Breastfeeding MasterClass Episode #1: The Nicest People in New York City

Breastfeeding MasterClass Episode #1:  The Nicest People in New York City

This is just a little anecdote I use to show the importance of skin to skin contact (AKA cuddle care) with mom directly after delivery.

So imagine you've lived your entire life in a beautiful tranquil place, a secluded farm house or deserted island, comfortable and secure.  One day a helicopter comes in and picks you up and drops you into Times Square in New York.  It's loud, busy, terrifying!  That's what it's like for a baby being born.  From a happy tranquil place to a loud room full of strangers and lights as they lay crying on a warmer bed being measured and assessed.  But imagine if instead of Times Square, you are brought to a nice, cush Park Avenue apartment with the two nicest people in New York.  It would still be a difficult transition but those people are there to help you through.  That's what it's like when baby goes directly onto mom's chest after birth.  Baby is able to deal with the transition much easier because he is surrounded by the hands, love, and voices he recognizes.  That's not even taking into account how much warmer babies stay and how much less they cry when they have cuddle care with their parents.

But lets not even think about baby right now.  What about those sweet New Yorkers waiting for their new arrival?  If they can't see him, he's lost in the crowd, imagine their worry!  When you see your baby across the room with nurses and doctor's surrounding him, of course you will be distraught!  Also, we are undermining your parenting abilities from the very start by basically telling you we can take better care of your baby than you can.  When baby is placed on your chest everything else in the room goes away.  The focus is like a laser on your baby and your partner.  Most women barely notice delivering the placenta and any post delivery maintenance that needs to be done.  And baby is right there ready for his first meal!  Most babies will breastfeed sometime in the first hour after delivery and if given that opportunity, do a better job with breastfeeding in the long run.  And moms, if you are not feeling well enough to have the baby on your chest after delivery, dad is the best substitute!  Babies can do this skin to skin care on dad's, grandma's, or any other support person's chest.  Anyone can keep baby warm and comfortable, the only thing that will have to wait is feeding.  But be careful daddies.  Babies don't care that your nipples are just decorative.  They may still try to latch!

I hope you enjoyed our first MasterClass episode!  Any questions or comments welcome below.

Boobie MasterClass

The whole reason I started this blog originally was because I had had a few patients recommend that I put some of my wise teachings in YouTube form.  Since I have a face for radio, I'm not super comfortable with that.  So I will occasionally be using this platform to post some of he tidbits I use in my education of patients. These will have the MasterClass designation in the title, so look for it if you want some excellent educational morsels pushed directly into your face holes.  First one coming later today!

Just because this is awesome.

Intellectual Pap

Hey kids!  I know it's been a while.  I fell down a Skyrim rabbit hole that I'm just now emerging from.

But emerge I must to rant about the inability of media sources to responsibly present medical study data. This is the study we're going to talk about today.  However you can pretty much pick any medical study from any medical journal and see the same thing.

The study in question discusses one hospital trying to become Baby Friendly, a designation that tells people "This hospital supports breastfeeding!".  They took away pacifiers as a step to become designated and their breastfeeding rates dropped.  OK on the surface that does look bad.  So if all you see is that headline you get articles like this and this and especially bad ones like this and this.  As a responsible Boob Nerd I refuse to take information like this at face value.  I like to actually go and read the study.  I know that's a difficult concept for some bloggers or journalists to consider.  Actually reading the source material they are going to report on sounds like it might be too much work.  However it might be a good idea anyway.  I'm not even suggesting they read the WHOLE study.  Even just the abstract is sufficient enough to tell them what they've written is utter bullshit.

This particular hospital had banned pacifiers but there was still full access to formula and the nurses had not been taught how to teach the mothers to soothe babies without using feeding or pacifiers yet.  Those are two equally important steps in becoming baby friendly.  The study tells you nothing more than nurse education and formula restriction should come before pacifier restriction in the Baby Friendly Designation process.  It upsets me greatly how the media has twisted this study to say "See!!!  We should use pacifiers!!!"    No!  That is not what this is advocating at all!  This study conclusion was that we need to do more studies.  Most hospitals are required to use evidence based practice.  If we used this article as our "evidence"  for not restricting pacifier use, our hospital would be a laughingstock.  I'd also like to note that Baby Friendly does not deny parents the ability to use pacifiers.  They just restrict the hospital's ability to hand them out for free.  If the parent's want to use a paci, by all means bring one in from home and use it.  I just can't give you a hospital freebie.  We continue to recommend use of pacifiers after breastfeeding is well established as a SIDS prevention tool.

