I USED DNOR BREAST MILK - PLEASE READ!!! FOR THOSE WHO DOUBT

I Used Donor Breast Milk for My Baby
by Mary Sauer


When my daughter began struggling with weight gain around four months old, it never crossed my mind that accepting donor breast milk could be a bad idea. My foray into breastfeeding started off strong, but the return to work proved stifling to my supply, so I started looking into different options for supplementing what I was feeding her. A friend pointed me to Human Milk 4 Human Babies, an altruistic milk sharing co-op. But naturally, as soon as I grew accustomed to picking up bags of frozen milk from donors on a regular basis, the practice of sharing milk started getting a lot of bad press. First, a study posted by the journal Pediatrics revealed that roughly 10 percent of breast milk sold online was diluted with cow’s milk. Then, an article published by Newsweek revealed that corporations supplying breast milk to hospitals, at an average of $5.90 an ounce, were using incentive programs to increase milk bank contributions. Under the guise of encouraging black mothers, who have been found to breastfeed at lower rates, to breastfeed their own children, Medolac began offering $1 per ounce of excess milk to black mothers in Detroit. Shortly after this incentive program was released, they faced harsh criticism and were forced to choose a different approach. The roar of negative feedback came from all sides. Some argued impoverished mothers would choose formula provided by the government for their babies, selling all of their breast milk as a means of taking care of other expenses. Others pointed out how the incentive mirrored past exploitation when enslaved mothers were used as wet nurses at the detriment of their own children. All of this attention on shared milk brought up some good questions. What was the deal with the donor milk I’d been feeding my daughter for the past six months? Had I been careless by supplementing with another mother’s milk? I read more on the subject, and quickly came to an important realization: even though all of the articles mentioned altruistic milk sharing programs, such as Human Milk 4 Human Babies, no one was actually testing donated milk. The samples for the study published in Pediatrics were not obtained through donation, they were bought online. When I spoke with Emma Kwasnica, the founder of Human Milk 4 Human Babies, the milk sharing Facebook community I used to find a donor, she did not hesitate in expressing her frustration with these studies. “The fundamental setup of this study goes against what Human Milk 4 Human Babies stands for,” she said, “it was exactly opposite of the altruistic, peer-to-peer sharing that takes place.” She went on to explain the model for altruistic milk sharing programs. HM4HB helps connect donors with moms in need of breast milk through local Facebook pages, and mothers are strongly encouraged to get to know their donor and talk about the details of the donor’s life and health. In fact, 96 percent of mothers receiving donor milk drive to meet with their donor, often going into their home to pick up the milk, according to Professor Aunchalee Palmquist of Elon University. Additionally, it’s important to note that donors are asked to never seek compensation for their breast milk. Compared to the studies mentioned in Newsweek and Pediatrics where researchers acquired milk anonymously, purchased online from for-profit milk banks, this felt incredibly safe. And, in my experience, it was. I went through the process exactly as Kwasnica described it. I posted my need for milk on the local HM4HB page, and quickly heard from a mama just a few miles from me. We met up, and discussed her health practices. I also received additional donations from a friend and a coworker on more than one occasion. The generosity of these women is the reason my daughter caught back up on the growth chart. I am so incredibly grateful for their help. I understand that many people may believe I took an unnecessary risk by feeding my daughter another mother’s milk, but that is not how I see it. Yes, I know formula is a fine option, as I was made aware by a less-than-kind internet troll after sharing about my donor milk experience online. Formula may be fine, but I also believe breast milk is the better option. In fact, we used formula between donations and my daughter became constipated and gassy. Here is the thing — ultimately, the choice is mine. As my child’s mother, I am more than capable of making an educated decision concerning how I feed her. Put in the same situation, you better believe

