Release the Fear and Prepare For Childbirth

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photo credit: @Blush Bouquet Photography on INSTAGRAM

By Melissa Portunato MPH, IBCLC, RLC

Fear of childbirth is real y’all! You can easily drive yourself crazy thinking about your dream birth plan and whether it will even happen. And of course, there’s the breastfeeding. Will I even be able to do it? Pregnancy and birth can feel scary at times, but it doesn’t have to. Be prepared and trust your body! You were created for this!

This is my fifth baby so it’s not exactly my first rodeo. But people are usually surprised when I tell them I was scared to give birth again. Yep! TERRIFIED, like legs shaking and teeth jittering, terrified. I’ve had two unmedicated vaginal births prior and I was planning on the same with this baby but just the thought of enduring the pain of natural childbirth again really sent my mind on an intense mental trip. Why was I so scared? I needed to face my fear and trust my body to do what it was created to do…birth new life.

Read on as I share with you my latest journey through childbirth and my top 3 tips that helped me prepare to totally rock labor and delivery.

#1 Stay Active: Mind, Body and Soul

With 4 other kiddos to care for, staying active just comes with cleaning, refereeing, cooking, and shopping. Just thinking about the daily to do list will give you a workout! Before I got pregnant, I was hitting the gym 3-4 times a week – jogging 1 mile on the treadmill, toning with weights and incorporating yoga a few times a week too. I felt so good throughout my pregnancy and continued to walk a mile every day, well into the late third trimester. Yoga stretching daily, even for just 5-10 minutes made a huge difference on how I slept and how I felt getting out of bed in the mornings. Connecting with a local prenatal yoga group would be an excellent way to prepare you for your birth journey but if you can’t make it out, YouTube has a ton of easy to follow videos! Even though I gained a ton of weight (more on that coming soon), I stayed active which helped with the flexibility and stamina needed for labor. Visualizing a healthy baby and a smooth delivery kept my mind in full control and my anxiety at a minimum. I began to listen to hypnobirthing affirmations pretty early on, at the end of my first trimester. In addition, prayer and meditation allowed me to release the fear I was harboring, embrace the unknown, and trust my perfectly designed body once again.

#2 Take a Childbirth and Breastfeeding Class

I’m a lactation consultant and I have 5 kids. You would think I am the guru of everything mommy and baby right? Nope. Even I have doubts and questions. Have an open conversation with your health care provider about your birth plan and find out if your local hospital is a designated Baby Friendly facility to get you the best start at breastfeeding. And remember – it’s never too late to change health care providers. You need to feel confident and trust your birth team! I’ll be honest with you, when my baby girl lost 6% of her birth weight on Day 2 and the nurses told me it was higher than usual, I doubted myself. Ugh! Even though my LC brain new the real truth. I knew 5-10% weight loss was normal. I knew my breast milk was all she needed but it doesn’t take much to plant seeds of doubt. Know the facts and be prepared to recite them to yourself and to others. You can track your baby’s growth and development here.  Trust me and save this link, you might need it later.

#3 Know Your Village

I went into labor on my due date. But did you know only about 4% of babies are actually born on their due dates? The weeks prior to delivery were brutal on me. Sleepless nights and the weight I gained was really starting to take a toll on me. The night I went into labor I called my mother-in-law to stay with the kids while my husband and I whisked off into the night to welcome baby number five. My mom was on call and was tasked to help with the kids in the morning. My plan was to labor at home for as long as possible and that’s exactly what I did. Breathing, yoga poses, stretching, hydrating, and even texting with friends kept me progressing through active labor. Baby arrived just a few short hours after I arrived at the hospital. My husband and I were a team. We breathed through each wave together while I squeezed his hand in a death grip. I’m thankful for my village of family, neighbors and friends.

Well to wrap it up, the preparations I had done prior allowed me to have the birth I envisioned. I successfully delivered baby Marcella with no medical interventions. Marcella was born awake, alert and breastfed instantly. Why did I want an intervention free birth? Evidence tells us there is a direct correlation between birth and breastfeeding. Medical interventions can have a negative effect on breastfeeding. Can you still breastfeed even if you have interventions? Absolutely! But you and baby might have a harder time to get the hang of things. Be prepared and rally your support team. Babies are born to breastfeed.

