How to get 2x the milk from breast pumping!

I am sharing a great video from Stanford on how to get almost 2x the milk from pumping for premature babies and moms immediately returning to work outside the home. Of course only nursing (no bottles) is the best way to have a good supply of breastmilk as the baby can eat on demand and his or her suction is the best type for draining and stimulating more milk. Pumping is not as great at getting milk out. New moms who try to pump when their babies are very small find that little or no milk comes out. These moms should try to keep the baby on the breast as much as possible. If the baby is premature or she is already returning to work outside the home, here is a great "hands-on" method to use your hands and pump simultaneously to maximize output. If output does not increase a Lactation Consultant should be privately hired (pediatricians and OBGYNs are not specialized in milk production).

http://newborns.stanford.edu/Breastfeeding/MaxProduction.html

A FREE Double Breast-pump and My New Facebook Page

GIVEAWAY ALERT!

You, my readers, have given me so much support!  So much so that I am going to the next level and I am thanking you for it. I set up a Facebook Page and if you LIKE it by December 20th, I will enter you to win a FREE brand new double breast-pump: The First Years Breastflow Memory Pump valued at $179.99.

Do you just want to support me and don't need a pump? No problem. You can pass on the pump or have it shipped anywhere: a friend, a relative or a women's shelter.

I had the opportunity to try this pump and it turned the head of every woman in the pumping room. The entire ensemble is incredibly light weight which was great for lugging around all day at the conference that I was at. The handle allowed for me to easily pump one handed. It's battery is rechargeable and was able to hold enough charge for me to go all day without plugging in although I had the light-weight plug in my bag just in case. It makes a great travel pump.

The First Years® Breastflow® Memory Pump is designed to make breastfeeding more comfortable and efficient. It features an easy-to-use digital touch screen that automatically tracks and stores data for up to 10 sessions, automatically recording important information including the date and time, suction and speed. For a complete profile, mom can enter milk volume for each session. Plus, the unique handle allows double pumpingwith one hand. Breastflow Memory Pump comes with a custom designed tote bag, plus a cooler bag with removable ice pack, two 5oz. Breastflow bottles with storage lids, 2 sizes of Flexi-fit™ breast shields and a rechargeable battery pack for ultimate portability. MSRP: $179.99, in Target stores nationwide


Win it by liking my Facebook Page.

How to Guarantee that your Baby will have a Higher I.Q.

As parents we all want to see our children reach their highest potential. We know that we cannot protect them from every danger, toxin, and heartache. We all want to make the decisions that will have the best long term outcome on our children.

Some moms and dads have known the secret to a higher I.Q. for thousands of years. Yet it comes as a news-breaker in papers such as the NYTimes when JAMA Pediatrics, a major mainstream medical journal, publishes a study about it. The World Health Organization recommends doing this for at least 2 years. The American Academy of Pediatrics recommends doing it for at least 1 year. 

Breastfeeding 1+ years WILL increase your child's I.Q.

(for those who have already chosen the formula path, have adopted, or have serious medical issues I am in the process of writing a post on how to pick the healthiest formula so check back and don't feel left out!)

Below is the latest study including the results and conclusion (the important part). The outcome has taken into account factors such as socio-economics and parents education level. They are looking at exclusive breastfeeding (no formula/bottles) compared to just formula feeding for the first six months followed by then breastmilk and solids. If you need another reference, the World Health Organization already found the relationship between exclusive breastfeeding and higher I.Q. (and as adults are less likely to be overweight or diabetic).



Infant Feeding and Childhood Cognition at Ages 3 and 7 Years: Effects of Breastfeeding Duration and Exclusivity.
JAMA Pediatr. 2013 Jul 29. doi: 10.1001/jamapediatrics.2013.455.
Belfort MB, Rifas-Shiman SL, Kleinman KP, Guthrie LB, Bellinger DC, Taveras EM, Gillman MW, Oken E.Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

IMPORTANCE Breastfeeding may benefit child cognitive development, but few studies have quantified breastfeeding duration or exclusivity, nor has any study to date examined the role of maternal diet during lactation on child cognition. 

OBJECTIVES To examine relationships of breastfeeding duration and exclusivity with child cognition at ages 3 and 7 years and to evaluate the extent to which maternal fish intake during lactation modifies associations of infant feeding with later cognition. 

DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study (Project Viva), a US prebirth cohort that enrolled mothers from April 22, 1999, to July 31, 2002, and followed up children to age 7 years, including 1312 Project Viva mothers and children. MAIN EXPOSURE Duration of any breastfeeding to age 12 months. 

MAIN OUTCOMES AND MEASURES Child receptive language assessed with the Peabody Picture Vocabulary Test at age 3 years, Wide Range Assessment of Visual Motor Abilities at ages 3 and 7 years, and Kaufman Brief Intelligence Test and Wide Range Assessment of Memory and Learning at age 7 years. 

RESULTS Adjusting for sociodemographics, maternal intelligence, and home environment in linear regression, longer breastfeeding duration was associated with higher Peabody Picture Vocabulary Test score at age 3 years (0.21; 95% CI, 0.03-0.38 points per month breastfed) and with higher intelligence on the Kaufman Brief Intelligence Test at age 7 years (0.35; 0.16-0.53 verbal points per month breastfed; and 0.29; 0.05-0.54 nonverbal points per month breastfed). Breastfeeding duration was not associated with Wide Range Assessment of Memory and Learning scores. Beneficial effects of breastfeeding on the Wide Range Assessment of Visual Motor Abilities at age 3 years seemed greater for women who consumed 2 or more servings of fish per week (0.24; 0.00-0.47 points per month breastfed) compared with less than 2 servings of fish per week (-0.01; -0.22 to 0.20 points per month breastfed) (P = .16 for interaction). 

