Boise Doula Pregnancy, Birth, and Postpartum Information and Inspiration, for the Treasure Valley

Breastfeeding: Get Off to a Good Start

8/1/2019

Photo Credit: Dave Clubb via Unsplash

The benefits of breastfeeding, or providing breastmilk to your baby, are well known. Most of my clients intend to breastfeed for some length of time.

What I try to impart in prenatal discussions with clients, however, is that intention is usually not enough to get off to a good start with breastfeeding. Maximizing the breastfeeding relationship also involves education, planning, and knowing where to turn if difficulties arise.

1. Take a prenatal breastfeeding class. There is so much more to breastfeeding than putting baby to the breast. While breastfeeding is a natural process, that doesn’t mean it is necessarily intuitive, easy, or without complications.

A good prenatal breastfeeding class should cover most of these topics:

The bodily mechanics of breastfeeding, including the hormones involved, breast anatomy, and how breastmilk is produced and transferred
The composition and benefits of breastmilk and breastfeeding
Your baby’s dietary needs, from birth through the first few weeks or months
Your baby’s hunger cues and feeding patterns
How to establish a good latch and why this is important
Different breastfeeding positions
Your dietary needs and postpartum support
How your partner can support and encourage breastfeeding
Hand expression and pumping and when to start, and breastmilk storage guidelines
Alternative ways to feed your baby
When and why to supplement with formula or donor breastmilk
Bottle feeding, including paced bottle feeding
Complications that can interfere with breastfeeding such as tongue tie, Cesarean birth, premature birth, nipple pain, clogged ducts and mastitis, thrush and supply issues
Local resources for breastfeeding support

While you may not retain or need all the information you learn in a prenatal breastfeeding class, you never know what important facts will be helpful as you learn to feed your baby. Misconceptions you may have had will be dispelled, enabling you to use the most accurate information to support your efforts.

Plus, it will be much easier to find the time and energy to learn about breastfeeding before your baby is born, rather than while you are recovering from birth and learning to feed your baby, all with limited sleep.

2. Get hands-on help with latch. A good, deep latch is one of the most important factors in establishing a good breastmilk supply.

When your baby suckles at the breast, it signals to your body to produce the hormone prolactin, which stimulates the production of breastmilk. Oxytocin is also released, triggering the let-down reflex which expels the breastmilk from the milk ducts.

When the latch is shallow, or there is a problem with latching, this hormonal interplay is interfered with and over time, your milk supply and/or baby’s ability to transfer milk from the breast can be negatively affected.

Most hospitals offer lactation support, sometimes immediately after birth and in postpartum recovery. Birth center and home birth midwives also help with breastfeeding and latch; during postpartum home visits, midwives assess baby’s weight gain and can make recommendations for additional lactation support if needed.

As a birth doula, I can help my clients with that initial breastfeeding right after baby is born, showing them the hallmarks of a good latch. Or, I can help them to facilitate baby latching on his or her own, either via a breast crawl or with a laid-back breastfeeding position. If there is separation from baby for a period of time, I can help them hand-express colostrum into a cup or syringe that can be given to their baby instead of formula, if that is their preference.

And when I visit my clients at home, either at the follow-up postpartum visit or as a postpartum doula, we can continue to work on latch after their milk has come in, trying out different positions. If there are signs of a complication beyond my scope as a doula, I can refer them to a local lactation specialist for professional support and problem solving.

Getting frequent, hands-on help with latch can ease anxiety and frustration in the birthing person, possibly avoid supply issues and injury to the nipples, ease pain or discomfort during nursing, and make the experience more enjoyable.

3. Turn to the experts for help. Breastfeeding problems and solutions can be complex and can involve several factors, including breast anatomy, baby’s anatomy, diet and nutrition, hormones, birth influences, emotional and cultural considerations, the need for supplementation, and more.

Sometimes, people get advice or help from family members or friends, or even professionals, including lactation consultants, pediatricians, and family doctors, that aren’t based on the latest research. Or the advice doesn’t take into account all of the factors mentioned above that can make breastfeeding issues challenging. They may not be familiar with alternatives or breastfeeding best practices. And they might not have the availability or resources to provide the frequent, hands-on help that nursing people often need.

