The co$t of infant formula

Budgeting for Baby: The Cost-Saving Benefits of Breastfeeding

September 3, 2013

Budgeting for Baby: The Cost-Saving Benefits of Breastfeeding
Of course, there are many benefits of breastfeeding to consider for both mom and baby, but what about cost? We all know that starting a family means a significant financial commitment – in other words, babies are expensive. No matter what your budget is like, it’s important to plan ahead and prepare for the lifestyle change that a new baby brings.

Whether you’re about to welcome a little one into the world or thinking about your current breastfeeding journey, you might be wondering how much breastfeeding costs. But first, take a look at the cost of not breastfeeding:

Powdered formula, the least expensive type of formula, usually costs between $20 and $30 per large can and formula-fed babies will likely need about 1-1.5 cans of formula per week. Feeding formula means spending $80-$150 or even upwards of $250 per month if your baby requires special formula due to allergies or other special nutritional needs. This means that in one year, your family could spend $960 (low end) to $3,000 (high end) on formula.

Compare that to breastmilk – perfect, complete nutrition without having to mix bottles or carry extra feeding gear – which is totally free. The Surgeon General of the United States notes that following optimal breastfeeding practices can save $1,200–$1,500 in the first year of your baby’s life when compared to buying formula. With that in mind, even spending a couple hundred dollars on a breastpump and supplies winds up costing considerably less than purchasing formula for your baby. We all know about the health benefits of breastfeeding, but don’t forget that healthier infants can also require fewer doctor visits, which lowers healthcare costs (and less time out of work for mom + dad). You can find more of the Surgeon General’s cost-saving benefits of breastfeeding here.

We can also take a look at the big picture. A study published in the Official Journal of the American Academy of Pediatrics found that the United States could save $13 billion per year (in direct and indirect health costs) and prevent almost 1,000 infant deaths if 90% of families chose to breastfeed their babies exclusively for 6 months.

Breastfeeding saves money (and lives) while creating a lifelong bond between you and your little one.

What made the biggest impact on your decision to breastfeed?

The Maternal Bond — News Room - UNC Health Care

The Maternal Bond — News Room - UNC Health Care

Your new baby and visitors

Bringing Baby Home: Four Ways to Manage Visitors

March 19, 2013

Bringing Baby Home: Four Ways to Manage Visitors
Bringing your new baby home for the first time can be one of the most exciting moments in your life! Before you ease into the calm and comfort of your home sweet home, prepare to be greeted by supportive friends and family. At times, it’s lovely to have visitors, but let’s be honest, it can also be exhausting. Blogger Amy Morrison recently shared a post on managing guests after birth. Here are some tips to help you relax and get support needed to ease into motherhood.

1.) Ask For Help
It’s easy to be overwhelmed by all the new responsibilities of being a mom. Don’t hesitate to ask guests for help. They’ll be thrilled to lend a hand and help you and your bundle of joy get comfortable in your new home.

2.) Make the Visit
Every family has one (or five) people who tend to visit for just a bit longer than most might prefer. If you’re not up for a marathon chat, offer to make the trip to see that person yourself (with your little one, of course). This way, you can choose to keep the visit short and sweet, or linger little longer if you’d like.

3.) Spread Out Guests
It’s okay to space out your visitors (and we don’t mean a few hours apart). Feel free to take a few weeks to get the hang of being a mom, and limit the amount of guests you have during this time. You’re a new mom whose life has just taken an exciting turn. Take some time to simply enjoy the giggles, smiles, and incredible little being you have by your side.

4.) Place Your Order
After diaper changes, breastfeeding, cleaning, playing, giggling and cuddling, it’s easy to lose track of your own mealtime. Remember, eating well and staying hydrated is one of the best ways to maintain breastmilk supply. So, say “yes” when visitors offer to bring over food. Moms deserve little treats too!

Read this before visiting a new Mom & Baby

Going to Visit Family or Friends Who Have a New Baby? Follow These Tips!

Posted on September 30, 2013


Baby in Hat

Your friend or family member has a new baby. You want to visit. You want to help. You want to meet that amazing new little person! Before you go, read this primer on how to be a good visitor to a family with a newborn in the house — the kind of visitor who will make the family feel loved, supported, and forever grateful!

Included are guidelines that apply to all visitors, plus tips specifically for close friends and family, long-term visitors, and friends and family who live far away but would like to help nonetheless.

In the United States, we shower attention on families during pregnancy, but not during the postpartum period — when in fact the postpartum period is the time when families need the support of their communities the most! Be a gentle, considerate visitor who puts the family’s needs first. Your thoughtfulness will be remembered and appreciated for years to come!

WHEN AND HOW LONG TO VISIT
◾Always call/message in advance to schedule the visit. Do not drop in unannounced. Be on time.
◾Front-porch meal drop-offs or short (10-15-minute) visits are good in the first several weeks, when families are overtired and commonly not feeling up to hosting company.
◾Longer visits (30+ minutes) are good in the later weeks/months, when long-term helpers (grandparents, etc.) have left; other visitors have stopped coming; and spouses have gone back to work. Mothers often report feeling isolated after 1-2-3 months at home with a newborn (and any other children), and welcome longer visits in the later weeks/months.
◾Very close friends/family may be invited to come for longer or more frequent visits to help in the early weeks, but should always ask the mother what type of visit — short or long — would be most helpful to her.
◾If the mother will be home alone with the baby most of the time (single parent, spouse deployed or working long hours), she may wish for visitors to stay longer. Ask.

PREPARING FOR THE VISIT
◾If you are ill in any way — even the tail end of a cold — stay home. Visit when you are well.
◾Do not wear perfume, scented body lotions, or aftershave. These linger for hours or days after your visit and are often overpowering for baby and mother, who have heightened senses of smell.
◾Leave your pets at home.
◾Leave your children at home. This is especially important in the early weeks, when the family is likely to want quiet, rest, and minimal outside germs. One exception is bringing your children over for a playdate or outing with the family’s older children, outside or away from the family’s house, which you plan to supervise.
◾Bring food. See “Bringing Food” below.
◾Bring small gifts for any siblings in the house, if you can. Gifts that do not make noise are best. Special food treats are a nice, inexpensive option.

