Nipple Shields - Ins, Outs, and All Abouts!

Many breastfeeding mothers have heard of a nipple shield. Your local target or Walmart typically carries them, and many hospitals hand them out to new moms without a second thought. So, what is a nipple shield, and when might you use one?

A nipple shield is a piece of silicone you put over your nipple to relieve discomfort and/or help baby latch better. The end of the shield has holes for your milk to come out.

Nipple shields can help a struggling new mom with latch issues or one who has had serious nipple trauma. However they are not a one size fits all solution; in many cases they are simply a band-aid masking a bigger issue. 

While suggesting a nipple shield to a new mother may seem like helpful advice, nipple shields should only be used under the supervision of an IBCLC. The nipple shield is a tool to assist in breastfeeding, but you still need to find the root cause of your nursing issues. 

There are downsides to nipple shields. Nipple shields have the potential to restrict milk flow, and this can cause weight gain issues with some babies. Babies who are struggling to transfer effectively will struggle more with weight gain using a shield as they cannot get all the milk. If your baby is struggling to transfer you need to figure out why. Over time the shield may help your baby latch, but you’ll have other struggles with weight gain. Using a shield for a long period of time can sometimes impact supply. 

Nipple shields can also be helpful in some situations. Moms who have nipple damage can use one temporarily to help their nipple heal. Babies with different needs like preemies, for example, may be able to latch better with a shield. A mother's anatomy may also be as such that a shield can help a baby latch better for a a period of time.

The big takeaway with nipple shields is that they can be a useful tool, however they should not be used without the supervision of an IBCLC. The IBCLC can help make sure you have addressed the underlying issues that caused you to need the shield in the first place and also assist you in weaning off the shield as your little one gets older.

NICU Support From A Mom Who's Been There

As dreams of baby doing the breast crawl and that perfect first latch in all of its euphoria are snatched from your freshly postpartum mind, you stare at your new baby tied to tubes, struggling, not being held and comforted but instead alone on a mattress.

Instead of the idyllic golden hour, your baby was whisked away to be cared for by specialists. As grateful as you are, the natural cocktail of postpartum emotions coupled with the shock and trauma of your baby needing more than you can provide nearly sends you reeling into an immediate post partum depression. What is a mom to do when her baby needs NICU care but she also desires to provide the baby breastmilk? There are so many variables at play. So many additional thought processes and considerations. Doctors and specialists are supporting baby with various therapies and treatments and the mom is often left to navigate a new medical world while also navigating new motherhood. When my third son arrived nearly 6 weeks early, I felt cheated out of all of the first precious moments I had with my other babies. Not only that, but I was in utter shock that my baby was not allowed to nurse. What do they mean I cannot breastfeed him? Are they not going to feed my baby? Breast milk is the food of the gods, right? I desperately desired to hold my precious newborn to my breast and offer safety and nourishment. I listened to the team of professionals. I worked on hearing them and truly tried to understand their intentions and reasoning. However, I also engaged them in conversations about breastfeeding. When will it be safe for my baby? What steps need to be taken to assure baby gets my milk? What are signs that baby is ready? When is it safe medically to attempt to nurse? These are all questions I asked and wrote down responses to. NICU moms quickly realize they are their child’s advocate. You are the one that remembers things often not brought to the forefront of the conversation. So, from one mama to another, I offer up a list of ideas for how to establish a breastfeeding relationship in the NICU.

1) Take care of yourself. Baby needs you. Baby will eventually need your milk. Drink. Eat. Sleep. Really, don’t forget these things. No amount of crying and praying at baby’s NICU crib will help as much as keeping yourself healthy and ready to get milk to baby.
2) Ask questions and present your ideas. Yes, it is intimidating to be surrounded by professionals, but your baby has only one birth mother. You are created to advocate for him or her. Speak up and engage with the team about your baby’s care. 3) Ask for lactation to support you. Request a pump if baby cannot nurse immediately. Pump every 3 hours around the clock. The NICU can provide labels and storage containers as well as freeze your milk.

4) Accept help. Other NICU moms can become friends. Their experiences will be gold for you. Many hospitals have patient advocates and parent to parent groups that will come to you in the NICU. Remember it is never all or nothing. Sometimes interventions are needed. Sometimes things don’t go as planned. Maybe baby can only get breastmilk through a tube. Maybe it has to be fortified. Maybe baby can only nurse once a day. Any breastmilk is beneficial.


