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Let's Tell your Story!  BFAR and Increasing Low Milk Supply Part I

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Let's Tell your Story! BFAR and Increasing Low Milk Supply Part I

During World Breastfeeding Awareness month Doulas of Capitol Hill owner and founder, Emily Smith, will share her story and journey of her fourth breastfeeding experience as a BFAR mom (breastfeeding after breast reduction).  She will be documenting her experience of trying to increase milk supply by utilizing herbs and supplements, known as galactogogues, as well as lactogenic (breast milk producing) food and drinks, to combat her history of low supply caused by a previous breast reduction surgery.  

Doulas of Capitol Hill believes that sharing one’s story, while unique unto itself, can help to encourage, to strength, and to inform the experiences of others.  That’s why our slogan is “Let’s Tell Your Story.” We have found that in the sharing of our stories, owning them, and allowing them to be lived in the context of community, we are all stronger for it.  

We acknowledge the causes of Low Supply in breastfeeding moms can be multidimensional.  

This blog and the information shared is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or IBCLC (International Board Certified Lactation Consultant) with any questions regarding low supply, any medical condition, or treatment.

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Hi everyone,

I’m writing this two-part blog series to share my experience using galactagogues to help increase my breast milk supply with my fourth baby.  Today I’ll share a quick run-down of my history and what brought me to this point in the story. Then, I’ll lay out the game-plan for the next 4 weeks.  And finally, at the end of World Breastfeeding Awareness month I’ll come back with part II and report on my experience. Thanks for joining me on this journey!  

How did I get here?

  • When I was 17 years old, I had a breast reduction surgery.  It was medically necessary for my health. I remember asking the surgeon what my chances to breastfeed would be and he said 50/50.  Many years later I’ve hears doctors saying the same thing to other mothers.. Now I know that MOST people who have breast reduction surgery are able to lactate to some degree.  For many this may be just drops (milliliters, not ounces). However, the odds of having a full milk supply and being able to exclusively breastfeed, are more unknown, and depend on many factors such as the type of surgery, how much tissue was removed, and the amount of time between the surgery and having a baby.  

  • Ten years later I gave birth to my first child.  After birth, by day 3, she was dehydrated and had lost greater than 10% of her birth weight (7-10% is the range of normal newborn weight loss).  We began supplementing with formula from bottles and an attempt at the SNS (supplemental nursing system which attaches a thin tube to the nipple and the baby can get formula/pumped milk at the same time as being latched onto the breast). I saw IBCLCs. Went to support groups. We battled painful vasospasms. At 3 months she had a tongue tie clipped. That helped some with the painful latching and we went on to breastfeed until around 15 months. However, I supplemented around 90-100% of her nutritional needs. We mostly nursed for comfort and bonding.  I was a warm pacifier.

  • My next baby was born two years after my first child.  At this point I was a birth doula, had read the BFAR “bible” Defining Your Own Success: Breastfeeding After Breast Reduction by Diana West, and had a new plan for what “successful” breastfeeding could mean.  I saw the director of the Breastfeeding Center for Greater Washington during my pregnancy.  We collected donor milk found from local moms on Human Milk for Human Babies and stored it in a deep freezer during my pregnancy.  I began hand-expressing colostrum at 36 weeks to give my baby right after birth, so we wouldn’t go through the scary experience of a dehydrated baby.  And this time some of my milk ducts recanalized (reconnected) and I was able to make more milk. I estimate around 30-40% of his nutritional needs. I pumped some but focused on the bonding and good latching. The rest we supplemented with a bottle.  We nursed until 13 months.

  • Our third (and what we thought final) baby came along 4.5 years later.  This time my approach to breastfeeding was to throw “everything and the kitchen sink” at the problem of low milk supply.   I took every herb you have ever heard of and even one pharmacological medicine called Domperidone. I drank every tea. I encapsulated my placenta and took those capsules.  I made a jar of tincture with galactagogues made with the most enormous bottle of Gray Goose vodka that has ever been created. I pumped. I collected donor milk.  And this time I was able to make about 50-60% of my baby’s milk. He and I went on to nurse until he was 2.5. I made peace with what breastfeeding was for me; success wasn’t a full milk supply but that it could still be a happy ending.  

