Preparation Archives - Evidence Based Babies
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mother breastfeeding her child

Is it safe to get a tattoo while breastfeeding?

Tattoos are a big part of society. People have had tattoos done since way back in the neolithic or new stone age. Whether it’s a part of your culture, or it’s just a personal preference, many people get tattoos, including new moms. If you’re a breastfeeding mother who’s also a tattoo lover or if you’d just like to get a new tattoo done, we get it, your little one is your pride and joy, and you may want to get new ink to celebrate your baby and your motherhood or even your breastfeeding journey. You may be wondering whether it’s safe to have a tattoo done while breastfeeding, if it’ll affect your milk supply, whether you should wait for a certain time or if it’s best to wait until after weaning. It’s always important to consider any possible risks with anything you do. The tattooing process and tattoo inks Tattoo artists use a handheld electric tattoo machine that’s fitted with many needles which is coated with ink. These needles will puncture through the first layer of skin, about 1.5 to 2mm deep. The needles will puncture the skin between 50 and 30 000 times per minute. These needles will pierce through the first layer of skin and inject the ink into the dermal layer, which is the second layer of the skin. Once the ink is injected into the skin’s dermal layer, it will become permanently trapped under the skin. It may break down over a long period of time. It’s unknown whether small ink molecules can pass through the breast milk as it breaks down over the months and years. Tattoo inks contain different types of compounds, including heavy metals such as cobalt, cadmium, titanium, lead, mercury and manganese. There are also synthetic and vegan compound inks available if it’s preferred. Is it safe to get a tattoo while breastfeeding? There is currently very little research or evidence on the safety of having tattoos done while breastfeeding or whether it can affect breast milk and the breastfeeding baby. So, there isn’t a straightforward answer. If a mother wishes to get a tattoo done while breastfeeding, it’s best that she learns about all the risks involved and how to minimize the chance of complications. Recommendations on the safety of getting tattoos done while breastfeeding, are made based on how we know the body works, how we know breast milk is produced, and how medications and other molecules pass through breastmilk. We also look at other risk factors such as local and systemic infections that could potentially be a risk during the tattoo procedure or during aftercare. The risks involved in getting a tattoo while breastfeeding – Tattoo molecules and breast milk From what we understand about breast milk production and how molecules transfer into the breast milk, it’s believed that the molecules of the ink used for tattoos are too big to pass through breast milk. There are of course possible very small particles that may be able to pass through, and we don’t know what effect it could potentially have on a breastfeeding child. – The risk of local bacterial infection and allergic reaction There is always a risk of local infection after any procedure, including the tattoo procedure. Where there is an open wound, there is a risk of infection. Whether it’s due to the tattoo artist or tattoo parlor not following universal precautions, or the person getting the tattoo picking up a local infection during aftercare due to not following strict aftercare guidelines. Sometimes infections happen despite everything done perfectly. There are many antibiotics compatible with breastfeeding, but sometimes an antibiotic that’s contraindicated while breastfeeding may be required for many different reasons such as allergic reactions toward certain antibiotics and antibiotic resistance etc. – The risk of systemic infections Systemic infections, which are bloodborne Infections, can also occur when the tattoo artist or tattoo parlor is not following universal safety precautions. With unhygienic and non-sterile equipment and materials, systemic infections are easily transmitted between different clients. Systemic infections include infections such as hepatitis b and hepatitis c, tetanus, HIV and MRSA. Although these infections are not necessarily contraindicated while breastfeeding, it is a choice each parent has to make on whether they feel comfortable continuing their breastfeeding journey. Each of these infections and the medications needed to treat it, could potentially have its own risk of transmission and side effects to the child. These systemic infections and the medications used to treat it, are usually considered compatible with breastfeeding. It’s best to discuss the specific infection and medication with an International Board Certified Lactation Consultant (IBCLC) or medical professional experienced in treating breastfeeding mothers. Just like with local infections, sometimes antibiotics and other medicine that are contraindicated while breastfeeding may be required as treatment for a variety of reasons. Is it safe to get a tattoo removed while breastfeeding? Just like with getting a tattoo, removing tattoos and the risks it imposes is unknown due to very limited research. Laser tattoo removal causes the ink to shatter into smaller particles which is picked up by the immune system and filtered out by the liver. Whether some of these tiny ink particles could potentially pass through breast milk and cause harm to a child is unknown. Removing tattoos holds the same risk of local infections that getting a tattoo holds, especially during the healing phase as removing tattoos may cause swelling, blistering and scarring. All of which is considered open wounds. Open wounds are always infection risks, even if it’s well taken care of. Things to consider if you do decide to get a tattoo while breastfeeding – If possible, wait until the 12-month mark before getting or removing a tattoo. Until the age of 1 year, breast milk is the main source of nutrition whereas after 1 year of age, a child would be fine without breast milk if the worst were to happen. – Ensure that the tattoo parlor is licensed and registered (if applicable

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grayscale photography of glass of milk

