Tuesday, April 28, 2015

Sleep and Babies

I get a lot of questions about sleep. Moms often ask, "How can I get my baby to sleep longer." First an foremost, there are no majic answers. I have no majic bullet solution. However, after doing some research, this is the best set of advice I can pass on to moms. I'd highly recommend Elizabeth Pantley's book, The No Cry Sleep Solution, available here.  Much of the advice I will pass on below comes from her book. Some comes from my own expereince with my 2 girls, as they grew up.
  1. Make sure baby is nursing/eating as often as possible during the day. Feed on demand is the bottom line. Be generous in offering time at the breast, if breastfeeding. The fuller baby is during the day, the better they will stretch out sleep at night. When your baby clusterfeeds in the afternoon and nurses every 45 minutes to an hour, they are ramping up to a longer set of sleep at night. Let them nurse when they are hungry.
  2. Establish a good night time routine and stick with it.  This becomes important as baby is about at that 3-5 months old. Now is a good time to start routines that will last well into childhood. We got to a point where we wrote it down and followed it religeously. You can tweak this as needed, but here's a sampling:
    1) start early... many times parents put baby down way too late. We always started bedtime routine at about 6pm and had baby down by 6:30 or 7pm. If you keep baby up later than their body needs, they get overtired and often fight it. EARLIER IS DEFINITELY BETTER.
    **turn down lights, turn off tv, quiet the household
    2) Bath
    3) Wash/brush gums/teeth
    4) books
    5) Last nursing
    6) rock/cuddle with music - wait until baby is in deep sleep, eye movement is done, when you lift an arm, it falls back limp and does not stir baby awake
    7) lay down to sleep

    This is a sample. Add in or take away things as needed. But notice, the rocking or cuddling after can get baby relaxed without boob in the mouth. As our kids got older, we'd add in an opoprutnity for bathroom, drink/snack before teeth brushing.
  3. Put baby to bed at the same time each night, without fail, no exceptions. We should ALL do this to improve our sleeping. Same time to bed solidify's the body's internal clock for sleep and wake times.
  4. Have Dad (or other care provider) put baby down at night after the last nursing. This became helpful for us. Be patient. It may mean you taking a walk while this is happening. It will allow baby to relax without needing to be attached to your breast.
  5. Employ music or other auditory cues when winding down to sleep. We used the same CD each night and I think it helped as a auditory cue for sleep. Think pavlov's dogs.
  6. Calm the household and shut down other media 1/2 hour to an hour before bed.  I'm preaching to myself too. I think we would all sleep better if we shut off electronic devices about 1/2 hour to an hour before bed. I do not follow this. I also do not sleep well. A friend was telling me she started removing electronics from her bedroom, tv, phone, computer, and it has helped her sleep. This might be a good thing to try. I think our kids feed off of our energy. If we are 'wired' they are 'wired'. If we are stressed, they are stressed. Maybe a media break beofe bed would help the household sleep better.
  7. READ, READ, READ.  We know how good it is to read to children in their early childhood. It is so important and positive in brain development and reading-skill development. It also helps with sleep. Reading from real books (not tablets) helps wind down the brain. It gives the brain a focal point. Make sure books are part of your bedtime routine. It's good for sleep and intellectual/brain development.
  8. Make sure baby is napping enough during the day. Establish napping routines as you have done with nightime routines. Full disclosure, we were failures at this. But in an 'ideal' world, you'd establish regular and predictable napping opporunities. These can be approximate nap times, but based on what baby is doing at the time. At 4/5 months, baby usually has 2-3 morning/afternoon naps. By about 1 year to 18 months, that switches to one afternoon nap. Have a napping routine, similar to the nightime routine. For a couple of days, record sleep patterns. Try to encourrage sleep when they are regularly sleepy with that nap routine/ritual. My kids always napped with me, 9 times out of 10, which is generally not encourraged, but do what works for you. I know moms who were religious about naps and routines, and they had good nappers. Same concept, set up a good and structured, predictable routine, the body responds. Being rested during the day helps. If they are overtired at night, it is harder to relax into sleep, which is counterintuitive, but a well supported piece of evidence in sleep studies. Sleep, play, nap is often a repeated pattern several times throughout the day.
  9. Understand a normal baby's sleep patterns. This is from Elizabeth Pantly's book, The No Cry Sleep Solution. It goes to show how often baby naturally wakes at night:

    Typical sleep cycling of a baby:
    Drowsy, falling asleep
    Light Sleep
    Deep sleep (for about an hour)
    Brief awakening

    Deep sleep, for about 1-2 hours
    Light sleep
    Brief awakening

    REM (Rapid Eye Movement): dreaming sleep
    Brief awakening

    Light sleep
    Brief awakening

    REM sleep: dreaming sleep
    Brief awakening

    Toward morning, another period of deep sleep
    Brief awakening

    REM: dreaming sleep
    Brief awakening

    Light sleep
    Awake for the day
    The takehome message with this is, it is NORMAL for baby to wake during the night. We all do. Taking away some sleep associations is helpful (i.e. always nursing back to sleep, esepcially if cosleeping is not practiced). Putting baby to sleep when you can sleepy, but not fully asleep can help. If baby heavily resists this, you need to either try another option... wait till baby is in a deep sleep to transfer them. Or, you can try putting them down and rubbing their back a bit to get them to ease back to sleep. Honestly, it's a little bit of trial and error to see what works best. There is no one majic-bullet answer.
  10. It's the total amount of sleep that matters. Understand what your baby needs based on their development.  Finally, this is from Elizabeth Pantley's book-- a list of 'average sleep hours' for different ages. Take this with a grain of salt. Babies will differ from each other. But I've heard many an expert say babies need about the same total hours of sleep a day, they just break it up into chunks based on their body's needs. Use this as a guide:

    1 month, 3 naps, 6-7 hrs of total nap time, 8 1/2-10 hrs of night sleep, 15-16 hours of total sleep per day

    3 months, 3 naps, 5-6 hrs of total nap time, 10-11 hrs of night sleep, 15 hrs of total sleep per day.

    6 months, 2 naps, 3-4 hrs of total nap time, 10-11 hrs of night sleep, 14-15 hrs of total sleep per day.

    9 months, 2 naps, 2 1/2-4 hrs of total nap time, 11-12 hrs of nightime sleep, 14 hrs of total sleep per day

    12 months, 1-2 naps, 2-3 hrs of total nap time, 11 1/2 -12 hrs of nightime sleep, 13-14 hrs of total sleep.

    2 yrs, 1 nap, 1-2 hrs of naptime, 11-12 hrs of night sleep, 13 hrs of total sleep per day

    3 yrs, 1 nap, 1-1 1/2 hrs of naptime, 11 hrs of night sleep, 12 hrs of total sleep per day

    4 yrs, 0 naps, 0 naptime hrs, 11 1/2 hrs of night sleep, 11 1/2 hrs of total sleep per day

    5 yrs, 0 naps, 0 naptime hrs, 11 hrs of night sleep, 11 hrs of total sleep per day.

Tuesday, October 7, 2014

Ways to Support A Breastfeeding Mother

October Health Focus: Breastfeeding For the month of October, I’ve been invited to share information about breastfeeding as the health focus for the month. Since January 2011, I’ve been serving as Breastfeeding Peer Counselor for the Door County Public Health Department and Door County WIC. I’m happy to share with you some information that might be helpful, weather you’re a new mom, aunt, uncle, or grandparent. Breastfeeding is such an important way to support the emotional and physical health of children, your role as breastfeeding parent or supporter of that relationship is critical. Heartfelt thanks to our church for allowing Door County Breastfeeding Support Group Meetings to be held in our nursery on the 1st Wednesday of the month at 10:30am and 3rd Wednesday of the month at 5:30pm. Please encourage breastfeeding moms to join us!

