24h-payday

Archive

Posts Tagged ‘breastfeeding’

New Webinar for Birth Pros: “Making It Work! – Breastfeeding Tips for the Working Mom”

March 24th, 2015 by avatar
breastfeeding working mother

flickr.com/photos/jennysbradford/4356862824

I often share in childbirth classes that breastfeeding can be the next big challenge after birth.  As a childbirth educator, I weave breastfeeding information throughout my class series. By the time the “breastfeeding” part of the class happens towards the end of the series, the families are eager and ready to learn how to be as prepared as possible to feed their baby, without actually having baby there yet to “practice” with.

I provide additional follow up resources for the families as well, including where to get help locally with breastfeeding issues, what current best practice says on a variety of breastfeeding topics and useful videos like effective hand expression.  Returning to work and breastfeeding is one topic that I feel is important to cover, but often gets short shrift due to lack of time. Families don’t even have their babies in their arms yet, and the “return to work” point still seems very far off, and I have a lot of information to share in a short class time. In some areas, there are specific classes that families can attend that specialize in the “breastfeeding for the working parent” topic, but not many families can locate or take advantage of this type of class.

I would love to be able to support my families long after their childbirth education class is over with information they can use and apply for the working/breastfeeding parent, and that is why I am planning on attending Lamaze International’s free (non-Lamaze members $20) 60 minute webinar “Making It Work! Breastfeeding Tips for the Working Mom” offered on March 26th at 1:00 PM EST.

It is well documented that exclusive breastfeeding rates drop significantly when women return to work or school.  There are many barriers to overcome and prenatal information and support can help families to prepare for the time when babies are being cared for by others and still being breastfed.  This online webinar is appropriate for doulas, childbirth educators, lactation consultants, nursing staff, physicians and midwives.

The webinar is being presented by Patty Nilsen, RN, BSN, BA, IBCLC, ANLC.  Patty is an Outpatient Lactation Consultant for Mount Carmel East, West & St. Ann’s Hospitals in Columbus, Ohio, where she provides daily private outpatient lactation consultation for women experiencing challenges and in need of encouragement with breastfeeding, leads weekly breastfeeding support groups, and answers over 300 breastfeeding helpline calls per month.  Patty has learned many innovative tips for returning to work and breastfeeding from the thousands of mothers she has worked with over the years and is eager to share them in this webinar.

© womenshealth.gov

© womenshealth.gov

The webinar is open to all, and Lamaze International members are able to attend at no cost.  Non-members will pay $20 at registration to participate.  Additionally, this workshop has been approved for continuing nursing education hours which  are accepted by DONA, Lamaze, ICEA and other birth professional organizations. The cost for receiving continuing education hours for Lamaze members is $35 and for non-members is $55, (which includes the cost of the webinar). As mentioned above, Lamaze members attend for free, if they are not enrolled for the contact hours.  Contact hours are awarded after completing the webinar and a post-webinar evaluation. CERPS are pending.

You can register for the webinar (select contact hours or no-contact hours) at this link – and then prepare to join on Thursday at 1:oo PM EST.  After the webinar, come back and share your top takeaways and how you are going to use this information to support families in your area with other Science & Sensibility readers.

Babies, Breastfeeding, Childbirth Education, Lamaze International, Webinars , , , , , , ,

Thanks IBCLCs – For Helping New Families Meet Their Breastfeeding Goals

March 5th, 2015 by avatar

IBCLCDayLogo 2015(2)Yesterday was IBCLC Day – a special day set aside once a year to recognize the hard work and efforts that International Board Certified Lactation Consultants provide all all year long in support of breastfeeding for mothers, babies and really, the entire family.  IBCLC Day is sponsored by the International Lactation Consultant Association, a professional organization for IBCLCs around the world.

Becoming an IBCLC is no easy feat; the requirements to become credentialed are very rigorous and involve many clinical hours and an exhaustive exam.  Continuing education hours and/or retaking the exam are required every 5 years to maintain the credentials.  There are over 27,450 IBCLCs worldwide.

Some IBCLCs are also Lamaze Certified Childbirth Educators.  Both organizations represent the gold standard in their field and it is not surprising that some professionals seek out both qualifications.  When an LCCE is also an IBCLC, their class families can really benefit.  The LCCE is able to weave in a rich knowledge of breastfeeding topics and information throughout the class, as well as share information about common challenges that they see when working as an IBCLC.

creative commons licensed (BY-NC) flickr photo by robysaltori: http://flickr.com/photos/robysaltori/4604876371

CC flickr photo by robysaltori: http://flickr.com/photos/robysaltori/4604876371

A lactation consultant can use their childbirth education skills to hone their communication and help families understand the nuances of feeding their babies when they are delivering breastfeeding information during a consultation.  The two professions can complement each other beautifully.