DURING THE VISIT
◾Remember that the purpose of the visit is for you to help the family, not for you to spend time with the baby. Now is the time for you – not the family — to prepare food and clean up any messes made during the visit.
◾Do not expect or ask to hold the baby. (Yes, this can be difficult — new babies are so snuggle-able!) Wait for the mother to offer. Many won’t. One big exception is offering to hold the baby after a feeding so the mother can take a shower or a nap.
◾Wash your hands when you arrive, and let the mother know that you have washed them before touching her baby.
◾Greet any siblings enthusiastically. Give a big hello and lots of love to the older children before fussing over the baby — it will make them feel special during a time when the baby is the focus of most adults’ attention.
◾Do a chore. Do it without asking. Or say, “It would make me so happy if I could [do chore XYZ]. Will you indulge me?” (Saying something like this helps ease discomfort the family might feel about having someone clean for them.) Load the dishwasher. Wash the dishes in the sink. Wipe down a counter. Sweep the kitchen floor. Fold that basket of laundry you see sitting there. Take out the trash. Excuse yourself to the restroom and scrub the toilet or wipe down the counters.
◾Or, watch the older siblings, or take them out of the house on an outing.
◾Or, offer to take dogs for a walk, if you’re a dog person. Adjusting to a new baby can be hard for pets, too. They need a little extra love at this time, as well!
◾Give advice only if the parents specifically ask for it. Do not criticize.
◾Follow the mother’s cues about how long a visit she’d like. Remember that it can be very difficult for her to ask you to leave once you are there, even if she truly needs privacy to nurse or pump or perform postpartum self-care.
◾If the family has a premature baby in the NICU, they still need support — lots of it! Tell them “Congratulations!” (they do want their new little one to be acknowledged and celebrated). Ask them how they and the baby are doing, and then really listen. Give them gift cards to restaurants near the NICU; gas cards; or a care package of healthy snacks and drinks that do not need refrigeration (dried nuts/fruit/veggies, trail mix, homemade muffins, snack/granola bars, seltzer water, etc.). If they are staying near the hospital, away from home, offer to pick up mail, water plants, care for siblings or pets, or bring needed things from home to the hospital.

BRINGING FOOD

◾Most families welcome food anytime, but it is often especially welcome at these times: after any other long-term helpers (visiting family, etc.) have left; after the first several weeks when other visitors have stopped bringing food; and when the spouse goes back to work or is away on a business trip.
◾Ask whether the family has set up an online meal-delivery calendar, such as Meal Train or Take Them a Meal. If they have not, organizing one is is a great job for a close friend or family member (see below).
◾Check the family’s Meal Train page (or check with the family) for information about food preferences, sensitivities, and allergies, as well as any other preferences (food delivery times, locations, dates). Respect that information.
◾Bonus points: bring a complete meal (main dish, salad/veggie side, and dessert) and/or meals containing ingredients that promote breastmilk production, such as oatmeal (oatmeal lactation cookies are one option), whole grains, dark leafy greens, beans, vegetables, and nuts/seeds.
◾Avoid bringing foods containing large quantities of those herbs which are known to reduce breastmilk production, such as peppermint and sage.
◾If you do not cook, consider bringing a healthy store-bought ready-to-eat meal (such as rotisserie chicken or a complete dinner from the supermarket) or a collection of healthy snacks that the mother can grab and eat one-handed during the day or while nursing, such as nuts or trail mix (unsalted), dried fruit/veggies, healthy snack bars, precut fruits/vegetables, cheese, hummus, and whole-grain crackers. Trader Joe’s and Costco are great places to buy these things inexpensively.
◾Bring the food in disposable containers or in inexpensive reusable Rubbermaid or thrift store dishes that need not be returned.
◾Consider attaching a note to the meal specifying that the dish does not need to be returned and that no thank-you note is necessary.

IF YOU ARE A CLOSE FRIEND OR CLOSE IN-TOWN FAMILY MEMBER

◾Run an errand. School drop-off, grocery store, Target. For example, call and say, “I am going to the grocery store. What can I get you? I will drop it by on my way home.” Note that it is “What can I get you?” not “Can I get you anything?”
◾Be the one to organize a group of friends/family to deliver meals in the first three weeks (or longer). Use an online organizing service like Meal Train or Take Them A Meal. Be sure to include information about food preferences, sensitivities, and allergies. If the meal-receiving family is not large, have meals delivered every other day so that the backlog of leftovers does not overwhelm the refrigerator before the family can get to them. Spread word of the Meal Train throughout the family’s social circle.
◾Help the family write a Chore/Helper List. This is a list of tasks that other visitors can help with, so that when visitors ask what they can do, the family has immediate answers. Place it in a prominent place, like the refrigerator.
◾Help the family research the baby/parenting information they need, if they would like. With a new baby in the house, it can be hard to find time and energy to research lactation consultants, breastfeeding or postpartum support group meeting information, etc. A list of local maternity and parenting resources can be found here.
◾Lend an ear. Ask the mother how she is feeling, then follow her signals. Do not pry. If she wants to talk about her experiences, she will.
◾Observe the mother for signs that she may be developing postpartum depression (PPD) or anxiety (at least 1 in 5 new moms in the United States do). Know the difference between normal new mom stress and a postpartum mood disorder. Be gentle and compassionate with the mother. Ask her what kind of support would help her feel better. If she wants peer or professional assistance, this page has a list of local and national postpartum support organizations. To better understand what a mother with PPD is experiencing, her friends/family may find it helpful to read Brooke Shields’ memoir, Down Came the Rain: My Journey Through Postpartum Depression.
◾Watch the father for signs of anxiety or depression as well. Postpartum anxiety and depression occur in fathers, too. Like mothers, fathers need sleep, good nutrition, exercise, and alone time to stay well. This page has a great list of resources both for fathers experiencing postpartum depression themselves, and for partners of women experiencing PPD. Additionally, Postpartum Men Online Forum is an online community that these men may find helpful.

