Migraines and Breastfeeding

You’ve had your baby for a few months, and then it hits you. Headache. Bad. You open your eyes and the light is blinding. Your partner comes to ask you something and they might as well be screaming at you. Is it a migraine? Could be. Many women find that after they have a baby, their hormones change. In some cases, this can be a cause for chronic migraines. Whether you have had migraines for years or this is your first one, you need the facts. Migraines can be a serious problem, as well as a symptom for other serious problems. Take your migraines and their prevention and treatment seriously, and you and your baby should be in much better shape.

What is a Migraine?
Some people think that a migraine is just a really bad headache. While migraines are often severe, this is not entirely true. Migraines are a little different. Here are a few signs of a migraine, according to the Mayo Clinic:
• Pain on one side or both sides of your head
• Pain that has a pulsating, throbbing quality
• Sensitivity to light, sound and/or smell
• Nausea and vomiting
• Blurred vision
• Lightheadedness, sometimes followed by fainting

Migraines can last from four to 72 hours and range from mild to very severe. When you experience what you believe is a migraine, you should plan to see your doctor as soon as possible unless you are already under a current treatment plan for chronic migraines.

When you go to the doctor, take a moment to consider the factors that may have influenced your migraine. Migraines have triggers, which are usually environmental. Some women get migraines based on outdoor allergies or food intolerances. Other women suffer at different times of their menstrual cycle. If you are dealing with chronic migraines, start keeping a journal of the things you did prior to your migraine triggering. This will help you to identify your triggers. With your doctor’s help, get ideas on minimizing your triggers to minimize your acute migraine attacks.

When to Seek Immediate Medical Attention
Migraines can be a sign of more serious health conditions, such as stroke. You should plan to seek medical attention immediately if you suffer one of the following symptoms:
• An abrupt, severe headache like a thunderclap
• Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
• Headache after a head injury, especially if the headache gets worse
• A chronic headache that is worse after coughing, exertion, straining or a sudden movement

Treating Acute Migraine Attacks
When you hear people talk about taking medications for migraines, they are usually referring to medications they take for an acute migraine attack. This means that they take this medication at the point they realize a migraine has been triggered. They do not take the medication on a daily basis. If you find that you are suffering from migraines more than just once in a blue moon, you may want to talk to your doctor about keeping a medication on-hand for acute attacks. Fortunately, many of the common migraine medications are safe to take while bf. Consider this list on Kellymom:
http://kellymom.com/bf/can-i-breastfeed/meds/migraine-meds/

You should note that many of these meds cause dizziness, nausea, lightheadedness or exhaustion as potential side effects. Until you know how you handle taking any particular medications, DO NOT plan to operate heavy machinery, drink alcohol or other sedatives, or care for your child alone.

These meds are not as simple as taking Motrin or Tylenol. They are serious prescription drugs, many with serious side effects. As such, what works for one woman may be awful for another. Your best treatment for chronic migraines is to work on identifying and minimizing your triggers, so that you can avoid them.

Natural Migraine Treatments/Preventatives
There are many OTC and natural migraine treatments and preventatives. Many people swear by taking Motrin or Tylenol with caffeine. You may also feel better if you go lay in a dark, quiet room with ice on the back of your neck. Some women say that their migraines have decreased in frequency and duration by applying peppermint essential oil, or taking regular doses of magnesium. However, if you are taking certain kinds of medications, especially those that affect your blood pressure or heart function, large doses of magnesium may decrease the efficacy of those medications. Be sure to ask your doctor before engaging in any treatment regimen, natural or otherwise.

Migraines are a horrible and horribly misunderstood affliction. If you are new to coping with chronic migraines, you may feel stuck in a vicious cycle. But, with consideration and treatment, you will eventually find a better path.

The Importance of Night Nursing for Working Mom

Night nursing is a big part of the breastfeeding relationship in the first year. Those overnight sessions help to maintain supply and offer our babies comfort when they are going through growth spurts and teething pain. But for working moms they are especially important to help maintain a good breastfeeding relationship and your supply. They can also be especially difficult.

If a mom is home with their baby all day, they have the opportunity to nurse on demand. This means whenever their baby is hungry, they nurse. A working mom has to schedule their pump sessions every 2 – 3 hours. Its very difficult for working moms to pump like a baby would nurse. Also babies are much more efficient than pumps at draining a breast so they could nurse for 5 minutes and ingest what it could take a working mom 20 – 30 minutes to pump.