Of course, the scope of practice of LCCEs and IBCLCs is different, and it is important to recognize the separation and to wear the proper hat when conducting yourself professionally in either capacity.

For official information on how to become an IBCLC, check out the information on the International Board of Lactation Consultant Examiners (IBLCE ) site. If you are considering becoming an IBCLC, there is an Facebook Group just for you, where you can discuss the different pathways, find out more about the requirements and costs, and receive the support of other men and women exploring the IBCLC process and preparing for the exam.

I reached out to some Lamaze Certified Childbirth Educators, who are also IBCLCs, to ask some questions and learn more about experience of wearing both hats.  Teri Shilling, Ann Grauer and Ashley Benz generously shared their thoughts below.

Sharon Muza:  Which credential did you receive first, your IBCLC or your LCCE?

Teri Shilling: I received my LCCE first.

Ann Grauer: I was an LCCE first. I never thought I’d be an IBCLC but one year the policies fit me and I decided to go for it.

Ashley Benz: I became an LCCE first and then an IBCLC. My goal had always been to become a lactation consultant. I knew that it was a long road and I was so interested in getting started working with families that I did a couple of certifications before I was ready to take my IBCLC exam.

SM: How does having both credentials benefit your students and clients?

Teri: So much of my work as an IBCLC is education – by the bedside, on the phone, etc.  Keeping things simple and memorable is key.  The certifications speaks to my professionalism and commitment to continuing education

Ann: I had a CLC before my IBCLC—I’ve always felt that I wanted and needed more information on breastfeeding. I’ve taught breastfeeding classes since the beginning but the information explosion in that one topic is incredible!  I feel very strongly that it serves my childbirth classes well that I have that credential and that being an LCCE serves my breastfeeding clients. I see things from a “facilitator of education” standpoint, rather than a traditional IBCLC standpoint.

Ashley: Because a lot of what a lactation consultant does is teach, I use the skills I’ve gained from teaching Lamaze class in breastfeeding consultations. In Lamaze class, I use my knowledge about breastfeeding and mother-infant bonding.

SM: Does your IBCLC knowledge influence how and what you teach about breastfeeding? 

Teri: Yes, I think it does, but I have been an IBCLC for 20+ years and can’t remember what I taught before.  But being an IBCLC gives me first had experience with the big bumps in the road many women hit during the postpartum time.

Ann: Yes. I’ve actually simplified what I teach. Being an IBCLC, means I now appreciate that parents need simple and honest information that they can incorporate into their parenting.

Ashley: I probably emphasize the need to seek proper help more than other educators. My class focuses on the basics of breastfeeding and assumes I’ve convinced my students to get support for issues that arise.

SM: What would you recommend for other LCCEs who might want to be an IBCLC? What are the challenges?

Teri: Do a community search for where the gaps are in support – is there a breastfeeding coalition in your area? It is important to network.  Find a mentor.  I would say go for it.  More education never hurts.  The challenge is being employed as an IBCLC as a non-nurse.  It helps if you are the entrepreneur type and able to set up a private practice.

Ann: If you’re a non-RN you will have to work incredibly hard. The system is set up to be medically-minded and there is not appreciation/understanding of what non-RNs bring to the table. Which, by the way, is a lot. Rather than focusing on becoming an IBCLC, allow yourself to enjoy the journey of learning and you’ll be there before you know it.

Ashley: The major challenge of the IBCLC path is that it can be very time (and often financially) intensive. I recommend checking out the IBLCE website and see if there is a pathway that you already fit into. If not, make a five-year plan to become an IBCLC.

SM: Where do you think it gets tricky wearing both hats?

Teri: I don’t think it does.  I love being able to be part of the continuum from pregnancy to postpartum.

Ann: I don’t think it does. My confidence is in the mother and baby. I’m just here to help in any role I can.

Ashley: Whenever you have multiple sets of skills, it can be difficult to maintain appropriate business boundaries and communicate those to your students and clients.

Careers as both a Lamaze Certified Childbirth Educator and an International Board Certified Lactation Consultant are fun, challenging and very rewarding.  They are a wonderful compliment to each other and families can benefit from the knowledge that someone who holds both credentials can share when serving in either role.  Are you an LCCE who has considered or would like to become an IBCLC?  Are you already on that path?  Share a bit about your journey in our comments section and let us know.

Babies, Breastfeeding, Childbirth Education, Newborns , , , , , , , , ,

Lamaze International Online Classes for Parents Expands Offerings!

