breastfeeding

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Why You Should Take a Breastfeeding Class: Podcast Episode #166

Kristin chats with Kelly Emery of Baby Beloved about why moms should take a breastfeeding class during pregnancy.  You can listen to this complete podcast episode on iTunes, SoundCloud, or wherever you find your podcasts.

Welcome.  You’re listening to Ask the Doulas, a podcast where we talk to experts from all over the country about topics related to pregnancy, birth, postpartum, and early parenting.  Let’s chat!

Kristin:  Hello, hello!  This is Kristin with Ask the Doulas, and I am so excited to chat with Kelly Emery.  Kelly teaches our breastfeeding classes at Gold Coast and our Back to Work pumping class, and she’s an RN IBCLC and has so many certifications and degrees including the fact that Kelly was a former doula before doulas were even really a thing.  So welcome, Kelly!

Kelly:  Thank you, Kristin.  It’s great to be here.  I’m happy to be on your podcast.

Kristin:  I would love for you to give our listeners a bit of a glimpse of your background.  As I mentioned, you have so many different degrees and trainings and you have so much experience.  You were helpful with my own children.  I’d love to learn more about you.

Kelly:  Yeah, sure.  It all happened way back – well, I went to college, actually, to be a teacher, and then a psychologist.  I wasn’t quite sure, so I got both certifications.  But during my graduate school when I was wanting to learn to be a therapist, I got pregnant, and that was way back in 1990.  And then all of life changed.  My focus changed, and I can’t even explain it to anybody, but I just fell in love with the whole birth and breastfeeding world.  It just took my world in a different direction.  And then I became – I did some certification for being a – it’s called a lactation educator, a certified lactation educator back then was the certification in 1994.  And then to become a doula around that same time, like you said.  So got some really good experience helping moms just in my role as a doula, and that grew and grew and grew.  It just keep snowballing, and I’m like, okay, I’m not going to be a psychologist.  I’m not going to be a teacher.  This is what I want to do.  Fast forward a bit, and I decided I needed to go to nursing school.  I wanted to learn more about how the body works and how the breasts work and how everything just kind of fits together and just how amazing our bodies are, actually, just really pulled me forward into that.  So I got a nursing degree, and then I started working – well, I’ve always been doing home visits, but then I started doing hospital work, which was an eye opener, and it was really great to see babies just right after they’re born and what happens in the hospital, and it just progressed.  I started a little boutique where I sold breastfeeding – I saw patients in my office, but I also sold, like, pumps and bras and all the breastfeeding gear.

Kristin:  Yeah, and I taught my first class in your space.

Kelly:  That was such a lovely time.

Kristin:  Yes, it was!

Kelly:  While it lasted, it was so great because we had so many classes and just people coming in and just lonely moms wandering in just wanting to get out of the house, you know.  We had a support group in there, and it was the best.  But unfortunately, 2008, and I just financially couldn’t keep it going.  It was a bad recession time.  So the boutique ended, but I still have – still kept doing Baby Beloved, which is my business, where I do home visits and office visits.  I do telehealth, and then I also go to six different pediatric offices and I subcontract with them.  So I’m all over the city, usually at least five, sometimes six days a week.

Kristin:  Yeah, you are busy, that is for sure.  And you’ve been an educator both in hospital and classroom for quite some time, as you mentioned?

Kelly:  Yeah, back from in the ’90s on, I’ve been teaching breastfeeding classes and just ventured out, you know, doing more of that via Zoom because of COVID and getting my online class going, too.  But I actually also a few years back got my master’s degree in nursing education.  So it was a really good adjunct to that to help me understand better how people learn and just different techniques for educating people about their bodies and their health and all of that.  So yeah, I have lots of little initials behind my name.

Kristin:  Yes, you sure do!

Kelly:  But long story short, I love teaching, and it’s a great – I mean, I teach even when I’m one on one with a person, but in a group, it’s a different dynamic, and it’s super fun.

Kristin:  Agreed.  And yes, with the pandemic, we had to shift all of our Saturday Series to virtual for a bit, and luckily we’ve been back to in person since the spring, and that has been so much better as far as being able to really, yeah, interact and attune to each couple’s needs.  But tell us a bit about your breastfeeding class and why it is important for couples who want to breastfeed to get educated before they have their baby or babies.

Kelly:  It’s something that a lot of people just bypass.  They don’t – not a lot of people take a breastfeeding class, and they wish they had later, you know, when I’m in their living room helping them breastfeed, they’re like, oh, nobody told me this, and oh, I wish all of those things.  But they focus a lot of childbirth education, which is very important, as well, but labor’s going to be over, you know, hopefully within 24 hours.  You know, labor is going to be over, and it’s a wild ride getting there, but in the end, you have your baby, and there you go.  But breastfeeding goes on and on for as long – however many weeks, months, years you want to do it.  It’s a daily thing, sometimes 8 to 12 times a day.  So it’s something that’s going to take up a major part of your day and lots of things to know.  Lots of expectations to set, and just learning how your body works but also how your baby eats, like how human mammals actually eat.  And then once you know that – like, once you know how your body works and how your baby works, then you can blend it together to make, like, a unique breastfeeding relationship for yourself within your family unit.  Everybody has competing things.  Like, I’ve got to go back to work in this many weeks or months, or I have my mother-in-law living with me and she had dementia, or I have six other kids.  There’s so many things that weigh into the decision of even whether you want to breastfeed.  But the more you know, the more you can tweak it to personalize it however you want it to be.

Kristin:  Exactly.  And your class is definitely recommended for partners, as well as the birthing person.

Kelly:  Yes.  That’s the first slide in my PowerPoint is a picture of the dad holding baby or a partner.  You know, whoever is going to be your person who’s going to be with you at 2:00 a.m. and who’s going to hold your hand through all of this, that person would ideally be in the class, as well.  And I know sometimes, especially guys if they’re there, they feel a little awkward being there, but I will tell you, I will not make it awkward for you, and a lot of what I have to say is directed at the support people because research has shown over and over again when we look at research about what makes breastfeeding successful and what helps a person meet their breastfeeding goals, it’s always the support person, the partner that’s there.  It’s not the lactation consultant.  I mean, I play a small part, as does your pediatrician and all the other people in your life, but far and away, it always rises to the top that that one person who is so influential in the breastfeeding rates and how they turn out is the partner.  So they play no small part in this, and I totally encourage everybody to come and bring your cheerleader.  Like, bring whoever’s going to be with you there at 2:00 a.m.

Kristin:  Yes.  And I know you touch on other feeding methods in the course, but you also have a specific class on back to work pumping for those clients who wish to pump later or, you know, some students have the plan to start out pumping for multiple reasons.

Kelly:  Sure.  Yeah, there are some people who don’t want the baby at the breast.  They want to lactate and they want to pump it and then feed it by bottle.  So I go over all of those in my class.  The last section of my class is dedicated a lot to going back to work or pumping and how can the partner introduce a bottle without it interfering with breastfeeding.  How do we manage both, if mom wants to do both?  A little bit of breast, a little bit of bottle; how can we set that up for success?  So yes, definitely, we do some of that in the last part of the class, but if you wanted a deeper dive into it, like it’s a three-hour class on back to work that goes through a lot more stuff.  Plus during the back to work, it’s a lot about pumping.  How to choose a pump, how to maintain your milk supply, are there any foods or what’s up with that, is there anything that helps it.  And then how do you talk to your employer?  There’s so much rich content in there.  If you did the breastfeeding and back to work class, you’d be there for six hours with me, so that’s a little long to sit for a class, so the back to work, that working and pumping class, is separate.  You have access to it for two years so you can always go back to it nine months later and say, what did she say about freezing this or blah, blah, blah, whatever.  So that’s kind of a nice option.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Kristin:  That’s amazing.  And then your breastfeeding class is part of our Saturday Series.  We offer that in our office in Eastown every two months.  And then for those students who can’t make that date on a Saturday afternoon, then you do have recorded self-paced options for the breastfeeding class that you can register for off of the Gold Coast Doulas website, as well as the back to work pumping, also, is a recorded version, correct?

Kelly:  Yes, that’s right.

Kristin:  And then with Saturday Series, the beauty is you can register for all three, the comfort measures, the breastfeeding, the newborn, or just pick ala carte what you want.  So if you’re only interesting in the breastfeeding class, then you can select that option.  And then as far as just getting into the differences, you did describe your class beautifully, but having attended it and gotten so much wisdom from your series, I’d love for you to talk about the difference between your class and a hospital breastfeeding class.

Kelly:  Yeah, sure.  I used to, a few years back, I used to teach a hospital class, and when I did it, I was representing the hospital, so I had to use their – it was like a prepackaged PowerPoint, basically, that they bought from a company.  So it was pretty basic, and it was good information, but it was pretty basic.  And because I have so much experience as a lactation consultant, I also peppered it, you know, with my own real life experiences and case studies and stuff like that, which kind of made it more fun and interesting.  But my PowerPoint, which is, for my own business, I have total control over creating that.  So mine is not so cookie cutter.  It’s very individually curated to what I see the most things that cause hiccups in breastfeeding in just all the patients that I’ve seen since 1994.  So I know what are the biggest hurdles that moms need to know about.  What are some ways – just basically boiling it down to, what does she really need to know?  What’s going to be important?  And I can tell her this and this, but she’s not going to remember it, so how do I bring a story to it so if this does happen, she can remember that story and then remember the concept better.  And I have lots of pictures.  Tons of pictures, which I think the more modes of learning, the better.  You know, when you can see it in motion.  So I have lots of videos, too, of moms breastfeeding.  And then the other thing, especially for the pump part, I bring in my pump, and we get to play with all these pumps and all these things like nipple shields, all these stuff.  I pass them around, so tactilely, they get to touch it and play with breast shields and see how they’re different sizes.  There are different sizes when you pump, so we can kind of look at all of it.  So that’s different, I think from the hospital one, and it’s fun, too.  I like to make it interactive, especially in a group class.  There’s just some cool dynamics when you get people together who are in the same stage of life, and it’s not like in a big auditorium where there’s 100 people in there and you don’t really feel like you can raise your hand.  These are smaller group classes where you can have a conversation, and I think where conversations happen, that’s where the richness is, and that’s how we understand concepts better, like when we talk it through.  Plus the camaraderie.  The other people all in the room, they’re in the same boat, and they’re just starting out, too.  So it’s really good to know that you’re not alone and you’re not dumb for not knowing this stuff.  It’s just you’ve never done it before.  You’re a rookie.  So it’s very normalized to be able to take in all this information.

Kristin:  And I recall from registering students that it’s not always first time parents who take your classes.  Some people didn’t have success breastfeeding with other babies and then really want to get that education and set themselves up for success this time around.

Kelly:  Yeah, and those are so good to have in class because they – when they talk, the others really perk up and listen because they want to hear it.  I mean, you can always hear it from a lactation consultant, but hearing it from another person who’s already been in the trenches and coming back with real talk about it, it’s very powerful to hear a real person’s story.

Kristin:  Agreed.  And again, just accommodating to different learning styles.  I loved the interaction and the way you demonstrated different breastfeeding positions and talked a lot about latch and supply.  That’s always a big concern for doula clients is, am I going to produce enough milk.

Kelly:  I know, it’s a big – I mean, most people do, but I’ll be honest, there are some people who struggle, and it’s through nothing wrong that they’ve done, but sometimes that happens.  So we also go over – you know, I’m honest about that, as well, to say there is a small amount of people who – with certain medical issues, usually, and I talk about those in my class, that if you have any of these medical issues, it’s great to get support right away to set yourself up for success, especially during those first two weeks of breastfeeding when supply is established.  The more you know, the better prepared you’ll be, and you can get support lined up ASAP.

Kristin:  Exactly.  And I love also the option with the recorded class that people can take your class from anywhere in the country or world.  With our Becoming students, they’re able to register for your virtual options, and they could live in New York or Seattle.  That is also amazing.  And you do – even though these are some recorded versions, you do offer Q&A calls, correct?

Kelly:  I do, yeah.  Like, once a month.  It’s the first Wednesday of the month in the evening.  There’s a free Q&A for anyone who’s pregnant, so they can come and ask me anything, and it’s free, and the last one that I did, I had someone who just wanted to jump on to see if she jived with me, you know.  Is this someone I want to be taking a class with?  So that was cool.  You don’t want to spend your time and money with someone who’s values you don’t – you know, you want to be able to know that you can talk to them and you’re going to gel with them.  So that was really good.  So anyone who just wants to get to know me better or has a burning question.  Maybe there’s something on your mind.  Maybe you did take a class already, but you still have questions.  Anyone can register for that on my website.

Kristin:  That’s great.  So any final tips for the listeners or our students?

Kelly:  No, I just really encourage you to think about taking a class because once your baby comes, it’s go time, and there’s not going to be a lot of time to sit down and read books and take three-hour classes after the baby’s born.  Now is the time to soak up as much as you can, and having four ears there is better than two because sometimes you may hear something and then your partner hears it a little differently, or it just hits differently, and then they can remind you later.  I’ve had that happen a lot where someone who’s taken my class and then later has hired me to be their lactation consultant, the dad comes in and says, yeah, remember, she said to do this, blah, blah, blah.

Kristin:  Right, they remember.  I know my husband did.

Kelly:  They do.  They really do.  They’re listening with a different set of ears.  So it’s good.

Kristin:  Totally.  So Kelly, you mentioned price before, so our course, the breastfeeding as part of Saturday Series, is $85.  Each class in our series is $85, so whether it’s an in person or virtual, that is $85, and we do accept health savings and flex spending.  And Kelly, your back to work pumping class is how much?

Kelly:  It’s $49, and that’s access for two years.

Kristin:  Awesome.  Well, thank you so much, and feel free to share your personal contact info with our listeners, and of course, you can find any of the class information on the Gold Coast Doulas website.

Kelly:  You can find me on my website, and that’s the best way to contact me, through the contact page.

Kristin:  And I know you’re on Instagram and Facebook and other areas.

Kelly:  Oh, yes.  Absolutely.  Thank you for that.

Kristin:  Well, it was lovely to chat with you.  Thank you so much for sharing all of your wisdom with our listeners, and I hope they’ll all be seeing you soon in either the in person or recorded class.

Kelly:  Me, too!  Thank you so much, Kristin.

Thanks for listening to Gold Coast Doulas.  Follow us on Instagram, Facebook, and YouTube.  If you like this podcast, please subscribe and give us a five-star review.  Thank you!  Remember, these moments are golden.

 

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Dr Katie Swanson headshot

Breastfeeding and Tongue Ties

Breastfeeding is Hard Enough…

If you are struggling with breastfeeding or experiencing pain when nursing, there may be a reason. It is not normal to experience pain when nursing and may be a sign of oral restrictions such as lip, tongue, and buccal (cheek) ties that can impact a baby’s ability to breastfeed. Lip, tongue, and buccal ties are bands of connective tissue in the mouth called frenums that are normal structures but when too restrictive, inhibit proper functional movement of the tongue, jaws, and lip muscles leading to pain when nursing and many other issues.

Not every mother will experience pain when nursing if their child has oral restrictions. Sometimes a strong let down can mask the issue since the baby doesn’t have to work as hard to engage with the nipple to feed. However, over time this can lead to a reduction in your milk supply if your baby is not sucking effectively and providing the neurological/hormonal feedback necessary for your supply to stay up.

Your baby will often show physical signs of oral restrictions, including:

– Poor weight gain

– Spits up, vomits frequently

– Makes clicking sounds when nursing

– Shallow latch, difficulty staying latched

– Excessive gag reflex

– Frequently falls asleep nursing

– Very long, frequent feedings

– Gassiness, constipation, or difficulty with bowel movements

– Blistering/callousing of the lips

– A high arched palate

– Open mouth when sleeping

– Diagnosed with colic

All of these are signs and symptoms that are associated with oral restrictions that prevent your baby from creating a deep, comfortable latch. A tongue tie restricts elevation of the tongue to the palate and peristaltic, wave-like motions of the tongue necessary for proper suction of the nipple to the soft palate. Lip and buccal ties restrict lip and jaw movement necessary for a wide mouth opening to bring in and create a good seal around the nipple. You may notice your baby has a small mouth, lip blistering, and trouble flaring the upper lip when lip and buccal ties are present. Without the proper suction and seal of the nipple, babies end up breathing in a lot of air causing excessive spit up, gassiness, pain, and colicky behavior.

A lip, tongue, or buccal tie can contribute to issues later in life if left untreated. Children may have trouble eating solids, issues with speech development, increased risk of dental cavities, and problems with jaw growth. Children with tongue ties have narrow palates from the tongue’s restricted ability to elevate to the roof of the mouth, in turn, a narrow airway contributing to the development of sleep apnea.

A procedure called a frenectomy can be done to remove the extra tissue causing the restricted frenum and create more functional movement to allow your baby to latch and nurse effectively. This procedure is done safely in office using a soft tissue laser that gently vaporizes and cauterizes the tissue versus cutting the tissue, reducing post-operative discomfort for your baby.

A heed of caution if your baby had their tongue tie clipped at the hospital or shortly after birth. There is often remaining tissue that is still restricting tongue movement and preventing your baby from creating a deep, comfortable latch. A consultation with a specially trained pediatric dentist may be helpful if you are still experiencing issues nursing.

There is a lot of training beyond a pediatric residency necessary to understand how to diagnose and treat a tongue tie and other oral restrictions. Many providers are not as familiar with how to diagnose the varying types of tongue ties that exist, including anterior and posterior tongue ties, so they often go undiagnosed, especially if a baby is gaining weight appropriately. If you or your baby are showing any signs of having oral restrictions, I strongly recommend consulting with a pediatric dentist specially trained in the diagnosis and treatment of lip, tongue, and buccal ties.

Breastfeeding is hard enough. You and your baby do not need to suffer through the pain and stress oral restrictions can cause. My best advice is to find providers who will listen to your concerns and help you find answers.

