A lactation consultant can be a valuable resource for mothers before and after their babies are born. Many hospitals and birthing clinics have lactation consultants that are available to answer questions and provide information about breast feeding and bottle feeding.
The prenatal period is a great time for mothers to discuss breastfeeding before the baby arrives. The lactation consultant can help women to understand the importance of breastfeeding and reasons for mothers to continue breastfeeding even after they return to work. The lactation consultant can provide practical strategies and encouragement.
Many mothers assume formula is a convenient way to feed their infant when they are separated from each other. A lactation consultant can help women to understand the importance of expressing breast milk for mother and baby. Some of the reasons to express instead of formula feed a baby include:
-Protecting the baby from illnesses and allergies.
-Providing comfort for the mother.
-Preventing engorgement, mastitis, and leaking from allowing the breasts to become to full because of missed feedings.
-Maintaining milk supply.
After a lactation consultant discusses the benefits of breast feeding over formula feeding, the lactation consultant can offer support and solutions to help the mother reach her breast feeding goals. This can be done by identifying breastfeeding classes in the community, which can provide information to help initiate and maintain breastfeeding, as well as hopefully create a bond of friendship with other breastfeeding mothers who can provide support to one another.
One of the biggest challenges for breast feeding mothers comes when they return to work. The lactation can help develop a plan for the mother to successfully incorporate employment with breastfeeding. This can be accomplished by helping her to maximize her maternity leave for as long as possible. The optimal amount of time is 12 weeks. Also, the consultant can provide information about job sharing; part-time employment; a gradual phase-back into a full-time schedule; or finding ways to work from home.
The uterus, (or womb), is a hollow organ normally about the size and shape of a pear, except during pregnancy when it expands considerably. It is located medially within the anterior portion of the pelvic cavity, above the vagina and over the urinary bladder. the uterus is supported by the broad ligament.
The uterus provides mechanical protection and nutritional support to the developing embryo and fetus. Its superior, thick-walled portion is called the body. The fundus is the bulging upper surface of the body of the uterus where the uterine tubes enter, and the area where the fundus joins with the uterine tubes is the isthmus. The cervical canal is the region where the body of the uterus joins with the neck of the uterus called the cervix. The muscular tube of the cervix projects a short distance into the vagina, and the uterine cavity opens into the vagina at the external orifice of the cervix, also called the cervical os, where sperm are deposited during sexual intercourse. Three tissue layers make up the relatively thick uterine wall. The inner tissue layer is called the endometrium. The endometrium is composed of a thicker inner layer, called the stratum functionalis, and a deeper thinner layer, the stratum basalis. The stratum functionals is where the embryo implants. When fertilization does not occur, the stratum functionalis of the endrometrium sloughs off during menstruation. The stratum basalis provides tissue for regeneration of the stratum functionalis following menstruation. The middle layer of the uterine wall is composed of a thick layer of smooth muscle called myometrium. The muscles contract rhythmically during the process of delivery in birth. The outer tissue layer of the uterine wall is called the peritrium or serosa. It is continuous with the mesothelium of the broad ligament.
Every expectant mother at one point or another in the pregnancy is eager to deliver their baby. If you are feeling like you can’t stand to be pregnant another day, don’t worry. You are not alone. The last trimester of pregnancy is exhausting and uncomfortable. You probably aren’t sleeping very well. You may be experiencing acid reflux in the evening when you lay down to rest and your back probably aches from the added weight in your stomach. All of these discomforts would make any woman long for delivery day…with one exception. No mother wants their baby to be born prematurely. About five or six out of one hundred births in the United States are premature, meaning that the infants are born before they are physically ready to leave the womb. Premature babies are more likely to experience medical problems at birth and generally require extra medical attention and assistance immediately following delivery. A specialized pediatrician called a neonatol nurse practitioner may be called upon to assist with the baby’s care, depending on how early the baby was born. The neonatologist will determine if the baby requires any special treatment.