November 11th, 2014 by avatar

Screen Shot 2014-11-10 at 5.16.54 PM

The Lamaze International Strategic Framework 2014-2017 that resulted from in-depth strategic planning meetings held earlier this year with the Board of Director and Lamaze Management resulted in many forward thinking, comprehensive and courageous goals, including plans to “innovate education and expand to the childbearing years” by:

  • reaching more women earlier and more frequently throughout childbearing years,
  • expanding delivery methods for online education (e.g., virtual classes, Facetime consults, and mobile apps), and
  • developing a strategy to broaden outreach at the electronic level and cultivate moms ‘up’ the ladder for more personalized services and training.

As part of fulfilling this mission, Lamaze International is pleased to announce that three online childbirth education classes are developed, online and open for business.  The first class to go live was “Safe and Healthy Birth: Six Simple Steps,” a class designed to help families prepare for birth by presenting six simple practices shown to greatly improve birth outcomes for both mothers and babies. The next two were recently added – VBAC: Informed and Ready and Breastfeeding Basics: From Birth to Back to Work.

The online classes are presented in an interactive, engaging format with unlimited access for parents, so they can complete the class(es) at their own pace. The classes are meant to be used as an important beginning point in a families’ complete prenatal education. They provide vital information, and throughout the online course, families are encouraged to find a comprehensive in person Lamaze class in order receive a thorough preparation for childbirth. Parents are informed that to be fully prepared for labor, birth, breastfeeding, and postpartum, it’s important to attend a good quality childbirth course. There are links to the “Find a Lamaze Class” portion of the parent website.

The online classes can be accessed on a computer (desktop or laptop), tablet or smartphone and learning can take place at a convenient time and place for each individual family.  There are interactive activities and discussion forums to connect with other participating families.  Fun quizzes are spaced throughout the course to help with the retention of information.

Safe and Healthy Birth: Six Simple Steps

Knowledge is power! It’s our goal to help you prepare for one of the most important days of your life – baby’s birthday! This course presents six simple practices that research has shown to greatly improve birth outcomes for both mothers and babies. These practices have been developed by Lamaze International and are based on recommendations by the World Health Organization. Lamaze has simplified the scientific facts into six healthy birth practices to make it easy for you to choose the safest care, understand your options, and steer clear of care practices or unnecessary interventions that may not be the best for you and your baby.

After completing this course, learners will be able to:

  • Discover how the Lamaze Six Healthy Birth Practices can simplify your labor and birth
  • Find out how your care provider and support team can make a difference
  • Learn about common medical interventions
  • Alleviate fears and learn ways to manage pain
  • Build your knowledge and confidence to make informed decisions

Breastfeeding Basics: From Birth to Back to Work

As comforting and healthy as breastfeeding can be, it is not always easy in the first few weeks while recovering from birth. If you find yourself struggling, know that hard work in the early weeks pays off as you and your baby learn to breastfeed. Having realistic expectations about how breastfeeding will go in the early weeks will help you to meet your breastfeeding goals. With the information in this class, you can prepare to get breastfeeding off to a great start and look forward to the many benefits that breastfeeding can provide to you and your baby.

After complete this class, learners will be able to:

  • Recognize the Benefits of Breastfeeding to Mother and Baby
  • Understand how milk supply works
  • Learn about the mechanics of breastfeeding, latch and positioning
  • Recognize good feeding and if baby is getting enough milk
  • Manage nighttime breastfeeding
  • Be prepared for what to do if there is a recommendation to supplement/pump
  • Prepare for returning to work

VBAC: Informed and Ready

This class will help you understand the facts, benefits, and risks of all your delivery options including a vaginal birth after cesarean (VBAC), and set you up for the best chance of success. Prepare yourself and learn how to simplify your labor and birth by participating in this interactive online course.

After completing this class, learners will be able to:

  • Understand the risks and benefits of both VBAC and repeat cesarean birth
  • Recognize the qualities of a VBAC supportive health care provider
  • Identify a strong support team for your  VBAC birth
  • Develop and practice coping and comfort techniques that will help during your VBAC labor
  • Write a VBAC and cesarean birth plan that reflects your informed preferences

International Cesarean Awareness Network (ICAN) has collaborated with Lamaze International to offer all ICAN members a 15% discount on the VBAC class, to help them feel better prepared as they plan for their subsequent birth after a cesarean.  To learn more about ICAN and become a member, in order to take advantage of this discount, follow the link to the “Join ICAN page.”

Additional courses planned include “Labor Pain Management: Techniques for Comfort and Coping” -scheduled to go live next month and an early pregnancy class in the early part of 2015.