Written by Dr. Katie Swanson, Pediatric Dental Specialists of West Michigan
University of Pennsylvania/Children’s Hospital of Philadelphia

 

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Gold Coast Doulas Saturday Series: Comfort Measures for Labor, Breastfeeding, and Newborn Survival Classes. goldcoastdoulas.com/events

Saturday Series of Classes: Podcast Episode #102

Kristin Revere, Kelly Emery, and Alyssa Veneklase talk about their Saturday Series of classes offered through Gold Coast Doulas.  Each goes in to detail about what their classes cover including Comfort Measures for Labor, Breastfeeding, and Newborn Survival.  You can listen to this complete podcast episode on iTunes or SoundCloud.

 

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I am Kristin, and I’m here today with Alyssa and Kelly, and the three of us teach our Saturday Series of classes.  So we’re going to talk about what each of our classes are and a bit about what we’re doing during COVID.  So welcome, Kelly, and welcome, Alyssa.

Kelly: Thank you.

Alyssa:  Hey.  So, yeah, we could kind of talk first about why we — so we used to teach all of our classes separately and have different days and different times, but then we had clients who were taking a breastfeeding class and my newborn class, and they would be on separate days, separate times, and we know how hard it is for people to coordinate their schedules.  So doing them all at once in a series on Saturday, and then Kristin adding on her comfort measures — you know, having three classes — it’s hard to find three nights in a week that either a pregnant person or a couple can both get off to take these classes.

Kristin:  Right, and some of our clients work nights, and if they have other children at home, childcare has been easier to find on a Saturday than a weeknight.  So that’s part of why we adapted to this format, and it’s also helpful that the Saturday Series is ala cart, so a client or student could sign up for just Kelly’s breastfeeding class or, you know, just the newborn class or all three.  Or they can take them at different times, since we offer the classes every couple months.  A client could take a class in September and then down the road later in the year take breastfeeding, for example, as it gets closer to their due date.

Alyssa:  And for the students who do choose all three and do them on the same date, it can definitely be a long day.  When we were doing the classes in person, we had a lunch break and then another break in between.  But the feedback we’ve gotten so far is that people really like knocking these out one after another.  And then because of COVID, they’ve been virtual, so that’s actually been kind of nice.  They don’t have to leave their sofa.  They can feel a little bit more relaxed, grab snacks.  So that’s worked out well, too.  But our next series is in September, and we plan on doing it in person for the first time since COVID, but that could change at any minute, depending on…

Kristin:  Right.  And our office is in Eastown, and we’ve talked about having a smaller class size and how we’re going to pivot due to COVID and all of, you know, the sanitation that will need to be done.  But our Zoom classes have been going well.  I wasn’t so sure about the fact that Comfort Measures is so hands-on, how that would work virtually, but the students seem to enjoy it, and they were hands-on as I instructed virtually.  So it went over pretty well the first time.

Alyssa:  Same with breastfeeding.  How does that — you know, you had said, Kelly, that it was going well virtually, but were you a little bit nervous at first about, you know, like, how do you show a position and, you know, what a proper latch might look like, through a computer?

Kelly:  Yeah.  Yeah, that was something — speaking of pivoting, we had to do pretty quickly because people were still having babies and they’re still learning to breastfeed.  That is not something in life that can just stop.  So, yeah, getting up and going on the Zoom and all the technology was rapid, and it was — it’s pretty slick.  You know, what I do is just like in the in-person classes, I show videos, and so I can share my screen.  I show videos, clips of things that — it will make more sense when they actually have their baby, but I think instead of me just talking about it, showing a visual and the videos and all of the pictures that I have.  I have just a slew of pictures over my 20-some years of doing this, so it’s able — the people are able to really see what I’m talking about better when I share my screen.  So it’s all actually working out, and the parents love it.  And, you know, they love being together in a class together, but also I’ve gotten great feedback about the Zoom classes, that they love that they can just sit on their own couch in their pajamas and eat dinner, you know, or eat a meal and have Dad be right there with them, as well.  So it’s all working out.

Alyssa:  Well, Kristin, do you want to talk about — so the series kind of starts with the Comfort Measures.  Then it’s Breastfeeding, and then Newborn Survival.  So you want to maybe in that order talk about each of our classes and what they’re about?

Kristin:  Yes.  So Comfort Measures is a hands-on class that the couple is encouraged to attend, but certainly I’ve had the birthing person attend without a partner, as well.  And so we go over breathing, relaxation, and it definitely doesn’t replace a traditional comprehensive childbirth class.  I’m not going to cover the stages of labor in two hours.  But it’s more about different positions that will relieve discomfort, both while they’re at home, if they’re birthing in the hospital, in the early stages of labor, or positions to utilize further along in labor in the active stage as well as the pushing stage.  And we do cover breathing, as well.

Alyssa:  So is it more to have the partner understand what’s going on and allow the partner to offer these comfort measures?

Kristin:  The partner does learn how to do some of the different measures.  Hands-on massage, light touch massage is covered.  We go over hip squeezes and a lot of the doula tools, just a variety of positions, like hands and knees and leaning up against a wall and dancing, sort of rocking in labor, as well as, you know, using the birthing ball.  And then we talk about different positions that they could consider pushing in, like squatting and sidelying.  And I answer questions, and there are some handouts that they use to just get a comfort level for where the partner and the birthing person are at as far as what their expectations of birth are and how comfortable they are supporting a partner.  So there’s a lot of communication in the short class, as well.

Alyssa:  And Kelly, what about your class?

Kelly:  It’s called Breastfeeding: Getting a Strong Start, and it’s a lot about — my goal, anyway, is to get the mom and her partner comfortable and feeling confident about at least starting out.  You know, I think it’s sometimes overwhelming.  It is a three-hour class, so it is a long time, and a lot of content is covered, but my goal is not to, like, overwhelm the parents with, like, what to do over the next, like, two years of breastfeeding or whatever, like that.  Because I think people in this moment when you’re pregnant, especially, you can take little chunks of information that are going to be relevant to you in the moment.  And so just getting off to a strong start, at least to get you through those first early days and weeks, you know, of breastfeeding, and then let you exhale a little bit and kind of find your answers as they are relevant to you is something that I’ve found over the years of doing this, honing, about what moms really want to know and what they need to know in the beginning.  So I might go over — I’m a really strong proponent of going over anatomy in the beginning, just because I think if moms know how their breasts work and how their babies work, they can figure out — they can put a lot of these dots together and make it make sense for them in their situation.  So, for instance, one of the first things I talk about in anatomy is, like, in our middle school health ed class, we skipped right over the breasts, I’m quite sure.  You know, they talk about your periods and, you know, maybe some birth control.  I don’t know.  I don’t even remember what they all talked about.  But I don’t remember talking about lactation or anything about the breasts other than that they get bigger, and then you wear a bra.  That’s about it.  And so I’m like, wait, wait, wait.  This is an incredible two glands we have here that sustain life.  They have so much to do and so much to contribute, and they’re kind of a natural next stage of being pregnant is lactating.  So it’s kind of all jumbled up together there, and I feel like in our society we kind of — as women, we’ve kind of not learned a lot about our breasts.  So I talk about what’s happening while we’re pregnant, what happens in the first couple days after delivery, and then how lactation and how their breasts change and make milk and all these other wonderful things that they do in the days and weeks, you know, after delivery.  Yeah.  So I’m big on helping women know about their bodies and then seeing how it works, and then I think it’s less of a mystery when things unfold because we just — you’re like, oh, yeah, we talked about.  That’s what I’m supposed to be doing, or that’s what my breasts are supposed to be doing.  Those little bumps on my areola, they mean something and they do play a role.

Alyssa:  What do those mean?

Kelly:  Those are your Montgomery glands, and they enlarge, you know, when you’re pregnant.  They secrete a couple things.  One is — it’s almost like a self-cleaning oven.  One is that they secrete the substance that kind of — it’s an antimicrobial, so kills bacteria.  It kind of keeps your nipples clean and your areola clean so you don’t have to scrub them.  A long time ago, like back in the ’50s, we used to think you had to scrub your nipples, and believe it or not, we would put alcohol on them before the baby would — like, we would sterilize your nipples, like we did with bottle nipples, before we would put the baby on you.  Just ridiculous.  And come to find out, you know, Mother Nature’s already taken care of that with those Montgomery glands.  Another thing that they do is they secrete — it’s an exocrine gland, which means it excretes something, you know, kind of like a sweat gland.  So they also secrete something that kind of keeps your nipple from drying out.  Keeps it kind of supple and moist.

Alyssa:  Kind of lubricated a little bit?

Kelly:  Yeah.  So all of those things — and one of the reasons I mention that is when moms think, oh, I have to buy some lanolin or some nipple ointment, those things are fine if you want to use them, but just use them just on your nipple.  You don’t have to smear it all over your areola because they can — if you smear up too much, they can block off those Montgomery glands, and then they can’t do their job.  So that’s one of the first things I talk about because it’s one of the most visible things you see when you get pregnant is your areola gets the little bumps on them, and then they darken and, you know, all of these things happening.  And then the next thing, the other part, huge part of the class, is getting the partner involved.  The baby’s other parent is going to be a huge part of breastfeeding, and I go over the research of how statistically, whether breastfeeding works or not has a lot to do with the mother’s partner and the worth that they feel and that togetherness.  And I joke that, you know, they’re going to be with you at 2:00 a.m., not me, and they’re the ones who know what motivationally you need to hear in the moment.  You know, what gets you — what makes you feel better.  What kind of cookies do you like?  What do you need in that moment?  And the partner is more tuned into that than I am, of course, you know.  So I can give some technical advice if I’m working with you postpartum to help with breastfeeding, but the partner is going to be there to be the other really important team member, and so that’s why I super, super encourage them to come to the class.  The in-person class or the Zoom class, any kind of class, so there’s four ears listening to all of this and not just two.  For the mom to have to listen to it and then go back and regurgitate it all, you know, it’s another burned on her, and she may forget things.  And I spend a lot of the time giving advice about what dads and partners can do to be helpful because I think they feel like they’re on the sidelines and they can’t be a part of breastfeeding.  And so I totally dispel that, and I give them lots of things, you know, concrete things that they can do that can be very helpful to breastfeeding.

Alyssa:  I know that everyone who’s taken your class has told me they love it.  They think you’re just so knowledgeable, and they had no idea about all these things, and they definitely go into it feeling more confident.

Kelly:  Awesome.  That’s my goal.

Alyssa:  Was there anything else you wanted to say about your class?

Kelly:  Well, I just want to say that I love being part of this entire series because knowing that I’m part of blending it together, like the big picture — like, the labor feeds into the breastfeeding.  The breastfeeding really ties closely with the newborn survival.  They’re all so well-interwoven that I think it’s great for the parents to have all of this information at once or, you know, dole it out as they need to, but just to have all of the information because then they get a sense of the bigger picture, I think.  It just makes total sense when all of these are taken together.  So I’m happy to be a part of this series, for sure.

Alyssa:  We’re happy you are a part!

Kristin:  So at what stage in pregnancy would you suggest someone take your breastfeeding class?  And I’ll also ask the same question of Alyssa and then answer that myself.

Kelly:  I would say the seventh month.  I wouldn’t wait to the last month because there’s a lot going on, you might go early, blah-blah-blah.  But, you know, you can take it in your ninth month, for sure.  But, yeah, I would say the third trimester would be good, start of the third trimester.

Kristin: Alyssa?  What would you say for Newborn Survival?

Alyssa:  You know, I would say third trimester, too, just so that this all is fresh in their heads.  The only problem is waiting that long, we do go over some items that are — you know, like baby registry items.  And by that point, usually they’ve already registered or had baby showers and gotten everything.  So that makes that a little bit irrelevant.  We still go over it, and I tell them, you know, keep things in packages with tags on.  If you don’t use them, you can always return them.  So we still go over it, but I think to do it any earlier, you’d kind of forget all of the stuff we’ve gone over.

Kristin:  I would say ideally the third trimester, though I’ve had students take it in the second trimester and still retain the information and practice the hands-on techniques that they learn.  A lot of my students also have doulas within Gold Coast or are working with me directly, so, of course, the doula is a great reminder of the different positions and comfort measures for labor and also some of the relaxation techniques that we learn.  And, certainly, you know, as far as who should take the class, we are also quite different from other childbirth education classes in that many are suited — just like Bradley method, for example, just for one type of birth.  Like, for those seeking an unmedicated birth.  For Comfort Measures, I have clients who want an epidural as soon as they get to the hospital or, you know, are having a home birth or are seeking an unmedicated hospital birth, so a variety of situations.  And, Kelly, I know that you have students who want to pump, and you do, of course, have the pumping class, the back to work pumping.  But it’s not for one type of parent or birthing person.  I know, Alyssa, you have everyone from attachment parents taking your newborn class to those who are more mainstream in parenting style.

Alyssa:  Yeah.  You kind of have to be open to all of the options and all of the parenting styles.  I would say, you know, for yours, it’s important.  Kelly, you know they’re going to breastfeed if they’re taking your class, or at least going to attempt it.  And I don’t know in my class, so I go over if they’re not breastfeeding.  We’ll go over bottle feeding.  Maybe they want to just pump exclusively and bottle feed.  I go over it very briefly.  Sometimes I can completely skip it because they’ve also taken your class, Kelly, and I don’t need to go over anything.

Kelly:  I think with my breastfeeding class, you’re right, there are some moms who just want to pump and bottle feed, and we do go over working and bottle feeding and how to combine all of that, for sure.  But even the part about the anatomy that I was telling you about, it’s good for the moms to know the anatomy of how, also, to maximize that with a pump, because there are ways — the ways that some of our hormones work with a baby, trying to also trigger those with a pump takes a little bit of knowledge, you know, and a little bit of practice.  So even if you’re not going to breastfeed, knowing about your breasts and how they work would benefit you even if you’re going to be pumping, because then you can work with a pump to work with your anatomy and how all of the pumping and maintaining your milk supply goes together.

Alyssa:  I feel like I should sit through your class.  I haven’t sat through yours, and I always love having a refresher on breastfeeding because when I’m working with sleep clients, we talk about feeding a lot.  So I feel like I should put the next September Series class on my calendar to sit in yours.

Kelly:  I know, and I should — I want to learn more about your sleeping, too, because that’s a big question when it comes around to breastfeeding.  They are so intricately tied together.

Alyssa:  So my Newborn Survival class, I started or I created because, you know, working as a postpartum doula — I don’t anymore, but when I did, you start hearing the same questions and same concerns from the parents over and over.  If only someone had told me this!  Why didn’t I know that?  How come nobody told me that this would happen?  When you start hearing the same things over, then I’m like, yeah, I had these same concerns and questions and fears when I was a new mom, too.  So I just kind of started compiling all these things and talking to experts and put this Newborn Survival class together, and it has real-life scenarios.  Like, things that happened to me, things that happened, you know, in my work, and how do we deal with these?  And then it’s very — you know, we do talk about, hey, has anyone changed a diaper?  If they haven’t, we’ll show them.  But that’s probably the most surface level type stuff.  I want to get into, hey, babies cry.  There’s no way around it.  How do we minimize that?  What do we check for?  And how do you communicate?  Like, you and your baby are a team, and from a very, very young age, they are communicating with you, and you need to figure that out.  So just giving them really pragmatic steps to — you know, the first few weeks, your baby’s just going to eat, sleep, poop, pee.  That’s about it.  But once, you know, six weeks rolls around, there’s kind of this schedule forming.  You probably have a pretty good idea of when they want to eat.  Maybe you start to see some sleep patterns forming by six to nine weeks.  And then if they’re crying, what does that mean?  What causes that crying?  How do we stop that crying?  What happened when the crying started?  And then talking a lot about feeding.  People usually want to ask me a lot of sleep questions, even though this isn’t a sleep class.  We go over sleep.  But a lot of it’s, well, you know, if my baby’s not sleeping well, do I just let them cry?  Never, never, never is my answer; never.  No.  We don’t just let them cry.  But if they’re not eating enough, no amount of letting your baby sit in that crib will do any good because they’re hungry.  So we talk a lot about feeding, whether it’s breastfeeding or bottle feeding.  And then we go over things like, you know, common skin issues.  Like, everyone always gets weirded out by cradle cap and baby acne and maybe some rashes, diaper rash.  And then like I mentioned, we go over some things that are not worth spending your money on.  Here’s some things you really need.  And then talking, too, about the partners keeping communication open and setting goals and expectations for each other ahead of time, because once that baby comes, you don’t have the time or mental wherewithal to be dealing with that in the moment at 3:00 in the morning.  So if you have these expectations set ahead of time, it’s really important.  And then obviously talking about, you know, letting them know that there are resources available.  They don’t have to go through this alone.  There are — you know, Kelly’s a lactation consultant.  She can do an in-person or a Zoom visit.  We have postpartum doulas who work day and night.  All these resources are available to them.  And then we go over a lot of soothing methods.  I show them my swaddling methods.  And we talk about bathing, too.  Bathing is a big one for parents that they’re usually kind of freaked out about.  But yeah, it’s just kind of how to survive those first few weeks or months home with a new baby because it’s a little bit scary when you walk through that door for the first time holding a human that you have to keep alive.

Kristin:  Great summary!  So let’s talk a little bit about — again, we mentioned breaks within the format and a little bit of the timing structure of each class.  So the Saturday Series usually starts off with my Comfort Measures class.  We have switched our schedule a few times, but my class is two hours from 9:00 to 11:00, and then there is a lunch break.  And then we get into Kelly’s class.  And, Kelly, you mentioned your class is three hours.  And then there’s a short break, and then Alyssa has an hour and a half for Newborn Survival.

Alyssa:  Yeah.  I think there’s a half an hour break to grab a snack, go to the bathroom.

Kristin:  Right.  And then as far as the fee for the class — again, the classes are a la carte so you could purchase one class or all three, and each class is $75.  And traditional insurance does not cover the Saturday Series, but if a student has a health savings or flex spending, most plans do cover childbirth classes.

Kelly:  And I would add, Kristin, on the same for breastfeeding classes.  As part of the Affordable Care Act, breastfeeding support and supplies and education should be covered, and I provide a superbill for my class as well with all of my codes and my tax ID number and everything that they would need to self-submit.

Kristin:  Fantastic.  And, Kelly, did you want to touch on your pumping class that’s separate from the Saturday Series?