Cow’s milk for babies: Risks and considerations

Whether you’re a breastfeeding mother or a formula feeding mother, you’ve probably heard about the recommendation of not switching your baby over to cow’s milk in the first year. Cow’s milk is quite normalized in today’s world, so you may be wondering why it’s not recommended for babies. Why is cow’s milk not recommended for babies? The simple answer is cow’s milk is meant for calves, not humans. Therefore, the composition will not be suited for human babies. A human baby and a calves’ needs are completely different. Cow’s milk does not offer your baby the nutrients they need in the first year of life. That’s why they invented formula as an alternative, where they formulated cow’s milk to be closer in nutritional value to breastmilk so babies can receive the needed nutrients. Without it being formulated, it won’t meet your baby’s nutritional needs. The risks of giving cow’s milk to human babies under the age of 1 year old – It contains too much sodium, potassium and protein Cow’s milk contains much higher amounts of sodium, potassium and protein than what a human baby need. Cow’s milk contains about three times as much sodium and potassium, four times as much calcium and six times as much phosphorus as human milk. These high amounts of protein and minerals can put stress on a baby’s immature kidneys and cause severe illness, especially during times of fever and illness. To give you an idea of the protein ratio differences, protein provides about 7% of the calories in human milk and 20% of the calories in cow’s milk. That’s quite a big difference. Although the amounts of whey protein are very similar, cow’s milk contains six to seven times as much casein then human milk. Casein is much more difficult for babies to digest, causing digestive issues for the baby. Cow’s milk can also cause iron-deficiency anemia in some babies, since cow’s milk protein irritates the lining of the stomach and intestine, leading to loss of blood in the stools. – Lack of vitamins and minerals needed for human babies Cow’s milk lacks the correct amounts of iron, zinc, niacin vitamin C and E and other nutrients that human babies need.  Cow’s milk also doesn’t contain the healthiest types of fat for growing babies either. – Increased risk of milk protein allergy Early exposure to cow’s milk proteins has been found to increase the risk of developing an allergy to milk proteins. – Increased risk of type 1 diabetes mellitus An association between early exposure to cow’s milk proteins and risk for type 1 diabetes mellitus has been reported in some studies. Exposure to cow’s milk proteins elicits antibody formation to insulin in some children. Because of this possible association, breastfeeding and avoidance of cow’s milk and products containing intact cow’s milk protein during the first year of life are strongly encouraged in families with a strong history of insulin dependent diabetes mellitus. What about other dairy products Moderate amounts of dairy products such as yogurt and cheese can be given to babies from the age of 6 months old. The protein in cow’s milk is much stronger and more concentrated in cow’s milk than in other dairy products. What to feed a baby in case of an emergency Life happens and sometimes emergencies call for unwanted but needed actions. It’s best to know what your different options are. – Breastfeed Now I know, it may not be your first choice, or it may not even be possible for you. But if it is a possibility to breastfeed, then do so. Relactation is very possible if you work with an International Board Certified Lactation Consultant (IBCLC). If finances are an issue, speak to a local La Leche League International Leader for guidance. Even if you can only supply a certain amount of breastmilk, it’s better than nothing at all. – Human donor milk Not everyone can breastfeed or have the means to find support to relactate. After feeding your baby your own breastmilk, donor breast milk will be the next best option. There are a few options, such as local hospitals, human milk banks or groups such as Human Milk For Human Babies in your local area. You may not be able to receive the full amount needed, but it’s still better than nothing at all. – Mix feeding Mix feeding is when you feed your baby both breastmilk and formula. This is a really great option for those who may not be able to produce the full breastmilk supply needed for their baby. By giving half breastmilk, it also reduces the price of full formula feeding. – Formula feed The next best thing is formula feeding. Although most formulas are technically cow’s milk, it has been formulated to better suit the needs of a human baby. Many babies thrive on formula feeding. – In severe emergencies cow’s milk can be given temporarily This should only be done under the guidance of a medical professional, only when it’s a life-or-death emergency situation and only temporarily. It’s clear that cow’s milk is not ideal for babies under the age of 6 months old, and it carries a lot of risks for your baby’s health. The only milk suitable for a baby under the age of 1 year of age is breastmilk or infant formula. Additional information and resources: Whole cow’s milk in infancy