Offering online classes serves to increase name recognition of the Lamaze International brand and create demand for in person Lamaze classes offered by LCCEs around the world.  Programs like this position Lamaze as the leader in childbirth education. Additionally, families that do not have Lamaze educators in their community can take advantage of the evidence based information and skills offered in the classes.  Educators can follow the class links above and sample all of the courses in a preview segment.

Breastfeeding, Cesarean Birth, Childbirth Education, Healthy Birth Practices, Lamaze International, Pain Management , , , , , ,

Breastfeeding & Racial Disparities in Infant Mortality: Celebrating Successes & Overcoming Barriers

August 28th, 2014 by avatar
© mochamanual.com

© mochamanual.com

August has been designated as World Breastfeeding Month, and Science & Sensibility was happy to recognize this with a post earlier this month that included a fun quiz to test your knowledge of current breastfeeding information.  Today, we continue on this topic and celebrate Black Breastfeeding Week 2014 with a post from regular contributor, Kathleen Kendall-Tackett, Ph.D., IBCLC, FAPA sharing information about the increased breastfeeding rates rates among African American women.  Kathleen also discusses some of the areas where improvements can help this rate to continue to increase. 

Celebrating Successes

Many exciting changes occurred in 2013 in the breastfeeding world. One of the best trends was the increase in breastfeeding rates in the African American community. The CDC indicated that increased breastfeeding rate in African American women narrowed the gap in infant mortality rates.  As the CDC noted:

From 2000 to 2008, breastfeeding initiation increased…from 47.4% to 58.9% among blacks. Breastfeeding duration at 6 months increased from…16.9% to 30.1% among blacks. Breastfeeding duration at 12 months increased from… 6.3% to 12.5% among blacks.

Much of this wonderful increase in breastfeeding rates among African Americans has come from efforts within that community. In 2013, we saw the first Black Breastfeeding Week become part of World Breastfeeding Week in the U.S. Programs, such as A More Excellent Way, Reaching Our Sisters Everywhere (ROSE), and Free to Breastfeed, offer peer-counselor programs for African American women.


We can celebrate these successes. But there is still more to do. Although the rates of infant mortality have dropped, African Americans babies are still twice as likely to die. In addition, although rates of breastfeeding have increased among African Americans, they are still lower than they are other ethnic groups.

For each of the 2000–2008 birth years, breastfeeding initiation and duration prevalences were significantly lower among black infants compared with white and Hispanic infants. However, the gap between black and white breastfeeding initiation narrowed from 24.4 percentage points in 2000 to 16.3 percentage points in 2008.

Barriers to Overcome

In order to continue this wonderful upward trend in breastfeeding rates, we need to acknowledge possible barriers to breastfeeding among African American women. Here are a couple I’ve observed. They are not the only ones, surely. But they are ones I’ve consistently encountered. They will not be quick fixes, but they can be overcome if we recognize them and take appropriate action.

1) Pathways for IBCLCs of Color

In their book, Birth Ambassadors: Doulas and the Re-Emergence of Women-Supported Birth in America, Christine Morton and Elayne Clift highlight a problem in the doula world that also has relevance for the lactation world: most doulas (and IBCLCs) are white, middle-class women. And there is a very practical reason for this. This is the only demographic of women that can afford to become doulas (or IBCLCs). The low pay, or lack of job opportunities for IBCLCs who are not also nurses, means that there are limited opportunities for women without other sources of income to be in this profession. Also, as we limit tracks for peer-counselors to become IBCLCs, we also limit the opportunities for women of color to join our field. I recently met a young African American woman who told me that she would love to become an IBCLC, but couldn’t get the contact hours needed to sit for the exam. That’s a shame. (I did refer her to someone I knew could help.)

2) We need to have some dialogue about how we can bring along the next generation of IBCLCs. We need to recognize the structural barriers that make it difficult for young women of color to enter our field. ILCA has started this dialogue and held its first Lactation Summit in July to begin addressing these issues.

These discussions can start with you. Sherry Payne, in her recent webinar, Welcoming African American Women into Your Practice, recommends that professionals who work in communities of color find their replacement from the communities they serve.  Even if you only mentor one woman to become an IBCLC, you can have a tremendous impact in your community. If we all do the same, we can change the face of our field. (Note, here is a wonderful interview with Sherry as she discusses “Fighting Breastfeeding Disparities with Support.”)

3) Bedsharing and Breastfeeding

 This is an issue that I expect will become more heated over the next couple of years. But it is a reality. As we encourage more women to breastfeed, a higher percentage of women will bedshare. As recent studies have repeatedly found, bedsharing increases breastfeeding duration. This is particularly true for exclusive breastfeeding.