But I wasn’t breastfed or didn’t breastfeed my children…
I breastfed both of my girls, but was not breastfed myself. Many of you may not have breastfed your children. This is common. breastfeeding was normative in our culture up until the 1940s and 50s. Since the late 1800s cows milk substitutes for human milk were used and often prescribed by doctors. By the late 1920s, soy-based formulas were developed. Advancements in food technology made these substitutes seem safe. Gradually, breastfeeding took a backseat to formula feeding as the common way to feed infants. People saw it as the ‘high-tech & advanced’ way to feed their children. In fact, older friends have told me that their doctors said it was ‘safer’ than breast milk. After the depression, many thought of breastfeeding as a sub-standard way of feeding, and even negatively associated it with being poor. Breastfeeding rates steadily declined until the 1970s.

As the medical community has been able to do more research, we’ve learned the error of our ways. Research has shown that breastfeeding is in fact the safest and healthiest way to feed our children, offering many positive health benefits. Breastfed children experience lower rates of cancer, obesity, and diabetes throughout life. A mother breastfeeding her children will enjoy lower rates of breast and ovarian cancers throughout her life. The longer the breastfeeding relationship, the greater the benefit to mother and child. The World Health Organization (WHO) estimates 11-13% of all deaths in children under 5 years of age could be prevented if they were exclusively breastfed for 6 months. Another 6% of deaths under-5 could be prevented with adequate, safe, and timely complimentary feeding. Infants who are not breastfed have a seven-times and five-times higher risk of dying from diarrhea and pneumonia respectively, compared with infants who are exclusively breastfed. Nothing can mimic or replace the complex and living components of breastmilk, which support the health and development of children.

Your support is important…
So, if you didn’t breastfeed your children, don’t feel bad about it, but do help the next generation breastfeed successfully. We now know better, so let’s do better!! You can support a mother breastfeeding in the following ways: 1) Encourage a mom to feed her baby whenever the baby is hungry. 2) Encourage a mom to feed her baby when and where she is comfortable. 3) Refrain from making negative comments about breastfeeding or her milk supply. Rather, encourage her to get help from a lactation nurse or breastfeeding specialist if she’s having problems. 4) Help a new mom with tasks other than feeding, like bathing baby, cuddling with baby after feeding, doing a load of laundry, or taking the family a meal. The early months of breastfeeding can be intense. A little extra help during this time can go a long way. 5) Encourage a mom to breastfeed as long as she and her child feel comfortable. The current World Health Organization breastfeeding recommendations include exclusive breastfeeding for 6 months (no other food or formula), continuing breastfeeding with introduction of solids beyond 6 months up to 2 years or longer for as long as mother and child are comfortable.

Please look for more information on the health bulletin board for the month of October. Feel free to contact me with any questions: I love to talk about breastfeeding!! ~Teri VanLieshout home 920-746-0047; email: vanlieshout (at) att (dot) net.

Tuesday, February 11, 2014

Pain During Nursing

Many women do experience pain at some point during their nursing journey. Breastfeeding educators usually tell moms that there shouldn't be pain during nursing if the latch is right, which is generally true. However pain does often crop up. Generally speaking, if there is pain during nursing, it's one of a handfull of things MOST OF THE TIME. But there are always exceptions to the rule. Below is an explanation of common causes of pain and some links to articles I trust:
  1. Poor Latch:
    OFTEN in the early weeks of nursing, getting a good latch can be difficult. I'd say that more often than not, this is the cause of MOST pain during nursing and is MOST OFTEN the cause of nipple damage. Usually the problem is that baby doesn't get enough breast in the mouth, making him pinch the tip of the nipple while he is nursing. This can be the cause of cracked & bleeding nipples.  I tell moms to sandwich the nipple between the thumb and forefinger, tickle baby's nose with the tip of the nipple (he wil naturally open up wide as a response), and SHOVE that sandwich in baby's mouth as far in as it will go, aiming the tip of the nipple to the roof of the mouth. There are other techniques described in the links below. You need a good amount of breast in the mouth to get baby to latch well. Try this. Latch does get better with time. Keep correcting it if there is pain. As baby's mouth grows and baby's muscle control gets better in the first weeks and months, latch becomes less and less of an issue. It's hardest in the begining. Hang in there. Get help from a lactation consultant or lactation educator. Know that this can be solved with help and with time!!

