When your baby wants to be Peter Pan – weight gain problems

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Since our little baby was born I have been acutely aware of his weight. Initially we went for weekly weight checks at our baby-clinic to determine whether he was gaining well. It is one of the few ways to determine if he was getting enough breast milk. I even went to buy a bathroom scale (something we never had), so I could get an estimate of what his weight was. Over the last 7 months I have realised I am not alone. Many of my friends struggled with babies that did not gain weight appropriately, causing stress on different levels. Every mom wants to know that her baby is healthy and GROWING, and if it all depends on milk that you cannot even see, it is easy to fall into a negative cycle of slow weight gain – anxiety – decreased breast milk production – slower weight gain – add-on feeds – decreased breast milk production – insufficient weight gain and finally changing over to formula feeding all together.

* In the end I agree it is more important that you have a healthy, GROWING baby, and if formula is necessary to achieve that then please give it, but I am at heart a big breastfeeding-fan, so I would like to help you get over this hurdle without giving up on breast milk! 😉

“Growth is never by mere chance; it is the result of forces working together” – James Cash Penney

So what is normal weight gain and when should you worry?

During the first few days of life it is normal for your baby to lose weight. This is due to all the excess fluids that you and baby retain during the last few weeks of pregnancy and can be exaggerated if you had an epidural / spinal with extra intravenous fluids during the delivery. Another contributing factor is the volume of colostrum. This liquid gold is very concentrated specifically to give your baby’s kidneys time to get used to working with larger volumes of fluid. It is however important to make sure your baby does not lose more than 10% of his birth weight, and that he starts gaining weight again after a few days. A term baby should reach at least his birth weight by 7-10days of age, a premature baby can take up to 14days to get back to birth weight.

There-after the general rule of thumb for a healthy weight gain is 20-30grams per day (140-200g/week) for the first 4months. From 4-6months breastfed babies tend to gain 90-120g/week and 50-80g/week from 6-12months. It is important to understand that these numbers are calculated from the average weights of a large number of healthy babies. This means that there were babies who gained more or less than these suggested weights and were still healthy. ^1,2

“All children, except one, grow up.” ― J.M. Barrie, Peter Pan

Peter Pan Before you start weighing daily or weekly for the rest of your baby’s life… remember that growth over time is more important than one good or bad weight. That is why we use growth charts to keep track of your baby’s weight gain over time. We want your baby to follow the shape of the curve (whether he is above or below the “middle” line). This allows your individual baby (who might have very tall or petite parents) to grow within a healthy margin. We as health care practitioners start to worry when your child drops from the line where he used to grow to a lower curve (percentile), or if the weight stands still, causing a flat line on your curve. Once again this should be seen in context. Your little one might have had a bout of gastro just before the weight was taken, or he might have a chronic disease or syndrome where we expect him to grow slower.

If you are worried that your baby is not gaining weight, take a step back and look at some of the other indicators that your baby is getting enough milk and is growing. Is your baby having 4-6 wet nappies per day? How many dirty nappies per day? (The stool frequency can change after 6 weeks, but before that there is usually a minimum of one stool per day). Is the length- and head-circumference measurements increasing? I have seen many babies have a growth spurt in length before the weight catches up. If your baby’s head is growing in circumference, it means his brain is getting enough calories to grow. Is it the same scale that was used previously? Is the scale calibrated?

If your health care provider is also worried about your baby’s weight gain, they should ask a thorough history, do a good clinical examination and appropriate special investigations to understand why baby is not growing well. The underlying cause is usually due to a lack of provided nutrients (baby is not latching well or has started sleeping through the night and is now missing out on calories previously provided by the night feeds), or due to a problem in the absorption of the nutrients provided (severe reflux and vomiting, allergies, certain metabolic diseases), or due to an increased use of the nutrients (acute or chronic diseases, congenital abnormalities).

It is important to understand the cause so that the treatment can be directed in the right direction. It does not help to only give supplemental feeds when the problem is that the baby is not absorbing any of his feeds. Regular follow-ups with your health care provider is very important until your baby gains weight sufficiently again.

Weight is an indicator of wellness over the last few weeks, while length shows us the wellness over months and years. If a baby does not grow well for a prolonged period of time, it may lead to him not reaching his full potential in height and other areas of his development. There might be complications of specific vitamin and mineral deficiencies and ultimately permanent damage to the brain. Early identification and treatment may help to prevent long-term complications.³

There is a handy app that you can download to your tablet or cellphone to keep track of your baby’s growth. It helps you keep track of the weight, height and head circumference, and will also show you the child’s weight-for-length (a handy measurement that shows overall wellness).

http://get.growthapp.net/ for Iphones

https://play.google.com/store/apps/details?id=com.abqappsource.childgrowthtracker for Android.

