Wednesday, April 28, 2010
Tuesday, April 27, 2010
Monday, April 26, 2010
By Erica Kain
I had a positive pregnancy test when my first daughter was just 9 months old, and I immediately called my ob-gyn to share the news.
“Stop breast-feeding,” she told me, and dutifully, I weaned my daughter that night.
A week later, when I miscarried what turned out to have been a chemical pregnancy, I had two things to mourn: the baby I’d expected, and the nursing relationship I’d ended with my daughter.
I wondered, even if the pregnancy had continued, was it necessary to wean her? Why would my doctor have said that?
What I’ve learned since that day has changed my mind entirely about nursing during pregnancy. In fact, if I am lucky enough to get pregnant while breast-feeding, I’d want to continue the nursing relationship, even extending into a “tandem nursing” situation after the baby is born.
Why don’t pregnant women breast-feed more often?
In all my years of playing with my young children in parks, I have never once seen an obviously pregnant woman breast-feeding. Why not?
Many times, apparently, it’s very painful.
According to Wendy Haldeman, one of the founders of the Los Angeles–based The Pump Station, it can hurt to breast-feed during the first trimester. “The nipple soreness is just something the mother has to endure,” she tells me. “Some can; others find it is just too painful to continue.”
Local mothers who attempted nursing while pregnant agreed with Haldeman. “By the time I was about 2 months pregnant, nursing became excruciatingly painful,” Amanda, a local mom, tells me. “I almost cried every time I went to nurse, it hurt so bad. I ended up weaning my son at that point.”
Milk supply can also diminish. “My experience is that if the first baby is over a year, the milk supply is not as much of a concern,” Haldeman says. “Infants under 9 months of age frequently need to be supplemented with formula because the mother simply can’t produce enough milk.”
Basically, your body begins producing a different quantity and quality of milk sometime in the second trimester. This is spelled out in Breastfeeding for Dummies by Sharon Perkins, RN, and Carol Vannais, RN:
“Somewhere between four and eight months of pregnancy, your milk does start changing from mature milk back to colostrum, the first type of milk that you gave your baby. The colostrum usually tastes a little different than mature milk, so you may find your baby not as interested in this new menu item and starting the process of weaning.”
But if I could bear the pain and my baby could bear the “new menu item,” is it a good idea from a medical perspective?
Will nursing hurt my unborn baby?
“In most circumstances, breast-feeding can be continued during an uncomplicated pregnancy,” says Pamela Berens, MD, an associate professor of obstetrics, gynecology, and reproductive sciences at the University of Texas Health Science Center, at Houston, who researches lactation and breast milk.
However, she explains that if your health-care provider has instructed you not to have intercourse, then you may not want to reconsider breast-feeding.
Apparently, both orgasm and breast-feeding trigger a release of oxytocin, which some women may want to avoid, as it can cause uterine contractions. “The increased oxytocin could be problematic in the patient that is experiencing preterm labor,” Dr. Berens says.
Dr. Berens advises that women with a history of preterm labor, placenta previa, or a “classical” C-section uterine incision consider weaning. However, these reasons occur later in pregnancy, so the mother wouldn’t need to wean abruptly in her first trimester.
Also, Dr. Berens recommends weaning for women with severe hypertension (high blood pressure), severe vascular or renal disease, or a prior “growth restricted” infant (a cautionary recommendation based on what Dr. Berens describes as a “small body of research that suggests that the weight of the infant born to the mother that breast-fed during her pregnancy may be very slightly reduced”).
Could nursing cause a miscarriage?
Though no research has found any increased risk of miscarriage in women who continue breast-feeding during pregnancy, women might want to consider weaning if they are experiencing bleeding during early pregnancy, says Dr. Berens.
But be sure to confirm the pregnancy is viable. “If the pregnancy has already miscarried or is ‘non-viable’ (meaning no fetus has formed or the fetus has no heartbeat), then there is no benefit to weaning,” Dr. Berens says.
If only I’d heard that sound advice four years ago! Armed with this knowledge, I know that for any future pregnancies, I’ll hold on to my nursing relationship with much more confidence.
Thursday, April 15, 2010
THIRD ANNUAL LOVE WALK
In partnership with the Pacific Palisades Junior Women's Club
June 6, 2010
Pacific Palisades, California
8:00 a.m. Check-in and Registration
9:00 a.m. Start of the Walk
Third Annual Love Walk - Moving Breast Cancer Beyond A Cure!
Join Dr. Susan Love and hundreds of breast cancer advocates for the Third Annual Love Walk on June 6th, 2010 at the Palisades Public Library in Pacific Palisades, California.
The 5K walk will benefit breast cancer research projects, and the pilot grant program at the Dr. Susan Love Research Foundation (DSLRF). Over the past two years, we have had over 1000 participants and raised more than $100,000 for our mission to move breast cancer beyond a cure and eradicate it once and for all. This year, we know we can raise even more!!