Kelly:  Yeah.  I have a class for moms who want to go deeper into just the pumping.  During my Saturday Series, I will go over some pumping and working and everything, but to dive deeper into that of what that looks like on a professional level and an emotional level, like leaving your baby, what that’s like, and if I have to travel, and how do I maintain a milk supply and what if my milk supply goes low?  Lots of little details swirling around.  If you’re still having, you know, after this class, if you’re still having questions about that, or if you want to skip over the whole breastfeeding class and just do the pumping and working one, I have a class, and you can just go to my website and you’ll see.  It’s called Work Pump Balance, and it’s an almost-three hour class in and of itself.  It’s self-paced modules that you can go through, and it’s myself and then a — my friend Mita, and she pumped for a year for both of her kids and worked full time.  She had a very demanding career in a very male-dominated industry, and she made it work.  She gives a lot of insight about how — you know, a lot of the laws have changed since she’s done it, so that only benefits moms even more.  But how to logistically travel and calling clients and work around this when you’re really the only female in the whole — it’s a big company, but you’re the only female around.  So, yeah, we dive deeper into that.

Kristin:  Fantastic.  And Gold Coast also offers a private multiples class for any of our clients or students who are expecting twins or triplets.  So we do offer each of the individual Saturday Series of class privately, since our Series is offered every couple of months.  There is the option of taking just breastfeeding privately through Zoom and/or, depending on COVID, in person.  So did each of you want to — I know, Alyssa, you just recently taught a newborn class on Zoom.

Alyssa:  Yeah.  We just did a private one because they were being induced this week.  So we just did it last week.  Yeah.  It’s great.  It kind of allows the couple an opportunity to ask the questions that they might be afraid to ask in front of other people, although I feel like with my class specifically, I make it very clear that there’s no such thing as a stupid question, and I think most of the students do feel very comfortable asking anything.  But it’s just a little different when it’s just me with one couple.  They can ask whatever they want freely.  And I do get told that it’s nice for them to learn the same techniques together so that it’s not, you know, one person saying, well, I think we should do that, and I think we should do that.  You know, they can kind of take all the information I’ve given and make their own decisions from there based on what they’re comfortable with.  So I’ve been told several times that they like that they’re hearing the same information together and not different information from different people at different times.

Kristin:  That makes sense, and yeah, it is nice that if someone wants to take a class last minute or wants the individual attention.  My students have enjoyed just being able to customize the comfort measures based on what their birthing goals are.

Alyssa:  Yeah.  So if anyone wants to register, they can go to our website and register for, like we said, one, two, or all three.  We also have the Multiple class and a HypnoBirthing Series.  And you can always reach out to any of us with questions.

Kelly:  I appreciate you doing this, and I’m looking forward to the next class in September.

Kristin:  Thanks for listening to Ask the Doulas with Gold Coast Doulas.  You can find us on SoundCloud, iTunes, and on our website.  These moments are golden.

 

Saturday Series of Classes: Podcast Episode #102 Read More »

Alyssa Veneklase and Kristin Revere sit in an office while podcasting together

Coronavirus Update on Doulas: Podcast Episode #94

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.

Kristin:  Yes!  Stay well, everyone !

 

Coronavirus Update on Doulas: Podcast Episode #94 Read More »

swaddelini

The Swaddelini Swaddle: Podcast Episode #93

Liz Hilton, founder of Swaddelini, tells us about the unique process she uses to create her amazing swaddle and why her swaddle is different.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin.

Alyssa:  And I am Alyssa.

Kristin:  And we’re here today with Liz Hilton, who happens to be a birth and postpartum client of ours.  She has an amazing product to talk about.  Tell us about your swaddles and where you came up with the idea and more about how we can put it into action!

Liz:  Well, first, thank you so much for having me on your talk.  My product in Swaddelini.  It’s inspired by my firstborn son, Thomas, who was a little Houdini.  Veritable little Houdini; got out of all his swaddles and would constantly wake up from the Moro reflex.  I’m really excited about my next baby that I’m going to be having a couple weeks here because now I’m equipped with a swaddle that is easy to use and protects against the Moro reflex and is completely kick-proof and escape-proof.

Kristin:  You’ll have your own baby model!

Liz:  I know!  I’ll have my own little cute baby model!  My Instagram Swaddelini is going to blow up with pictures of my new baby.  But yeah, what’s different about it is that typically swaddles involves a lot of wrapping or cumbersome closure systems like zippers, Velcro, or God forbid, snaps.  So mine just goes on and off like a sock, and I’ve incorporated some light compression therapy into the chest area to give the sensation of a hug all night long.  So I’ve actually trademarked that as Hug Technology.

Kristin:  Love it!

Liz:  And the individual tubes help keep the arms down for the Moro reflex.  It encourages that sleep safe position of being on the back and arms at the sides.  And then when you need to change the diaper, there’s an easy access diaper flap so you can change the diaper without having to take the swaddle on and off.

Kristin:  That’s such a pain to remove the swaddle and wake the baby!

Liz:  Yeah!  And it’s also adaptable, so with any baby product, you want it to adapt because all babies are different.  Every baby is different.  Every mom is different.  So some babies like their arms out.  Now, part of the thinking behind that is so they can self-soothe when they do wake up from the Moro reflex.  The idea with the Swaddelini is that that won’t happen as often because their arms are encouraged to be down.  But if your baby insists on having their arms out, you can just leave their arms out.  You’re still going to get that Hug Technology benefit.  Probably my favorite thing is that this swaddle is easy to put on, but also doesn’t restrict motion.  That’s one thing that doctors have been telling moms is, you know, don’t swaddle your baby.  It will cause hip dysplasia.  And that’s just because some swaddles, there’s no stopping point when you’re wrapping them or pulling the Velcro.  It’s very easy to do it too tight.  Whereas with this, it’s a four-way stretch knit.  It’s soft.  It’s stretchy.  And there’s no risk in that.  And even though the baby feels hugged all over, they have freedom of movement.  So if, for example, you’re breastfeeding, the baby can, while wearing the swaddle, can kneed your breast but can’t scratch.  Same when they’re sleeping; they can touch their face, but not scratch it.  So that’s another benefit.

Kristin:  And you have different sizes, so as they grow bigger, their swaddle size is based on how many pounds the baby is?

Liz:  I’ve done it that way.  I’ve said the small is good for 6-12 pounds and the large is 12-18 pounds.  The reason I did the larger one is just because there’s that transition where your baby’s kind of rolling over their side, and you’re, like oh, my God.  Is it going to happen?  Are they going to roll over?  Am I going to wake up and my baby’s on their front?  You have all these fears.  What I say is with the larger one — or even with the smaller one, if your baby is toying with rolling over sooner before they’re out of the smaller size, just take one arm and leave it out.  And then one they’re rolling over a lot during the day, you can take both arms out.  If your baby likes to sleep with their feet out, leave the feet out.  My niece slept in her large swaddle between month 8 and 11 until she was ready to get out.  She was smaller, though.  She was a smaller baby, so that’s why she went so long.  But she just didn’t want to leave it, but it was a nice transition.

Alyssa:  And they’re made out of different things.  I’m very curious what the process is and how you make them, too.  We talked a little bit about it on the phone, but I thought it was very cool how you make these.

Liz:  Yeah.  I have two very distinct designs.  The first one I did, I made out of just a bunch of synthetic fibers that I’ve used for compression garments that I’ve made for kids with, like, CP or lymphedema.  And so that helps with the light compression at the chest.  So that part is the same.  For the rest of it, it’s a moisture-wicking nylon-polyester blend.  It feels very lightweight, but it’s actually very cozy and very soft.  You can feel that.

Alyssa:  So soft!

Liz:  Yes!  But at the end of the day, it is a synthetic fiber, right?  I learned very quickly that some moms like natural fibers.  So after much research, I found a supplier of bamboo, and they make this bamboo in a mechanical process versus chemical.  You’ve seen a lot of maybe bamboo-rayon products.  This is not that.  This is just a natural bamboo made in a nonchemical process, and I pair it with a really exciting new fiber.  I’m actually the first in the industry to license this.  It’s called 37.5 because what it does is it regulates your body temperature to put it at a perfect 37.5 degrees Celsius.  So that is why the bamboo swaddles are a little cooler to the touch.

Alyssa:  So adult swaddles will be next.

Liz:  Actually, if you go on my website to the About section and watch my videos, I have my husband in an adult swaddle.  Yeah!  I just made one for a marketing thing, and then I told my husband, hey, will you get in this so I can do a video on YouTube?  And he was, like, you’re going to put it on YouTube?  No, I’m not doing this!  And I’m like, um, I had your baby.

Alyssa:  I’m asking this one thing!

Liz:  Yeah.  So there’s now a video of him in an adult swaddle!

Alyssa:  It sounds really cozy, actually.  I think I would wear one.  I love that it’s easy.  Can you explain putting it on and how it goes on?

Liz:  You basically just scrunch it up like a sock, and then you go in feet first and you get the Hug Technology over the butt area, and then you have it over the chest.  And then you go through the easy access diaper flap.  So stick your arm through that opening at the bottom, and then go through one of the arm tubes and then grab the hand.  Put that hand in yours, and just slide it down so that the arm is in the tube.  And so now their arm can move around, but it just encourages the arm to stay down at the side.  And then you just do that on the other side.  So these arm tubes are very, very stretchy, and their hands are absolutely free to move around.  And then the top naturally curls the opposite direction from their face.  But I also had this product tested at world-class third-party laboratories, where they do a suffocation hazard test.  They literally roll my product up in a ball, put it over a fake infant face, and they measure the CO2, and mine has passed every time.

Alyssa:  That was my question.  You know, you walk in, and it’s like this.

Liz:  That is absolutely fine, and if you wanted to do a suffocation hazard test on any product that you buy, what you do is roll it up and put it against your face and breathe.  With the design, though, it does naturally curl away from the face.  So if you put your baby to sleep like this, they wake up like this.

Alyssa:  And then demonstrate poopy diaper time when you don’t want to wake the baby.

Liz:  We’ve got this flap here, and again, it’s very, very stretchy.

Kristin:  As a doula, I love that.  It’s so easy.

Alyssa:  And do you recommend just like this doll has, like a onesie underneath this?  That’s all you need?

Liz:  Definitely.

Alyssa:  The right temperature?

Liz:  Even just a diaper and socks is fine.  I get that question a lot.  It’s really what you’re comfortable with, what your baby’s comfortable with.  If they’re really tiny and maybe they’re sliding, if their arms are so small they’re sliding out, you can put a onesie, like the sleeves on it, and that friction between the fabric will keep it on.  So then you get access to the diaper.  You do the diaper.  And then you can put it right back on, and you don’t have to take it off.  And then taking it off also is very easy because you just pull it down.  It’s actually easier with a real baby.  You can do it all in one motion.  I’ve gotten that a lot where moms say, oh, I didn’t know it was going to be this easy.  That’s always good!

Kristin:  And you have different designs.  You brought some samples with you.  There’s a fun funky orange and pink and…

Liz:  It’s interesting you say that because the design is pretty much the same.  The only difference is the colors and the fibers.  The blue, pink, orange, and gray here are all in the moisture-wicking synthetic fibers, and these more neutral colors, this neural white-pearl and this cloud-gray are the bamboo.  The best-selling ones are the grays, the grays in both the synthetic and the bamboo, and then orange.  Everyone loves neutrals.  The way this is made is a really interesting process.  One of the benefits of the Swaddelini is that it’s seamless, and it’s seamless because it’s actually manufactured in one piece, in one process, using 3D knitting.  Kind of like the Nike Flyknit shoes.  It’s the same technology, and I have a machine that knits all of these in my garage.  I make them all myself.  I don’t have some manufacturer in China that I outsource this too.  So it’s very, very local.  And it’s actually my life’s work.  I’ve been a 3D knit programmer for over ten years now and working primarily in technical knitting, knitting solutions for office furniture and automotive and aerospace and stuff like that.  But when I had my first baby two and a half years ago, I had an idea to use that same process to solve my swaddling problem.  That became Swaddelini.

Alyssa:  That’s amazing!  You said there’s a couple tiny stitches you have to do yourself at the very end?

Liz:  At the very top because it’s all made with this one end of yard.  At the very top, you have to pull it through a loop and then that’s the final thing that I do.  And I sew on these cute little tags with washing information and stuff like that.

Alyssa:  Yeah, what is the washing information?

Liz:  For the synthetic fiber, I recommend cold.  It will shrink up a bit, but honestly, if that happens to you, let me know.  I can work something out with you because I don’t want someone to get it and have it shrink.  I recommend that, and then air drying it is fine.  But for the bamboo ones, I actually prewash them in a natural, unscented detergent, so they’re already preshrunk.  They won’t shrink anymore.  You can wash and dry them in heat, but I still recommend cold just for longevity.

Alyssa:  Things look better.  I wash all my stuff in cold.  They just last so much longer.

Kristin:  Thanks, Liz!  We appreciate you coming in!  How do people order or find you?

Alyssa:  Well, if you’re a Gold Coast client, you can get a discount.  But for everyone else, what’s the best way to order these?

Liz:  On my website, but if you want to learn more about my product before you buy it, I highly recommend going on my Instagram, @swaddelini, because I have a lot moms on there that have shared their videos of how they use it because every mom might use my product differently.

Kristin:  It’s great for the visual learners.

Alyssa:  I’m going to add this to my newborn class repertoire because I think some people get overwhelmed with the old-fashioned swaddle, and like you said, if you have a really strong baby, they’re popping out of this thing.  So this is a great option, and they’re super cute!

Kristin:  We will definitely check in with you after, since you’re a client of ours, and we can see how it’s working with your own baby and also hear your birth story.  We love hearing personal stories!

Liz:  Well, I’m really excited to have doula support this time because I didn’t last time, and I definitely regret it.

Alyssa:  Yeah, we can have you back in to talk about that and how it was with doulas.

Liz:  That would be awesome!

 

The Swaddelini Swaddle: Podcast Episode #93 Read More »

Kelly Wysocki-Emery

Meet our new IBCLC, Kelly Wysocki-Emery!

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.

 

Meet our new IBCLC, Kelly Wysocki-Emery! Read More »

Spectrum Health Midwives

Baby-Friendly Hospital Initiative: Podcast Episode #89

Today we speak with Katie and Becky from Spectrum Health in Grand Rapids about what it means to be a designated Baby-Friendly hospital. You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin: Welcome to Ask the Doulas with Gold Coast Doulas. I’m Kristin, co-owner, and I’ve got Alyssa here. And we’ve got special guests joining us today from Spectrum talking about the Baby-Friendly initiative. So welcome, ladies! Introduce yourselves and tell us about your background!

Becky: My name is Becky Crawford, and I’m a nurse manager at Spectrum. My background is in postpartum and labor and delivery nursing.

Katie: And I’m Katie. I’m the project specialist for women and infants at Spectrum Health. My background: I am an RN, and my background is high risk OB and postpartum nursing.

Alyssa: Awesome!

Kristin: Fantastic! Thanks for joining us! Tell us about what baby friendly means and why it’s such an intense process to go through certification. Fill us in!

Katie: The Baby-Friendly hospital initiative was actually created back in the early 90s, and it’s an international organization to promote, protect, and support breastfeeding practices. Spectrum Health Butterworth was designated Baby-Friendly initially in October of 2014, and we just went through the redesignation process and were redesignated at the end of May of this year. There are ten steps for Baby-Friendly that each support breastfeeding practices, and we can talk through some of those steps, as well. You have to be proficient in all of those ten steps to receive the designation, so you really have to show breastfeeding excellence, and it’s a really strict and rigorous process to go through.

Becky: I think overall, the way I describe it to patients is that we’ve created a culture that’s supportive of breastfeeding and of moms that want to breastfeed. So it’s not that we force anyone to breastfeed. Our goal is just to educate moms, support them, and help them be successful if that’s the option they choose.

Katie: Absolutely. As nursing professionals, part of our responsibility it to make sure that best practice and current research reaches our patients and that they’re educated on all of those best practices. Breastfeeding is best practice, but it’s also about informed choice and supporting our patients with whatever choice they make. While Baby-Friendly is primarily about breastfeeding and supporting breastfeeding, there is a formula feeding option there, and we support patients in that option, as well. It should never be about pressure. It should just be about education and informed choice.

Kristin: That is a question that I get from doula clients. If they choose, whether for medical necessity or personal choice, to formula-feed, how they can navigate the system with Baby-Friendly hospitals.

Alyssa: That’s what I was going to ask, too. Do you think that designation scares a mom who knows she doesn’t want to breastfeed? Does she think shes going to come into this hospital and you’re going to try to force it? What does that look like for a mom who doesn’t want to?

Becky: We do hear that feedback from moms that haven’t delivered with us, that they’re just nervous. Having to talk about breastfeeding, even, can be an uncomfortable conversation if they know that’s not the choice they want to make. So our approach with our staff is to educate the patient on all the options, let them choose, and then support. So it should be a one-time conversation. We’re going to talk through all your feeding options. These are the great benefits of breastfeeding. If you choose not to do it, okay. Then let’s talk about formula feeding, and we’ll focus our education there. So making sure they know their options, they understand the benefits, and then support.

Katie: And, you know, nurses educate on a lot of topics, right? It’s not just about breastfeeding. But the other topics we educate on, it’s the same sort of informed choice, right? Breastfeeding is such a personal decision. It’s such an emotionally charged topic. I think that while we need to educate our patients on breastfeeding and why it’s great, we also need to acknowledge the fact that it is a really personal choice, and it’s okay if you choose not to, as long as we’ve given you all of the information.

Kristin: And so your labor and delivery nurses, your postpartum nurses — everyone is specially trained to support the initial latch and continued breastfeeding through their stay?

Katie: Yes.

Kristin: And that’s something that we always stress as doulas is that you have support from your nurses as well as the board-certified lactation consultants who do rounds in the postpartum time.

Katie: Actually, one of the ten steps is staff education. All of our nurses receive 20 hours of dedicated breastfeeding education. Of that, 15 hours are classroom education and then 5 of those is clinical, practical breastfeeding education hours. Every one of our nurses; it’s built into orientation for any women’s nurse, so everyone from labor and delivery to postpartum gets this education. There’s also a requirement for providers, so nurse midwives as well as physicians, to receive additional breastfeeding education, as well. Per Baby-Friendly, they’re required to receive three hours of breastfeeding education.