IF YOU ARE A FAMILY MEMBER VISITING FOR AN EXTENDED PERIOD
◾Come for an extended visit only if the family has invited you to do so. Never invite yourself.
◾Ask if the family would prefer that you stay in a hotel during your visit. Be gracious if they say yes.
◾Offer nighttime help. Offer to stay up late with baby while they catch a few early-evening hours of sleep. Offer to burp/walk/bounce a fussy baby after a midnight nursing/feeding so that the parents can sleep. Nighttime is often a time when help is scarce but dearly needed.
◾Be their personal assistant. Do whatever they indicate they need. Drive them to appointments or support meetings. Run errands. Grocery shop. Pick up prescriptions. Babysit siblings. Cook. Clean. Do laundry. See “During the Visit” above.
◾Encourage them. Tell them that they are doing a wonderful job. Tell them that you are proud of them. Especially for a nursing mother struggling with breastfeeding, the words, “You are doing a great job,” are magical.
◾If you are a generation older, understand that parenting techniques likely have changed since you last cared for babies. Ask the parents about their parenting philosophies. Follow any specific baby-care instructions they provide. Reading (and following) the same baby-care books that the parents are can be helpful.

IF YOU LIVE FAR AWAY BUT WOULD LIKE TO HELP
◾Pay for the services of someone who can help in person: a postpartum doula, a house cleaner, a diaper service, a grocery delivery service. A list of such local resources is available here.
◾Be part of the family’s virtual support team. Let the mother know that you are a friendly, supportive ear that she can call or Skype at any time, day or night.

IF YOUR SPOUSE OR CHILDREN WANT TO HELP, TOO

As stated above, having a crowd of visitors in the house — or running in and out of the house — can be overwhelming for a family with a new baby. But having a work crew tackle the work literally piling up outdoors? Such a help. If you can bring your own tools (for example, rakes and leaf bags for raking leaves) so you have no need to ask where to find supplies, it’s all the more helpful.
◾Pet care. Walk the dogs. Poop-scoop the yard. Change the litter box or the hamster cage.
◾Yardwork. Mow the lawn. Rake the leaves. Shovel the snow off the driveway and sidewalk. Snow and leaf blowers can be grating on the nerves — avoid them.
◾Garden work. Weed. Pick veggies. Especially good for parents of babies born during harvest season!

FURTHER READING
◾Why Are America’s Postpartum Practices So Rough on New Mothers? (The Daily Beast)
◾A Letter to Grandparents by Penny Simkin
◾After the Birth, What a Family Needs (Gloria Lemay)
◾How To Be the Best Post Partum Visitor in 15 Minutes or Less (There Are No Ordinary Moments)
◾The Answer Is Always “YES!” (Or, How To Help a Struggling New Mom) (Dou-la-la)
◾For Parents: Visitors After the Baby? 10 Tips for New Parents (Huffington Post)
◾For Parents: Is DAD the Ideal Postpartum Doula? (The Birthing Site)
◾For Parents: DONA International’s Postpartum Plan (DONA)

This post has been several years in the making. Sincere gratitude to the many mothers who have contributed, both directly and indirectly, the ideas, suggestions, and wisdom reflected within it!

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Breastfeeding Lowers Odds of Maternal High Blood Pressure --Doctors Lounge

Breastfeeding Lowers Odds of Maternal High Blood Pressure --Doctors Lounge

Should nursing Moms avoid certain foods?

Should breast-feeding moms avoid certain foods? Here are some tips to put nursing moms and their babies on the right track. By Chanie Kirschner Fri, Aug 02 2013 at 2:15 PM Related Topics: Healthy Eating, Raising Healthy Kids breast-feeding foods Photo: Oksana Kuzmina/Shutterstock Breast-feeding is a wonderful gift you can give your baby. And while you should always maintain a balanced diet, what you eat while you’re a nursing mom is especially important since the foods you eat are nourishing your baby as well. So what should you avoid while breast-feeding? “There are no foods that mothers ought to avoid while breast-feeding,” says Dr. Nancy Brent, noted pediatrician, lactation consultant and medical director at the Breastfeeding Center of Pittsburgh. “In fact, most mothers can eat anything they want while breast-feeding. However, if your baby is fussy and you’re noticing other unusual gastrointestinal symptoms, such as bloody or mucus-y stools, try cutting out dairy and then soy.” If you eat something and notice that two feedings later (about the time for that food to enter your breast milk) your baby is especially fussy, you might try cutting out that food and seeing how your baby responds. “Then, after two weeks, gradually add that food back into your diet and see if your baby tolerates it,” Brent advises. She’s quick to add, though, that without any gastrointestinal symptoms, infant fussiness is likely not the result of maternal diet, and can be a sign of overtiredness, colic or acid reflux. Though foods mentioned above may or may not have an effect on your breast milk, there are certain things you should avoid while you’re breast-feeding to ensure your baby’s health. First item on the list? Alcohol. The American Academy of Pediatrics says that an occasional drink for a breast-feeding mom is OK, and Brent agrees. “Generally, a woman can have one drink of beer or wine two to three times a week. She should time it immediately after a feeding. If she's feeling the effects, then the alcohol is in her milk. If she's still feeling a little drunk when it's time to nurse next, she needs to give a bottle of previously expressed milk or formula.” You can “pump and dump” the milk to avoid engorgement and clogged milk ducts. Either way, too much alcohol can harm your baby, and it’s important to monitor your intake. Another thing to avoid while you’re breast-feeding is caffeine. While a morning cup of coffee is OK, experts say to limit your daily intake to no more than 300 mg a day. That’s generally one cup of fresh-brewed coffee, though actual amounts of caffeine may vary a little. If you’re like me and you just like the taste, feel free to go crazy on instant decaf — there’s only 2 mg of caffeine in a cup. Be watchful of other things that contain caffeine, such as chocolate or caffeinated tea. (If you’re unsure how much caffeine that certain food items have, check out this chart.) Finally, trim your seafood intake while you’re breast-feeding, especially if white tuna, swordfish or mackerel is your thing. That’s because these types of seafood are known to contain high levels of mercury, which could potentially harm your baby’s nervous system in high doses. If you do like seafood, choose fish that are typically low in mercury, such as wild-caught Alaskan salmon. Salmon is also high in omega-3s and protein, two essential nutrients for breast-feeding moms. You don’t need to go crazy to avoid specific foods while you’re breast-feeding. Just be smart about your intake and feel confident knowing you’re doing the best you can for you and your baby. Happy nursing! Related breast-feeding stories on MNN: •What not to eat when you're pregnant •More U.S. mothers breast-feeding, CDC says •Breast-feeding mama gets happy surprise at restaurant

