pregnancy - La Leche League New Zealand

Keeping Baby Close at Birth

Post category:Pregnancy
Reading time:4 mins read

“Because of health problems developing late in my pregnancy, I must be in hospital for the birth. I’ve read that having my baby as close as possible (skin to skin) at all times is the best way to breastfeeding success but I’m not confident I can do this in a hospital ward. How have other mothers managed to keep their babies close when staying in hospital?”

Responses

Robyn Watkins, Pukekohe – Owing to my recent work with the local maternity hospital – Middlemore – I can tell you that if the hospital you plan to give birth in is accredited under the Baby Friendly Hospital Initiative skin to skin contact between the mother and her baby is always offered and encouraged. At Middlemore it is done as soon as possible after birth and for at least an hour if there are no health concerns. Middlemore also will initiate skin to skin whenever a baby is unsettled or temperature is unstable. Skin to skin contact often leads to baby lead latching.. There are health board pamphlets available and I am sure if this mum talks to her L.M.C and makes it clear she would like this to happen ASAP it will be seen through. Middlemore even encourages and provides for skin to skin contact in theatre after caesarean births and staff will often transport mums in beds from delivery up to the ward with the baby still skin to skin with mum. Lovely to see.

Claire Hargest Slade, Timaru – I think you will be pleasantly surprised at how keen they are for you to have skin to skin contact with your baby. Make sure you write it into your birth plan with who ever will be caring for you. Many mothers have extended periods of skin to skin contact way past the first few hours after birth. There is great evidence to support this practice. Babies are less likely to experience hypoglycaemia and hyperthermia and have lower levels of stress hormones while in direct skin to skin contact with their mothers. They use fewer calories because they are using less energy to maintain their temperature. Midwives all know this, so skin to skin contact will really be at your discretion unless there is a medical reason that it can’t be so. Be assertive about having your intention documented in your notes, and you may well be surprised how well supported skin to skin really is.

Janine Pinkham, Kaiapoi – For mothers concerned about keeping babies close New Zealand is probably the best place in the world to give birth in a hospital setting. Just about all maternity units in New Zealand are now accredited as Baby Friendly. This means that they adhere to the Ten Steps to Successful Breastfeeding. Two of these steps relate to mother and baby togetherness. Step 4 calls for babies (if well) to be placed in skin to skin contact at the time of birth for at least an hour and encourages ongoing skin to skin contact. Step 7 requires “rooming in” where mothers and babies stay together 24 hours a day, just like when you get home. Some facilities even have clip on cots so that babies never need to be more than an arm’s reach away from mum and most facilities encourage mothers to bring their babies into bed with them as long as this is done safely. These and other assistance that supports breastfeeding will help you get to know your baby and get breastfeeing off to a good start.

Lisa, Hibiscus Coast – I had both my babies in hospital, the first in Wellington 19 years ago and the second Tauranga 8 years ago. Both stayed with me skin to skin for at least the first hour and then after being weighed. I was very happy with the way both labours and births went. They were both vaginal births without any interventions. The midwife and my husband knew what my wishes were and supported them. I can’t see why you wouldn’t be able to keep your baby with you at all times in hospital too.
Best wishes for an uncomplicated birth.

Fertility and Breastfeeding

Post category:Pregnancy
Reading time:7 mins read

“I have a 26 month old son who has always breastfed enthusiastically and still breastfeeds frequently. My menstrual periods returned when he was approaching two years old and I’m now thinking about trying for another baby. However I’m not sure whether I’ll be able to conceive with such a keen breastfeeder! Is it likely that I will be able to get pregnant without weaning my son? He is really not ready to give up his beloved “nunu” and I don’t want to rush him.”

Responses

Nicole Evans, Whangarei – My son has always been an avid breastfeeder too, we started trying for another baby when he was two and a half.

I did have some difficulties conceiving our second child. Breastfeeding delayed ovulation so I wasn’t ovulating mid-cycle, and had a short luteal phase (the phase after ovulation until menstruation starts) so there wasn’t long enough for an egg to implant.

It would be worth charting your cycles to pinpoint when you ovulate, as my daughter was conceived on day 22, and I think this may be fairly common. I took vitamin B6 to lengthen my luteal phase and it worked the first month I took it. It also might be worth you reading Taking Charge of Your Fertility by Toni Weschler, as this book helped me no end.

I breastfed throughout my pregnancy with no problems (I was really nervous about it being painful), and am now tandem feeding and finding it easier than I ever imagined.

Good Luck!

Adith Stoneman, Kelston Auckland – Isn’t it wonderful that you do not have to wean at all. . The return of your menstrual cycle indicates that you are able to conceive. When you do fall pregnant you may notice a real tenderness in your breasts, which for some women is so strong they need to limit breastfeeding time. It is also true that some women feel emotionally unable to keep breastfeeding their toddler.