You can help support the Dr. Susan Love Research Foundation by registering to walk and collecting pledges from your family and friends. Individual registration is just $35 and Family registration is $100 (limited to a family of four). CLICK HERE TO REGISTER TODAY.
Want to Walk with a Team?
Join Dr. Susan Love’s Team! By joining the Dr. Susan Love Team, you will get the opportunity to walk the 5K with Dr. Love and help her reach her goal of raising $10,000! Click here to join Dr. Susan Love's team.
Not in the Greater Los Angeles Area?
Pledge for Dr. Susan Love’s Team and support DSLRF from afar! By pledging support to Dr. Susan Love’s Team, you can participate in the comfort of your own home and still fundraise to help eradicate breast cancer once and for all! With your support, Dr. Susan Love can reach her goal of raising $10,000! Support Dr. Love and her team!
Other Ways to Get Involved!
As we walk to raise funds for breast cancer research, we also would like to honor those that have been personally touched by the disease. This year, we are introducing Love Walk Dedication Messages, which will be displayed at the Love Walk in two different forms:
Love’s Lane Sign: Put a personal message on a sign to be displayed on the Walk route! Purchase a Love’s Lane Sign for your team, company, or favorite walker to dedicate your walk in memory of a loved one or share a message with walkers. Love’s Lane Signs are available for $25. Deadline for submittal is May 28, 2010. Purchase your Love's Lane sign today!
Dedication Wall: Pay tribute to those affected by breast cancer and write a personal message on the Love Walk Dedication Wall! Heart-shaped messages will be posted on the Dedication Wall the day of the event for all walkers to see and be inspired by! Dedication Wall messages are available for $5! Deadline for submittal is May 28, 2010, but messages can still be purchased on the day of the Walk. Honor or remember someone today by purchasing a heart message!
If you have questions about the Love Walk or would like more information, email us at Lovewalk@dslrf.org or call 310-828-0060 ext. 33.
Thank you and we look forward to seeing you at the Love Walk!
The 2010 Love Walk is sponsored in part by:
City National Bank, The Pump Station, On Assignment, Career Builder, and Prudential Real Estate.
Tuesday, April 13, 2010
Thursday, April 8, 2010
Precious Prints is coming to The Pump Station!
1 Day Only – Your Ceramic Keepsakes will arrive in time for Mother's Day gift giving.
Santa Monica Store: Saturday, April 10th 1:30-4:30PM
Westlake Store: Sunday, April 11th 11:00-3:00PM
For more info visit: www.clayprints.com
My daughter came out of the womb hungry. Now 10 months old, she happily nurses six times a day. We both thrive on the wonderful intimacy of our nursing relationship. But this relationship may be preventing her from becoming a big sister.
Regular nursing sessions can lessen a woman’s fertility. Although it is a nice idea to allow a woman’s body time to rest between pregnancies, this can create a real conflict when that woman, like me, is almost 39.
I am part of a relatively new subset of nursing mothers—those whose age necessitates closer-than-ideal spacing between births. Every woman’s body is different; some can continue nursing on demand and conceive, while others need to wean completely before they ovulate again. So how do we balance the needs of a current infant against the desire for another child?
Wendy Haldeman, RN, an international board-certified lactation consultant, and one of the founders of the L.A.-based breast-feeding support center The Pump Station, faces this question frequently, as most of her clients are older than 35.
Haldeman encourages mothers to exclusively breast-feed for the first six months, and then, if need be, wean all night feedings. “Often, if moms have a regular 12-hour stretch without suckling, they will ovulate. If not, they have to continue to reduce the number of feedings until they do ovulate.” But some moms, she notes, have to wean completely before they are able to ovulate.
How does breast-feeding stave off ovulation?
Although there isn’t one clear answer, it seems that high prolactin (the hormone that causes lactation) levels have a lot to do with the continued suspension of ovulation.
Dr. Pamela Berens, MD, an associate professor of obstetrics, gynecology, and reproductive sciences at the University of Texas Health Science Center, at Houston, who researches lactation and breast milk, explained how prolactin levels fluctuate and affect reproductive functioning.
“Baseline prolactin levels typically fall after delivery, and by 2–3 months postpartum, the basal levels are about 40%–50% of initial levels,” Dr. Berens says. “Even though the basal level may have dropped, it still roughly doubles with each nursing.”
She says that the fall in the basal level is somewhat related to how often you breast-feed, but the pattern and level of prolactin do not accurately predict when your fertility will return.
According to Dr. Berens, prolactin inhibits the normal release of gonadotropin-releasing hormone (GnRH). GnRH is responsible for the release of two hormones—luteinizing hormone (LH) and follicle-stimulating hormone (FSH)—that are crucial to stimulating ovulation. And to make matters worse, when your ovaries are exposed to higher levels of prolactin, the follicles in the ovary do not develop properly.
Am I fertile yet?