When my clients need breastfeeding help beyond what I can provide, I refer them to the infant feeding experts: International Board Certified Lactation Consultants (IBCLC’s). The requirement to become an IBCLC includes extensive education, over 1,000 hours of clinical experience, and passing a rigorous exam. IBCLC’s know breastfeeding and can help you work through a myriad of problems, with solutions tailored to your individual needs and preferences.

See my Parent Resources page for some local IBCLC’s I know and trust.

4. Support for breastfeeding goes beyond actual breastfeeding. Knowing how to support breastfeeding and actually having the support you need to breastfeed are two different things.

When you are recovering from birth and learning to care for your new baby, it becomes much more difficult to learn to breastfeed when you also have to worry about preparing meals, keeping your house in order, caring for older kids, entertaining visitors, or “bouncing back” to a preconceived notion of how your life should look.

Anything that adds stress instead of reducing it can interfere with breastfeeding. Making a postpartum plan while you are pregnant, reframing in your mind for what the postpartum period should look like, and enlisting help wherever possible— whether that be from your partner, family and friends, outsourcing tasks, or a hiring a postpartum doula— are all ways to support breastfeeding.

5. Be gentle with yourself in your journey. Breastfeeding doesn’t always go as you plan. Sometimes you find that supplementation, or exclusively pumping, or formula feeding, or sourcing donor milk, or weaning, or some combination of these, is the best choice for you at any point in time.

Know that what works for you now may not be what works for you down the road. Know that if you struggle now, that doesn’t mean you will be struggling later. Know that if you hit a snag, there are people in the community who can help.

And know that your mental and physical health matters. There is no “right” time to wean, except when you and/or your child are ready. Be gentle with yourself and allow yourself the grace to find your own way.

I am a certified birth doula, postpartum doula, and childbirth educator serving clients in Boise, Meridian, Eagle, Nampa, and the Greater Treasure Valley.
What kind of breastfeeding help will you need when you have your new baby?

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Copyright 2019

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Embrace the Parenting Season You're In

11/1/2018

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These gorgeous photos are courtesy of Natalie Koziuk Photography. Clients of Elevated Birth get discounts on sessions with Natalie!

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New Baby? Pregnant? Trying?
What's Your Season?

Fall is in full swing here in the Treasure Valley. The hardwood trees are showing off their splendent colors like a proud peacock, while the evergreens are happy to provide an understated contrast to their brilliance. The air is crisp in the morning, but often mild enough in the afternoon to encourage bathing in the warm light of the sun.

This is the season for pumpkins, and jewel tones, and scarves and boots. It’s also the season of extending the time between shaving my legs a little (okay, a lot!), and sleeping in as long as possible in the mornings because it’s dark outside, and then without fail, rushing on our way to school.

The seasons are a time of transition, of moving from one state of being to another. The same is true of the seasons of our lives, especially when we have children. When we transition from not pregnant to pregnant, from pregnant to raising a newborn, through toddlerhood, teething, returning to work, deciding to stay home, our relationship without kids and then with kids—these seasons look different because they are different.

We make different choices; we approach life differently than we did last season. We are, in many ways, different people.

And despite what social media presents, or what your friends are doing, or what your critical inner voice is telling you, it’s okay to just embrace the season you are in. Here’s how:

1. Identify your season.
After I had my first child, I gave away all of my high heels. I decided I was going to quit my corporate job to stay home with him, and since my Friday nights now looked exactly the same as my Tuesday mornings— in yoga pants and flats— they were just taking up space in my closet. Purging a small section of my closet felt like a big step toward embracing my new life.

What season are you in? Are you getting out as much as possible before your baby arrives? Are you hunkered down at home with eternally sick toddlers? Are you freezing breastmilk for an upcoming return to work? Are you trying to get pregnant?

When you recognize where you are, you can then:

2. Accept both the joys and the limitations.
I miss breastfeeding. It surprises me to say it now, because my daughter never took a bottle and wanted to nurse all the time, until she was almost two years old. Dinnertime was the hardest, because she always wanted to be on my lap nursing and I could never seem to finish a hot meal.

In that season, eating my dinner without a child attached to me wasn’t possible. But being able to comfort her in a way only I could, was. In that season, my dream to pursue doula work wasn’t possible for our family. But now that my kids are older and don’t need me in that way, I’m able to help other families as they begin their early parenting journeys.