How to be the Best Post-Partum Visitor in 15 Minutes or Less

Resources How To Be The Best Post Partum Visitor In 15 Minutes Or Less How To Be The Best Post Partum Visitor In 15 Minutes Or Less Have a friend who had a baby and you're on the roster to drop off a meal? Here's everything they want you to know and do, but are too shy and polite to say and ask. They are tired. Breastfeeding is still awkward and having people around makes it more awkward. The mother is recovering physically, either from a surgical birth, or from the equivalent of a triathlon where the prize was a grapefuit sized head flying out of her vagina. Either of these things makes you sore and tired. They would like to see you, but don't want to be tired out by a long visit. You are not going to stay longer than 15 minutes, no matter how polite the parents are in saying you can stay longer. If your visit/meal drop off scheduled for 5.30. BE ON TIME. Make plans for 6:15 so that you HAVE to leave. Read More Before you walk in the door, put your game face on. Set a timer, on your phone or watch for 15 minutes. When it goes off, get out of there! Remember that you are going to be a quiet, productive blessing. This visit is NOT about you. It is not about the parents hosting you and putting on a cup of tea so you can sit and visit and hold the baby. Think about how you would feel if you had either had surgery or ran a triathlon. What would you want people to do for you? This visit is about blessing the parents and making their life a little bit easier. Your prize is getting a quick peek at the cute new human. Here's how to play out your 15 minute visit: 1. Bring a healthy meal. Include a salad or fresh vegetables. Only use disposable dishes. There is nothing more annoying than a) having to wash more dishes when you have a new baby and b) having to try to return dishes to all sorts of random people when you have a new baby 2. In addition to your meal, bring cut up veggies and fruit, unsalted trail mix or nuts, or other such healthy snacks for daytime munching for mom to eat while she's nursing. 3. Go into the kitchen and spend 5 minutes clearing off a counter, washing a sink-full of dishes, loading the dishwasher etc. Don't ask permission, just do it. Then set the table for their dinner. 4. Before you leave your house, put some paper towels and some powdered bathroom cleaner like Commet or Ajax in a baggie. Stick it in your purse. While you are at the house, go and use the washroom...and while in there do a three minute bathroom shine-up, using your paper towels and cleaner. 5. Coo over the baby, but wash your hands before touching it. 6. If they want to eat right then, heat the food up and put it on the table, give everybody kisses and then leave. 7. Take the garbage out when you go. In and out. This will be the best visit the parents will have had. They will love you and you will be awesome in their books forever. You can come back and have a longer visit when the parents have adjusted to their new normal.

Baby refusing to nurse? Laid back and baby-led breastfeeding may help.

Baby refusing to nurse? Laid back and baby-led breastfeeding may help.

Press Release from the USLCA

United States Lactation Consultant Association FOR IMMEDIATE RELEASE Celebrity Breastfeeding and the United States Lactation Consultant Association RALEIGH, N.C. --- Somehow it is news that one celebrity is breastfeeding a two-year-old and another "refuses" to breastfeed. The royals are not immune from infant feeding hype as speculation surrounds Kate Middleton. Will she or won't she? That breastfeeding regularly tops tabloid headlines speaks volumes about our cultural conflicts. Breastfeeding is seen as healthy and good...but potentially scandalous if it takes place in public or beyond infancy. Breastfeeding is viewed as good mothering...but may "ruin" the idealized female body. The American Academy of Pediatrics takes the stand that breastfeeding is not a lifestyle choice, but an important public health initiative. It is the desire of the United States Lactation Consultant Association (USLCA) that every woman have the opportunity to be fully informed about breastfeeding so that she may make the best decision for herself and her family. Women need to know that it is not breastfeeding, but rather pregnancy itself that changes breast latitude and longitude. Women need to know that breastfeeding offers significant protection from breast and ovarian cancer and reduces the risk of type 2 diabetes, high blood pressure, and heart disease. And they need to know that breastfeeding offers their children protection from a host of illnesses and chronic diseases such as ear infections, obesity, respiratory infections, sudden infant death syndrome (SIDS), and even some childhood cancers. And once they do make the decision to breastfeed their babies, women need support to do so. A study published in the journal Pediatrics found that only a third of women meet their own breastfeeding goals. A British study recently concluded that breastfeeding may help children climb the social ladder. The child of Prince Charles and Kate Middleton is unlikely to have difficulty with that climb. Children of celebrities have a head start, too. USLCA is concerned for the children whose mothers don't make headlines. We support the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and Michelle Obama in their call for more Baby-Friendly Hospitals so that breastfeeding gets off to a good start. And we urge Congress to continue funding for breastfeeding peer counselors through the Women, Infant, and Children's (WIC) supplemental food program so that the most vulnerable women and children are more likely to benefit from the health, cognitive, emotional, and social perks of breastfeeding. Breastfeeding support comes from employers, businesses, families, and health care providers. Mother-to-mother counseling and encouragement is invaluable. But when designing breastfeeding support policies and programs and when help in overcoming challenges is needed, International Board Certified Lactation Consultants (IBCLC) are the ones to call. In the maze of breastfeeding helpers, only the IBCLC is required to demonstrate completion of specific college-level, health sciences courses, complete ninety hours of education specific to lactation, and spend hundreds if not thousands of hours in clinical practice before sitting for a rigorous international exam. For healthy mothers and babies, for climbing the social ladder, for the health of the nation, breastfeeding is worth the IBCLC. For more information or to find an IBCLC in your area, visit www.uslca.org.

Don't be a "Strong Mom"