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Milk bleb

Milk blebs: Causes and treatment

If you’re a breastfeeding mother, chances are, you’ll probably experience a milk bleb at least once during your breastfeeding journey. Especially if you find yourself having breastfeeding or pumping difficulties. Although milk blebs are small, they can be quite painful for some mothers. The good news is that it’s quite easily treatable and even preventable. What is a milk bleb A milk bleb, also known as a milk blister or a blocked nipple pore, is a small clear, white or yellow dot that appears on the nipples and areolas. They look almost very small pimple like. They are caused by skin growing over a nipple or areola pore, or a small amount of hardened milk, thus blocking the opening. It’s important to treat the milk bleb promptly, as the blockage can potentially lead to more serious issues such as blocked milk ducts and mastitis. Signs of a milk bleb – A small clear, white or yellow dot on the nipple or areola. – Painful nipples or overall pain during breastfeeding or pumping. Milk bleb causes – Poor latch When a baby has a poor latch, it will cause excessive pressure on the nipple which can in turn, cause milk blebs. – Engorgement Just like with a poor latch, engorgement can lead to excessive pressure on the milk ducts which can lead to milk blebs. – Excessive pressureWhether you wear tight and restrictive bras or clothing, make use of ill-fitting products such as silverette nursing cups and nipple shields or use ill-fitting pump equipment, the excessive pressure can lead to milk blebs. – Skin conditionsCertain skin conditions such as eczema and dermatitis, may also affect nipple and areola pores and how the skin behaves around it, potentially causing milk blebs. Treatment for milk blebs – Latch correction If the milk blebs are caused by a poor latch, simply correcting the latch and whatever is causing the poor latch will help resolve the milk blebs and reduce the risk of recurrence. – Better fitting equipment If you’re using equipment such as silverette nursing cups, nipple shields or you’re pumping, ensure that you have the correct fit to reduce any and all excessive pressure on the nipple and breast. – Warm moist compressDoing a warm moist compress before nursing sessions may help soften and loosen the overgrown skin. A very warm and wet cloth applied to the nipple will be sufficient. – Epsom salt soaksSoaking the affected area in a glass of Epsom salts may help open the nipple pore. You can do an Epsom salt soak by mixing 1 or 2 teaspoons of Epsom salts with 1 cup of hot water to dissolve the Epsom salts and then leave it to cool down slightly. Once slightly and appropriately cooled, you can soak the affected area. Do this multiple times a day before breastfeeding your baby. – ExfoliationYou can very gently exfoliate the affected area with a warm wet cloth by gently rubbing the affected area. This may help remove the excess skin, opening the pore. – Olive or coconut oilSoaking a cotton ball in olive or coconut oil and then applying it to the affected area may also help open and heal the milk bleb. – NeedleIf none of the other methods are working, or you’re struggling with recurring milk blebs, you may have to consult with a medical professional to open the blockage with a sterile needle. It’s important to only let a medical professional do this for you in order to avoid any damage or infection. – Cold compressIf the milk bleb causes you a lot of pain or discomfort, a cold compress can be done between feedings to alleviate the discomfort. You can use an ice cold or frozen cloth for the cold compress. This is especially helpful if you struggle with engorgement as well. – MedicationIf the pain or discomfort feels unmanageable for you, you can take medications approved by your medical provider such as Ibuprofen and Paracetamol to help with the pain and inflammation caused by the nipple bleb. Important notes If at any time you’re experiencing fever, severe pain, puss or swelling, you should contact your medical provider immediately. Sometimes thrush can be mistaken for a milk bleb, as thrush can also present as a white, or multiple white dots on the nipples. It’s important to ensure that you or your baby aren’t presenting with any other thrush symptoms. If you do have more than 1 symptom consistent with thrush, seek out the correct diagnosis and treatment from your medical provider. You can consult an International Board Certified Lactation Consultant (IBCLC) at any time to assess your situation and provide you with a treatment plan that best suits you and your baby, especially if you’re experiencing other symptoms or other breastfeeding difficulties. Additional information and resources: Case Report of the Management of Milk Blebs Facebook Twitter Linkedin

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Lactation Consultant (IBCLC)