Each season has its joys and limitations, even if you aren’t always able to see them until you’re out of it. So,

It’s okay to let the dog hair accumulate on the floor because nursing a newborn takes forever, and a shower was more important than spotless floors.

It’s okay that all you did today was hold your baby. That was all you needed to do. Everything else really could wait.

It’s okay that your body looks different than it did before. It’s a different body, an amazing one, that grew and birthed a human! And in three months, one year, or three years, it will be a different body again because you will be in a different season.

Photo credit: Natalie Koziuk Photography

3. Say no to what doesn’t fit into this season.
When you say no to one thing, you are often saying yes to something else. And vice versa. Only you and your partner can determine what does and doesn’t fit into this season.

If you say no to hosting visitors, maybe you are saying yes to getting enough rest and sleep.
If you say yes to a messy house, maybe you are saying no to added stress and physical strain.
If you say no to allowing a particular person into your birth space, maybe you are saying yes to establishing healthy boundaries.
If you say yes to giving your baby a bottle, maybe you are saying no to neglecting your own mental or physical health.
If you say no to returning to work right away, maybe you are saying yes to establishing breastfeeding.
If you say yes to the expense of outside help, maybe you are saying yes to more time to take care of yourself.

And so on. Embracing your season means making choices that align with what you want and need from this time.

And when the next season begins to unfold, take a deep breath and open your eyes to the beauty to be found at any time. Even in the biting cold of winter there is warmth in the nuzzle of a baby's soft cheek. At any time, this amazing, exhausting, incredible world of parenting has so much to embrace.

I am a certified labor doula (birth doula) and professional postpartum doula serving Boise, Eagle, Meridian, Nampa, and the Greater Treasure Valley. What season are you in?
Do you need support for an upcoming birth, or help with your new baby?

Let's Talk!

elevated birth
Copyright 2018

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Five Facts About Newborns You May Not Know

9/20/2018

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He will teach you what you need to know

One minute they are in your body, the next minute they aren’t. It’s pretty insane when you think about the moment of birth, when the baby who grew from a speck of cells inside of you, is now an individual, still very much dependent on you, but now distinctly their own--although tiny--person.

Experienced parents will tell you that babies are born with a particular personality, and that looking back, traces of that personality were evident as early as birth. Some strong-willed tots emerged from the womb with mighty wails from their freshly-initiated lungs, and more pensive kids met the world with a quiet awareness. It’s one of the greatest lessons I personally have learned as a parent— that there is so little about my children that I can control. They are who they were when they were born.

Still, newborn babies share many common characteristics. The various newborn reflexes that have been identified are the same in babies the world over. Many of these reflexes are designed as survival mechanisms, or to facilitate finding and latching onto the breast.

Newborn sleep cycles, those initial smiles and coos, the surprisingly tight grasp of a baby’s hand around your finger (or strand of hair— ouch!) We take classes during pregnancy and read books to prepare ourselves for life with a newborn, but often most of our learning comes from on-the-job training. They teach us how to be their parents.

And there are some things the books don’t tell you, or even if they did, you may have glossed over. So here are five newborn facts you may not know, that may help you as you meet and learn to care for your new baby:

1. Babies sometimes take a while to breathe. When babies are born, it can take about ten seconds—sometimes longer— until they begin to breathe with their lungs. Because the umbilical cord is still attached to the placenta, which at this point, is still attached to your uterus, your baby continues to receive oxygen through the blood that is traveling from the placenta to your baby. As soon as the umbilical cord is cut, the placental oxygen supply is cut as well. (This is one reason why parents and care providers choose to delay clamping of the cord, so that baby receives as much blood from the placenta as possible.)

Babies can appear blue or purple in color for minutes after birth; once their bodies are fully oxygenated, they begin to “pink up.” Parts of their bodies, especially their extremities, can still appear bluish after birth, but this usually improves after their circulatory system begins to mature.

2. Babies benefit from the breast even before your milk comes in. Your breasts don’t begin to fill with milk until around 2-3 days after birth, sometimes even longer. However, babies benefit from latching onto the breast as soon as they are born, if possible, and then every few hours after that.