Bedsharing is a particular concern when we are talking about breastfeeding in the African American community. Of all ethnic groups studied, bedsharing is most common in African Americans. It is unrealistic to think that we are going to simultaneously increase breastfeeding rates while decreasing bedsharing rates in this community. The likely scenario is that breastfeeding would falter. It’s interesting that another recent CDC report, Public Health Approaches to Reducing U.S. Infant Mortality, talks quite a bit about safe-sleep messaging, with barely a mention of breastfeeding in decreasing infant mortality.  A more constructive approach might be to talk about being safe while bedsharing. But as long as the message is simply “never bedshare,” there is likely to be little progress, and it could potentially become a barrier to breastfeeding.


Reason to Hope

BBW-Logo-AugustDates3Even with these barriers, and others I haven’t listed, Baby-Friendly Hospitals are having a positive effect. When hospitals have Baby-Friendly policies in place, racial disparities in breastfeeding rates seem to disappear. For example, a study of 32 U.S. Baby-Friendly hospitals revealed breastfeeding initiation rates of 83.8% compared to the national average of 69.5%. In-hospital exclusive breastfeeding rates were 78.4% compared with a national rate of 46.3%. Rates were similar even for hospitals with high proportions of black or low-income patients (Merewood, Mehta, Chamberlain, Phillipp, & Bauchner, 2005). This is a very hopeful sign, especially as more hospitals in the U.S. go Baby-Friendly.

http://kcur.org/post/kc-group-fights-breast-feeding-disparities-education-support

In summary, we have made significant strides in reducing the high rates of infant mortality, particularly among African Americans. I am encouraged by the large interest in this topic and the number of different groups working towards this goal. Keep up the good work. I think we are reaching critical mass.

Additional resource: Office of Women’s Health, U.S. Department of Health & Human Services Breastfeeding Campaign for African American families.

References

Merewood, A., Mehta, S. D., Chamberlain, L. B., Phillipp, B. L., & Bauchner, H. (2005). Breastfeeding rates in U.S. Baby-Friendly hospitals: Results of a national survey. Pediatrics, 116(3), 628-634.

Reprinted with permission from Clinical Lactation, Vol. 5-1. http://dx.doi.org/10.1891/2158-0782.5.1.7

About Kathleen Kendall-Tackett

kendall-tackett 2014-smallKathleen Kendall-Tackett, Ph.D., IBCLC, FAPA is a health psychologist, International Board Certified Lactation Consultant and Fellow of the American Psychologial Association in both the divisions of Health and Trauma Psychology. Dr. Kendall-Tackett is President-Elect of the Division of Trauma Psychology, Editor-in-Chief of Clinical Lactation, clinical associate professor of pediatrics at Texas Tech University Health Sciences Center, and Owner/Editor-in-Chief of Praeclarus Press, a small press specializing in women’s health. Dr. Kendall-Tackett has authored more than 310 articles or chapters and is the author or editor of 22 books on women’s health, maternal depression, family violence and breastfeeding. Dr. Kendall-Tackett and Dr. Tom Hale received the 2011 John Kennell and Marshall Klaus Award for Research Excellence from DONA International. You can find more from her at Uppity Science Chick

 

Babies, Breastfeeding, Childbirth Education, Guest Posts , , , , , , , ,

Sleeping Like a Mammal: Nighttime Realities for Childbirth Educators to Share With Parents

August 21st, 2014 by avatar

By, Linda J. Smith, MPH, IBCLC, LCCE, FACCE

In recent days, there has been much press and discussion about a new book written by pediatricians that professes to help parents “train” their new baby to sleep through the night. The scathing criticism of the book by both parents and professionals alike are consistent with what we know about the needs of a newborn baby and their sleep and feeding patterns. Today on Science & Sensibility, Linda Smith, MPH, IBCLC, LCCE, FACCE shares accurate, evidence based information that childbirth educators and other professionals can use to talk to new families about newborns and their sleep and feeding patterns. Linda is one of the authors of La Leche League International‘s newest book; Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family.

This book written by Smith along with co-authors Diane Wiessinger,  Teresa Pitman and Diana West provides families with information to help the entire family get more sleep and do so safely, while meeting the nutritional and developmental needs of newborns. Preparing families for life with a newborn is one of the challenges we face as educators. The information Linda provides here along with the resources included in this post can help you to be sure that your information is backed by research and appropriate for your new families. – Sharon Muza, Community Manager, Science & Sensibility

How do I address sleep with my childbirth class participants?

