Kristin and Alyssa, Co-Owners of Gold Coast Doulas, give an update on doulas and the coronavirus. How is this affecting birth doulas in the hospital and postpartum doulas in the home? They also talk about virtual classes such as Mama Natural Online to help new parents stay prepared while social distancing. You can listen to this complete podcast episode on iTunes and SoundCloud.
Alyssa: Welcome to Ask the Doulas. You are here with Alyssa and Kristin, and today we’re going to talk a little bit about the coronavirus. I’m going to let Kristin do most of the talking just to kind of update our friends and clients on the current status.
Kristin: Yes! So we are happy to share the protocol within Gold Coast on how we are keeping our doula team, our childbirth educators, and our clients healthy. We are recording this on March 17th, so things are changing daily, and by the time you listen to this, the information that we’re giving you may be a bit different. But we did want to respond quickly and have notified all of our clients about our safety protocols. With birth doula clients, we are doing all our prenatal, our free consultations, and our postpartum meetings virtually. So our clients now know that they are talking to teams by phone or Zoom meetings or Facetime, whatever the preferred method is. We’re still giving you that same time and attention; just keeping you safe and healthy during this critical time.
We had been working with area hospital administrators and with the governor’s office to make sure that we were able to support our clients in person, and again, this may change by the time you’re listening to this, but we had a day yesterday where we were told birth doulas would not be able to support in the hospital. So we contacted all of our clients and made a plan to support in the home before and support virtually in the hospital. Through work with the governor’s office and area administrators, we were able to obtain entry into area hospitals. So starting today, that is not an issue. With the executive order from the governor’s office, a partner and a doula are allowed to admit into area hospitals. There will be a health screening, and we’re going through credentialing processes with every hospital having different requirements, but we plan to support our clients. This is as of today, and again, if the outbreak continues, we may need to rely on virtual support. Because Gold Coast has a big team of birth doulas, we will monitor symptoms of coronavirus and the flu, as we have always done, to assure that a healthy doula will be attending the birth. We’ll be doing the best we can to isolate our team. We’re staying home with our families. We’re not going out into the public unless we need to get provisions. Going from there to ensure that we’re able to support our clients during this time when they need the emotional and physical support of doulas now more than any time.
Alyssa, I know that in postpartum support, we have made some accommodations as well, and part of that is some of our clients had contracts that were about to expire, and we’ve talked to them about delaying support, and with our postpartum doulas, who our clients want us in the home, we are of course making sure that the doulas are healthy. We’re using sanitization methods. If we’re doing cleaning, we’re cleaning doorknobs and handles at our clients’ homes. We’re coming in with clean clothing, taking our shoes off, as we always do, and using whatever precautions our clients want us to in their home with caring for baby and caring for the mother. And, again, with our postpartum doula team, we have a lot of doulas. So if a doula has any symptoms of coronavirus or the flu or even a cold, we are sending in a healthy doula to replace the scheduled doula. Do you have anything to add to that?
Alyssa: No. I mean, nothing’s really changed in that regard. All of our clients get that same kind of care. It’s just extra — I guess maybe an extra added step at this point.
Kristin: And as a sleep expert, part of what we do as postpartum doulas, both daytime and overnight, is allow our clients to rest. Now, with your sleep certification, I know you focus on newborns and toddlers and so on, but let’s talk a bit about the importance during this time to keep your immune system strong and getting sleep for families.
Alyssa: Yeah, the problem with sleep deprivation is your immune system starts to decline, and more than ever right now, it’s important to keep your immune systems healthy. So that means still going outside and getting fresh air, getting exercise. But you also need sleep. And with a newborn and/or a toddler at home, that can really be trying. So the beauty of my sleep consultations is that I don’t need to do it in person. We can do it via phone and text. So if that is an issue, you can call me still for that. But regardless, you just have to focus on sleep. You have to get your required amount of sleep, and your kids need to be going to bed on time. I know this feels like a big vacation for them, but you need to have a set bedtime and awake time. I mean, if we’re going to be in this situation for three to six weeks, they are going to become sleep deprived. They are going to become little monsters. It’s going to make your days even harder, but then again their immune systems could start to decline.
Kristin: Right. And, again, we do offer sibling care, so we can help with snacks around the house, and we have noticed that a lot of West Michigan families tend to have family support of grandparents or other family members, and now with some of the guidelines for keeping the elderly safe and away from children, I know my kids are being distanced from my parents due to my father’s heart condition and so on. And so we can come in when you are relying on your family right now and take some of that burden off of you and your partner.
Alyssa: I have canceled all family functions. A birthday party, a sleepover. You know, my parents called and offered to help, and “thanks, but no thanks.” We’re stuck at home anyway. There’s nowhere I can go, nothing I can do. So, yeah, we’re just kind of laying low at the house.
Kristin: Yeah. And so people are obviously isolating, canceling things, and we’re able to — we do offer bedrest support, so we are able to do virtual bedrest support if that is something that a client is interested in. Or, again, support in the home with childbirth education. We can do mini classes virtually or in home and provide sibling care for our clients who are on bedrest and need to feed their other children, especially now that daycares are closing and schools are closed at least through April 10th, if not longer. And so we’re adapting as best we can and keeping our team safe. For clients who are not part of our current childbirth series that has now gone virtual, our Hypnobirthing class started out in person, and due to the coronavirus, we’ve turned that into an online class with our instructor. But we are an affiliate for Mama Natural, so we wanted to talk about that as an option for clients who are not able to take a hospital childbirth class or take Hypnobirthing or a different child preparation method. You can go onto our website and sign up for our online affiliate program through Mama Natural and take the class online. We’ve gone through the class. I personally went through the entire curriculum, and my clients have used it and have had success, so that is a great option during this time when we need to isolate and be at home and still want to prepare our clients and have our clients feel like they’re ready for this birth.
Alyssa: And Kelly Emery, our lactation consultant, also offers an online pumping class and a breastfeeding class.
Kristin: Perfect! So there are some things you can do, and again, things are ever changing, but as of right now, all of the area hospitals are limiting visitors to one support person, so your partner or family member and a doula who is credentialed in area hospitals. So in the postpartum units, you are not able to have siblings visit or family at this time. Everything is limited to protect the health workers and the patients. So it is good to have these conversations with family members. I always tell my birth clients at prenatals that now is the time to express whether or not you want visitors in your birth space, and now knowing some of these plans have changed, if you have family members flying in, you may want to delay, or if you have older family members or immune-compromised caregivers, then now is the time to have these discussions rather than having disappointment at your due date if you’re due this spring.
Alyssa: Yeah. They won’t even be able to come in, and probably family members can’t even fly in at this point. We’re getting close to that.
Kristin: Yes. Domestic travel is limited and could be delayed indefinitely. So we’re just taking things day by day. But we want you to remain calm and positive about this and go with the flow, so try not to take in too much negative media and use this time to focus on connecting with your baby. And if you have other children, reach out to us if we can help. We’re here for you.
Alyssa: I think it reiterates the importance of an agency like Gold Coast Doulas being professional and certified and insured and, like you said, credentialed so that we can get into the hospitals. The hospitals trust us. They have a list of our certified doulas’ names. They might ask for a federal ID number. They might ask for certification; proof of certification. These are all really important things to consider when hiring a doula anytime, but especially right now.
We are thrilled to have Kelly join the Gold Coast Team. Many of our doulas have used Kelly personally for lactation consultations with their own children. She comes to us with years of experience and a trusted name in the community.
1) What did you do before you became a lactation consultant?
In a former life, I was on a path to become a counseling psychologist. I was working on grad school in Oklahoma when I had my first baby; my life course then changed dramatically. My undergraduate degrees were in psychology and education, which serendipitously helped in my final career choice as a lactation consultant.
2) What inspired you to become a doula/lactation consultant?
I think it’s so true that we become what we wish we had. I was certified as a doula in the early 90s after having a difficult postpartum period with my first baby. I lived many states away from my family and friends, and felt the isolation and loneliness hard. I also had a rough time breastfeeding. As I crawled out the other side, I decided to help other women who were going through the same experiences I had been through. In the end, I gave up the doula role, went back to nursing school, and continued earning experience and education to become a lactation consultant.
3) Tell us about your family.
I have two adult children, girl and boy (or a woman and a man, now!), and four step-children; so six “kids” in our blended family. Although the kids are spread out over the country, we still get together throughout the year to enjoy each other’s company. My husband is an emergency medicine physician, who also works in medical education at Michigan State University. I am expecting my first grandchild in July of 2020, and am so VERY excited about that!
4) What is your favorite vacation spot and why?
Anywhere I can be warm and near water, and not have to wear shoes or a coat! I’d have to say Greece, if I had to be more specific. I went to Greece to help pregnant/breastfeeding refugee women in 2017, and fell in love with the place so much that two years later I returned for a vacation there with my girlfriends. I definitely will be going back with my husband in the upcoming years. The climate AND the history/culture/people/food of Greece have won over my heart forever.
5) Name your top five bands/musicians and tell us what you love about them.
Patty Griffin – She sings the raw truth with her beautiful voice. Got me through my divorce intact.
Beatles – I discovered them in early college and connected immediately.
Eagles – A band from my childhood with so many songs that spark memories for me.
Eminem – Don’t ask me why. I just do. Don’t judge me.
Aerosmith – I have a secret thing for Steven Tyler. Again, don’t ask why. I just do.
6) What is the best advice you have given to new families?
Your baby is going to love you no matter what. Remember the big picture: Lead with love. You are not alone in what you are experiencing, and it can, and does, get better in time. Hang in there!
Oh, and you’re doing much better than you think you are!
7) What do you consider your lactation superpower to be?
I’m pretty good at getting babies off nipple shields. Not every single time, but often I can do it!
8) What is your favorite food?
Lately, I am really enjoying miso soup and sushi at Ando.
9) What is your favorite place in West Michigan’s Gold Coast?
I’ve moved downtown and live by the Grand River now, so my husband and I really love walking or biking up and down the river, exploring the landscape, watching the fish and birds (the Osprey are our favorite), and seeing the city grow and change each and every year. We can really stare at the water all day and be content.
10) What are you reading now?
Just finished up Tongue Tied by Richard Baxter. Very interesting new research and helpful modalities for babies who are having trouble latching/nursing.
11) Who are your role models?
My mother, who taught me about unconditional love, loyalty, how to work hard and do things that you are afraid to do, how to make people feel welcome, and how to have fun.
My husband for his incredible work ethic and ability to plan for the long-term; I continue to learn so much from him about how to have a healthy relationship with money.
Jamie Platt, Birth and Postpartum Doula with Gold Coast Doulas, tells us about three completely different breastfeeding experiences with her three children. This podcast was recorded over a year ago, and Jamie is now a certified lactation counselor. You can listen to this complete podcast episode on iTunes or SoundCloud.
Alyssa: Hi, welcome to another episode of Ask the Doulas. I am Alyssa, your host for today, and today we have a special guest, Jamie. Hello!
Alyssa: Thanks for coming! So we were talking the other day, and you’ve had three really, really different experiences with breastfeeding with your three children. Tell us a little bit about your three kids and how breastfeeding went differently for each of them.
Jamie: Sure! So I have three children. My oldest son, Noah, is 14. And then my two younger children are five and three. So I was a young parent and gave birth to my oldest, Noah, when I was 21. My breastfeeding journey with him was very short and limited. I knew I wanted to breastfeed, and I received a manual pump, I remember, at my baby shower.
Alyssa: Did you even know what it was?
Jamie: No! No one ever showed me how to use it. I knew what it was for, and that’s it. And I remember in the hospital, no one ever gave me any tips about breastfeeding. It was expected that I was going to breastfeed. My mom breastfed all three of us for over a year. It was challening not knowing what to do with breastfeeding. The funniest story I remember from that journey was, since I was young, I went back to work right away. I was coaching volleyball at the time, and I went to a tournament and coached all day. I didn’t bring a pump; I didn’t know that I was supposed to be pumping this whole time.
Alyssa: That’s what this whole manual pump was for!