Working moms are told over and over, the golden rule of leaving milk is 1 – 1.5oz per hour you are away. This number is determined based on the idea that in 24 hours your baby will take about 24oz of milk. A mom nursing on demand at home has the option of offering their baby to nurse more frequently in the day, therefore their baby may take much of the 24oz they need in the daytime hours and sleep better at night. For working moms however, it is not feasible to pump 24oz in an 8 hour shift. In fact in a typical 9 hour separation a mom would only expect to pump about 8 – 12oz. That is 100% normal. This is why it is so important to nurse on demand at home as much as you can.
A baby who drinks 8 – 12oz when mom is at work needs to nurse for the additional 12oz, which means ideally your baby should be getting at least 4 additional nursing sessions a day. If you figure mom nurses right before work, right after work, and before bed that’s 3, so therefore it is very understandable your baby will wake at night to nurse too. We also have to remember transfer rate varies from baby to baby and also the amount of milk baby takes will vary from nursing session to nursing session. This is why, for working moms especially, limiting nursing overnight can impact not only supply but their overall nursing relationship.

If baby is sleeping for 12 hours overnight or not having any milk overnight, it means in those other 12 hours of the day they need to be drinking about 24oz of milk. If mom is only nursing 2 times a day and then at work that means your baby would be drinking 16 – 20oz of milk while you are gone. For most women pumping that much milk in a normal work day is not possible. Biologically it's not what our bodies were made to do. More stimulation = more milk. In this scenario mom is only having 2 nursing sessions and 3 pumping sessions a day. Babies in the first 9 months of life typically nurse at least 8 times a day. The end result is ultimately mom not producing enough milk at work for their baby and then ends up pumping more on the nights or weekends or supplementing.

So what is the best solution for a sleep deprived mom?

First off knowing that this too shall pass. It helps to have realistic goals. Anticipate nursing every 3 – 4 hours overnight in the first year. Remind yourself this night nursing is important to the nursing relationship. It's exhausting, but normal. If you have a baby that wakes every 1 – 2 hours, try sending your partner in to offer comfort. If you cosleep try moving your baby to a crib in their own room. If you don’t cosleep, consider it. Another trick is to try and tank your baby up before bed. If you get home at 5 and your baby goes to bed at 7, offer lots of nursing sessions in those few hours. That cluster nursing not only helps your baby fill up, it also helps to stimulate your supply. The big key however is finding a sleep situation that helps everyone get the best nights sleep possible.

How Does Food Really Affect Your Breastmilk?

Do any of these sound familiar?

“You’re not eating beans are you?! That will give your baby horrible gas!”
“You can’t eat that candy cane, mint will cause your supply to dry up!”
“Are you sure you want coffee? That’s going to keep your baby up all night long!”
“Bell peppers gave my kids horrendous gas. You should avoid them at all costs!”

We’ve all been told well meaning advice about what we should and should not eat when breastfeeding. Everyone will tell you a food that you should avoid, everything from broccoli to chocolate! But how much do we really need to be concerned with what we are eating when we breastfeed? 

First, let’s get one thing straight. No matter what you are eating, your body will still produce the perfect breast milk for your baby. 

So why do people suggest avoiding specific foods? First off, gas. How many times does someone say something made their baby gassy. Just because a food makes you a little gassy does not mean it will do the same to your baby. Newborns digestive systems are still immature, hence the gas. Often times gas is worse overnight or early in the morning, which is why women often think something they ate the night before is the cause. In most cases it’s just normal newborn gas. Thrush, oversupply, and a strong letdown can also cause gas issues in newborns. Gas is also notorious for showing up during growth spurts which are plentiful in those first months! These are much more likely culprits than something you may have eaten the night before. (http://kellymom.com/parenting/parenting-faq/gassybaby/) 

Another thing people are told to avoid is coffee and/or caffeine. While yes, some babies can be sensitive to caffeine, most are just fine. From Dr. Hale it’s rated an L2 and found at low levels in breast milk. And just because your LO suddenly wakes up at night doesn’t mean it’s the coffee! Remember sleepless nights are a large part of the first year due to growth spurts, teething, and sleep regression. In fact caffeine peaks in your system 1 – 2 hours post drink so unless you are having a late night coffee binge its probably just a fluke! (http://kellymom.com/bf/can-i-breastfeed/lifestyle/caffeine/) 