Sometimes it is our toddlers who wean completely during our pregnancy as the milk tastes different and is not quite as abundant as before. This helps to move the breastfeeding relationship along to get ready for the new baby. And then of course there are many mums and toddlers who keep breastfeeding quite happily which may lead into tandem nursing both baby and toddler.

As with so many things related to birthing, breastfeeding and parenting, nothing is a given. Each mum and baby dyad is unique. Be prepared for the physical and emotional turmoil that a pregnancy can bring and always know that La Leche League Leaders are able and willing to provide you with correct information.

Claire Hargest Slade, Timaru – The return of your fertility can be affected by the frequency and intensity of breastfeeding your adorable little one. In cultures where babies and toddlers are given free access to the breast, they may feed briefly several times per hour round the clock. Exclusive and intensive breastfeeding followed by gradual introduction of solids and continued breastfeeding day and night has been reported to delay ovulation for up to four years.

The LLL mantra of “don’t offer and don’t refuse” might be useful to space feedings a little more so that ovulation isn’t suppressed. Usually an eight hour gap between feeds at night is enough to let ovulation begin again. But as we all know not offering the breast to a fractious and very put-out toddler in the middle of the night is easier said than done. I remember being told not to breastfeed my 20 month old son during night hours, and I wondered what parallel universe that advice was coming from!

Offering plenty of nutrient dense food, frequently throughout the day and water for thirst may decrease breastfeeding frequency just enough to help your fertility return.

Mother Nature is so clever in naturally spacing our children, giving number one the chance needed to become more mature, and to let our bodies recover from childbirth and lactation and build up nutrient stores. Further discussion with your GP regarding hormone levels may be useful also.

Robin Jones Greif, Blenheim – Of course you can have another baby while still breastfeeding; every mother who tandem feeds has done just this! Once you are having regular periods, it would be unusual to not be ovulating as well. Remember all the warnings that new mums are given about not relying on breastfeeding as a contraceptive?

At 26 months breastfeeding is highly unlikely to interfere with an ability to become pregnant. You may find he weans himself during your pregnancy as the taste of your milk changes and the quantity diminishes, but this may not bother him at all. You may also find that nipple tenderness makes you encourage him to cut back on his feeding, but once again, this may not happen to you.

There is certainly no need for premature weaning in order to add to your family. I wish you all the best on your breastfeeding journey; long may it continue!

Sandie Fransen, Te Awamutu – My first was a relatively keen breastfeeder. When he reached 14 months and I still hadn’t had a menstrual period I worried that I might have to wean him in order to have another baby (which we were keen for soon). I decided to wait until he was 18 months old and see if anything had changed, then maybe I might think about weaning him.

However I got my periods back when he was 16 months old and after a few cycles we discovered we were pregnant. As baby number one was still having his milky-milks, he wasn’t too impressed when my supply dropped when I was about seven weeks pregnant – but that didn’t deter him that much at all!

When number two reached toddlerhood, and was much more attached to his milky-milks than his older brother had been I thought; this will be interesting… He was about 20 months old when my menstrual cycle returned, and after only two periods we are expecting again! Baby number two still loves his ‘milks’ but has naturally cut back on how many ‘feeds’ a day he has – however if it’s what he wants – nothing will stop him!

My suggestion is to start trying for another baby, and if after a few cycles you haven’t conceived start noting your ‘mucus’ daily as it changes throughout the month – then take these notes along to a natural fertility advisor/Billings teacher or your family doctor who should be able to help you work out if you are actually ovulating.

If it turns out you that you aren’t, then I’d just gently try to cut back the amount of ‘nunu’s’ your son is having for a while to see if that makes a difference. I definitely wouldn’t wean him outright before trying the other options first. My first ‘baby’ only gave up feeding when I became pregnant with number three (just as he turned four). Perhaps after the drop in supply this time he decided that it wasn’t worth it? All the best with trying for baby number two.

Active Birth

Post category:Pregnancy
Reading time:7 mins read

“I am halfway through my pregnancy, and really starting to think about this concept of active and alert birth. I am keen to find out what worked for other mothers. My husband is really keen to be well armed with practical things he can do too. What are some ideas?”

Responses

Claire Hargest Slade, Timaru – It’s easy to get hooked into creating labels for how we want to birth. Instead, think about creating an environment where you and your partner feel safe, secure and at ease to do and be how you really are. The actual venue is without consequence, but the relationship of trust and partnership you build with your birth attendants will help this. When women have freedom to move, to position themselves in any manner, to be held as they want or conversely have the peace and privacy they desire at any given moment; then they birth in the instinctual way that is right for them. I created an eight point guideline for birth support people that goes a little like this.