Jamie! Yes! And I looked down during a break at a game, and my shirt was all wet! I had leaked through my shirt, so I had to put a sweatshirt over me, and of course, it was so hot in the gym all day. And shortly after that, I stopped nursing. I don’t recall how old my son was, but it had to be within a month or two. And so I wish, looking back, that someone had sat down with me, shown me what I needed to do to nurse and to pump, but that didn’t happen.
Alyssa: Do you think that it lasted such a short period of time because — I mean, did your milk supply just dry up because you were back at work and not pumping? Or did you just say, I’m so over this; I’m just going to stop?
Jamie: It’s hard to remember the details. I just remember stopping. I was in school at the time and working, and just one day, I stopped.
Alyssa: So a lot of things all mixed together, I’m sure.
Jamie: Yeah. So when my second child was born — he’s five now — I knew I wanted to do things differently. I was older and wiser; knew a little bit more about breastfeeding, but still not enough to know what to do in certain situations. I nursed him until he was about 18 or 19 months old.
Alyssa: Wow! So you learned a lot more, then. I mean, in nine years time, to go from one month to 19 months.
Jamie: True. There were just a few different barriers along the way. I was a single parent, so I went back to work when he was around three months old. However, he wouldn’t take a bottle at the time, so with that situation, my sister came to my home and was watching him for me, but she would bring him to my work, or I would quick drive home on my break just to feed him, and that lasted a good one or two months. And I knew what to do at the time, as far as I was trying different bottles, but I did feel quite alone trying to figure this out. And then while working, I pumped for over a year. Another obstacle I had to overcome was with coworkers. A friend of mine told me that a coworker complained to my manager that I was still pumping, and my child had reached a year old, so I shouldn’t have these pumping breaks anymore. And the manager never said anything to me, but I had heard this through the work grapevine. I also had an experience around the time he was a year old with his pediatrician at the time. We went in for his one year well child check, and they ask you if you have any questions. And I asked about nighttime feedings. I think that’s a popular topic. He was still feeding through the night, and it didn’t bother me, but at the time, I thought it was something to bring up. The pediatrician told me that I had to stop nighttime nursing immediately, that she had done it with her kids; he’ll be fine, that he was going to get cavities — which we know from research that that is not true.
Alyssa: Cavities from breastmilk?
Jamie: Yes, during the night. That’s still kind of a popular myth that’s out there. And the big thing she told me was that he wouldn’t be potty trained by the time he was eight, and that sticks into my mind because she chose the year eight.
Alyssa: Okay, that’s really confusing. If you breastfeed your one-year-old at night, they won’t be potty trained when they’re eight?
Jamie: Yes. So this wasn’t our usual pediatrician; she had stepped in. And immediately after she told me these things, I wanted to leave. I stayed, but she could tell that there was a problem because I was silent. She asked me if there was anything wrong, and I said yes, I don’t agree with anything that you’re saying! The visit ended shortly after that. I was kind of angry that she was telling me these things because I knew better. So I called my dentist’s office, and I asked them about the cavities with breastfeeding. I reached out to other individuals that I knew were very knowledgeable about breastfeeding and asked them different questions, and I ended up looking up scholarly articles, anything that had to do with research, that I could bring back to her and tell her that she was wrong. I ended up calling the office a few days later. I had all my stuff in front of me when I called. I spoke to the manager, and I ended up speaking to the pediatrician. I remember telling her that I felt sorry for her patients that believed everything she told them. I said, “I am an educated person, but some people might not know as much about breastfeeding or they don’t know to do the research about it before making a decision, and they would go along with what you said.” And she apologized. She said she had no research to back up the potty training claim.
Alyssa: Oh, wow.
Jamie: And she did end up sending me something in the mail, as well. Ever since that encounter is when I became passionate about breastfeeding and being up to date on the research about it, sharing with others about it.
Alyssa: And you joined several lactation support groups, correct? You belong to a couple now?
Jamie: I am on a couple of local Facebook groups about breastfeeding, and I talk to a lot of my friends about breastfeeding. I just really want to educate people more about it, after that encounter. So that’s just when I really started to delve into researching more about breastfeeding and the benefits that it has for both mother and baby.
Alyssa: So what happened after the pediatrician visit and you realized that information was wrong? Did you continue nighttime feeds?
Jamie: I continued nighttime feeds.
Alyssa: No cavities, and he potty trained?
Jamie: No cavities, and I left that office and found a new pediatrician. He’s a healthy, happy little boy. He did end up weaning on his own because I was pregnant with my youngest at the time, and I could tell that had something to do with that. But I was the working, pumping mom. I brought my pump to work every day. And it is a lot of work to pump at work, making the time to take those breaks. I worked in a busy medical office, and it is hard to say, “I need to do this for my child,” when you know that other people are picking up your slack for a little bit. But I think if, as a culture, we all realize that breastfeeding is good for mom; it’s good for babies; it’s good for our society.
Alyssa: And aren’t there studies that say that women who breastfeed actually overall have a better sense of self-esteem, better sense of self, almost? Like, they are actually more productive, even though we like to look at them and say, oh, well, I have to pick up your slack while you’re pumping? Well, you know what, because you’re pumping, you actually are more productive when you are working. Does that make sense? I swear I’ve read things about that.
Jamie: I’m not sure about that, but I do know that research shows that mothers miss less work because their babies are sick less and they’re not taking their kids to the doctor. So it’s better for the economy overall. We actually save millions of dollars; the United States saves millions of dollars every year through moms breastfeeding, so it’s important that you support your coworkers if they’re nursing. It’s for a relatively short time in the grand scheme of things, and it’s great to also find those breastfeeding buddies at work. I had other moms that nursed. I had my nice, double electric pump, and it hurt when I pumped, but I never could figure out why, and finally I complained about it to a coworker who was also pumping. She was a little more experienced mother, and she helped me realize that part of my pump was too small.
Alyssa: Were the nipple shields too small?
Jamie: The flanges were too small, yeah, so I had to buy new ones, and that made a world of difference. So it’s really helpful to find a more seasoned breastfeeding friend who can help you along your journey, because there’s lots of little things that you may not know about.
Alyssa: Or a lactation consultant, right, if you get into those serious binds?
Jamie: Yes. Thankfully, I’ve never had mastitis or a clogged duct, but if I did, I definitely would have called a lactation consultant for help.
Alyssa: So tell us about your third child. I think your youngest has been a little bit longer, so tell us how that journey went.
Jamie: Yeah, so my daughter turned three on Halloween, and I am still nursing her. So this is definitely another new experience for me. I would never have imagined I would be nursing a child for this long. I have realized that I did have some preconceived notions about extended nursing; maybe some judgmental thoughts about it, as well. And I honestly still struggle a little bit with those internally myself as I’m still nursing, thinking, man, you know, you should really stop; you should be done. And while I would love to be done, I do want my daughter to wean on her own. I tell myself I am decreasing my risk of ovarian cancer every time I nurse! Even when you nurse your baby longer than the one or two years, it’s still healthy for Mom and it’s still healthy for Baby, and it’s been a very different experience doing this.
Alyssa: So tell people what it looks like. Having a three year old; it’s not going to be nursing every three hours. Is it a nighttime feed kind of thing, or when she’s sick or tired? Is it more like a comfort thing almost at this point?
Jamie: It is more of a comfort thing. She nurses at night. However, I’ve been on three or four extended trips, and by extended, I mean I’ve been gone for four to six days at a time at conferences, and thinking every time I leave, this will be our last nursing session, and I come back and I don’t bring it up, but she still wants to nurse. So it is usually just at night; if she’s feeling sick, then she’ll nurse a little bit more.
Alyssa: And you don’t lose your milk supply after six days of being gone with no nursing?
Jamie: I did not. The first time I went away, she had just turned two, and it was the first time I had ever been away overnight from her, actually, when she was two. So I did bring a pump with me, but I didn’t produce a lot when I pumped, so I knew that for my next trip, I wasn’t going to bring a pump with me. But I still have a supply, and I was lucky enough with her, as well, to stay home with her for almost the first full year and nurse, and that was just a blessing. I hadn’t been able to do that before with a child, and it was so nice not to have to pump for that time! And then right around a year is when I started nursing school, and so I would pump when I was away from her. And I finally decided to stop pumping. Pumping is so hard! If you’ve done it, you know! And we’ve just been nursing ever since.
Alyssa: Well, it sounds like a lovely plan. You know, you say you had maybe judgments about nursing for that long. What still bothers you that you think shouldn’t, or what have you had to tell yourself to get those thoughts out of your mind?
Jamie: It’s still hard to get over the way our culture thinks about breastfeeding. That you shouldn’t breastfeed in public; Mom should cover up; anything over a certain age is gross or weird, or why are you doing that? Once they have teeth you should stop; once they start talking and can ask for it, you should stop. All these different things our culture tells us about breastfeeding is a little backwards. We know, if we went to a different country or a different culture, that things are definitely different than they are in the United States, but it’s just the media that always sexualizes breastfeeding as well, and you grow up with that. So you’re growing up in this culture that sexualizes breasts, when we know that you use them also to breastfeed your child! And so for me, it’s just getting past those thoughts that I’ve had growing up about breastfeeding and just telling myself this is normal and it’s okay to do. It’s not hurting anyone. It’s my decision as a mother. It’s been a really neat and wonderful journey that I never though I’d be on.
Alyssa: Well, and I imagine nursing a three-month-old and a three-year-old, you’re probably not going to attempt to breastfeed your three-year-old in public. Or have you?
Jamie: I don’t, but she doesn’t ask to, either.
Alyssa: So it’s almost like you guys have this unspoken thing; that it’s something in private that you two do together, and I’m sure it’s still this amazing, beautiful bonding experience, just like it is with a newborn.
Jamie: Definitely a strong bond, and again, I as a mother and a parent and working, I did reach a time where I wanted to be done. I’m like, okay, we can be done with this now! But I’m just letting her take the lead with it, and I can tell you that I do hope she’s done relatively soon! I have another week-long trip coming up in three weeks.
Alyssa: Maybe that will be it?
Jamie: Yeah, we’ll see if that’s the end of our journey.
Alyssa: You know, I wonder culturally, too, if it was a son who was three, would it be different, because of the sexualization of breasts? Would it be different if it were a boy? I don’t know; can they remember that at three when they get older? I don’t know. Just a thought that I wonder if that would make a difference.
Jamie: I’m not sure. I’m sure that for some people, a boy versus a girl breastfeeding is different. I’ve had people very close to me tell me I should stop breastfeeding. This was with my middle son when he was around six months. I was still nursing, and I got asked, when are you going to stop? He’s six months old! And I tried to throw all the evidence-based research at them to show them that this was still okay; the AAP and WHO, all these big organizations say you should breastfeed until one. And so then I got to one, despite people telling me to stop. I just pretty much ignored them because I can be stubborn like that, and when he turned one, I got the same comments again. When are you going to stop? And it’s funny that once I just plowed through all the negativity and judgmental comments, I haven’t had those same comments with my last child, because I think those people know — well, obviously, she’s three now, but when she was younger, they knew I was going to continue breastfeeding her for as long as I wanted to. So people may not talk about it a lot, but I have had the challenges at work with comments from people; I’ve had people very close to me have very negative comments about breastfeeding, and you see all the big media stories that just happen to pop up because social media is so prevalent now. It is everywhere, but there’s all those things that women that you know may be experiencing but they don’t talk about it. It doesn’t reach the news. And so we really need to support everyone in their own breastfeeding journey because you don’t know what someone may be going through.
Alyssa: Right, and I think as postpartum doulas, we have a unique experience and a unique opportunity to deal with this with new moms right when they come home with their babies, to really help support them. Maybe we are that one person who’s cheering them on, in the face of everyone else who’s saying, why in the world would you do that? Or isn’t that weird? I remember having friends saying things that were trying to make it sexual when it’s not at all! It’s something you can’t even describe to someone who doesn’t understand, this crazy bond. And I get that. Like, you so want to quit; some days, you’re just like, God, when is this going to be done? But then when it finally is, you don’t get that back! And then you actually kind of miss it. It’s like you don’t know what you’ve got until it’s gone. And I do; I think back on it. My daughter just turned five, so it’s been a long time since she breastfed, but I think back to those days, and there’s nothing like it.