IBCLC: education and responsibilities

If you’re a breastfeeding parent, the chances are high that you’ve heard about, or even worked with an IBCLC, especially if you’ve experienced some breastfeeding difficulties. Some people may wonder what IBCLC’S are and what they do, what their education and training consist of, and most importantly of all, if they’re worth it. What is an IBCLC? IBCLC stands for International Board Certified Lactation Consultant (IBCLC), lactation consultants who are certified by the International Board of Lactation Consultant Examiners (IBLCE). IBCLC’S are allied healthcare professionals who specialize in the clinical management of breastfeeding. They are responsible for duties such as advocating, educating, assessing and supporting. All while adhering to a strict code of ethics set out by the IBLCE IBCLC’S possess a comprehensive understanding of the anatomical, physiological and hormonal aspects of breastfeeding. All of which enables them to assess and support parents with a wide range of breastfeeding difficulties. The education and training of an IBCLC It’s not uncommon for people to underestimate the knowledge and training that an IBCLC had to go through in order for them to become certified and to keep an active certification. There are 3 different pathways to become a lactation consultant and all of them will require certain health science prerequisites, lactation and communication specific education and clinical training. Health education Candidates must either possess an approved medical degree, finish a lactation specific college/university program, or complete 14 health science courses. The 14 health science courses include: – Biology – Human Anatomy – Human Physiology – Infant Growth and Development – Introduction to Clinical Research – Nutrition – Psychology or Counselling Skills or Communication Skills – Sociology or Cultural Sensitivity or Cultural Anthropology – Basic Life Support – Medical Documentation – Medical Terminology – Occupational Safety and Security for Health Professionals – Professional Ethics for Health Professionals – Universal Safety Precautions and Infection Control Lactation specific education Lactation consultants must also complete a 95-hour lactation specific certification program where at least 5 hours must be focused on communication. Clinical training What truly makes a lactation consultant is the physical hands on clinical training they complete to prepare them to work with breastfeeding dyads. Clinic training for each pathway: – Pathway 1 1000 practical hours directly supporting breastfeeding dyads as either a healthcare professional or a recognised and approved breastfeeding organization volunteer. – Pathway 2 300 practical hours directly supporting breastfeeding dyads under the supervision of a certified IBCLC. – Pathway 3 500 practical hours directly supporting breastfeeding dyads under the supervision of a certified IBCLC, shadowing the IBCLC first before starting the practical hours and also including extra activities and studies. 4-hour international examination After completing all of the above educational and practical requirements, candidates are then required to sit a 4 hour international examination and pass at a specific pass rate before being certified as an International Board Certified Lactation Consultant. Recertification Once certified, IBCLC’S must continue practicing and studying in order to recertify every few years. Failure to continue education will result in losing their certification. This is to ensure that IBCLC’S stay up to date with current research and continue to offer the very best evidence-based practice to their clients. The role of IBCLC’S in lactation support – AdvocatingIBCLC’S are some of the best and most important breastfeeding advocates in the breastfeeding community. They will advocate for breastfeeding and breastfeeding related topics, they will advocate for parents to receive current evidence-based care for their healthcare providers. They will also advocate for mothers who are employed, and they will advocate for a mother and their child’s right to breastfeeding when, where and for however long is needed. – EducatingIBCLC’S are also responsible for educating parents about everything breastfeeding and child behavior related during both the pre and the postnatal period, up until the weaning age. They also provide education not only to parents, but also to others, such as family members, friends, daycare centers, hospitals, medical staff and even employers. – Lactation supportIBCLC’S are trained in everything breastfeeding related, and a part of their responsibilities is advocating, educating and overall lactation support. Lactation support includes, but are not limited to, prenatal breastfeeding education, latch and positioning support, support with supply establishment and maintenance, support for optimal breastfeeding management, monitoring the baby and their milk intake, pumping support, and so much more. – Complex lactation supportIBCLC’S are also clinically trained to assess and offer support for complex breastfeeding difficulties such as assessing for and/or supporting parents with medical complications such as reflux and other complications that could interfere with breastfeeding, blocked milk ducts, mastitis, oral ties, clefts, muscle tone issues, anatomical difficulties, low and oversupply and so much more. – Emotional support and empowermentOne of the most important responsibilities of an IBCLC is counselling. It’s not just about educating and physically supporting parents with breastfeeding, but also about offering emotional support whenever a parent may need it and empowering parents as much as possible. IBCLC’S and the work they do are not just an easy little profession, they go through extensive and ongoing education and training to educate and support breastfeeding parents. IBCLC’S are experts of the field of lactation. They often work in a multidisciplinary team with other medical professionals to ensure the best possible treatment for families. Research has found that the work that lactation consultants (IBCLC’S) do, plays a positive role in breastfeeding support and outcomes. If you ever need a lactation consultant, do ensure you search for IBCLC’S in your area. Most countries will have 1 or more national directories where IBCLC’S may be listed. Many IBCLC’S also offer virtual consultations when possible. If you want to ensure the lactation consultant you want to work with is indeed certified, you can check the IBLCE public registry by entering the IBCLC’S credential number or full name and surname. You are entitled to this information should you wish to know. Additional information and resources: International Board Of Lactation Consultant Examiners (IBLCE) Effectiveness of the IBCLC: Have we Made an