CONCLUSIONS AND RELEVANCE Our results support a causal relationship of breastfeeding duration with receptive language and verbal and nonverbal intelligence later in life.

Related Posts:

Why Breastfeed? - Includes 10 steps to successful breastfeeding

Pumping at Work - It is the law!

Breastfeeding in Public - So much easier than dealing with bottles.

Parenting School 101 - Includes a great breastfeeding book to read!

Nursing Tea Recipe - One recipe for pregnancy, postpartum, and to increase milk supply.

The Birth of Baby #3

Not a Pre-Planned Birth

During this blogging experiment, I have been planning and awaiting the arrival of Baby #3. She was due 8/24/12. Like my other babies, that due date came and past. My other two births were pushed along before my body went into labor. For this birth, I was worried that my husband would not be able to make it from work in time. My last labor was only 3 hours and I was thankful that we lived near my husband's work. Now we are in the suburbs and my hospital was even further away (a two hour trip from his office to the hospital). I could use a closer hospital but there is nothing closer that has midwives. So I tried to "plan" the birth! The day before my due date, my husband took the day off and went to my midwife appointment with me. We hoped that she would strip my membranes and send me into labor. Unfortunately the baby was not low enough yet and she worried that the cord could get in the way. So instead we had a "date" and went out to lunch and for a 3 mile hike in a nearby national park. We decided that we would just wait for the baby to be ready and run to the hospital as soon as labor started.

The Birth Story of Baby #3

The three days leading up to my labor, I felt different. I felt the need to sit down for no particular reason. My body does not tell me when I am in early labor so this might have been early labor for me. On the night of 8/30/12, I was mentally ready for the baby to come. I had done several tricks to relax my cervix and my husband was going to be working from home the following day (the eve of Labor Day weekend). It seemed like the perfect timing for the baby to make her arrival. It was almost midnight and I started to have a lot of back pain with a lot of downward pressure. When I stood up, I felt the baby drop so low that she felt like she completely opened my cervix and was between my legs. The back pains were very uncomfortable and I was exhausted from the day. All I wanted to do was go to sleep. I realized that the most intense back pains were coming every 10 minutes thus my labor had started. This baby, like my others was posterior so I get excruciating back pains (plus those regular contractions but who cares about those when my back was being stabbed!). I decided to try to talk myself out of the labor so I could get a little sleep and feel more rested.  I could not lay down because the baby was between my legs and it was extremely uncomfortable.  So I propped myself up on pillows and slept sitting up in bed. I woke up four hours later and was no longer in labor.  Labor restarted at 9am when I was getting ready for my 10am midwife appointment.

On the way to my 41 week midwife appointment, I realized that I was in labor but my contractions were only 10 minutes apart so I thought that I had plenty of time. At the appointment, I felt constant back pain and the need to do small hip rolls although the strongest contractions were still 10 minutes apart. My mom and daughters were in the exam room with me and the kids completely sensed my labor and fought the whole time (after 9 months of them being perfect at my appointments).  I had to send my mom out of the room bribing them with lollipops.  Yes, I knew I was in labor because my kids drove me crazy! My midwife checked me and I was 6 centimeters dilated!  She looked at me in confusion and surprise because I was not in the "heavy labor" that most women would be in at 6 centimeters. I must have been having mini-contractions that were just causing back pain between the larger contractions. At this point, I knew that it was time to head to the hospital that was luckily only five minutes away.

At the hospital, while waiting a few minutes for my room to get ready, I entered active labor so my husband and I did our slow dancing routine during contractions. Slow dancing with him makes my body feel fabulous through contractions and we both love how close we feel with each other. The first 20 minutes in the delivery room had to be spent hooked up to monitors according to hospital protocol. Of course this was not so fun in active labor but I was able to move around and rock my body through contractions. My husband massaged my back and pressed it with a warm pad to help ease the extreme back pain. My previous babies were also posterior so I experienced the same sharp back pains with contractions. This time the back pains did not subside between contractions. I remembered my NYC yoga instructor's advice to go right into the pain and hit it face on with deep exhales (Melissa Feldman -- I still love the Dark Vador exhale)! It is amazing how facing pain head on made my body really release natural pain killers. Or did it make me go into a trance? I don't know but it worked.

During the last contraction on the monitors, my body knew that it was time to move on and my exhale turned into an orgasmic song. The midwife joyfully announced "that's the baby" and I was thrilled to finally be allowed in the jacuzzi tub that I had been eyeing. As soon as I slipped into the tub and put my back against the jets, I was so at ease. All of my back pain went away and my body fully relaxed. I felt like I was on vacation (minus the pina colada and palm trees)! My body gave me a little break from contractions. When the contractions started again they seemed so mild in the water and the tub had taken away my back pain. My husband slipped into the tub behind me so I could use his knees to hold onto. In just a few minutes, my body felt like it was ready to push the baby out and I soon felt my body pushing so I pushed too and the baby came right out in one long push.

The baby, my husband and I enjoyed a beautiful couple minutes embracing each other skin to skin in the tub. I could not believe how great my body felt from being in the tub. When I got out of the tub, and rested with the baby on my chest, I was surprised to have no tares and a placenta that pushed itself out (this was a change from my past tares and pain pushing the placenta out).

Baby Katja Elizabeth was 8 pounds 7 ounces and 20.5 inches long, born posterior after a 3 hour labor! My baby was born loving to suck and insisted on sucking my breasts for her first 1.5 hours of life!

Looking Back

Baby Katja met her sisters a few hours after birth.

It is now a week later and I am still shocked how wonderful the water birth was and would recommend that every pregnant woman get herself a good MIDWIFE and a TUB!  My hospital was far more nurturing and had much warmer staff than I experienced with my NYC hospital births. I was glad that I did not do a home birth (which I wanted with birth #2) because I really needed the distance from my kids. After they would visit for 2 hours each day, I was ready for them to leave and to enjoy quiet time when my baby allowed it.