When Big Pharma “Strong” Arms Mothers, We All Lose By Contributor on May 6, 2013 Mother feeding newborn sonCorporations have a very bad habit of telling moms how to be. Or better yet, co-opting some very common “mom” archetypes for their marketing pursuits. For decades, we were told “Choosy Moms Choose Jif.” More recently, “It Moms” were more likely to choose a particular fabric softener. This week, infant formula maker Similac has taken on the dubious role of connecting their brand to “Strong Moms” — those supportive, they say, of a less judgmental environment for mothers. This new affinity for strength is being launched with a Strong Moms Summit on May 7th in New York City featuring a number of high-profile mom bloggers. Please forgive me for being suspect. It is certainly true that there is way too much pressure on mothers today, and we all could take a proverbial “chill pill” on the mommy-bashing. But when a multi-million dollar pharmaceutical giant (Similac is owned by Abbott Laboratories) plows millions of dollars into telling mothers to be “strong” and “non-judgmental,” I think I’m rightfully engaged in a side-eye glance. Selling women messages that sound good on the surface but actually undermine them has been a corporate tactic since at least the 1950s. We aren’t really being supported to be strong moms–whatever that means anyway — we are being sold the idea of “strong” as a marketing tool for corporate interests. There’s a big difference and all parents should take note of the dangerous undercurrents. What I typically find most insulting is that these corporations are counting on moms not knowing better. That we are so weary from the pressures of motherhood, that we will hang on to any messaging that appears to be a “release valve” without delving one centimeter beneath the surface to find the real facts. Apparently “strong” does not mean savvy. Because one centimeter beneath the surface of Similac’s “Strong Moms” Summit and online campaign you will find that framing of infant formula use around a “lifestyle choice” that is not to be judged has been its primary marketing strategy for decades. Ah, choice. It used to be such a powerful word–one that conjured up women’s suffrage, the feminist movement and our battle for reproductive rights. The problem today is that “choice” has been taken out of the context of women’s rights and misconstrued into a dirty and insidious word. In its most disgusting reiteration it is being marketed to women and girls by corporations — in this case, by infant formula marketers, who are more concerned with profits than infant health outcomes. Women have been led to believe that the “choice” between formula feeding and breastfeeding is merely a matter of inclination–a personal decision, a feather in the cap of liberation. And since choices are individual, they have no social consequences; women are therefore relieved of responsibility of considering the broader implications of their decisions. And once I make my choice, no one is to challenge me. We can’t talk about it. And if you do, you are judging me. This is dangerous territory for all women and mothers as the issue of breastfeeding vs. formula feeding is turned into a mere lifestyle choice as opposed to a child health matter. No wonder Similac is supporting so-called non-judgment. What is really happening is that by leaving each other alone in our so-called non-judgmental circles, we are simply leaving the current unjust system in place and discouraged from forming opinions about the value of different choices. With this type of continuous marketing messaging, we lose the ability to have critical discussions about where the real choices lie and which “choices” are merely illusions. Most problematically for the future of mothers, it deters us from addressing the systemic problems such as improving child care options, increasing the market for part-time work, the lack of a paid federal maternity leave, and other deep-rooted, anti-family policies that actually devalue mothering and shape our infant feeding choices, and prevent us from being active agents of change because we are being told that many aspects of mothering from our infant feeding to work decisions are “choices” and, therefore, private matters. Choice becomes the silencer on a dangerous handgun. In this context, choice is not liberation. It is suffocation. In this context, Similac is asking moms to be strong when they really want us weak and silenced. Framing the infant feeding conversation as an empowerment experience erases the context of corporate interests and deep pocketed marketing machines that have always put profit motive ahead of infant health and the health of mothers and our actual empowerment, for that matter. Let’s face it, this isn’t the first time that women have been sold on an ideal that sounded good on the surface but was actually manipulated to undermine them. It’s been over 50 years since Betty Friedan’s The Feminine Mystique ripped the veil off the problem behind a very good-looking pretense of waxed floors, perfectly applied lipstick and domestic bliss in the 1950s to help women breakthrough a malaise they didn’t know existed. At that time, the idea that women were naturally fulfilled by devoting their lives to being housewives and mothers was borne out of similar cultural forces and commercial interests. It was presented as if this was the woman’s choice, when in fact cultural forces dictated that preparing for marriage and motherhood even from the teenage years was her only option. Meanwhile, the dialogue around the real issues that could actually significantly impact our lives and the health of all infants has been suffocated while we clamor behind choice and non-judgment and use it as a shield to deflect our mommy guilt. Our ability to build conversation and support among each other has been quashed because we won’t discuss what we have been told is a private choice. With so much individualism embedded in our views about choice, there is little room for examining interdependence or acknowledging individual fallibility of our choices. It is women and infants who are paying the price for this so-called freedom of choice. Until “choice” is presented with accurate information, then choice is just a mirage. What’s more, we have to understand the difference between choice and options. Having unequal options doesn’t make for true choice. And truly strong moms don’t need big pharma’s underhanded and predatory marketing ploys under the guise of a summit. Thanks, but no thanks.

'Bye nursery; hello rooming-in!