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Thrush in baby

Thrush while Breastfeeding

Understanding and Managing Thrush during Breastfeeding Breastfeeding is a wonderful way to nourish your baby and to build a strong bond with them, but it’s not always without challenges. One of the most common issues that breastfeeding mothers may encounter is Thrush, a fungal infection that can affect both you and your baby. What is Thrush? Thrush, also known as Candidiasis, is a fungal infection caused by the yeast Candida Albicans. This yeast is normally present in small amounts on the skin, in the mouth and in the digestive tract. But under certain conditions such as a weakened immune system or very warm and moist environments, Candida can multiply and lead to an infection. Causes of thrush during breastfeeding Thrush during breastfeeding typically occurs when Candida overgrowth affects the mother’s nipples and the baby’s mouth. The warm and moist environment of the baby’s mouth and the mother’s breasts provide an ideal breeding ground for the yeast to thrive. It’s important to reduce any and all risk factors as best as possible. Factors that can contribute to the development of Thrush – Antibiotics The use of antibiotics in either the mother or the baby can disrupt the balance of microorganisms in your body, including the beneficial bacteria that help keep Candida in check. – Weakened Immune System A weakened immune system due to stress, illness or certain medications can make you more prone to develop Thrush. – Poor Hygiene Not keeping the nipple area clean and dry can create an environment favorable to yeast growth. – Pacifier or Bottle Use Pacifiers and bottle nipples can provide an opportunity for yeast to thrive and be passed back and forth between mother and baby. – Diabetes High blood sugar levels associated with diabetes can promote yeast overgrowth. Symptoms of Thrush – Nipple pain and soreness, often described as shooting or burning sensations. – White spots on the mother’s nipples. – Itchy or flaky nipples. – Shiny or red areolas. – Baby’s mouth showing white patches on the lips, tongue, gums, or the inside of the cheeks. – Bum rash in the baby. – Baby being fussy or irritable during nursing. Treatment and Prevention – Consult a Healthcare Professional If you suspect thrush, it’s essential to consult a healthcare provider that’s experienced in lactation. They can accurately diagnose the condition and recommend suitable treatment options for both you and your baby. – Antifungal Medications Both you and your baby will need antifungal medications such as nystatin or fluconazole to treat thrush. These medications can be applied topically to your nipples and taken orally by your baby. It’s crucial to complete the entire course of treatment to prevent recurrence. – Maintain Good Hygiene Keep your nipples clean and dry. Change breast pads frequently and wash them with hot water to prevent reinfection. – Sterilize Equipment If you’re using breast pump parts, bottles, or pacifiers, make sure to sterilize them thoroughly with very hot water after each use to prevent the spread of yeast. You’ll also have to sterilize anything else that comes into contact with either your breasts or your baby’s mouth and bum, such as bras, cloth diapers and towels. – Probiotics Some research suggests that taking probiotics, either through supplements or certain foods, may help restore the balance of healthy bacteria in your body and potentially reducing the risk of thrush. – Adjust Your Diet Reducing your intake of sugary foods and refined carbohydrates may help create an environment that’s less favorable to yeast growth. – Treating Both Mother and Baby It’s very important to treat both you and your baby at the same time to prevent passing the infection back and forth, even if one of you may not be showing any signs of Thrush. Important note Thrush is a highly over diagnosed infection. Very obvious, or more than 1 symptom should be present when making a diagnosis or when possible, a swab may be taken to confirm Thrush infection. If treatment isn’t working or Thrush is recurrent, a swab must be taken to confirm whether it is Thrush, another infection or something else completely. Things like the letdown reflex and Vasospasm are often misdiagnosed as Thrush and therefore it may be a good idea to consult with an International Board Certified Lactation Consultant (IBCLC) to rule out any other issues and to help with overall breastfeeding education and support. Thrush can be an uncomfortable and challenging experience for breastfeeding mothers and their babies, but with prompt diagnosis, evidence-based treatment, and preventative measures, you can effectively manage and overcome this infection and continue your breastfeeding journey with more ease and enjoyment. Additional information and resources: Thrush in the breastfeeding dyad: results of a survey on diagnosis and treatment Relationship Between Personal Hygiene During Breastfeeding And Oral Thrush In Infants 0-6 Months It’s Not Yeast: Retrospective Cohort Study of Lactating Women with Persistent Nipple and Breast Pain Overdiagnosis and overtreatment of nipple and breast candidiasis: A review of the relationship between diagnoses of mammary candidiasis and Candida albicans in breastfeeding women Facebook Twitter Youtube

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mother breastfeeding her child in park

Responsive feeding

How often should babies, toddlers and children breastfeed? On demand? Every 2-3 hours? 8-12 times per 24 hours? On a parent, doctor or sleep consultant’s set schedule? The simple answer is none of the above, a child should always be fed responsively. What is responsive feeding? Responsive breastfeeding is how a mother responds to her baby’s cues, as well as her own desire to feed her baby. Feeding responsively recognizes that feeds are not just for nutrition, but also for comfort and bonding. It’s feeding a baby on demand, while offering additional feeds whenever you or your baby/child may feel like it. The wonderful thing about exclusive breastfeeding at the breast is that you can’t overfeed your baby, so go ahead and breastfeed as much as you and your baby want to. When a mother and baby are left to follow their biological instincts, to truly feed responsively, they won’t be able to tell you how often or how long they breastfeed, they will however be able to tell you that they’re in sync with each other and that they breastfeed as often as needed, which will usually be quite frequently. Studies have found that babies on average feed about 10-14 times in a 24-hour period, although some may feed less, and some may feed more frequently. Babies are intelligent and will cue to you when they’re hungry, in the early weeks it’ll be things like rooting, stirring, opening their mouths, smacking their lips, bringing their hands to their mouth, and as a late sign, crying. After the newborn period, they may no longer show the same hunger cues, so it’s up to you to learn your baby’s cues and to offer breastfeeds frequently too. Newborns will usually breastfeed 8-12 times or more during each 24-hour period. With 8 being the minimum number of times that you should feed your newborn to ensure that you establish an adequate milk supply and to ensure that your newborn is receiving adequate amounts of milk. It’s important to note that these feedings will rarely be at the same intervals such as every 3 hours for each 24 hours or every 2 hours during the day and every 3 hours during the night as many people may promote. Newborns will feed as needed on their own schedule which could look something like every hour for 4 hours, then every 3 hours for the next few hours, then some cluster feeding for 3 hours then once every 2 hours. This is all very normal. It’s okay if your baby has moments of very frequent feeding and a few bigger gaps in between some of the feedings. As long as your newborn baby is fed responsively as they need it, feeding at least 8-12 times during a 24-hour period, during both the day and the night, is having adequate amounts of wet and dirty diapers based on their age and is gaining weight and growing as expected, everything is perfect, and you can continue to follow your baby’s lead. It’s important to remember that a big part of responsive feeding is to offer a feed to your baby if you feel like you or they may need one. Never force it but offer if you’d like. Especially if it’s been a while, 3+ hours. A baby can’t overfeed when they exclusively breastfeed directly at the breast, even if they breastfeed 20 times a day. Some babies may not cue for hunger in the first week or two though, especially if you had a medicated or traumatic birth or if the baby has any health or neurological complications. Strong pain medications can also cause sleepiness in newborns. In this case, it’s even more important to ensure you feed your baby at least 8-12 times in a 24-hour period for the first few weeks, during both the day and the night, more if possible. Try and offer as frequently as you’d like. Should I wake my baby to feed? This is a tricky one. Most babies will wake by themselves as needed. Babies will usually cluster feed in the evening before having a 4 hour stretch of sleep and then wake every 3 hours from there, on average, it does vary from each individual baby. Frequent feeding during both the day and the night are equally important and night feeding helps ensure that you build a good milk supply, your baby is getting enough milk and it helps to protect your baby against SIDS. Many babies don’t wake by themselves though, for the same reasons as above and this is why many lactation consultants will encourage you to wake your baby for feeds. Everyone will have a different opinion on how often and for how long this should be done. My recommendation is that your baby will most likely wake by themselves as needed, but if they don’t and to be safe or if your baby is swaddled or you use a white noise machine or a pacifier, set the alarm for every 3-3.5 hours. You don’t have to completely wake your baby, you can dream feed them, which is when you feed your baby while they’re asleep. If they won’t dream feed though you’ll have to wake them. It’s usually fine to let your baby sleep without waking them from around the 4-6 week mark. By then they will be on a good weight gain pattern as expected and things like birth trauma and medications used during and after labor is no longer a concern. Most babies will wake by themselves at this age. Once you do leave your baby to sleep and you have a baby who tends to sleep big stretches of 6+ hours which is very rare in the first few weeks, working in at least 1 dream feed in the middle of that big stretch for another week or three will be a really good idea. It’s also especially important to offer enough opportunity for your baby to feed very frequently during

