LA LECHE LEAGUE OF DALLAS

Breastfeeding Information and Support

Happy Holidays? Coping with the Season By Barbara Wilson-Clay, Special Contributor, Austin, TX

he winter holidays are here with all their bustle and excitement. It is a fun season, but it can also be stressful— Tespecially for women, who often feel responsible for orchestrating the events that make family celebrations special. When the holidays coincide with the birth of a baby, some new quickly become overwhelmed. Fatigue and stress can make these mothers vulnerable to . The baby can be affected too. Over-stimulation Issue 16 and interrupted feedings can lead to a nursing strike. hot lines have so many seasonal crisis calls that they have named the phenomenon "holiday ." Nov/Dec 2005 Postpartum Versus the Holidays The early postpartum period is supposed to be restful. and baby are advised to "nest" for about six weeks. Frequent nursing during this time stimulates the supply. All the cuddling helps the mother and baby get to know one another and to fall in love. Because newborns feed around the clock, experts recommend that tired new Inside this issue: moms nap whenever the baby sleeps. Ideally, grandmothers or other family members are available to help by taking over some of the nor- mal chores, errands, and care of older children. A lighter workload and Happy Holidays? Cop- 1,5 ing with the Season staying out of crowds protects mom and baby from infections as they recover from . This may be especially important during flu season. As sensible as this advice may be, it frequently flies out the Fall Harvest 2 window the day before Thanksgiving. Perhaps mothers overestimate their own energy. Perhaps they succumb to pressures to be Super Mom. Holiday Shopping Guide Perhaps family members who want the holidays to be the same as usual 2,3 for Nursing Moms place unreasonable expectations on the new mother. Whatever the rea- sons, instead of resting and recovering, mothers who deliver babies in November/December 3 November and December often find themselves shopping, cleaning, Events decorating, cooking, and entertaining. Holiday Shopping and Stress and Fatigue Can Lead to Plugged Ducts and Infection 4 Calendar Breastfeeding is affected in a number of ways when new moms take on too much too soon. Newborns feed fre- quently. Their frequent feeding schedules are nature’s way of preventing the from becoming overly full. Announcements and 6 When feedings are interrupted or delayed, the breasts may become engorged. If engorgement is coupled with fa- Thanks tigue, an inflammatory condition called 'plugged ducts' can occur. A woman may notice that part of her breast has become especially tender. The skin over the plugged area may redden. Mothers with these symptoms need to get off their feet immediately. They should encourage the baby to nurse frequently until the breast softens and thor- This newsletter is produced every oughly empties. Comfort measures include ibuprofen and the brief use of warm compresses before nursing. Cold two months. Contributions are welcome. Next edition will be compresses between feeds help reduce swelling. Most of the time, rest and good breast emptying will prevent pro- January/February. gression to mastitis. Mastitis is an infection of the breast. Mothers with cracked are at much greater risk for mastitis. Some, but Please send articles, book reviews, not all, women with breast infections will develop high fevers. Most women report headache and flu-like discom- quotes, questions and answers, fort. Localized pain and redness on the breast occur along with reduced milk flow from blockages caused by inter- recipes, birth stories, weaning nal swelling. Milk supply almost always decreases during episodes of mastitis. The milk supply stabilizes as moth- stories, poems, etc. to: [email protected] ers recover. A woman with symptoms of mastitis should telephone her doctor or clinic. The treatment for mastitis is bedrest for two days, breast emptying, and treatment with oral antibiotics. Some women report good results from the use of Information and ideas included do not necessarily reflect the views and homeopathic remedies. Hot and cold compresses may be used, but some experts discourage prolonged use of heat. opinions of all members. (Continued on page 5) Page 2 LA LECHE LEAGUE OF DALLAS

