Baby’s First Bath: Who, When, and Where?

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In the discussion of what interventions and procedures may be offered for your baby postpartum, the first bath rarely makes the list.  You may wonder why it should!  A bath is perfectly harmless, right?  Could it really be considered an intervention?

If an intervention is defined as anything that intervenes in the continuous physiological process of labor, birth, and breastfeeding, then the in-hospital bath certainly qualifies as one.

Ultimately, the “burden of proof” for any intervention should lie on the intervention itself.  Are there any real benefits to a first bath being given in the hospital by a stranger?  If so, do these benefits outweigh the risks?  Rather than framing the discussion around risks of an in-hospital bath, though, let’s look at some of the wonderful benefits of delaying your newborn’s first bath, which include:

The Magic of Vernix At birth, your baby’s skin will be coated with a white, waxy or cheesy substance called vernix.  Depending on how many weeks your baby gestated, there may be a little or a lot of vernix on the skin.  Vernix provides protection in the womb from contact with the amniotic fluid (so that baby’s skin won’t wrinkle like ours does after a long bath).  Vernix also provides antibacterial protection, a true benefit in a hospital setting.  Vigorous scrubbing and bathing can remove this protective layer.  Rather than washing this natural barrier away, you can massage it into baby’s skin like lotion.

Breastfeeding Instincts Baby uses the smell of amniotic fluid on his or her hands to help initiate breastfeeding.  You may notice your baby nuzzles her hands against her nose as a cue that she is ready to nurse.  Washing away the natural smells on the baby’s skin will also get in the way of the signals provided by these smells which kick start instinctual breastfeeding and bonding processes.

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Together is Best for Mom and Baby Mother and baby both benefit from uninterrupted skin-to-skin contact for the first several days after birth.  This closeness helps with regulating temperature, heart rate, and stress hormones, as well as increasing bonding hormones, and helping to establish mom’s milk supply. Baby’s other parent is the next best habitat when mom needs a break; familiar sounds and smells are comforting and calming to baby.  Removing baby from the loving arms of his parents for a bath interrupts this bonding time.

First Bath is a Lovely Ritual Giving baby her first bath is a sweet privilege that parents can enjoy when they are ready.  Bath time can be a good way to transition to a change in setting once the family leaves the hospital and settles at home.  Or, it can wait until days later when intuition says it’s time.

Who will give your baby his or her first bath?  When and where will it occur?  This choice is up to you!

How is a lactation consultant like a nursing bra? Both should make you feel comfortable & supported!

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This is my second post in a series about lactation support.  Check out my previous post “Differing models of lactation advice: Go with the flow.” to read about different approaches to understanding breastfeeding. 

In many cities these days, mothers are blessed with lots of options for where to turn when breastfeeding doesn’t go smoothly.  Most hospitals have lactation consultants on staff.  Many nurses working in labor and delivery or postpartum care positions receive some lactation training.  Obstetric and pediatric practices often have lactation consultants in office.  More and more private practice IBCLCs are finding a niche in the community.  There are breastfeeding peer counselors available through La Leche League and WIC.  If you’re lucky, you live in a place with all of these options and more .   So, how do you know where to start?  And, once you’ve visited with one or more of these resources, how do you know if you’re getting the best help for YOU?

Each mother and baby is special and many variables exist  within the nursing relationship.  Breastfeeding is an art, not just a science, and while the mechanics are very important, so is the emotion.  There aren’t always going to be easy answers or quick fixes to breastfeeding problems (in fact, I’m always wary of any solution which promises to be quick or easy).  In many cases, mothers are able to learn that the things they thought were indications of a problem are just examples of normal newborn nursing behavior.  But, in those cases when a very real challenge or problem appears, getting the proper help is vital.

You SHOULD feel one of more of the following after a visit with a breastfeeding support person if that person is a good fit for you and your situation:

* Relief –Whether it is physical relief from painful latch or emotional relief, some sort of lightening should occur.  You may say, “Ah, it feels much better now when she latches.” or “Thank goodness.  I’m glad to know this is normal.” or “My burning question has been answered.”  If you do not feel actual immediate relief, you should at least feel…

Hope – Because it takes time to break old habits and train new, and because healing isn’t instantaneous, you may need to continue practicing techniques and tips you learn in your visit to acheive noticeable results.  But you should at least feel that some progress is being made and you are on the right track to improvement.  At the very least, you should feel that your support person is committed to helping you figure out what WILL work if this path does not.  So, you may be thinking, “We are working on this and it will get better.” or “We are going to figure this out.”

*Increased Confidence – Notice I say “increased” and not just “confidence”.  For many mothers, confidence is something we must develop over time as we learn about our babies and how to trust our intuition and reason.  Breastfeeding can be a huge part of gaining confidence IF a mother receives positive messages of support.  Your lactation pro should encourage this feeling in you by helping you to see all the things you are doing right and by recognizing that your baby is a perfect individual.  Some confident things you may say to yourself include, “I am a good mother.  I am seeking answers for my baby and my self.”  or “My baby and my body work beautifully.” or “I can make enough milk to feed my baby.” or “We are learning together.”