  • And now, our surprise baby #4, who came 5 years after a failed vasectomy.  Just like my breast tissue which recanalized more over time, so did my husband’s vas-deferens.  This time, armed with over a decade of research and experience, I’ve decided to meet this breastfeeding journey with a more systematic approach than in the past.  

The Plan-

I’m very excited to partner with some fantastic companies who make products for breastfeeding moms to have a different experience this time.  Some of these companies have offered sample products for me to try. Others have gone a step above and sent along samples for our doula clients to try also.  Many of them have given us a special discount code for our clients to use. And lastly a few companies have offered to do special giveaways for World Breastfeeding Week to celebrate together!  

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Who?

Earth Mama Organics

Gray’s Cowbell Lactation Treats

Legendairy

Majka

Motherlove

Traditional Medicinal

Upspring

Uplifties

How/What?

I will be adding in a new galactogogue twice a week over the first four weeks from birth and recording the impact of the added galactogogue by measuring my milk production 2 days after the introduction of the new product by doing a weighed feeding (which is when the baby is weighed with a precision scale, like those used by our IBCLCs, before a feeding, then fed at the breast, and finally weighed again after to see how much they consumed) AND pumping with a quality breast pump.  If the galactogogue seems to have a positive or neutral impact I’ll continue it throughout the duration of the 4 week time. However, if it seems to have a negative impact I’ll stop immediately. At the end of World Breastfeeding Awareness month I’ll report on my experience.

Baseline variables:

  • Under the guidance of my midwife I started taking goats rue glycerine tincture during pregnancy. This herb is one of the few which is considered safe for pregnancy.  It is known to help grow breast tissue and for this is often recommended to people who have a diagnosed low supply from prior breast surgery or IGT (insufficient glandular tissue.) Another which is safe for pregnancy is alfalfa and I also started during pregnancy.  Some of the products I’ll be sampling have goats rue and alfalfa as ingredients. I plan to continue the doses of goats rue (alcohol-based tincture) and alfalfa which I consumed during pregnancy throughout my postpartum period. I’ll also be drinking loads of water and eating lactogenic foods as often as possible. Most well-known is oatmeal, healthy fats like salmon, avocado, and coconut oil, and maybe an occasional beer, as hops, barley, and malt are all lactogenic. My favorite book in my personal library for lactogenic (and anti-lactogenic) foods is Mother Food by Hilary Jacobson.  

  • Every baby is different!  While I have a history of low supply on the maternal side of the relationship, the baby is the other half of the equation.  Unknown variables like mode of delivery (vaginal or cesarean), feeding impediments like tongue or lip tie or high pallet, gestational age at the time of birth, and illness or infection (like thrush or mastitis) can all impact how breastfeeding gets established.  While I certainly hope and plan for a smooth, uneventful birth experience and no ties or infections, it’s important to mention these as variables to my ability to see results from the product testing. Put another way, if things are off to a rocky start for any unknown variables, it may not be a reflection of the effectiveness of the products and more a consequence of the challenges faced.  

Emily Smith is owner of Doulas of Capitol Hill and co-owner of sister agency, Doulas of Prince George’s County, which provides professional, non-judgemental birth doula, postpartum doula, newborn care, breastfeeding (and bottle-feeding) support throughout the DC, Virginia, and Maryland region.

Emily Smith is owner of Doulas of Capitol Hill and co-owner of sister agency, Doulas of Prince George’s County, which provides professional, non-judgemental birth doula, postpartum doula, newborn care, breastfeeding (and bottle-feeding) support throughout the DC, Virginia, and Maryland region.

Stay plugged into Doulas of Capitol Hill on Facebook and Instagram throughout the month of August to get in on the giveaways and discounts we share.  You can also swing by our Community page and check out our Affiliates. Then, be sure to be back again on the blog at the end of the month to hear the part II of my BFAR story!

