the only way for your baby to thrive! You still have options. You may still be able to breastfeed again, at least a little bit, if you get help from a lactation consultant, or someone knowledgable.  A short term plan, taking it a day at a time, where you keep coming back and checking in with your original goal is always helpful. Baby-feeding combinations tailored for each family’s circumstances are often created by trial and error. If you can’t, or don’t want to breastfeed, then make a plan for grieving.  Grieving is a marathon, not a sprint. Do a little every day by setting a timer, grieving and then putting it on hold until the next session. Therapy with the right therapist can help.  A lactation consultant who understands that you are done, can help you as well. Nobody breastfeeds forever and often women have strong feelings when the wean. It’s well within the scope of a lactation consultant to counsel you, when you end breastfeeding. Social support can be tricky at this time. The right kind of social support can be very helpful when you stop breastfeeding. Unfortunately, it’s hard to find the acceptance and the grace you need, when you are feeling so crappy about your choices.   You need empathy and compassion. You need a broadening of your knowledge of breastfeeding, and a bigger picture of feeding your baby. You don’t need affirmation when you still feel conflicted about whether you are doing the right thing! In our lives, we have flowers and thorns.  Only some have perfect births. Only some have perfect breastfeeding experiences. Ultimately, we have to accept what we have been given, or co-created, and make the best of it.  It’s the role of mothers to face these difficult choices for everything in our child’s lives. It’s not because you are a bad mother, it’s because you are a very good, and a very caring, mother that these choice are so painful.

Moms can’t believe how quickly the first 2 months go by, but that only happens after the first two months are over. Make a long term commitment to breastfeeding by focusing on one day at a time. Try not to quit on your worst day, because it really can take a two or three months to get comfortable breastfeeding. And while it's true that some moms hit their stride early on, it still takes awhile for anyone's milk supply to even out, and for her to feel really confident that she is breastfeeding well. There’s a wide, wide range of normal. Breastfeeding takes many forms. Some women breastfeed exclusively, but in the USA, many more do not. Some women express and breastmilk feed. Some women make enough milk for three babies and their baby won't latch comfortably. Some women use donor milk or formula in a supplementer. Some alternate bottles of formula with breastfeeding.  When you are in the thick of it, days last forever--you may dread feeding your baby. You can hate breastfeeding and your baby may even refuse to breastfeed. When you are facing one challenge after another and its affecting your physical, mental or emotional health, its healthy to re-evaluate how committed you are to breastfeeding, or breastmilk feeding. Before making the decision whether to continue or to stop, you need to look at how much support you have and what resources are available to you for continuing. If you don't have the support from your family to continue, or you don't have information and guidance from professionals, it's going to be very, very hard to breastfeed successfully when you reach a certain point.  If it isn’t working, it's healthy to accept that it isn't working. In your life, you will have to find ways that work for you and your family not only with with birth and breastfeeding, but with sleeping, foods, vaccines, discipline, friends, school, and more. There’s more to life than breastfeeding, even though in the beginning, it feels like there is ONLY breastfeeding. There are many, many reasons why breastfeeding doesn’t work out and you may never know exactly why. When breastfeeding goes off the rails, almost nobody will sit down with you and explain why. There are only a few professionals who will give you a full report of why its not working. It's not like infertility where you get a lab report with numbers and diagnoses. Instead, you get a container of formula, and a shrug... "It doesn't work for everyone..." But even if you do know why, it’s still not what you wanted. It’s sad and even devastating, when you have to stop breastfeeding before you are ready to. And, it takes a while to grieve your loss even if you feel relieved that you stopped. It’s normal to have mixed feelings about ending breastfeeding. You may feel angry, sad, defensive or resentful, and relieved and happy, all at the same time. It's normal to cry and be weepy about weaning, and then feel better when your baby gives you a goofy grin. Feeling your feelings doesn’t mean you are a bad mom, it means you are a healthy mom. Give yourself time to be sad; to be angry; to rage at yourself, your doctor, the hospital, the world, or even God. Anger is expression of an injustice that has been done, and it's a force for positive change. You may fill a journal full of bad thoughts. And, you may also find your life’s purpose through your anger, and need for change. Accept it, grieve your loss, and make time to also enjoy your life, and enjoy your baby. Once you make the decision, you will have energy to discover other things that make you and your baby feel good, and connect with each other. In the end, what matters most is that you love and accept yourself, and your baby. Everyone deserves to feel successful. When moms don't meet their breastfeeding goals, many women shift gears, expanding into an area of their life where they do feel successful. The breast is half full, not half empty. I hope you create your own positive way of thinking about your experience, because any amount of breastmilk, and breastfeeding helps you and your baby. Know that however long you nursed, and however much milk your baby received, you gave them a wonderful start in life, with life-long benefits. When people, who didn't see the cascading chain of events leading to weaning, judge you, it can be helpful to use statements like “I made an informed choice.” and “I didn't plan this, but it's working for me and Little Miss.” Saying things like, “I didn't get the right information and support.” can lead to productive conversations. Whatever you do, just don’t think, or say, you failed. Maybe you didn’t breastfeed as much as you wanted to, but you tried and in trying, you got to know yourself and your tremendous courage, strength and love. Everyone has insurmountable challenges in life, and this is yours, right now. Your grief right now may be overwhelming and all consuming! It might help to zoom out and re-frame your current situation. Over the course of your baby's lifetime, you are going to know babies with disabilities, kids with life-threatening allergies, teens who die in car crashes, parents who lose their jobs, friends who have cancer, and so much more. This is your challenge happening right now. It's not an easy one, but you will find the strength to get though it, because you love your baby. One day, you will be on the other side of this and you will begin to see, that in the end, there really is more to life than breastfeeding.