At birth (and sometimes during pregnancy), you produce colostrum, a concentrated form of early breastmilk that contains antibodies and nutrients. Even though it may not seem like they are getting much from the breast, colostrum is usually all your baby needs until your milk comes in. Plus, the very act of sucking at your breast puts in your baby’s “order” for milk later on. The more your baby latches on, the more your body gets signals to produce milk. So if you intend on breastfeeding for any length of time, have someone help you get a good latch going and get lots of nursing practice!

3. You may want to opt out of that first bath. Not yours— a nice, hot shower after labor can feel like heaven! I’m talking about your baby’s first bath. Many hospitals have changed their policies to delay bathing newborn babies for at least 24 hours, or not at all. Here are some reasons why you may want to wait to bathe your baby:

Some babies are born with vernix caseosa (known simply as “vernix"), a thick, white substance coating your baby’s body. Vernix has antibiotic properties, and along with colostrum, can help protect your baby’s vulnerable immune system. You can rub it in like lotion, or wipe off areas that may have been stained with baby poop. (Note: later-term babies tend to not have vernix at birth, and that’s perfectly normal!)
The stress hormones released by the bathing process can cause baby’s blood sugar levels to drop, which may have a negative impact on feeding.
The more time a baby spends with his parents, bonding and breastfeeding, the greater the rates of breastfeeding success. Oxytocin, the hormone responsible for contracting the uterus during labor, is also called the “love hormone,” because it plays a role in bonding with your baby, bonding with your partner, and breastfeeding. Delaying that bath keeps the oxytocin flowing.

4. Newborns are noisy. Your baby's cries can feel like the loudest sound on earth. But newborns are noisy when they sleep, too. They grunt and grimace, whimper and yelp. All while they are sound asleep. While it is important to respond to your baby's cries and offer immediate comfort, you may be unintentionally waking a baby who is actually asleep!

If your baby is due for a feeding soon, look for cues like rooting or sticking their hands in their mouths. These are more reliable sign of hunger than the noises you hear when they are actually asleep. If you co-sleep with your baby, you may find that you become more quickly familiar with the noises she makes, and begin to anticipate your baby's needs before she begins to cry.

5. Newborns learn with their hands. You may look back on photos of you as a baby, hands covered by cotton drawstring baby mittens, and assume that mittens are a must for your baby registry. This thought is confirmed when your baby’s dagger-like nails are already scratching up her cheeks with red marks just days after birth. Or maybe you feel she needs mittens to keep her hands warm.

However, baby development experts now advise to ditch the mittens. Babies learn by touch, and when their hands are covered by mittens, they miss out on valuable tactile learning time. Instead, use a baby nail file to shorten and smooth out their nails, and allow them to explore their new world through their sense of touch.

So let those baby hands free!

Let those baby hands free!

I am a certified labor(birth) doula and professional postpartum doula serving Boise, Eagle, Meridian, and the greater Treasure Valley.
Need help preparing for birth or need help with your baby? Let's talk!

Let's Talk!

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What this Doula Wants You to Know - Part II

5/2/2018

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Treasure Valley Postpartum Doula Support

Image by Oleg Sergeichik via Unsplash

This is a two-part series. Look for the first part in my previous post:
What this Doula Wants You to Know About Birth

What this Doula Wants You to Know About Postpartum

1. The postpartum period is underestimated. Many people focus on the birth of their baby, choosing a care provider, a birth place, and making a birth plan. These are important endeavors, and require adequate research and planning. Yet often little consideration is given to the specifics of how life will function after the baby is here. Researching options for baby gear, registering for diapers and essentials, and choosing a pediatrician is only part of what you need to decide. Just as you need to determine who will take care of your house, older children, pets, work commitments, etc. before and during your birth, these needs will continue and perhaps be more difficult to meet when your baby is earthside. Factor in the need for physical healing, dramatic hormonal changes, and caring for your baby-- all with limited sleep-- you may realize that you need much more help than you planned for. Making a postpartum plan during pregnancy can help prepare you, your partner, and extended support system to meet the needs of the entire household after the birth.

2. Your body may take longer to heal than six weeks. There is a popular meme circulating on social media that pictures a paper dinner plate. That dinner plate represents the size of the wound in your uterus where your placenta was attached. I admit, as the mother of two kids and a trained doula, I had never considered the size of the wound inside my body after birth. It's a powerful visual. If that wound was on the outside of your body, no one-- including yourself-- would expect you to do much for several weeks after birth.