Your lactation consultant or counselor SHOULD:

-Be respectful of your personal space.  Of course she is on your team to talk to you about your breasts, but she should explain what she is doing and/or gain permission from you before touching you or your baby.

-Be respectful of your concerns and feelings.  She should listen to what you believe to be the problem, ask questions to gain more information, and understand that fear, love, anxiety, exhaustion, and many other feelings can come in to play surrounding breastfeeding.

-Address the specific problem which concerns you.  She may understand other issues which are linked to your concern as well and it may be necessary to solve one problem before a related one can be fixed.  But, it is not up to her to decide for you that you should fix something which you don’t define as a problem.  

-Provide a follow-up plan.  You should understand such specifics as “How long should I try this before deciding it isn’t working?” and “What is the next step if this doesn’t solve the problem?”  She should also provide a clear understanding of what sort of follow-up care is provided within her fee if applicable (further visits, phone help, etc).

A lactation support person SHOULD NOT:

-Dismiss your concerns.  This includes problems with pain during nursing.  If her answer is “Everything looks fine.  It shouldn’t hurt,” move on to someone who will help you figure out the source of the pain and solve the problem.

-Make you feel worse.  No guilt.  No fear mongering.  No shaming of your choices or your body.  Negativity is not going to bring about a postive result.

No lactation support person has all the answers to every question.  All professionals have limits and make mistakes.  And that’s fine!  If the person helping you doesn’t have the answer to your question or problem, she should either be willing to search for it to your satisfaction or direct you to someone else who can.  If you don’t feel you’ve gotten the help, support, or answers you need, DON’T GIVE UP!  Ask someone else!  Keep asking until you feel satisfied.  You and your baby deserve good support.

And, most of all, remember that YOU are the expert on YOUR body and YOUR baby.  While medical professionals and breastfeeding support people are experts in certain fields and have seen lots of babies and mothers, no one is smarter than you about what is right regarding you and your baby.  If an expert answer just doesn’t ring true with your gut, you have the right to get another opinion.

Stay tuned or sign up for email updates to read my next post in this series, in which I’ll delve more into the who, what, where, why, and how of the different lactation support people who may be available in your community.

Differing models of lactation advice: Go with the flow.

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Newborn baby breastfeeding

Newborn baby breastfeeding (Photo credit: HoboMama)

This is the first post in a series about lactation support. 

Let me begin by saying: I am not a certified lactation consultant or lactation counselor.  I am a mother of 4 who has been breastfeeding for the better part of 9 years, a trained La Leche League leader, and a voracious reader who geeks out on all things birth and breastfeeding related.  I do not receive money for assisting mothers with breastfeeding.  I provide breastfeeding information and support, not advice, much like in my role as a birth doula.  This post is NOT intended as medical advice or as a contradiction of medical advice. 

It’s no secret that there are various models for looking at birth. We may hear or use terms such as “technocratic model”, “medical model”, “holistic model”, or “midwifery model” when referring to ways of caring for mothers and babies throughout pregnancy, labor, birth, and the immediate postpartum period. It is only recently that I’ve begun to realize there are vastly differing philosophies and methods for veiwing lactation support as well.   This concept has come up often over the last few months in my conversations with mothers about the sort of breastfeeding advice, help, and encouragement they’ve received.  It’s something I want to explore more because I believe each mother and baby deserves the best possible support and,  just like each mother/baby is unique, there is no one-size-fits-all method to dealing with breastfeeding issues.  Different mothers and different situations call for differing methods of care. 

One model/philosophy says birth and breastfeeding are rife with opportunity for “failure” on both the part of mother and baby and thus require management, intervention, and contraptions to work at all.

On the flip side, the other model/philosophy assumes that mother and baby possess the inherent skills and wisdom to succeed at birth and breastfeeding and that these processes work best without interruption or intervention, and with gentle and empowering support.

While there are times when intensive treatments, techniques, and interventions are necessary, there are other times when these things are totally out of place and actually harmful.   As the adage goes, “if it ain’t broke…”  Telling women their breasts, milk supply, babies, or intuition are faulty from the start and need to be “fixed” even when all is well can be damaging to the breastfeeding relationship and the mother’s psyche.

Both modes of viewing birth and breastfeeding can become self fulfilling prophecies by locking mother and baby in a cycle. Breaking down a woman’s confidence in her body’s ability to produce milk for her baby, adding steps to her breastfeeding routine, or putting machines or devices between her and baby as a matter of course (as opposed to as a therapeutic means or treatment of an actual problem) can interrupt the very thing which is best for milk production and mother/baby satisfaction: skin to skin breastfeeding. Conversely, building mother’s confidence in herself and instilling positive feelings about breastfeeding can help her persevere even in the face of challenges and avoid unnecessary anxiety which can disrupt the natural process.

Why does this matter to me?  Because I have witnessed how a certain kind of advice can be dangerous to the breastfeeding relationship, and, perhaps more importantly, to a woman’s ability to trust her intuition, her body and her baby.