I am thankful for my body. Genetically I have an incredibly shaped pelvis that has allowed me to easily deliver three posterior babies that most women would require a c-section for. I am also thankful for keeping my body in shape while pregnant. Up until the end (and post due!) I was at yoga class, hiking in the forest, taking my older kids for outings and eating very healthy (especially avoiding sugar and processed foods). This allowed my body to labor nicely and for it to already be in good shape post-partum. All of that coconut oil that I rubbed on my tummy paid off because I still don't have any stretch marks.

Encapsulating my placenta again was a priceless idea. The day that I came home from the hospital, the idea of taking care of a newborn that requires so much time while my older kids were crying, demanding attention, etc. was a stressful thought. I knew that I would have my placenta pills in another day and told myself to save those thoughts until I had my pills. Indeed as soon as I started taking them, I felt so much more at easy with my mothering abilities. My own mother is here to entertain the older kids and keep the house afloat so the real test will be when she leaves us!

I am reminded again that every baby is different. This is the first of our babies that wants to co-sleep.  Katja and I did not sleep well in the hospital with all the interruptions and her wanting to suckle constantly. I even tried a pacifier and sent her to the nursery one night for someone else to hold a pacifier in her mouth so I could get two hours of straight sleep. As soon as we were home in our own bed, Katja was so happy to just sleep cuddled next to me. Last night she even went 6 hours between feedings!

I thank you all for following this blog and will now search for what I should do with the roughly written information that I have posted here.

Warmest regards,
Elizabeth

Yes I am cloth diapering this baby!

My method: a prefold diaper in a cover.
image: www.omahababystore.com

The main reason why I love cloth diapering is that I love knowing that my baby's diapers are not going to sit in the landfill! The way that I wash diapers once a week is ABSOLUTELY more environmentally sound than disposable diapers. Of course it is also nice to know that my little one's skin does not have the carcinogenic bleaches and chemicals rubbing against her sensitive genitals. Both of my kids were out of daytime diapers at 18 months and I attribute this to them "feeling" wet in their cotton cloth diapers (and some reading that I had done about early potty training).

Act I: The Diaper Service

When my first baby was born in our little NYC apartment (no washer/dryer), we used a diaper service for the first 6 months. It seemed nice because we didn't have to deal with the laundry or the up front investment of diapers. The diaper service only used the prefold style of diapers pictured above. Once a week I would put a plastic bag of dirty diapers outside my apartment door and the service would replace it with a plastic bag of clean diapers. Here is what I learned from the diaper service:

• It is okay for dirty diapers to sit a week in a plastic bag (websites everywhere tell you to wash them every 2-3 days).
• The heavy duty "prefolds" that the diaper service use are easy if you pre-fold them in the shape that you need.
• The covers are very easy to hand wash (since I didn't have a washer) or throw in the cold wash weekly.
• I loved 100% cotton was against my baby's skin. Other types of modern cloth diapers (like the "all in ones" and "inserts" are synthetic fleece).
• The diaper service was using bleach and I did not want that up against my baby.
• $20 per week is way too much money to pay for diapers. This is what I was paying so I entered Act II below.

Act II: G-Diapers

Friends had told me about "G-Diapers" that appeared to be like the prefolds that the diaper service was using except that instead of having to collect and wash the prefolded fabric, you would use and flush a pad that fit in the diaper cover. I had heard from experienced moms and read about how they work best once the child starts solid foods and has solid waste so we waited until the 6 month mark. This system was ingenious for us because our building had industrial toilets that could handle the load and it made diapering really easy. It also cost half the price of the diaper service and I didn't have to remember to put diapers out on a certain day. Then we went away for 2 weeks and used disposables and got a diaper rash that just would not easily go away. I was using un-natural creams with all sorts of chemicals that I did not want to be using. I realized that the best thing for my baby would be to have that nice 100% cotton of cloth diapering against her skin so we moved on to Act III below and ditched the diaper creams.

Act III: Cloth Diapering at the Laundromat

Since I loved the 100% cotton prefolds (instead of the synthetic modern fleece diapers), I stocked up a supply of prefolds and was shocked at how inexpensive they are! I quickly learned that you MUST buy the more expensive heavy duty laundry service quality prefolds. I used basic covers like the Prowraps and Thirsties. I let my diapers build up for a week in a plastic like at the diaper service then I took them to the laundromat (in the stroller with my other laundry while baby-wearing my baby). The machines were so big and hot that I never did any special rinses. Just a hot wash with half the detergent worked perfect and I never had to strip my diapers (like I do now that I have hard water in the suburbs; and I now have to do those rinse cycles!).

Why am I Cloth Diapering with Prefolds and Covers for a 3rd Time?

I love prefold diapers and I think that they are highly underrated in the modern cloth diapering world. The modern "all in one" and "insert" diapers are made of synthetic fabrics, take a long time to air dry, are expensive (about $18 each) and can only be used once per washing thus making it financially impossible to have a week's supply. Since you cannot have a huge supply, you are doing laundry every 2-3 days (which is what is recommended anyways). I have other things to do in life and want to do my diapers just once a week so prefolds are great for me. I reuse the covers until they are dirty then toss them in my regular cold wash laundry (although I hand washed them in the city to make my 3-4 covers last all week). After doing laundry, I fold the prefolds in thirds so they are ready to insert in a cover at diapering time. It is then just like putting panties and a pad on the baby; no diaper pins or clips are used in my house! When we have a babysitter, I put the prefold already in the diaper and they change the diaper just like a disposable. It is very easy! Everyone thinks that my diapers must smell. Breastfed only diapers do not smell. When babies start solids, the urine and bowels do start to smell but you flush the bowel down the drain and a good diaper pail will keep the odors out.