    Here are some articles with pictures showing a good latch:

    Link to PDF on latch from La Leche League:

    Great article with good illustrations and other links from KellyMom.com
  2. Yeast or Thrush:
    So, if your latch is good, another pesky problem can be yeast. Yeast is a fungus that is found in the birth canal (vagina) and can be transfered to baby during birth. Yeast also lives on surfaces all around our environment and can find its way into baby's mouth or your nipple in many other ways. If you have a yeast infection (also called thrush) in your nipple it can be very painful, often causing a burning sensation that radiates through the breast during nursing. If you are experiencing burning pain in one or both breasts, GO SEE YOUR HEALTH CARE PROVIDER SOONER RATHER THAN LATER. They can perscribe an antifungal treatment (oral or topical) to get rid of the yeast. See a doctor and they can make the proper evaluation.

    Link to article on yeast/thrush from La Leche League:

    Link to a compilation of great resources on yeast/thrush from KellyMom.com
  3. Mastitis:
    If latch is good, and it's not yeast, pain during nursing can often be caused by mastitis. Mastitis is a bacterial infection of the breast. Moms who have mastitis can have pain in one or both breasts. They often have symptems of feeling 'run down', which is hard to pinpoint being a new mom. But it's more than just being exhausted from motherhood, it's feeling like you've got a bug of some sort. Moms often will run a fever. If you have general illness sympoms along with breast pain, SEE YOUR HEALTH CARE PROVIDER SOONER RATHER THAN LATER. A doctor or other health practitioner needs to diagnose mastitis and then can perscribe an antibiotic.

    Link to article on mastitis & plugged ducts from La Leche League:

    Link to artile on mastitis and plugged ducts from KellyMom.com:
  4. Plugged Ducts:
    Something that can preceed mastitis or occur independently is a plugged duct. This happens when the tubes that carry your milk out through the nipple get blocked from some dried or thickened milk. This can cause lumps in the breast as well as pain. Sometimes you'll see a white dot on the nipple, called a bleb, that is evidence of a plugged duct right at the tip of the nipple.  The articles under mastitis also deal with plugged ducts. I'll include some articles below that deal specifically with plugged ducts:

    A mom's story about plugged ducts from La Leche League:

    Solutions to dealing with plugged ducts from La Leche League:

    An article about using lecithin (a supplement) that can help with plugged ducts
    from KellyMom.com
  5. Vasospasm or Ranaud's Syndrome:
    This is more rare, but I have heard a few moms talk about it. Sometimes there is a spasm of the blood vessles in the breast and nipple that carry blood away from it. It can cause pain during or after nursing. It is often accompanied with blanching of the nipple. Experts say that blanching is USUALLY caused by a poor latch, but that said, it can be this.

    An article about nipple blanching and vasospasm in the nipples from KellyMom.com:

    A wiki article on Ranauld's Phenomenon:

    La Leche League didn't have a whole article, but this blurb within an article:
    Vasospasm of the nipple (Raynaud’s phenomenon) has been reported. This may manifest as blanching and pain of the nipple, either spontaneously or after nursing. This may or may not be associated with other manifestations of Raynaud’s phenomenon or rheumatologic disease. Avoiding nipple trauma and keeping the nipple warm can prevent some of the occurrences. Calcium channel blockers may be used in severe cases.https://www.llli.org/ba/may01.html
  6. Other causes of nipple pain:
    Above are the biggies--the most common sources of pain while nursing. If it's not any of those, it will take some evaluation from a lactation consultant and/or doctor. Get help from a professional!! I'll include some links to articles about pain while nursing and solutions for soothing irrititated nipples. Hopefully with time and some professional help, you can get things feeling better soon!!