261653 ML Algebra1 2007New parents are instantly thrust into the reality of life with a baby. As Dr. Helen Ball writes, “Sleep (or the lack of it) looms large for parents-in-waiting—and it is pointless to pretend that your sleep will not be disrupted by your new bundle of joy. His body clock, which until recently was controlled by your own, is now free-running, and a day-night pattern does not start to emerge until he is around three months old. His stomach is tiny, and he will need frequent feeds all around the clock—he cannot wait eight hours through the night to be fed just because you need to sleep. If you don’t feed him, he will cry. If he’s cold, he will cry. If he hurts, he will cry. If he misses being in close contact with you, he will cry. He doesn’t know that you will come back once you leave his sight. If he feels abandoned, he will cry frantically—it’s his only method to attract attention and bring himself to safety. If he cries frantically, it will take a long time for him to calm down and you will have to help him.”

“The experience of sleep, and of being left alone for sleep, is very different for babies than it is for adults. The more quickly you can understand your baby’s needs—for comfort, food, reassurance, contact, love—the less disruptive nighttime baby care will become, and the less anxious you will feel. Some of the decisions you make early on about nighttime baby care will affect how you manage sleep disruption and cope with your new baby.” Dr. Helen Ball

What is normal sleep?

  • Pregnant women do not sleep in long unbroken stretches, i.e., “all night.” Neither do postpartum mothers – not for many months, regardless of how they feed their babies.1 Breastfeeding mothers get more sleep than formula-feeding mothers; breastfeeding mothers who bedshare get the most sleep of all new mothers.2,3
  • Before birth, babies sleep rather randomly, not necessarily closely synchronized to their mothers’ body clock. After birth, babies sleep in short (1 to 1½ hour) cycles and need to be fed approximately hourly because of their very small stomachs.4 They do not even begin to develop day-night sleep patterns for several months, regardless of how they are fed.5
  • Frequent feeding day and night is normal, essential for the baby, yet is often called ‘inconvenient’ for parents. Let’s face it – all babies are “inconvenient.” Most of us didn’t get pregnant just to make our lives less complicated. Babies need to be touched – a LOT, day and night, and skin-to-skin.6 Touch is nearly as important to babies’ overall development as food.7 Breastfeeding is an easy way to assure plenty of touch; so is safe bedsharing.8 Most breastfeeding mothers nurse their babies to sleep and sleep with their babies at least part of the night.9

LLLI | Safe Sleep 7 Infographic

Safety issues

  • SIDS (Sudden Infant Death Syndrome) and suffocation are two distinct and rare risks to infants in the early months. SIDS is a diagnosis of exclusion: there’s no obvious reason for a baby’s death. Risk factors for SIDS are well- documented, so avoiding these can help parents reduce the already-small risk: (1) smoking;10 baby sleeping prone;11 formula feeding;12 and baby sleeping unattended.13 (details below)
  • Suffocation is a more easily-preventable risk to babies than SIDS. The main risks for suffocation (entrapment) are putting the baby to sleep on a sofa with or without an adult,14 and/or a drunk/drugged adult sleeping with a baby on any surface.15 “Never bedshare” warnings don’t tell tired parents/mothers where they CAN safely feed their babies at night. A new infographic by La Leche League, “Safe Sleep Seven: Smart Steps to Safer Bedsharing,” lists seven steps that vastly reduce the major SIDS and smothering risks.
  • Prenatal smoking is very bad for babies and increases risk of SIDS at least five-fold. Smoking is a significant hazard to babies if the mother smokes during pregnancy, and smoking in the household (and everywhere) continues to be a risk to the baby after the baby is born. Smokers exhale carbon monoxide for many hours after each cigarette,16 and secondhand smoke is harmful to babies.17 Smoking is a well-known risk to adults, too.
  • Every health authority in the world recommends exclusive breastfeeding for the first six months starting in the first hours after giving birth, then continued breastfeeding while adding family foods till the child is at least two years old.18 Formula-fed babies are less arousable from sleep than breastfed babies;19 have more than double the risk of (SIDS);12 and have many other health problems.20 If families need help with breastfeeding, contact WomensHealth.gov or La Leche League International or the federal government Women, Infants and Children program (WIC).
  • Unattended babies (sleeping out of sight and sound of a competent adult) are at higher risk of SIDS and entrapment/smothering accidents. People are better monitors than electronic devices. Babies should always sleep face-up, in a safe container, and within sight and sound of a competent adult for all sleeps, naps and nights – unless they are safely tied on someone’s body or safely in someone’s arms or sleeping next to their sober, nonsmoking, breastfeeding mother on a safe surface. Baby should be lightly clothed (not overheated. One study reported swaddling as an independent risk factor for SIDS. 21).
  • Recommend that parents baby-proof the family bed, even if they think they won’t ever bedshare. Sleep happens, and exhaustion overrules common sense. No thick covers, no toys, no pets, firm clean flat mattress. Most breastfeeding mothers sleep with their babies at least part of the night, and breastfeeding mothers have the lowest rates of SIDS and other sleep-related accidents.12 Accidental bedsharing is riskier than planned bedsharing.22 A side-car attached to the bed can be a good option – baby is close enough for touching and feeding, yet separate enough to avoid rollovers and exhaled breath of smokers. A safe crib for the baby in the bedroom is safer than baby sleeping unattended in another room.
  • Adults should never lie down with a baby on a sofa or in a recliner, even “just for a minute” – the threat of suffocation, entrapment or dropping the baby is high especially when (not if) the adults falls asleep.23 If a sofa or recliner is the only option for sleep, the adult can lean back and tie the baby securely onto their chest with a scarf, shawl or soft carrier so their arms aren’t holding the baby when the adult dozes off.
  • Wearing a baby many hours a day in a soft-tie-on carrier or sling is a great way for everyone to nap, and helps baby’s motor development besides. Baby’s face should be fully visible and her head should be close enough to kiss. This babywearing guide has information on how to safely wear an infant.