I hope your baby will grow and GROW and GROW! 😉

We continually ask God to fill you with the knowledge of his will through all the wisdom and understanding that the Spirit gives,^[a] ¹⁰so that you may live a life worthy of the Lord and please him in every way: bearing fruit in every good work, growing in the knowledge of God, ¹¹being strengthened with all power according to his glorious might so that you may have great endurance and patience. – Col 1:9-11

Photo’s from Google Images

https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/infant-growth/faq-20058037
World Health Organization Child Growth Standards, 2006
Perrin E, Frank D, Cole C, et al. Criteria for Determining Disability in Infants and Children: Failure to Thrive. Evidence Report/Technology Assessment No. 72. AHRQ Publication NO. 03-E026. Agency for Healthcare Research and Quality, Rockville, MD, March 2003.

The oral thrush episode…

One of my biggest mom-fails/pediatrician-fails to date must be the episode with the oral thrush…

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‘Love never fails’ 1 Cor 13:8

I still feel really red-in-the-face when I tell this story, but it is important to share. I think we all try our very best as moms to do only what is best for baby, but sometimes the sleepless nights and hormones overwhelm us and then we need our support system to keep us on track. It is also important to know that as a pediatrician I also want what is best for your child, but we are only human and can make mistakes.

At about 3 weeks old I noticed that our baby boy’s tongue had a white patch on the middle of his tongue. I did not think much of it as we have been giving him white, crushed “Magnesium Phosphate” tablets for cramps before each feed and that left a white residue everywhere. I did not notice that the white patch became thicker and larger. At our next weigh-in the sister asked me if I saw that my baby has oral thrush… I immediately objected and told her about the tablets, but she was wise enough to show me that you cannot remove this patch with a tongue-spatula, and that it was indeed oral thrush. I was very upset, not only because my poor baby had a problem, but also because I realised that the pediatrician-me missed a very easy diagnosis! Luckily I have a very supportive husband who quickly calmed me down and reminded me that I am Eran’s mother, not his pediatrician, and as such I do not need to make diagnoses on him, I only need to love him and care for him.

Let me tell you a little bit more about oral thrush:

oral thrush It is caused by a fungal organism (mostly Candida Albicans)¹and presents as white patches on your baby’s tongue, cheeks and palate. This white patch cannot be easily wiped off with a washcloth as a milk-patch would be, and if it is removed it might bleed. It can be asymptomatic, but it can also cause a burning sensation in your baby’s mouth or be painful and prevent baby from drinking well.

It is very common in babies under one month of age, and can also affect children/adults with a defective immune system. Candida is a fungus that normally resides in your mouth/other mucosal areas together with other organisms we call “flora”, and that all form part of your microbiome. When the balance between these organisms are disrupted, then you get an overgrowth of the Candida which then causes thrush. We started washing Eran’s dummies in Milton when he was 2 weeks old, and I think this wiped out all the “good” flora in his mouth, leaving ample space for the Candida to thrive.

The infection can spread to the mother’s nipples (presenting as very red, tender or a burning sensation of the nipples, or it can cause a red ring to form around the areola), and then can spread back to the baby, so it is very important to treat both the mother and the baby. The baby also swallows the spores, and thus the infection can easily spread to the buttocks where it presents as a red rash that does not improve only by using barrier creams, affects the skinfolds and scrotum, and may have red satellite lesions.

Specific treatment with an antifungal (usually Nystatin drops or Miconazole oral gel) aims to kill the overgrowth of Candida in baby’s mouth and on the mother’s nipples. There are many more “natural” ways to regain the balance in your baby’s mouth, but these should only be used in mild cases, and if it does not resolve, rather get an antifungal. We used a mixture of 1 cup cooled boiled water, ½ teaspoon salt and ¼ teaspoon Bicarbonate of Soda to create a more alkaline environment in which the Candida cannot grow, and then we applied Miconazole gel after every feed. Within 3 days the patches improved dramatically, and within 5 days it was totally cleared up. It is important to continue using the medication for 7-10 days to make sure the Candida does not take over again.

Other measures to ensure there are no more infective spores around baby, is to wash your bras / pajamas in hot water and to properly boil / sterilize his dummies / bottle teats.

Hopefully you will do better in noticing this condition in your baby than I did… Luckily it is not a very serious condition, but we don’t want anything making breastfeeding harder than it already is in the beginning, so rather sort it out asap!