Fall Harvest

Fall is finally here and that means you may notice some different produce options at your local Thank you, Jen Widhelm, for grocer. Take advantage of the bountiful fall harvest by adding some seasonal side dishes to your hosting the LLL of Dallas meals. Here are a few favorites! garage sale on October 27 and Parsnips are a root vegetable that look bit like a white carrots and are an excellent source of folate and vitamin C. If they are peeled and cut into 28 at your house. The wedges, roasted with a little garlic salt in the oven, and served with proceeds from the sale totaled ketchup, even the most discerning toddler may think they are French fries. nearly $450.00. Everyone, There are so many wonderful varieties of squash available during this time of the year. Two fa- please start saving gently vorites are spaghetti and acorn. Scoop out the insides of a cooked spaghetti squash and top with used baby and children’s Parmesan cheese. Or satisfy a sweet tooth by adding a bit of butter and brown sugar to the halves clothing, baby equipment, of an acorn squash during the last part of baking in the oven. toys, adult clothes, and Fresh cranberries are also in season during this time of the year and as a native American fruit, have typically found a place on the holiday table. They are rich in antioxidants and can also help household items for our next maintain urinary tract health. Cranberries can add a nice flavor to everyday salads or for a special garage sale this coming treat, try adding dried cranberries, pear slices, and chopped walnuts to mixed greens with a light vinaigrette. Spring. This Fall, seize the opportunity to experiment a little and introduce your family to some new dishes that can easily add some flair, color, and nutrient-dense foods to your table. –MONICA BLANDO