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Lactation consultant (IBCLC)

A thank you to the entire breastfeeding community

World breastfeeding week 2023 is also about thanking those who promote, advocate, educate and support breastfeeding families. Thank you to the International Board Certified Lactation consultants (IBCLC’S) for choosing to study, train and work as a lactation expert to help mothers with the clinical management of breastfeeding as well as offering education, support and being such big advocates for the breastfeeding community. Thank you to each and every healthcare professional who’s made the choice to obtain further education in breastfeeding to be able to educate and support their patients. We see you and we appreciate every single effort you make. Thank you to both La Leche League International and their leaders for finding La Leche League International and for being some of the very first people to step up for breastfeeding, thank you for all the amazing resources you offer to the world and for the wonderful peer education and support that you offer to breastfeeding mothers. Thank you to all the breastfeeding peer counselors for doing the effort of obtaining education in breastfeeding to offer peer education and support. We see you; you make a bigger difference than you know. Thank you to all the researchers, authors, educators and other professionals who devote their time, resources and even their entire lives to breastfeeding. Without you, we would not have been able to achieve the level of success that we have or to continue making a difference. Thank you to all the supportive employers who support breastfeeding mothers with breastfeeding and/or pumping while at work so they can continue their breastfeeding journey. Thank you to all the supportive partners, families and friends who stand by mothers and support them when they need it. Breastfeeding isn’t always easy, but with the right support, it makes the load a lot lighter. Thank you so very much to all the mothers out there, thank you for the beautiful and selfless act of breastfeeding your child. A successfully breastfeeding journey consists of an entire community. Each of us have a very important role that we play. Together we can make a difference, but it takes an entire community. #WBW2023 #WABA #Breastfeeding #SDGS #WorldBreastfeedingWeek2023 #WarmChain #BuildingBackBetter #EmpoweringParentsCampaign #EnablingBreastfeeding #MakingADifference #EvidenceBasedBabies Additional information and resources: La Leche League International Facebook Twitter Linkedin

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a person using black and silver laptop