Knowing when you’re ovulating isn’t as simple as having a period—it isn’t unusual to menstruate without actually ovulating while breast-feeding. My ob-gyn suggested that I test my LH levels throughout a cycle to make sure that I am actually ovulating, even though I have a regular period.
If I have no LH surge, yet wanted to conceive, I would need to knock out some of my baby’s feedings in order to kick-start ovulation.
And therein lies the quandary—do I do what’s best for this baby, or some future hypothetical child? (Especially when a recent study found that each year, more than 900 preventable child deaths occur in the United States because most mothers don’t follow the six-month breast-feeding recommendation.)
I could hope to join the ranks of the many women who have conceived while breast-feeding. According to a 1993 study published by the World Health Organization, a woman with a child younger than six months, who hasn’t had her period return, and is fully or nearly fully breast-feeding has a 2% chance of getting pregnant. But if any of these three criteria are not met, a woman’s chance of pregnancy begins to increase.
In my community alone there are dozens of women who can point to the children they conceived while breast-feeding; they were surprised by closely spaced children after they believed that breast-feeding was an effective form of birth control.
But it’s a different story for the women who have had reproductive dramas in their family-building efforts, and, like me, are approaching the end of their fertile years. We face a difficult decision between breast-feeding and fertility.
Monday, April 5, 2010
Breast-feeding could save lives, money
Cost-analysis study shows profound health benefits
Wendy Haldeman MN, RN, IBCLC
Wendy Haldeman, MN, RN, IBCLC is a co-founder of the Pump Station and Nurtury™. She received both her nursing and lactation education at UCLA, is an International Board Certified Lactation Consultant (IBCLC), and a certified Happiest Baby on the Block instructor. She lectures frequently on human lactation at medical and nursing schools and has been identified by publications, such as Fit Pregnancy, as an "expert" in her field. Wendy facilitates the New Mother Support groups, and teaches the prenatal Breastfeeding and Baby Care Classes at The Pump Station. She and her husband Tim are proud of their two grown daughters and will welcome their first grandchild in May.
AP Medical Writer
CHICAGO (AP) — The lives of nearly 900 babies would be saved each year, along with billions of dollars, if 90% of U.S. women breast-fed their babies for the first six months of life, a cost analysis says.
Those startling results, published online Monday in the journal Pediatrics, are only an estimate. But several experts who reviewed the analysis said the methods and conclusions seem sound.
CDC: Breast-feeding varies by race, place
MOM'S CHOICES: Aging well starts in womb
"The health care system has got to be aware that breast-feeding makes a profound difference," said Dr. Ruth Lawrence, who heads the American Academy of Pediatrics' breast-feeding section.
The findings suggest that there are hundreds of deaths and many more costly illnesses each year from health problems that breast-feeding may help prevent. These include stomach viruses, ear infections, asthma, juvenile diabetes, Sudden Infant Death Syndrome and even childhood leukemia.
The magnitude of health benefits linked to breast-feeding is vastly underappreciated, said lead author Dr. Melissa Bartick, an internist and instructor at Harvard Medical School. Breast-feeding is sometimes considered a lifestyle choice, but Bartick calls it a public health issue.
Among the benefits: Breast milk contains antibodies that help babies fight infections; it also can affect insulin levels in the blood, which may make breast-fed babies less likely to develop diabetes and obesity.
The analysis studied the prevalence of 10 common childhood illnesses, costs of treating those diseases, including hospitalization, and the level of disease protection other studies have linked with breast-feeding.
The $13 billion in estimated losses due to the low breast-feeding rate includes an economists' calculation partly based on lost potential lifetime wages — $10.56 million per death.
The methods were similar to a widely cited 2001 government report that said $3.6 billion could be saved each year if 50% of mothers breast-fed their babies for six months. Medical costs have climbed since then and breast-feeding rates have increased only slightly.
About 43% of U.S. mothers do at least some breast-feeding for six months, but only 12% follow government guidelines recommending that babies receive only breast milk for six months.
Dr. Larry Gray, a University of Chicago pediatrician, called the analysis compelling and said it's reasonable to strive for 90% compliance.
But he also said mothers who don't breast-feed for six months shouldn't be blamed or made to feel guilty, because their jobs and other demands often make it impossible to do so.
"We'd all love as pediatricians to be able to carry this information into the boardrooms by saying we all gain by small changes at the workplace" that encourage breast-feeding, Gray said.
Bartick said there are some encouraging signs. The government's new health care overhaul requires large employers to provide private places for working mothers to pump breast milk. And under a provision enacted April 1 by the Joint Commission, a hospital accrediting agency, hospitals may be evaluated on their efforts to ensure that newborns are fed only breast milk before they're sent home.
The pediatrics academy says babies should be given a chance to start breast-feeding immediately after birth. Bartick said that often doesn't happen, and at many hospitals newborns are offered formula even when their mothers intend to breast-feed.
"Hospital practices need to change to be more in line with evidence-based care," Bartick said. "We really shouldn't be blaming mothers for this."