About Projects Who's Involved Newsroom Resources Contact You are here: Home > Newsroom > Goodbye Nursery, Hello Rooming-in Goodbye Nursery, Hello Rooming-in Hospital goes from 10 percent to 100 percent rooming-in in less than a year April 16, 2013 By Cindy Hutter The traditional hub of maternity floors, the baby nursery, is getting a makeover. The nursery is transitioning from the central place for doctors to evaluate babies and families to ogle at newborns to a specialty care area that rarely is used. The new nursery identity is to support the practice of keeping mothers and babies together 24 hours a day, known as rooming-in. The practice helps mother and babies get acquainted, learn feeding cues and establish breastfeeding patterns. Rooming-in is one of the Ten Steps to Successful Breastfeeding External Link, as outlined by the World Health Organization. Birthing facilities who comply with these steps achieve Baby-Friendly External Link status, a designation indicating a commitment to supporting breastfeeding. “It took a lot of teaching to get staff to understand that that we are not doing the mom a favor by taking the baby away from her during the night for her to sleep,” says Marianne Allen, a clinical nurse specialist for Women and Children’s Services at PinnacleHealth System in Pennsylvania. “It’s a change in the mindset of staff that we serve the mother best by teaching her the skills and giving her the confidence she’ll need to take care of her baby in the days to come once she goes home without the safety net of the hospital. The best way to do that is to have them together.” PinnacleHealth is one of 89 hospitals participating in Best Fed Beginnings, a NICHQ-run nationwide project that aims to help hospitals improve maternity care and increase the number of Baby-Friendly designated hospitals in the United States. A significant component to support rooming-in is providing couplet care, meaning the same staff takes care of the baby and the mother. In many hospitals baby nurses take care of the newborns and postpartum nurses take care of the mothers. Having one person take care of both the mother and baby helps promote family-centered care, which is shown to lead to more successful breastfeeding, higher patient satisfaction levels and improved nursing and medical staff communications, according to the Centers for Disease Control and Prevention. “We had to change the whole culture of our unit in that all the postpartum nurses had to be trained for infant care. It was a yearlong process,” explains Teri Grubbs, BSN, director of Women’s Health Services at University Health System in Texas, another hospital participating in Best Fed Beginnings. “Also moving the lactation nurses out of the nursery and on to the postpartum unit helped to support rooming-in and boost our exclusive breastfeeding rates.” What’s in a Name? One challenge to rooming-in is changing the expectations of mothers who want to send their babies to nurseries, not realizing it can make breastfeeding more difficult later. How have these Best Fed Beginnings hospitals been able to deter moms from sending their babies to the nursery? It’s all in the name. The University Health Center renamed its nursery the Neonatal Observation Unit. PinnacleHealth will call theirs the Holding Nursery (starting May 1), which will be a place for babies to get intervention, not care. Greenville Health System in South Carolina went a step further. They put a self-proclaimed “scary” sign on the nursery door that reads: “Authorized Personnel Only. This space is reserved for flu isolation, MRSA isolation, urgent evaluation for sick newborns and procedures. Healthy newborns are assigned to rooms on the Family Beginnings unit. Please see your nurse for more information.” “Overnight the nursery became empty. I was astounded,” says Jennifer Hudson, MD, medical director for Newborn Services at Greenville. “Nurses said the sign really helped to define the space differently and made it look like a place people didn’t want to put their babies. It was the most effective intervention we had so far.” Greenville’s rooming-in rate went from 10 percent in July 2012 to 100 percent in February 2013. Chart showing the increase in the rooming-in rate from July 2012 to March 2013 at Greenville Health System. Credit: Greenville Health System. Click image for larger version. Chart showing the increase in the rooming-in rate from July 2012 to March 2013 at Greenville Health System. Credit: Greenville Health System. Mothers’ reactions to rooming-in has reportedly been overwhelming positive at the three hospitals, with some mixed reactions from second-time moms used to the nursery. “It’s very empowering for families,” said Hudson. “It’s really a positive when it comes to security and safety. We emphasize that mothers get to watch everything we do for their babies, including the first bath, exams and screening tests. Hourly rounding by nurses will ensure that they get the help that they need while families learn about and bond with their newborns." Terri Negron, RN, director of Nursing at Greenville Health System, adds, “While some second-time moms are apprehensive, first-time moms don’t know any different and when they come back, rooming-in will be an expectation.” All three hospitals say the transition to rooming-in has been a team effort. It required support from nurses, doctors, unit leadership and executive management. Staff had to understand the evidence-based reasons for change, be committed to the idea and embrace the changes. It didn’t happen overnight for any of them. “You have to have the nucleus of nurses that are supportive and believe in it,” says Grubbs. “You start with them and you train them and have success and then you train more and have more success. You continue to open the door.”

Breastfeeding...It's only natural

HHS offers moms knowledge, help, and support through a new breastfeeding initiative, It’s Only Natural Today, Surgeon General Regina M. Benjamin, MD, MBA announced the launch of It’s Only Natural, a new public education campaign that aims to raise awareness among African American women of the importance of and benefits associated with breastfeeding and provide helpful tips. It's only natural. mother's love. mother's milk “One of the most highly effective preventive measures a mother can take to protect the health of her infant and herself is to breastfeed,” said Surgeon General Benjamin. “By raising awareness, the success rate among mothers who want to breastfeed can be greatly improved through active support from their families, their friends and the community.” Breastfeeding offers mothers and their babies a healthy start. According to the Centers for Disease Control and Prevention, nearly 80 percent of all women in the United States—regardless of status, race, or income — start out breastfeeding. Among African American women, the breastfeeding rate is almost 55 percent — up from just 35 percent in the 1970s. However, while these rates are improving, breastfeeding rates among African American women remain lower than the rates of other ethnicities in the U.S., particularly among those living in the south. This gap may indicate that African American mothers face barriers to meeting breastfeeding goals and need additional support to start and continue breastfeeding. It’s Only Natural was specifically designed to provide materials that reflect the experience of African American moms. It’s Only Natural was developed to equip new moms with practical information and emotional support from peers, as well as tips and education about the benefits of breastfeeding and how to make it work in their own lives. All of the material is uniquely crafted for African American women. Materials include: •video testimonials from new moms talking about the challenges they have overcome, providing breastfeeding tips, sharing their individual stories, and much more; •articles on a variety of topics ranging from laws supporting breastfeeding to how to fit breastfeeding into your daily life; •two fact sheets, which contain proper holding and latching techniques, as well as information on managing discomfort and how much milk is enough; and •radio public service announcements. To learn more about the campaign, visit www.womenshealth.gov/ItsOnlyNatural. ###

