Sunday, February 23, 2014

Skin to Skin Contact: The Right Start


Being skin to skin with your baby after birth has many benefits on your health and baby's health including:

  • Baby is warmer. Your skin is a radiant warmer and will help regulate your baby's body temperature. Simply lay baby on your skin, abdomen or chest, dry the baby off while there and put warm blankets over you and baby.

  • Baby breathes more normally. Babies who are skin to skin with mom after birth breathe more easily and more rhythmically.

  • Baby cries less. The comfort of being with mom leads to babies who cry less after the initial cries at birth.

  • More breast milk. When babies are skin to skin after birth, they are more likely to nurse and nurse sooner and longer. This can lead to a better breast milk supply.

  • Baby can her your heart beat. After nine long months of hearing your heart beat, your baby feels comforted by hearing the heart beat he or she has grown with.

  • Baby is more likely to have a normal heart rate. All of these add up to a baby who is more stable.

Skin to skin with baby is good for all types of births, assuming your baby is stable.   Often even after a cesarean birth mom can hold baby skin to skin ; or dad can perform this important role if mom is not available.  There are a multitude of studies that show that mothers and babies should be together, skin to skin (baby naked, not wrapped in a blanket), immediately after birth, as well as throughout the fourth trimester. 

We know that this is true not only for the baby born at term and in good health, but even for the premature baby. Skin to skin contact and Kangaroo Mother Care can contribute much to the care of the premature baby. Even babies on oxygen can be cared for skin to skin, and this helps reduce their needs for oxygen, and keeps them more stable in other ways as well.

From the point of view of breastfeeding, babies who are kept skin to skin with the mother immediately after birth for at least an hour, are more likely to latch on without help and are more likely to latch on well, especially if the mother did not receive medication during the labor or birth. 

There is no reason that the vast majority of babies cannot be skin to skin with the mother immediately after birth for at least an hour. Hospital routines, such as weighing the baby, should not take precedence.

The baby should be dried off and placed on the mother. Nobody should be pushing the baby to do anything; nobody should be trying to help the baby latch on during this time. The mother and baby should be left to enjoy each other’s company. (The mother and baby should not be left alone, however, especially if the mother has received medication, and it is important that not only the mother’s partner, but also a nurse, midwife, doula or physician stay with them—occasionally, some babies do need medical help and someone qualified should be there “just in case”). If the optional eyedrops and the injection of vitamin K are being administered, they can wait a couple of hours.

Studies have shown that even premature babies, as small as 1200 g (2 lb 10 oz) are more stable metabolically (including the level of their blood sugars) and breathe better if they are skin to skin immediately after birth. The need for an intravenous infusion, oxygen therapy or a nasogastric tube, for example, or all the preceding, does not preclude skin to skin contact. Skin to skin contact is quite compatible with other measures taken to keep the baby healthy. Of course, if the baby is quite sick, the baby’s health must not be compromised, but any premature baby who is not suffering from respiratory distress syndrome can be skin to skin with the mother immediately after birth. Indeed, in the premature baby, as in the full term baby, skin to skin contact may decrease rapid breathing into the normal range.

Tuesday, February 4, 2014

Planned Birth Support by Harmony at Home


Caring for your newborn after a cesarean presents many different challenges. Feel secure, prepared and nurtured with the support of Harmony at Home. Whether a planned or unplanned C-Section, we will determine your individual needs and goals for successful healing. We'll provide the comprehensive support you and your baby need to safely make the transition from pregnancy to family.



​Harmony at Home offers hourly and overnight C-Section Support. Services may include:​

  • PreNatal Visit and Planning Session
  • Immediate Postpartum Support, Hospital to Home
  • Overnight Care
  • Incision Care
  • Breastfeeding and BabyWearing for the C-Section mom
  • Basic Newborn Care
  • Meal Preparation, Grocery and Menu Planning
  • Light House Cleaning and Errands
  • Infant Massage Instruction
  • Pet Care
  • Dad Support
  • Care to 6 weeks Postpartum



Here's how our program works~

*Free consult, if you would like we will meet with you for coffee (or tea!) so we can get to know each other in person.

*One Home Visit at 38 weeks to "fluff your nest!" We plan and prepare for you to have a smooth transition home, with everything you need all in place. 

*Post Natal support the day of the planned birth. We will be there to facilitate the natural bonding process from lots of skin-to-skin to back-to-basics breast feeding support so you are set up to succeed from the very beginning.

*24 hour Hospital visit for continued breastfeeding support and troubleshooting.

*First Postpartum visit the day you travel home. With your pillows just right, and fresh food and water on your night stand, it's straight to bed with your sweet new baby. We will leave you feeling confident in your ability to rest, recover and nourish your newborn now that you're home.

*Photography & Birth Announcements, Belly Casting and Infant Massage Instruction are all available upon request.

*Daily to overnight Newborn Nurse & Doula services are tailored to meet the needs of the family and change over the course of the Postpartum period. Our goal is to gracefully step aside as your new family settle in.


References available upon request.
Newborn Nurse, PP Doula Insured.
Contact us now! Space is limited.

Breastfeeding Basics for New Families


During the first few days after your baby is born, breastfeeding can be daunting and confusing. Many new parents are haunted by questions of whether their baby is getting enough milk and "are we doing it right?" Successful breastfeeding relationships are establish in an atmosphere of trust, support and knowledgeable guidance.  Harmony at Home is here to help if you have any questions or problems.

Here are some of our basic guidelines to keep in mind for the first few weeks.

Whether or not baby is getting enough milk is one of the most common concerns of new moms. Since we don't have measurement markers on our breasts, we can't initially "see" that our babies are really getting the milk they need. You can tell baby is getting enough milk, however, by keeping track of dirty diapers, weight gain, and appearance.

Diapers

Counting your baby's diapers can be a helpful indicator as to whether or not he is getting enough of your milk.
baby's agemother's milkwet diapers/24 hrsdirty diapers/24 hrs
1-2 dayscolostrum (provides immunities and helps with jaundice)1-2greenish-black tarry meconium
2-6 daysmilk "comes in"; bluish color5-6 wet disposable diapers
(6-8 wet cloth diapers)
At least 3 greenish transitional stools
6+ daysmilk supply adjusts to suit your baby's needsSame as 2-6 daysAt least 3-5 very loose stools; bright yellow color that are about 2.5 cm
6 weeksmilk supply establishedSame as 2-6 daysSome babies switch to less frequent but large bowel movements


Signs of poor feedings

  • Feeling pain during feedings
  • Sleepy baby
  • Inconsistent, flutter (weak) sucking
  • Difficulty latching-on and staying on
  • Clicking or popping sounds in your baby’s mouth
  • Prolonged nursing (more than 20-25 minutes on each side)
  • Infrequent nursing (baby does not wake to feed at least every 3 hours)
  • Frequent nursing (more than 12 per day)
  • Baby is not satisfied at the end of the feeding
  • Engorgement
  • Inadequate wet diapers and stools
  • Rapid or excessive weight loss (more than 7-10%) during the first few days
  • Has not regained birth weight by 2 weeks
  • Slow weight gain thereafter (less than 1/2 – 3/4 oz per day)


Signs of good feedings

  • Feeling a deep, strong pulling sensation without sharp pain
  • Consistent sucking with only brief pauses
  • Hearing swallowing (after the milk comes in)
  • Latch-on is easy
  • 15-20 minutes of vigorous sucking per breast (20-30 minutes for one breast feedings)
  • Breasts are softer after the feeding
  • Seeing milk in your baby’s mouth
  • Feeling a let-down reflex or seeing a change in the baby’s feeding rhythm
  • Adequate wet diapers and stools
  • Minimal weight loss during first few days
  • Regain birth weight by 2 weeks and gains ¾ to 1 oz thereafter


Breastfeed Often

A baby needs to breastfeed frequently. Your milk is digested quickly and easily, sometimes in as little as 60 minutes, and small amounts are perfect for baby's tiny stomach. These frequent feedings also help to establish your milk supply. In simple terms, the more milk that is removed from your breasts, the more milk your body will produce. Frequent feedings are good for both of you!  Keep in mind that some babies "cluster nurse," which means that they nurse very often for a few hours and then sleep for several hours. The number of feedings in a 24-hour period is more important than the spacing of feedings.  A sleepy baby may need to be wakened every two to three hours to feed, particularly if he has jaundice. Talk with your health care provider if baby is lethargic and difficult to wake for feedings.


Watch Baby, Not the Clock
Watch your baby for signs of hunger, not the clock. Follow baby's feeding cues and do not try to schedule feedings or limit feedings. Early hunger cues include:

Baby opening his mouth and moving his head side to side (known as the rooting reflex).
Baby making sucking motions with his mouth.
Baby begins to chew or suck on his hands or fingers.

Don't wait for your baby to cry to let you know he is hunger. Crying is a very late hunger cue.


Increasing Your Supply

Mothers throughout the ages have been able to produce plenty of milk for their babies. In certain situations because of a health problem or other complication, a mother may have a reason to be concerned and may need to carefully monitor her baby's weight gain in order to be sure he is getting enough milk. If baby is not gaining well or he is losing weight after the first few days, contact baby's health care provider. Slow weight gain may indicate a serious health problem. If you're concerned about your milk supply, get help. Being in touch with a Postpartum Doula, La Leche League Leader, or Lactation Consultant can often provide the information, support, and encouragement that mothers need to be reassured that they are providing plenty of milk for their babies. 

Steps that will help your baby get as much of your milk as possible include:

Nurse often for as long as your baby will nurse. The more milk that is removed from the breast, the more milk the breast will make to replace it. Frequent breastfeeding helps to establish a plentiful milk supply. A sleepy baby may need to be awakened and encouraged to nurse more frequently. A baby who nurses for excessively long periods may not be nursing efficiently.

Offer both breasts at each feeding. This will ensure that your baby gets all the milk available and that both breasts are stimulated frequently. Allow your baby to indicate he is finished on the first breast, then offer the other breast.

Check baby's positioning and latch. Breastfeeding should not hurt. Hold baby close with his whole body facing you so he does not have to turn his head. When he opens his mouth wide, his head should be slightly tilted back with his nose at the level of your nipple. As he approaches the breast with his head slightly tilted back, this will bring him to the breast chin first. This will help you better aim his lower jaw so that he covers more of your breast with his lower jaw than with his upper mouth. As you bring baby onto the breast, aim your nipple toward the roof of his mouth. If you feel comfortable and baby is nursing actively, the latch is good.

Try breast compression to keep your baby interested in breastfeeding. Squeeze the breast firmly with your thumb on one side and fingers on the other to increase milk flow. Keep squeezing until baby is no longer actively sucking, then release. Rotate fingers around the breast and squeeze again. Then switch to the other breast, using both breasts twice at each feeding. Squeeze firmly but be careful not to cause injury to your breast tissue.

Feed your baby only your milk. If your baby has been receiving formula supplements, do not cut these out abruptly. As you improve your breastfeeding techniques with the help of a lactation professional, and as your milk supply increases, you will be able to gradually reduce the amount of supplement. Monitor baby's weight gain and stay in touch with your baby's health care provider during this transition.

All your baby's sucking should be at the breast. If some supplement is necessary, it can be given by spoon, cup, or with a nursing supplementer. Be aware that a pacifier can create more problems than it solves. If you decide to give your baby a pacifier, wait until he is nursing effectively and gaining well.

Use skin-to-skin contact. It may encourage your baby to nurse more often. Skin-to-skin means that baby will be nestled upright between your breasts, clad only in his diaper directly against your skin. Your warmth, smell, and heartbeat will also soothe baby, which in turn aids in his development.

Try to relax. Paying attention to your need for rest, relaxation, and proper diet will help your milk supply and improve your general sense of well-being.

Talk to your health care provider about diet, medicinal herbs or prescription medications to increase your milk supply.



If you have concerns...

Some mothers think their babies are not getting enough milk when they are actually getting plenty of milk. Some "false alarms" that worry mothers include:

Your breasts feel different. If your breasts suddenly feel softer or your breasts no longer leak between feedings, it does not mean that you are producing less milk; it simply means that your supply has adjusted to your baby's needs.

Baby seems fussy. Many babies have a fussy time every day that is not related to hunger. Some babies need lots of stimulation and activity; others need soothing. You will learn how to respond to your baby as you find the ways that comfort him. If your fussy baby settles down when you offer him the breast, go ahead and breastfeed. But don't take this as a sign that he is not getting enough to eat.

Baby suddenly wants to feed more often, or seems hungry again soon after being fed. Babies often go through "growth spurts" when they are two to three weeks old and again at six weeks and three months. At these times, breastfeed as often as possible as your supply catches up with baby's demand.

Baby decreases his nursing time, perhaps down to five minutes or so at each breast. As babies get older, they become very efficient at taking the milk so this is a positive sign that breastfeeding is going well, not something to worry about.

La Leche League Leaders are accredited volunteers who are available to help with breastfeeding questions in person, over the phone, or online. Locate an LLL Leader near you at www.llli.org.


Please be aware that the information provided is intended solely for general educational and informational purposes only. It is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician for any questions you may have regarding your or your infant’s medical condition. Never disregard professional medical advice or delay in seeking it because of something you have received in this information.