Holiday Shopping Guide for Nursing Moms By Carole Baas, Dallas LLLI Member

s there a pregnant woman or breastfeeding mom on your holiday gift list? Or perhaps you’d like a special gift for yourself? While a mother who is Ibreastfeeding is born with everything she needs to nurse her baby, it’s nice to show your support of her decision by choosing gifts that make breast- feeding easier and more fun. All of these gift suggestions are available online; check the websites for information on local distributors and retail outlets. And for more gift ideas, check out the LLLI online catalog at www.lalecheleague.org. Books and Videos Since information helps mothers get off to a smooth start, books and videos about breastfeeding are terrific choices. Good bets for great information are the classic guides: The Womanly Art of Breastfeeding (7th Revised edition, La Leche League International, 2004, $17) and The Ultimate Breastfeeding Book of Answers by Jack Newman, M.D. (Prima Lifestyles, 2000, $19.95). For a more lighthearted read, So That's What They're For!: The Definitive Breastfeeding Guide by Janet Tamaro (3rd edition, Adams Media Corporation, 2005, $12.95), has been updated to include the latest in breastfeeding research. Packed with humorous anecdotes, this book proves that breastfeeding advice does not have to be boring! Many new moms find reading difficult with a new baby, but discover that watching videos while nursing fits right into their schedule. The Real Deal, a new 25 minute video about breastfeeding, provides advice, insight and inspiration for nursing success - complete with a group “chat session” of real breastfeeding moms sharing their stories (www.realdealvideos.com/, $19.95 VHS, $22.95 DVD). And add the Mother of 7: Birth and Breastfeeding Videos to your list to start the New Year. Scheduled for release in January 2006, this series of videos by Stephanie Neurohr, a Dallas-based filmmaker and mother of seven breastfed children (including twins and a baby with special needs), includes interviews and advice from experts around the world as well as profiles of women who have successfully breastfed their children –even in challenging situations (www.motherof7.com/, $29.95 to $79.95). Nursing Pillows and Supports Breastfeeding succeeds when a new mom gets the moral support she needs from those around her, but it’s also critical that she receives physical support and is comfortable. A well-designed nursing pillow is a welcome addition to the nursery, as it positions the baby properly and supports mom’s back, arms, and elbows. Some models can double as a back support for the baby as she learns to sit up. There are many different nursing pillows available: some of the most popular are The Boppy (a U-shaped washable pillow, available in many different fabrics and several styles, priced from around $20: www.boppy.com/) and My Brest Friend (a wrap-around pillow that secures to your body with a latching belt: www.mybrestfriend.com/, $40). But why not try something a little different? Little Beam (www.littlebeam.com/, $40) is a unique breast- feeding pillow designed by a board-certified consultant. The small firm pillow rests on your lap, so it fits women of all shapes and allows (Continued on page 3) Issue 16 Page 3 Gifts (continued from page 2) children of different sizes proper orientation at the breast. It is particularly useful after a C-section (no pressure on the incision) and for tandem nursing. The Bosom Baby Pillow (www.bosombaby.com/, $45 to $65) is a large, boomerang-shaped pillow. It can be used as a supportive maternity pillow before baby arrives and, because of its large size, is great for nursing twins. The Udderly Yours pillow functions differently: it supports the mother’s breast, not the baby, to provide optimal breast positioning for nursing. Tar- geted towards larger-breasted women or those who require support while breastfeeding, the pillow wedges lift the breast for hands-free nursing (www.udderlyyours.com/; available in four sizes and priced from $10 to $20). Meditation CD Life with a new baby can be tiring and overwhelming –which can affect your milk supply. Learning to relax is important in getting your milk flow started (“let-down”), a skill sometimes difficult to achieve when using a or in stressful situations such as the NICU. Researchers have found that listening to relaxation audiotapes can dramatically increase nursing mothers' milk flow. Sheri Menelli, a certified Clinical Hypnotherapist and HypnoBirthing Educator, applied this research in her Breastfeeding Meditation CD. This CD offers guided meditations and affirmations that promote deep relaxation and increase mothers' milk production (www.menelli.com, 760-431-2228, $15.99). Jewelry Ahhh, jewelry is always nice! Why not treat the new mom to a nursing necklace? Made from non-toxic beads and heavy-duty string and clasps, these necklaces are designed to keep a little one focused on playing with the baby-safe necklace rather than your tender skin or hair during breastfeeding or just while being held. For a fun, brightly-colored necklace that you and baby will both enjoy, For the Monster offers a variety of designs (www.forthemonster.com, $19.99). The Baby Hammock (www.thebabyhammock.com/nursingnecklaces.htm) carries beautiful designs that you’ll wear long after your baby has weaned ($25 to $59). And Tickled Pink Designs specializes in jewelry for moms, with nursing necklaces that provide visual and tactile stimulation and can be used as a teaching tool as mother and child explore colors, shapes and letters. Their line of “Mother’s Necklaces” includes dressier designs with a choice of clasps that your baby will find almost impossible to break (www.tickled-pink-designs.com/, $18.99 to $94.99). Another useful piece of jewelry is a nursing bracelet. Designed by a breastfeeding mom who struggled to keep track of her son’sfeeding during his first months, the Nursing Bracelet™ is a wearable nursing log that tracks your breastfeeding schedule. You can use it to remind yourself which breast you fed from last and the time that your baby nursed, using number and colored beads arranged to represent a 12-hour clock. A charm is moved to mark the time. An extra contrasting charm can be added for twins or to add an alternative function, such as counting your baby’s wet or dirty (www.uniquemums.com/, $24.95 to $64.95). In order to prevent clogged milk ducts and maximize production, women should nurse evenly on both breasts. But keeping track of which breast you last nursed on can be difficult when you first begin nursing. A beautiful way to remember is Mama Jewels, a unique piece of jewelry consist- ing of a ring of Swarovski crystals, sterling silver and glass beads. Mama Jewels are designed to wear on your bra strap. The idea is that at the end of each breastfeeding session, you place your Mama Jewel on the bra strap of the side where baby last nursed. At the next feeding, you begin nursing your baby on the side where the Mama Jewel is located (www.freshbaby.com/buy_our_products/minders.cfm, $9.95). Nursing Journal The New Mother’s Nursing Journalis a wonderful companion for a new mother planning on breastfeeding her baby. This one month breastfeeding journal helps guide the mother in documenting important information every day. She can write down when each nursing session begins, comment on the quality of the session, and record the number of wet and soiled diapers. Additionally, the breastfeeding journal has a separate page for each day’s thoughts and feelings, and an area to record diet and liquid consumption (www.sandsivia.com/, $10). Breastfeeding Slogan Baby Clothes Who can resist cute baby clothes, especially when they’re emblazoned with slogans promoting breastfeeding? Check out the adorable embroidered baby clothes from Granola Threads. T-shirts, rompers and onesies are available in several colors with your choice of breastfeeding advocacy slogans, including "Breastmilk: It Does a Body Good," “Breastmilk Only Please,” and “My Milk Comes from the Human Species.” Mom can wear her own advocacy shirt, decorated with slogans such as “I Make Milk: What’s Your Super Power?” and “Fresh Milk on Tap!” (www.granolathreads.com/, $14 to $42). Another source for pro-breastfeeding and gentle advocacy clothing is Mothers Milk Marketing Board. The British company, which ships their t-shirts and accessories worldwide, sells cotton clothing screenprinted with original designs. Slogans include “Formula is for Suckers,” “Still Breastfeeding and Proud of It,” and “Care Instructions: Hand Wash Only, Love Unconditionally, Breastfeed as Required” (www.lactivist.co.uk/, $16 to $19).