Be her support person, offer comforts, drinks, touch or don’t touch as she needs it. This will change throughout her labour.
Privacy and intimacy enables the love hormone oxytocin to create effective contractions. Try to keep disruptions and worry at bay for her.
Be a tree. Let her hang off you in weight-bearing positions to help weather the storm of each contraction.
Care for yourself well during the labour. Eat, drink and emotionally refuel as need be; so you can stay strong for her as she is swept along by the power of her labour.
Create an atmosphere of quiet confidence in her ability to birth. Smile at her, hold her.
Praise is a wonderful tool in any circumstance. Warmly praise her to encourage her efforts.
Be her advocate, be willing to ask for things you have already discussed she wants. Ask again about the birth pool being filled. Know her birth plan, support her wishes.
However she births, validate her strength and courage. Giving birth is a huge achievement.

A great book you may enjoy is Gentle Birth, Gentle Mothering by Sarah Buckley.

Rosemary Roberts, Hamilton – This may not be for everyone, but for my second birth I used childbirth hypnosis. It was amazing. I was able to keep myself deeply relaxed through self-hypnosis and since the programme includes a special part for dads; my husband was able to be very active in keeping me relaxed and diverting my focus when needed through cue words and firm touch.

Phoebe Quinlivan, Wellington – I had a beautiful home birth experience with our first son, and a big thing for me leading up to and during it was my wholehearted belief and trust that my body knew what to do, and that I was not mentally going to be ‘in control’. My body would just do its thing and I just had to concentrate on keeping as calm and relaxed as possible.

When the contractions started amping up in the early stages, I imagined my cervix as a big thick rubber band that had to be slowly stretched to let the baby through, so each time I began to feel uncomfortable, I imagined pulling that rubber band slowly more and more open. Once things were a little more intense, I stopped thinking anything and just concentrated on breathing through it (and squeezing the bottle of lavender essential oil that I was holding in my hand!). Staying as calm as possible is important in order to let all those lovely pain reducing hormones flow.

Your husband can be a big part of that by staying really calm himself and reassuring you. I really wanted my hubby to stay up near my face and leave the midwife to do the delivering which worked well for me. I found the pressure on the two points at the base of my spine during contractions really helped, then ice cubes fed into my mouth, and a great big hand to hold (squeeze!) while I was at the pushing stage.

Being at home, everyone was able to potter about, help themselves to food, read and relax and slip in to be with me when I needed it. I think this also contributed to me managing well and being able to just focus on what I needed to do during the contractions (be in the zone). Because I didn’t have everyone focusing on me all the time, I wasn’t feeling self conscious.

Having said that, some mothers feel more relaxed in hospital and so that’s where they choose to be and that’s good too. I was ready to go to hospital if we needed to, and had decided before the birth that I would be okay with whatever happened. Once I was fully dilated; I got into the pool – I was loath to move at first because I had found a good position (squatting on the floor with my elbows on the couch) where I was managing, but once I was in, I felt the pain ease off by about 30 to 40 percent. Lovely!

Your body was made for this. I am sure you will have a peaceful and empowering birth experience.

Jillian Grant, Wellington – Yoga ball, lavender oil, tens machine were helpful, but an emergency caesarean meant I had to leave all that behind, quite literally! But the thing I could take with me was in my head – the visualisation and relaxation techniques from the hypnotherapy CD I’d casually listened to through pregnancy.

I hadn’t taken it too seriously as it kept sending me to sleep, but something had filtered through. It helped me get through the medical procedures as calmly and alertly as was possible. My partner had listened to the CD too, so he knew what I was doing. There are probably local hypnotherapy CD’s or
classes. I hope your birth and breastfeeding go well.

Stephanie Gudgeon, Te Awamutu – Relaxation and positive affirmations is a great place to start. Get super comfy with cushions and a blanket if needed. Doing this everyday is the ultimate and as you get into the groove, you will be able to call upon this technique when you have a spare moment or need some reassurance if you come across negative vibes.

Create a space of ‘you time’ every day, use this time to relax with some deep breathing. Breathing from the stomach with big belly breaths, feeling each breath relax you into the floor. Imagine each new breath bringing in new energy for you and your baby within. Send your breath around your body soothing any anxiety and creating a state of calmness and confidence. Visualise colour, either red for love, blue for healing flowing around your baby bringing it love and strength.

Create a positive affirmation that is focused on you, or look up online for some help. It might be, “my body is growing a beautiful healthy baby and I am going to birth this baby with ease and joy.” It could be shorter, or have a different meaning; but it is important that it is significant to you. On your exhale, think to yourself or quietly say your positive affirmation. Do this for as long as you can. Start with maybe two to five minutes and who knows where it will take you. Positive affirmations wire the cells in our bodies and our mind, helping our desires and dreams to become a reality.

Once you are well practiced, you will be able to use it during birth to keep you going and to bring you into a state of calm. Your husband may even say it with you. It’s a great way to focus together during birth.