Do you have any doubt, fear or questions about pregnancy, labor or breastfeeding? We all need support, yes even lactation consultants. Schedule your prenatal consult with us today! Let us help you prepare for your journey into motherhood. We’re here for you mamas and we support you!

Pregnancy and Breastfeeding after 35

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mom on couch with breast pump

By Jacquelyn Ordner BSN, RN, IBCLC, RLC

The fact is that most moms over 35 have healthy babies and normal pregnancies.  There are increased risks for mothers experiencing pregnancy after age 35, but the risks are still relatively low.  The increased risk of pregnancy complications correlates to potential increased difficulty in breastfeeding as well.  So, what should you know before considering pregnancy after 35? We’ve got the details!

For the first time in history, the birthrate of babies born to mothers in their 30’s has eclipsed the birthrate of babies born to mothers in their 20’s.  For this reason, it is important to know the risks associated with what is technically called a “geriatric pregnancy”. Another medical term, used to identify mothers over age 35, is “advanced maternal age”.  Ouch! Though these terms may not feel very flattering, it is important to understand what they mean. 

Why 35?  There is no magic transition that happens the day a woman turns 35, but many risks begin to increase rapidly by a woman’s mid-thirties. 

Fertility – By age 30, a woman’s ability to get pregnant begins to decline and does so   more rapidly as she approaches her mid-thirties and beyond.  In fact, the odds of getting pregnant naturally at age 45 are less than 4%. Why does a woman’s fertility decrease as she gets older? This happens because women are born with a certain number of eggs.   The amount of eggs she has decreases, and eggs remaining into the mid-thirties and    beyond are more likely to have abnormal chromosomes. As a woman ages, her risk of fertility affecting disorders, like uterine fibroids and endometriosis, also increases.

Complications – The risks of preeclampsia, gestational diabetes, and placenta previa all increase for older mothers as well.  The increased incidence of these complications largely contributes to the increased risk of cesarean delivery. It is important to know  that the risks of stillbirth and miscarriage are also increased for pregnant women over   35. The risk of miscarriage is about 15% at age 35, 20% at age 40, and 40% at age 45. Miscarriage occurs in every 1 out 1,000 births in women under 30 and increases to 1.4 out of every 1,000 births for mothers ages 25-39. The rate increases to 2 out of every 1,000 births at age 40. *It is especially important to understand that maternal pre- pregnancy health is a huge factor in the development of pregnancy complications. Mothers are encouraged to ensure any existing health conditions are well controlled, that they are at a healthy weight, and that they are eating a healthy diet BEFORE trying to become pregnant.

Chromosomal Abnormalities/Birth Defects – A chromosomal abnormality occurs when there is any missing, damaged, or extra chromosome. Down Syndrome is the most   commonly occurring chromosomal abnormality for babies born to older mothers. The risk of a mother having a baby with Down Syndrome increases from 1 in every 1,480     births at age 20 to 1 in every 353 births at age 35. Prenatal screening tests are available to assess the risk of baby being born with certain specific disorders or conditions.

What about breastfeeding? Does being over 35 mean moms will have more difficulty nursing or pumping breastmilk for their babies? The available evidence leads us to believe that any increase in breastfeeding difficulty is likely related to the increase in complications experienced by mothers over 35 years of age. Complications such as preeclampsia, gestational diabetes, and the need for cesarean section can delay mom’s milk from coming in by a few hours to as much as a few days. This can set the stage for future breastfeeding difficulties.  Additionally, babies born with certain chromosomal abnormalities or birth defects can have a harder time nursing. This can lead to a delay in mom’s milk coming in, low milk supply, and even mastitis. 