Edited to add:
There are details on how to wash and fold prefold diapers now on my blog! They are still my favorite!

Parenting School 101

We all spent years and years in school to essentially learn how to survive in the real world.  Many people went to specialized schools or universities to get an even more specialized education.  Most of us did not learn a thing about raising children and how they develop.  When I was first pregnant, I was overwhelmed with the fact that I knew nothing about raising kids or changing diapers. 

There is a lot that parents SHOULD know before they bring the baby home from the hospital. Yes there are 45 minute parenting workshops at the hospital but they tell you little more than how to change a diaper, bathe the child, and not hit or shake your child. You may have family that are willing to help and be a wealth of information but I highly suggest reading books on different methods and determine what YOUR parenting style will be.  If you don't educate yourself then you are blindly sending your child down a path that molds their future.

These are the books that I found very helpful to reference before giving birth:

• The Happiest Baby on the Block - How to sooth a fussy baby. If you have a baby with colic, do more research because these babies benefit from seek dietary restrictions for at least 1 week -- dairy (most common cause of colic), eggs, soy and gluten are a good first step.
• The Sleep Lady's Good Night, Sleep Tight: Gentle Proven Solutions to Help Your Child Sleep Well and Wake Up Happy - Your baby's sleep patterns will change weekly then monthly. To ensure that your baby is getting the right type of sleep and to help you make sure that you are not setting yourself up for sleep issues (or to solve sleep issues), I highly recommend this book.  I have to warn you that this book is anti-co-sleeping. If co-sleeping works for your family, do it because it is great!  But if it stops being great, don't be afraid to try something new.
• Smart Medicine for a Healthier Child - A great all round medical reference that gives you conventional treatments, dietary guidelines, nutritional supplements, herbal treatments, and prevention tips for common ailments. This is a good first stop before contacting your doctor.
• The Nursing Mother's Companion, 6th Edition: 25th Anniversary Edition - You should have a nursing book if you plan to nurse. It is a great reference to read before giving birth, to keep in your hospital bag and to have as a reference at various stages of nursing.
• The Baby Book: Everything You Need to Know About Your Baby from Birth to Age Two

These are good books to read as your baby is growing:

• The Happiest Toddler on the Block: How to Eliminate Tantrums and Raise a Patient, Respectful, and Cooperative One- to Four-Year-Old 
• Raising Our Children, Raising Ourselves: Transforming parent-child relationships from reaction and struggle to freedom, power and joy 
• Simplicity Parenting: Using the Extraordinary Power of Less to Raise Calmer, Happier, and More Secure Kids 
• Playful Parenting 
• Unconditional Parenting: Moving from Rewards and Punishments to Love and Reason 
• How to Talk So Kids Will Listen & Listen So Kids Will Talk 
• The Diaper Free Baby

• The Vaccine Book: Making the Right Decision for Your Child

  
  

That should be a good start. There are many more wonderful books on parenting and play so read whatever looks interesting and make your own opinions.

Pumping at work

Pumping at Work
There is no doubt that some working women find it hard to schedule breast pumping into their schedules. It is important to talk to your employer (ideally before you have your baby) and to find out your state's laws. When I took classes, I had to pump in a corner of a hallway but I did it. My mom in the 1970s was one of the minority who breastfeed. She used to sit in the corner of her company's break room and hand-pump -- thanks mom!


Section 4207 of the law amends the Fair Labor Standards Act of 1938 (29 U.S.Code 207) to require an employer to provide reasonable break time for an employee to express breast milk for her nursing child for one year after the child’s birth each time such employee has need to express milk. The employer is not required to compensate an employee receiving reasonable break time for any work time spent for such purpose. The employer must also provide a place, other than a bathroom, for the employee to express breast milk. If these requirements impose undue hardship, an employer that employs less than 50 employees is not subject to these requirements. Furthermore, these requirements shall not preempt a state law that provides greater protections to employees.


Here are breastfeeding laws by state.


It is extremely important for working moms to have a good quality breast pump and to make sure that they pump as often as the baby would feed. Do not be shy to call your lactation consultant the moment that you suspect your supply going down. They can help you fix that! 


Some of my friends kept their pump at work so they did not have to carry it back and forth. They would either wash the breast cups at work (if there was a good place), wipe them down with cleaning wipes, or put them in a zipper bag and bring them home for washing. 


If your pump does not attached to your bra, you can make it attach by using big rubber bands to connect the breast cup/tube to your bra strap. Then you can sit hands free and get work done or read a magazine. Moms often enjoy this peaceful time and find it relaxing and productive.

Breastfeeding in public

Nursing Tank from Target $20

After your new baby arrives, it will feel great to be out and about when you are back in the swing of things. Then there is the moment that every new mother dreads: a hungry baby.  Oh no, the baby is crying and you don't want anyone to think that YOUR baby cries!  You want to get milk in the baby as fast as possible.  Luckily you don't bottle feed and have to get all that stuff in order.  All you have to do is sit down and give the baby a breast. My friend Melissa (and fellow Holistic Moms Network Co-leader) wrote all the details out to Breastfeed Your Baby in Public with Confidence. Like Melissa, I don't think that the solution is to pump then bottle feed! She has great tips.

I don't recommend a cape or cover-up for nursing. They are scary for most kids and confusing for the mom causing stress and a possibly stressed out baby. Most of the time in public, I put a receiving blanking near the baby's face after a latch if I want to be super discreet. People think that the baby is sleeping in my arms when I nurse and they often walk up and comment how sweet it is to see my baby sleep -- haha!