The effects of this breakdown can be far-reaching, showing up in other areas of mothering and life.  So often, when mothers come to me with breastfeeding questions, I find with a little further listening that there is something else beneath their concerns.  They are looking for someone to reassure them and give them permission to trust themselves.  They are looking for someone to say, “You aren’t broken and you never were.  You are doing a wonderful job mothering your baby.”  This is also true of mothers who have lost the breastfeeding portion of the mothering relationship either due to physical reasons or because of lack of accurate information and support.  “You aren’t broken and you never were.  You are doing a wonderful job mothering your baby.”

What I wish more than anything in this line of work is for happiness for mothers and babies. High confidence, relaxed and loving time together, and sufficient milk supply can all contribute to happier pairs.  All mother/babies deserve proper information, support, and encouragement for their lactation success (however they define it).

I want to hear from you (even if it’s to disagree with me!)

 What kind of lactation support has been helpful or harmful to you? 

In my next post, I will discuss how to choose a lactation support person, and how to know if  the lactation counseling you recieve is a good fit for your needs. In the third post of this series, I’ll be talking about the different “players” in the lactation support “game”, their different roles, and how they can help you.  Check back or sign up to receive updates via email.

Shame Shame!

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A group of men and women marching with strike ...

A group of men and women marching with strike signs (Photo credit: Kheel Center, Cornell University)

Here in Louisville, labor unions often hire a couple of workers to stand in a conspicuous location holding a giant yellow sign that reads something like “SHAME SHAME Business Name” and a brief description below such as “Labor Dispute”.  I notice these signs but I often wonder if they actually make any difference.  Do the corporations being targeted actually feel any shame due to these signs?  Does the average passerby ever question the cause for the signs, let alone boycott the “Shamed” businesses?  What’s the point?

 Then I had the thought that maybe the importance of these signs lies in what they represent for the unions of people who sponsor them.  Perhaps they are simply a way for these workers to say “I matter.  I don’t deserve to be treated this way.  I am shining my little light in the big darkness.”

 

In the spirit of the Giant Yellow Shame Shame Sign, I offer the following open letter to our current culture:

 Shame on you for making women feel like our bodies are defective.  Shame on you for telling us we aren’t strong enough to give birth without drugs.  Shame on you for telling us doctors know better than we what is best for us.  Shame on you for telling us pregnancy and childbirthing are illnesses that need to be fixed and cured and managed.

 

Shame on you for telling us our pelvises are too small to allow our babies to fit through or our cervixes are incompetent or our uteruses are so weak that they will likely rupture.  Shame on you for telling us our bodies are too old to grow a healthy baby at the very age our lives have just made room for one.  Shame on you for telling us our bodies don’t know the proper time to give birth, that we need you to set the date or start the process.  Shame on you for telling us we need someone else to pull the baby out, suck the baby out, or cut the baby out.

 

Shame on you for telling us our chests and arms aren’t warm enough to nurture our babies immediately after they are born, that your fancy warming machines are superior.  Shame on you for scaring us out of keeping our babies close when they need us by telling us they need your medical training more than our loving presence.  Shame on you for telling us we can’t trust our intuition about how often or how long to hold, cuddle, nurse, and nurture our children. 

 

Shame on you for making us think we can’t make enough milk.  Shame on you for telling us to worry because we only pumped an ounce this time or the baby only ate two ounces.  Shame on you for telling us that artificial baby milk is the solution, that plastic contraptions are the solution, that giving up is the solution because we’ll probably never get it right anyway.

 

Shame on you for giving us dirty looks when we breastfeed our children in your line of sight.  Shame on you for telling us we should cover up or go to the bathroom or just stay home to do “that”.  Shame on you for telling us it’s gross or attention-seeking or inappropriate for your children’s eyes.  Shame on you for making us think a machine is superior to our baby for removing milk from our breasts and a bottle is superior to our breasts for feeding our baby. 

 

Shame on you for telling us the milk our bodies make is causing our babies to cry because they are allergic to it or it is too gassy or not nutritious enough.  Shame on you for telling us the milk we make is not as good as artificial baby milk or even “just as good as” artificial baby milk.  Shame on your for telling us we are making our babies too dependent or clingy or manipulative or spoiled by feeding them from our bodies and holding them when they ask for us.

 

Shame on you for telling us our bodies ought to look supermodel perfect 6 weeks after we give birth.  Shame on you for telling us the importance of our bodies lies more in how they look to the outside world than in the wonders they can perform for us and our families.  Shame on your for failing to notice just how perfect and beautiful and powerful our bodies are right now, as they are, no changes needed.

 

 

(Please note that I am not judging any woman who has made any choice listed above.  And I am also not attempting to say there is never a need for any of the things listed above to be used for good.  What I am condemning is the breakdown of women’s confidence, not the proper use of science, medicine, and intervention.  So please, no comments telling me, “But, I really didn’t make enough milk.  I really did need formula.  Stop picking on me.”, etc.  I support every woman’s choice to do any or all of the above.  My hope is only that we are given the opportunity to make those choices from a place of informed empowerment.)