And what about supply lowering foods? Moms are told often to avoid specific foods because they will cause supply to decrease. While some herbs can have a negative impact on milk supply, the amount needed to do so is therapeutic quantities. This means that eating mint flavored chocolate or adding oregano to your cooking isn’t going to affect your supply. (http://kellymom.com/bf/got-milk/herbs_to_avoid/) 

When IS it appropriate to change your diet for baby? When you notice excessive spitting up, consistent green and mucousy poops, bad “baby acne” or eczema, dry skin, colic and fussiness.
Cutting out large amount of veggies and fruits from the diet (ie, eating a “bland” diet of starches and meats) is actually one of the worst approaches to this problem. In many cases the culprit turns out to be a dairy/soy sensitivity. 

So what is the take away here? Babies have gas, its normal. The chances are if your baby is gassy it is NOT something you ate. Babies not sleeping at night is normal, it’s probably NOT due to caffeine. If you are worried about your baby showing signs of a food sensitivity, keep a food log to try and track down the offending food. Dairy, Soy, and Gluten are 3 big offenders. 

Happy Eating!

Bottle Strikes

For weeks your baby has been taking bottles every few days with no problems, but now suddenly  your baby wants nothing to do with the bottle and screams when it comes close. What happened?!

The first thing to do when this happens is to take a deep breath and remind yourself “my baby took a bottle before, they will again”.

Bottle strikes, just like nursing strikes, happen. There are a variety of reasons they can occur.

-          Your baby is having a growth spurt. During a growth spurt your baby may suddenly decide “why should I take this bottle from someone else if mom is right there?” They also may prefer to nurse.

-          Teething. This is one of the prime culprits for a bottle strike. When your baby teethes it causes pain and pressure in their mouth. Sucking on a bottle can be painful! This may cause them to refuse bottles all together.

-          An off day.  Remember your baby may just be having an off day. They decided hey, today I don’t want that bottle. Today I’d rather just wait for mom.

SSo what should you do if your baby suddenly refuses a bottle?

-First off look for a reason. If teething seems to be the problem try offering something to help with teething pain. An amber necklace, a frozen washcloth, teething toys, or a homeopathic teething remedy are all great options.

-Don’t force things. Just like with a nursing strike they tell you not to force nursing, don’t force the bottle.  Be patient.  The more upset and frustrated you get the more upset and frustrated the baby will get. If you don’t need to offer bottles at this time, take a break. Put them away for a week and nurse and then try again. If you are working and are worried about your baby not drinking milk in the day, look into alternative feeding methods. 

-If your baby has always been a reluctant bottle taker look at the big picture. Is your baby nursing well when you are together? Is the weight gain going well? Some babies do not love bottles and will not drink tons of milk from them.  They will take what they need (sometimes as little as 2 or 4oz) and will make up for things when mom is around.

-If your baby is older, 5 or 6 months, try offering the milk in a sippy or straw cup instead of a bottle.

http://www.lalecheleague.org/nb/nbseptoct94p152.html

All About Solids!

Usually when your baby is about 4 months old you will start getting the questions. “have you done cereal yet?” “you know, we did cereal at 4 months to help our baby sleep better” “It’s totally fine to offer food now! My parents did it!” Even your own pediatrician may start to encourage you to offer solid foods at 4 months.

Let’s start with the basics. It’s stated by many organizations (including the WHO and AAP) that in the first 6 months of life babies should only have breastmilk or formula.  Previously it had been thought by doctors and other organizations that 4 months was a good age, however more recent research into infant health has caused the organizations to change their recommendations to 6 months. Remember no matter when you start solids in the first year of life your baby’s primary source of nutrition should be breastmilk or formula! Solid food does NOT replace milk until after they are 1. http://kellymom.com/nutrition/starting-solids/delay-solids/