Becky: We also have a team of lactation consultants that offer further help for any mom that’s struggling, but I’m also bringing in more peer counselors, too, just to round on every patient and offer every mom some support, ever with those first few times they’re latching, just so they can hear that they’re doing a great job. It’s really just to address the breastfeeding concerns of all moms, not just the moms that are struggling, just to really walk them through it.

Katie: And we do have quite a few nurses that are certified breastfeeding counselors, so they have received additional education as well as the education that they received for Baby-Friendly.

Kristin: How are you able to support moms with babies that go to the NICU initially with their breastfeeding goals?

Becky: Well, actually, we get them pumping right away. If your goal is to breastfeed, we like to have them pump within two hours of delivery to start establishing that supply. Our nurses will come in and do education, and the lactation consultants will see them, also, and just talk about the importance of pumping to build up that supply. They’re also going to skin to skin. There are some lactation consultants that are dedicated just to the NICU and these moms, so there’s a lot of support there, too.

Katie: The providers in the NICU are very, very supportive of breastfeeding, and they encourage and educate moms on the importance of breastfeeding, as well, so there’s good collaboration between our OB teams and our NICU teams regarding supporting those moms in breastfeeding and being successful.

Kristin: That’s what my clients tell me, that they get a lot of support, even over at Helen DeVoss, as well as in their rooms with lactation. As far as other elements of the Baby-Friendly designation, what else encompasses those ten standards?

Becky: There’s a lot. We start right at delivery, with the golden hour after delivery. We place baby skin to skin immediately after delivery, and we avoid all unnecessary care for that first hour. Any exams or assessments would all be done while the baby is skin to skin on mom. We try to give them that time to bond and establish that first feeding.

Kristin: And if the mom can’t do skin to skin, I have dads ask me all the time about the benefits of them doing skin to skin with baby. So that’s something that’s encouraged, as well?

Becky: Absolutely. We’ve had lots of dads do skin to skin. We like to bring them in on the process whenever possible.

Kristin: That’s fantastic. And then delayed cord clamping is now a standard policy?

Becky: Yes. And we also room-in, so babies stay with their moms 24 hours a day unless mom requests otherwise. But that’s what we try to encourage and do all procedures at the bedside to keep the family together 24 hours a day.

Katie: I think that rooming in is another hot topic when you’re talking about Baby-Friendly and breastfeeding, and the literature does tell us that rooming in does help moms to be more successful breastfeeding. I think that it’s important that patients understand that we’re going to allow you to keep your baby with you. We’re going to be able to take care of mom and baby together. You’re going to learn your baby’s feeding cues. You’re going to learn all those little nuances. We’re going to help you learn that in the couple of days that you have with us. There is space where if you wanted your baby to go to a nursery, we could do that. We’re supportive of that, as well, but again, we are going to educate, and then we’re going to honor choice.

Becky: Exactly.

Kristin: And then there’s delayed bathing and other procedures beyond that?

Katie: Yes.

Alyssa: What’s the thought behind all the delayed cord clamping, delayed bathing? Why? What are the benefits?

Katie: The delayed bath is sort of about the transition from being inside mom and then outside and regulating temperature. So we wait at least twelve hours. We like to wait closer to 24 hours to do that first bath. We’re, of course, not going to hand you an ooey gooey baby. We do a little wiping off, but it really does help that baby transition to life outside of mom and regulate. It also allows you to go immediately into skin to skin so the baby can help regulate not just the temperature, but the heart rate and the breathing. And, again, that’s evidence based. In fact, there’s a pediatrician out in Massachusetts who really pioneered the Baby-Friendly initiative in the hospitals out in Massachusetts, and she did a study on delaying the baby bath, as well. That’s the literature we have for it; it’s all about maintaining stability for the baby.

Kristin: That’s awesome, Katie.

Becky: For the delayed cord clamping, that just gives the newborn a little more blood volume, and, actually, it’s better for baby. There’s no reason to cut the cord any sooner, unless the baby is having a respiratory issue and would need resuscitation, so that would be out of the norm. But otherwise, we do wait and delay so the baby can have more blood volume from the placenta.

Alyssa: How long?

Becky: Our standard is a minimum of one minute. I know a lot of moms request —

Alyssa: So this isn’t like it’s for an hour —

Becky: We’re not saying 10 minutes or 20 minutes. Generally, the cord stops pumping within five minutes. So some moms request to please wait until it stops pulsating, and we can do that, too. Generally, we wait about a minute, and that’s probably close to when it stops pulsating. But we’re not talking about an hour or anything like that.

Kristin: Yeah, some of my clients want to see it actually turn gray and stop pulsating before it’s cut.

Alyssa: And I didn’t want to see mine at all.

Becky: I didn’t either, personally!

Alyssa: My husband did accidentally and was like, oh, my God, an organ just fell out of you!

Katie: I love all of that stuff. It’s so fascinating!

Kristin: As far as additional steps that you take to get recertified, tell us about that process and why it’s important.

Katie: You will see in our women’s and infant services department that OB triage is on A level, and then all the way up to the 8th floor in that tower, you’ll see the 10 Steps for Baby-Friendly posted. It’s just showing our support of those ten steps. We have to show that patients receive prenatal education in our clinics regarding breastfeeding. We have to show that all of our staff receive the education. The people that come out to do our survey — the interview staff.

Becky: And patients.

Katie: And patients and providers, so they will go in patient rooms to see that they receive the education about breastfeeding and that they’re being appropriately supported for breastfeeding. So they look at our exclusive breastfeeding rate.

Kristin: And then you have support groups, as well, when mothers go home and need additional support. They can go to free support groups and seek help through their OB or midwives or pediatricians?

Katie: Absolutely. I think a lot of our pediatricians have at least one pediatrician who is an IBCLC, so a lactation consultant, as well. I know that our DeVoss clinic has two pediatricians that are lactation consultants.

Becky: And our pediatrician who is an IBCLC actually oversees the residents, and so she’s the one working with them and training them. It’s kind of keeping that mindset forefront for all of them, too, and helping them learn the Baby-Friendly system.

Katie: So while nursing took this on and rolled it out, there is a lot of support from providers, as well. Of course, our nurse midwives receive, as part of their education, breastfeeding, but our pediatric providers are all very supportive of breastfeeding, as well.

Alyssa: Is there anything that you think is a misconception for this Baby-Friendly Initiative? Is there anything that it isn’t? You told it what it is, but what isn’t it?

Becky: Yes. I think the thing we hear most is that, I’m going to be pressured to breastfeed if I deliver there. And there is nothing further from the truth. Our goal is a culture supportive of breastfeeding, not a culture of pressure. So our goal is to educate, let moms make decisions, and support them. So there’s no pressure. I think the other big misconception is about rooming in. Sometimes you have a mom who, let’s say, has had a C-section and she’s exhausted, and she just needs support for a couple of hours. We will accommodate that. We’re all about supporting moms. So although we do encourage rooming in, and there are a lot of benefits to it, in certain circumstances when it’s not best for the family, we support what is.

Katie: I think that it’s the 80/20 rule. There’s going to be exceptions to every rule, and it’s just important that we support our patients through that. I think that Becky and I have probably both taken care of those moms that have had long labors or C-sections, and they come up to the floor, and they just need rest. You have to take care of yourself.

Becky: They’re crying. The baby’s crying. Everyone’s hit a wall. And it’s like, why don’t I just cuddle your baby for an hour. You take a nap, and then let’s try again. Sometimes just 45 minutes of sleep can change the entire situation.

Katie: I remember after my second one, I got two hours of sleep. Like, two consecutive hours. And it was the best two hours ever!

Alyssa: I’m thinking about my situation. It was fairly quick. Yeah, sure, I was tired, but I did choose one time in the middle of the night to have them take my daughter to the nursery so I could get — it was about two hours. But I felt so amazing. But I wasn’t in this dire circumstance. So today with — this was before the Baby-Friendly. So today, would I have to prove to you that I need the sleep?

Becky: No.

Katie: No!

Alyssa: It’s just, would you take her for a couple of hours? You’re not going to say, well, you don’t check these boxes, so she won’t go.

Becky: No. I think the goal is when moms come up to the postpartum unit to talk to them about, well, babies room in 24-7, and we keep you together and care for you together. However, if you have a need to send your baby to the nursery, we’ll accommodate that. So our goal is to not educate the mom at 2:00 a.m. who’s exhausted and crying about how she should room in with her baby. That’s not really the time to have that conversation, and it probably wouldn’t be well-received. So we want to educate them when they first come up so that at that point, at 2:00 a.m., if you decide to make that decision, it will be more like, okay. I’ll bring her back for her next feeling.

Alyssa: I didn’t think I wanted to, but now I do.

Becky: And that is common. Okay, I just need a little bit of a nap, and then I can keep going.

Kristin: Yeah, we’ve had clients hire us to help out in their postpartum room when their partner had to go home to tend to another child or had a job to get back to. We’ve loved that role of being in the hospital, as well as later on in the home, to support them and help them get sleep and also learn baby cues and feedings and help support breastfeeding.

Alyssa: Basically, be their postpartum doula in the hospital as well as at home.

Becky: We would welcome that support, definitely! I’m sure our nurses would love to partner with you on that!

Alyssa: For those moms who don’t want to send — maybe they desperately want the sleep, but they don’t feel comfortable sending their baby to the nursery. Your doula sits in the rocking chair and holds your baby.

Becky: What a great option!

Alyssa: Yeah, it’s been really kind of life-altering for a few of our clients who are a little bit more on the — you know, a lot of moms just have anxiety, especially first-time moms.

Katie: I think that so much of the focus goes to the baby, but we’re taking care of mom, too, and that needs to be in the forefront, as well. There’s two patients there.

Becky: And be aware of her self-care and her needs in the moment, too, because what I always try to tell my patients is, you need to take care of yourself so you can take care of this baby. And if that means a short nap, then I think we need to do that because it’s going to make you a better mom in the morning when you’ve had a little bit of sleep.

Kristin: Exactly. What other hospitals in the area within the Spectrum brand are Baby-Friendly? We have clients in a 50-mile radius of Grand Rapids, so we work with a lot of your smaller hospitals, as well.

Katie: So Spectrum Health Butterworth just received redesignation, like we talked about. Spectrum Health Zeeland.

Becky: They’re newly designation last September.

Katie: And then Spectrum Health United Memorial up in Greenville. They were designated five years ago, and they’re going through the redesignation process right now.

Alyssa: So is it every five years?

Katie: Yes. And then Spectrum Health Big Rapids is going after designation, as well. We have, as a system, Baby-Friendly requires us to have an infant feeding policy, and we have standardized that infant feeding policy across the system for all of our regional hospitals, as well. So you’re going to see a piece of Baby-Friendly in all Spectrum hospitals. And the reason for that is that it’s evidence based and it’s best practice, so even if they’re not designated Baby-Friendly, these are practices that we should all be doing.

Becky: Right. They’re probably practicing very similar to Baby-Friendly, even if they don’t officially have that designation.

Alyssa: That’s great. Anything else you want to share before we sign off?

Kristin: What resources, if any of our listeners want to learn more about Baby-Friendly or some of the work Spectrum has done — where can they go online to get more information?

Becky: I think just going to the Baby-Friendly website will give you a lot of information about the 10 Steps and about what we’re focused on as a Baby-Friendly hospital. So you can really start just researching Baby-Friendly, and we are following that to a T, so that will tell you how we’re practicing.

Katie: Our provider offices also have education and information about Baby-Friendly, and then —

Becky: Our childbirth education classes.

Katie: Yes, at Spectrum Health Healthier Communities. They have information, as well.

Kristin: So the educators can fill their students in with any questions they have?

Katie: Correct, yes.

Kristin: And then is there anything special with the hospital tours that our clients go on before delivery? Do you incorporate Baby-Friendly or answer questions based on that? I haven’t been on a tour in a while.

Katie: I don’t think that they specifically talk about Baby-Friendly, except that —

Becky: The practices, probably.

Katie: Yeah. They likely don’t highlight the nursery like they used to. Our nursery — we don’t have babies lined up in the nursery like we used to. They’re with their moms, so you can’t go to the maternity floor and look through the window of the nursery. There’s no babies there.

Becky: I do think they talk about some of our practices, about how you room in and we keep babies together. And I think the other thing is maybe some of the practices, like the skin to skin after delivery. Things that might be different than other hospitals, just so they know what to expect; that we would never supplement a baby unless it was medically necessary, and we’re not handing out pacifiers unless somebody requests it. So it might be slightly different than other hospitals that are doing deliveries in the area.

Katie: Our childbirth educators are pretty passionate about breastfeeding and supporting breastfeeding practices, as well as supporting natural birth. They give the whole gamut of the birth experience.

Kristin: Well, thank you for joining us and sharing so much!

 

For tips on how to make your hospital room feel cozy for birth read Creating A Cozy Hospital Birth Space in First Time Parent Magazine by Kirstin Revere.

 

Baby-Friendly Hospital Initiative: Podcast Episode #89 Read More »

HypnoBirthing Story

Maddie’s Birth Story: Podcast Episode #83

Our listeners love hearing a positive birth story.  Today Maddie, a previous HypnoBirthing and Birth client, tells us all about her labor and delivery as well as her experience in the hospital right after having her baby.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin, and I’m here today with my former birth client, Maddie, and we’re here to talk about her personal birth story.  Welcome, Maddie!

Maddie:  Thank you.  I’m glad to be here!

Kristin:  So we talked a little bit about why you chose HypnoBirthing in a previous podcast, so tell us about your birth story.  How did you know you were in labor?  Give us all the details.  I was lucky to be there!

Maddie:  Yes, it was wonderful to have you there!  I went into work on a Wednesday, and I was due July 18th, and it was July 13th.  For some reason, I just kind of thought, oh, I’ll know.  It’s not going to happen yet.  I went to work; I had a normally-scheduled weekly appointment with my midwife.  I went at 10:30, and I had been kind of grouchy all day and just felt a little off but did not think about it at all.  I’d been having practice labor for a few weeks, so I really wasn’t noticing anything different.  I went to my appointment and sat down, and she said, how are you feeling?  And then I started bawling. I said, “I just feel so confused by my body!”  And she was like, well, let’s just take a look.  How about we just take a look, and so she did an exam, and she said, girl, you’re six to seven centimeters!  And I was like, what?!  And I started crying again, and then I said, but what does that mean?  Even though I’d been through HypnoBirthing; I knew what it meant, but it was just so unexpected.  I was so far along already.  She was fantastic; she was so wonderful, and she said, well, it means you’re going to have a baby today.  Go have some lunch.  So I called my husband.  He was working, and I told him I was six to seven centimeters, and he said, well, what does that mean?  And I called my mom who was coming, and she said, but wait; what does that mean?  So we were all pretty taken off guard because it wasn’t like I had woken up and said, oh, you know, I think something’s happening.  No one was really prepared.  Hey, I’m six to seven centimeters.

Kristin:  Right, I couldn’t believe it when I got the call.  I was like, what?!

Maddie:  Yeah!  I went and got some lunch and drove myself to the hospital and parked on the fifth floor of the parking structure and waddled in.  You showed up; you were the first one, and we went up to the room.  Fortunately, since I’d already had the exam, I didn’t have to go through and wait for 20 minutes for them to monitor me or anything.

Kristin:  That’s so nice to skip triage and go right up.

Maddie:  We went up the room, and it was not bad for a really long time.  You know, my body was doing a lot of the work as far as maybe turning the baby or getting more effaced.  Having done HypnoBirthing, I knew that dilation is not the only factor that you need to pay attention to, so I was able to just kind of relax and say all right, it’s going to happen when it happens.  You were there; you did a lot of hip squeezes for me, which was really fantastic for that counter pressure, because I was having back labor.  My husband is not able to do those with his wrists, so that made a huge, huge difference.  And we just kind of hung out, and I listened to my HypnoBirthing, and I listened to some relaxing music.  My appointment was at 10:30, and he wasn’t born until 10:45, so it was a while, but…

Kristin:  But for a first-time mom, it was pretty quick, and it’s one of the few calls I get in the daytime hours.  Most of the time, I get a call at 2:00 AM or 11:00 PM.

Maddie:  Right!  Things started to get ramped up some, and then I started noticing it more, but none of it was overwhelming.  One thing that we talked about in HypnoBirthing was breaking the amniotic sac.  That’s protection for baby, so I didn’t want to do that; didn’t really feel like there was any reason to.  The contractions really weren’t bad.  The surges weren’t overly painful or overwhelming, and so my midwife worked her full day at the office and then came in.  She checked me again quite a bit later, and then she did accidentally break the amniotic sac, and then after that, things got pretty intense.

Kristin:  Yeah, that can intensify a lot!

Maddie:  Yeah! I think from the time my water broke until the baby was born was about 2 hours and 45 minutes, so doable.  I spent a lot of the time in the tub, and that felt really great.  My husband was able to just use the hand shower, and having that, the different points of pressure, I think kind of helps take your mind off of it to some extent.  The water makes it a little less intense.  I really liked to be in there.  Then we got out, she said she wanted to check me, and I was Group B Strep positive, so they wanted to do another round of antibiotics.  That had been one thing that, when I found out, I was super devastated, because I wanted to labor at home for as long as possible.  I didn’t want to have to come in before six centimeters, and we had me the plan that if I came in and I wasn’t six centimeters, I didn’t want to know what I was at.  But I would just not go home.  You could know; my husband could know, and then we could make the decision.  Let’s walk around a little bit or just not be admitted.  But because I was already six to seven centimeters, when I was checked, we went right in after I got lunch.  We went right in and got admitted, so I was able to get those antibiotics in.  Once she checked me again and broke my water, it got intense.  It was really just — I felt very internal.  You know, it was not a lot of talking, and it was — I think right after it broke, I kind of got to that point where I was like, oh, no.  I can’t do this!

Kristin:  Which most women go through with unmedicated births.  Transition!