If your birth was physically difficult, you had tearing that required stitches, complications, a high-intervention birth, or a Cesarean birth, your body may take even longer to heal. In the immediate postpartum you may experience vaginal soreness, pain while urinating, difficulty pooping, heavy bleeding, contractions as your uterus shrinks back down to its pre-pregnancy size, sore breasts from learning to breastfeed, irritation or pain from your Cesearan incision site, swelling, profuse sweating, and a host of other physical discomforts.

Your care provider may "clear you" at six or eight weeks, but your body may need more time. You may not be ready for intercourse, work, chores, or outings. You may need more periods of rest, even if you feel physically better. You may need additional treatment, like physical therapy. Accept that your body went through a LOT, and allow yourself the time and grace to heal.

3. Be proactive with lactation support. If you choose to breastfeed, know that it can be difficult to get started. Taking a breastfeeding class in pregnancy is a good idea, but it may still confusing to implement what you learned when baby is actually at your breast. Add in hormonal changes, a baby that needs to eat, and conflicting advice from those trying to help you, and you have a recipe for anxiety and unnecessary stress. Seek out the support of a postpartum doula or lactation specialist early in the postpartum period to get you off to a good start. Any issues outside of normal may be more easily identified and addressed. If needed, referral to an IBCLC (International Board Certified Lactation Consultant) can be made.

Two IBCLC's in the Treasure Valley I refer clients to are Melanie Henstrom at Baby Bonds and Lynnelle King at Family Seasons, LLC.

4. Pelvic floor therapy is a no-brainer. Pregnancy and childbirth do a number on our pelvic floor muscles. Complications include urinary and fecal incontinence, uterine prolapse, pubic symphysis pain, diastasic recti, and more. In France, postpartum pelvic floor therapy is standard care. In the United States, it is not, and unresolved injury can be left untreated, causing years of pain, discomfort, and embarrassment. Check out my blog post all about the pelvic floor.

Seeing a pelvic floor specialist in pregnancy can set you up for easier care after your baby is born, or even prevent issues postpartum. In the Treasure Valley, pelvic floor therapy is now even easier to obtain, with the launch of Treasure Valley Pelvic Health, a mobile pelvic therapy provider who will come to you. Your first visit is 20% off in the month of May.

5. Your emotional and mental health needs as just as much attention as your physical health. Postpartum mood and anxiety disorders (PMAD) affect 15-20% of women. These include postpartum depression, postpartum anxiety, postpartum panic disorder, postpartum obsessive-compulsive disorder (OCD), and rarely, postpartum psychosis. Educating yourself, your partner, and close family and friends in pregnancy about the signs of these disorders can help to identify them and get treatment as soon as possible.

Even just noticing that you feel "off," and "not yourself," can be enough proof to seek out an evaluation from your care provider. Don't discount (or let others discount) the effects of a traumatic or disappointing birth experience on your emotional health, either.

Resources to begin to seek out help include Postpartum Support International (PSI) at www.postpartum.net, your care provider, or local mental health professionals with experience in treating PMAD's. You can find a recommended list of providers on my Parent Resources page.

Even if you don't suffer from a PMAD, you may feel overly tired, stressed out, emotional, sad, disappointed, discouraged, or down at times. A healthy and committed support system that allows you to rest, heal, eat well, and focus on little more than you and your new baby can maximize your chances for a positive postpartum transition. Postpartum doulas can play an important role for those without a strong support system, or those who want or need extra support as they transition to life with a newborn.

By planning for the postpartum period, building a robust support system, and taking advantage of local resources, you can start off on your new parenting journey from a place of confidence and strength. Everyone benefits from a healthy mother or birthing parent-- your baby, your partner, and you especially.

I am a certified labor doula and professional postpartum doula serving clients in Boise, Meridian, Eagle, Nampa, and the greater Treasure Valley. How can I help you plan for your postpartum?

Learn About Postpartum Doula Services

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Body Positive, Birth Positive

3/13/2018

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She's got the neck support down!