At the very beginning, I planned my outfits around nursing in public. Until my postpartum belly returned to normal, I was self conscious and wanted to make sure that no one would see it. This is where nursing shirts come in handy. The easiest type to use is the simple tank style that has a built in shelf bra. This style does end up showing your whole breast. If you wear a button down shirt on top, the button down shirt does shield most of your breast and tummy no matter what type of shirt that you have on underneath. When the baby and I get in a routine, I prefer to wear a loose shirt that pulls up to nurse. The baby ends up covering my tummy naturally. Other women like to remove their breast from the top of their shirts or use special nursing shirts that I find hard to handle. Try it all at home and see what works for you.

I find nursing bras to be essential. With my first born, I had such a hard time finding a bra that fit well and that I liked (I went to several maternity stores and was "fitted").  Finally I went to a specialized nursing bra store in NYC (I love that NYC has stuff like this shop) and was fitted with super cute bras at a not so super cute price of $60 each. With my second and now third babies, I realized that Target carries a style that fits be really well and looks great for $16. If you breastfeed for as long as I do, you do wear out your nursing bras.

Why breastfeed?

There is an extremely small percentage of women who cannot breastfeed. Sadly most women who I have met who claim to have not been able to breastfeed, were not evaluated by a professional lactation consultant. I hear things like "I didn't have enough milk," "it didn't feel like my milk came in," "the baby seems hungry," "it hurt," "the baby wouldn't latch properly," "the baby has digestion issues with my milk," and much more! Please, please, please, have a good reference for a lactation consultant at your fingertips BEFORE you give birth. That way, if you have any questions or issues, all you have to do is pick up the phone. Most consultants will come to the hospital or your home. Ask on your local mom boards or your local Le Leche League leader.

It is still shocking to me that babies are not born knowing how to breastfeed but they must be taught. And us as mothers, have to learn how to breastfeed and how to teach the baby to breastfeed.  Yes, this is a lot for a new mother and that is why support is so important! I found it helpful to go to a free breastfeeding class before giving birth and to cover to cover read a book about breastfeeding. The book was in my hospital bag so I read and re-read it again while in the hospital to make sure that I was doing it right. The nurses in my first hospital, were telling me that I had a great latch when I didn't (it should never hurt) and I was happy to have extra help in my book!

Which birthing class to choose?

In the movies it seems like a woman goes into labor, runs to the hospital, lays on her back and then has her baby. In reality, most women have an early labor that lasts for hours (and often days) in which it is in their best interest to stay home and work through their labor before going to the hospital. So what do you do at home?  Well a good birthing class will teach you what to do during each stage of labor and delivery. Most importantly, birthing classes give moms and partners the self confidence that they need and the tools to empower themselves. I am sure that most of you reading this are looking for a natural un-medicated birth and a good class will teach you how to be in control of your body and not experience "pain." There are several options that you should investigate to see what is the best option for you.

image: www.123rf.com

ronen

Doula
For my first birth, I had a doula who came to our home and gave my husband and I private birth preparation classes.  She prepared us psychologically and physically for the birthing process using various methods that cross over with the other birthing methods. She wanted us to be ready to use whatever method would feel good to me during each moment of labor. Before the doula came, my husband was adamant that he would not cut the cord and he was not in favor of seeing the baby crown or the idea of a slimy baby coming out of me. When we had to watch a home birth video as our homework, we compromised and watched it on double speed.  At the end of the video he not only thought that birth was a beautiful family process but that he would consider a home birth for our future kids! Yay! The added bonus of going the doula route is that the doula is present during your labor, delivery and postpartum so she was able to support my husband to feel empowered in the process (did I mention that she gave my husband and my mom massages while I was in early labor!). There are different types of doulas and you can hire one for just a portion of the process but I encourage first time moms to get the whole package (well worth it)! The birth was not painful, we had someone to help us deal with stuffy hospital staff, and my husband remained calm, helpful and with beautiful memories.


Hypnobirthing
From www.hypnobirthing.com: "HypnoBirthing is a childbirth method that focuses on preparing parents for gentle birth.  In HypnoBirthing classes, you will learn proven techniques in a well-thought-out program of deep relaxation, visualization, and self-hypnosis. All of these are designed to help you achieve a more comfortable birth. HypnoBirthing encourages a calm, peaceful, and natural pregnancy, birth, and bonding experience for families. Unlike other childbirth methods that teach you how to cope with and manage pain, HypnoBirthing is based on the premise that childbirth does not necessarily need to be painful if the mother is properly prepared and relaxed. When women understand that pain is caused by constrictor hormones, created by fear, they learn, instead, to release fear thus creating endorphins—the feel good hormones. They are then able to change their expectations of long, painful labor and are able to replace them with expectations of a more comfortable birthing.  Rather than exhausting, shallow breathing and the distraction techniques of typical “prepared childbirth” programs, HypnoBirthing parents learn deep abdominal breathing and total relaxation, enabling the laboring mother to work in harmony with her body and her baby. This allows her to achieve a shorter and more comfortable labor for herself and baby."


The Bradley Method^®
From www.bradleybirth.com: "Natural childbirth is an important goal since most people want to give their babies every possible advantage. Without the side effects of drugs given during labor and birth. The Bradley Method^® classes teach families how to have natural births. The techniques are simple and effective. They are based on information about how the human body works during labor. Couples are taught how they can work with their bodies to reduce pain and make their labors more efficient. Of over 1,000,000 couples trained in The Bradley Method^® nationwide, over 86% of them have had spontaneous, unmedicated vaginal births. This is a method that works!" The classes are 12 weeks long so plan ahead and be prepared to do some homework because you will have a 130 page workbook.