Maddie:  Right.  However, as soon as I had that thought — I have a distinct recollection of, oh, no, I can’t do this.  No, wait – that means I’m really close.  That means I can do this.  And so then I really tried to just focus on my breathing, because we’d talked about that and learned and practiced about getting those breaths in.  And I did end up struggling with that, but having you, having my husband, having my midwife all saying, all right, this is the birth you prepared for.  You can do this.  Just take those big breaths.  Breathing and focusing on those voices helped me to kind of get back on track, get it under control.  We tried a lot of positions for delivery, which that was one big thing.  I had changed providers pretty early on from an OB who said you’re only allowed to birth on your back, and I said, I want the freedom to do whatever position feels comfortable for me and for my baby and my body.  And so I ended up doing a lot of my laboring and pushing leaning over the back of the bed on my knees, and that definitely felt like the best position for me.  We tried on the side with the peanut ball.

Kristin: I remember trying a lot of different positions, and it’s all about listening to your body.

Maddie:  Right, and my body was saying, this does not feel good!  Don’t do that!  So I spent a lot of time there, and then I got to a point where I just remember feeling so hot and just, you know, put as many ice-cold washcloths on me as possible.  I was so hot, but I was just kind of getting right there to the end.  It was right at the end, and then my midwife had said, okay, I want to check you after this next surge, and so I want you to roll over.  And I already knew I was crowning, but I couldn’t really explain it at that point.  I’m like, no, no.  He’s there.

Kristin:  Right.  I feel him!

Maddie:  He’s right there!  So I did end up flipping over, and that was okay on my back, and that was fine.  What was helpful was the nurse that was there; she had said, do you want a mirror?  And I had said no, no, I don’t want a mirror.  And then she said to reach down and feel your baby.  When I could feel — he’s right there.  More than just oh, I feel it with my body, but actually touching it with your hand — he’s almost here!  That kind of gives you a little reinvigoration.  I’m right there at the end!  So I was able to catch my baby and put him right on me and do optimal cord clamping.  It was fantastic, just beautiful.  He was born on July 13th at 10:45 PM, so about 12 hours from when I figured out that I was in labor until he was born.  And it was being just relaxed about the whole process and recognizing it’s going to happen when it happens, and your body is going to do it, and trusting your body.

Kristin:  Exactly, trusting your baby and your connection with your own body and your baby, because it’s the two of you working together along with, of course, your partner and support team.

Maddie:  The very first thing I ended up saying after Charlie came out was, good job, buddy!  He was a part of it, too.

Kristin:  Exactly, babies work so hard!  They have to turn in the canal and — yeah, they’re exhausted.  You’re exhausted.

Maddie:  Exactly, there’s a lot happening.  It was beautiful!

Kristin:  It really was.  It was an honor to support you.  How did it go with the skin-to-skin time and breastfeeding as a first time mom?  Let’s talk about some of that and how you felt bonding in that first golden hour.

Maddie:  That was fantastic that I could do skin-to-skin right away.  I didn’t feel pressured to stop.  That was super important.  I did have some postpartum bleeding, and so while all of that was being taken care, not being separated from my baby was so big so I could just focus on him.  That part was wonderful.  We got all cleaned up.  The breastfeeding definitely was more difficult.  I have one side that’s inverted normally, and so baby really struggled to latch on that side, but he also struggled on the other side.  I was fortunate that Spectrum has IBCLCs on staff 24 hours a day, and so they were able to come in at 3:00 AM and focus on what’s going on, why is baby not latching.  We did end up using a nipple shield, and that was pretty demoralizing for a while.  We used it until six weeks, and I went to some Le Leche League meetings and things like that.  It really was important to have those contacts ahead of time and know where the meetings are; know when the meetings are; know an IBCLC that’s recommended in case you are having those issues so you’re not having to try to figure that out when you’re exhausted and you’re feeling downtrodden and things aren’t working.  It’s really hard to try to find that when you’re already struggling.  So having figured that out ahead of time, I was able to go to a meeting, go meet with a lactation consultant again.  We did stick with it, and then at six weeks, which is pretty common, he just kind of got it.  We got in the tub where it was warm and kind of womb-like and got rid of the nipple shield, and it worked.

Kristin:  That’s amazing that you were so persistent and it paid off!

Maddie:  Yes!  We just weaned at 2 years and 11 months.

Kristin:  Oh, congrats!

Maddie:  Yes, that was exciting.  We had a fantastic nursing journey.  If you really stick with it and arm yourself with that support system, you can do it.  I feel like so many women don’t have that support system.  My mom nursed; my sisters nursed all of their children.  Having that support system makes a huge, huge, huge difference.

Kristin:  Yeah, and like you said, just taking advantage of lactation while you’re in the hospital, even for moms who have a great first latch, to just have someone see your holds and answer any questions you might have — it’s a resource that I highly recommend anyone take advantage of, if they’re birthing in the hospital, of course.

Maddie:  Right.  That was important that they did come in.  They came multiple times to check on us and did work on holds and really understanding, you know, here’s another technique.  Here’s another hold to try if this one isn’t working, so you have those skills in your toolbox to pull out.  Okay, this isn’t working; let’s try this.  That definitely was helpful for me, as well.

Kristin:  Great!  Well, thanks for sharing your story!  Do you have any parting words?

Maddie:  I would just say to do your research.  It’s easy to just say that my doctor is going to do what’s best for me.  This is what happens.  This is how it goes.  But it doesn’t have to be.  You can be such an advocate for yourself, and you can surround yourself with other people to advocate for you so that you can get the type of birth that you want so that you have the support that you need.  Even if you have a partner that’s not able to be there in the way that you need, you can get a doula.  You can have a midwife who births in the hospital.  It’s really not different.  I know people that really think, oh, they’re not a doctor.  That’s totally different.  Just really doing your research and asking other moms who have been through it.  Moms are very willing, good or bad, to give you their advice, so get as much information as you can so that you can make your own informed decisions.

Kristin:  Yes!  Thank you for sharing your story because other women want to hear personal, especially positive, stories.  I feel like when it comes to birth, you here the dramatic or tragic.  Everyone likes to tell negative stories, and there aren’t enough positive, and a lot of women in pregnancy want to surround themselves with light and positivity.  We really appreciate you coming in!  Thanks so much, Maddie.  Thank you, everyone, for tuning into our podcast.  Remember, these moments are golden.

 

Maddie’s Birth Story: Podcast Episode #83 Read More »

pregnant

7 Ways To Save Money When Having A Baby

Emily Graham is the creator of mightymoms.net. She believes being a mom is one of the hardest jobs around and wanted to create a support system for moms from all walks of life. On her site, she offers a wide range of information tailored for busy moms — from how to reduce stress to creative ways to spend time together as a family.

While most of us understand that having a baby is expensive, many don’t have an accurate idea of just how much so. A 2017 survey revealed that most parents-to-be are vastly underprepared for the cost of having a baby, with over half of them assuming the first year would cost less than $5,000 (the real figure was $21,248 for lower-income households).

This can be worrisome when you are expecting your first baby, but it’s no reason to panic. There are many ways to save money during pregnancy and those first few months of parenthood. You just have to be smart and do your research.

Check Your Insurance Coverage

Under the Affordable Care Act, health insurance must include coverage for pregnancy, labor, delivery, and newborn baby care. The actual benefits, however, depend on the individual policy, so find out exactly what you are eligible for. If you can’t afford private insurance and don’t have it through your employer, you may be able to claim it through Medicaid or CHIP (Children’s Health Insurance Program).

Get Creative With Your Gender Reveal

Some people go big on their gender reveals, but you really don’t have to. There are many ways to do a memorable gender reveal with very little money. Kindred Bravely suggests ideas like having a cute photo op for social media, printing bespoke T-shirts, or using colored sparklers. By getting creative, you’ll be sure to end up with something more personal.

Buy Second-Hand Accessories

Baby accessories are the quintessential second-hand item. The baby will inevitably outgrow everything, and once you’re done having children you’re left with a bunch of useless stuff. For this reason, second-hand websites are some of the best and cheapest places to find everything you need for your baby, from strollers to cribs to clothes.

You may also be able to get some free stuff on websites like Freecycle. It’s not all low-quality, either – some people just prefer to give their stuff away rather than going to the trouble of finding a buyer and selling it.

Look For Free Formula

Not all mothers breastfeed, and even those that do may want to supplement with formula. The cost of this can add up quickly, especially if you need to buy fortified formulas. Luckily, there are many ways to get free formula. Major brands often offer free samples and coupons, and you can also get some at your doctor’s office or hospital.

Ask for a Prenatal Prescription

There are several supplements that are often recommended for a healthy pregnancy, such as folate, iron, Vitamin D, and prenatal vitamins. If you’re at the beginning of your pregnancy, you know you’re going to be taking these for the foreseeable future. Ask your doctor to give you a prescription for prenatal vitamins, which you can easily fill for $4 at retailers like Walmart and Target.

DIY Your Nursery

It’s easy to get carried away with dreams of the perfect nursery, but remodeling a whole room can quickly become expensive. Instead of spending a fortune on decor that your child will want to change in a few years, make your nursery even more special with some cute DIY projects. This list by Brit + Co has some lovely ideas, from washi tape wall art to an upcycled cradle and several pom-pom projects.

Teach Your Partner Some Massage Tricks

Soreness is an almost inevitable part of pregnancy, and not everyone can afford regular massages. What you can do is teach your partner (or a generous friend) to do it for free. A good prenatal massage should be gentle, with unscented oils, in a position that is comfortable for you – usually, sideways with pillows supporting your back.

Some parents feel like they have to spend large amounts of money to give their child the best. However, as long as you provide them with the basics for their health, comfort, and safety, you are doing your job as a parent. Being smart about money at this stage allows you to devote more money to things that matter, like saving up for college or having fun family experiences. In the end, it’s the love and support you give the baby that’s going to make a difference, not the money you spend.

 

7 Ways To Save Money When Having A Baby Read More »

Jamie Platt

Jamie’s Breastfeeding Experience: Podcast Episode #76

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!

Jamie:  Hi!

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.

Jamie:  Definitely!

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 info@goldcoastdoulas.com.  Remember, these moments are golden!

 

Jamie’s Breastfeeding Experience: Podcast Episode #76 Read More »

postpartum doula

Benefits of A Postpartum Doula and Why Should You Hire One?

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.

Photo credit: The People Picture Company

 

Benefits of A Postpartum Doula and Why Should You Hire One? Read More »

Breastfeeding Tongue Tie

What’s the tongue have to do with breastfeeding? Podcast Episode #75

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?

Alyssa:  Yeah.

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.

Alyssa:  Hopefully!

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 info@goldcoastdoulas.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.”

 

What’s the tongue have to do with breastfeeding? Podcast Episode #75 Read More »

Biz Babysitters

Postpartum Support for Business Owners: Podcast Episode #74

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.”

Alyssa:  Huh.

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?

Chris:  Yes.

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?

Chris:  Right.

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.

Alyssa:  Thanks, girl!

Chris:  Thank you!

 

Postpartum Support for Business Owners: Podcast Episode #74 Read More »

lactation consultant

Meet our new IBCLC, Cami!

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.

 

Meet our new IBCLC, Cami! Read More »

Pediatric Dentist

Podcast Episode #64: Pediatric Dentistry and Speech Therapy

What do tongue ties, lip ties, oral aversions, and picky eaters have in common?  Everything!  Listen as two experts talk about how pediatric dentistry and speech therapy are both helping parents discover ways to help their children.  You can listen to this complete podcast on iTunes or SoundCloud.

Alyssa:  Welcome to Ask the Doulas.  I am Alyssa Veneklase, and I am here with Courtney and Katie today.  Courtney is with Building Blocks Therapy Services, and Dr. Katie is with Pediatric Dental Specialists of West Michigan.  Welcome, ladies!  I wanted to get you two together because I’ve talked specifically with Katie before about pediatric dental topics, and then with Courtney about speech therapy.  I’m thinking they both have to do with mouths, so I figured we would have a lot to talk about together.  So it sounds to me like in the dental office, Katie, you often are the one who sees these signs of speech delays before parents even understand that their child has a speech delay at one, two, three years old?

Katie:  Oh, absolutely.

Alyssa:  So they don’t see Courtney or call Courtney because they don’t even know there’s a problem yet.  So how does that work?  What does that look like?

Katie:  Well, on a day to day basis, I am seeing so many kids of all ages, and I have these interactions with kids, and I have a sense of the wide range of normal in development.  I can anticipate and see when maybe there might be something arising, but also a lot of any speech development issues I see really has a lot to do with their anatomy.  So that’s what I’m evaluating as well, whether it’s tonsils or some kids have tongue ties or other ties in their mouths that can cause some issues with speech, and other things I’m evaluating as well that I find that I really need help from a speech pathologist, actually.  And that’s where you come in, as well!

Courtney:  And I also have parents who are constantly asking me, regarding any speech delays, “Could this be a dentition problem?  Could this have anything to do with their oral cavity?”  So I think that a lot of times that we kind of cross paths in a lot of ways.

Alyssa:  So what about a kid who – is it called an oral aversion if they don’t really like certain types of foods or maybe textures of foods?  Let’s say I’m working with a sleep client, and this kid is two, won’t eat much, doesn’t like certain types of foods.  Is that a dental issue?  Is it a speech therapy issue?  Is it both?

Katie:  It can often be both issues.  I will see a lot of kids come in, and kids are always going to be picky, and that is totally normal.

Alyssa:  Especially at that age, right, to a degree?

Katie:  What’s interesting is research has shown that a kid needs to try a food 20 times before they will actually like it because you have to train your taste buds.  So with anything, your taste buds are actually learning how to like foods, and obviously there are some foods that come easier than others, like sugar.  That has other affects on our brain that we’re just going to like it immediately.  Something like broccoli – yes, some kids are not going to like that right away, and there’s absolutely a chemical reason why.  The problem arises when I am talking to a family and Mom is at a loss because he will only eat three foods.  And I see this often, that he will only eat bread, hot dogs, and crackers.  That’s not normal, I will say, and there’s a lot of reasons that could be going on.  It could be so many things.  It could be stressors in the home.  It could be that he has some anatomical reason.  Or it could be that he has a lot of tooth decay, and he has a lot of pain in his mouth, and he is very smart.  Kids are very resilient and very smart; that child knows exactly what he can eat that doesn’t cause him pain when he eats.  Quite often, though, there is something anatomically going on, whether it’s really large tonsils, especially in that two to six range.  Their tonsils can be quite large, and that can cause some swallowing issues, and I’m sure you can touch on that a little bit more, Courtney.  But also what I’ll notice quite often that goes missed a lot is if a child has a tongue tie.  A lot of people don’t even know what a tongue tie means, but basically, our tongues have a tissue attachment to the floor of our mouth.  And sometimes, that area of tissue is quite pronounced, a little bit too strong, and there’s too much attachment with the muscle fibers of the tongue to the floor of the mouth, and that can impact how well the tongue moves.  And if the tongue is really restricted and cannot move very well, then they cannot manipulate food very well, either, in order to actually –

Alyssa:  Yeah, you don’t realize how much you move your tongue around, right, to move food around?

Katie:  Absolutely.  The tongue is one of the strongest muscles in our body, and if you can’t use it properly, it’s going to be really hard for them to manipulate food around their mouth, chew the food, and thus swallow the food, as well.  So I don’t know if you want to touch more on your experience with that, as well, Courtney.

Courtney:  Yeah, so as we eat, our tongue has to have a significant range of motion to it, so especially if that tongue is tied in, we have to be able to actually initiate the swallow.  We have to be able to push our tongue up against the roof of our mouth to create the suction to be able to get all the food to actually go down into our esophagus.  But also, along with that, when you’re looking at different textures of food, you have to be able to manipulate it in your mouth.  So if it’s going into your cheeks; if it’s getting stuck around your teeth; you have to be able to do tongue sweeps or to be able to angle your tongue to be able to move all the food towards the center of your tongue.  So if there’s not that range of motion in there, then it’s going to be really hard for them to use different textures of food.  So as a speech therapist, a lot of times when a parent will say, “Oh, they’re really picky,” I’ll look at the pattern of textures and what is required for the mouth, the tongue, the cheeks, and everything to do to manipulate that and see if there’s a pattern with this.  Wow, they really don’t like those liquids because maybe they can’t control.  Maybe it’s coming out of their lips.  Or that bread, when you’re chewing the bread and crackers, that sticks together, a bolus, and it sticks together so they don’t have to manipulate that tongue as much.  So we start to look at all that and their structure.

Katie:  And with that restricted diet they have, it can trickle down and cause a lot of tooth decay because, obviously, those things that are much easier for them to eat and manipulate are going to be those carbohydrates that can easily cause cavities.  So a lot of times, there is a lot of that simultaneously going on where they are having trouble manipulating foods, and then I see a lot of dental decay, as well; a lot of cavities going on.  One aspect, as well, if they don’t have a lot of range of motion with their tongue, then they can’t self-cleanse their mouth either.  So now that I talk about this, you’re probably going to notice how often you’re wiping your teeth with your tongue, moving your tongue to the cheek –

Alyssa:  I never knew that was called self-cleansing!  So every time you wipe your tongue over your teeth –

Katie:  Yeah, exactly.  And it’s just something we don’t even think about.  It’s a natural reaction because it’s not normal to have pockets of food in your mouth and things like that.  That’s something I even see a lot with kids coming in.  I’ll see that they have food pocketing where there’s actually food stuck in their cheeks, in the vestibules of their cheeks.

Alyssa:  That’s what I just imagining and visualizing in my head, that if a kid had a tongue tie and isn’t able to move their tongue over to the side, like if I have something stuck down here, I can pop it out with my tongue.  So if they can’t get that out, it’s just going to sit there, which is going to smell and cause tooth decay and make it difficult to – I wouldn’t want to eat very much, either, if I knew it was going to get stuck down there.

Katie:  No, you’re going to know what works for you and want to just stick to that, yeah.

Alyssa:  So what other kinds of things do you see that might be speech-related, or is that the biggest one?