“Even on the days you feel like you are failing, look around, I promise your kids still think you are the best mom in the whole UNIVERSE.” Julie Clark, Motivating Mother

Photo’s courtesy of Pixabay and Google Images

https://www.cdc.gov/fungal/diseases/candidiasis/thrush/index.html

My Breastfeeding Journey

6H3A2872k In my 3^rd year in medical school we had a few lectures on breastfeeding. Firstly a lecturer from the Physiology department taught us exactly how the hormones oestrogen and progesterone assists in the development of glandular tissues in the breast, and the changes that take place in the areola and nipple as you go through puberty. We were taught how the pituitary gland secretes the hormones oxytocin and prolactin that assists with the let-down reflex and milk production. We had a session on the 10 steps to successful breastfeeding (from a hospital-management point of view) that would save the whole community. And then we had a lecture with Sister Vanessa Booysen. She is a registered Nurse that has worked in the NICU for many years, and that has an absolute passion for breastfeeding and the nurturing of babies.

She lovingly taught us about the benefits of breastmilk (especially in the premature babies she has worked with for so long), the immune benefits, the bonding, positive emotional outcomes for mom and baby, the ultimate love story that is breastfeeding. It was inspirational! When we walked out of that class we all (the male students included) just wanted to go and breastfeed something! 😉

In the 8 years of working that followed I always very passionately explained to the mommies in the obstetric unit and sitting beside the beds of their babies in Neonatal ICU how very important breastfeeding is. It broke my heart when a mother chose to bottle feed before even trying to breastfeed or when we had to start a premature baby on formula milk because the mother was not interested in expressing. I believed everyone could breastfeed if they tried hard enough! I probably was a little bit of a “breastfeeding-cheerleader/tirant”!

Fast forward another year and now I have my own little milk monster that have been on this breastfeeding journey with me for almost 7 months! I have learned so much and have definitely gained a lot of respect and empathy for breastfeeding mothers. My cheerleading-approach will be more thoughtful and caring in the future.

(Warning– I am sharing my journey openly and honestly! If you are not comfortable with your boobs yet, this might get a bit squeamish!)

Despite all my physiological knowledge about the breast and breastmilk, I did not know much about breastfeeding and the trouble-shooting of the niggly-midnight-issues. I read a lot of blogs and attended the ante-natal classes to make sure I was as prepared as I could be. We attended the class on breastfeeding when I was around 28weeks pregnant. We were shown the technique for hand-expressing, and that night I tried it out… great was my surprise when a drop of milk appeared!!! How amazing are our pregnant bodies that our breasts are ready to produce milk the moment that it is needed!

Seeing as I did not have a normal vaginal delivery, I was adamant that I would at least get this breastfeeding thing right! When our midwife placed the crinkly, pink, warm body of our son on my chest in the theatre and he looked me in the eyes, the oxytocin surge was immediate! Our midwife assisted me right there to help him to latch on my breast (quite an awkward feat while still lying on the theatre table with all the drapes and cables in the way). In the recovery room our little boy finally got the hang of it and tried the sucking thing for a few minutes. I was overjoyed!

The next three days in hospital were mostly a bootcamp of breastfeeding! I made sure I had an easy-access top on, and baby stayed in or next to my bed so that I could feed him on demand. I was very worried when he did not pee for a whole day (yes, I kept checking for the blue line on the nappy!) and woke my husband in the middle of the night with a photo of the blue line when it eventually appeared! J Luckily the nursing staff was very supportive, and the baby-sister gave a pearl of wisdom : if baby has passed both stool and urine once after birth, we know he can do it. Then you do not worry too much for the next 3 days as output can vary. They take in very little fluids (colostrum is very concentrated) so they do not produce a lot of waste initially. Once your “milk has come in”, then they should have 4-6 wet nappies a day if baby is drinking enough.

As with any bootcamp you are tired, sore but satisfied by the end of it! Baby fed almost hourly the first two nights (clusterfeeding), this was necessary to stimulate my breasts enough for them to realise they need to up the production as they have to provide milk for a hungry little human for the next few months. My nipples where very tender, but fortunately did not bleed. I had the nipple-cream in my hospital bag, but in the end it was much easier and much more effective to apply colostrum to my nipples after each feed and let it air-dry.

By the time we went home, we were both a little bit more comfortable with the whole process. By then my milk had come in (this basically means that the milk has transitioned from colostrum (very rich, concentrated milk, 1ml colostrum = 25ml formula milk, looks golden in colour) to normal breastmilk (whiter in colour and baby needs more of it to keep him happy) and your breasts are now ready to produce larger volumes.) In the beginning your breasts overshoot in supply and baby still has a relatively small demand, and thus your breasts end up looking and feeling huge, heavy and warm (engorged). I was privileged that my milk-factories was moderate in their supply, so I never had hard, lumpy breasts. Another pearl of wisdom from my lactation consultant, Sr Vanessa Booysen, was that told me that I can feed from one breast per feed (this was at about day 6) so that baby can empty the breast completely – good for me and baby (he gets both the fore-milk and fattier hind-milk to keep him full for longer). At times baby struggled to latch as my breast was too full and I had to hand-express a little bit to make the areola-area soft enough for baby to manipulate.