WINE AND BREASTFEEDING

Guest Post: Breastfeeding and Alcohol Consumption By Jennifer Heisleman Ingalls Breastfeeding and alcohol…it’s the season for a holiday beverage or two. What’s a nursing mama to do? Many breastfeeding moms wonder if it is safe for them to have an occasional alcoholic beverage. Controversy and misinformation surrounds this topic. The conventional wisdom is to pump and dump. Or buy the alcohol “test strips.” Or even, “If you are safe enough to drive, you are safe enough to nurse.” But what happens if mama has a few drinks and feels tipsy, maybe not safe to drive…then baby wakes up to nurse? Is that safe? Is it worth the “risk?” The breastfeeding and alcohol question is just another way that the mother-baby dyad is consistently and insidiously undermined, or “booby-trapped.” It is so hard to know where to look for information, especially for evidence-based advice. Part of the blame lies with our consumer based economy, which needs to have a product for every situation. Our consumer based economy is constantly frustrated by breastfeeding mamas. Oh dear, they make their own perfect baby food, quick, how can we get them to buy something they don’t need?!? Whether the advice is to pump and dump (which doesn’t work and what a waste of precious milk!) or to buy the test strips (someone needs to make money off breastfeeding mamas some way) the end result is that women who consider having an alcoholic beverage while nursing are faced with guilt or shame. Each breastfeeding mother who is considering having a glass of wine is just like every other mother; she simply wants what is best for her baby! So, with all of the misinformation floating around many mothers either abstain altogether out of fear, or gently imbibe with great foreboding. But neither guilt nor abstinence is necessary if you examine the physiology and pharmacology of breastmilk and alcohol metabolism. When we look at the way alcohol is processed by the body, it helps to first look at how it is transferred into the breastmilk. Some drugs and medications stay in the breastmilk until the milk that contains them is expressed or consumed. These substances are where the “pump and dump” advice comes into play. Alcohol doesn’t work like this. Alcohol in the blood maintains approximately a 1:1 ratio with the alcohol contained in the breastmilk. This means that if your blood alcohol content (BAC) is 0.08 (over the legal limit in California) then your breastmilk alcohol content is approximately 0.08%. Only eight one-hundredths of a percent of the breastmilk would contain alcohol. This 1:1 ratio also means that as you get more sober, your milk gets more “sober.” The liver is continuously processing the alcohol as it filters your blood, and the consistently dropping blood-alcohol level is mirrored by a consistently dropping breastmilk alcohol level. Many mothers will have a glass of wine or two with dinner, and then be so concerned about the alcohol content of her milk that she will pump and dump with the mistaken belief that it is necessary to rid the breastmilk of the alcohol content. But the liver is already metabolizing the ethanol and reducing the ethanol content of the breastmilk in a 1:1 fashion. So there is absolutely no need to pump and dump your milk after drinking, or the next morning. Not even if mama were to go out and get trashed. (Which I am not recommending). More confusion comes into play when people confuse the all the numbers involved. The proof of the alcoholic beverage involved does not directly equal the blood alcohol content of the mama drinking it. There are more complicated things to consider including weight, number of drinks consumed, and rate of consumption. Compare the alcohol content of the breastmilk of a legally intoxicated mama (0.08 BAC) to the alcohol content of orange juice is approximately 0.09% ethanol-by-volume (aka ABV). The legally intoxicated mama will have breastmilk which has an ABV concentration that closely mirrors her BAC, approximately 0.08. That means that mama’s breastmilk when legally intoxicated is less alcoholic than orange juice! And for mamas who only consume one alcohol beverage, their BAC (and thus the ABV of their breastmilk) is considerably lower than that found in even the most innocuous of fresh juices. I can’t tell you how many times I have heard mamas say “Well, I will just pump and dump to be sure…” And the abundance of caution is certainly understandable. But really, if the mother would feel comfortable with a child imbibing the alcohol concentration found in fresh juice, why even blink at the alcohol concentration in milk after a glass of wine. It’s not logical. So what’s the bottom line here? It is safe to have a drink and breastfeed. Moderation in everything is key, and this should in no way be construed as encouraging mothers to become intoxicated. But the reality of the science is that even when legally intoxicated, the mother would only pose a threat to the infant through loss of motor function (dropping baby, rolling over on it, etc) and not through the alcohol content of her breastmilk. Indeed, the motor impairment of an intoxicated mother is my major concern when mothers choose to drink, rather than the risk of exposing the child to miniscule, infinitesimal concentrations of alcohol. If you would like to see what your BAC would be after that one glass of wine, for example, please check out this link. I plugged a few of my personal numbers into the handy-dandy calculator for a real-life example (like the one right here: http://oade.nd.edu/educate-yourself-alcohol/blood-alcohol-concentration/bac-calculator/). Personal Case Study: I am a 123# woman who loves to have a Guinness every now and then. After baby goes to sleep I have a 12 oz. bottle of Guinness and watch a movie with DH. She wakes up fussing two hours later. Am I safe to nurse? Yes! My blood alcohol content is only 0.004948576955424729%… which is less than five-one-thousandths of a percent alcoholic. Infinitesimal. No pumping and dumping (which doesn’t work anyway as the alcohol has to be metabolized out). No spending money on test strips. No fear-mongering. About the Author: In real life, Crunchy Mama Jenn is Jennifer Heisleman Ingalls. A Registered Nurse, Jennifer obtained her M.S.N from the University of San Francisco, with a specialization in Clinical Nurse Leadership and also has a post-licensure certification in Oncology. Jennifer has worked in pediatrics, oncology, stem-cell transplant, infusion therapy, vascular access, and most recently as an Assistant Professor of Registered Nursing. But her favorite “job” and truest calling is as