Katie:  That’s the biggest one.  A lot of it, too, is how you were talking about their orthodontic occlusion, so how teeth are biting together.  One thing that can definitely impact speech is how your jaws are growing, how your front teeth are overlapping or not in the front, as well.  A lot of kids who have had a pacifier longer, like past age three, have a finger-sucking or a thumb-sucking habit.  Even kids who have used a sippy cup for an extended period of time.  All of those things can cause what we call an open bite, meaning your front teeth don’t overlap, and they often have what’s called a large overjet, meaning your front teeth are not overlapping how they should.  From the front teeth to the bottom teeth, there’s a very wide gap between them.  So that, I know, can cause some speech issues as well because your tongue isn’t really able to be placed where it should be properly on those front teeth, right?

Courtney:  Yeah, so our speech sounds are all how we manipulate that airflow, and we manipulate that airflow with our tongue and with our cheeks.  And so where we place our tongue, a lot of times, we’re doing it just behind those front teeth or against our front teeth, and so that can – and then there’s more behind the scenes; there’s so many muscles in the tongue, but it can really – there’s different areas that then the air can sneak out, so then you don’t have those quality speech sounds.

Alyssa:  So do you teach children to move their tongue differently?  What do you do?

Courtney:  Well, there’s a kid that I have right now who tends to jut her lower jaw out when she does her SH sound.  A lot of kids have trouble moving their jaw separate from their tongue or dissociating all these different parts of the mouth.  And so we’re talking centimeters at a time, fine-tuning where that tongue is and where that jaw is.  Everybody speaks in their own way and produces their sounds in their own way, but what sounds the most acceptable to those who are listening?  So it’s being able to kind of manipulate exactly where that tongue is and all of that.

Katie:  And that’s something, too, where if you’re noticing you have patients with having those types of difficulties, definitely touching base with them and asking if they’ve been able to see a dentist or an orthodontist and just kind of gauging if they have any history with that, as well, because that’s something that we wouldn’t want to go missed, either, if that’s something that can help them.  We would want to do that, for sure.

Courtney:  Exactly.  Some kids have the palette expanders and things like that.

Katie:  Yeah, even how you were talking about how her lower jaw is moving forward like that.  That could be something to do with how her front teeth actually occlude.  It could have something to do even with her TMJ or something like that.  Even our tonsils, how big our tonsils are, affects our jaw growth, as well.  If our tonsils are really large, our jaw growth and the rest of our anatomy finds a way to compensate so they can breathe.  So that’s really interesting, as well, and there’s definitely physical signs we look for that can coincide with large tonsils, especially if it’s something that’s kind of gone missed for a longer period of time.  A lot of kids who I see for the first time coming in, even that seven to nine range, at that point, you can really see some changes in their jaw development, especially their upper jaw.  They’ll develop a really, really high palette because, again, it’s trying to open up their airway so that they can breathe better.  A telltale sign, obviously it’s kids with ADHD and all that as well.  Any time I hear that in a medical history, I beeline for looking at the tonsils because if kids are not getting the sleep they need, it comes out during the day because when you don’t get enough sleep, you are going to be more hyperactive.  That’s how our brains work.  So that’s how sometimes it can affect how they act during the day, unfortunately, and oftentimes I do see kids a little bit older and I see that going on, and they have tonsils that are almost touching in the back of their throats, and that’s very abnormal and not healthy for them.

Alyssa:  Is that a form of sleep apnea?

Katie:  Yeah, absolutely.  And sleep apnea is really interesting because there are so many things, so many symptoms.  A kid won’t necessarily have all the symptoms; they may only have one, and it could be their body actually compensating as it grows to make sure that it’s avoiding some of those symptoms, as well.  So, obviously, a kid who snores a lot; bedwetting is one.  Obviously, the hyperactivity during the day or just generally their sleep cycle is off and they’re waking up at night, things like that.  Those are all signs that we’re evaluating, and sometimes I’ll still have them see an ENT, even when the tonsils are not so pronounced, but just in case.  Every body is so different, and how your body reacts to whatever is going on is going to be totally unique for your body.  So less than 30% occlusion of your tonsils is pretty normal, but anything more than that could be causing an issue.

Alyssa:  I love that you think about sleep because I’m obsessed with sleep!  That’s my jam!

Katie:  I love that you are!  That’s such a huge thing for us, and going to see a pediatric dentist, we are looking at so many different things because all of that goes into how a child develops.  We have so much training on just child development in general, physically and emotionally, and all of that.  So we are evaluating all of those things to make sure nothing is going missed because things can, unfortunately.  So definitely pediatric dentists have more school that we go through to be able to learn those things, thankfully.  Not that general dentists don’t, as well, but you do have to seek out extra training as you graduate, and it just kind of depends on what opportunities you find and learn and all of that, as well.  Since I’ve graduated from residency, I’ve had to seek out meeting speech therapists and pathologists to learn more, and obviously training on lip and tongue ties and the procedure to help relieve that for kids.  So that’s something that we can work together on, as well, because I can use a laser to actually to a frenectomy, which means we can remove that extra tissue that’s causing the tongue tie, and that can give the child so much more mobility and relief.  But even when we do that procedure, kids will still need therapy afterwards.  The procedure is part of a spectrum of working together to make sure that child is able to function at their best.

Courtney:  I think that for children, especially, their bodies adapt amazingly, and they compensate so well.  And so many things can go hidden with a child because their bodies just automatically do these amazing things, and I think I do a very similar thing, where I really look at how are they functioning in their whole world, looking at the whole child.  Like with ADHD; you’re saying that this child is really acting out at school, for example.  Well, let’s look at these patterns of behavior and sleep or if it always seems to be around writing time that they have a little bit of difficulty with the endurance of those things.  It’s really looking at the whole picture and not just honing in on one narrow thing like the teeth or just communication.  It’s how everything is interacting together in their world, because gosh, kids adapt amazingly.

Katie:  I say this all the time: kids are so resilient!  They’re so fascinating, how they can grow and change to make the best of what they are given.  And so many situations where I’m always fascinated that they’ve been able to cope for this long in whatever situation it is, and that they’re doing really well, but I know they can do better.

Alyssa:  I have a tongue tie question, because in my world as a doula, it often relates to newborns.  Do you see a ten-year-old kid – or maybe that’s too old; maybe a five-year-old who still isn’t eating well?  Will they still have issues?  Can you take care of that?

Katie:  I actually had a 13-year-old patient who came to see me because she was having tooth pain, and she needed a deeper filling fixed and all of that.  She was a great girl, but just very generally anxious.  A typical 13-year-old, but a little further down the spectrum of having a little bit of social anxiety and things like that, as well.  And I noticed that she had a really severe tongue tie, and I just asked, since she was having the tooth decay, and a tongue tie can cause or impact the development of tooth decay.  So I just asked Mom; I said, “You know, I’m noticing she has a really tight connection between her tongue and the rest of her mouth.  Have you guys ever had any issues with eating, speech, anything like that at all?” I’m asking those questions because I don’t want to miss anything as a dentist, as well.  I’m not just looking at her tooth.  And Mom goes, “Oh, yeah, she used to be in speech therapy for a while.  They weren’t really making a lot of progress.”

Alyssa:  So the speech therapy wasn’t looking at the tongue tie?  Courtney is over here dying!

Katie:  So then I’m the crazy lady who comes in for this 13-year-old, and all of a sudden, she has a tongue tie.  And then we start talking a little bit more, and even she starts chiming in.  She was not saying a word until this moment, and she’s, like, “Yeah, it’s really hard for me to eat.”

Alyssa:  Thirteen years!

Katie:  And I was, like, oh, my gosh, you poor girl!  And I could just see that it was really starting to emotionally affect her.  You could tell!  They didn’t end up coming back to the office I was at during that time, but they were really relieved when they heard that there could be some other solution, as well.  And I talked to her and said that I really wanted her to get another referral for a speech therapist.  I wanted her to talk to them about the fact that the pediatric dentist noticed the tongue tie and that we could do a really simple procedure to give her some more mobility with her tongue, but that she would likely need some therapy afterwards, as well.  Mom called me back, and she had made an appointment with one of the Spectrum facilities, and then I moved offices, so I’m not sure what happened with it.  I’m sure she got the treatment.

Alyssa:  So without an actual revision done, you can help – let’s say somebody doesn’t want the frenectomy because it’s too scary or just that, I’m 13 and I don’t want to do it.  Can you actually help, or is it limited because there’s only so much you can do?

Courtney:  It would be limited because she probably has already figured out her range of motion and probably put it to the max.  So at that point structurally, there’s not much manipulation.  You know, as speech therapists, we can’t change structure.  And so we have to use the structure that we have, and I’m going to trust in all my ability that that girl probably already utilized what she had.

Katie:  That’s why sometimes you do need to have that physical change in order to be able to progress in that therapy, and she clearly had not progressed.  And I think that’s why they stopped going to therapy, because at that point, what are you supposed to do?  So that was just kind of an unfortunate case where something really could have been done way early on because she had clearly been having speech issues.  Honestly, at the time, her speech seemed great, and I was much more concerned about the fact that even she said herself that it was hard for her to eat.

Alyssa:  Well, I’m thinking about a 13-year-old going to a pizza party, and she’s probably dreading it because it’s really hard to eat and swallow.

Katie:  Exactly!  Especially at that age, your social life is really dramatically impacted by things like that.  That starts, really, as soon as kids start school, but especially when they start noticing differences between each other.  That’s huge as a 13-year-old to have gone that long and be struggling.  On a more happy note, I’ve had a nine-year-old patient recently, and he had been in speech therapy and wasn’t progressing.  I spoke with his speech pathologist, and she said, oh, yeah, just give it a try; do the laser frenectomy.  And I did, and he even said, “I felt better talking that same day.”

Courtney:  Wow, that’s so great to hear!

Katie:  So that was really cool.  I was, like, oh, my gosh.  That’s so awesome, and Mom was so ecstatic that they could finally progress a little bit more in their treatment.  Usually, when we’re doing a laser frenectomy, we remove some of that tissue, and the kids do great, honestly.  You’re a little bit sore for a couple of days, but generally, they can still function normally.  Sometimes they need a little bit of Ibuprofen or Tylenol for some older kids, but generally, it’s an easy recovery, which is awesome.  And every kid is different with their recovery.  Some kids, it’s harder; some kids just bounce back the same day.  But generally, kids do really, really well.

Alyssa:  When they need therapy afterwards, is that something you give?

Courtney:  It depends.  So speech therapy, we work on that musculature in the mouth, and so if need to work on some range of motion exercises with them, but also with that new freedom that they have with their tongue, suddenly those sounds might be coming out different, and they might not know how to manipulate things right away.  So providing a hierarchy and all that and working with them on being able to manipulate the airflow a little differently.

Alyssa:  Yeah, that’s a weird thought, too, being a nine-year-old who, you’ve been speaking for eight of these nine years, and suddenly, your tongue moves completely differently, and you’re saying sounds differently.  How weird that must sound and feel!

Courtney:  Yes!

Katie:  Well, it is cool, especially because I’m doing these frenectomies from basically birth until whenever they still need them, but it is really awesome to see when an older kid can actually explain to you how it did affect them in a positive way.  So that’s really cool.  Obviously for kids who are really, really little, I can still see it in a physical way, how much better they’re doing, whether it’s breastfeeding.

Courtney:  I was going to say with newborns and the latching, yeah.

Katie:  Even with doing lip tie releases as well, and just how much easier it is for parents to brush at home.  So that’s something with occupational therapy, as well.  Having oral aversions; if you have a really tight lip tie, then it’s really hard to brush that area because it actually does hurt because your lip is being pulled so tightly against your teeth that it’s really difficult to brush that area.  So that’s always something I’m looking for, as well, when I’m in a patient’s mouth moving their soft tissue around.  You can tell when a kid is like, oh, that didn’t feel good!  And I can see what the tissue is doing inside the mouth to tell, like, yeah, that’s a little too tight right there!  I can tell that uncomfortable!  So on top of having a parent trying to brush their teeth, obviously for a two-year-old, it’s already still really difficult to brush their teeth sometimes, but having that on top of it – generally, I say you are not hurting your child by brushing their teeth.  So if they’re crying, that’s okay, and we give them ways to work through it.  But that is something where, yes, that doesn’t feel good, so that’s hard as a parent, as well.  But it’s good that we can observe that and give the child some relief and give Mom and Dad a little bit of relief, as well.

Alyssa:  Well, I think it’s amazing to have these resources for parents where they know that people like you are working together to where you’re not just looking at a tooth; you’re not just looking at the sounds a kid makes.  It’s all connected and they need you both.

Katie:  We all need to work together, yeah.

Courtney:  Yes, absolutely!

Alyssa:  So each of you tell us where our clients can find you and our listeners can find you if they have questions or need a new pediatric dentist or want to have some speech therapy.

Katie:  Yeah, we are a new office at East Paris and Burton in the Bankston Center, so we will be open on March 11th, but we’re taking new patients right now.  You can email us at smile@pdsofwestmi.com.  You can also find us on our website.  Otherwise, you can give us a call at 616-608-8898, and we’re happy to help you.

Courtney:  And Building Blocks Therapy Services; I’m off of Alpine, right across from the weather ball; that’s a good landmark.  You can find me on my website or give me a call at 616-666-6396.

Alyssa:  Perfect!  Thank you, ladies, for joining us today!

Katie:  Thanks for having us!  So fun!

Alyssa:  Thanks for listening!

Image © Matt Madd

 

Podcast Episode #64: Pediatric Dentistry and Speech Therapy Read More »

Two babies holding hands while being held by their parents

Doula Support for Adoptive Families

Most parents probably don’t think about hiring a doula if they aren’t pregnant. They think of a birth doula only supporting a laboring mother, but that couldn’t be farther from reality. Birth doulas can support any parent. Postpartum doulas can support adoptive families by helping them to prepare for baby’s arrival and in-home after baby arrives. There are so many ways doulas can support families that are adopting!

At Gold Coast we are focused on educating parents. We offer several prenatal and postnatal classes to help new parents navigate this new territory. We offer a Newborn Survival class that goes over essentials of surviving those first few weeks and months home with your baby. Real life scenarios and raw topics are discussed to help parents feel confident in their roles.

We also offer a Prenatal Stress class. This is designed for any parent, pregnant or adopting, to understand the affects that stress has on a developing child’s brain, not just throughout pregnancy but through their growing years as well.

Infant Massage is a great way for adoptive parents to bond with a new baby. Our instructor offers classes as well as private in-home instruction. Another great way to bond is babywearing. We have a certified babywearing expert that does in-home instruction and can show you how to safely use your carrier(s).

For parents that might be bringing multiples home (twins or even triplets) we offer a Preparing for Multiples class, and we have a postpartum doula that is a mother of twins herself. Her in-home support, expertise, tips, and tricks are invaluable!

If grandparents will be primary care givers, we offer a class called The Modern Grandparent that updates them on the latest safety information as well as informs them about today’s parent and how parenting styles differ from generations past.

Our lactation consultant can help adoptive mothers induce lactation and can also offer advice about chest feeding.

At Gold Coast, our postpartum doulas are available day and night. Daytime support includes help with baby bonding, newborn care, help with older siblings, meal prep, and evidence based resources. Your postpartum doula is your trusted guide for anything baby related. Overnight support allows parents to get a full nights rest while the doula takes care of the baby through the night. The doula will feed the baby, burp, change diapers, etc allowing the parent(s) to get as much rest as possible knowing there is an experienced professional caring for their child. 

A postpartum doula is an amazing gift idea for baby showers! We can create a custom insert for your shower invitations and you can also register online for any of our services at EcoBuns Baby + Co online.

We also offer Gentle Sleep Consultations. Sleep is critical for adults and babies. Babies needs proper sleep for brain development and physiological growth. Parents need sleep to help manage the day to day obstacles of parenthood as well as for basic health and wellness.

We also have doulas specially trained in grief that can help you through loss.

Some of the trusted resources we suggest to families are:

Kelly Mom https://kellymom.com/category/parenting/ Athough there is alot of information about breastfeeding on this site, there are some relevant parenting and adoptive parenting tips as well.

This link features several apps our clients like. http://redtri.com/apps-every-new-parent-needs/slide/3

The Baby Connect Tracker App is also popular with our clients. https://www.baby-connect.com

At Gold Coast Doulas, we pride ourselves on being the premier doula agency in West Michigan. We offer judgment-free support to all families regardless of their parenting styles. We are here for your family, wherever you are in your journey.

 

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breastfeeding

7 Things You Didn’t Know About Breastfeeding

Today’s guest blog is written by Natalie Michele of Maternity At Home.

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

References:

https://www.parents.com/baby/breastfeeding/problems/breastfeeding-soothing-solutions/

https://www.thebump.com/a/11-things-you-didnt-know-about-breastfeeding

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newborn sleep tips

Newborn Sleep Tips

As a sleep consultant, I get asked often how early you can sleep train a baby. My answer is this – Most babies are ready around 12 weeks, but it’s never too early to start introducing heathy habits to make the sleep training go smoothy when baby is ready.

Why 12 weeks? Most babies are developmentally ready around this time. They’ve also established a healthy eating routine (whether breastfeeding or bottle feeding), and they’ve gained substantial weight.

At 12 weeks most babies are ready to sleep through the night. Many breastfeeding mothers will actually wake their babies to nurse them, even though the baby would sleep through on their own. Some mothers pump once in the night and let baby sleep. Other mothers can make it through the night just fine sleeping 8 hours straight, but they will more than likely need to nurse or pump right when they wake up!

Please note that at 12 weeks sleeping through the night does not mean a 12 hour stretch. Very few babies at this age are ready for that. But some babies may be ready for a 6 or 8 hour stretch. If you’ve only been getting sleep in 2 hour chunks, this sounds fantastic!

When I put a plan together with a family, I first talk with them to find out what their values and goals are. If nursing in the night is a priority, we create a plan around that. If their main objective is for baby to get a full nights rest, uninterrupted, then we create a plan around that. There’s no one right answer to sleep training; it has to fit each individual family.

So what kinds of things can you do with your newborn before that 12 week mark? You need to realize that babies thrive on routine. A chaotic schedule is not the ideal environment for a newborn. From day one, you can start to create a sense of consistency.

Wake up around the same time in the morning and go to bed around the same time at night. Do this for you and your baby.