After one week we went to a clinic to have baby weighed. I initially thought weekly weigh-ins are unnecessary, but in the end it was so comforting to know that baby was growing well, and the sister gave me a wonderful pep-talk each week. Baby always became hungry in the middle of the consultation, so his latch and positioning and my posture could also be evaluated, and the sister gave valuable tips each time. I also joined La Leche league on Facebook, and a local breastfeeding whatsapp group. I learned so much from the other moms, and it was wonderful to know I was not alone.

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At 2.5 weeks I noticed that there was a little blister on our son’s upper lip that sometimes formed after a feed, then would fall off and then form again. I asked around and heard that it was mostly associated with a lip-tie. After some more investigations, I realised that he had a small lip tie of his upper lip, but because he was latching and feeding and growing so well, we decided to just watch it. Lip ties usually resolve later (while for example brushing your teeth), and mostly does not need any interventions. Speak to your breastfeeding consultant, paediatrician or ear-nose and throat specialist if you are worried.

By week 3 my parents came to visit and baby and I started practising to feed with a feeding-cover. It was good to become comfortable with this in my own home, as it has saved me during many coffee-shop or mall visits. I only started expressing after 6 weeks as I did not want to mess with the demand/supply process (your milk production is relatively stable after 6 weeks) and we only tried to give baby a bottle after 10weeks (mostly because I was too lazy to express). Many moms express/bottle feed much earlier with big success. In my experience very few babies really get “nipple confusion”, they may start to prefer the bottle because it is so much easier to get the milk out. Breastfeeding is hard work! It is thus important to do paced feeding if you do give some bottles in between.

After 6weeks my nipples and breasts were not sore anymore, baby latched like a pro and suddenly only drank for 5-10minutes per feed (he used to take at least 20min per feed initially). Suddenly all the initial worries, pain, frequent feeds was worth it and I started to really enjoy these special times with my little boy.

“And my God will meet all your needs according to the riches of his glory in Christ Jesus.” Phil 4:19

We fell into a synchrony of request and production and all was well until he was almost 5months old and hit yet another growth spurt. I received very sad news from a friend and suddenly my milk production dropped! Baby boy wanted to drink every hour (grazing is also not good for milk production, as he only drinks a few sips and then stops, so the breast only replaces those few sips). I drank litres of water, jungle juice and tea, and spoke to my lactation consultant again. She advised that I use a few Rescue tablets and just relax, Oxytocin will do the rest. I also visited my clinic again, and seeing that our little boy actually gained some weight helped a lot to calm me down! After praying and declaring that God is my provider, and believing that He will also provide milk for our baby, I could finally feel my breasts filling and having a proper let-down again. I am so thankful that we can continue our breastfeeding journey for now.

So in a nutshell… make up your mind, have a good support system (especially a passionate lactation consultant) and believe that God will do the rest! What did you learn during your breastfeeding journey?

Mother knows breast – benefits of breastfeeding for baby (Part 2)

“ …A little child, born yesterday, a thing on mother’s milk and kisses fed…” Hymn to Mercury (one of the Homeric Hymns written in the 6^th century), translated from Greek by Percy Bysshe Shelley.

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Babies have been breastfed since the beginning of time. It is interesting to read about the history of infant feeding and how the role of breastfeeding has changed over the eras and according to the cultural expectations. There has always been a need for an alternative feeding mechanism (when the mother died or was very ill), and initially wet nurses were used to fill this need. From about 950-1800BC mothers often opted to use a wet nurse due to social conventions (it was hard to play cards during afternoon tea or wear the beautiful corsets if you were breastfeeding).¹

Alternative milk sources have also been used with varying levels of success since early times. Initially only animal milk was used, but as food preservation became more successful, and chemistry evolved, scientists developed substitute infant foods which were advertised widely as the perfect infant food. (This perfect infant food initially consisted of cow’s milk, wheat, malt flour, and potassium bicarbonate!)¹ Advertising campaigns in developing countries and directly to the general public did a lot of damage as it painted an ideal picture, and many moms chose formula- over breastfeeding.

So what did you base your feeding choice on? History? Cultural expectations? Need? Social conventions? Advertising? Social media? Your mother or grandmother’s choice? I would like to give you some facts, and then I hope you can make your choice based on love and evidence!

“A baby sucks a finger as instinctively as the breast – but the breast is better for the baby.” Martin H. Fischer (1879-1962)

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Here are some of the benefits for your baby…

Preterm infants:

A large part of my career consists of working in the Neonatal ICU, and I have seen the wonder of breast milk for these teeny tiny humans! Although the mother’s milk is the ideal, most of these benefits are also attained if pasteurised donor breast milk is used for the babies.