Jamie: One of the things that I really love about being a postpartum doula is the fact that I get to help mothers with breastfeeding. That’s something I really enjoy, especially — they may have gotten some help from the lactation consultant at the hospital, but when they get home, that’s another ballgame. Problems can start to arise. They don’t feel confident anymore. They think their milk’s not coming in. So it’s really a blessing to support them.
Alyssa: That’s one of the biggest fears for moms, I feel like, who are breastfeeding, is how do I know that the baby’s getting enough milk? How do I know that the latch is right? How is this supposed to feel? There’s just so many questions about this thing that’s supposed to be so natural. Like, we have boobs to breastfeed and it should be so natural, but it’s sometimes one of the most frustrating and difficult parts of having a baby, I feel like.
Jamie: Definitely. I would strongly recommend, if you are having problems with breastfeeding, there’s a lot of community support right in our own area. There’s breastfeeding support groups from the hospitals; Le Leche League; we have wonderful lactation consultants in our area that will go to your home. So it’s really important to utilize the resources that you have and reach out for help.
Alyssa:Shira is our in-house lactation consultant, and having that consult in your home: it’s quiet; it’s one-on-one. There’s nobody in the hospital coming to check your blood pressure and poke and prod you. She spends two hours with them at that first visit, and she really gets to know you and what’s going on and figure out a solution. So I feel like, yeah, that’s — I wish; if only I had known Shira four and a half years ago!
Jamie: She’s very knowledgeable! I do have lots of friends who ask me questions about breastfeeding, but I have sent her a quick text to say, hey, this is out of my scope of knowledge; can you help me with this problem? And she helps me out.
Alyssa: I think it’s great to have the support of postpartum doulas, and you have even more extensive knowledge than I do because of all the groups you’ve been in and the research you’ve done. I’ve breastfed one child; you’ve done three. I feel like we can do only so much for clients, though. It’s good to know that they have a resource beyond our scope, to really help with the hard things.
Alyssa: Well, thanks for sharing your stories! If anyone has questions about breastfeeding or more questions for Jamie, in particular, you can always reach us at firstname.lastname@example.org. Remember, these moments are golden!
Author Bio: Roselin Raj is a journalist and a writer. She has been writing extensively on health and wellness related topics for over a decade. Besides her professional interests, she loves a game of basketball or a good hike in her free time to fuel her spirits. “Health is wealth” is one motto of life which she lives by as well as advocates to every reader who comes across her blogs.
In the months leading up to my first delivery, I had many emotions ranging from excitement to fear. The idea of delivering a baby was daunting and had occupied my headspace completely. Though I had a consulting doctor and limitless information on the internet, getting the personal assistance and care from a doula did the trick.
According to What To Expect, “Doulas, who offer non-medical emotional support, are growing in popularity in the delivery room (or birthing center), but many also do postpartum work, helping new moms navigate the stressful, bleary-eyed early days of parenthood. Here’s why you may want to consider hiring a postpartum doula to help you through the fourth trimester.” With the rising popularity of doulas, let us understand what a postpartum doula is and how they help expectant mothers through and post pregnancy.
What is a Postpartum Doula?
As mentioned earlier, a doula is a trained professional who guides mothers with information, emotional and physical assistance before, during, and a short while post birth. The guidance and assistance are given to expectant mothers to make the process a healthy and less stressful experience. However, a postpartum doula extends their assistance until the baby has adjusted with the family.
A postpartum doula is skilled to assist with a variety of needs and requirements according to each family. For instance, once the baby is born, all the attention is directed towards the new bundle of joy. But the physical and mental health recovery of a mother is very important. A postpartum doula can help the mother ease into motherhood, provide necessary information on caring for the baby or help with breastfeeding issues, and much more. But a postpartum doula is not a nanny and helps the mother emotionally to recover after the birth of the baby, bond, offer newborn care, sibling care, and lighten the load of household tasks.
Benefits of a Postpartum Doula
The work of a postpartum doula extends post birth, unlike a birth doula. The postpartum doula’s main purpose is to make the mother comfortable with the baby and support her in doing so. The tasks may vary from mother to mother, and she is equipped to do the best in any situation. Here are a few of the tasks a postpartum doula can provide:
Postpartum Care for the Mother
Once the baby has been delivered, the mother requires a lot of caring and help. The basics involve eating healthy food, drinking water at regular intervals, and most importantly, rest. A postpartum doula will help in cooking, running errands, etc. to allow the new mother to recover. In the case of c-section delivery, she can assist the mother with the newborn, household tasks, offer support and resources, rest and healing, and aid in hassle-free recovery.
Women are usually emotionally weak post-birth with chances of depression and anxiety. Postpartum doulas can help create a stress-free environment, take care of the baby, and be emotionally available for the new mothers.
Breastfeeding and Newborn Support
Postpartum doulas are equipped with complete knowledge of handling newborn babies, and they help mothers to ease the process of parenting. The next big challenge after giving birth to a child is often breastfeeding. And as you are probably aware, it can be a challenging experience for both the mother and the baby.
In such cases, the doula helps with information on newborn behavior, soothes the process of breastfeeding or transitioning to bottle feeding. If further breastfeeding support is needed, she can offer local resources to an IBCLC (Board Certified Lactation Consultant).
Finding the Perfect Doula for You
Doulas can be found through word-of-mouth or going through service providers to find certified doulas as per your needs. The idea is to get a suitable doula who is certified, experienced, and well-synced to you and your family requirements. Before hiring a doula, talk to the agency regarding their qualifications, certifications, insurance, etc. to get a clear idea of who you are hiring.
Doulas or the agencies usually charge for services by the hour, location, services required, and the experience of the doula. There may be provisions to use your Health Savings Account (HSA) to hire a doula. Clarify with your insurance provider or the doula agency before going ahead with the plan.
Hear two experts talk about the link between a baby’s tongue and breastfeeding. What are some signs of a tongue tie and what does that procedure even look like? Shira Johnson, IBCLC, and Dr. Katie Swanson, Certified Pediatric Dentist, give us some insight into breastfeeding a newborn. You can listen to this complete podcast episode on iTunes or SoundCloud.
Alyssa: Hello! Welcome to Ask the Doulas. I am Alyssa Veneklase. I am sitting here today with two lovely ladies, Katie Swanson and Shira Johnson, and we are going to talk about breastfeeding and oral growth and development. Hello! So we don’t really have an agenda for what we’re going to talk about per se, but before we started, I was kind of asking, like, well, you know, as a dentist, you send clients to a lactation consultant, or does the lactation consultant send clients to a dentist, and how soon, and what does that relationship even look like?
Dr. Katie: Yeah, Shira, what do you see in a patient that makes you want to send them to me?
Shira: Yeah, so I see babies of all ages. I see newborn babies; I see older babies, and really, regardless of the age, if I am noticing something, I’m always seeing them in some capacity related to feeing, usually breastfeeding, and when I’m seeing them and there are any kinds of feeding difficulties, I do an oral exam, and if I’m noticing anything out of the ordinary or anything that might suggest that the baby is having trouble using their mouth optimally, then I often refer to a dentist.
Alyssa: Even as a newborn?
Shira: Even as a newborn, yeah. Infants can have things going on with their mouth. People have probably heard of tongue tie, so that’s one example of something that I might be looking for signs and symptoms of.
Alyssa: Should we talk a little bit more about tongue tie? Because I know you have a very special machine.
Dr. Katie: Yeah! So when I meet a baby for the first time, we do an exam with Mom, Dad, or whoever the caregiver is, where we examine the mouth and all the attachments in the mouth. We have an attachment from our lip to our gums. We have an attachment of tissue from our tongue to the bottom of the mouth, and we have even other attachments in our mouth, even with our cheeks to our gum tissue, called buckle ties, that Shira and I have talked about. And all of these attachments in their mouths can actually affect the movement of the tongue, the lip, the cheeks, and how they actually are able to breastfeed. So when I see a patient, I’m doing an exam, typically just with my fingers, kind of playing and tickling around in their mouth and stretching the lip and moving the tongue around and kind of seeing what kind of movement they have and even evaluating — a tongue tie is actually fairly easy to identify with a baby when they open or if they start crying a little bit. Their tongue actually almost forms into a bowl if they’re tongue-tied, and that’s a pretty tell-tale sign, whereas otherwise, when they’re crying, typically their tongue will raise, and that helps me see how much movement they have, as well. So I don’t know if you want to talk about other…
Alyssa: Yeah, Shira, what are your first signs? What do you notice right away with a tongue tie?
Shira: So even before I do an oral exam, just talking with the family and hearing the story of how breastfeeding is going or how it’s gone and hearing different red flag symptoms, which can really vary from family to family, but certain things like pain with breastfeeding. We consider it normal to have some nipple pain with breastfeeding during the first week after the baby is born, but then it should subside, and there should be no pain associated with breastfeeding after week one.
Alyssa: And the initial pain is just because your nipple is getting a lot more action than it probably ever has?
Shira: Yeah, and there are some hormones on board, too, that can make nipples more sensitive. But any kind of nipple damage; if baby is nursing and causing cracks or bleeding or scabs, that’s one sign that the latch isn’t right, and there are a number of reasons why. It could be positioning. But often, it’s really what’s going on with Baby’s mouth that affects whether the latch is a good latch. And then in addition to how comfortable it is for the mom and for the baby, the latch also determines how effective the breastfeeding session is. So a baby that has some of these oral restrictions going on may not be able to remove milk from the breast as effectively, as efficiently. So the feedings may go on a very long time. The baby may be struggling with weight gain. Those are some common other signs, but then there are some babies that don’t have those signs and they still have a tongue tie, so it’s a little harder to detect.
Alyssa: And then you would actually, like Katie does, look in their mouth and look for something specific?
Shira: Yeah, and I do that, too. In addition to interviewing the family and watching a breastfeeding session, in most of my lactation visits, I’ll get gloves on and really examine the baby’s mouth. Similar to what Katie said, I’ll look under their tongue and feel around their lips and their cheeks. I let the baby suck on my gloved finger, so I feel what the suck feels like, and there’s a certain movement that the tongue is supposed to do, a wave-like kind of undulation kind of movement when they’re sucking. So if there’s any variation in that, I make note of it. Sometimes babies hold on really tightly with their gums and it almost feels like they’re biting, and that’s a sign that they’re maybe needing to compensate with other facial muscles rather than letting the tongue do its job. So there are just lots of different little clues that we look at, and if all the pieces come together, it can potentially point to a probable tongue tie, and as an IBCLC, an international board-certified lactation consultant, it’s not in my scope of practice to diagnose anything. So when I notice all these symptoms, if things are looking like there is an oral restriction going on, that’s when I would refer to a pediatric dentist.
Alyssa: And you, Katie, can diagnose and treat?
Dr. Katie: Yeah, and what’s great about being a pediatric dentist is that I’m very familiar with the growth and development of infants and kids. But not all pediatric dentists are actually trained in really how to evaluate and treat frenectomies. You know, yes, I am a board-certified pediatric dentist, and that doesn’t necessarily entail that I can treat frenectomies, but how I’ve been able to acquire this knowledge is through taking a lot more courses in order to be able to understand frenectomies and how it affects the whole body and how it affects feeding and speech. It affects children from, honestly, in utero when they’re still developing and how it affects the whole body’s growth, and obviously, the first sign typically is how well they latch and how Mom and Baby are doing during those first few weeks of life when they are able to start feeding. But definitely, it’s really important that I and my business partner, Dr. Kloostra, have taken these courses so that we can work with lactation consultants and better understand how to evaluate for this and how to work with other specialists, as well, like Shira, in order to make sure we’re giving those patients the best treatment possible. What’s interesting is that when you’re developing in utero, obviously all of the tissues are developing; the muscles are developing. And when you have a little bit too strong of attachments in certain areas with what’s called fascia — it’s basically tissue attachment in our body. We have it in our faces; it’s between our lungs, between our organs and muscles, and all that kind of tissue. Sometimes, in your mouth, you might have a little bit extra tissue, and that’s when a tongue tie, lip tie, or other ties can develop in the mouth that can actually create a lot of tension in that tissue and thus tension in muscles that attach to that tissue. When you have all of that tension, it does affect how their whole body is growing. Even torticollis and other symptoms at birth have been linked to tongue and lip ties, as well. The flat head at birth and things like that, too, can all be impacted. So it’s great when moms and babies, if they’re having difficulty, when they seek help from an IBCLC like Shira because it’s an important sign that there’s something going on and the baby needs some help in order to be able to actually grow and develop normally and comfortably as well, too.