Talk to your baby. Narrate life to them. Tell them what you’re doing (changing their diaper, feeding, nap time, wake time, play time, etc). They are listening!

Have all sleep happen in a dark room with white noise. A good, arms-down swaddle is great for newborns! There are several types of swaddles (muslin wraps, Miracle Blanket, Love to Dream), find what works best for you and your baby.

As your baby establishes feeding patterns, try to stick to a schedule for feedings. Remember you must always be flexible. Babies are not always hungry every three hours on the dot. If your baby typically eats every three hours, be aware that sometimes it will be 2 hours, sometimes 2 1/2, but usually 3. Don’t ever let your baby cry for food just to wait until the right time on the clock. Always watch for their cues and respond accordingly before letting them get too upset.

Speaking of cues, watch for them! Your baby is constantly communicating with you. From day one, they are communicating. As they grow, if you’re paying attention, you will begin to distinguish what different cries mean. This is important to create a relationship of trust between you and your baby. You cannot assume every cry means food. Just as if you stubbed your toe, it would not help if someone offered you a hamburger. You would want to sit down and maybe have someone give you some ice or even a band aid.

By assuming all of your babies cries mean hunger, you are telling them you’re not listening to what they are saying. Pay attention to what was happening to and around the baby when they started crying. Some babies are more introverted and like staring peacefully at a wall. They may begin to cry if there is a loud noise, a bright flash of light, or someone gets in their personal space too quickly. Others want to be in the room with all the action. Those babies may cry when you leave the room, or if they can’t see out the window. They do not want to stare at a blank wall, they want colors, noise, and lights.

Your baby might cry because they are too hot, too cold, sitting in an uncomfortable position, have a dirty diaper, are tired, are hungry, have an upset stomach. By paying attention to how they react to what you offer, you start to establish that trust relationship that says,”I’m paying attention to you. I’m listening to what you’re telling me, and I will react accordingly.” Your baby will know that when something is too stimulating, you will pick them up and put them somewhere they feel more comfortable. Your baby will know that when they are tired, you will put them to bed.

A good example of this the well meaning visitor – or the “Space Invader” as I like to call them. They rush over to the baby and get right in their face. When the baby starts to cry, the visitor thinks the baby does not like them, when in fact they just invaded their personal space too abruptly. If a baby is content and then suddenly starts crying, it usually isn’t too hard to figure out why if you’re paying attention.

What does this have to do with sleep training? Everything! By establishing routines and a trust relationship from the beginning, you are eliminating unknowns for your baby. They trust you to do what’s best for them. When you talk them through what’s happening, they know what to expect. They know when it’s time to change a diaper, put on clothes, or take a nap because you’ve been narrating their story to them and you’ve created consistency. This level of routine, consistency, and trust is your foundation to healthy sleep habits.

Then, when you call me around 12 weeks to start gently guiding your child through a full night’s sleep, the ground work is already laid. A child that gets enough sleep is a healthier and happier child, and so are their parents.

For more information on sleep training, contact us by phone (616) 294-0207, email, or fill out our contact form. You can also learn more about Alyssa’s methods on our blog.

 

Gold Coast Doulas is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.

 

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breastfeeding

My role as a postpartum doula.

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.

 

My role as a postpartum doula. Read More »

plagiocephaly and torticollis

Podcast Episode #28: Plagiocephaly and Torticollis

What is Plagiocephaly?  Torticollis what?  Jessica Buikema of Hulst Jepsen Physical Therapy talks about both and what parents can do to prevent them and how physical therapy can help their baby.  Listen to the podcast on iTunes or SoundCloud.

 

Alyssa:  Hello.  Welcome to another episode of Ask the Doulas.  I am Alyssa Veneklase, co-owner and postpartum doula at Gold Coast.  Today we’re talking to Jessica Buikema of Hulst Jepsen Physical Therapy.  Hey, Jess.

Jessica:  Hey, thanks for having me.

Alyssa:  Yeah.  We recently spoke to one of your colleagues, JoEllen Bender, who works at a different location but does pelvic floor physical therapy.  And we had an event with both of you together, and I want to talk to you separately about what you specialize in, plagiocephaly and torticollis.  Now, those are super big, long, fancy words for people who don’t know what they are.  Can you break down what each of those are and what that means for a new mom and a new baby?  And then, how you can help?

Jessica:  Yeah, definitely.  So torticollis is going to be tightness or a mild lump in a muscle called your sternocleidomastoid.  It’s a neck muscle, and basically what you’ll notice with your baby is that they tend to prefer to tilt one way, and they tend to want to rotate the opposite way of the tilt.  So that’s when you know that torticollis could be an issue with your baby.  Plagiocephaly is going to be any form of head flattening due to external pressure on the skull.  We’ve seen a huge increase in both of these with the Back is Best campaign to prevent sudden infant death syndrome, and it’s very important to continue doing Back is Best, but these two conditions have increased almost five-fold since that has started.  They both can be caused from the same issues, as well, but we advise you to just kind of look at your baby, and if you’re noticing that, bring that up to the pediatrician.  A lot of times, the pediatrician will notice it right away, too, and they’ll have those conversations with you.

Alyssa:  So I’ve noticed in babies, you know, if they do have a tightness in one side, you’ll try to put a toy over there or try to get them to look, and it’s just their eyes that will move, but they won’t actually move their head.  And then there can be breastfeeding issues, too?

Jessica:  Right.

Alyssa:  They might prefer one side over the other because it actually hurts to move their head that way to get to the breast on that one side.

Jessica:  Yes.  So it’s important that the baby does get treatment if we’re noticing that either of these are significant.  Especially, they can have issues with posturing of their mouth, so they’ll have an open mouth posture.

Alyssa:  What does that mean, posture of the mouth?

Jessica:  So their mouth will stay open, and it will lead to issues with breastfeeding.  Suck and swallow issues, too, with breastfeeding, when there’s tightness in either –

Alyssa:  So it will hurt to actually close their mouth, so they just leave it open?

Jessica:  No, it’s just the way that they’re positioned because of the way the muscle attaches, so their posturing of both their head and neck will be different.  It will be offset.  So you’ll notice, as a mom, these could be issues leading up to problems with breastfeeding, and this could be one of the culprits.  I know that you guys, especially your lactation consultants, will kind of try to figure out what the cause of breastfeeding issues is, and this is one of the issues that could come up.

Alyssa:  So who do you mostly see?   Do you see very, very newborn babies?  Do you see them months later?

Jessica:  In an ideal world, we would see the babies fairly early.  Because everyone goes to their pediatrician quite frequently when the baby is born, this does typically get caught early, and the earlier the better, because again, this – torticollis and plagiocephaly can be caused from so many different things, and a lot of times, it’s caused in the womb.  It’s not caused because you as a mom did something wrong, so that’s something I definitely want to stress, because that can stress parents out.  They’re trying to do everything right, and they think they caused this, when in fact it could be caused due to the positioning in the womb; if you had low amniotic fluid; if there was any trauma at birth; multiple births, this is very common because they run out of space.  Prematurity, if they’re in the NICU for a while; that can cause that as well.  And plagiocephaly and torticollis kind of go hand in hand, so you can have both or you can have one or the other, and they’re actually both caused from very similar things, so any of the things that I mentioned can cause it.

Alyssa:  So what do you tell parents who – you know, I see a lot of babies, like you said, with helmets now because – I mean, a lot of times it’s because of sleeping on the back, but it’s what’s recommended; it’s what we have to do.  Is there anything they can do to prevent that from happening with sleeping on the back, or is the helmet the only fixer?

Jessica:  No, so the earlier we see babies, the better because we can teach parents very early on ways to play with their child and ways to position their baby in various environments.  So although we provide a lot of manual treatment, like we do massage to the neck and work on positioning, but there is so much education that goes with this.  We’re only seeing the baby, dependent on what’s needed, but we’re only seeing the baby for 30, 45-minute sessions a couple times a week.  So much of it goes into what you’re doing outside of physical therapy.  So different positions when you’re playing; different positions when you’re carrying the baby; different positions when you’re breastfeeding; those are all things that we can provide at these sessions when we treat them.

Alyssa:  So if a mom came to you before there was even an issue, they could potentially prevent it?

Jessica:  Yeah, if there was – prevention would be huge as well.  As you know, especially with when the baby comes out of the birth canal, their skull is very soft to allow them to be able to come out, so their skull is susceptible to getting flat spots due to pressure after birth, as well.  So learning different positioning techniques would be very helpful to prevent that, and just telling moms what to look for to help prevent that.

Alyssa:  How do we find you?  If we have a mom who says, I need help with this?

Jessica:  I’m located at Hulst Jepsen Physical Therapy’s Cascade location, so I am at 5136 Cascade Road Southeast.  It is at the corner of Cascade and Spalding, and our number is 616-301-1215.  If my location’s not convenient for you, there are multiple Hulst Jepsen clinics that have physical therapists that enjoy treating plagiocephaly and torticollis and could definitely help you as well, and you could call any clinic and they could give you the information on the closest clinic for you.

Alyssa:  Yeah, there are several.  I keep seeing them.  How many locations are there?

Jessica:  We have 14 locations.  Our website, www.hjphysicaltherapy.com, will also list the locations, and then we also have our specialties broken down.  But if you can’t find it on the website, don’t hesitate to call any location.  They can direct you in the right place that’s most convenient for you.

Alyssa:  Awesome.  Well, thanks for coming in today!

Jessica:  Yeah, thanks for having me!

Alyssa:  Email us if you have questions for us or Jessica or anything about their physical therapy offices.  You can email us at info@goldcoastdoulas.com.  Find us at www.goldcoastdoulas.com,  Facebook, and Instagram.  You can listen to our podcast, Ask the Doulas, on SoundCloud and iTunes.

Podcast Episode #28: Plagiocephaly and Torticollis Read More »

cesarean birth

Podcast Episode #21: Supporting a Cesarean Birth

April is C-section Awareness Month!  On this episode of Ask the Doulas, Alyssa and Ashley talk about how birth doulas provide support during a Cesarean section delivery.  You can listen to the full podcast episode on iTunes or Soundcloud.

 

Alyssa:  Hi, welcome to Ask the Doulas with Gold Coast Doulas.  I am Alyssa, co-owner and postpartum doula, and we have Ashley Forton with us again today.

Ashley:  Hi.

Alyssa:  And today the question is, how does a birth doula support my Cesarean birth?  And I think that’s a really good question because everyone thinks of a doula’s support during a normal – I don’t want to say normal, but the typical vaginal delivery.  And what if someone has a planned C-section, or what if they want a vaginal delivery and end up with Cesarean birth?  In their mind, they’re saying, “I had all these ideas about what you do; I paid this money, and now I’m having surgery.”  How do you support that?

Ashley:  Yeah!  So, plans change; birth is unpredictable.  Sometimes we do have clients that have a planned Cesarean and still see the value in our support.  So we can talk about it two different ways.  When you have a planned Cesarean, whenever you hire us during your pregnancy, we’re still there for emotional and informational support throughout the pregnancy, so that can be really valuable.  We can also help you come up with a birth preferences or a birth plan for your Cesarean.

Alyssa:  What does that look like?

Ashley:  When most people think of a birth plan, they think of a labor and vaginal birth, but it still applies to a Cesarean.  You still have choices, and you can still kind of customize your experience.  So we always talk about a birth plan being a starting point for a conversation with your provider, but you can certainly talk to your provider about, is a pass-through drape an option?  Or even a see-through drape?  Is there a clear drape so that I can see my baby emerging, if that’s something that you’re interested in?  Letting them know if you want to have skin-to-skin contact with your baby right away; is that possible?  Have that conversation.  Talking about, hey, can I pick the music that’s playing in the room?  I’ve got this song in my head that I really wanted to play when my baby is born.  Hey, I want to read this poem to my baby as soon as my baby’s born.  You can still do a lot of these personal things.  Talk to the provider about who you’d like to have in the room.  As doulas, sometimes we’re allowed in the OR; sometimes we’re not.  But letting your preferences be known and saying, he, I have a birth doula, and I’d really like them to be in the OR with me.  Have that conversation with your provider.  As a birth doulas, I have been in the OR, but I haven’t been in every single time.  So it’s always worth asking and having that conversation.  So you can talk about who is in that OR with you; you can talk about what happens immediately afterwards.  Hey, I’d like my birth doula in the recovery room with me.  You can talk about all these different preferences when you have it planned ahead of time.  It’s kind of nice to come up with a game plan before going in, whereas when you’re having a physiological birth, you’re going in for a vaginal birth, and then plans change.  Something happens with you; something happens with baby, or you change your mind, and you go in for Cesarean.  Sometimes you don’t have that time to plan ahead and say, hey, this is how I wanted my Cesarean to go.  So sometimes, it’s nice to have that birth plan already written up just in case.  And the way that we support – so let’s say we’re having a planned Cesarean and the birth doula is not allowed in the OR.

Alyssa:  Who is that up to, normally?

Ashley:  That’s up to the anesthesiologist at the hospital, so they make the final call.  So it’s usually a good idea to ask your OB, let them know if that’s something that you want, and then when you see the anesthesiologist, make sure you talk to them about it because they get the final say at most hospitals.

Alyssa:  And I think it’s huge to at least ask because I say the same thing to clients who wonder if their insurance covers this.  The more we ask, the more they keep hearing this word doula, it will maybe someday be covered by insurance, and it will maybe someday be a norm to have a doula in the OR.  So ask!  Keep mentioning it!

Ashley:  Absolutely.  Because you are the consumer; you’re a customer.  You are a paying customer, and we know that customer’s voices are important.  Hospitals pay attention to those surveys.  We know that.  So make sure that you make your desires known, and if it’s not an option, let them know in the survey.  “Hey, this is something I wanted; it wasn’t an option for me.”

Alyssa:  So if you’re not allowed in, what happens?

Ashley:  So what happens if we’re not allowed in is we go to the hospital with you the morning of.  I’ve had some really fun times hanging out with clients ahead of their Cesarean, you know, just having fun, telling jokes, making sure they’re comfortable and feeling good about what’s happening; making sure they feel safe and secure and being there for any emotional needs that they may have during that time, and then when they go back for their Cesarean, I’m in the waiting room.  So I’m there the whole time, and whenever possible, I go back into the recovery room as soon as they’re out of surgery.  So what that looks like just depends on the hospital and what their policy is, but if I can go back into recovery, then Dad is there to support the mom, as well, and I’m there to help with breastfeeding, if they want to breastfeed; to see how they’re doing physically and emotionally; how do you feel right now, after that?  And spend some time with them there.  If I’m not allowed in recovery, then I meet them up in their room.  As soon as they’re settled in their room, we still have that few hours of time together to process things emotionally and talk about how you’re feeling physically.  Is there anything that I can get for you right now?  Can I go get you some extra water?  Something simple like that, but most of the time it’s more emotional; helping them process what’s going on; asking questions about breastfeeding.  As birth doulas, we are trained to support breastfeeding, so we want to make sure that you get a good comfortable latch the first time.  If there’s something tricky going on, we’ll help you get set up with a lactation consultant and make sure that you make that connection.  We’ll get you the resources that you need.  If all of a sudden there’s a medical concern for you or baby, we’ll make sure that you’ve got the information that you want or need.  If it’s out of our scope, if it’s clinical or medical, we’re going to make sure that you know who to talk to.  Hey, talk to your OB; talk to your pediatrician.  Let’s ask your nurse.  We’ll make sure that you’ve got the connections that you need, and if all of a sudden, you’re thinking, shoot, I really feel like I’m going to need some help at home, we can talk to you about how postpartum doulas are an option; let’s talk about that.  Is that something that might be helpful?  So whatever your emotional and physical needs are, we try to address those, and then we still come do a postpartum visit when you’re home and address all those same things again; spend some time together and see how you’re doing because in a week or ten days, a lot changes when you’re home, especially after a Cesarean; you’ve got a lot of healing to do, and we want to make sure that that’s all going smoothly and that you have what you need.

Alyssa:  Thank you for that.  If anyone has further questions about how a birth doula can support either a vaginal delivery or your Cesarean, email us at info@goldcoastdoulas.com.  Remember, these moments are golden.  Thanks, Ashley.

Ashley:  You’re welcome!

Podcast Episode #21: Supporting a Cesarean Birth Read More »

Postpartum depression

Podcast Episode #19: Lisa’s Postpartum Journey

On this episode of Ask the Doulas, Alyssa talks with Lisa about her postpartum doula and how having a doula helped with her recovery.  You can listen to the complete podcast on iTunes and SoundCloud.

 

 

Alyssa:  Hi, welcome to another episode of Ask the Doulas with Gold Coast Doulas.  I am Alyssa Veneklase.  I am co-owner and postpartum doula.  Today we are talking to a client, Lisa, again.  Hello, Lisa.

Lisa:  Hello.

Alyssa:  Last time we talked about her and her husband’s struggle with fertility and how that looked for her.  Just to kind of recap, it took them about two and a half years, and then she ended up with an emergency C-section five weeks early.  So we’re going to talk about what her life looked like once she got home.  So Ethan spent five days in NICU, and you said you were ready.   You were ready after that; five days was enough.  Is that because it was scary having a baby in the NICU, or you just wanted to go home?

Lisa:  Everything is very medical and monitored, and it feels – there’s definitely a separation between the natural kind of mother-and-child bonding, I think, that happens in those early hours, those early days.  So for example, when I had the C-section, they wouldn’t actually let me go visit him until I was able to get up out of bed by myself and go to the bathroom.  So I ended up not being able to see him for the first 17 hours.

Alyssa:  You were like, “I will get up and pee by myself!”

Lisa:  If this is the last thing that I do, I am going to get out of this bed and go pee!  Yeah, so, that made me anxious because I was literally sitting in this hospital bed by myself in a room by myself because my husband was with the baby doing skin-to-skin, and I was counting the minutes.  When do I get to go meet him?

Alyssa:  So five days later, you get to bring him home.