So I guess what I'm really saying here is, if you see an article citing medical studies, it would behoove you to look up the study and read it yourself.  You cannot trust anyone else to spit the predigested informational pablum directly into your brain.  They nearly always get it wrong.

On a lighter note I also found breast shaped plush animals?  Dolls?  Thingies?  Um, I'm  not sure what to call them.  They are from Japan.  I know that's shocking because nothing weird EVER comes from Japan.

I have not yet figured out how to purchase these.  I cannot find the website.  But I need them.  All of them.  Now.

It's probably only me...

I spend way too much time thinking about breastfeeding for someone who is no longer nursing herself.  I get that.  That's why I consider myself a Boob Nerd.  I'm obsessive about it, which for my job I guess is a good thing.  For my personal life, maybe not as much.  I know my childless girlfriends are like, "OK we get it.  Now shut up about it!"  But it informs the way I look at the world in a very specific way.

Take The Walking Dead for example.  I was so looking forward to Lori's death because I just hated that bitch so hard. (Sarah Wayne Callies you are a truly amazing actress to get me to want to punch your character in the face for an hour each week yet still love the show so much.  I have loved it even more for my hatred of Lori.  Carl too at first, but he's redeemed himself for shooting his mom in the face.[I know, I'm a terrible human being.])  But with all my looking forward to Lori's demise, I was pretty sure they wouldn't kill off the baby in the TV show.  You can build so much drama around children in danger, it would have been wasteful to kill off mom and baby at the same time.  So that lead to much concern on my part about how this kid would get fed.  Literally I thought about this.  I know.

Hershel says they have to go out to get formula--Me: NO!!!


But I know I'm in the minority.  Normal people do not think
about those things when they are watching escapist television.

Put the baby to breast!!!!  You CAN make the milk!!!!

Of course Ganger babies probably don't need  milk

I also worried about poor baby Melody/River's ability to nurse in Doctor Who.  Because that's how I roll.   Luckily I was saved from that worry because The Doctor speaks baby and she wouldn't call Amy "big milk thing" if milk didn't come from her.  Mind eased.

Then there are thing like this that make me very happy.  From The New Normal:

And the episode of the office when Jim and Pam have their first baby and the lactation consultant is a man.  Awesome.  I love the subversion of putting a man in a role primarily filled by women.  The Mindy Project did the same with the male midwife brothers.  Love that.  But back to the office.  The episode is called The Delivery Part 2 and also in the middle of the night she nurses the roomate's baby on accident.  A fun cameo of The Big Bang Theory's Melissa Rausch as the roomate.  Of course it's all completely fictionalized and you have to take it with a grain of salt but still one of the best comedic breastfeeding portrayals in television.  Points for realism for the "bottles are fine, send the baby to the nursery" nurse.  That really happens.

Bye Bye Boobies

Well it finally happened.  I've been waiting for it for 8 months.  My bosses finally asked me to stop wearing my "I Love Boobies" lanyard.  I can't say I'm surprised.  My expectation was that it wouldn't last a week.   Apparently it has been a bone of contention for a while but no one had enough cojones to ask me not to wear it.

What I don't understand is how we can, as a hospital that is attempting to persue Baby Friendly designation, can be so puritanical about breasts.  I've often been asked to tone down the pictures I use for PSAs because EEK!  TOO MUCH BOOB!!!! Here are a couple of the offending images: 
I could see if I had chosen something like this,which I happen to love:

Apparently even the word boobies is offensive.  Of course this is a symptom of the issues with the culture at large.  Breasts are not offensive.  Are men's nipples offensive?  They are purely decorative and for sexual use but people don't gasp and shield themselves from a shirtless man.  Of course not!  It just disappoints me sometimes.  We in the medical profession should be trailblazing, leading the way to a more enlightened age.  Instead we get bogged down in not wanting to offend anyone.  We don't seem to worry that smokers will be offended by this:

  Why should we worry about this?

I am sad to lose the lanyard though.  It was a great ice breaker.  And the daddies loved it so much!