6 minute film on the billion dollar formula industry

Breast is Best

www.bottledupthefilm.com

Home About Evidence Giving Birth Based on Best Evidence Can Hospitals Keep Moms and Babies Together after a Cesarean? © by Rebecca Dekker, PhD, RN, APRN of www.evidencebasedbirth.com In my previous article on skin-to-skin care after a C-section, I wrote that skin-to-skin care after a C-section has many benefits for moms and babies. However, I have come to realize that women cannot do early skin-to-skin if they are routinely separated from their babies after a C-section. In order to do early skin-to-skin, women and newborns must stay together—a process known as “couplet care.” However, the vast majority of women are separated from their babies after a C-section. Why don’t more women and babies receive couplet care? Is it possible for hospitals to make the switch from routine separation to routine couplet care after a Cesarean? Keep reading to find out. What is the history of mother-infant separation after birth? Separation of human mothers and newborns is unique to the 20-21st centuries and has been a complete break from natural human history. In the past, infant survival depended upon close and virtually continuous mother-newborn contact. The practice of routinely separating mothers and newborns started around 1900. At the time, most women received general anesthesia that made them and their babies incapable of interaction after birth. Because mothers couldn’t care for their babies, hospitals created central nurseries to care for newborns, and infants were typically separated from their mothers for 24-48 hours. Separation from parents was also meant to ”protect” infants from maternal illnesses (Anderson, Radjenovic et al. 2004). In her book Hypnobirthing, Marie Mongan described her experience of being separated from her infant in the 1950′s… My head was held as the ether cone was forced onto my face. That was the last I remembered. I awakened sometime later, violently ill from the ether, and was informed that I had “delivered” a beautiful baby boy, whom I would be able to see in the morning…. My husband saw our son only through the window of the nursery for the next five days, as no one was allowed to visit when “the babies are on the floor.” Our family bonding was nonexistent. When did things begin to change? In 1961, Dr. Brazelton published a classic study showing that general anesthesia was harmful to newborns (Brazelton 1961). As a result of his research, more people began to move away from using general anesthesia during birth, which resulted in mothers and infants being more alert—and capable of interaction—immediately after birth (Anderson, Radjenovic et al. 2004). In addition, most mothers who give birth by Cesarean receive regional anesthesia instead of general anesthesia, so these mothers, too, are usually alert after giving birth. Furthermore, in the past 30 years, an abundance of research evidence has shown that when mothers and babies are kept close and skin-to-skin after birth, outcomes improve (Moore, Anderson et al. 2012). It is very important for you to understand that when researchers study human mother-newborn contact, keeping mothers and babies together is always considered the “experimental” intervention. In contrast, when researchers study other non-human mammals, keeping mothers and babies together is the control condition, while separating newborns from their mothers is “experimental” (Moore, Anderson et al. 2012). What is routine practice today? Although most mothers now are capable of taking care of their babies after birth, and despite the fact that research overwhelmingly supports couplet care—hospital practices have been very slow to change. Routine separation of moms and babies during the recovery period still happens at 37% of vaginal births in the U.S., with rates ranging widely from state to state. In Alaska, only 5% of babies are separated from their mothers after a vaginal birth, while in Mississippi, 81% of infants are separated from their mothers after a vaginal birth. (Centers for Disease Control, 2010) After most C-sections, babies are sent to the nursery for routine care Credit: brettneilson How often are women separated from their infants after a C-section? Separation of mothers and infants is very common after a surgical birth or C-section. In the U.S., 86% of women who give birth by C-section are separated from their babies for at least the first hour (Declercq, Sakala et al. 2007). With more than one-third of U.S. women now giving birth by Cesarean, this means that a substantial proportion of mothers and babies experience a critical delay in bonding, skin-to-skin contact, and breastfeeding. Research shows that most of the time when babies are separated from their mothers after a C-section it is so that the hospital can provide routine mother/baby care in separate rooms—not because the babies need any kind of special care (Declercq, Sakala et al. 2007). When infants are brought to the nursery while their mothers recover separately, it is common for a nurse to give a first feeding of formula (Elliott-Carter and Harper 2012). What are the benefits to keeping moms and babies together? To read the benefits of keeping moms and babies together, please refer to my article on skin to skin care after a Cesarean. To summarize, babies who receive couplet care—in other words, who stay with their mothers and receive early skin-to-skin care—are 2 times more likely to be exclusively breastfeeding at 3-6 months, compared to babies who receive routine hospital care. You can read about the many other benefits of early skin-to-skin care—and the potential harms of separating mothers and babies— here. Submitted by an anonymous reader. Dads can do skin-to-skin care, too. Everyone can stay together. Are there any potential harms to keeping moms and babies together after a C-section? It is important to know that some mothers may not capable of independently caring for their infants immediately or for several hours after a C-section. For example, if mothers received strong sedatives, are nauseous, or were sleep-deprived for many hours before the Cesarean, then they may need supervision or assistance in caring for their newborns. The mother’s level of awareness and her ability to remain awake when caring for and feeding infants must be assessed and closely monitored by nursing staff, especially when a Cesarean follows a prolonged labor or when sedative drugs have been given (Mahlmeister 2005). In this case, then the father or partner can do skin-to-skin with the infant. Is it possible for hospitals to keep moms and babies together after a Cesarean? Yes, it is possible for hospitals to keep moms and babies together after a Cesarean. Two different hospitals have published quality improvement reports describing how they switched from routine separation to routine couplet care after C-sections (Spradlin 2009; Elliott-Carter and Harper 2012). As both reports were very similar, I will focus on the most recent article by Elliott-Carter (you can read the article for free in its entirety here). Why did this hospital decide to make the change? In 2011, nurses at Woman’s Hospital in Baton Rouge, Louisiana, led a switch from routine separation after Cesareans to couplet care—keeping moms and babies together. The hospital was motivated to change for several reasons, including a desire to stay competitive with other hospitals and repeated requests from patients to not be separated from their babies. Perhaps most compelling, the staff felt it was simply “not fair” that moms who gave birth vaginally were allowed to stay with their babies, while moms who had C-sections were automatically separated from their babies. The C-section rate at Woman’s hospital was 40%, and they have more than 8,000 births per year. So making this change affected 3,200 families per year. How did the hospital change to couplet care? Amy and her baby Kareanna stayed together after a Cesarean– which allowed them to do very early skin-to-skin care. One of the first things the hospital did was put together a leadership team to plan for the change. This team included nurse managers from labor and delivery, postpartum, and newborn care, as well as pharmacists and materials management. The team communicated the plan to other groups (such as medicine). One of the team’s challenges was finding a large enough space where moms and babies could recover together after a C-section. They ended up choosing overflow labor and delivery suites that were big enough to accommodate the couplet. They also modified the existing recovery room (PACU) so that it could be used in case the overflow rooms were full. They moved curtains to make each patient’s space big enough for both mothers and infants to recover together, and they put a radiant warmer for the infant in each recovery space. The team had to make several other small changes. They had to train the recovery (PACU) nurses in neonatal resuscitation. They made sure baby blankets were placed in the heated blanket warmer, and that appropriate medications for both moms and babies were stocked in each room. Perhaps most importantly, staff made a commitment to provide care where the mothers and babies were, instead of always taking the baby away to the nursery. Although taking the baby to the nursery was easier and more convenient for the staff, they realized that keeping the couplet together was best for moms and babies. It took about 6 weeks from the beginning of this process until couplet care was fully implemented. How did it go for this hospital in Louisiana? In the first year after starting couplet care, the percentage of infants who were separated from their mothers dropped from 42% to 4%. Nurses stated that everyone was extremely satisfied with the change—including staff, physicians, and mothers. Nurses report that mothers are able to have skin-to-skin contact earlier, and that the first breastfeeding session goes smoother. Inspired by the bonding they witnessed between moms and babies, nurses decided to delay administration of erythromycin ointment and the vitamin K shot until after the initial breastfeeding. As nurses from the Woman’s Hospital said, “If a hospital that delivers 8,000 infants annually can find a way to decrease the separation of mothers and newborns, concerned nurses everywhere should be able to implement this type of care.” In the ideal situation, mom does skin-to-skin in the operating room. The family is never separated during recovery. So what is the bottom line? Evidence has shown that it is possible—and best practice—for moms and babies to stay together after a Cesarean. If a hospital staff member tells a mother that it is “impossible” for her to stay with her baby after a C-section, that statement is false. Making the switch from routine separation to couplet care can be done—some hospitals have already done so. Although couplet care may be more inconvenient for staff in the beginning, in the end, keeping mothers and babies together after a Cesarean is what is best. Mothers who want to do very early skin-to-skin care and interact with their babies after a C-section should talk with their providers about this mother-friendly and baby-friendly practice. Moms should also talk with their anesthesiologists to make sure that they do not receive sedative drugs unless medically necessary, as these drugs may make some women incapable of early interaction with their newborns. If you want to read more medical research: These researchers describe how critically ill babies had a higher mortality rate when they were separated from their mothers after birth. These researchers found higher cortisol (stress) levels in infants who were not held by their mothers after birth. In this small randomized, controlled study, researchers experimented with keeping moms and babies together after a C-section. Not surprisingly, the intervention group had earlier first mother-baby contact, earlier first feedings, and more stable infant body temperatures. In this landmark study, researchers randomly assigned mother-baby pairs to several different groups, and one of the groups was assigned to mother-baby separation for 2 hours after birth. Mothers and babies who were separated for 2 hours had a higher risk of poor maternal/infant bonding outcomes one year later. This risk was not alleviated by “rooming in” for the rest of the hospital stay. In this animal study, baby horses were separated from their mothers for one hour after birth (intervention group) or left undisturbed with their moms (control group). The separation increased the risk for poor bonding and other adverse social outcomes. If you Google “hospital”, “couplet care” and “cesarean” you will find a large number of hospitals that already offer this mother-friendly and baby-friendly practice. If you liked this article, you may be interested in: The evidence for skin-to-skin care after a C-section An interview with a mother who received skin-to-skin care in the operating room An interview with a mother who asked to stay with her baby after a Cesarean An interview with a doula who helps facilitate skin-to-skin care in the operating room Our Facebook album with amazing photos of skin-to-skin care in the operating room References: 1.Anderson, G. C., D. Radjenovic, et al. (2004). “Development of an observational instrument to measure mother-infant separation post birth.” J Nurs Meas 12(3): 215-234. 2.Brazelton, T. B. (1961). “Effects of maternal medication on the neonate and his behavior ” Journal of Pediatrics 58: 513-518. 3.Centers for Disease Control (2010). Maternity Care Practices Survey. Accessed online January 5, 2013. 4.Declercq, E. R., C. Sakala, et al. (2007). “Listening to Mothers II: Report of the Second National U.S. Survey of Women’s Childbearing Experiences: Conducted January-February 2006 for Childbirth Connection by Harris Interactive(R) in partnership with Lamaze International.” J Perinat Educ 16(4): 9-14. 5.Elliott-Carter, N. and J. Harper (2012). “Keeping mothers and newborns together after cesarean: how one hospital made the change.” Nursing for Women’s Health 16(4): 290-295. 6.Mahlmeister, L. R. (2005). “Couplet care after cesarean delivery: creating a safe environment for mother and baby.” J Perinat Neonatal Nurs 19(3): 212-214. 7.Moore, E. R., G. C. Anderson, et al. (2012). “Early skin-to-skin contact for mothers and their healthy newborn infants.” Cochrane Database Syst Rev 5: CD003519. 8.Spradlin, L. R. (2009). “Implementation of a couplet care program for families after a cesarean birth.” AORN J 89(3): 553-555, 558-562.