Can I still have an, uncomplicated pregnancy, a healthy baby, and a successful breastfeeding experience after age 35? YES!!!  You absolutely can!  When reviewing the risks associated with advanced maternal age, it’s important to notice that the percentage of increase is small in many categories.  Gaining knowledge and insight before becoming pregnant can be immensely helpful. Also, working with a healthcare team, who is experienced in caring for older mothers, is key! It is essential to contact an International Board Certified Lactation Consultant (IBCLC) for support with any breastfeeding challenges that are not easily managed.  Having the right support can make all the difference!

 

Sources:

Colombo, L., Crippa, B. L., Consonni, D., Bettinelli, M. E., Agosti, V., Mangino, G., … Mosca, F. (2018). Breastfeeding Determinants in Healthy Term Newborns. Nutrients, 10(48). doi: 10.3390/nu10010048

Women’s Health Care Physicians. (n.d.). Retrieved December 16, 2019, from http://www.acog.org/.

What’s in Breastmilk Anyway?

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mom holding breast milk bottle

By Jacquelyn Ordner BSN, RN, IBCLC, RLC

Breastmilk contains over 200 components, and that’s just what scientists have discovered so far! It is no surprise that breastmilk is the optimal food for babies, but what exactly is in it anyway?  With macronutrients, micronutrients, trace minerals, bioactive components and more, breastmilk truly is a living food!

Macronutrients

Macronutrients are nutrients that our bodies require in large amounts, typically measured in grams. Here’s a look at the average concentrations of macronutrients in 1 ounce of mature human milk. 

Carbohydrates 2.1 grams/oz
Protein 0.39 grams/oz
Fat 1.2 grams/oz
Calories (kcal) 22/ oz

Micronutrients, Vitamins, and Minerals

Micronutrients and minerals are essential for human growth and development.  It is important to note that some of these components of breastmilk can be influenced by mom’s dietary intake. Below is a list of just some of the micronutrients and minerals present, on average, in mature human milk.

Iron 23 mcg/ oz
Sodium 4.5 mg/oz
Phosphorus 4.5 mg/oz
Vitamin C 1.2 mg/oz
Vitamin A 18.2 mcg/ oz
Calcium 10.6 mg/ oz

*Note the above table is certainly not a comprehensive list of all micronutrients and minerals contained in breastmilk.

Additional Components 

Breastmilk not only contains amazing nutritional components, but also digestive enzymes, hormones, growth and development factors, antimicrobial components, and immune modulating components.  These non-nutritional agents make breast milk ideal for babies and toddlers! Here’s a brief look into some of these breastmilk super components:

Macrophages Protect against infection by seeking and engulfing potential immune threats
Stem Cells Essential for regeneration and repair
Secretory IgA Most prevalent immunoglobulin in breastmilk. Anti-microbial and anti-inflammatory
Cytokines Help modulate immune response and play a huge role in gut health.  Help protect against NEC (necrotizing enterocolitis)
Lactoferrin 2nd most abundant protein in breast milk, anti-inflammatory and antioxidant, aids in iron homeostasis, helps reduce instance of sepsis and NEC (necrotizing enterocolitis) in pre-term infants

Wow!  It’s obvious that breastmilk is truly amazing and can’t be duplicated!  How incredible is it that women’s bodies can create this incredible living food for their babies!  So, nurse or pump on mamas……you’re providing the best food on the planet, and every drop counts!

Sources

  • American Academy of Pediatrics, Policy Statement. Breastfeeding and the use of human milk. Pediatrics 2005; 115:496-506.
  • ESPGHAN Committee on Nutrition; Agostoni C, Braegger C, Decsi T, et al. Breast-feeding: A Commentary by the ESPGHAN Committee on Nutrition. Journal of Pediatric Gastroenterology and Nutrition 2009; 49:112-125.
  •  Ochoa, T. J., & Sizonenko, S. V. Lactoferrin and prematurity: a promising milk protein?. Biochemistry and cell biology = Biochimie et biologie cellulaire 2017, 95(1), 22–30. doi:10.1139/bcb-2016-0066
  • Walker A. Breast milk as the gold standard for protective nutrients. Journal of Pediatrics 2010; 156(2):Suppl. 1.
  • World Health Organization http://www.who.int/topics/breastfeeding/en/