Short term benefits:

Breast milk is better tolerated by the immature bowels, and thus the volume of feeds can be increased quicker and these babies are discharged sooner from the Neonatal ICU.
Necrotising enterocolitis (NEC) is reduced up to 6-10 times² in prems receiving breast milk
Breast milk may contain some beneficial factors to reduce the severity of Retinopathy of Prematurity (ROP).³
Fewer episodes of late onset sepsis⁴

Long term benefits:⁵

Improved Neuro-developmental outcomes in mental, motor and behavioural aspects
Lower rates of metabolic syndrome (obesity, heart disease, high cholesterol, diabetes) and thus better insulin metabolism and lower blood pressures.

Benefits in Term, healthy babies ^{5, 6}:

Short term :

Decrease the risk of otitis media (middle ear infection), and lower respiratory tract infections. I will not bombard you with statistics, but for illustrative purposes hear me out. Your baby’s risk for middle ear infection is 50% less if you breastfeed exclusively for more than 3 months, and 23% less with any breastfeeding! You can give your baby some of the benefits even if you are struggling… just try!
Decreased risk for diarrhoea… up to 64% less with any breastfeeding!
36% decrease in the risk of Sudden Infant Death Syndrome.
Great for bonding as explained in my previous post, very convenient as it is free, always available, always clean, always the perfect temperature.

Long term:

Protective effect against allergic diseases, celiac disease and inflammatory bowel diseases
15-30% decrease in adolescent and adult obesity with any breastfeeding
Lower risk of Type 1 Diabetes and childhood leukemia / lymphoma

These are only a few of the benefits that were researched in developed countries. In South Africa it has been found that the risk of a baby dying increases 10 times if a baby is not breastfed, due to the higher risk of poverty, malnutrition and HIV.

“If you, then, though you are evil, know how to give good gifts to your children, how much more will your Father in heaven give good gifts to those who ask him!” Mat 7:11

I have used a lot of medical terms in this blog, so I hope you see my heart through the strange words. If you are a prem-mom, then you will know all the scary conditions like sepsis, NEC and ROP very well. There are many high quality studies that prove that breast milk really is the best food for your baby for the first 4-6months. Currently the World Health Organisation recommends exclusive breastfeeding until 6months, and then continuing to breastfeed until 2years or beyond to achieve the optimal growth, development and health. ⁷

Will you at least try to give your baby the golden liquid that your body is capable of making, even if it is only for a few months or supplemented with formula? Surround yourself with people who will support you on this journey, join a breastfeeding group and become an advocate for breastfeeding among your friends! In my next blog I will share my journey until now.

If you have any questions or comments, you are welcome to contact me and I will gladly chat with you.

Stevens EE, Patrick TE, Pickler R; A History of Infant Feeding; J Perinat Educ. 2009 Spring; 18(2): 32–39.
Lucas A, Cole TJ; Breast milk and neonatal necrotising enterocolitis; 1990 Dec 22-29; 336(8730):1519-23.
Okamoto T, Shirai M, Kokubo M, Takahashi S, Kajino M, Takase M, Sakata H, Oki J; Human milk reduces the risk of retinal detachment in extremely low-birthweight infants. Pediatr Int. 2007 Dec; 49(6):894-7.
Underwood MA; Human milk for the premature infant; Pediatr Clin North Am. 2013 Feb; 60(1): 189–207.
Ip S, Chung M, Raman G, et al. Tufts-New England Medical Center Evidence-based Practice Center; Breastfeeding and maternal and infant health outcomes in developed countries; Evid Rep Technol Assess (Full Rep). 2007;153(153):1–186p
American Academy of Pediatrics; Policy Statement, Breastfeeding and the Use of Human Milk; Pediatrics; March 2012, VOLUME 129 / ISSUE 3
http://www.who.int/mediacentre/news/statements/2011/breastfeeding_20110115/en/

Growing Kids with Character

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Start children off on the way they should go,
and even when they are old they will not turn from it.

Proverbs 22:6 (NIV)

This verse was one of the key verses at our baby boy’s dedication last weekend. I am so thankful that I had the opportunity to read it in a whole new context in the book “Growing Kids with Character” by Hettie Brittz this week, as it showed me a practical way to live out the promise we made. Litfuse Publicity gave me the opportunity to be a part of the blog tour and sent me this e-book, and I jumped at the opportunity as Hettie Brittz is one of my favourite authors.

I have started reading this book in Afrikaans, but the was interrupted by the first few months of surviving with a baby… and now, 6 months down the line I finally had the motivation to complete it.