Lamaze
Www.lamaze.org is a practice that my mother learned in her birthing classes in the 1970's. It teaches women six practices: let labor begin on its own; walk, move around, and change positions throughout labor; bring a loved one, friend or doula for continuous support; avoid interventions that are not medically necessary; avoid giving birth on your back, and follow your body's urge to push; keep your baby with you -- it's best for you, your baby, and breastfeeding. Personally I get the impression that these are the basics for a natural birth and that all of the other methods go into deeper insight and support in the areas.


Prenatal yoga
Most studios that offer prenatal yoga offer a yoga based birthing class usually as an afternoon session. I found that the special breathing that I learned in my yoga classes in NYC with Melissa Feldman to indeed make the contractions painless by me mentally embracing the contractions (she had the greatest "pain" position). My current NJ yoga classes are less preparatory in embracing pain and laboring breathes so it all depends on your instructor. Generally the instructors do save most of their tricks for the preparatory classes. If you feel that you just need a little class to get you rolling, then this is it.


Hospital Birthing Class
Hospitals offer these classes and it is a coin toss as to what you get. I would think that they are general Lamazee sort of information. Since the hospitals in my area have a 37% C-section rate, I am not so keen to follow their natural birth advice!


Birthing Refresher Classes
During my second pregnancy, my husband and I took an afternoon natural birthing refresher class because my husband was nervous that we were not having a doula. Our previous doula, Karen Kelly, was taking her midwifery finals during my due date and my midwife swore that my labor would be so fast that I would not have time for a doula because she would be with me the entire time (and she was right). We found the refresher class useful to mentally prepare us. This third time around, we feel that we remember what to do and are excited for labor and delivery!


What methods did I not list? I would be interested to hear about more.

Creating a birth plan

image: http://www.freeimages.co.uk

What is a birth plan?


A birth plan is a list of what you want during labor, delivery and postpartum. It is helpful for you to sit down and decide on what decisions you want made in advance so you are not having to make spur of the moment decisions in between contractions and no details will be forgotten.  During my first pregnancy, I had so much to learn and found it useful just to read through the options that my doctor never told me about. I became very educated by just researching what those options meant!


Free birth plan template.


This one is really good from Earth Mama Angel Baby: http://www.earthmamaangelbaby.com/free-birth-plan


Should I create a birth plan?

During my first pregnancy, my doula had me review all the birthing options. She was adamant about me not being too set on a fixed "birth plan" because she wanted me to be flexible and not get too disappointed if my dream birth did not happen. Since my doula was at my side the entire time, I felt like she was my living birth plan and it was fine that I did not have one in writing.

With my second pregnancy, I darn well knew what I wanted and wanted everyone to know it!  Plus I had no doula so I had to be my own advocate at the hospital. Thankfully my labor was super speedy and my midwife was incredibly respectful of making my birth plan work 100%.

Now with my third pregnancy, I am again going to have a birth plan to let everyone at the hospital know what I want and to remind my midwife since I am now with a practice of midwives versus a single midwife.

What is a doula?

I had no clue what a doula was. Then two moms both raved about their doula. As soon as my husband heard the other husbands rave about their doulas, he was sold and instantly made me call her and hire her. The story that got me was the couple that went for the cessation with a breach baby. Of course that was not in their birth plan but they said that the doula kept them both calm and turned it into an embracing and positive experience where it would have been horrifying without her. I had a doula for my first birth and she was priceless.  And of course she shared her wonderful pregnancy tea recipe with me! I will speak more about her when it is my turn to tell my birth story. For my second birth, my midwife told me not to have a doula because she (psychic or really talented?) predicted how fast my labor would be and told me that as soon as my contracts started, I needed to run to the hospital and that she would be at my side the entire time! It was true!

Here is some information about doulas from DONA Interational:


What is a Doula? The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.

Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.

A Birth Doula

• Recognizes birth as a key experience the mother will remember all her life
• Understands the physiology of birth and the emotional needs of a woman in labor
• Assists the woman in preparing for and carrying out her plans for birth
• Stays with the woman throughout the labor
• Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decision
• Facilitates communication between the laboring woman, her partner and her clinical care providers
• Perceives her role as nurturing and protecting the woman's memory of the birth experience
• Allows the woman's partner to participate at his/her comfort level

A birth doula certified by DONA International is designated by the initials CD(DONA).Research evidence shows that the quality services of a postpartum doula can ease the transition that comes with the addition of a baby to a family, improve parental satisfaction and reduce the risk of mood disorders.

A Postpartum Doula

• Offers education, companionship and nonjudgmental support during the postpartum fourth trimester
• Assists with newborn care, family adjustment, meal preparation and light household tidying
• Offers evidence-based information on infant feeding, emotional and physical recovery from birth, infant soothing and coping skills for new parents and makes appropriate referrals when necessary

A postpartum doula certified by DONA International is designated by the initials PCD(DONA).

Must have baby registry items

Stokke High Chair

As promised in my Useless Baby Registry Items and Useful But Not Necessary Baby Registry Items posts, here is my list of what you must have on your baby registry or in your home. To be truly green would be to make your own items or to have used items. If you cannot find them used or homemade, only buy it if you are sure that you will get very good use out of it for a long time.