If your baby is born prematurely, she might weigh 5 pounds or less and depending on how early she arrives. It is very likely that your baby will not look like a full-term infant. This is because the earlier she is born the bigger her head will be in relation to her body, which will also not have as much fat as full-term babies. With less fat, a preterm baby’s skin will seem thinner and more transparent. She will probably not have any of the white, cheesy vernix protecting her at birth, because the vernix is not produced until close to the end of a full-term pregnancy.
With very little fat to keep her warm, your premature baby will probably be rushed to an enclosed bed that allows for the temperature to be adjusted keeping her warm. She will most likely be sent to a special-care nursery to be monitored until they determine that she is strong and healthy enough to be placed in the regular nursery. She may be in the special-care nursery for several weeks depending on how early she was born.
If you are a mother who breast feeds, you probably wonder how much milk your baby is consuming at each feeding and through the entire day. Mother’s who express or formula feed their infants know exactly how much their baby consumes. Mother’s who nurse exclusively can only hope that they are able to provide enough milk to satisfy their baby’s needs.
According to research done on lactation and according to lactation consultants in the United States, the mean volume of milk secreted by healthy women, whose infants exclusively breastfed, during the first 4 to 6 months is approximately 750 to 800 ml/day. In the United States, we are more familiar with ounces and this equates to approximately 25 ounces of breast milk per day. The amount of milk your baby consumes could be more or less than this. The amount of breast milk your body makes depends on your baby’s demand for it.
Research has determined that women who have twins or triplets produce more milk than women with only one nursing infant. This is because the demand from multiple infants causes the body to produce more milk to meet the need. If your baby’s feeding are supplemented with formula, it is very likely that your milk production will be less than a women who nurses exclusively.
Some mothers claim that they are not able to produce enough milk to satisfy their baby’s hunger. Research has still not determined why some women seem to produce milk easier than other women. Caloric intake does not seem to affect milk production. There are several home remedies that claim to help stimulate lactation. However, no research has been done to prove or disprove any remedies.
If you are concerned about whether your baby is getting enough milk from breast feeding exclusively, be patient and observant. Pay attention to how long your baby nurses at each breast. How many feeding she has in a day and how your breasts feel. Are they fuller in the morning and more depleted in the evening? Also pay attention to how you feel. Are you stressed during feedings? Do you relax or are you rushing to get other things accomplished? Are you getting enough rest? Eating nutritious foods and drinking enough water? Improving your diet, drinking more water and reducing stress may be able to help your milk production.
If you are still concerned, consult with your pediatrician before supplementing your baby’s feedings with formula.
Routine vaginal deliveries can occur in several different positions. Generally most people think vaginal deliveries occur with the mother lying on her back. Although this is a common position, there are several other positions that are used to help speed the delivery of the baby. Regardless of the delivery position, most vaginal deliveries are very similar.
Once the baby’s head is delivered, the certified midwife or doctor will likely suction the nose and mouth. This helps to remove any fluid that may be blocking the airway to allow your baby to take his first breath. Many babies quietly breath and do not cry so do not be worried if you do not hear your baby cry initially.
The rest of the baby’s body is usually easier to push out with much less difficulty. Once the baby is completely delivered, the midwife or doctor will more thoroughly suction the baby’s nose and mouth before being handed to you to hold for the first time.
You will notice that your baby is covered with a white cheesy substance called vernix. This is a protective coat that is produced toward the end of pregnancy by the sebaceous glands in his skin. He will be wet from the amniotic fluid in your uterus and may have some of your own blood on him if you experienced an episiotomy or vaginal tear during delivery.
This first interaction with your baby is priceless. Enjoy this moment and pay attention to how your baby’s skin feels. Enjoy this skin-to-skin contact and take advantage of his attentiveness, which will probably only last for a few short hours. Your baby’s skin tone may appear blue at first. This is normal and your baby will gradually turn more pink as your his breathing becomes more regular.
Over the next few days your newborn’s breathing may seem irregular. This is normal. Your newborn may take as many as 60 breaths per minute and may alternate with short, shallow breaths and long pauses between breaths.
Your babies head may be elongated. This is because his head had to adapt to the contour of the passageway in order to squeeze through. Do not worry. Your baby’s head will return to its normal oval shape after several days.
