Barb's Daily Dose

Donating Breastmilk

Yesterday, I was on View from the Bay, talking about a new trend of sharing breastmilk among moms. A few moms are not only breastfeeding their own babies, but are also offering up a snack for babies of friends or family. This is something that breastfeeding professionals try to discourage because of the risks of passing infections on to another baby.

Incredible, as this seems, some moms wonder if this is a new twist on “Wet nurses” or a dangerous fad.

Q:  Breastmilk is undoubtedly the perfect food for babies.  But is it safe for moms to breastfeed other children?

A:  This is a both a simple and a complex issue and I wish there was an easy answer. There are risks of transmitting more than just milk Including HIV, Hepatitis B, Hepatitis C, CMV, and other dangerous microbes. Remember, breastmilk is body fluid, so sharing body fluids can be a risky exchange.

Breastfeeding in Public

This is a guest post by Tangela Walker-Craft who invented an amazing breastfeeding pillow, The Go Pillow. Tangela saw a need for moms and designed a solution.  Here's her story.

Breastfeeding Babies

No matter how controversial it can be, all moms have the right to breastfeed their babies anywhere.  The catch 22 is that just because someone has a right to do something doesn’t always mean that they should.  The rights of breastfeeding moms should be respected; conversely, the rights of those around breastfeeding moms should be equally respected.

As a mom that breastfed for two years, I always took the rights of those around me into consideration.  I knew from personal experience that small children may not fully understand the concept of breastfeeding.  I became aware of this when I saw my two year old niece attempt to breastfeed her doll after seeing me feed my baby.  As cute as that was, I recognized that she was mimicking a behavior that may not have been appropriate for a child her age, and since she was my niece, I wanted to be sensitive to her parents.  

Though she may have breastfeeding in her future, it was not something that she needed to practice for at such an early age.  Out of respect for her parents, I tried to avoid breastfeeding in front of her whenever possible.  Because I was very modest anyway, I would never have breastfed in front of any little boy.  I personally feel that it is inappropriate to expose one’s breast in front of anyone’s young son.

Codeine After Birth

Careful with Pain Relief

Recently, there have been disturbing reports of new moms who were prescribed codeine to help reduce their pain after giving birth. Sadly, some moms have a genetic variance that causes them to be rapid metabolizers of codeine. When codeine is rapidly metabolized it produces high levels of morphine in the blood and breastmilk which can leave babies very drowsy and difficult to wake. In 2007, in Toronto, one baby whose mom had taken her prescribed codeine for pain relief died after breastfeeding.

Rare

Thankfully the genetic variance that causes rapid codeine metabolism is rare. So taking codeine is not risky for most women and is worrisome for a few.

• The US FDA found that 1% to 10% of Caucasians and about 3% of Asian and African Americans are rapid metabolizers.

• Women from North Africa, the Middle East and Africa have much higher rates of this genetic variance, and it’s estimated as high as 28%.

Don’t stop Breastfeeding

The most important thing that we all have learned from this terrible tragedy is to ask women if they’ve ever used these medications in the past and whether they felt drowsy of more of the effects than expected. These moms should try non-narcotic pain relief first.

Successful breastfeeding

Top breastfeeding hospital in California

For the 2nd year in a row, El Camino Hospital in Mountain View, California had the highest rate of breastfeeding moms, a whopping 95%. This is fantastic news, and I’m excited because that’s where all of my patients deliver their babies. It’s a testimony to the superb and enormously dedicated lactation consultants who spend hours with moms to help support them. I practice at Women Physicians Ob/Gyn there with a great group of brilliant and talented doctors who also support breastfeeding.

At the hospital, there’s also a drop in lactation center, classes and lactation consultants available. I practically walk my patients downstairs to to sign up for classes. I strongly recommend (read: push) my patients into the pre-delivery breastfeeding classes, because I've found over the years, that women who take the classes and read the books before the baby shows up hungry, have a much easier time and fewer issues.

No one takes off their top

After all it's a new skill for both, so it makes perfect sense to have an idea ahead of time what to expect.

Breastfeeding After The Baby's Born

Before your milk comes in your breasts will produce a thick, yellow
fluid, or first milk known as Colostrum. This is a rich source of
nourishment from protein, fat, minerals, milk sugar (lactose), and
antibodies that help protect the baby from infection.

Colostrum—Is less than 1 ounce per feeding. In the first days,
baby’s stomach is about the size of a marble, so this is the perfect
amount for them.

Nurse frequently—This is especially important in the first few
days. Aim for every 2 - 3 hours. The time interval starts from the
beginning of a breastfeeding session to the beginning of the next.

Frequent nursing will:
• Stimulate further milk production.
• Help lessen or prevent engorgement when the milk does come in.
• Help the baby clear their meconium (the dark, sticky, tarry
first stool that we nurses call toxic waste)
• Provide nourishment and antibodies.
• Provide lots of practice for mom and baby.

Practical tip for Meconium:
• Baby oil on a soft cotton pad (the kind you use to wipe off makeup) will help wipe away meconium
• Warm water on soft cotton pads eliminates the need for diaper wipes and is less costly