Friday, December 23, 2011

Does Your Breastmilk Look Different Today?

Believe it or not, you will notice changes in the consistancy and even color of your breastmilk. A mom recently asked me if it was normal to have watery milk in the morning and thicker milk later in the day. This is absolutely normal. Why does it do this? Long explination short, your milk consistancy, smell, color, and amount vary throughout your breastfeeding experience from day one to the last day.
For this mom, she had just mentioned that her baby was sleeping longer hours thru the night and during this last week, she noticed that the consistancy was changing. Why was it thinner in the morning? There are two levels of milk that you provide to your baby. The first 2-5 minutes will be "foremilk" or front milk. The consistancy is thinner and has few calories. Your "hindmilk" or the milk behind the foremilk is thicker and packs a lot of fat and calories. If your baby is sleeping in longer, your breast fills up with excess milk, thus at first causing you to overfill. At first, you may notice that your breasts are swollen and full, until they adjust to your baby's new schedule.
You may nurse or pump and notice that you have a lot more of the foremilk than usual, again, the thinner-watery consistancy. This is great for building up your stock of breast milk, but this can cause your baby to have looser stools because their bodies excrete foremilk at a faster rate. If your baby misses a feeding, it is okay to do self-expressions or pump a bit before breastfeeding, 1-3 minutes. Or, if you are pumping and noticing that baby is having very loose stools, you may want to discard your first 1-3 minutes of pumped milk.
Color and smell of breastmilk is also affected by changes in your diet. If you eat a lot of green vegitables, you may notice a green tint to your milk. If you eat a lot of garlic, your milk may smell a bit like garlic. Remember that what you take in may affect what comes out of your breastmilk. This includes alcohol and medication. If you have any concerns about what is being passed to baby, please ask a breastfeeding counselor or your physician.
The amount of milk pumped will also fluctuate, based on the needs of your baby. When your baby goes thru growth spurts, your baby will nurse often. When your baby nurses often, your milk production will increase. Remember supply and demand? Well, this is the best description to give when talking about the amount you see pumped. Moms are often concerned about if their baby is getting enough. In the majority of cases, they are, but if you notice any issues or have concerns, please seek help. If you slow down on the amount of times you breastfeed, your milk production will slow down. Keep this in mind when you notice any changes. A breastfeeding counselor does have ideas on how to naturally increase or decrease milk supply. Often times, issues can be resolved rather quickly with just some helpful hints or reminders.
This was one of my great questions of the week. Send me your questions and I will help! I guarantee that you are not the only mom with your question.

Wednesday, December 7, 2011

Who Can Eat During Labor?

You have probably heard that eating during labor is not allowed, nor advised. Did your mom get ice chips only during labor? Times have changed and the voices are speaking out about choices in childbirth.
Originally, in the 1940's doctors prohibited eating and drinking during labor amidst some concerns about aspirating during emergency anesthesia. They found that aspirating stomach contents would cause severe health concerns, such as pneumonia or even death.
Research has shown that these results are very minute and there are fewer women having anesthesia.
According to the American College of Obstetricians and Gynecologists (ACOG) guidelines, it is okay for moms-to-be to drink clear liquids if they're having uncomplicated labors. But physicians may still draw the line at solid foods (like toast).
Most moms often loose their appetite during labor and choose not to eat. Small doses of water and other clear liquids are great during this time. I usually recommend eating small snack foods in early labor. This will help increase your energy and it helps keep the momentum throughout labor. As a doula, I let families know that it might be a great idea to find your favorite popsicles or protein bars that they will use at home or during the first 2-4 hours of labor. I do not suggest eating full meals once you know that you are in labor. This is strongly discouraged, because it can make you feel awful when your contractions start becoming stronger; it often leads to increased nausea.
I encourage mom to drink a bit of water after every 2-3 contractions, to avoid dehydration and IV fluids.
What happens if you don't eat? Restricting food in labor can cause problems of its own. Besides the stress factors, restricting intake during labor can cause dehydration and ketosis.

What other items do I recommend during labor?


Fruit juice, and


(All of which more and more hospitals already have on hand for birthing mamas).
For Dads:
Dads, although I recommend that you also eat during labor, please be considerate and eat outside the birthing suite or bring items that do not have a strong smell. Mom may become sick because of what you are eating. It may also make her feel a bit jealous.
What happens if mom has nausea?
I love Preggie-Pops!
Slow way down on liquids-mom is most-likely in transition and will be pushing soon!

NOTE: Ask your doctor/midwife about their policies about food and drink during
labor. If they do not reflect the current medical studies you may share the
information with them and see if they will go along with your plan. Many
hospitals and birth centers have special labor diets now and the women report
being very satisfied with the outcomes.
For more questions, please ask me.
Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia, Anesthesiology:Volume 106(4)April 2007pp 843-863.Providing Oral Nutrition to Women in Labor, American College of Nurse-Midwives, Journal of Midwifery & Women's Health - May 2008 (Vol. 53, Issue 3, Pages 276-283, DOI: 10.1016/j.jmwh.2008.03.006)Restricting oral fluid and food intake during labour. Singata M, Tranmer J, Gyte GML. January 2010 Cochrane Review Additional Resources: References
1. Swift, L., 1991, ‘Labor and fasting’, Nursing Times, vol 87, no 48, pp. 64-65. ACOG.ORG Roberts, C.C. & Ludka, L.M., 1993, ‘Eating and drinking in labor: A literature review’,
Midwives: hear the heartbeat of the future, proceedings of the International
Confederation of Midwives 23rd International Congress, May 9-14 1993, Vancouver,
Canada, pp. 1559-1572.
3. Enkin, M., Keirse, Marc J.N.C., Neilson, J., Crowther, C., Duley, L., Hodnett, E., &
Hofmeyer, J., 2000, A guide to effective care in pregnancy and childbirth, Oxford
University Press, New York.
4. Sleutel, M. & Golden, S.S. 1999, ‘Fasting in labor: relic or requirement’, Journal of
Obstetric, Gynecologic, and Neonatal Nursing, vol 28, no 5, pp. 507-512.
5. Hazle, N.R., 1986, ‘Hydration in labor: is routine intravenous hydration necessary?’,
Journal of Nurse Midwifery, vol 31, no 4, pp. 171-176.
6. Carp, H., Jayaram, A., & Stoll, M., 1992, ‘Ultrasound examination of the stomach
contents of parturients’, Anesthesia and Analgesia’, vol 74, no 5, pp. 683-687.