The first two weeks after your baby is born can be the most joyful and painful two weeks since delivery. Although you will be thrilled to finally hold your baby in your arms, the pain of nursing can often take your breath away during these first weeks home. This is especially true if your baby is not positioned properly or does not latch on well when you start breastfeeding. The result is usually cracked or sore nipples.
Cracked nipples are almost always the result of incorrect positioning of the baby at the breast. The first and most important part of breastfeeding is positioning the baby correctly. There are several nursing positions that a lactation consultant can discuss with you to help you prevent any discomfort. If your baby is not able to latch on to the breast properly your nipple may become traumatized. This often results in severe pain to the nipple or other areas of the breast.
There are some simple tips you can follow to help minimize your discomfort. Wash the breasts only with water, not soap. Soap can be drying to the sensitive areas of the breast and cause cracking. Applying creams and lotions will not help and may agitate the problem more. Using a different nursing position at each feeding can help to prevent one area of the breast from feeling raw. Also, limit the length of feedings to five or ten minutes. If you limit the feedings, you should add more feedings to the schedule.
If you live in a humid climate, the best way to treat cracked nipples is to allow your breasts to dry out any moisture. Do not wear plastic breast shields or plastic-lined nursing pads. When possible, expose your breasts to the air as much as possible. A hair dryer, set at a low setting and kept safely away from the skin, can be an effective tool at keeping the breasts dry. After nursing, rinse the nipples to remove the baby’s saliva and try to express a little milk from your breasts and allow the milk to dry on the nipples. Dried milk can help with the healing process.
Dry climates will require the application of ointments or purified hypoallergenic lanolin on the nipples. Lanolin is a safe choice for you and baby. Be careful when applying other ointments. Ensure that they are safe for consumption by your baby.
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Lactation Consultant: Colostrum in Breast Milk
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Breast milk contains several nutritional and immune supporting components for a growing infant. One of the benefits of breast milk is that these important components can change depending on the age and needs of the infant. Choosing to breast feed over bottle feed provides your child with the best nutrition at every stage of development. As a lactation consultant, it is your job to educate the mother on all attributes of breast milk.
Colostrum is a component of breast milk that is secreted as early as approximately 12 to 16 weeks of gestation. This highly dense, thick, gel-like liquid is generally yellow-colored, due to the amount of beta-carotene it contains. During the first two days after the baby is born the primary liquid secreted from the breast is colostrum. In most instances, transitional milk is secreted on day 3 and mature milk is available on or about day 5. The primary function of colostrum is to provide a protective barrier in the gut from pathogens and to help promote the closure of the infant’s gut.
Colostrum contains enzymes, white blood cells, hormones and proteins. White blood cells like polymorphonucleocytes make up about 90% of the cells found in colostrum. The protein, secretory immunoglobulin A (sIgA), is an antibody that is found in high concentrations of colostrum immediately after delivery. This antibody helps to protect the body from pathogens. Several other components, such as lactoferin, lysozyme epidermal growth factor and interleukin 10 are also found in colostrum.
Colustrum is also beneficial to infants because when it is ingested it helps to clear the meconium out of the infant due to its reservoir of belirubin. The intestinal non-pathogenic flora is also established in the gastrointestinal tract with the help of colostrum. This flora helps to create a balance in the gastrointestinal tract and aids in the digestion of important vitamins and minerals.
Colostrum is an extremely valuable first food for every infant. It is highly recommended for the long term health and well-being of every infant. The combination of components found in colostrum makes it the best food option.
The third trimester of pregnancy can often feel like the longest and most agonizing trimester due the physical strain that is placed on the mother’s body. During this trimester, the mother’s abdomen grows quite large and can begin to feel very tight. The baby has grown substantially during the last two trimesters and will continue to grow and gain a significant amount of weight.
Often during this phase of pregnancy many women experience acid reflux, which is caused from the limited space that is available for food. This can be extremely uncomfortable for mothers, especially during the night when they are laying in bed. Unfortunately, there is very little that can be done to relieve the discomfort caused by pregnancy induced acid reflux. Fortunately, as soon as the baby is born and pressure is relieved from the stomach, the acid reflux goes away.