1. Baby carrier. Babies are used to being next to your body for nine months. They are calmed by the sounds and smells of your body. When a baby is born, it is widely known that babies do best skin to skin with their mom which is where they are used to being. It only makes sense that when you are out for a walk (or trying to cook dinner), your baby will be most comfortable up against your body. I have often seen screaming newborns being walked or driven around the block in a stroller/carseat to get the child to sleep with the white noise and movement. This seems so silly since the baby just wants to be against a warm human. My husband LOVES wearing our babies (and still our 2 and 4.5 year old!) because it helps him bond a deeper relationship with the baby. I think that he likes the reactions of the people who verbally ooh and ah at the sight of a proud daddy being so loving with his child. Sorry for my tangent!  Anyways, I love the Moby Wrap for newborns and mid-sized babies because it keeps my body in alignment and keeps the baby in healthy alignment. Those mainstream Baby Bijorns are horrible for the baby's hip alignment and get uncomfortable as soon as the baby puts on decent weight.  I also own the Ergo Carrier which I have used from around 5 months until well... my daughter is 4.5 and still loves having a ride on the back when she gets tired of hiking. I never felt right with the Ergo's infant insert so I skipped that.
2. Receiving Blankets. I did not put these on my registry because I did not know that I needed them but it seemed that everyone else knew that I needed them and I received so many that I had to return/exchange some.  Anyways, I used them for a lot of things. I would get a lot of use out of a single blanket by giving it a different purpose each day until it hit the laundry basket: swaddling, burp cloth, under messy diaper changes. They are great to throw in your on the go bag, to have a clean place to change the baby or to tuck over the crib mattress to absorb sleepy drool. Just don't go crazy and collect too many!
3. Cotton Sleep Sacks. Thankfully an experienced mom bought me one of these. They are the greatest way to cover a baby while they sleep.  I love them! You only need 1-2.
4. Plain Cotton Onesies and Sleep-n-Play Outfits. Onesies are great for a baby to lounge in during the summer or to layer underclothes in the winter. The sleep-n-play outfits are the most comfortable thing for babies to wear whether they are awake or asleep. Those other fancy clothes are just irritating and hard to get on and off a newborn.
5. Tummy-time Playmate. It is nice to have a special blanket or a pre-bought playmate that you can use for the baby to play on. I had a mainstream one that I loved because it created a lot of entertainment while my newborn was on tummy time and it folded flat and fit behind the couch when we were not using it. It had toys hanging that we were able to use for several months after my babies were mobile.
6. Boppy Pillow.  The Boppy Pillow is a hard pillow in a special shape to support the baby while your are breastfeeding.  This pillow makes it so much easier to focus on getting a good latch. While pregnant, I use this super firm pillow between my legs when I sleep. I suggest that you buy it new with two covers because babies spit up sometimes and I have seen some gross ones!  If you find one used in good condition then go for it!
7. Incidentials: shampoo, cream, comb, brush. I love California Baby Tea Tree Shampoo, and Weleda Calendula Diaper cream (although I barely use it since I cloth diaper), a soft baby brush and a little comb. I never bought those baby finger nail clippers because another mom warned me that the best way to cut little nails is to tear, bite or file them. She was right! When they get older, our family cutters work perfect.
8. Laundry Detergent and Dryer Balls. Keep the detergent, dye free and fragrance free. Stay away from chemicals because they could irritate the baby's skin plus they damage our environment and our own health. There are many brands out there including: Seventh Generation, Ecos, Biokleen, and Meyers.
9. Wool Nursing Pads. Most women have leakage for months following their milk coming in and find that they need nursing pads between their breasts and bra to soak the leakage up. I was not a fan of the disposable ones (unless going out in a fancy outfit) because they are like maxi-pads and are filled with chemicals that I did not want against by nipples. I used cotton pads for my first baby and found that sometimes I leaked through them. For my second I bought one pair of wool nursing pads and was in love. They are mostly self cleaning so I only washed them once a week. I liked that they were larger so they were not apparent though my cloths and I never felt wet or cold from the milk. I will reuse these again for the #3.
10. Cloth diapers, diaper pail, cloth wipes. If you are interested in cloth diapering, just do it!  All of my kids have been cloth diapered except while traveling and we have loved it. I will do a special post on cloth diapering but I found that good quality prefolds with a good quality cover to be the easiest and cheapest. Since they are so cheap, I have a huge supply so I only wash them once a week. For baby #2 I made some super easy cloth wipes out of cotton flannel and used a spray bottle with water and a drop of castile soap. Add a good diaper pail to your registry either way because you want to keep smells out of your room.
11. Non-toxic Mattress, Crib, sheets, Wool Mattress Pad. These are only useful if you are not going to be co-sleeping. You can certainly buy these used but if you are like me and going for baby #3, you will be glad that you bought high quality new items.  We LOVE wool mattress pads so much that we have them also on our bed and our daughter's twin bed. They regulate temperature, are naturally absorbent and self cleaning!
12. Gender Neutral Car Seat. We had one on our registry for baby #1 even though we were carless in the city. It was helpful when we rented a car or to put the baby in when I wanted to shower since we didn't own a bouncer or swing. If you want to be on the lowest level of consumerism, buy a "convertible" car seat that holds a child from newborn until preschool.  Your primary carseat should be bought new so you know that it has not been in an accident and that the plastic has not become brittle as it aged.
13. Gender Neutral Stroller. Of course if you are going to have more than one child you don't want a gender specific stroller, but I just don't like them in general, sorry. I am glad that we bought our stroller new because it gets a lot of use. We bought it with gift cards and by returning items that we did not need. Everyone has a different need when it comes to strollers. City dwellers go straight for the Maclaren stroller because it is sturdy and folds with one hand to quickly get on buses. Suburban moms often have a garage stroller (aka SUV stroller) that would be large folded up but that they don't fold up but just use around town. These moms keep flimsy umbrella strollers in their car trunk for outings. In the city I just had a Maclaren and now it is my trunk stroller in suburbia. I have a Phil & Teds double stroller (bought used) that is my garage stroller that I use daily to and from preschool, library and parks. My neighborhood has old bumpy sidewalks that this stroller glides over and is extremely easy to push. I love both strollers because they are metal and sturdy. I know people who have bought those strollers with plastic trays and handles. Guess what? Plastic breaks easily! I would not buy a super expensive ($1000) single stroller if you plan to have multiple kids close together because you would hate to have to buy an expensive double stroller so soon (My Phil and Teds converts from single to double!).  Just like breast pumps, cheap strollers are cheap for a reason.  Buy quality and it will treat you well. You can find really good strollers used but you have to look hard because most people who have a great stroller do not want to part with it until it is in shreds when their kid is 6 years old. If you don't walk much then don't bother with a good stroller :)
14. High Chair / Booster. You can completely buy these used but I found most of the used ones had food caked into cracks and knowing that I was going to have multiple kids, I wanted mine new. I knew before I was pregnant that I wanted the Stokke High Chair so it was the first thing that we added to the registry (my husband also fell in love at first sight since this is the only high chair anyone in his home country seems to have). It was the first thing that someone bought off our registry! It slides into our table like a regular chair so the kids feel like part of the family and it does not take up extra space at the table. The chair adjusts as the child grows and can even support adults.  Their ergonomics are always perfect. DO NOT BUY A CLOTH COVERED HIGH CHAIR. Kids get food everywhere and the idea of having a cloth and seams to clean is just gross. I have never seen one that looks good. If you are short on space or funds, a booster seat on top of a regular chair works great and is easy to clean!
15. Bumkins Super Bibs. Those cute cotton bibs are only good for drooling babies. As soon as they eat food those bibs get stained and you can only use them for one feeding. The Bumkins Super Bibs are a vinyl that can be easily wiped after each snack or meal. Then you instantly have a clean bib to reuse. One set of three seems to last through one child from 6 months to 3 years so you can get something gender themed if you please. I have tried endless other plastic and cloth bibs but have not been happy with any of them except for these bibs. They are just the best!