The 4 big questions

1. When will the baby sleep through (longer) the night?

Probably not for many months. Welcome to parenthood! (Sorry, biology rules!)

Babies are growing faster in the early months than they ever will, and need food and comfort very often for normal physical, emotional, and psychological development. A famous scientist described the first 9 months of a baby’s “outside” life as the period of “external gestation.24” The best way to get enough sleep is for parents to plan to safely bedshare with their breastfed baby, and take naps with the baby. (see the Safe Sleep Seven and “Sweet Sleep25 for more information.)

Beware of “sleep training” programs, books and advice, which have a long sad history.26 New strong evidence of baby’s biological and emotional needs suggests that babies remain highly stressed even when the parents think sleep training “worked,” with serious long-term negative consequences for the baby. Babies cry because they need to be touched held, fed, rocked, and nurtured, and simply cannot meet their own needs for any of those comforts.

2. When will the mom sleep like she did before she got pregnant?

The research definition of “sleeping through the night” range is inconsistent and arbitrary.27 Parents can make up any definition they want when quizzed about the baby “sleeping through.” A useful (and vague) response: “Of course the baby is a good sleeper.”

3. Will parents ever have sex again?

Beds aren’t the only places where sex can happen.

4. Will parents ever get the baby out of their bed?

Babies who bedshare get their emotional needs met sooner and more fully than those who sleep separately.28 All babies are inconvenient for a while.

Where can parents get more information?

What do you talk about with families in order to prepare them for parenting a newborn? How do you find the balance between providing accurate information and not “frightening” them with the realities of newborn sleep patterns. Have you read this new book? Would you recommend this book to families who are desiring more information about how to provide a safe sleep environment for their breastfeeding newborn? – SM