Alyssa: So did we talk about this is a podcast before, or was it when we were just talking here, about what that looks like — the actual frenectomy? So they see you, and you say, I think this is a tongue tie; I want you to go see the dentist. Katie sees the baby; says, yes, this is in fact a tongue tie. Then what?
Shira: Right, that’s a good thing to talk about! And we should define frenectomy, too. I often call it frenotomy, so…
Dr. Katie: Frenotomy is more old school, like using a scalpel, going under general anesthesia or getting sedated, and they are cutting the tissue and suturing it or putting stitches in. Whereas frenectomy, it’s basically just a general term for tissue removal. So that can really be all-encompassing because there’s multiple ways to do a frenectomy, and I can definitely talk more about all of those options because, really, every parent is going to have their own comfort level, too, and we have to be respectful of that, as well. But generally, with a frenectomy, it does mean removal of tissue, and there is more of a surgical approach. Typically, you would see an ear-nose-throat specialist, an ENT, and there are children’s ENT specialists, as well, that are typically trained at a children’s hospital. And if someone wanted to go that route, definitely seeing a children’s ENT is the way to go because, just like myself, I am much more, you know, trained on the growth and development of kids and kids’ anatomy and how it grows and changes as their body grows and changes. But when you see an ENT, typically, the child would have general anesthesia. General anesthesia is a full-body anesthetic, meaning they are sleeping. A machine is helping assist with breathing. They’re breathing in gases. It’s basically triggering an area in the brain to just relax the whole body, even the lungs, to the point where they need assistance with breathing. It’s generally very safe, but there is a lot of research showing that having general anesthesia before the age of two to three can actually have an impact on their intellectual and behavioral development. So because of that research, there has been more evolution of how we do that procedure for infants because they are so little, and obviously their brains are going to be impacted by having general anesthesia. We don’t know how specifically, but definitely, there has been more recent studies out there were excellent studies done to show, yes, there is definitely an impact, which was very helpful in educating everyone. And so that’s why things have evolved to the point where there’s other options. There’s even multiple kinds of lasers. There’s something called electrosurgery where you essentially burn the tissue away. It’s another option; it’s not the best option, but it’s an option that I know has been used. And then there’s multiple kinds of lasers, and that was part of my training as a pediatric dentist and going to these courses and understanding the types of lasers, which ones are going to be best for certain procedures. Definitely, the bread and butter for soft tissue removal is something called a CO2 laser, and I guess I don’t probably need to go into the science of everything, but generally, that has been shown to be the most optimal for soft tissue because of, basically, its ability to have less pain, less bleeding, less inflammation to make sure that soft tissue heals that much faster and the recovery is easier, as well. But there’s other lasers that are great options that I have also used, and my patients have done great with those, as well.
Alyssa: But the CO2 laser is what you currently have?
Dr. Katie: The CO2 laser is, yeah, what we have in our office. And definitely after trying lots of lasers, that’s the one we really wanted to utilize for our patients. But yeah, there’s multiple types of lasers that work awesome and are able to provide patients with a great outcome, as well.
Alyssa: So walk us through that. It’s a mom who has seen Shira for a lactation visit or two, and she says, I believe this is a tongue tie and a lip tie, and you need to go see Dr. Katie. So she goes into your office, and you say, yep, sure is; here’s what we’re going to do. I know we have talked about this, but what does Mom do? What does Baby do? What does the lactation consultant do? What do you do? What does this whole process look like going forward?
Dr. Katie: For doing the actual frenectomy?
Dr. Katie: Well, at our office personally, we do an interview first, as well, because I want to check what symptoms are going on and talk to Mom and get to know the family and the baby, too, because even getting to know the baby, it’s going to help me understand post-operatively what kind of exercises will be best for them, things like that, in order to make sure that the function they gain from the procedure continues and working with a lactation consultant afterwards, obviously. The procedure itself: one thing is that it definitely needs to be done by somebody who’s trained to do the procedure because it’s a very quick procedure, but it’s a very involved procedure. It’s how much we’re thinking about and looking at and trying to control in two minutes. But generally, once we interview the family and make sure we see the anatomy and this is what we think is a good option for the baby, we basically swaddle the baby so they’re comfy and have Mom or Dad or whoever is there give them a little kiss and we have them step out while we do the procedure. We have a couple assistants in the room with myself or Dr. Kloostra, my business partner, and we use the laser to do the procedure. It takes, again, about two minutes to do, to vaporize that tissue. It’s very quick.
Alyssa: And what about anesthesia?
Dr. Katie: Yes, thank you. So I do not use any local or topical anesthetic for any infants. For what we’ve been advised by pediatricians, just with the immaturity of their liver health, it’s really not ideal, and topical anesthetic for that young of a kid is actually now not approved by the FDA because it does have such toxic effects. So obviously using a small amount in a controlled environment is safe, but we really don’t want to put any of our really, really little patients at any risk at all. But the procedures we’ve done, the babies do amazing. So what I observe is they do cry during the procedure. It’s generally a typical coping cry is what I like to call it. They’re crying; they’re confused; they don’t really know what’s going on. And then once we’re done, after about two minutes we take them out of their swaddle blanket and I rock them. It’s kind of amazing how resilient babies are because they calm down immediately. Every baby I’ve seen for this, they calm down immediately, and that’s when I have Mom come in. If they’re comfortable with it, I like them to breastfeed just to help relax the baby, and that’s really why we don’t have parents present in the room because I want them to be able to swoop in, be their comfort zone, and help them relax. I imagine it’s very stressful as a parent to actually watch that procedure. I guess I could even compare it to having your son circumcised at the hospital a couple days after their birth. It’s kind of a similar situation. I don’t think I would personally want to watch it, but everyone has their preference of what they want to do. How we do it at our office is just really based on what we’ve observed and learned to make sure that we’re optimizing that baby’s treatment to make sure we’re in a controlled, super-safe environment and that Mom or Dad or whoever it is isn’t stressed either and that they can come in and comfort that baby because if Mom is stressed at all, it does make it harder for Baby, as well. The babies do sense that stress in the mom, so that doesn’t really help the baby if Mom is stressed or feeling anxiety. From what I’ve found, babies do great in that scenario, which is awesome.
Alyssa: So then they get some exercises to do and then, seeing Shira again, you can then help with breastfeeding? And what do those exercises look like? What do you recommend and what have you done, Shira, for exercises after?
Shira: Yeah, so I think from provider to provider of people that do frenectomies, there tends to be a pretty big range of what’s recommended by the provider as far as there’s some wound care, I guess we could call it. So where the wound is under the tongue, if the tongue is what’s been released, I think it can be really important to keep that wound open in a sense. We don’t want it to heal back on to itself, and the mouth heals so quickly. So many providers — Katie can talk about what she recommends, too — but many providers do recommend lifting the tongue to prevent that wound from just healing back on itself. We want to create a lot of space under the tongue to help keep that area open as the tongue heals so that the tongue is then able to obtain full range of motion, which is the goal of the procedure.
Dr. Katie: Right. And the exercises are really pretty simple, and after the procedure, it’s kind of cool how you visually see right away where the tie had been because after we release the tissue, you basically see a diamond shape where that tissue was released. So whether it’s under the lip or under the tongue, when you would raise the tongue or raise the lip, you would see a diamond shape, and the whole goal is that when you do the exercises, you really want to make sure you’re seeing that open diamond appearance. But with the lip, it’s really just lifting the lip and raising it so that you see that open diamond, and with the tongue, a few finger sweeps underneath to just make sure it’s still open or just lifting the tongue gently with your fingertip is usually a nice way to go, as well. But it doesn’t have to be a lengthy process. The moment I just took to talk about it is as much time as the exercises should take.
Shira: That’s what I always describe to parents, too, because babies tend to get a little bit upset when parents are doing the stretches or lifting the tongue. I think it’s probably a little bit uncomfortable, but you do it a handful of times a day, but it can be done in ten seconds, and then you’re done.
Dr. Katie: Exactly.
Shira: And I recommend a lot of other exercises, and they’re really kind of personal, depending on what is going on with that baby, whether that particular baby has really tight jaws or a stiff neck or they have a hard time getting a deep latch or a really sensitive palate and a sensitive gag reflex. So depending on what else is going on as symptoms correlated with that tongue tie or restriction, I may recommend different exercises.
Dr. Katie: And that’s why it’s so crucial that even after the procedure, the mom and baby still follow up with an IBCLC like Shira because she’s going to be able to diagnose, too — or maybe not diagnose, but definitely observe if there’s something else going on, as well, because maybe there’s something else going on, as well. The procedure I do is not the end-all, be-all. It’s not the 100% answer to fix everything going on. Baby is still going to need a little practice, whether it’s lip positioning or tongue positioning, whatever it might be, and whether they need to go see another specialist as well, like a chiropractor or something like that, to help with all that tension in the body. That tension is probably still there, and sometimes someone else needs to be involved, too, and Shira would be really helpful in anticipating those needs, too. I think that’s an important thing to understand because I would never want to see a patient and then have them go home and not really have that kind of care that they need and not have the best results they could have, especially with the wound care, as Shira said. It can be challenging for parents to do it because it’s hard to make your baby cry, especially when it’s already been an anxious thing in your life, having to do the procedure itself. And I’ve learned, too, about other ways of doing the wound care when they’re sleeping and things like that, and that’s something to talk about with the parent too and follow up with them. I like to call them the next day and see how things are going and then offer them other ideas for wound care, as well, like just pulling the chin down when they’re sleeping or lifting the lip up gently while they’re sleeping, things like that. What we wouldn’t want is for the baby to not get the proper care afterwards and develop some sort of oral aversion with having the wound care and not getting anything else treated that they might need treated because, like I said, myself doing the frenectomy might not solve everything going on, and they might still have something else going on that can give them some difficulties with feeding, as well. So that’s why it’s very important to work together and communicate.
Shira: Yeah, I think this whole topic of oral restriction is such an important place where collaborative care comes in and using a team approach. You, a provider who can do the physical release, and then a lactation specialist to help support families with any issues related to lactation. So when there’s been an oral restriction, there’s often issues with Mom’s milk supply, too, because if Baby has been ineffective at the breast, that can slowly cause a drop in milk supply. Sometimes, we see moms, when babies have an oral restriction, moms’ bodies may somehow compensate for that by having an oversupply or a really active, fast letdown. But that doesn’t last forever, so making sure that the oral function is addressed early on before there are issues with milk production. So from a milk production standpoint, lactation is really important, as well, and like you mentioned, the third piece that I think is crucial in most of these cases is somebody, a body worker of some kind; a chiropractor or someone that does soft tissue work or both. Depending on what is going on with that particular baby, the specialist that would be best for them would probably vary. But yes, I think a team approach is really important because, like you mentioned, that fascia that is the connective tissue that had been holding the tongue is tense elsewhere in the body, so these babies with oral restrictions may also be the babies that have digestive issues. They may be constipated or have gas, and that can be related to how their mouth has been functioning. Or they may be babies that are really stiff and don’t want to bend their hips. Babies that are stiff as a board and seem like they want to stand up when they’re three weeks old; those babies. We want babies to not need to hold so much tension in their bodies.
Dr. Katie: And like you said, the babies who are spitting up and things like that: one really big red flag is when I hear that a baby is taking reflux medicine.
Shira: Yes, I’m glad you said that.