Warmly,

Emily



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Braxton-Hicks, Breaking Water, Birth Tubs, and Breastfeeding: World Water Day

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Braxton-Hicks, Breaking Water, Birth Tubs, and Breastfeeding: World Water Day

Today is #WorldWaterDay which was created by the United Nations to bring awareness to the global crisis of access to safe drinking water, particularly those most vulnerable are  marginalized groups like women, children, indigenous peoples, disabled people, and refugees. In 2010, the UN recognized “the right to safe and clean drinking water and sanitation as a human right that is essential for the full enjoyment of life and all human rights.” The 2019 theme is “Leaving no one behind.”  

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Today we’d like to share our top water-related tips for pregnancy, birth, and breastfeeding.  For every share on Facebook or Instagram of our blog we’ll donate $1 to Water for People.

The World Health Organization estimates that for every $1 spent on water, sanitation and hygiene programs, there is about a $4 return in productivity.

Water is life and that is true even more true during pregnancy when access to clean water means a healthier pregnancy.  

Access during labor means an environment with less risk for easily avoidable infections (hello, hand washing!) and preventable deaths.  Availability of clean drinking water for new mothers and babies means healthier families who grow and thrive.

This article in the Huffington Post explains many of the direct and indirect consequences to lack of clean water to women and girls and how that relates to maternal health.

Thankfully, our clients in DC, Northern Virginia, and Maryland who are hiring a doula, overnight newborn care, or breastfeeding specialist aren’t likely to be personally impacted by lack of clean water access in their homes, birth center, or the hospital where they deliver.  So today we’re giving our 4 Doula Tips about water for pregnancy, birth, and postpartum!

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Braxton Hicks-  

You’re up at night Googling “What does a contraction feel like?”  and you’re not sure if it’s time to call your doula. You remember she insisted you CALL (not text or email) if ANYTHING was potentially happening, so you call. She listens intently to what you’re feeling, and agrees, it could be labor, or it could be Braxton-Hicks, aka “practice contractions.”  She suggests trying these three steps and to call her back, reassuring her that “real labor” contractions will get longer, stronger, and closer together. If this doesn’t happen after trying these three steps, it’s probably safe to say your body is just practicing.

Braxton Hicks or real labor contractions


Birth Tub-

You’ve seen tv and movies of childbirth.  From Katherine Heigl’s screams in Knocked Up to Melissa McCarthy banging on a drum during The Back Up Plan to basically everyone in What to Expect When You’re Expecting, all of them have one thing in common, the women are freaking out.  

But at Doulas of Capitol Hill we’ve seen LOTS of births (probably more than the filmmakers in Hollywood) and shake our heads.  It is possible to find real comfort beyond the epidural (which we also fully support!)


We know, and studies agree, that laboring and pushing in the water has a lot of advantages.  That’s why when you search “waterbirth in DC” or “waterbirth in Northern Virginia” you may see our name come up; we rent birth tubs for people to use at home.  

We also support clients who are delivering at hospitals and birth centers where laboring or delivery in the water is an option. We’re especially looking forward to the return of tubs at George Washington University Hospital!

where can I have a water birth in DC, Northern Virginia, Maryland

Breaking Water-

It’s that moment that everyone fears will happen at the worst time, like when you’re in your bosses office!  People make jokes about it, too, which makes it even more nerve wracking. One mom told us about her own experience with a person working at Wal-Mart who thought they’d be funny and followed the mom around the store with a mop “just in case” her water broke while she was shopping.  She was only 7 months pregnant! Some people just have no idea!

Did my water break?

Breastfeeding-

If staying hydrated during pregnancy is important then drinking enough water during breastfeeding is equally important.  While breast milk works on a supply and demand system, meaning the more you remove the more that it signals your body to make, dehydration can be a huge factor for some people in low milk supply.  If you’re wondering “how much water should I drink while I’m breastfeeding?” Here’s what Kelly Mom (a fantastic resource for breastfeeding) had to say:

“Pumping moms may find that they need to pay more attention to remembering to stay hydrated.” - Kelly Mom.com, Do Breastfeeding Mothers Need Extra Calories or Fluid? By Kelly Bonyata, IBCLC.

“Pumping moms may find that they need to pay more attention to remembering to stay hydrated.” - Kelly Mom.com, Do Breastfeeding Mothers Need Extra Calories or Fluid? By Kelly Bonyata, IBCLC.

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Health Care Quality Week: Interview with Dr. Nicole V. Lang MD

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Health Care Quality Week: Interview with Dr. Nicole V. Lang MD

October 21-27 is Health Care Quality Week and Doulas of Capitol Hill is honored to feature one of Washington, DC’s most loved pediatricians, Dr. Nicole V. Lang, MD, and her practice at Washington Pediatric for this month’s Local Business Spotlight.

Dr. Lang is a board certified pediatrician with over 22 years experience in caring for children in the Washington metropolitan area.  She is the Founder, President and CEO of both Washington Pediatric Associates and the specialized extension of her practice called, Premier Pediatric Concierge Care.  The Concierge Service provides an even more personalized convenient and comprehensive approach to health, education and wellness. 

She is recognized locally as one of Washington DC’s Top Pediatric Doctors according to Washingtonian, Washingtonian Mom, Washington Parent and the Washington Post

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What led you to this career?

My life’s calling, since the age of 7, was to be a pediatrician. I am the first doctor in my family and greatly value taking care of “my children.”  I am truly living my dream. 

What do you enjoy most about work?

I absolutely enjoy helping new parents navigate parenthood and watching the evolution of growth and development of my children over 21 years.  I also love being able to positively influence children during their formative years. My motto is to help children make “Smart, Healthy, Safe Choices in Life” and encourage them to reach their full potential. 

If you are a parent, how was your birth and postpartum?

I am the proud mother of my daughter, Nia. I had a wonderful natural child birth experience in a hospital setting. I needed a lot of support with breastfeeding during the postpartum period and ultimately did find balance with supplementing with formula. I always say that my baby had the best of both worlds and is thriving today. 

What resources would you want parents to have?

I want all parents to have the book Touchpoints, written by my mentor and world renowned pediatrician, Dr T Berry Brazelton. This book focuses on a child’s social and emotional health, which is just as important as a child’s physical and cognitive well being.  He stresses the importance of having a holistic look at a child and supporting the family in any way possible. 

What's one thing you think the world needs to do to improve the lives of new parents (or people living in our service area)?

New parents need longer maternity and paternity leave to be with their newborns. We need to be a family centered society to help foster the love and support a new family needs in order to thrive. 

What do you think is the hardest part of expecting baby or becoming a parent?

The hardest part of becoming a parent is the amount of pressure parents (especially mothers) put on themselves to be the perfect parent. There is not just one way of parenting. It is a process of trial and error. It is important to trust your gut intuition because it will always lead you in the right direction.  Trust the process and remember Self-Care along the way. (Remember the airplane rule: parent put your oxygen mask on first then help your child).

What products or services do you personally love?

I am a wellness advocate for the company, Doterra.  I utilize a wide variety of their products personally and in my practice- from essential oils, soaps/lotions to vitamin supplements.  There is a new baby/kid product line now available too, that I love. This company also has a wonderful humanitarian mission that helps support poor communities around the world. 

How do you start each day?

My mother always taught me to count my blessings. I start each day with a prayer of gratitude for the gift of life, family, friends and nature.  I ask God to guide me and give me strength for the day.  I also tell my husband and daughter that I love them dearly. 

What's your favorite thing to do in DC?

My favorite thing to do in DC is to spend time with my family and friends—i.e. hiking in Rock Creek Park, visiting the Smithsonian museums or trying different ethnic restaurants (Cher Cher Ethiopian restaurant is our favorite)—as long as I am with my loved ones, I am filled with JOY!



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