In reading and writing I love using metaphors, and Hettie nailed the parenting journey with her gardening metaphor. She used four types of trees to describe four temperaments that your kids could have (or any combination of the four). There is an online questionnaire that you can complete to figure out what “tree” (temperament type) your child is growing to be, and then the book teaches you more about the characteristics, strong points and weaknesses of that temperament, and how to parent that child better. Life is full of hard, confusing, scary weeds and other temptations, and we all want our kids to grow into the plan the Father has for them. Based on scriptural principles, this book helps you to reach that goal.

Sneak peak…

Palm tree 1

The palm tree conjures pictures of an island, with coconuts hanging from the tree and monkeys playing around the branches, dancing to the beat of the hula… these kids are jovial, fun-loving and live for the moment, but do not like routine and chores.

rose bush 1

A rose bush may be prickly but it produces the most beautiful flowers! They require aggressive pruning, but they’re tough… these kids are driven, competitive, and usually very successful, but need to be shaped early in order to grow their beautiful roses.

boxwoodtree 1

The boxwood tree is often used as decoration and appears very neat and tidy and controlled. Kids with this temperament thrive in situations with strict rules and regulations, and have high standards for themselves.

pine tree1

The pine tree represents the calm you find in a plantation. Pine-tree kids are deeply anchored, stubborn and not eager to be transplanted. They are peaceful in nature, loyal friends and very attached to their families.

“I am not the whole story when it comes to parenting. God, other parents, life, friends, and influences will parent with me. I will deserve neither all the blame nor all the glory. I will be stretched in the process.” Hettie Brittz, Growing Kids with Character

This book is full of practical tips, but also full of grace for parents. You will feel more equipped to handle discipline, relationships and praise for your specific child. There are even some characteristics outlined that you can start recognising from as young as babies and toddlers, so the book grows with your family. You do not need green fingers to have happy, healthy children!

I really want to encourage you to read this book. (It is also available in Afrikaans as “Kweek kinders met Karakter”). It creates a strong, wise framework for you to build your parenting on. You can also become part of the Evergreen parenting / Tall trees profiles community on Facebook or on their websites (https://evergreenparenting.co.za/ or https://www.talltreestraining.com/).

Hettie Brittz is a South African–born author, international speaker, and a foremost voice in parenting advice and personality styles. She is the author of “(un)Natural Mom,” the developer of the Evergreen Parenting Course, and the codeveloper of Tall Trees Profiles. She heads up Tall Trees Consulting (USA).

Benefits of Breastfeeding

Breastfeeding 1

There are a few brand new babies in our friend-circle, and looking at them, I cannot believe how far my little boy and I have come on our breastfeeding journey in just 5months! I have already forgotten the difficulties of those first few days, and he is now breastfeeding like a pro!

“If we wear our nursing covers backwards like capes, then everyone can see we’re breastfeeding superheroes.” Cassi Clark, Breastfeeding Is a Bitch: But We Lovingly Do it Anyway

Let us be honest with each other, breastfeeding is the most “natural” choice, but it is definitely not the easiest initially and it does not always come naturally to a brand new mom. As you might know, breastfeeding is ruled by two hormones: Oxytocin and Prolactin, both secreted by the pituitary gland in the brain.¹The regulation of both these hormones are very sensitive to pain, fear, stress, love, happiness and bonding with your baby. So basically, breastfeeding is “all in the mind”…

If you choose to breastfeed, make up your mind that you WILL BE ABLE TO! Your body was made wonderfully, so do not let anybody stir doubt in your mind. Surround yourself with people who will be supportive, and people who can help you when you are struggling and then give it your all. It truly is one of the best gifts you can give your baby and yourself.

“Yet You are He who pulled me out of the womb;
You made me trust when on my mother’s breasts.” Ps 22:9

I really want to encourage you to breastfeed! There are so many benefits for mom and baby. To help you stick it out over the long haul, I want to look at a few of the benefits of breastfeeding with you. Today I want to only look at the benefits for mom (after all, you will be doing all the hard work), next week we will look at the benefits for baby in both the short and long term, and then I will share a little bit about my own journey.

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Immediate and Early Benefits for Mom:

Bonding. This has a lot to do with the hormone Oxytocin (so called “love-hormone”) that is released both in you and your baby while breastfeeding (the suckling, the close skin-to-skin contact and the eye contact releases oxytocin, but there is also some of the hormone in your breast milk).² Oxytocin is also released when you hug someone for longer than 6 seconds and after sex… so it is safe to say that a trusting, positive bond should develop between you and your baby.

Reduce bleeding after delivery.³Once again… that wonderful hormone Oxytocin! It helps the uterus to contract (just like in labour) which in turn limits the bleeding.

Reduce stress and improve sleep. You probably know the answer by now… Oxytocin! 🙂 It makes you feel calm and produces feelings of trust, thus lowering your stress levels. It reduces cortisol, lowers blood pressure and improves digestion. This in turn is the perfect recipe for sleep, giving you a little more of a very valuable and scarce commodity in those first few days.

Prolong amenorrhoea and an-ovulation.³Breastfeeding exclusively has the natural effect of suppressing ovulation, thereby acting as a natural birth control for up to 6 months (or as long as the woman is exclusively breastfeeding and her menses have not returned). This is not 100% fool proof and your gyne will usually discuss other methods of contraception with you at your 6 week follow-up, but it helps. And who will not take the chance to be free of “Aunt Flo” for as long as possible!

Long-term Mom-Benefits

Postpartum weight loss. Yes ladies, you heard right… finally something that burns fat!! Pregnancy tends to add on the kilos, but luckily we have a built-in solution. In a large prospective cohort study, Baker et al.⁴ showed that greater exclusivity and duration of breastfeeding was associated with greater weight loss at 6 and 18 months postpartum in women of all BMI categories. Another great reason to stick it out!

Reduce Type 2 Diabetes Mellitus, Metabolic disease and Cardiovascular risk. During pregnancy your body adapts in order to sustain your growing baby. Some of these changes include a mild degree of insulin resistance and changes in your lipid profile. There is some evidence for a “Reset Hypothesis”⁵that happens when you breastfeed so that your cells are once again more sensitive to insulin, and that changes your lipid profile back to a healthier combination, thus decreasing the risk for chronic metabolic diseases.

Reduce risk for breast and ovarian cancer. According to a 2002 meta-analysis⁶ (a very trustworthy type of study), your risk for developing breast cancer is reduced by 4.3% per year of breastfeeding. There is also a decreased risk for ovarian cancer. It is thought that this is due to a decrease in the time that your body is exposed to estrogen (during breastfeeding this hormone is suppressed).

Benefits that spill over to the whole family…

(These have nothing to do with your biology or health, but believe me they play a big role in your overall well-being!)

It is FREE! Babies cost a lot of money, but this is one area that does not have to cost you a cent for at least 4 months. No need for bottles, formula or sterilizing equipment.
It is always the right temperature (no more stumbling to the kitchen to try and heat the bottle in the middle of the night)
It is naturally sterile! This saves a lot of time, as you do not have to wash and boil water or microwave or steam bottles and teats. In fact, the microbes that baby get into contact with during breastfeeding are GOOD for him! (More on that in the next post).
It is always available! If you stay out for longer than planned and baby wants to eat NOW, it is very easy to just find a quiet corner and let baby eat.

After saying all of that, I am sure you can start to understand why I am very passionate about breastfeeding. In the end however I agree that “fed is best”. I do understand that there are some circumstances where the ideal is not achievable, and I know your mommy-heart only wants what is best for your baby. The goal is to have a baby that is healthy, growing well and loved.

“Successful breastfeeding take courage, resilience, patience, and support and it always has. If your partner or support group hasn’t piled on the accolades for your heroism, then let them know you will expect oohs and has when you make it through the first two to three months (no matter how you got there) and your baby is happy and healthy — because you are awesome!”
Cassi Clark, Breastfeeding Is a Bitch: But We Lovingly Do it Anyway

**** Photo’s taken by myself in multiple museums in Italy and Slovenia in 2015.

SESSION 2, The physiological basis of breastfeeding; Infant and Young Child Feeding: Model Chapter for Textbooks for Medical Students and Allied Health Professionals
Takeda S, Kuwabara Y, Mizuno M; Concentrations and origin of oxytocin in breast milk; Endocrinol Jpn. 1986 Dec;33(6):821-6.
Dieterich CM, Felice JP, O’Sullivan E, Rasmussen KM; Breastfeeding and Health Outcomes for the Mother-Infant Dyad; Pediatr Clin North Am. 2013 Feb; 60(1): 31–48.
Baker JL, Gamborg M, Heitmann BL, Lissner L, Sørensen TI, Rasmussen KM; Breastfeeding reduces postpartum weight retention; Am J Clin Nutr. 2008 Dec; 88(6):1543-51.
Stuebe AM, Rich-Edwards JW; The reset hypothesis: lactation and maternal metabolism; Am J Perinatol. 2009 Jan; 26(1):81-8.
Collaborative Group on Hormonal Factors in Breast Cancer; Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease; 2002 Jul 20; 360(9328):187-95.

My Birth Story (Part 3)

Our perfectly beautiful baby boy was born at 04:15 on a Saturday morning. He screamed loudly just after he was born and was so beautifully pink that he scored an Apgar of 10 and 10 out of 10. It was the best moment of my life!