Photo by: Marcos Moraes

As a doula, my kids are exposed to a lot of Birth talk. They ask questions about what I do, but I don't always know how much they have retained. Then one day over a year ago we were driving around and I heard the following exchange between my then 9 year old son and 6 year old daughter:

Daughter: A baby can come out of the woman's vagina or they can cut it out of the mom's belly.
Son: You mean a C-Section. Or, what's that other word, Mom?
Me: A Cesarean.
Son: Yeah, a Cesarean. But usually vaginal is better for the mom and the baby because the Cesarean is major surgery.
Daughter: Yeah, I'm going to have my babies born through my vagina.

The conversation didn't go much further than that. What struck me at the time was how comfortable they were with talking about birth, vaginal or otherwise. Perhaps because of what I do, in our family we make a point to use proper names for body parts; the vagina is different from the cervix and the vulva. The baby grows in a "belly," but they know that it's actually in the uterus.

The comfort my husband and I share regarding the facts and process of birth, has led us to share information about sex and development in an age-appropriate way with that same level of comfort. Recently I accompanied my son to a school-facilitated boys' puberty class. There were the expected dramatics-- giggles, groans, and feigned screams of horror at the mention of a girl's period-- but the factual manner in which my son absorbed the material made space for more than the facts. Because this information was not new to him, extended conversations about feelings and expectations of his own development were possible.

My daughter has added "doula or midwife" to her list of what she wants to be when she grows up (along with professional soccer player, teacher, and puppy rescuer). She asks a lot of birth-related questions, usually during bath time or right before bed. She asks, and I answer factually. If she asks further, we go further. Aside from facts, our conversations have gone deeper than I would have ever imagined at this age. One day she asked, "What if the woman wants to have sex but the man doesn't?" Internally giggling, I answered, "Both people need to want to have sex or else sex doesn't happen." Just like that, we began a rudimentary conversation about consent.

Birth creates an opportunity to have these conversations, with our own kids, and with ourselves. Many of us did not grow up in households where sex or birth were discussed as normal events, or they weren't discussed at all. If birth was discussed, it was in negative terms, focused on pain, or bad moods, or absent and neglectful partners, or complications. Instead of pain and shame, we need to hear stories of perseverance and pride.

It's normal and common to poop during pushing? Maybe we can let go of anxiety around that. The muscles of the vagina and pelvic floor stretch for birth? Maybe we can stop worrying about our vagina "never being the same." You had a 3/12/24/48 hour labor that ended in unmedicated vaginal/emergency Cesarean birth? Maybe we can praise ourselves for facing our fears and challenges to the best of our abilities, and let go of the rest.

Our views of our own bodies can affect the way we give birth. We might consider birthing in a different way than our parents or friends. We may take more care in choosing a care provider that respects our preferences for birth, who values and practices informed consent with their patients. Our relationships may be strengthened through pregnancy and birth, as we marvel in the bodies of our partners and their role in creating new life.

The kids we raise will benefit from our positive feelings about our bodies and our births. The child exposed to breastfeeding as a normal, non-shameful way to feed a baby may have an easier time in her own breastfeeding journey, or may be more supportive to a future breast-feeding partner.

When we know what our bodies can do, we take ownership of our births.

Birth is normalized. Shame loses its power.

When we are body positive, we can positively birth.

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Breastfeeding: Get Off to a Good Start

Embrace the Parenting Season You're In

New Baby? Pregnant? Trying?
What's Your Season?

Five Facts About Newborns You May Not Know

What this Doula Wants You to Know - Part II

What this Doula Wants You to Know About Postpartum

Body Positive, Birth Positive

Doula Raquel

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Categories

Location

What Our Clients Are Saying

connect with me

Subscribe TO my EMAIL LIST FOR UPDATES & PROMOTIONS

Breastfeeding: Get Off to a Good Start

Embrace the Parenting Season You're In

New Baby? Pregnant? Trying?​What's Your Season?

Five Facts About Newborns You May Not Know

What this Doula Wants You to Know - Part II

What this Doula Wants You to Know About Postpartum

Body Positive, Birth Positive

Doula Raquel

Archives

Categories

Location

What Our Clients Are Saying

connect with me

Subscribe TO my EMAIL LIST FOR UPDATES & PROMOTIONS

New Baby? Pregnant? Trying?
What's Your Season?