This trimester can be very exhausting for mothers. The increased weigh gain often makes moving around more tiring. The increased size of the uterus often causes many women back pain and sleeping becomes more difficult. The mother’s joints often begin to loosen and creak due to the secretion of the hormone relaxin, which is supposed to help prepare the mother’s body for labor and delivery. The baby is noticeably the most active during this time. Bursts of movement often occur during the evening and at night, making sleep more challenging. The baby’s quite times are often during the day when the mother is most active. Come the seventh month, the baby begins to run out of room causing the mother to be acutely aware of every movement the baby makes. Generally, this phase of pregnancy is the least favorite for many mothers
Between the 22nd and 25th week the baby has developed to the point that should delivery be necessary, the baby could survive being born prematurely. The closer the baby is born to full term, between 36 and 40 weeks, the less likely that the baby will be born with any complications. If the baby is born before 36 weeks, the baby will generally be kept in the hospital for observation. The length of time that the baby will remain in the hospital if born before 36 weeks depends on the development of the baby’s lungs. The lungs are usually the last organ to develop.
The second trimester spans from 12-24 weeks and is often considered the most pleasant time of pregnancy. Generally nausea, vomiting and fatigue have subsided and although the mother’s uterus has grown substantially, she is still able to comfortably enjoy many of her normal activities.
During this trimester, many exciting events take place. Sometime between the 15th and 20th week, the mother may begin to feel the baby moving. This may not be as evident to new mothers, who may dismiss these first kicks as gas. This event is called quickening and can be easily overlooked.
During this trimester, the baby is continually developing, expanding and gaining weight. The baby’s organs are still developing. The stomach begins to aid in digestion and the distribution of nutrients and oxygen through the baby’s body. The baby is still considered extremely immature during this trimester. Should the baby be born at this time, the odds of survival are very unlikely. Many of the baby’s organs are still too immature to withstand the demands placed outside of the womb.
The second trimester can also be an exciting time because between the fourth and sixth month many parents get their first opportunity to see their baby via ultrasound. This scheduled appointment with the ultrasound technician can provide valuable information about the baby’s overall growth and development thus far. The technician may be able to identify any growth abnormalities and may also be able to identify the gender of the baby for curious parents. Often being able to see the baby moving and the heart beating gives parents a visual connection and answers many questions they may have had during those early formative weeks.
The normal length of a full term pregnancy is 40 weeks. This length of time includes the two weeks between your last period and approximately when the egg was fertilized. This 40 week span of time is divided into three parts that are commonly called trimesters. Each trimester lasts approximately three months. During each trimester the baby and mother go through changes that are specific and unique to that period of time. In the next three blogs we will be looking at the stages of pregnancy to familiarize ultrasound technicians with what can be expected.
The first trimester encompasses many of the early signs of pregnancy. Some women may experience nausea, vomiting, breast tenderness or swelling, a feeling of fullness in the abdomen and often unexplainable fatigue or exhaustion. These early signs of pregnancy are not guaranteed to affect every woman and are only general signs that are common during this phase. Often women, who do suffer with nausea, vomiting or breast tenderness, experience relief from these symptoms during the second trimester.
The first trimester is considered the most unstable time in a woman’s pregnancy. The risk for miscarriage of a developing fetus is extremely high during this trimester. The tissues and organs form during this time. If the mother is exposed to certain chemicals, drugs, radiation or other harmful agents the potential for damaging the delicate developing tissues of the fetus are high. Depending on the severity of the birth defects that are formed at this time, the fetus may miscarry. Many women are likely to experience this type of spontaneous abortion before they are even aware that they are pregnant. Approximately 20% of all confirmed pregnancies will result in miscarriage. Repeated miscarriages are usually caused from a problem with the uterus, however, two-thirds of all miscarriages are caused from the abnormal development of the growing fetus.
As soon as the egg has been fertilized and has implanted into the soft lining of the uterus, the placenta and amniotic sac forms around the egg. Within a few weeks the developing embryo will develop internal organs that will differentiate it from the embryos of many other animals. The arms, legs, hands and feet begin to form. By the end of this trimester the baby’s heart beat can be heard with Doppler ultrasound.