Useless baby registry items

image: 123rf.com
Moodboard

As I plan for the arrival of my third baby, I need to buy some crib sheets, and a pacifier (to stuff in her mouth while asleep, on airplanes, or during screaming fits in the car).  This short list is because I own everything that I need (including mama milk and cloth diapers).  

My heart breaks when I see first time moms (or subsequent moms) engulfed in the consumerism of useless baby items. I know firsthand what is useful because my first two babies were born into a small one bedrooms NYC apartment with no storage. We simply did not have the space for "things" that we could only use for a short time so we took the opinion of "let's live without it and see if need it". After having the second child, we moved into a house and had endless storage so our baby supplies have increased greatly (thanks mostly to donations and yard sales) but we still only have what we really need.

The most important thing is not to be afraid to return things that you don't like, want or need. Stores like BabiesRUs took back all sorts of gifts that I received in exchange for store credit. I think that I returned around 15 extra cloth bibs and 10 extra receiving blankets. It is not that I was ungrateful or unappreciative of the generosity, but I really had to be practical. I exchanged gifts that I didn't need for items that I needed. I knew that the gift giver would be happy to know that I had something that I really needed.

Useless:

1. Gender specific "stuff".  If you plan to have only one child and then get your tubes tied: do whatever you want. If you don't then think about what you want to buy or make again if your next child is the opposite sex. Is it really worth buying a new car seat, stroller, or activity mat: NO! I am also a fan of neutral crib bedding because they use things like bumpers for a short period. 
2. Bottle warmer. Breastmilk is fine at room temperature for several hours. My husband had a good routine of just leaving a container of milk at room temperature and the babies adapted to it instantly. This makes bottle feeding on the go easier. He spent afternoons with the baby all around the city thanks to not needing to warm the milk!
3. Bottle drying rack. Do you really need something else on your kitchen counter? Most likely you already own a drying rack.
4. Bottle sterilizer. Another counter top item that does the same thing as a $1 bottle brush. Most bottle cleaning directions say that they should be sterilized once before first use then just washed with soap and water. They take 1 minute to clean by hand with one of those bottle brushes.
5. Baby wipes warmer. Why get your baby used to having warm wipes? Then what would you do when you are out and about?
6. Bumbo seat. This seat allows a baby to sit upright before they are old enough to sit. Why do they need to sit before they are ready?
7. Crib toys. These things clip on to the crib and make music and give the baby something to look at. When they are newborn these are a suffocation risk. When they are older it is just a distraction that can create a "sleep crutch" of noise or a distraction to going to sleep.
8. Stuffed animals. These collect dust, absorb spit-up and clutter a room. Return or give away most of the ones that you get. Keep 1-2 that you love as a special "lovey" for your child.
9. Burp cloths. You will have enough cloths to use. I use yesterday's swaddle blanket as a burp cloth for today before it goes to the laundry basket.
10. Baby food makers. Been there, tried these, and didn't like them. My cuisinart mini-chopper and blender were able to do more than these things. I just chopped or blended what we were eating for dinner and had instant baby food. Best of all I used what I had and was not stuck with "stuff" when the baby moved on to larger chunks of food.
11. Diaper bag. Yes, you need a bag to put stuff in but 99% of diaper bags sold are just ugly and oversized. They encourage moms to bring too much stuff with them. Most kids are good to go with a few basics in their cute purse. My husband prefers a backpack when he has the kids solo.  Breastfeeders are at a huge advantage that they don't have to bring much.
12. Hanging diaper holders. People buy these as part of themed decorations for a room. I find them unattractive and rather useless. I rather like to repurpose a cute basket or a drawer filled with diapers. The drawer is my preference so it doesn't look messy.
13. Special laundry basket for the baby. We have always kept our babies in our room for up to their first 2.5 years so it never made sense to need a laundry basket in a separate room.  The clothes are so small that I like keeping a basket in my room so I can easily see when it is full of family clothes. Having multiple places to check and transfer clothes from one pile to another seems like extra work to me! We wash all cloths in a dye/perfume/chemical free and ecological laundry soap (please don't use Dreft or another mainstream baby laundry detergent that is filled with chemicals and skin irritants!) so there is no need to wash the baby's cloths separately.

Posts will follow that include things to buy used and things that must be on a first time mom's baby registry.