5) Do skin to skin and kangacare as often as they will permit. Even if baby is not latched and nursing, skin to skin promotes the hormone release necessary for breastmilk production. Enjoy snuggling that precious baby.

You’ve got this, mama. You are a Dairy Queen.

"I'm Running Late For Work And Don't Have Time For Breakfast" Oatmeal Muffins

Being a working mom is HARD. How many times have we spent the morning running around making sure everyone else was ready, only to forget about ourselves? We have to remember the lunches, the bags, the daycare stuff, the pump parts... our brains are so overwhelmed often times we realize "I didn't eat this morning!" These oatmeal cupcakes (i say cupcake but really they are more like a muffin!) are PERFECT for those busy mornings! You can make a batch ahead on the weekend and freeze, so you can grab and go! They are filled with healthy ingredients like bananas, oatmeal, and flaxseed!

Ingredients: 

3 cups rolled oats

2 large overripe bananas

2 Tbsp pure maple syrup

1 cup mini chocolate chips, optional

1/4 cup coconut oil, melted

2 eggs at room temperature

1 cup milk at room temperature (Use regular or your favorite dairy free option!)

1/2 cup flaxseed meal

2 tsp vanilla extract 

2 Tbsp coconut sugar 

1 tsp baking soda

Directions:

1) Preheat oven to 350F and line 24 muffin cups with liners. 

2) In a large bowl mash the bananas until they are in a smooth consistency (like baby food). Add the milk, coconut oil, vanilla and maple syrup. Mix well! 

3) In a large bowl mix together the rolled oats, chocolate chips, flaxseed, coconut sugar, and baking soda. 

4) Add the wet ingredients to the dry ingredients. Mix well. 

5) Fill muffin cups with mixture. Note: This does not rise, so you can fill it all the way to the top!

6) Bake the muffins for 25 - 30 minutes, or until they are firm and turning brown on top. Let cool for 5 minutes in the muffin trays before moving to a wire rack to cool completely. 

7) Store in the fridge or freezer. Enjoy!! 

NOTE: If you are egg free, you can replace the eggs with your favorite egg replacement. 

5 Minute "Oh Crap Company Is Coming" No Bake Granola Bars

We've all had that moment. We are running around like crazy, trying to take care of kids and keep the house clean, and suddenly we remember: SOMEONE IS COMING OVER. You have no time to go to the store and only have about 10 minutes before the baby wakes up from the 20 minute power nap she decided to take. Well, we've got you covered! These granola bars can be made in 5 minutes using one bowl. YEP. They really are that simple. And kids and adults alike will love these! No one will suspect that you threw them together at the last second!

Ingredients:
1 cup Shredded Coconut
1 cup Chocolate Chips (use your preferred brand)
1/3 cup Coconut Oil
1/2 cup Flaxseed Meal
1/4 cup Pure Maple Syrup
2 cups Old Fashioned Oatmeal
1/2 cup Raisins
1 cup Peanut Butter (or alternative nut butter or sunbutter)

Directions:
1) Place peanut butter, coconut oil, maple syrup, and chocolate chips into a large microwave safe bowl. Microwave for 45 - 60 seconds on HIGH. Stir together.
2) Add all dry ingredients to the bowl and stir until well mixed.
3) Pour mixture into a glass or ceramic 13 x 9 baking dish and use a spoon to spread evenly.
4) Place in the fridge (or freezer if you are really running out of time!!) to cool!
5) After the mixture is completely solid, use a knife to cut into squares. ENJOY!

The beauty of this recipe is that you can adapt it to use anything you have on hand!! Don't like coconut? Add some extra oats or flaxseed! No raisins? Add other dried fruit and nuts! You can truly make this using whatever you have on hand, and it will come out amazing every time!

Mother Nature vs Nursing Mother: Preparing For A Hurricane

Hurricanes can be scary. I know. I've lived most of my life on the Gulf Coast of Texas. Here are a few ways you can prepare yourself to weather the storm. 