Dr. Katie: Because, like you said, all that tension — obviously, that is all connecting to their esophagus, as well, and down to their stomach and things like that, and when they’re not having the optimal latch, they’re bringing lots of air into their stomachs, as well, and all of that can actually mask what is truly going on. We may think it’s just reflux going on; they just have reflux. But what’s missing is the other parts to it: why do they have reflux?
Shira: Yeah, why do they have reflux?
Dr. Katie: That’s always the question that needs to be asked when a baby that young is having any sort of health problems is why is that happening. There’s probably something anatomical; maybe something functional, that is actually causing that issue. Not to say that, yes, some babies may have a true reflux going on, and that absolutely needs to be treated, but what we generally want to avoid is having a baby go on medications or immediately have to go to a bottle or things like that when they don’t need to. So having those evaluations done so that we can avoid those things and help them grow optimally and all that good stuff, too. And then mom is less stressed, as well!
Alyssa: Well, let’s end on a happy note and talk about the amazing stories that we’ve seen of maybe a really struggling mom and a struggling baby, and then they have this procedure, and this whole breastfeeding relationship changes. Can you put a number on that? How often does that happen?
Shira: In my experience, and even just from hearing from other practitioners, as well, I would say definitely a majority of people who have the procedure do notice improvement afterwards, especially if they’re doing this sort of team approach and getting some body work and doing the exercises afterwards. I do want to emphasize that it’s not an instant fix. So, like Katie mentioned, she is a really important piece, the dentist to do the procedure, but I always try to encourage parents not to expect an instant improvement. As an average, I would say it takes anywhere between two and five weeks to see real improvement. You may notice a little bit, but it’s not going to be all of a sudden. It’s gradual.
Alyssa: I think that’s important to note because I could see how a mom would say, I’m going to fix this right now. You’re going to do the procedure; you’re going to help me do the exercises, and it will be all better.
Shira: And that does happen. I mean, it happens occasionally where you have a mom that has incredible pain nursing, and a baby has a procedure and a mom can tell a huge difference that first nursing session after the procedure. So that does happen, but I would say more often than not, it’s a process, and it can take weeks for that to change.
Alyssa: It’s almost like retraining the baby. What if it’s a one-week old baby? Like, the baby hasn’t even been nursing for that long? They don’t need to be retrained if it’s only been a week.
Shira: Well, they practice sucking in utero, though.
Dr. Katie: They’ve been practicing for a while.
Alyssa: So when you’re saying this affects things in utero…
Dr. Katie: They’re moving around. When they’re kicking you, they’re probably sucking as well and practicing all that movement.
Alyssa: Well, yeah, you do see them sucking their thumb on ultrasound photos.
Shira: Some babies that have tongue restrictions also will have a high palate, so the roof of their mouth may be higher than usual, and that’s because the tongue’s normal, healthy resting position is on the roof of the mouth, and that starts in utero. So way back, when baby is first developing, the tongue should be hanging out up on the roof of the mouth to shape the mouth. And that was something else we’ve been talking about, too, is how the tongue having its full range of motion is so important not just for feeding but for oral development, facial development, jaw development.
Dr. Katie: Yeah. And one thing I wanted to touch on, too, is that babies are amazing. They’re very resilient, and even before I had taken these courses, my niece was somewhat tongue and lip tied. And I’m so sad even now because my sister had been struggling so much with breastfeeding and with having all this spit up and reflux. She would hiccup after almost every feeding, like a lot of hiccupping. Things like that where she didn’t really need to have that, and she had worked with a lactation consultant and all that, as well, but it never really truly got resolved. But my sister worked through it and breastfed for a year. With probably accommodations they both made in order to make it work, though; it was extra work. It didn’t need to be that way. But now, things are otherwise happening with my niece. She’s a thumb-sucker. She has a little bit of a lisp. So that’s a really good example where it may have not totally affecting feeding for mom and baby, but it can have other impacts later because now, she still needs some oral stimulation, so the thumb got involved because her tongue doesn’t have full range of motion. When we’re at rest — and you’ll start to think about this now — when you’re at rest, you’ll notice your tongue goes to your palate.
Dr. Katie: Hopefully! That’s typically what happens, but because she’s tongue-tied, she needs her thumb now to have that stimulation, and that’s sometimes a sign, as well. Not always, but that can be something, as well. And then the little lisp going on, so now there’s a speech situation going on. It’s just a situation where, man, I wish I had gotten involved when she was three weeks old, but now she’s almost five. But it’s kind of amazing how babies can grow and change and evolve to get their nutrients and what they need, and the same with Mom. But, again, their growth and development happens over the years to come, so all of that development going on can still be impacted later. There’s been lots of good stories, though! I had one baby who was about six weeks old when I met her. Her mom had been working with a lactation consultant briefly and was told that she was probably tied, but they couldn’t really tell and that they should see a dentist about it. So she had seen a friend of mine who referred her to me because he knew I could diagnosed those kinds of things. We did do the frenectomy procedure for her lip and tongue, and the first 48 hours were a little tougher because she was healing and all of that, but generally, she did much better as the week went on. I saw her at two weeks and three weeks post-op. When I had initially seen her, she had baby acne pretty severely, like, red, rashy, peeling skin, lots of bumps, things like that. And then when I saw her two weeks later, she had gained weight. She no longer had baby acne at all, and Mom was obviously much less stressed and much happier. And she said it was still a little tough; when I saw her at that two-week mark, there was still some healing going on. I said, let’s see her in another week, and I want to see how you guys are doing after she’s 100% healed. I saw her after three weeks, and she was doing so much better. So just like Shira said, it takes some time. It does. I don’t know specifically what was going on because lots of kids have baby acne and things like that, but when I saw her after two weeks and she had cleared up, I was like, well, maybe it’s because mom is less stressed, and there’s less cortisol in her body, which is our stress hormone. Who knows; it could be multiple things, but that could have been part of it.
Shira: Or more milk volume, too.
Dr. Katie: That, as well. So lots of things going where baby was just doing great afterwards, and Mom was so helpful for me, as well. It was probably one of the first times I had actually really done the procedure for that young of a baby, and Mom was really helpful in all the things she was observing as it went. They were doing great. So that was a good success story. Oh, and she had been on a reflux medicine, and she didn’t have to take it anymore.
Shira: That’s probably one of the biggest things I see. I see lots of babies that are on reflux meds, and babies who have their tongue tie treated are the babies that tend to no longer need that. That’s usually a symptom of the tongue tie, and it goes away. Gassiness, things like that. Babies are sleeping longer. A lot of times, babies with a tongue restriction don’t have long sleep cycles. They are woken up; probably because of their tongue not resting on the roof of their mouth, which is kind of a soothing thing.
Alyssa: Well, and part of it, too, is that if they’re not effectively draining the breast, they’re hungry. They’re waking up hungry.
Dr. Katie: They’re hungry more often; they fall asleep at the breast because it’s really exhausting for them to eat.
Alyssa: Yeah, I mean, if a breastfeeding session takes an hour at each breast…
Dr. Katie: It’s like running a marathon for them to even breastfeed. So they’re exhausted.
Shira: So it’s not necessarily just what breastfeeding feels like to the mom or that baby is all of a sudden gaining weight, but there are all these other little pieces of health that can be related that maybe no one would have thought would be related. You know, you take a baby to the doctor for gassiness or digestive things or not sleeping enough, and a tongue tie is rarely the first place they look. Oral function is not often where they’re going to look. But they’re definitely related.
Alyssa: So moral of the story is, you need to find a team to help support you, and be patient once this happens and don’t expect instant results.
Shira: Yes. And I want to emphasize that you do need to find people who are well-trained and familiar with this process, with this procedure, and with assessing oral function in the first place because I will say that many pediatricians, many dentists, or many lactation consultants, in fact, are not trained at really assessing what the tongue is doing or what it should be doing. So this situation gets overlooked or even ruled out, even, when it’s a concern that parents have. It’s often ruled out when it really should be addressed.
Alyssa: Well, I know that for the two of you, it’s kind of your specialty. Shira, I know it is for you.
Shira: So if a parent think that they’re dealing with these symptoms, just keep looking. Keep looking for somebody who will listen to you and really give you the help that you need.
Alyssa: They should just call you!
Dr. Katie: Absolutely I’m not going to diagnose something if it’s not there, but it is really important to go to someone who does, like you, understand oral function and what should be going on. Obviously, as an IBCLC, you have more training in what’s going on, and myself, as a pediatric dentist, I have sought out that training, but yes, not even every pediatrician understands how to evaluate. That’s why I’m a kid specialist of the mouth; that’s a simple way of putting it. I’m always in the mouth; I’m looking at the mouth, and that is my specialty.
Shira: It’s an important part of the body!
Dr. Katie: It is!
Alyssa: Well, tell people where to find you.
Dr. Katie: I’m actually in a practice called Pediatric Dental Specialists of West Michigan. We are located at East Paris and Burton in the new Bankston Center, and you can find us online on our website or give us a call at 616-608-8898. We’d love to connect with you and connect you with Shira, as well.
Alyssa: You can find Shira on our website. People call for you all the time! People love you. We love you, too! We’re so happy to have you!
Shira: I’m so happy to be with you!
Alyssa: Thanks for tuning in, everybody! If you have any questions for either one of these ladies, email us at email@example.com. We are also on Instagram and Facebook, and you can listen to our podcast on iTunes and SoundCloud.
After this podcast aired, Shira wanted us to clarify some things that were mentioned:
“A tongue release procedure, frenectomy, can be done well by any type of provider (dentist, ENT, physician, midwife, etc), as long as they have good experience and training. Likewise, good releases can be done with a laser, scissors, or scalpel — it is the skill of the provider that matters most, not the tool used.
An experienced release provider does not use general anesthesia for babies – they either use topical anesthetic, or nothing at all. Avoid providers who say they use general for babies, as that is neither safe nor necessary.
A good way to find a provider is to ask an experienced IBCLC who they recommend, or ask a potential provider how often they do frenectomies, how many they’ve done, what their training is, etc. Having it done by a less experienced provider often results in an incomplete release, which may have to be redone to provide full benefits”.
Shira also wanted to note that she did not train with Dr. Ghaheri, but did get to shadow and learn from him during her education.”
On this week’s episode of Ask the Doulas, we chat with Chris Emmer, owner of Biz Babysitters, about postpartum life and owning your own business. You can listen to this complete podcast episode on iTunes or SoundCloud.
Alyssa: This is Alyssa. I am recording with Chris Emmer again. Welcome to the Ask the Doulas Podcast. How are you, Chris?
Chris: Good, how are you?
Alyssa: So we talked to you about sleep before, and today we’re going to talk a little bit about being a mom in business and how that affected us. We were talking about this book you just read and the rage, the fire, that it lights under you about just how – I don’t know, would you say a mother in general, or would you say a whole family, is treated during pregnancy and how we’re just kind of disregarded during this postpartum time? And how we wish more was part of the whole process. You get pregnant, and you just get X, Y, and Z, instead of having to seek it out yourself and pay for it all yourself.
Chris: Right, that’s the biggest thing is that there is this huge lack of support postpartum. I guess I can only speak from my experience, but I felt like when you’re pregnant, you see the doctor every two weeks, and people open doors for you, and they smile at you, and you just hold your belly and you’re so cute. And then you have the baby, and it’s like wait, what? It’s just a complete shock, and it’s like, now is the time I need people to be nice to me! This is the hard part!
Alyssa: Yeah, you’re completely forgotten, and it’s all about the baby. Nobody’s holding a door open. I mean, how many moms do I see trying to struggle with a toddler in one arm and trying to push a stroller through a door, and I’m watching people walk by? I’m running up to her, like, let me get the door for you! Why are people just completely ignoring you?
Chris: Blowing past you like you’re not there, yes. Absolutely. So, I mean, I don’t know what your birth experience was, but there was a six-week checkup or an eight-week checkup, maybe, and at that appointment, my OB said, and I quote, “You are a normal person now. Go back to life as it was.”
Chris: And I was like, but…
Alyssa: I’m not! And define “normal,” please!