    "Nipple Pain: Causes, Treatments and Remedies" from La Leche League:

    "Healing Tips for Nipple Cracks or Abbrasions" from KellyMom.com

    "Why are my nipples sore after months of pain-free nursing" from KellyMom.com

    An Article About Tongue Tie--possible cause that needs to be evaluated by a health care practitioner:

    Where to get help from a professional Lactation Consultant/Educator in and around Door County, WI:

    I hope this helps!!!!

Friday, July 19, 2013

Door County Breastfeeding Support Group

Check out our other pages:

Website/blogsite for Door County Breastfeeding Support Group
                        with meeting dates, times, and topics.

Facebook Page for Door County Breastfeeding Support Group
                       this is a closed group... ask to join.

Tuesday, June 18, 2013

Door County Breastfeeding Support Group Meetings

Door County Breastfeeding Support Meetings
Description:  Moms meet together with infants and older children.  Snack provided. We talk about any breastfeeding issues that we are dealing with at the time, as well as other issues in our family. It is an opportunity to give and receive support, get to know other breastfeeding moms, bounce ideas off of each other. Together we support each other on the journey of parenting and breastfeeding our children.

More information can be found at:  http://doorcountylatch.blogspot.com/

Location:  Meetings are held at the United Methodist Church of Sturgeon Bay
836 Michigan Street; Sturgeon Bay, WI  54235
*The church with the big cross and flame on Michigan Street

Call Teri if you have questions
cell - 920-493-2577
home - 920-746-0047

Meets 2 times per month in Sturgeon Bay, Year Round:
Meets 1st Wednesday of the month 10:30am
Meets 3rd Wednesday of the month 5:00pm

Upcoming Dates:
June 19, 2013, 5pm

July 3, 2013, 10:30am
July 17, 2013, 5pm

August 7, 2013, 10:30am **World Breastfeeding Week Celebration
August 21, 2013, 5pm

September 4, 2013, 10:30am
September 18, 2013, 5pm

October 2, 2013, 10:30am
October 16, 2013, 5pm

November 6, 2013, 10:30am
November 20, 2013, 5pm

December 4, 2013, 10:30am
December 18, 2013, 5pm

January 8, 2013 (changed from 1st, due to holiday), 10:30am
January 22, 2013 (changed from 15th, due to holiday on the 1st), 5pm

Tuesday, January 31, 2012

Door County Breastfeeding Support Network 2012

Door County Breastfeeding Support Network
Fall 2012 Meeting Dates

held at the United Methodist Church of Sturgeon Bay
836 Michigan Street; Sturgeon Bay, WI 54235


Meets on the first Wednesday of the month year round. The following are upcoming meeting dates in 2012:

October 3 - Breastfeeding & pumping
November 7 - Nutrition & breastfeeding
December 5 - Sleep & breastfeeding

Call Teri if you have questions
cell - 920-493-2577
home - 920-746-0047

Thursday, December 1, 2011

Some Links on various topics

A mom-friend of mine was asking about what to say to a mother who was not interested in nursing. Sometimes when a person is resistant to the idea of nursing, it's hard to break through that barrier. The mom in question was expecting twins. So, I compiled a list of links with good information. I thought these were good enough to pass on.

All but one of these articles originates from La Leche League, my first go-to source for questions:

Here's a link about BF after a Cesarean birth:

An extensive article on colostrum:

The science of breastmilk as it compares to formula:

Breastfeeding and work, showing the business case for breastfeeding, that nursing is actually good for the employer, too:

This is a great article written from a nursing mama  who is also  a practicing lawyer. It covers nursing on demand and folowing mother's instincts and baby's cues. After her article there is a note from her husband about what he went through in his evolution as a father:

An article about breastfeeding twins:

Resource page on nursing multiples from LLL: