Lifestyle

8 Tips to Help You Breastfeed In the NICU

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NICU -- four letters no one wants to think about when they’re pregnant or about to give birth. But as much as ignorance is bliss, what actually helps us when things veer off course is being prepared and informed about our options. And that’s especially true if you want to breastfeed your NICU baby.

Breastfeeding and keeping your milk supply up when your little one is in the neonatal intensive care unit can be stressful. You are dealing with your baby’s special needs right now; and though studies show that premature babies need breast milk even more than full-term babies, NICUs in America are often not set up to support early breastfeeding. But with a good support system and a little know-how, you can push through these obstacles and initiate a healthy, successful nursing relationship while your newborn is still at the hospital.

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Here are 8 tips to help you nurse your baby in the NICU and get you both on the road to a beautiful breastfeeding journey.

1. Extend your birth plan to your postpartum wishes. Everyone talks about the “birth plan”-- or what we, at Birth Day Presence, like to call your “birth preferences.” While you’re thinking about your birth preferences, it’s wise to make an “in case of NICU” plan or requests, with a specific focus on breastfeeding. Mention the fact that you want to breastfeed, do skin-to-skin as much as possible, and do everything you need to keep your milk supply up.

2. Find out ahead of time how the NICU at your hospital works. If your baby ends up in the NICU, can you stay with him or her? For how long? Do they have International Board Certified Lactation Consultants on staff to help NICU babies breastfeed and to help new moms express breast milk for the babies who can’t nurse yet? Can you sleep next to your baby overnight? (Note that, unlike Swedish NICUS, a lot of the facilities in America can’t accommodate parents overnight because of lack of space or insurance issues. But it’s worth asking ahead of time).

3. Begin breastfeeding as soon as you can. Most progressive NICUs will prioritize breast milk and breastfeeding. But there’s still the misconception that premature and other babies in intensive care can’t breastfeed. But it’s really not the case. So read on the topic and be prepared to advocate for yourself and your baby.

4. Consider hiring your own Lactation Consultant. To effectively breastfeed a preemie or any baby with special needs, you might need support with latch, flow, and more. If the hospital doesn’t offer someone who can really sit with you and help you nurse your baby who might be connected to wires and other medical support, hiring a private consultant can make a big difference.

5. Start expressing your milk as soon as possible. If you can’t breastfeed yet but baby can take your milk, give him or her colostrum and then breast milk as it matures. That said, not all babies are able to feed by mouth while in the NICU. Some will need sustenance through an IV or feeding tube. So begin expressing colostrum by hand or breast pump as soon as possible. This will let you body know that it needs to make breast milk. You’ll need to express milk as often as your baby would breastfeed (about 8-12 times in every 24-hour period) in order to create and keep up your milk supply. You can ask the hospital for a double-electric pump, which is the most effective, and lactation consultants can provide support and guidance in doing this.

6. If possible, stay in the NICU near your baby. Bring in a lounge chair or a cot if you have to! If it is possible to stay with your baby, do. If this simply is not possible, consider staying in a hotel right next to the hospital so that you can come in easily to nurse or hold or touch or talk to your baby.

7. Give your baby as much skin-to-skin time as possible. It will do wonders for you and your baby. To learn more, check out Mary Esther Malloy’s interview with Nino Birth’s amazing founders Dr. Nils Bergman and Jill Bergman here. There are many carriers out there that make this easy and possible, like The Nesting Days or Vija Skin-to-Skin Shirt. If for some medical reason you are truly unable to hold your baby, ask if you can at least touch and talk to him or her.

8. Learn more about Donor Breast Milk. If you cannot produce breast milk, there are many wonderful resources to still provide your little one with the best nutrients possible. Donor breast milk is a great alternative to consider.

9. Persist, even when you get home. If breastfeeding in the NICU just wasn’t possible, do skin-to-skin with your baby as much as possible, every day. Just relax together at home and let your baby freely suck or lick your nipples. Even if the baby doesn’t latch, skin-to-skin can really help, and it is still possible to start breastfeeding at this stage. Again, a breastfeeding professional can help.

We all hope our babies don’t end up in the NICU. But if yours does, you don’t have to be sidelined. Whether it's love, skin-to-skin contact, breast milk, or any combination of those, what you have to offer will crucially complement the doctor’s care as your baby gets strong and stable enough to come home. If breastfeeding in the NICU proves impossible, know that no matter how your baby feeds, the love and care you and your team provide is the most important thing.

Original photography by JADA SHAPIRO, BIRTH DAY PRESENCE.

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Parenthood has a way of making table talk out of otherwise taboo subjects. Case in point: You will likely keep a subconscious log of your child's bowel movements for several years—and for good reason. Although constipation is relatively common with up to 30% of children experiencing it, parents who understand the triggers and best treatment methods can help reduce discomfort and avoid recurrences.

When trying to find relief for constipation, the very first step should be determining the cause, says Dr. Latha Vrittamani, MD, a pediatrician with Stanford Children's Health. The challenge here is that there are multiple possibilities, including both physical and psychological triggers.

That said, the majority of pediatric constipation cases Dr. Vrittamani sees at her Bayside Medical Group practice are associated with three transitions: when an infant is starting solids, when a toddler is toilet training and when a child is starting school.

Unfortunately, as diets become more processed and lives become busier, research shows rates of constipation are increasing among the general population—and the issue can compound when a child begins to associate pain with going to the bathroom.

"When there is constipation, try to tackle it early because chronic constipation comes from not intervening at the right time," says Dr. Vrittamani.

Here is what parents should know about pediatric constipation so there can be peace at potty time once again:

Identifying constipation

For the most part, constipation is easy to identify: A child is uncomfortable while unable to pass a stool, experiences minutes of straining and pain while attempting a bowel movement, or goes three or fewer times per week with hard, dry stool. Other side effects may include a distended belly or, in more serious cases, vomiting, fever or bloody stool—which Dr. Vrittamani says are good cues to call a doctor.

Although some children are more prone to constipation due to genetic causes, dietary or psychological factors can be the difference between relatively easy bowel movements or chronic struggles. A smaller number of constipation cases may be related to other causes, such as spinal abnormalities, Irritable Bowel Syndrome (IBS) or other conditions diagnosable by a physician.

But there are some misconceptions about constipation that can throw off parents. It's common for breastfed newborns, for example, to go days between stools and they may even appear to strain in order to have a bowel movement because of immature abdominal toning. The difference in these cases is that the babies don't experience the more tell-tale signs of constipation, such as belly distention, irritability or hard stools. (It is best to trust your own gut if you're concerned or call your family pediatrician!)

Dietary causes + cures for constipation

More typically, constipation challenges coincide with the introduction of solid foods—especially as highly starchy, processed or dairy-rich foods enter the baby's diet. Some culprits may even be surprising, such as apples, sweet potatoes and bananas. Rather than banish these foods from the home altogether, Dr. Vrittamani suggests "mixing and matching" at mealtime with foods that can help keep the digestive system moving along.

A few good examples she points to include…

  • "P- fruits," such as prunes, plums, pears, peaches, papaya and pineapple
  • Avocado
  • Berries
  • Lentils
  • Flaxseed for babies over 8 months
  • Brussels sprouts or broccoli
  • Prune juice

If diversifying your child's diet isn't working or you're eager for a short-term solution, Dr. Vrittamani also suggests offering small amounts of a concentrated apple juice. Even in a small dose, the pectin naturally found in apple juice can help stimulate the digestive system—and the encouragement to drink extra fluid can help, too. In fact, limited fluid intake is a commonly overlooked cause that may contribute to constipation. But, thankfully, it is just as easily fixed by encouraging water consumption throughout the day. (A good reminder for us all!)

A few more remedies include…

  • Moving baby's legs in a bicycle motion or encouraging older kids to play.
  • Taking a baby's temperature rectally, which can loosen stools.
  • Giving your baby a warm bath.
  • For older children, drinking warm lemon water.
  • Offering a probiotic supplement or food, such as yogurt.

If the constipation persists, a physician such as those at Stanford Children's Health would be able to offer advice on the proper course of treatment. Dr. Vrittamani says this should always be done before drastic, potentially dangerous steps are taken.

Specifically, she would advise against…

  • Stimulating laxatives
  • Milk of magnesia
  • Changing a baby's formula preparation to include more water
  • Switching to a low-iron formula
  • Mineral oil for children under age 2

Common psychological triggers

Although dietary changes may benefit anyone struggling with constipation, the cause isn't always dietary in nature: Especially in situations like toilet training or going to school for the first time, a child may end up "holding it in" out of fear or anxiety. This can be avoided or minimized by reading a child's cues about how he or she is feeling before sending the child into uncomfortable new territory.

Looking at potty training, parents should look for readiness signs, such as vocalizations about wet diapers and an interest in using the potty that is encouraged with books and videos on the subject. "What is important is for us to realize that when parents do start toilet training they want to do it in a way that is non-threatening so the child is involved in it," says Dr. Vrittamani, adding parents should use "encouragement rather than punishment" and employ non-food rewards.

Like the rest of us, children are also beings of habit, so it can help to create a routine out of potty time. Dr. Vrittamani suggests encouraging a child to sit on a toilet after breakfast each day for no more than 10 minutes, but without distractions from books or videos.

For school-aged children, the same kinds of stress may contribute to constipation, which can be compounded by anxiety about cleaning themselves or having to tell a teacher when they need to go. "All of this becomes a self-esteem issue eventually," says Dr. Vrittamani, explaining parents should work with children before school on having bathroom confidence and independence.

Just as constipation triggers can vary from child to child, the right solution may require a bit of time and experimentation to pin down. But with these best practices in mind for a solid starting point, you can minimize the struggle—and hopefully prevent constipation from making a return to your home anytime soon.

This article was sponsored by Stanford Children's Health. Thank you for supporting the brands that support Motherly and mamas.

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It's finally 2020. It's hard to believe but the old decade is over, the new one is here and it is bringing a lot of new life with it. The babies born this year are members of Generation Alpha and the world is waiting for them.

We're only a few days into the new year and there are already some new celebrity arrivals making headlines while making their new parents proud.

If your little one arrived (or is due to arrive) in 2020, they've got plenty of high profile company.

Here are all the celebrity babies born in 2020 (so far):

Ashley Graham is a mama! 🎉

A new chapter is unfolding for model and podcaster Ashley Graham, who just announced she and her husband Justin Ervin have met their baby.

The baby arrived Saturday, according to a post made on Graham's Instagram Stories.

"At 6:00pm on Saturday our lives changed for the better," reads the Story. "Thank you for all your love and support during this incredible time."

Graham previously announced that she and Ervin were expecting a son. They initially announced the pregnancy on their ninth wedding anniversary.

Congratulations to Ashley and Justin!

Cameron Diaz and Benji Madden just welcomed a baby girl! 🎉

Surprise! Cameron Diaz and Benji Madden are ringing in the New Year as first-time parents!

"Happy New Year from the Maddens!" reads a birth announcement posted to both Diaz and Madden's Instagram accounts. "We are so happy, blessed and grateful to begin this new decade by announcing the birth of our daughter, Raddix Madden. She has instantly captured our hearts and completed our family."

Raddix Madden is the first child for Diaz, 47, and Madden, 40.

The couple say they won't be posting any pictures of their daughter on social media as they "feel a strong instinct to protect our little one's privacy."

Congratulations to the Maddens! 🎉

Dylan Dreyer of 'Today' is a mom of 2! 

Today meteorologist Dylan Dreyer and her husband Brian Fichera, welcomed their second child, Oliver George Fichera, the first week of January 2020. Oliver joins his big brother Calvin to make the family a foursome.

Dreyer is still recovering from birth but her voice was on TV this week when she called into her show with an update on her new family. "I feel good," Dylan told her colleagues. "I just feel so happy and so blessed."

Caterina Scorsone of 'Grey's Anatomy' now has 3 girls!

Caterina Scorsone of Grey's Anatomy has so much to be thankful for in 2020: She's now a mom of three! The actress announced the birth of her daughter via Instagram, noting that her baby's name is Arwen.

Arwen joins big sisters Eliza, 7, and 3-year-old Paloma, who has Down syndrome. Speaking on The Motherly Podcast last year, Scorsone explained how Paloma's diagnosis made her "whole concept of what motherhood was had to shift."

It is likely shifting again, as any mama who has gone from two kids to three knows.

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When it comes to taking care of the baby and the house, modern dads say they want to be equal partners.

But when Saturday arrives, research shows men are often relaxing while women are the ones doing unpaid housework with a “leisure time" discrepancy of more than 50 minutes a day on the weekends.

The study revealed that women were more likely than men to spend their weekends watching kids or performing housework.

So after a long week of watching kids or clocking hours on the job, what does mom do more of than dad? Work.

Claire M. Kamp Dush, Ph.D., an associate professor of human sciences at The Ohio State University, and lead author of the new study, says she is hopeful we can all find more balance. It's just going to take some hard discussions—and an understanding that there's more than one way to load a dishwasher or dress a baby.

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The study published in the journal Sex Roles saw Ohio State researchers tracking how 52 dual-income couples spent their time on a minute-by-minute basis as they welcomed their first child. The participating couples kept time diaries for workdays and non-workdays during the third trimester and for about three months after the baby's birth.

The researchers expected to see a lot of entries where mom and dad were doing childcare or housework together, but they didn't.

“Men actually increased their time doing leisure while she was doing work across the transition of parenthood," Kamp Dush shares. “It actually got worse once the baby was there."