Chris: How do you know I was even normal before? But yeah, and then that was it, and then she scheduled me an appointment for one year out or whatever, just a normal physical exam like you would have just as a person before kids. And that just felt so shocking and kind of, to be honest, just cruel and unjust. Like, you’re in this huge transition, the most incredible and important transition of your life, and the bottom drops out, and you’re completely alone there. And we know that mental health is a huge issue postpartum, and there was really no education on that besides circling which happy face you feel like today.
Alyssa: Yeah, we’ve been talking to pediatrician offices a lot because they oftentimes are the ones who see this mom and baby before the six-week checkup, so they’re the ones who are seeing this mom struggling with breastfeeding. She’s crying all the time. We can tell she’s not sleeping. Let’s talk about her mental health. Even though you’re here for me to see this baby, I’ll weigh the baby and do all the things I need to do with the baby, but let’s also ask Mom. So thinking about tests, you know, different tests and not just picking the smiley face; let’s really ask you some real questions. Because, yeah, six weeks is too long. It’s way too long to wait to see a mom, and then to tell her that she’s normal and to go home and go on with life. I mean, maybe somebody feels kind of back of normal again at six weeks, but sex is not the same at six weeks. You might not even be completely healed, especially from a Cesarean. Maybe breastfeeding is still not going well. How do I deal with these leaky boobs? What’s going on? Nothing is normal!
Chris: There is zero, zero normal, and I think in that circumstance, being told, “You’re normal now,” when on the inside you’re like, “This is anything but! I feel like an alien in my own body and in my own brain and in my life! Who am I?” You look in the mirror and honestly have no idea who you’re looking at, and to be told you’re normal, then it adds, I think, a layer of shame, because you’re like, oh, I’m supposed to be back…
Alyssa: They think I’m all right, so what am I doing wrong?
Chris: Yes, and then I think of the way that I handled that appointment. I probably just smiled and giggled and said, oh, thanks! Yay, I can chaturanga again! See you at yoga; bye! You know, and then just acted happy and normal, and then got in my car and cried or whatever happened next. But yeah, getting back to what we were originally on – now, I’m almost a year out, and I’m coming to a point where I can look back, and I’m processing all the different stages and reflecting on what everything meant, and I’m getting really obsessed with this transition and I’m soaking up all this literature on how we do it in other countries. My question for you is this: how do you come to terms with that? It feels so – I don’t know.
Alyssa: Just unjust?
Alyssa: I think knowing that what we’re doing at Gold Coast is just a small, small piece of this pie, right? We’re one tiny piece of this bigger puzzle. I could look at the whole big picture and get really, really angry, but what can I do right here, right now, for my community? But then, even then, I’m like, okay, so, even in my community, there is just a small portion of people who can afford this because it’s not covered by insurance. So what about the rest of the community that I can’t help? So we just do the best we can. And every family that we support, we support them the best we can, and we know that we’re making a difference for those families. And then they’re going to, in turn, hopefully, kind of pay it forward, right? Like, either tell someone there’s this support available, or they’ll say, “I struggled too. I want to help you.” You know, my sister, my neighbor, my friend: be that support! Because maybe your neighbor can’t afford to hire a postpartum doula, but you have a group of friends who could stop over. You know, I’m going to stop over for two hours today. She’s going to stop over for two hours tomorrow.
Chris: That’s a really cool way to think about it, the ripple-out effect. Because you do need a lactation consultant; you need a sleep trainer. All these things; where the lack is in other areas, you end up having to find that somewhere else. So what about people who can’t afford these things? But I love what you said, that you could teach this one family this thing, and then you know that that mom is on a group text with, like, 15 other people. Like, I’m in probably five different group texts with different groups, like my cousins that are also moms, my friends from growing up that are also moms, and we’ll text each other pictures of things like a rash. The trickle-down image is cool to think about, that if you equip one family with the tools to do something, that they can then kind of pay it forward.
Alyssa: Yeah, and I think, too, about sleep. So I try to make my plans very affordable, but there’s always going to be people who can’t even afford the most affordable package, so I’m like, what can I do? Maybe a class. So I’m actually working on a class right now where I can give new parents some of this basic knowledge about healthy sleep habits. But again, like we talked with your sleep podcast, there’s not just one solution that works. So I don’t want people to think that by taking this class, they’re going to walk away and say, “I can now get my kid to sleep through the night.” I will give you the tools that I can that are generalized to children in certain age groups, but then from there, they kind of just have to take it on their own, if they can’t afford to have me walk with them and hold their hand through the whole process. But I guess it’s one step of, like, what else can I do to reach those people who maybe can’t afford everything? I think we’re just slowly working on it. We’re finding ways to infiltrate the community in so many different ways, whether it’s volunteering. We used to teach free classes at Babies R Us until they closed. That was another way that we could just get information into the community and let people know, you have options. You have a ton of resources in this community, and here they are.
Chris: That’s so cool.
Alyssa: Otherwise, yeah, you can get really, really mad about it.
Chris: Yeah, you can get really mad!
Alyssa: And I think that is the fires that burns. That’s what makes us passionate about what we do, because it is not fair that moms feel so isolated and alone once they have a baby. It’s not fair.
Chris: And then take that passion and turn it into something that can help people.
Alyssa: Yeah. So this kind of is a good lead-in to your new business because you, reflecting now back over the past year and owning your own business, and thinking, “Oh, I got this; I can do it all during my maternity leave” – even though you work for yourself and you don’t really give yourself a leave. Life still goes on; you still have emails to deal with and all your social media stuff, and looking back and saying, how can I help other moms when they’re going through this transition? So explain what you went through and what made you start this new business.
Chris: Yeah. So a little bit of background info: I have a social media business, so I do social media for a handful of clients, and when I was prepping for my ‘maternity leave’ last spring, I thought I was getting ahead of the game. I was, like, “Chris, you’re amazing! Look at you pulling it together!” I hired some people to my team. I started training them. I started onboarding them. I thought I had all my systems put together, and I thought everything was awesome. In my head, I was going to take at least one full month off, not even checking email, just completely logged off. In my head, I was, like, wearing a maxi dress in a field, holding a baby, effortlessly breastfeeding, with sunshine. It was going to be awesome. And then I thought that I would just slowly ease my way back in and maybe come back in September. In reality, what happened was I had a C-section. My water broke one week early and I ended up having a C-section, and in the hospital still, just hours after my surgery, I was doing clients’ posts on social media and doing their engagement because I hadn’t tested my team. I actually had a few people who I had hired who ended up just not working out. And so it all fell back on me because, as a business owner, it does. And so that was just in the hospital, and then getting home and starting to learn how to do, like, sleep training and breastfeeding and even just dealing with my own healing – that was more than a full-time job already, so I was trying to balance that with continuing to work. So there was zero maternity leave there, and that made my transition, which was already really pretty tough, a lot harder than it needed to be, and I can see that looking back. I’m like, whoa, girl. That was nuts. But at the time, it felt like the only thing that I could do. And so, like we said, looking back and seeing that, I’m like – it fires me up, and I don’t want anybody to have to do that. And I will do anything again to prevent that for other people. So when I see women who are pregnant and own their own business, I just want to shake them and tell them, “You don’t know what’s coming! You need to prepare!” Because I wish that somebody would have done that to me. But all I can do is offer to them what I wish I would have had. So I started a business now called Biz Babysitters, and what we do is we take over clients’ social media completely. So we can handle posting; we can handle stories; we can handle DMs, engagement, comments – literally everything. We can handle your inbox, as well, so that you can log off totally in your maternity leave. Because there is such a temptation to just bust out your phone, and there are so many things that you think, while you’re breastfeeding or raising a newborn, that you can quickly, easily do. You just can’t!
Alyssa: On that note – so I too was a breastfeeding mom, scrolling through my iPhone. I recently learned that there’s an increased risk of SIDS by trying to multitask while breastfeeding because you can get your kid in an unsafe position. Like, especially a teeny-tiny baby who needs to be held in the right position. They can suffocate on the breast. So that’s another reason for mom to just put your phone down.
Chris: Put your phone down!
Alyssa: Yeah, stop multitasking.
Chris: Two other things with that. One is the blue light that comes off your phone. If you’re shining that in your baby’s face in the middle of the night and then wondering why they don’t sleep or why you don’t go back to sleep? I would get up and breastfeed my baby and be scrolling through Instagram, and then I would lay down in bed exhausted but completely unable to fall back asleep, and I think it was because I was staring into a glowing blue light. And the other thing is just the mental health aspect of social media. There’s so many more studies coming out on this now, but Instagram is not good for our mental health. You’ve got to really clean up your feed and be intentional about it if you want Instagram or whatever app to not send you down a shame or comparison spiral. And I remember feeling, while spending hours and hours on Instagram and breastfeeding, that this whole world was out there happening around me, and I was watching all the fun things everyone was doing, and I remember just feeling like I was stuck in this one place. So I could feel the negative effects of being on social media in my immediate postpartum, very strongly. So I think that just acknowledging, like, maybe this might not be a great thing for you in a time when you are so tender and vulnerable.
Alyssa: So we had talked about this, and you had said, “I wish somebody would have told me all these things I needed postpartum,” and then you were looking back through old emails and you found one from me, saying, “Hey, you should take my newborn class.” And you were, like, “Yeah, yeah, yeah, I’m too tired.” And now you’re like, well, shoot, I wish I would have done that! So how do you tell moms who are pregnant and saying, just like you did, “I got this. I’m lining everything up; all the Ts are crossed; the Is are dotted; when I go on maternity leave, everything is done. I’m good.” And you’re saying, no, you actually need to prepare. How do we really reach people? You don’t know what you don’t know, so unfortunately, this mom isn’t going to know she needs you or me until she’s already in the thick of it and losing her mind and crying and saying she can’t handle this anymore. So maybe it’s just education? They need to hear it over and over and over again that this harder than you expect, and you have to prepare ahead of time.
Chris: Right. I don’t know! This is the hardest part, because you’re exactly right, you don’t know until you know, and I looked back this morning on that email that I had sent you, where I was like, eh, I think we’re good. We were so not good! Oh, my God! That’s the hardest thing, I guess. All you can do is share your story, and maybe it will connect with some people. But I think that a lot of it is, in that state of shock afterwards, to be there to help out, too, as sort of like a 911.
Alyssa: And we have that. You know, a lot of people call us. “We need postpartum help,” or, “I need sleep help.” And it is like, how soon can you start? But with your business, if I was a new mom and I was in the middle of this social media campaign, but you don’t know anything – like, how would a mom do that 911 with you?
Alyssa: Would that even work?
Chris: It would, because we’ve got systems set up, like our intake forms and everything. I mean, it wouldn’t be as effortless. You know, you would have to go through a lot of onboarding because we need to figure out your voice, your tone. A lot of it we can do just from stalking your account and everything that you already have out there on the internet, but yeah, there is a little bit of work that needs to go into handing off the reins to somebody. But I really like to tell people – this is the cheesiest – it’s a skill to chill. But it’s for real, especially for people who own a business. We are a weird breed of people where you don’t know how to relax because you’re so passionate about your business that a second that you have to breathe, you are probably dropping into your business. I don’t know. I was that way.
Alyssa: No, it’s true. I’m always on, and I think occasionally, let’s say an appointment cancels or I end up having an hour of free time. I find myself wandering, and I don’t even know what to do. What do I do right now? I just finished all my work because I was supposed to be doing this other thing right now, but I can’t get out of that mode to just sit and read or go for a walk. I’m trying to get a lot better at that. It’s beautiful out; I should go for a walk. But it is hard to get out of that mode and into chill mode.
Chris: Yes, so it takes practice because it’s shocking. And so I love to recommend to people to get started working together around 30 weeks. Go through all the intake forms; get everything put together, so that you can start your log-off at, like, 36 or 37 weeks. And in those last couple weeks, you can start to practice relaxing and see what it feels like to not check your email, and see what it feels like to not being in your Instagram DMs every 15 minutes. Fill in your vice of choice, but you can start to slowly – just like how you want to phase slowly back into working, you can slowly phase out of it. And you don’t know what’s going to happen towards the end of your pregnancy. You could go into early labor. You could want to nest so bad that you just wander around Home Goods for eight hours. So I love to tell people to start early; start around 30 weeks, then slowly phase it out. We can work out any kinks, and then you can practice for maybe a week, maybe two weeks, seeing what it’s like to be completely stepped back and completely relaxed. And I think that’s a great way to mentally and physically prepare for your immediate postpartum as well so that you aren’t tempted to jump back in. That little reaction you get with your thumb when you turn your screen on where it just goes to Instagram and you don’t think about it – you can start deprogramming that now.