Why 6 months? The one big reason for delaying solids till 6 months is to give your babies gut and digestive system a change to mature. Starting solids too soon can cause an upset fussy baby. Another big reason is the “open” gut. Infants younger than 6 months contain an “open” gut which means that there are spaces in the cells of their small intestines that allow macromolecules to pass into the bloodstream. While this is a positive in terms of the antibodies provided by breastmilk it is a negative in terms of solid food. The proteins from these foods can pass through and this is thought to play a role into allergies.  There is no way to tell when your babies gut has closed, but it is generally agreed that its by 6 months. http://www.thealphaparent.com/2011/07/virgin-gut-note-for-parents.html

Many moms are told by their pediatricians to start cereal with iron because your baby needs iron. Ironically this is actually counterproductive. This addition of iron fortified food early actually can reduce how efficient your baby is at absorbing iron. Studies have shown that healthy full term infants do not need any extra iron supplementation. If you are concerned about iron levels in your baby the best course of action would be to get a bloodtest to confirm an issue before adding cereal with iron. http://kellymom.com/nutrition/vitamins/iron/

Another reason to delay starting solid foods is to protect your milk supply! Many people mistakenly think that frequent nursing and night waking between the ages of 4 – 6 months means that their baby is “hungry” and “not satisfied by milk alone”. This simply is not the case. Between the ages of 4 – 6 months babies sleep patterns and life changes immensely. This is the period of time when babies are growing and developing new skills such as rolling and trying to crawl. Babies are becoming more and more aware of the world around them and may be more distracted when nursing, preferring to “snack” instead of have long meals. Also remember that babies start to teeth between 4 and 6 months and this can cause pain which will lead to more night waking and nursing! If you compare the fat and calorie content of milk vs the fat and calorie content of most foods you can see your baby gets much more nutrition from milk.  http://kellymom.com/nutrition/starting-solids/babyfoodcalories/  http://kellymom.com/nutrition/starting-solids/solids-sleep/

So your baby is now 6 months old, are they really ready for solids?  Just because your baby has hit a magic age doesn’t mean they are ready for solid food. It’s a developmental milestone and all babies hit them at different times.  Some babies are more than ready for solid foods at 6 months while some don’t show an interest until closer to 8 or 9 months. What are the signs of being ready developmentally for solids? Kellymom explains it very well:

Signs that indicate baby is developmentally ready for solids include:

§  Baby can sit up well without support.

§  Baby has lost the tongue-thrust reflex and does not automatically push solids out of his mouth with his tongue.

§  Baby is ready and willing to chew.

§  Baby is developing a “pincer” grasp, where he picks up food or other objects between thumb and forefinger. Using the fingers and scraping the food into the palm of the hand (palmar grasp) does not substitute for pincer grasp development.

§  Baby is eager to participate in mealtime and may try to grab food and put it in his mouth.

We often state that a sign of solids readiness is when baby exhibits a long-term increased demand to nurse (sometime around 6 months or later) that is unrelated to illness, teething pain, a change in routine or a growth spurt. However, it can be hard to judge whether baby’s increased nursing is related to readiness for solids. Many (if not most) 6-month-old babies are teething, growth spurting and experiencing many developmental changes that can lead to increased nursing – sometimes all at once! Make sure you look at all the signs of solids readiness as a whole, because increased nursing alone is not likely to be an accurate guide to baby’s readiness.

http://kellymom.com/nutrition/starting-solids/solids-when/

So I should start with baby cereal right?

Wrong.  Cereal was originally suggested as a first food because it was considered to be a low allergen food. Nutritionally most cereals are stripped of nutrients. If you have waited until your baby is showing all the signs of readiness above and is over 6 months old their gut should be closed and there is no need to start with cereals at all. If you do feel like you want to start with a cereal go for a whole grain cereal, not a baby cereal.  

Ideally skip straight to soft whole foods such as avocado, banana, or sweet potato. All are nutritious and perfect first foods for your baby!

http://www.analyticalarmadillo.co.uk/2011/12/nine-good-reasons-not-to-use-baby-rice.html

http://kellymom.com/nutrition/starting-solids/first-foods/

http://www.lalecheleague.org/llleaderweb/lv/lvdec99jan00p130.html

How you offer solid foods is up to you. You can offer puree foods either made yourself or purchased from the store, or you can do large easy to grab soft foods known as baby led weaning. This is when you let your baby feed themselves from day 1 instead of spoon feeding purees. Just remember that food before 1 is for fun and always offer milk before food. Try not to stress out if your baby doesn’t seem interested in solid foods at first! Some babies don’t really become interested in eating until closer to 12 months.

http://www.babyledweaning.com/

http://wholesomebabyfood.momtastic.com/babyledweaning.htm#.UkBwcNLigVghttp://kellymom.com/nutrition/starting-solids/delay-solids/

Remember: babies should be showing all of the signs of solid food readiness before introducing solids! Frequent nursing and night waking are NOT signs your baby needs solid food. Food before 1 is just for fun. Milk contains all the nutrition your baby needs in the first year!!