Power outages are a common concern. Especially for pumping moms. All that liquid gold in the freezer! A full freezer can hold its temp for 24-48 hours if you leave it shut. So you'll want to freeze large containers of ice to fill the empty spaces in your freezer. I also recommend freezing a cup of water and after it's frozen, place a coin on top. This will help you evaluate the contents of your freezer if you leave and return after power has been restored. If the coin is still on top of the cup, then the contents of your freezer are likely fine. If the coin is at the bottom of the cup, you know that the everything completely defrosted and needs to be thrown away. If the coin is in the middle, then you'll need to evaluate each item and determine whether you can save it or not. 
A quick note about dry ice: dry ice needs to be properly ventilated. If you're using dry ice make sure you're using it in approved containers. It is not safe to fill your freezer with dry ice and shut the door.
Pumping during a power outage also requires advance planning. This is especially important if you're exclusively pumping. You'll want a battery back up for your pump, a car adapter, or a manual pump. Hand expression can also be a valuable tool if you don't have access to a pump. Freshly pumped milk can be safely kept in a cooler with ice for 24 hours. 

If you're evacuating and taking frozen milk with you, pack your cooler as tightly as possible. When you arrive at your destination, any milk with ice crystals can definitely be refrozen. And while many sources recommend using thawed milk within 24 hours, newer research indicates that milk that has completely thawed *may* be marked as thawed and refrozen. Smell upon defrosting and use at your discretion.

Stress and supply is another common concern of nursing moms. And anyone who's lived through a storm knows that your stress level can skyrocket during a disaster. Do your best to stay hydrated. Continue to eat. Get sleep when you can. This means you'll need to stock up ahead of time on essentials. Don't wait until the last minute. And don't be afraid to ask for help if you need it.

Many concerned mommas in unaffected areas want to donate milk to mommas in disaster areas. While this is incredibly generous, there are a few key things to remember: availability of power and access to shipping are sketchy at best after a storm. And most shelters are not equipped to store and dispense breastmilk. If you want to contribute to relief efforts, there are more helpful ways to spend your money than on shipping breastmilk. 

The DQ Admin Team hopes you all stay safe this hurricane season! Nurse on! 

https://kellymom.com/hot-topics/frozen-milk-power-outage/

https://med.stanford.edu/.../hand-expressing-milk.html

https://kellymom.com/bf/pumpingmoms/milkstorage/milkstorage/

Depressed Moms: What You Need To Know

 Depressed Moms: What You Need To Know

Thomas Hale, R.Ph., Ph.D., executive director of the InfantRisk Center

Today we have a guest blog written by Dr. Thomas Hale of InfantRisk. InfantRisk focuses on research concerning breastfeeding and medication to help moms make an informed choice about the risks of breastfeeding while taking medication. They have the most up to date information and are the go to for questions concerning medication safety and breastfeeding! You can help support InfantRisk by donating here: Support InfantRisk

Depression is one of the most common mental disorders in the U.S. Research shows us that the cause of depression can be a combination of genetic, biological, environmental and psychological factors. Many women sufferers attest that the onset of depression came without any major life event, but the pervasive symptoms are unbearable.

And, of course, many women also experience post partum or perinatal depression. Often overlooked, this is full-blown depression and potentially very serious. Feelings of extreme sadness, anxiety and exhaustion can be confusing and overwhelming for new mothers, making it difficult to care for their little one and complete every day tasks.

Like with most conditions, pregnancy and breastfeeding do not preclude the ability to safely and effectively treat depression in mothers. Balancing risks and benefits, providers and mothers can work together to create a plan to keep both mom and baby healthy.

This plan might include a range of therapies, including bright light therapy, a strategic breastfeeding schedule, counseling and medications. Despite what many believe, many antidepressants have been thoroughly studied in pregnancy and breastfeeding and are believed to be relatively safe. When making a decision about the safety of a medication while pregnant or breastfeeding, for any condition, it’s important to weight the risks associated with that medication against the risk of the condition being untreated.

For example, while the likelihood of a baby being exposed in utero to drugs like selective serotonin reuptake inhibitors (SSRIs) is high and the dosage the baby receives can be relatively high, the risk of birth defects caused by these medications is apparently very low. Infants might also absorb SSRIs residue in breast milk, but some types were more likely to be absorbed in the breast milk than others. Furthermore, studies have shown that even in cases with the well-absorbed SSRIs, breastfeeding babies frequently display no symptoms and there is little to suggest there will be long-term developmental effects. However, more data is certainly needed and as the use of these medications increases, the InfantRisk Center is working to get a clear picture of what the implications are for babies.

Antidepressants are not the only option for treating depression. But for individual mothers, they may be the best or most-realistic choice. Although, there is some risk associated with the use of antidepressants while breastfeeding, the risk of untreated depression is definitely even greater. Lastly, all risks and benefits must be carefully weighed for each mother. But generally, we must bear in mind that a healthy mom makes a healthy baby.