Photos reprinted with permission (from left): Mother of 7: Birth and Breastfeeding Videos (Breastfeeding Techniques), available January 2006; the Original Nursing Bracelet™ in Midnight Blue from Unique Mums; Breastfeeding Meditation CD from Sheri Menelli.

The opinions expressed in this article are those of the author and not necessarily those of La Leche League International. LLLI does not promote or recommend any of the products reviewed unless otherwise noted. Issue 16 Page 4 Holiday Shopping

Babies can be unpredictable and even the most easy-going baby can become over-stimulated with all of the hustle and bustle of a holiday shopping experience. Planning ahead and organizing can help make your holiday shopping trips a little easier for you and baby. Much shopping and browsing can be done on the Internet; however, it’s inevitable that there will be some items that will require a trip to the mall or other shopping venue. Here are a few tips and questions to con- sider before embarking on your excursion.

 Try to plan several shorter trips spread over several days instead of a long marathon shopping day.  Make a list of needed items and the store locations.  Group your stops so that you get in and out of the car as few times as possible.  Determine the best time of day for both you and your baby to shop. Or, consider planning a short outing for a time when your partner could watch the baby.  Determine where you will be able to comfortably nurse your baby and wear clothes that are conducive to breastfeeding. Plan your shopping so that you are near this location when it’s time to feed your baby before he/she becomes overly hungry.  Be prepared with essentials that you will need for your baby but don’t pack so much that your bag becomes too heavy to lug around.  Decide how you should carry your baby and packages. Will a sling keep your baby happy for a longer period of time or will using a stroller be handy for storing your packages and keeping your little one content?

And finally, don’t become discouraged if your shopping isn’t as smooth as you had hoped. Try not to set unreasonable expecta- tions for your outing and realize that you may have to cut your excursion short or postpone it for another day. –MONICA BLANDO

November 2005 Events

3 Series Meeting Open Forum for Breastfeeding Questions, 7:30 pm 15 Toddler Meeting The Family Grows: Nursing While Pregnant, Tandem Nurs- ing, and Dealing with Jealousy, 10:00 am (Third Tuesday due to Thanksgiving)

December 2005 Events

1 Series Meeting The Art of Breastfeeding and Avoiding Difficulties, 7:30 pm

No Toddler Meeting

Series Meeting Toddler Meeting Playgroup First Thursday 7:30 pm Fourth Tuesday 10:00 am Date and Time TBA

Presbyterian Hospital of Dallas Greenland Hills United Methodist Lake Highlands North Recreation 8200 Walnut Hill Lane Church Center Dallas 5830 Penrose 9401 White Rock Trail (Near Skill- Dallas man and Church) Margot Perot Building Lower Level Dallas (LL) Conference Room Off Greenville, between Skillman and At the playground, weather permit- Near DART Station on Walnut Hill Matilda; south of Mockingbird ting, otherwise indoors. Page 5 LA LECHE LEAGUE OF DALLAS