Alyssa: That’s really smart. So for any moms who are listening to this and going, “Oh, my God. I need that. I’m a business owner and I’m pregnant.” Whether it’s your first or fourth, you can use this. How do they find you?
Chris: You can find me on Instagram, of course.
Alyssa: Of course. You have a beautiful Instagram feed. I love it.
Chris: I’m such a nerd for Instagram. I love it so much. So on Instagram, I’m @bizbabysitters. And you can find every other piece of information from that point. Instagram is the hub. And then bizbabysitters.com is the website. I also have a free maternity leave planning workbook for anybody who is coming up on your maternity leave and you’re not sure you want to work with somebody. This is totally free and a good way to just get started wrapping your head around a game plan.
Alyssa: And they can download that on your website, too?
Chris: Mm-hmm, bizbabysitters.com/freebie.
Alyssa: Lovely! Well, thanks for joining me today! Is there anything else that you want to say about either your business or this crazy mess of being a mompreneur?
Chris: I think it’s such an interesting, cool breed of women. And there’s so many more of us now! A big shift is happening, I think, and it’s really cool to be part of it.
Alyssa: I have a daughter, and so do you, so I think it’s really cool that as Sam gets older, she’s going to see you as your own boss. I think that’s really cool. My daughter knows that I own my own business and I am my boss, and I work when I want to work – and I’m going to get better at working less – but I just think it’s really cool and empowering. That, in and of itself, is really empowering.
Chris: It is! Julie, the postpartum doula at Gold Coast, left me a stickie note. She always leaves little stickie notes, and I save all of them. She left a stickie note that said, “You are setting a good example for your daughter.” And I was, like, tears!
Alyssa: Tears! Oh, Julie.
Chris: She’s the best!
Alyssa: Yes, we love her too!
Chris: So I guess also just a reminder that you’re not alone, even if you feel that way. We’re all feeling it.
Alyssa: So help a sister out. Stop this mom shaming stuff. You are no better than another mom, and don’t even try to make yourself look better than another mom. We’re all struggling in our own way, no matter what stage; six weeks or six years. We all have different struggles.
Chris: Yeah, and different areas of thriving, as well. We’re all in it together.
We are so excited to announce that we now have a Lactation Consultant on the lakeshore! Cami comes to Gold Coast with an amazing medical background and almost 20 years of experience as an IBCLC. Let’s get to know her a little better.
1) What did you do before you became an IBCLC?
I have been an RN for 28 years. I worked many years in the Surgical Critical Care unit at Spectrum Hospital. Once I started my family, I switched to Labor & Deliver, Special Care Nursery, Postpartum Care and normal newborn nursery, mainly working Labor & Delivery and Special Care Nursery. After my first child was born in 2000 I began helping in the Lactation Office, and became an International Board Certified Lactation Consult in 2001. After many years of working many positions on the birthing center, I began to concentrate on my skills as a Lactation Consultant. I have been working in the field of Lactation soley since 2010.
2) What inspired you to become an IBCLC?
While working on the birthing center, I found I truly enjoyed working with the mother baby dyad and their breastfeeding journey.
3) Tell us about your family.
I’m a single mom of two children. My son Jarek is 19 and just recently joined the Air Force. My daughter Skyler is 16 and is just finishing up her Sophomore year at Zeeland East High School.
4) What is your favorite vacation spot and why?
With a busy family life, vacations are hard to come by. My daughter and I enjoy horseback riding, feral cat/kitten rescue, hiking the lake shore, and hammocking. My son and I enjoy hanging out together watching movies, working on his car, and attending car shows.
5) Name your top five bands/musicians and tell us what you love about them.
I enjoy all types of music, however my go to music is 80-90’s Alternative. Bands such as The Cure, Smiths, Cranberries, and the Pixies.
6) What is the best advice you have given to new families?
My advice to new families is to be open to change, talk to your partner open and honestly. Enjoy every step, the good and the challenging because the days go by quickly.
7) What do you consider your superpower to be?
I find that as a Lactation Consultant I’m able to connect with families and help moms reach their goals. I love new families, and it shows in how passionate I am at what I do.
8) What is your favorite food?
I love finding new fresh foods. I have Celiac disease and enjoy turning normal dishes that I grew up with into Gluten Free dishes. Italian food and desserts are my two loves.
9) What is your favorite place in West Michigan’s Gold Coast?
Saugatuck Dunes is my favorite place to hike and to enjoy the coastline of Lake Michigan. I’ve been lucky enough to enjoy horseback riding on West Michigan beautiful beaches, enjoying summer rides, and even a few Christmas eve rides with the snow billowing around my horse and I.
10) What are you reading now?
I’ve recently been reading about and studying the Baby Friendly Initiative, and I have been involved with research over the years to help determine what can help increase the breastfeeding rates in MI. I’ve just joined an amazing group of woman on the lakeshore to form the first Ottawa County Breastfeeding Coalition.
11) Who are your role models?
My Grandmother and Mother are my biggest role models. My Grandmother passed away many years ago, but she was a huge influence in my life, always showing love to anyone in need. She raised 12 amazing children. My Mom has always been my biggest supporter and has the same spirit as her Mother. She has a huge heart and passion for life. She has helped mold me into the Mother and friend that I am today.
As soon as you start to breastfeed, most of the women you meet on a daily basis, including your mom, friends, and even acquaintances, will have one or two things to tell you about what to do when nursing a baby. Some will tell you that eating cabbage will work wonders for you while others will advise you on when to start expressing milk by use of a breast pump. However, there is a whole lot of information that is left out. Here are some of the things you probably didn’t know about nursing a baby:
1. Your Diet Does Not Define You
Naturally, your body will make quality and healthy milk for your baby. Adopting a healthy diet while breastfeeding is not about producing “healthy milk” but is more about making sure your body maintains both its health and energy. Therefore, there is no need for you to agonize over not eating like a dietician.
If you have chosen to eat two Oreos instead of a plate full of veggies, don’t get depressed or suddenly think you aren’t going to produce the very best milk for your baby. You can always fill the nutritional gap by simply taking a prenatal vitamin. These vitamins are often loaded with iron, calcium, and vitamin D.
2. Expect Increased Cramps
Oxytocin, the same hormone that is responsible for milk letdown is also the culprit for increased cramps. This hormone causes your uterine wall to shrink and as a result, triggers contractions from the uterus.
As annoying and uncomfortable as these cramps may be, it is a good sign; it shows that your body is healing well. Some researchers believe the pain increases with subsequent pregnancies; this is because the uterine wall stretches a little bit more every time you have a baby.
3. Leaky Breasts
You can blame this on the same hormone, oxytocin. A single thought about your little one, talking about him or her, or hearing another baby cry will often trigger your body to release oxytocin and most likely a little bit of breastmilk along with it.
This could be embarrassing more so when it happens when you are out with friends, at work, or even on the streets. However, this should not worry you. It happens to each and every mom who is nursing a baby. To sop up the milk leakage, you could buy yourself some nursing pads or reusable silicone cups whose pressure prevents any milk letdown.
4. Your breast milk is different from the milk from a cow’s milk
Your breast milk will look different from time to time and does not in any way look like cow’s milk. Your breast milk changes every now and then to meet your little one’s nutritional needs.
In the beginning, your breasts will produce yellowish-white colostrum that is quite sticky and loaded with proteins. A few days later when the milk letdown increases, your milk will have two parts; you will see these two parts separate when stored in the refrigerator. One part is watery while the other contains more fat and has more cream thus making it appear thicker.
5. Latching on can be super hard
Lactation Consultants believe that by establishing a good latch, many other breastfeeding problems can be avoided. For you to have a good latch, you have to make sure that your nipple and at least half your areola are inside the little one’s mouth as you breastfeed.
A bad latch will cause you to feel a pinch while nursing which will eventually lead to you have sore or cracked nipples. If this happens you may want to try pumping and storing your breast milk to help you while your breasts can heal.
6. A quality bra is a must-have
While breastfeeding, most women’s boobs grow bigger. For this reason, it is important to wear a quality bra that will not only offer you comfort but also minimize the sagging of breasts that often happens post pregnancy. Invest in a bra that has a wide band that fits comfortably under the breasts and has cups that offer support without being too tight. You want to take care of yourself as best as possible.
Avoid wearing bras with an underwire as they could inhibit the flow of milk and cause your milk ducts to get clogged. If you are not so sure about the right bra for you, feel free to get a professional fitting from a medical care store or the maternity department.
7. You may experience breast engorgement
A few days after delivering your baby, your breasts will begin to produce lots of milk. When your breasts are full you will experience engorgement. Initially, it may be super uncomfortable, but the situation will get better as your milk supply syncs with the little one’s demands.
To relieve you from the engorgement pressure, you could:
Wake your baby up for breastfeeding
Consider expressing milk using a breast pump
Shower or bathe with warm water
To avoid the feeling of engorgement, you could:
Keep switching the first breast you offer the baby during the nursing sessions
Breastfeed for 15 or 20 minutes on each side before switching
Our very own Jamie Platt, BSN, RN, CLC, CPST shares her personal insights on what it’s like to be a postpartum doula.
What is the role of a postpartum doula? What does it look like, and how might a doula support the breastfeeding relationship between mom and baby? A postpartum doula can take care of mom, baby, and the entire family. Sometimes mom needs emotional support, help around the house, or even just a nap! I’ve taken care of baby while mom takes a nice hot shower or has one-on-one time with older siblings. We’re also able to prepare meals and run errands. We help with newborn care; we serve a variety of moms from different cultural backgrounds and some families need help with bathing, breastfeeding, and diaper changes. Some of our doulas have had additional training regarding the care of multiples, or have multiples themselves!
I have completed special training in perinatal mood & anxiety disorders so that I am able to recognize the signs and symptoms of a variety of mood disorders. It’s important that mom receives help if she needs it, and the general Grand Rapids area has great resources that include therapists and community support groups. In fact, we have one of the few Mother Baby programs in the entire nation, which provides a day program where mom can bring baby with her while she receives treatment. It is critical that we recognize when a mom needs help, that we support her, and in turn reduce the stigma of postpartum mood & anxiety disorders. Postpartum doulas are right there in family’s homes and can be a direct source of help and information.
Doulas also provide overnight support, which can be so great for moms (and partners)! The entire family can get the sleep they need and mom can still breastfeed baby through the night. I like to think that when I show up to a family’s home at night, I am well rested and mom may be feeling tired- but when I leave in the morning, I leave with bags under my eyes and mom looks and feels like a goddess when she wakes up. That is my goal!
I also want to acknowledge the importance of breastfeeding while still respecting the needs of mom, which may include formula feeding. As a postpartum doula I provide nonjudgmental support, and I help mom reach the goals SHE wants – not me. I recently completed my Certified Lactation Counseling (or CLC) training. The CDC considers both CLC’s and IBCLC’s as professional lactation supporters.
So why is breastfeeding so difficult that mothers need help? Well, our culture has unrealistic expectations of what the newborn period is like. The fastest drop-off in breastfeeding rates occur in the first 10 days after hospital discharge. The main reasons mothers stop breastfeeding is because they believe they don’t make enough milk, the baby won’t latch, and/or mom has sore or painful breasts. Breastfeeding rates drop again when mom has to return to work or school between 8-12 weeks. It is so important that as a community we support mothers who want to breastfeed. As doulas, we can help mom gain the confidence she needs, give basic breastfeeding information, and make appropriate referrals if needed. Gold Coast Doulas offers lactation support through our IBCLC, Shira Johnson, who makes home visits. Gold Coast also has other doulas who have other breastfeeding-specific training, like the CLC training. We know that breastfeeding has amazing benefits for both mom and baby, so it’s time that we start normalizing it, and again, support all moms regardless of their feeding choice.