Returning to work when breastfeeding

Before going back to work, it’s important to think about your options, discussing it with your partner and/or your employer. There are many different options that may work for you and your family. Different options for employment: – Not going back Say what? I know, for a lot of people this may not be a choice, or it may not be something they want to do and that’s perfectly fine. But for some, their priorities, dreams and plans may have changed, and they may not want or need to return to work. If this is you, always remember that you can decide to stay at home with your baby. Being a full-time mom is also a job, a very hard one. Don’t feel guilty if that’s the choice you want to make. Remember, you’re easily replaceable at work, but not as a mother. – Part time work or flexible hours If staying at home is not going to work for you, part time work or flexible hours may be an option, at least for a few months while you and your baby settle into these big new changes. You can discuss with your employer to reduce your work hours from full time to part time so you only do half days or only certain days a week or you may discuss flexible hours with them for example only working school hours, mornings, afternoons or evenings. Whatever suits you and your family best. – Changing careers If neither staying at home or changing or reducing your work hours is an option for you, changing your career completely may be. This is insane to suggest, isn’t it? But the truth is, priorities, dreams and plans change and that’s okay too. If you have a hectic job with a lot of hours you may feel it’s not what you want or need or that it may not suit you and your family’s needs, so you may want to change to a job with fewer hours or more flexibility. It can be the same career or it can be a completely different one too. Many mothers and even fathers have changed both jobs and careers to better suit their new lifestyle, and you can too if you want or need to. – Work from home or become self employed When Covid happened, a lot changed. Including the working sector. Working from home or becoming self-employed quickly became a very popular option and even now, a few years later, a lot of companies offer their employees the option to work from home. So, if you feel this may be the better option for you and your family, discuss it with your current employer or change to a job that offers work from home opportunities. On the other hand, you may choose to work for yourself. Starting up your own business depending on your skills and interests may be the perfect option for you. Don’t be afraid to try if this is a possibility for you. The best part is you can either keep your baby with you at home or choose your own hours to suit your best. That’s a lot of options, and hopefully one of them may suit your needs, but more often than not, neither of them may be an option for you. In this case you will probably return to whatever job and hours you had before you had your baby. But don’t be discouraged, many mothers return and still breastfeed successfully while they express milk at work for their babies to continue breastfeeding. Expressing at work: – Type of pump Chances are you will probably have to invest in some type of pump depending on your needs and finances. Don’t be afraid to splurge if that’s an option for you. No one has ever regretted a good quality pump. If you’ll only have to pump occasionally or a few hours a day, or you have very limited finances available, a manual pump may work well for you. If you’ll be working occasionally or half time, a single or double electric pump may be a better choice for you. If you’ll be going back to work for quite a lot of hours or even full time, or even if you’re only going to pump occasionally but have the finances available to you, a double electric (and wearable pumps) will always be a fantastic option. If hospital grade is an option, that will be the top choice to ensure success in expressing and maintaining your supply. Hospital grade pumps are by far the superior choice. So, if possible, please do invest in one, regardless of your pumping goals. As a very last resort for those who may not be able to afford any type of pump, hand expression will always be an option, but only as a last resort as studies have shown that although effective, double electric (hospital grade) pumps more efficient in removing milk. It is of utmost importance to use the right technique and to follow all the same basics as other types of pumps. – Flange sizing Flange sizing is an extremely important factor when it comes to pumping. If you use the wrong size flanges, it won’t only cause damage to your nipples and breast tissue, it will affect the amount of milk you express and eventually lower your entire milk supply. It’s important to measure your nipples correctly or to have a lactation consultant assess and determine the right flange sizes for you. Do remember to measure both nipples as they’re often different sizes from each other. – Replacing pump parts Pump parts like the valves, duct bills, tubing, backflow protectors and flanges/breast shields will need to be replaced every few weeks or months depending on how often you’ll be pumping. Even if they don’t look damaged, micro tears and wearing and tearing does happen, and it does affect the pump’s efficiency. – Amount of milk and milk storage It’s important to remember that babies

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Paternity leave

The importance of paternity leave when breastfeeding

Dads. Let’s not forget the important role you play in the success of breastfeeding this World Breastfeeding Week 2023. You matter, a lot when it comes to breastfeeding. More than you may know. One study has found that when men took paternity leave, their infants were more likely to be breastfeeding at 2, 4, and 6 months of age. Another study also shows that breastfeeding education and promotion for fathers in the antenatal and postnatal periods improved exclusive breastfeeding rates at 6 months, decreased the probability of full formula feeding at 2 months, decreased the occurrence of breastfeeding-related problems, increased the level of support offered by the father in breastfeeding-related issues, and improved the mothers’ knowledge and attitude towards breastfeeding. Fathers being on paternity leave and being able to support mothers during a critical time helped raise the rates of success in breastfeeding due to many factors including help with household duties, helping recognise infant hunger cues help taking care of the infant with non feeding related responsibilities such as changing and bathing and just offering overall emotional support to the mother at a time where breastfeeding is still being established, the mother is still adapting to her new lifestyle and support is greatly needed. Research clearly shows us that fathers matter when it comes to breastfeeding duration and success and that they should be receiving paternity leave to be able to offer their partners the needed support and to also have the opportunity to adjust to their new lifestyle and to help build a healthy attachment with their babies. Breastfeeding matters, it matters to both the child’s emotional and physical health and wellbeing and to their development, it also matters to the mothers emotional and physical health and wellbeing, it matters to the attachment between mother and child, it matters to the family’s financial wellbeing and it matters to the global economy. That’s a lot of matters! Dads, you play a huge role in the success of breastfeeding too. You matter. You deserve education and support, and you deserve paternity leave. Let’s stand up for dads!!! #WBW2023 #WABA #Breastfeeding #SDGS #WorldBreastfeedingWeek2023 #WarmChain #BuildingBackBetter #EmpoweringParentsCampaign #EnablingBreastfeeding #MakingADifference #EvidenceBasedBabies Additional information and resources: The Role of Fathers in Promoting Exclusive Breastfeeding Translating fathers’ support for breastfeeding into practice Paid parental leave and family wellbeing in the sustainable development era Effectiveness of targeting fathers for breastfeeding promotion: systematic review and meta-analysis Dads make a difference: an exploratory study of paternal support for breastfeeding in Perth, Western Australia Longer shared parental leave is associated with longer duration of breastfeeding: a cross-sectional study among Swedish mothers and their partners Facebook Twitter Linkedin