Ban those "Free Diaper Bags"?

 Those free diaper bags handed out to new the mothers prior to their discharge home; what could be wrong with that? Studies have shown that new moms who received diaper bags, which are provided by the formula companies, will have a decreased percentage of breastfeeding success. The diaper bags contain a free sample of infant formula; aka artificial baby milk. Many new mothers, especially first time moms, doubt their body's ability to provide enough breastmilk. So many new moms will offer formula early on to supplement their own breastmilk. As soon as that happens; it undermines the new mom's ability to then produce breastmilk, and it affects how baby then behaves at the breast. Providing new mothers with free formula companies' diaper bags is great advertising for the formula company; but not good for the breastfeeding mother/baby dyad.

 

Report: Massachusetts birth hospitals ditch free infant formula gift bags

(Credit: Shutterstock)

(CBS/AP) Massachusetts maternity hospitals will no longer offer infant formula gift bags to new moms, according to a new report.
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Public health officials tell The Boston Globe all 49 birth facilities in the state had voluntarily eliminated the giveaways by the beginning of July. The announcement is a milestone for breast-feeding advocates.

Studies have shown that breast-feeding mothers who receive free formula are less likely to be breast feeding by the time their infant was 1 month old.

Massachusetts first tried to end the free formula practice with a statewide ban in 2005. The decision was overturned several months later when Gov. Mitt Romney replaced some members of the council that approved the ban.
"Clinical studies and many years of consumer use have shown infant formula to be a safe alternative which supports normal growth and development in infants," the industry's trade group, the International Formula Council, said in an emailed statement. "At the end of the day, the real objective for any campaign intended to increase breastfeeding rates should be to provide sound advice and support to new mothers."

In November of 2011, Rhode Island became the first state to eliminate free infant formula samples at hospitals, removing them from its seven maternity hospitals.

The American Academy of Pediatrics recommends that mothers exclusively breast-feed for the first six months to provide babies with protection against many illnesses and allergies.

The Centers for Disease Control and Prevention says babies who are fed formula and stop breast-feeding early may be more likely to develop diabetes, respiratory and ear infections, and tend to require more doctor visits, prescriptions or hospitalizations. Children who aren't breast-fed are also more likely to be obese and are at a higher risk for sudden infant death syndrome (SIDS).

Also, mothers who breast-feed have a lower risk for breast and ovarian cancers, the CDC said.

Last year, a CDC report card on breast-feeding found less than 5 percent of U.S. babies are born in hospitals that fully support breast-feeding, and 1 in 4 infants receive formula within hours of birth. The CDC hoped to eliminate the free formula practices at many hospitals.


The World Health Organization recommends exclusive breast-feeding for the first six months of a baby's life, with continued breast-feeding along with healthy foods through age 2 and beyond.