Hulk Smash Moments

I occasionally have moments of such pure rage that they can only be described as Hulk Smash Moments.  The most common reason for these moments revolve around infant formula or the companies that manufacture infant formula.  I just had one less than five minutes ago while searching for a breastfeeding pocket guide for new moms.  The two paid Google ads at the top were from Enfamil and Similac respectively.  The Enfamil ad was masquerading as "Breastfeeding Resources" but the Similac ad didn't even bother to pretend that it wasn't a formula advertisement.  I nearly threw my phone across the room and did yell, "Are you fucking kidding me?!?" at the top of my lungs.  The ballsiness of of these companies galls me.  And it frustrates me that so many people can't see what they are doing.  We breastfeeding crusaders get a bad wrap for trying to "force" our beliefs of healthy child feeding on the populace but these companies get a pass when they are actively campaigning for for your hard earned cash for a product so far inferior to the free stuff that it contributes to over a million deaths each year worldwide and 10% of the global disease burden in children per a 2012 article in the journal Archives of Disease In Childhood .  But yeah, totally, we're the bad guys trying to take away your choices.  I just want people to know all the facts before they make their decision.  If the decision is "formula feeding works best for our family" after they've been well informed, I have no problem with that. Formula companies have the opposite approach.  Be as big and as loud and as visible as you can so you can drown out any competing messages!

And that leads me to another Hulk Smash inducing issue.  Feminists who believe we trying to take away their choices.  The ones who are trying to limit choice are the guys out there with the billions to spend on adverts not me with my shitty cardboard sign on a stick that says "Breastfeeding is better for babies but don't get pissed that I said so, kay?"  This chick makes my blood boil.  Way to completely disregard years of scientific evidence to make yourself feel better.  That's super productive.  And since I linked to the ass hat above I feel compelled to also link to someone who might reasonably be expected to have an opinion that might mean something.  As an anthropologist who studies nutritional anthropology in humans and other primates, Kathy Dettwyler's opinions might mean more than some random shock journalist.  Also Mayor Bloomberg, I sort of appreciate your support except that I don't, because you're kind of a dick who likes to tell other people what to do, so it undermines the credibility of all of the rest of us.  So feminists, I have to give you a pass on that particular sitch.  

I've had these moments in public as well.  Ask my kids about the time I found the "Organic" formula at Toys 'R Us.  I'm not sure ape shit covers that one.  I'm certain they all tried to melt away from me.  I do not know this woman!  For good reason, I did go a little crazy there.  OK I get that cow's milk formula can be made from milk from hormone free, pesticide-free cows and using naturally sourced ingredients, but you can't tell me there isn't chemical involvement in the production of these formulas.  The DHA and ARA in these formulas are most often extracted from algae and fungus using a chemical called hexane which is also found in glues and gasoline.  Sounds totally safe to me.  There have been numerous reports to the FDA of DHA/ARA enhanced formulas causing gas, vomiting, constipation, diarrhea and generalized fussiness.
As a side note, organic formula producers apparently like to call their product "non-artificial baby milk supplement" as a clear F-U to the Lactivists who have started calling formula "artificial baby milk".  I can kind of respect that.  

Ahh.  Much better.  No more throbbing head.  Thank you internet!

Happy New Year to me

Ugh. I hate the flu.  Especially because I get a flu shot every year and I still always get it.  Don't you love how whichever the major flu of the year will be They seem to conscientiously forget to put that one in the shot?

Anyway, I've been sick since New Year's Eve.  The kids wanted to celebrate New Years by staying up til midnight and watching The Snowmen episode of Doctor Who that we hadn't seen yet because we were out of town the week after Xmas without access to the DVR.  God I love my nerdy kids!  They are so awesome!  Unfortunately I missed most of it related to the NyQuil coma that I was in.  I would wake up just to fast forward through commercials and catch snippits now and again.  So I was forced to watch it twice, darn!  I was happy to see that the Clara character apparently is the same as the Oswin character because I did love her in Asylum of the Daleks.  I actually had a bit of a "NO!  NOT T-DOG!" moment upon finding out she was really a Dalek.  I'm now super excited to see how they work this one out in the next series.  Anyone know when that's supposed to premiere?  I don't want to wait!

Other than that one bright Doctor spot in my week the rest was filled with illness.  I was sick hubby was sick, only 1 of 5 kids sick so far.  I did take the weekend off.  i assumed the new moms would prefer their newborns not getting the flu over getting extra breastfeeding help.  Luckily one of my amazing colleagues covered for me for a few hours both days.  Thanks Judy!  I'm going in tomorrow since I'm finally feeling almost human again and it is a long day. Meetings until 7 PM.  I hope I make it that long!