Coping with the Season (continued from page 1)

Some women will need pain relief. It is important that the cause for sore nipples be discovered and treated, as cracks in the nipples continue to provide an entry point for bacteria to invade the breast. The baby should continue to nurse if the mother has mastitis. The milk is not dangerous for the baby, but scientists have discovered that it can taste salty during a bout of mastitis. This may be the body's way of controlling bacteria levels in the milk. Unfortunately, some babies will reject the mastitic breast because the milk temporarily tastes bitter. In that case, the baby can nurse on the other side while an effective pump or hand expression keep the af- fected breast drained. Authorities discourage abrupt weaning during mastitis because of the risk of abscess formation. Nursing Strikes Mothers aren't the only ones affected by the hectic pace. It can be tempting to hand the baby over to someone else to bottle-feed in order not to interrupt holiday activities; however, as many mothers look back over their experiences, there can be a sense of regret that they allowed the holidays to interfere with breastfeeding. are tiny for such a short time, and it is a special time in the lives of both mother and baby. While a few bottles here and there probably will not adversely affect most newborns, too much separation during the early weeks postpartum can create a sense of detachment that inter- feres with the attachment process we call bonding. The baby, over-stimulated by being handled by so many new Often it is the calm perspective of another that helps the people, becomes anxious about the separation from his mother new mother relax some of her standards and allows her during this critical time period. The baby may become fussy and to focus on the baby instead of the shopping, decorating, distracted at feeding time, as if to say to the mother: I'm mad at and entertaining. you! As a sort of protest, some babies will begin to refuse the breast. Mothers may notice that their baby arches, pushes away, or cries when placed in a breastfeeding position. Some babies will bite the breast, although they happily accept the bottle. This experience is distressing for mothers, who feel rejected and confused. Family members and friends may tell them that the baby is just ready to be weaned, but young babies seldom self-wean. More than likely, the baby is on a nursing strike. Nursing strikes can last from a few hours to over a week. They are most likely to occur if the environmental stress coincides with a cold or virus, the baby is teething, or the baby has an earache. Occasionally they occur after a mother has yelled when the baby has bitten her . Thankfully, once a mother realizes her baby is on strike, she can take measures to help restore the breastfeeding relationship. It may become necessary to pump the breasts to protect the milk supply until the baby settles back into nursing. In the meantime, the best trick to reverse a nursing strike is to nurse the baby when he or she is sleepy or asleep. In a drowsy state, many babies will breastfeed just fine. Some moms find that nursing while standing up, lying down, or in the tub distracts the baby long enough for a successful attempt. A quiet feeding environment, dim lights, reduced noise, and increased skin-to-skin contact will help relax and reassure the baby. A nursing strike is always an indication that the baby is feeling ill or overwhelmed. A Word About Alcohol and Rich Holiday Food Scientists have good information about the transfer of alcohol into breast milk. We know that too much exposure to alcohol in mothers' milk is a bad thing for babies. Alcohol may affect milk let-down and alter the taste of the milk. However, occasional, moderate intake of alcohol has not been shown to be harmful. What constitutes reasonable, moderate intake? An average size woman could occasionally consume a beer, a glass of wine, or a mixed drink and continue to breastfeed normally. If she consumes more alcohol than this, she should wait several hours before nursing again. If her breasts become full in the meantime, a woman can express the milk and discard it. Becoming intoxicated is risky because it impairs the ability to respond ap- propriately to the . who plan a party at which there will be lots of drinking should plan to have a sober babysitter care for the baby. Husbands Can Help Provide a Balanced Perspective Often it is the calm perspective of another that helps the new mother relax some of her standards and allows her to focus on the baby instead of the shopping, decorating, and entertaining. Husbands can be that voice of reason. They can be the strong and supportive protector of the mother and baby, insisting that others not interrupt their postpartum recovery in ways that jeopardize breastfeeding. The holidays will come around again next year, and family life will be more settled. There will be time enough another time for all the trappings. Per- haps the house won't be perfectly decorated this year, and maybe the pies won't be homemade, but after all, isn't family the real cause for Thanksgiving? And isn't the little child the reason for the season? And isn't the faithfulness of us one to another the spark for the festival of lights? By breastfeeding your baby, your child receives the dual gifts of health and intimacy. Don't let the pressure of the holidays obscure their real meaning. Relax and take good care of yourselves. Happy Holidays! (An earlier version of this article appeared on Babyzone.com. The author revised the article in October 2005 for this issue.)