REFLUX AND NATURAL REMEDIES

For my natural people THIS WAS A FACEBOOK THREAD I THOUGHT YOU WOULD ENJOY. slippery elm gruel has worked wonders on my reflux baby! Thought I'd share smile emoticon • Nancy Nels Hamm how do you use it and in what proportion etc. 9 mins • Like • • Lacey Jayne Welker Yeah, the extract? Or powder? 7 mins • Like • • Lindsay Gibson Cinnamon powder, fennel seed powder, marshmallow root powder and slipper elm powder. Its one tablespoon divided with those ingredients. Pour one cup water and bring to boil with the ingredients...summer 10 mins covered then cool. I give Layla 1/2 teaspoon after each feed and if she's extra upset or spitting up. Can't od on it...Its all food based (says pediatrician) 5 mins • Like • Lindsay Gibson No problem! Our pediatrician gave recipe so it's all ok to use! 3 mins • Like • • Nancy Nels Hamm How long does the concoction stay good 2 mins • Like • • Lindsay Gibson Store in fridge and can warm up each day a small amount to use! Also breastfeeding mommas can drink 3 to 4 cups daily as well 2 mins • Like • • Lindsay Gibson So one cup good for 4 to 5 days so I make just one cup a time for her and I make my own batch for me drink 1 min • Like • • Lindsay Gibson If a mom wants to try...tell her give it 24 to 48 hours to really take effect. The ingredients in it soothes esophagus and stomach so it takes a bit to work • • • • Lindsay Gibson I give her the alhoe if she's extra gassy/spitting up. But the main thing is when she does spit up, even if it's forceful she doesn't cry! Crying would cause her spit up even worse! She went from spitting up bad after every feed to only once or twice! ...See More 2 hrs • Like • • Robin Pierce Norris So are you refe

HOW TO CORRECTLY FIT BREAST SHIELDS

Choosing a Correctly-Fitted Breastshield Choosing the right size PersonalFit™ Breastshield If you are using a breastpump to remove milk for your baby, it is very important that you have correctly-fitted breastshields. The breastshield is the part of the pump kit that fits directly over your nipple and forms a seal around the areola (the darkened part of your breast). The breastpump works by creating a vacuum, which gently draws your nipple into the tunnel of the breastshield – just like your baby would draw it into the mouth with sucking. A correctly-fitted breastshield will make your pumping comfortable and allow the pump to remove as much of your milk as possible each time you pump. Medela PersonalFit™ breastshields are available in five sizes: Medium (24mm), which is the size that comes with Medela’s breastpump kits; Small (21 mm), Large (27 mm), Extra Large (30 mm), and XX Large (36mm). Medela’s breastpump kits make it easy to use a larger or smaller breastshield, because all sizes are designed to fit into the same connector on the kit. Many women appear to benefit from a size other than the standard 24 mm breastshield. It is almost impossible to tell which size breastshield is the best fit without watching the nipple movement during pumping. The following tips will help you determine whether a different size breastshield would be right for you. Remember the word ‘COMFY’ to determine whether you might need a different size breastshield. The term was designed to help you remember five specific guidelines about breastshield sizing. The following identifies these five guidelines: ‘COMFY’ C – Centered nipple which moves freely. Look at your nipple as it is drawn into the tunnel of the shield during pumping. It should move freely and easily and should not rub against the sides of the tunnel. If the breastshield fits tightly, your nipple will rub against the sides of the tunnel with each vacuum movement of the pump. O – Only a little or no areola tissue is pulled into the tunnel. When your nipple moves freely in the tunnel of the breastshield, you will also notice a gentle pulling movement in the areola each time the pump cycles. If you do not see any movement in the areola with the pump vacuum, the breastshield is probably too small. If you see a lot of movement of your breast or a large amount of areola tissue is pulled into the tunnel, the breastshield is probably too big. M – Motion of the breast is gentle and rhythmic with each cycle of the pump. Just as you should see gentle nipple movement each time the pump cycles, you should also see gentle breast movement. This breast movement suggests that the breast is getting proper stimulation while pumping. F - Feels comfortable pumping. Pumping should be comfortable for you and should not cause nipple pain or tenderness. If you feel any pain or tenderness, your breastshield is probably too small. Y – Yields a well-drained breast.Your breasts should feel soft after each pumping session. An incorrectly-fitting breastshield can affect how your breasts empty and lead to problems with milk supply. During pumping, your milk flows out of the breast due to the pump’s vacuum and your milk ejection (or “let-down”) reflex. However, an incorrectly-fitting breastshield does not allow good breast emptying-even with the best breastpump and a strong milk ejection reflex-because it squeezes the small ducts inside the nipple that carry your milk out of the breast. Ordinarily, these ducts increase in size when you feel milk ejections so that the milk can flow out of the breasts quickly and easily. However, if the ducts are squeezed by a too small breastshield or not emptied by a too large breastshield, some milk stays behind in the breast. Eventually, this incomplete milk removal can lead to plugged ducts, mastitis, and problems with low milk volume. You may note breast engorgement that seems to last a long time – or little ‘knots’ or hardened areas in the breast that do not seem to empty with milk expression. If you experience nipple tenderness around the outside surface of the nipple or problems with breast emptying-your pumping will probably be improved with a different size breastshield. You will want to correct these problems as soon as possible. Sometimes you may experience discomfort at the base of the nipple due to rubbing of your breast tissue with the breastshield tunnel. Use of a lubricant such as Tender Care™ Lanolin may be beneficial. For more information or to purchase Medela’s PersonalFit breastshields, contact your lactation professional.