Fact: Most breastfeeding mothers, at one time or another, worry about their milk supply. They wonder whether their body will make enough milk for their baby; if their supply will last.
Not surprising, since most of us have heard stories about moms who, despite wanting to breastfeed, reported not being able to; their milk dried up, baby refused the breast, they were told their milk wasn’t good, etc. Many mothers head into breastfeeding with an expectation that milk production will be a struggle, due in part to these stories that are shared widely by well-meaning strangers, friends, family members, and even healthcare providers. But the reality is that most mom’s bodies can make plenty of milk. The fear of low supply is much more common than the reality!
Before I go on, let me be clear that not all women who want to breastfeed can make enough milk to sustain a baby. There are many physical conditions that potentially impact milk production including birth complications, thyroid conditions, PCOS (Polycystic Ovarian Syndrome) and other hormone conditions, anemia, retained placenta, breast or chest injuries/surgeries, various illnesses, medications or hormonal birth control, or Insufficient Glandular Tissue (IGT – the technical term describing when breasts contain less milk-making tissue). It’s important to recognize that low milk supply is a very real scenario that many struggle with, and it’s a serious topic that deserves a lot of attention of its own. But here we will focus on milk production in mothers with no prior physiological limitations; specifically on how low milk supply is less common than people think, and that it is much less common than “perceived low milk supply”.
Perceived low milk supply, or Perceived Insufficient Milk, is when moms are making enough milk but think that they are not. This may not sound like a big deal, but it is. Why? Because, despite having no physiological basis, perceived low supply is one of the most frequently-reported reasons for early weaning! And it’s a very stressful thing to worry about.
The good news: Perceived low supply does not equal actual low supply.
The bad news: Perceived low supply is very common, and, in addition to the fact that worrying is no fun, perceived low supply can cause low supply!
How can perceived low milk supply cause actual low supply?
When moms believe their supply is low, the way they feed changes, and how we feed has a strong influence on milk production. For example, moms might introduce supplemental formula if they perceive baby to be dissatisfied or hungry after nursing, or if baby is nursing more often than they expected or is waking frequently at night. It’s easy to assume that low supply is the cause of these things if we aren’t familiar with normal breastfeeding behaviors (especially when formula-feeding culture perpetuates unrealistic expectations for breastfed babies). Feeding on a rigid schedule, sleep training a young baby, or otherwise altering baby’s feeding routine can impact milk supply very easily, so understanding the nuts and bolts of milk production, baby behavior, and growth patterns is important. All of the conflicting advice we receive from family, pediatricians, and friends is confusing! Knowing how to tell when things are going well gives parents confidence to keep going through the ups and downs. Since perceived low supply is not a physical issue, it is totally avoidable, as long as parents have support and access to good information.
How does milk production work?
Milk production begins as a hormonally-driven process, initiated by hormone changes at birth. Over time, it becomes a supply and demand process (meaning that, ideally, the body will adjust to make exactly what baby needs – no more, no less). The baby communicates how much it needs by eating exactly what it needs! If it needs more, it will suckle more, sending hormonal signals to mom’s brain, which in turn tell her body to make more milk. This is one reason babies might seem to nurse around the clock during growth spurts. Not only are they trying to eat more, they are also instinctively “putting in the order”, so to speak, for more milk to be made to accommodate their increased needs. Simply put, the more milk is removed, the more milk the body will make. Milk can be removed in a number of ways: directly feeding baby at breast, or expressing with a pump or by hand. If milk isn’t removed regularly, milk production will be altered. This is how extra pumping can increase supply, or how skipping feeds or going long stretches between pumping at work can decrease supply. This also explains why babies who struggle to transfer milk can result in decreased supply over time, even if they are at the breast a lot! (There are many reasons why a baby might struggle to transfer milk effectively. Their feedings might take a very long time, or they may fatigue easily at the breast. If you suspect this, it’s a good time to call a lactation consultant). But, compared to pumps, babies are usually more efficient at removing milk, due to the additional stimulation, warmth and eye contact inducing more milk-making hormones. Expressing milk, however, is very effective for some, and is a necessity for breastfeeding moms who work out of the home or are separated from their babies.
For more about milk production, look for a future post all about how to maintain a good milk supply!
If you need support in the meantime, an IBCLC, Board Certified Lactation Consultant, can help answer your questions about supply, foods and herbs to support lactation, help you determine if baby is getting enough, or troubleshoot concerns even before your baby arrives!
We are pleased to present a guest blog by Shira Johnson, IBCLC.
Can My Body Make Enough Milk for My Baby?
Fact:Most breastfeeding mothers, at one time or another, worry about their milk supply. They wonder whether their body will make enough milk for their baby, if their supply will last.
Not surprising, since most of us have heard stories about moms who, despite wanting to breastfeed, reported not being able to; their milk dried up, baby refused the breast, they were told their milk wasn’t good, etc. Through no fault of our own, many mothers head into breastfeeding with an expectation that milk production will be a struggle, due in part to these stories that are shared widely by well-meaning strangers, friends, family members and even healthcare providers. But the reality is that MOST moms’ bodies can make plenty of milk. The fear of low supply is much more common than the reality!
Before I go on, let me be clear that not all women who want to breastfeed can make enough milk to sustain a baby. There are many physical conditions that potentially impact milk production (including birth complications, thyroid conditions, PCOS -Polycystic Ovarian Syndrome- and other hormone conditions, anemia, retained placenta, breast or chest injuries/surgeries, various illnesses, medications or hormonal birth control, or Insufficient Glandular Tissue -IGT- the technical term describing when breasts contain less milk-making tissue). It’s important to recognize that low milk supply is a very real scenario that many struggle with, and it’s a serious topic that deserves a lot of attention of its own. But here we will focus on milk production in mothers with no prior physiological limitations; specifically on how low milk supply is less common than people think, and that it is much less common than “perceived low milk supply”.
Perceived low milk supply, or Perceived Insufficient Milk, is when moms are making enough milk but think that they are not. This may not sound like a big deal, but it is. Why? Because, despite having no physiological basis, perceived low supply is one of the most frequently-reported reasons for early weaning! And it’s a very stressful thing to worry about.
The good news: Perceived low supply does not equal actual low supply.
The bad news: Perceived low supply is very common, and (in addition to the fact that worrying is no fun) perceived low supply can cause low supply!
How can perceived low milk supply cause actual low supply?
When moms believe their supply is low, the way they feed changes… and how we feed has a strong influence on milk production. For example, moms might introduce supplemental formula if they perceive baby to be dissatisfied or hungry after nursing, or if baby is nursing more often than they expected or is waking frequently at night. It’s easy to assume that low supply is the cause of these things if we aren’t familiar with normal breastfeeding behaviors (especially when formula-feeding culture perpetuates unrealistic expectations for breastfed babies). Feeding on a rigid schedule, sleep training a young baby, or otherwise altering baby’s feeding routine can impact milk supply very easily, so understanding the nuts and bolts of milk production, baby behavior and growth patterns is important. All of the conflicting advice we receive from family, pediatricians and friends is confusing! Knowing how to tell when things are going well gives parents confidence to keep going through the ups and downs. Since perceived low supply is not a physical issue, it is totally avoidable, as long as parents have support and access to good information.
How does milk production work?
Milk production begins as a hormonally-driven process, initiated by hormone changes at birth. Over time, it becomes a supply and demand process (meaning that, ideally, the body will adjust to make exactly what baby needs – no more, no less). The baby communicates how much it needs … by eating exactly what it needs! If it needs more, it will suckle more, sending hormonal signals to mom’s brain, which in turn tell her body to make more milk. This is one reason babies might seem to nurse around the clock during growth spurts. Not only are they trying to eat more, they are also instinctively “putting in the order”, so to speak, for more milk to be made to accommodate their increased needs!) Simply put, the more milk is removed, the more milk the body will make. Milk can be removed in a number of ways: directly feeding baby at breast, or expressing with a pump or by hand. If milk isn’t removed regularly, milk production will be altered. This is how extra pumping can increase supply, or how skipping feeds or going long stretches between pumping at work can decrease supply. This also explains why babies who struggle to transfer milk can result in decreased supply over time, even if they are at the breast a lot! (There are many reasons why a baby might struggle to transfer milk effectively. Their feedings might take a very long time, or they may fatigue easily at the breast. If you suspect this, it’s a good time to call a lactation consultant). But, compared to pumps, babies are usually more efficient at removing milk, due to the additional stimulation, warmth and eye contact inducing more milk-making hormones. Expressing milk, however, is very effective for some, and is a necessity for breastfeeding moms who work outside of the home or are separated from their babies.
For more about milk production, look for a future post all about how to maintain a good milk supply!
If you need support in the meantime, an IBCLC, Board Certified Lactation Consultant, can help answer your questions about supply and foods to support lactation, help you determine if baby is getting enough, or troubleshoot concerns even before your baby arrives!
We are pleased to present a guest blog by Shira Johnson, IBCLC .
Breastfeeding is natural, right? Well, yes… But it doesn’t always come naturally!
Just like parents educate themselves about pregnancy and birth, it’s valuable to have basic knowledge about breastfeeding before baby arrives (we don’t read up on childbirth while in labor, after all). Breastfeeding is a relationship, a complex dance between mom and baby, and many factors influence how each pair works together. Even if mom knows just what to do, it might not come as easily for baby (or vice versa!). Getting off to a good start begins at birth, and in the hours and days following. Having resources and realistic expectations can help.
Facts about Breastfeeding Education
Parents who receive prenatal breastfeeding education have more successful breastfeeding outcomes
Fears about breastfeeding? Have you heard horror stories from well-meaning friends or family members? Are you worried you’ll have to restrict your diet, worried about making enough milk, or about breastfeeding in public? You’re not alone! These unknowns and concerns are common, and they undoubtedly influence our expectations! It’s no fun to head into something feeling nervous or skeptical. Having a basic understanding and being prepared with tools and resources can set the stage for success.
Many parents who start off breastfeeding don’t meet their own breastfeeding goals. Many stop breastfeeding before 6 months, despite health guidelines (by the American Association of Pediatrics, as well as the World Health Institute) to breastfeed exclusively for 6 months, and provide breastmilk for a minimum of 1 to 2 years. Yet in 2016, only 22% of babies were exclusively breastfed for 6 months, and only 50% were still received any breastmilk at 6 months. Most parents start off breastfeeding, but many stop before these suggested guidelines.
The most commonly-reported reasons for early weaning (such as concerns about milk supply/production, pain associated with breastfeeding, and going back to work) are typically addressed in a breastfeeding class, preparing parents with information and resources to successfully troubleshoot these most common challenges and obstacles.
What’s so great about breastmilk, anyway? Most of us have heard “breast is best” and similar hype about the magical health benefits of breastmilk. Well, there’s a reason for this. New research continues to come out every year about amazing discoveries around the functions and content of breastmilk. While formula might be nutritionally complete (and is an invaluable tool, when needed), the nutrients in it are not as bioavailable (not as easy for the body to access or utilize). Also, formula does not have the amazing protective and immune functions that breastmilk has. Breastfed babies are less likely to be obese or have diabetes later in life, and breastfeeding reduces risk of cancer not just for baby but also for mom! Breastfed babies tend to get sick less often, and recover from illness more quickly than their formula-fed peers. The majority of parents who sign up for a breastfeeding class are often already planning to breastfeed, but if you’re on the fence about breastfeeding, or are concerned about whether it is worth the effort, these cool facts might inspire you. A breastfeeding class can help you weigh your baby-feeding options. There is certainly no shame in feeding your baby in any way you choose to. But having more information can help this choice be an easier one to make.
If you are a parent who plans to breastfeed or just wants more information, if you’re curious about how it all works, how to do it, whether or not it’s “for you”, how to return to work as a breastfeeding mom, or if you have any concerns, fears or simple curiosity and a desire to learn more, then a breastfeeding class is for you!