“Be happy in the moment, that’s enough. Each moment is all we need, not more.”
― Mother Teresa

Let me backtrack a bit. I explained in Part 1 and Part 2 why I wanted to deliver our baby via a Normal Vaginal Delivery (NVD). However, our story ended differently. It is still a little bit emotional for me to share, but in the end it really is a testimony of God’s grace.

At the 31week gestation check-up, our gynaecologist said that he was a bit worried as our little boy was still sitting head up. I was full of faith that he would still turn, because I knew that only 4% of babies are breech at term. At the 35week follow-up he was still upright. I started reading up on all the maneuvers that could help the baby to turn head-down in preparation for labour. Google is a scary place, but I found a great site “Spinning Babies” that had a lot of relevant advice. I spent many minutes lying head-down on my couch, in the swimming pool, and doing the “Breech Tilt” and “Open-knee-chest” maneuvers.

I sang songs about God “turning lives around”, read verses about situations “turning around” and did not want to tell anybody that he was still breech. I really believed that God would step in and turn him. I really badly wanted to deliver via NVD!

“When you come looking for me, you’ll find me. Yes, when you get serious about finding me and want it more than anything else, I’ll make sure you won’t be disappointed.” God’s decree. “I’ll turn things around for you”. Jer 29:13 (MSG)

Seeing as he had not turned at our 37week follow-up, our gynecologist tried an External Cephalic Version (a quite painful procedure where he puts his hands on your abdomen and pushes the baby’s head down towards the pelvis, while at the same time lifting the bum). Our little boy would not budge.

Although I still confessed with my mouth that God will turn him, I realised in my heart that I have to find peace with any outcome. My will is not necessarily God’s will, and I had to surrender my hopes and dreams (especially about the delivery) to Him. I was very passionate about a normal delivery, but the evidence is overwhelming that delivering a breech baby like this would be very risky. It would have to be a C-section. I discussed it with my gyne, and he was very supportive to give me as much time as possible for things to change. I told him that I would at least want to wait until I go into labour spontaneously, so that I knew that baby was ready.

At 38weeks 5days I started getting random contractions early in the morning. I visited my gyne, who confirmed that nothing was really happening. That evening my husband and I went out for pizza and a movie (perfect timing as this would be the last date night for a while). When we climbed into bed the contractions started becoming more regular and more intense. At 2am we went to the hospital and the sister and CTG monitor confirmed… I was in labour! I was ecstatic and a little bit disappointed, because Mister Baby was still sitting upright. My husband said that it doesn’t matter if our baby comes with a plane or a train or a boat, as long as he gets here safe! I was very thankful for the 2 weeks I had to make peace with this outcome.

Everything happened very fast from there. The doula we organised for the NVD was replaced by a Midwife from Estherea who has rights to work in theatre and to assist with a “sensitive C-section”. She was so supportive and caring and helpful to everyone. I must admit it felt VERY awkward to be sitting on the bed. Usually I am next to the bed talking to the mommy, waiting for the baby. Everything was so familiar, yet so so different. The spinal worked well and my husband (being an anesthesiologist), could not help keeping an eye on my blood pressure.

And then I heard my baby cry. After a minute of delayed cord clamping, he was shown to me over the covers and then dried, and then the midwife wrapped him in the blanket that I have been sleeping on for the last few weeks and brought him straight to me. That moment was almost unreal. For a moment I thought, who are you? I don’t know you! But then the hormones kicked in and I could not stop smiling. This perfect little body was ours! The midwife pushed the screen back a little bit and baby stayed with me until they had to move me off of the theater bed. He stayed with my husband for a little bonding with daddy, but as soon as I was pushed into recovery he came back to me. The midwife helped him to latch and he had his first feed. Our bodies are so wonderfully designed! He stayed on my chest all the way back to my room and there the midwife weighed him and gave his Vitamin K and eye drops. Then we both slept a while.

So even though I did not have a NVD as I had hoped and dreamed about, God knew best. I am so thankful that I could go into labour naturally and that my own gyne was on duty the weekend when I needed to deliver. I am so grateful that the midwife was available, she really made the “sensitive C-section” very special and I was so thankful that my baby never had to stay in an incubator. The gyne told me afterwards that the umbilical cord was looped around our baby’s neck, and we would have had a lot of trouble if we had tried to deliver him via NVD. This was a journey that really stretched and grew my faith. To trust God even when it did not make sense to me. God certainly did not disappoint me! All glory to God for this healthy little boy that I can now cuddle in my arms every day, no matter how he came into this world…

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“For My thoughts are not your thoughts, neither are your ways my ways”, declares the Lord. “As the heavens are higher than the earth, so are my ways higher than your ways and my thoughts than your thoughts.” Is 55:8-9