Barbara Wilson-Clay, BSEd, IBCLC has been assisting breastfeeding families since 1981. She is a La Leche League Leader and private practice . Barbara is a member of the editorial review board of the Journal of Human Lactation, and has served on the IBLCE Board. She is a co-founder and volunteer board member of the Mothers Milk Bank at Austin, and is a volunteer lobbyist for pro-breastfeeding legislation in the Texas Legislature. Barbara is the co-author (with Kay Hoover) of the clinical training text, The Breastfeeding Atlas, and helped create The Diaper Diary, a widely used tool to help new mothers evaluate early breastmilk intake.

Photo of Little Beam Nursing Pillow reprinted with permission (www.littlebeam.com). Page 6 Breastfeeding Information and Support

The La Leche League International (LLLI) mission is: To help mothers worldwide to breastfeed through mother-to-mother sup- La Leche League of Dallas Leaders port, encouragement, information, and education and to promote a better understanding of breastfeeding as an important element  Gwen 214.320.9789 in the healthy development of the baby and mother. [email protected] LLLI reaches well over 300,000 people in 65 countries every  Katie 214.351.9816 month and offers information in 32 languages. Currently ap- [email protected] proximately 7,200 accredited Leaders facilitate more than 3,000 monthly mother-to-mother breastfeeding support group meetings  Vicky 972.235.6092 around the world. [email protected] Your membership contribution helps defray the cost of mother-  Maria 214.321.1019 to-mother help, including phone calls, printing, postage, bro- [email protected] chures, monthly meetings, etc. Annual membership is $40 and includes a subscription to the bi-monthly publication New Begin-  Connie 214.520.0938 nings and a discount on most items from the LLLI catalogue. [email protected] Please be sure to initiate and renew your membership through La Leche League of Dallas so that our local group receives a portion WE’RE ON THE WEB! of the proceeds. http://home.swbell.net/barnes57/

A Special Thanks To… Announcements… New Arrivals…

New and Renewing Members Discover LLL Leader, Vicky Suarez gave birth The practice of carrying your baby to Janey Annabelle on October 24 Marina Armstrong in a soft carrier close to your body while going about daily life. Kim Sierra gave birth to Nicholas on Tin Pfaff October 29 Maria Blois, a La Leche League of Dallas leader and author of the Don’t Forget… Group Workers new book, Babywearing, will be offering her final workshop on Sat- Newcomer Packets: Maureen Sweeny La Leche League of Dallas is a partner Series Librarian: Grace Murphy urday, November 19, from 10:30 in the Tom Thumb Good Neighbor Series Snack Coordinator: Kim Sierra am to 12:30 pm at Destination Ma- Program. Stop by any Tom Thumb, Toddler Librarian: Juli Davidson ternity (5539 LBJ Freeway, near fill out a reward card application and Yahoo Group Monitor: Barrie Glasscock the Galleria). This is a free semi- pick up your card. Then give the Newsletter: Monica Blando and Carole nar with demonstrations of various cashier your reward card and the num- Baas baby carriers and displays by area ber 581. carrier vendors, and offers a great Your personal reward card will be opportunity to learn the benefits of linked to LLL of Dallas. Every time wearing your baby. you shop and use your reward card, (www.drmariablois.com) Tom Thumb will send a percentage back to us as a donation.