Lisa:  Actually, eight days later.   Yeah, we bring him home, and it was so funny because as much as I wanted to leave the NICU, the minute we got home, he wasn’t hooked up to a monitor so you don’t know his oxygen saturation levels; you don’t know his temperature; you don’t know all these things that the machines are telling you.  And I literally was fearful that he was going to die in the middle of the night.  I’m like, “Well, he’s just going to stop breathing, and I’m not going to know because the beeper isn’t going to go off.”  And so then I had this anxiety about not having all of the faculties that you have in the hospital.  But luckily, we knew right from the beginning that – we had a birth doula who played a very different role than what I expected her to play in the beginning.

Alyssa:  Yeah, absolutely.  How did your birth doula end up supporting you with an emergency C-section?

Lisa:  She didn’t make it to the hospital in time because it was – it happened basically in 45 minutes, and so just with the distance, she couldn’t get there, but she sat with me in the room after I recovered for several hours, when I was coming down off the gas and stuff that you get.  Not gas; it’s an injection, but anyway, you know, when you’re really coming out of the stuff that they give you, and that was really helpful.  I’m glad that I wasn’t alone then.  But we knew that we also wanted a postpartum doula.  Neither of us had been around babies very much in our adult life, and we wanted somebody who was an expert with infants that knew the research and the range of – what are the options, when I have a question?  You know, about sleeping or whatever; that would be a great one because we did struggle a lot with sleeping.  What are the different approaches and why, and what are the pros and cons to each?  I talked a lot to my postpartum doula about sleeping and how to encourage sleeping, creating the right environment and all of that.  But otherwise, I didn’t know what I was doing.  I was also recovering from an abdominal surgery, and I just plain needed help, you know?  I was struggling with getting up and down stairs because it was still quite painful.  And so we had a postpartum doula come in every morning from six to nine through the work week and then on the weekends, my husband and I were together, so then we were able to kind of tag-team, and that was obviously different.  And then we also did have several overnight stays.  But even simple things the postpartum doula helped me with was, how do you get up with a new, new baby, at least get yourself in the shower, and eating breakfast, before you’re kind of down on the couch nursing them for the first time or for the first nap during the day?  And I think that would have taken me weeks to figure out.

Alyssa:  To figure out, like if I get up a half an hour early and try to get in the shower…

Lisa:  Yes!  And just a shower and eating before you’re starting the whole rigmarole of the day, especially when you’re breastfeeding, because I was really hungry – that makes a huge difference.

Alyssa:  Well, and most women, especially in the beginning when you feel like you’re nursing all the time –

Lisa:  All the time!

Alyssa:  And you’re so hungry and so thirsty, and then they tell me, well, I don’t have time.  You need to make time.  If you’re not drinking, you’re not eating, your milk supply is just going to start to slowly diminish.

Lisa:  Yeah.  And then I couldn’t do things like go to the grocery store; that was a big challenge, or do any type of meal planning.  So then our postpartum doula – we said, this is the food that we like, and so she basically created some meals, went to the grocery store, brought them back, did some or all of the food prep for the different meals, and that was just life-saving as well.   But mostly I think for me it was a trusted partner.  Like, who can I just ask anything to and it be just fine?  And maybe it’s lack of knowledge for me or just that I don’t know who else to ask this question to.

Alyssa:  Well, it’s overwhelming your first time.  You literally know nothing.  I mean, very little.

Lisa:  I didn’t even know how to swaddle.  I mean, swaddling was a big learning curve for me.  I never really got it tight enough.  In the beginning; I eventually did, but –

Alyssa:  He’d just kind of ninja his way out?

Lisa:  Yes, he did!  Yeah.  This person, this woman, this angel of mine, her name was Kate, and she was wonderful.

Alyssa:  Now, we should mention – we didn’t mention that you lived in Seattle at this point.

Lisa:  Right.

Alyssa:  So you were not in Grand Rapids.  When did you find out you were moving?

Lisa:  When our son was three months old.  He had just turned three months.

Alyssa:  Yeah, because you had just gotten here when he was about four months, right?  So you had a month to prepare.  How was that?

Lisa:  I think I was in a little bit of denial about how much needed to be done.  We decided to spend more money to push the easy button, so we hired movers to actually pack us for the first time as well as do the cross-country move, and that was worth every dime that we spent, even though that is not cheap.  It was really worth it.  And I just focused on my recovery and my baby and the bonding and just let all that other stuff go.

Alyssa:  So then you got here, and you had Judd’s family here.  You have no family here, and your doula in Seattle found me.

Lisa:  Right, so then I was talking to her, and I said, “You know, I don’t know what I’m going to do.  I don’t know anybody there.  How am I going to unpack into a new house, meet anybody?”  And she’s like, “Oh, well, let me just do some research.  I’ll do some looking for you today,” and she came back the next day, and she was like, “I found somebody.”  And it was Alyssa.  And I was like, “Perfect!  Perfect!  At least I have a doula that I can totally lean on!”  And that was you, and…

Alyssa:  We met, and the rest is history, right?

Lisa:  The rest is history.  And my husband’s family helped us move into the house, and that was unbelievably healthy.  Healthy?  Helpful!  I still have mom-brain.

Alyssa:  It never goes away.

Lisa:  I transpose these words and then it doesn’t make sense.

Alyssa:  It doesn’t go away.  It’s not pregnancy-brain; it’s mom-brain, for sure.

Lisa:  So at the end of the day, I’m really glad that we moved.  I think it was a really, really hard time.  I think moving may be – if you can wait until your baby is closer to one or something, that might be easier, an easier transition for the mom just because you’re so exhausted in the beginning.  But Grand Rapids is really family-friendly, and I’m just so appreciative of that, and I feel like it’s a good place to raise kids.

Alyssa:  We’re glad you’re here.

Lisa:  I’m glad that we’re here.  And I’m glad to have met you!  Thank goodness for you!

Alyssa:  Yeah, we worked eight months, maybe, seven months?  Off and on; it was a lot in the beginning.

Lisa:  Yeah, until he was about a year, yeah.  At a year, I kind of felt like, oh, the weight of all of being a new mom kind of lifted a little bit for me, and I just felt more confident, I guess.

Alyssa:  Well, and he was gaining so much more independence that it was almost – I remember one day you saying “It’s so great.  He’s sitting up and he’s doing all these things, but he’s not my little baby anymore.”  It was like this – I’m so glad he’s doing this because now he can play by himself for a little bit on the floor and I can actually go sit down and eat or do dishes or something, but you struggled with this.  He’s my baby, but he’s not my little baby anymore, and he’s doing all these other things.  And I think we all struggle with that.  Me, I only have one child, so every phase, every developmental stage, I just – good and bad, I love it.

Lisa:  Because that’s the only one you get.

Alyssa:  Yeah.  So I guess that’s a piece of advice I give, especially if you’re only having one –and you may end up trying for more; who knows, but you just – it helps you get through the hard times.  Even the sleepless nights; it’s all temporary because soon he’s going to be eight, right?  He’s not going to want to sleep with you, and he’s not going to want to wake up.  You’re going to have to wake him up!

Lisa:  That’s right.  I can’t even imagine that!  He’s still waking up probably three times, religiously, every night.  But it’s a lot better than what he was.

Alyssa:  You’re getting sleep.

Lisa:  Yeah, I’m getting enough sleep now.  I’m not crazy like I was; sleepless-crazy.  You know, an hour or 45 minutes of continuous sleep, all during the day, if that’s all you get, that is not enough for a person to have their wits about them.  It’s just not.

Alyssa:  No.  I think we’ll talk next time with Lisa about the effects of sleep deprivation and how – you know, a pregnancy journey that doesn’t go as planned along with sleep deprivation and an emergency C-section; all these things; how does that play in your brain.  So stay tuned; we’ll talk next to Lisa about that.  Thank you for sharing today!

Lisa:  Thanks.

Podcast Episode #19: Lisa’s Postpartum Journey Read More »

Tandem Nursing

This article was written about four years ago by Kristin when she was tandem nursing both of her children. She recently stumbled upon it and we thought it would be a beautiful piece to share with all of you!

I never imagined myself as a tandem nursing mom, it just worked out that way.

My children are 21 months apart. We night weaned Abbey during my second pregnancy and I had planned to fully wean her before our son was born. She wanted to be close to me though, and my nurse midwife and friends in the lactation community thought that it would be too much strain on my body to wean during pregnancy, particularly with the potential for the re-emergence of preeclampsia that I had experienced with my first pregnancy.

It is interesting that my daughter loved nursing as much as she did given the challenge it presented early on. I was induced a week early due to the preeclampsia and Abbey was born with low glucose levels. In the NICU she was given an IV, then enhanced formula, and shortly after my pumped milk. Things had to be regulated and scheduled in the NICU. I was given ten minutes to nurse toward the end of her stay, and with such limited exposure it often didn’t work out well. I pumped like crazy, and my husband and I took turns feeding her pumped milk.

When I got home from the hospital, I was overwhelmed. I went back to the lactation consultants at the hospital for assistance and had help in home as well. My husband sometimes had to help me get Abbey latched. After a month of this, she finally took to nursing. I felt like I could finally provide for her. Without support, I would have given up completely. She grew to love nursing so much that it was tough to wean her, even during my pregnancy when I wasn’t producing much milk.

When Seth was born, he nursed easily even with a moderate tongue tie that was corrected within his first few weeks of life. Abbey wanted to nurse whenever Seth nursed, which became a challenge; dealing with toddler gymnastics adjacent a new baby. Seth became accustomed to his sister’s presence on the breast, and the two would latch at the same time during daytime hours.

On my best days of nursing, I felt so present with them. I think about the bond they were building during this time, brother and sister holding hands on my lap. It was beautiful and blissful.

On my worst days, I felt touched out. I wanted to wean them both. I wanted my body to be my own. Sometimes I even wanted to scream, but then I would breathe deeply and realize that this is such a short window, and that they would wean soon enough.

Some of my friends and family disapproved of, or failed to understand, my need and desire to have extended breastfeeding and tandem nursing. I just did what I felt was best for my kids. I took things day by day. That worked for me and for my husband back then.

My kids were healthy and ate well. They never used a pacifier, a bottle, or a blanket or a toy for comfort. It was me they wanted. I could soothe them when they fell. I could make them feel safe after a bad dream. I got to enjoy the bond that they had with each other, sharing my love in that way. It was our life in that moment, and I miss those moments now that they are long gone. I did wean them separately and it wasn’t a problem.

We all have our own individual journeys as mothers. Let’s treat each other with kindness, even if our journeys are much different. If you need help weaning, Gold Coast is here to support whatever your circumstance is, day and night, without judgment.

photo credit: Brooke Collier Photography

 

Tandem Nursing Read More »

Postpartum Doula

Podcast Episode #8: Kristin’s Experience with the NICU

In this episode of Ask the Doulas, Kristin shares her experiences with the NICU when her daughter was born.  You can listen to this complete interview on iTunes.

Alyssa:            Hi, welcome back to another episode of Ask the Doulas with Gold Coast Doulas.  I am Alyssa, and we are talking to my partner Kristin today.

Kristin:           Hello, I’m Kristen, and I’m a birth and postpartum doula at Gold Coast.

Alyssa:            When we talked to Kristin earlier, we found out about your birth story, and during that time, you had said your daughter Abby when she was born spent four days in the NICU.  So can you expand on what it felt like as a parent to have a baby – you know, after a kind of traumatic birth experience, and then you don’t get to bring that baby home right away.  How does that feel?

Kristin:           Yeah, and again, those of you that heard my birth story, it was traumatic in some ways, and then I had preeclampsia, but very redemptive in that I was able to have an unmedicated birth with very few interventions with the preeclampsia, which is pretty rare.  And after I had Abby, it was very standard.  I was able to do skin-to-skin and breastfeed, but they did some testing and found that she had glucose issues, and so then it led to her getting transferred to the NICU, and we were fortunate in that the DeVos Children’s Hospital had literally just opened.  And they had the really-preemie babies in there, and they had the regular ICU that we started out in, which was overcrowded and there were parents standing everywhere, and I was trying to nurse and hold my baby.  And they somehow ended up transferring us to the Helen DeVos Children’s Hospital where we had our own private room and more individualized nurse attention, and I had a rocker and I could hold Abby and nurse her there.  So we got to experience those amenities which now as a doula has served me very well.  And so that was really fabulous, but because of her glucose issues, our pediatrician had recommended that she start with an IV and then it led to, once she got off of that, she was on enhanced formula.  And I was pumping the entire time, so we would spend time with her, and then I would go back to my room to pump, and my husband would stay with her.  And I was pumping without a baby in my room, which obviously you never imagine that you have your child and then they aren’t actually in the room with you.  So that was overwhelming because I kept getting all of these people coming in to help me, like say, okay, you’ve got photographers that want to take your picture with your baby.  Well, my baby’s not there when I’m in there pumping.  The lactation consultants come in, and my baby’s not there, so they’re helping me with pumping, and that’s about it.  So I’m going back and forth, and even though again I had what’s considered a natural birth, I was in a wheelchair because it was one end of the hospital to the other.  So I was getting dizzy trying to walk all of that way myself, so I was overwhelmed by a lot of things.  And the pumping was overwhelming.  So again the heel pricks constantly were hard on me as a mom to see her get poked so many times and cry, and all of the cords and everything that’s involved in a NICU stay is overwhelming.  Everything beeps all of the time.  You can’t really fully hold your child.  And everything was timed when I was eventually able to attempt nursing with her.  So once she got off the formula, I was able to spend about ten minutes, because everything was very timed out in the NICU, trying to nurse.  So if I couldn’t get her to latch or if I couldn’t get my milk to come in – it was coming in at the time that she was in the NICU, so some of that was frustrating because she wasn’t getting a full feed, and then they had to supplement after.

Alyssa:            They’d take her away from you?

Kristin:           Yes, so I had my ten minutes to get that done, and that was really overwhelming.  So I wasn’t sleeping.  And my husband had experienced, with his daughter from a previous marriage, five weeks in the NICU, so he was very familiar with the NICU.  So for me, that made everything easier, so all of the protocols and the beeps and the wires, he was able to help me with, but for me, even four days was a lot, but for him, this was nothing in comparison to his daughter.  So we were able to navigate that, and again, I mean, there was a rocking chair there, and it was very comfortable.  My step-daughter could come in and visit, but it can be overwhelming.  So I have a heart for NICU and high-risk moms because of my own experience, and many of them experience longer stays and just so much more intensity as far as conditions with their babies.  Glucose is very minor in comparison, but it certainly made breastfeeding challenging because, again, with nipple confusion – and in the NICU my daughter had to have a pacifier, which all of my natural birth plans were like no pacifier; never going to introduce a bottle, at least until the first month or six weeks, according to what I learned in Lamaze class and everything.  So that really – a lot of my plans just went out the window, and I had to adapt.  And so I wasn’t sleeping well, and we ended up getting released a day before Abby, so luckily, the hospital allowed us to stay an extra day, but we went home without our daughter, so you can imagine the car seat behind you, and not having a baby, and all of these family members and friends – it’s my first baby, and wanting to come visit us in the hospital, and I was turning people away and saying “No, there’s no baby.  You can’t go to the NICU; there’s no visiting.”  And then to go home and spend the night in your home without your baby there is really tough.  So again, I have a heart for moms that experience that for so much longer than what I did.  But then the next morning, we got up very early and went to the hospital, and she got her glucose tested and she was fine to go, so we were able to go home.  But then when I got home with her, I didn’t know what to do.  I wanted to breastfeed, but she didn’t really want to breastfeed.  She wanted a bottle.  It’s so much less work; it’s quicker.  So, you know, I was pumping, so she had my pumped milk that she could use, and we stopped supplementing by that point, but I had to get a lot of help from lactation, so I went back to Spectrum Health multiple times and met with the lactation consultants, and that wasn’t really working.  So then I ended up having lactation consultants come into my home and help, and I finally got the latch that would really work for me comfort-wise, and I was able to make it work.  And then my daughter didn’t to wean.  She wanted to nurse forever.

Alyssa:            She never gave up.  So was there any fear that day you brought her home, like, she just spent four days in the NICU because there’s something wrong, and they said it’s manageable now, but now she’s home.  Did you have this fear of what if something happens while she’s home?

Kristin:           Yeah, I mean, I certainly wanted to go to the pediatrician’s office as much as I could for reassurance that everything was okay.  And I didn’t know that I could care for her as a new parent and having other people have their hands on her and telling me what to do, and so I was overwhelmed.  And my husband went back to work, and I was used to working, so I had my leave time, and that was a little challenging, especially having spent three weeks on bed rest right before having her.  So that isolation was a bit much, and I didn’t know what postpartum doulas were back then, but I did have the help from a local nonprofit called Moms Bloom, and a volunteer came into my home who was retired.  So she was a grandmother, essentially, and she would hold Abby so I could take a shower or do some things around the house, and that was nice.  And it gave me someone to talk to because again, I was overwhelmed and lonely.  And it reassured me that I was doing everything that I needed to, and that there were no concerns, that she was normal and healthy.  So yeah, there is some of that anxiety as a new parent coming back from the hospital and that’s something that I wouldn’t be able to catch, could be wrong again with her.  But we got through it, and again, she nursed into toddlerhood, so it all worked out.

Alyssa:            Go, Abby!

Kristin:           It’s all about, yeah, just getting resources and having a support system around you after getting home from the NICU because it can be overwhelming.

Alyssa:            It’s so easy to give up.  I think that’s key it just have enough support and don’t be afraid to ask for help.

Kristin:           Yes, exactly.  Yeah, and so you’re not alone, NICU moms!  I understand, in a very small way, what you go through, but there are so many wonderful nurses and support groups within the hospital, and the breastfeeding support groups, so just know that you have resources and reach out to the community.  Postpartum and overnight doulas are here to help, so again, that’s something that I would have used had I know that that was an option, and for NICU moms especially, we can lighten your load a lot and give you reassurance and support with your new baby or babies.

Alyssa:            Well, thanks for sharing, and if you want to find out more our daytime and overnight postpartum doulas, you can check out our website, goldcoastdoulas.com, and then if you want to email either of us, Kristin or I, info@goldcoastdoulas.com.  We would love to hear from you.  Thanks, Kristin.

Kristin:           Thanks.

Podcast Episode #8: Kristin’s Experience with the NICU Read More »