According to Kamp Dush, there are a couple of factors behind this disappointing dynamic.

“One thing that's going on is women have a lot of societal pressure put on them to be perfect mothers. So if something is less than perfect with the baby or the house, the consequences are coming back on them," she explains, adding this pressure to have everything done to high standards may lead some moms to micromanage their partners.

If a dad is slacking, Kamp Dush suggests moms ascertain what his motivations are. Often, she says the solution may be as simple as empowering him to do things his own way. (Even if it isn't the outfit you would have picked for the baby...)

“It may also be the case that he just doesn't want to do it and he enjoys his leisure time," says Kamp Dush. If that's the case, she suggests calmly explaining the cost that his rest requires you pay. That may prompt him to do a bit more because, as Kamp Dush says, “He might also enjoy having a happier spouse and co-parent."

The earlier you can have these conversations, the better

Unaddressed resentment in relationships tends to build overtime, which is why it's essential to check in on how you (and your partner) are feeling early and often.

Kamp Dush suggests moms with heavy mental loads write down the tasks and duties they're dealing with. Then rip the list in half and hand it to dad. Couples can certainly negotiate the listed responsibilities, but the important thing is that they're not all on mom.

“Then, you're going to have to let it go," she explains. “Men know how to do these things. As women, we need to just let them do it."

Dads need to do 50 minutes more of unpaid work

The gender disparity in unpaid work hurts our careers, our families and our relationships, but it doesn't have to.

According to the Promundo's State of the World's Fathers' report, if men did 50 minutes of unpaid work a day we could close the gender gap.

"We need men to do our share. Fifty minutes more to relieve women of 50 minutes less would get us really close to equal," the president and CEO of Promundo, Gary Barker, tells Motherly.

When dads are more empowered and moms feel like their household responsibilities are more balanced, the whole family is going to be better off.

[A version of this post was first published July 29, 2018. It has been updated.]

News

For new mamas back to sitting behind their desks at work some six weeks (or fewer) after their babies are born, the institutionalized parental leave policy in Denmark is the stuff of daydreams: Over in that Scandinavian paradise, parents are granted 52 weeks of paid leave to divide between them.

There's no denying this is much, much better than the state of parental leave in the United States, but it isn't quite as perfect as it seems from the outside. According to Denmark's Directorate of Employment, Labour and Social Affairs, women take an average 93% of leave allotted to couples. And when they do return to work, mothers' wages suffer both in comparison to men and women without children.

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The good news is that it seems the solution to this gender income gap is something we—the mothers of today, even here in America—can do something about.

A new paper from the US National Bureau of Economic Research that examined Danish administration information from 1980 to 2013 found the motherhood penalty “creates a gender gap in earnings of around 20% in the long run," which is comparable to the gap in the United States.

What's more, the income discrepancy only increases for each child a family in Denmark has: If a woman has four children, her income is only $0.60 to every dollar a man makes—10 years down the road.

While this indicates paid parental leave alone may not be the panacea for the gender income gap, the researchers suggest that changing the way we think about roles in the workplaces and homes could help—at least when it comes to the next generation.

“As a possible explanation for the persistence of child penalties, we show that they are transmitted through generations, from parents to daughters (but not sons)," the researchers note, explaining that the more a daughter's mother worked while the girl was growing up, the less the daughter's income was affected when she became a mother.

“Women tend to adopt a balance of paid work and childcare that is correlated with the one they saw their mother strike when they were growing up," Henrik Kleven, a Princeton economist and the paper's lead author, tells Quartz At Work.

What this looks like in practice is splitting household responsibilities from the get-go and encouraging fathers to take more leave. (In Sweden, where fathers are penalized for not taking advantage of paternity leave, women's earning rose an average 7% for each month of leave that men took.)

According to the State of the World's Fathers' report, produced by Promundo (a non-profit organization dedicated to engaging men and boys in gender equality in partnership with Dove Men+Care) 85% of dads surveyed in the United States, the UK, Argentina, Brazil, Canada, Japan and the Netherlands want to take paternity leave, and yet less than 50% of fathers take as much time as their country's policy allows, and social norms, financial pressures and a lack of support from their managers are all factors.

The report also found that if fathers are able to do just under an hour of unpaid work per day, mothers can cut their unpaid labor time by the same amount.

"We need men to do our share. Fifty minutes more to relieve women of 50 minutes less would get us really close to equal," the president and CEO of Promundo, Gary Barker, told Motherly.

This may help shift us toward more income equality today—and, as the research shows, our daughters will really be able to reap the benefits.

[A version of this post was first published January 29, 2018. It has been updated.]

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