References

1. Montgomery-Downs HE, Stremler R, Insan SP. Postpartum Sleep in New Mothers and Fathers. Open Sleep Journal. 2013;6(Suppl 1: M11):87-97.
2. Doan T, Gay CL, Kennedy HP, Newman J, Lee KA. Nighttime Breastfeeding Behavior Is Associated with More Nocturnal Sleep among First-Time Mothers at One Month Postpartum. J Clin Sleep Med. 2014;10(3):313-319.
3. Doan T, Gardiner A, Gay CL, Lee KA. Breast-feeding Increases Sleep Duration of New Parents. J Perinat Neonatal Nurs. Jul-Sep 2007;21(3):200-206.
4. Bergman NJ. Neonatal stomach volume and physiology suggest feeding at 1-h intervals. Acta Paediatr. May 10 2013.
5. Rivkees SA. Emergence and influences of circadian rhythmicity in infants. Clin Perinatol. Jun 2004;31(2):217-228, v-vi.
6. Feldman R, Rosenthal Z, Eidelman AI. Maternal-Preterm Skin-to-Skin Contact Enhances Child Physiologic Organization and Cognitive Control Across the First 10 Years of Life. Biol Psychiatry. Jan 1 2014;75(1):56-64.
7. Feldman R, Singer M, Zagoory O. Touch attenuates infants’ physiological reactivity to stress. Dev Sci. Mar 2010;13(2):271-278.
8. Hofer MA. Psychobiological Roots of Early Attachment. Current Directions in Psychological Science. April 1, 2006 2006;15(2):84-88.
9. Ward TC. Reasons for Mother-Infant Bed-Sharing: A Systematic Narrative Synthesis of the Literature and Implications for Future Research. Matern Child Health J. Jul 2 2014.
10. Zhang K, Wang X. Maternal smoking and increased risk of sudden infant death syndrome: a meta-analysis. Leg Med (Tokyo). May 2013;15(3):115-121.
11. Dwyer T, Ponsonby AL. Sudden infant death syndrome and prone sleeping position. Ann Epidemiol. Apr 2009;19(4):245-249.
12. Hauck FR, Thompson JMD, Tanabe KO, Moon RY, Vennemann MM. Breastfeeding and Reduced Risk of Sudden Infant Death Syndrome: A Meta-analysis. Pediatrics. June 13, 2011 2011.
13. Moon RY, Fu L. Sudden infant death syndrome: an update. Pediatr Rev. Jul 2012;33(7):314-320.
14. Blair PS, Sidebotham P, Evason-Coombe C, Edmonds M, Heckstall-Smith EM, Fleming P. Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. Bmj. 2009;339:b3666.
15. Ball HL, Moya E, Fairley L, Westman J, Oddie S, Wright J. Bed- and sofa-sharing practices in a UK biethnic population. Pediatrics. Mar 2012;129(3):e673-681.
16. van der Vaart H, Postma DS, Timens W, et al. Acute effects of cigarette smoking on inflammation in healthy intermittent smokers. Respir Res. 2005;6:22.
17. Tong EK, England L, Glantz SA. Changing Conclusions on Secondhand Smoke in a Sudden Infant Death Syndrome Review Funded by the Tobacco Industry. Pediatrics. March 1, 2005 2005;115(3):e356-366.
18. American Academy of Pediatrics. Breastfeeding and the Use of Human Milk. Pediatrics. March 1, 2012 2012;129(3):e827-e841.
19. Mosko S, Richard C, McKenna J. Infant arousals during mother-infant bed sharing: implications for infant sleep and sudden infant death syndrome research. Pediatrics. Nov 1997;100(5):841-849.
20. US Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding. Washington, DC: US Department of Health and Human Services, Office of the Surgeon General,; 2011.
21. Richardson HL, Walker AM, R SCH. Influence of Swaddling Experience on Spontaneous Arousal Patterns and Autonomic Control in Sleeping Infants. J Pediatr. Mar 12 2010.
22. Volpe LE, Ball HL, McKenna JJ. Nighttime parenting strategies and Sleep-related risks to infants. Social Science & Medicine. 2012(0).
23. Kendall-Tackett K, Cong Z, Hale T. Mother–Infant Sleep Locations and Nighttime Feeding Behavior: U.S. Data from the Survey of Mothers’ Sleep and Fatigue. Clinical Lactation. 2010;1(Fall 2010):27-31.
24. Montagu A. Touching: the Human Significance of the Skin. Third ed. New York: Harper & Row; 1986.
25. La Leche League International, Wiessinger D, West D, Smith LJ, Pittman T. Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family. New York: Random House – Ballantine Books; 2014.
26. Middlemiss W, Granger DA, Goldberg WA, Nathans L. Asynchrony of mother–infant hypothalamic–pituitary–adrenal axis activity following extinction of infant crying responses induced during the transition to sleep. Early human development. 2012;88(4):227-232.
27. Adams SM, Jones DR, Esmail A, Mitchell EA. What affects the age of first sleeping through the night? J Paediatr Child Health. Mar 2004;40(3):96-101.
28. McKenna JJ, Mosko SS. Sleep and arousal, synchrony and independence, among mothers and infants sleeping apart and together (same bed): an experiment in evolutionary medicine. Acta Paediatr Suppl. Jun 1994;397:94-102.

About Linda J. Smith, MPH, IBCLC, LCCE, FACCE

© Linda J. Smith

© Linda J. Smith

Linda J. Smith, MPH, IBCLC, LCCE, FACCE, is a lactation consultant, childbirth educator, author, and internationally-known consultant on breastfeeding and birthing issues. Linda is ILCA‘s liaison to the World Health Organization’s Baby Friendly Hospital Initiative and consultant to INFACT Canada/IBFAN North America. As a La Leche League Leader and Lamaze-certified Childbirth Educator, she provided education and clinical support to diverse families over 40 years in 9 cities in the USA and Canada. Linda has worked in a 3-hospital system in Texas, a public health agency in Virginia, and served as Breastfeeding coordinator for the Ohio Department of Health. Linda was a founder of IBLCE, founder and past board member of ILCA, and is a delegate to the United States Breastfeeding Committee from the American Breastfeeding Institute. Linda holds a Masters Degree in Public Health and is currently an Adjunct Instructor at the Boonshoft School of Medicine at Wright State University in Dayton, Ohio. She owns the Bright Future Lactation Resource Centre, on the Internet at www.BFLRC.com.

Babies, Breastfeeding, Childbirth Education, Guest Posts, Infant Attachment, Newborns, Parenting an Infant , , , , ,