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grayscale photo of a boy crying

What yelling does to a child’s brain

Most of us were raised in a home where yelling at you as a child occurred frequently or even daily. It’s normal for us, but is what our parents did to us healthy? A lot of us are probably doing the same to our kids because we were raised that this is normal. I’m here to tell you that it’s not healthy. It wasn’t healthy for your parents to do it to you, and it isn’t healthy for you to do it to your kids now. Each time you yell at your child, you’re causing a little more brain damage. Yes, you read that right, brain damage. Now it’s probably safe to say that most of us would never want to cause our children any harm, especially something as severe as brain damage, which will have an effect on your child and who they are for the rest of their lives. What happens to your child when you scream at them? – It makes their behavior worse Studies have found that when you scream at your child, instead of changing their behavior in a positive way, it actually causes their behavior to do the exact opposite. One study found that mothers’ and fathers’ harsh verbal discipline at age 13 predicted an increase in adolescent conduct problems and depressive symptoms between ages 13 and 14. – It can lead to depression While most of us think that when you yell at your child and they get scared and cry, that it’s only temporary emotions, but that’s not the case. You see, the anxiety yelling causes can actually cause much deeper psychological issues for a child, even when they’re all grown up. In one study that tracked behavioral problems of 13-year-olds who were yelled at, researchers found an uprising in depression symptoms. Many other studies also show a connection between emotional abuse (which yelling is classified as) and depression or anxiety. Not only can these symptoms lead to worse behavior, but it can even develop into self-destructive behavior such as substance abuse. – It changes the way their brain develops Studies have found that both yelling and spanking causes severe stress and trauma in children of all ages. Early stress and/or emotional abusive language towards children causes negative changes in the development of a child’s brain. It’s been found to have a noticeable physical difference in the parts of the brain responsible for processing sounds and language. According to one new study, repeatedly getting angry, hitting, shaking or yelling at children are linked with smaller brain structures in adolescence. Previous studies have already shown that children who have experienced severe abuse have smaller prefrontal cortexes and amygdala. These two brain structures play a key role in emotional regulation and the emergence of anxiety and depression. Yelling at your children can and will cause issues with your child’s brain development, causing serious complications for them not only as children, but as adults too. How to stop yelling It’s hard though, isn’t it? Not yelling that is. It’s what we’re all used to from our own parents. It’s hard to stay calm when a child is having a huge meltdown, screaming or even physically hurting you. But here’s what you need to remember; they can’t help it. Their brains are still very underdeveloped, they can’t regulate their own emotions yet, they need you to help them and teach them how to deal with their emotions in a healthy way. You, the adult on the other hand? You have a fully developed brain and should have the ability to regulate your own emotions. If you don’t, it’s time to get help. If not for you, then for your child. Once you understand that children can’t help it, that it’s not their fault, you will be able to handle the situations better. Regulate your own emotions. Pause and breathe before reacting, identify the emotion you may be feeling and understand why you’re triggered, accept your emotion, practice mindfulness, engage in positive self talk, look for positive emotions and then react calmly. This may all sound easier said than done, but once you learn to regulate your emotions in a healthy way, it will make your life much easier. If you struggle with regulating your own emotions, it might be a good idea to look into getting therapy. There’s absolutely no shame in receiving the support you need to heal your trauma and learn the correct techniques to regulate your own emotions. Once you’ve begun regulating your own emotions, you can help your child regulate their emotions as well. It’s important to remember that children can’t regulate their emotions on their own, they need your help. They need to co-regulate with you. Yelling is not healthy. We as adults need to learn to heal our childhood trauma and how to regulate our own emotions so our children can grow up healthy, with the ability to regulate their own emotions in a healthy way so they won’t have any trauma they need to heal. We don’t want to raise children who need to heal from their childhood. Next time you want to yell at your child, just remember, your kids and the health of their brains are up to you. What you do next matters. Additional information and resources: Exposure to parental verbal abuse is associated with increased gray matter volume in superior temporal gyrus When Emotional Pain Becomes Physical: Adverse Childhood Experiences, Pain, and the Role of Mood and Anxiety Disorders The Long-Term Health Consequences of Child Physical Abuse, Emotional Abuse, and Neglect: A Systematic Review and Meta-Analysis Longitudinal Links Between Fathers’ and Mothers’ Harsh Verbal Discipline and Adolescents’ Conduct Problems and Depressive Symptoms Psychological stress in childhood and susceptibility to the chronic diseases of aging: moving toward a model of behavioral and biological mechanisms Exploring the Relation of Harsh Parental Discipline with Child Emotional and Behavioral Problems by Using Multiple Informants. The Generation R Study Prefrontal cortex and amygdala anatomy in youth with persistent levels

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