Nursing During Pregnancy!

Congratulations! You just found out you are pregnant! And with all those new emotions of excitement and anxiety you have another thought in your mind: What about my current nursling? What am I going to do about breastfeeding? You go to your doctor for your first prenatal check up and are met with a frown and "Well, you probably want to consider weaning now." You leave feeling sad and confused, not wanting to wean your child yet. The good news is that most women do not have to wean during pregnancy! So why are so many women told to wean when they become pregnant? There are a few myths still floating around about nursing and pregnancy. The biggest is that nursing during pregnancy can cause miscarriage. There is absolutely no proof that this is true. The theory is that nursing causes nipple stimulation that can release the hormone oxytocin to the uterus, which causes contractions. The human body is smart however. Early in pregnancy, your body protects the uterus from the oxytocin. While you may feel some uterus tightening during nursing, this is normal and the same muscle tightening that occurs after sex sometimes. While miscarriages do happen in 15 - 30% of pregnancies, they are not caused by nursing. Another reason doctors tell mothers to wean is because your body will take nutrients from the baby. Again, this is not true. A mother who eats a healthy well balanced diet should have no problems nursing through pregnancy. You will want to make sure to eat enough calories in a day to cover not only the baby's calories but the breastfeeding ones as well.

This may be difficult in the early months, when morning sickness is a factor. It also depends on the age of your nursling. If s/he is only six months old, s/he will be nursing more for nutrition than if your nursling is 2.5 years old. You won’t starve your baby or your nursling if you aren’t interested in eating a lot of things. However, you should take care not to become dehydrated. If you are having trouble eating at least 1800 calories per day, or if you are suffering from repeated vomiting episodes, please seek medical attention.
What are the big concerns when nursing through pregnancy?

An excellent resource for nursing through pregnancy and tandem-nursing a newborn and an older child is Hilary Flower’s Adventures in Tandem Nursing.

http://store.llli.org/public/profile/77

First off is supply. During the first trimester, your supply will start to decrease and will continue to decrease and may even disappear. Not all mothers completely dry up, however most do notice a dramatic drop in supply. This is because your body is changing the milk from mature milk to colostrum. It is normal towards the end of pregnancy for your supply to again increase. If your nursling is under 1 and still primarily getting their calories from breastmilk, you need to keep an eye on your baby. If you start noticing a dip in weight gain or a decrease in wet diapers you may have to consider supplementing with donor milk or formula. It is not advised to take supply-boosting supplements during

pregnancy! Most galactogogues are also emmenagogues, which mean that they promote menstruation. Therefore, they are not to be taken during pregnancy. Some babies will wean during pregnancy due to the decrease of milk and the change in taste.

Another concern during pregnancy is sore nipples. This can happen at any time and usually comes and goes in waves. It can become very painful to nurse at times! When the pain occurs, how painful it is, and how long it last will vary from women to women. At this point some women choose to wean because it is too uncomfortable to continue. Some women also will set time limits on nursing sessions if it becomes too uncomfortable. The good news is that for many women, this discomfort lasts only a short time. Don’t feel bad about setting loving limits with your nursing child. You will be helping them develop a sense of self and independence for many years to come. This is only the beginning. There are very rare instances where weaning during pregnancy is recommended. If you are suffering from pre term labor or having severe health issues during your pregnancy, it may be best to consider weaning your nursling. Most women however can continue to nurse through pregnancy and even during labor! Don't be surprised if your child’s nursing behaviors change through the course of your pregnancy. Many of our admins have nursed when pregnant!http://kellymom.com/nursingtwo/resources/pregnancynursing-faq.pdfhttp://www.lalecheleague.org/nb/nbjulaug00p116.html