Delaying Baby’s First Bath: Shown to Increase Breastfeeding Rates

There are a number of things that can be implemented or avoided to increase breastfeeding
rates for new babies. These things range from baby being held skin-to-skin for at least the first
hour immediately following birth, to opting not to send your newborn to the hospital nursery, to
having a birthing team that is supportive of breastfeeding, among a host of other
recommendations. This past January, something additional was added to the list: delayed
bathing.

Recently, a study at the Cleveland Clinic, has determined that there is a link between delaying a newborn’s first bath and an increase in exclusive breastfeeding rates. While the traditional hospital-protocol has baby
being bathed very shortly after birth, this study of about 1,000 newborns showed an eight
percent increase in exclusive-breastfeeding rates for babies whose baths were delayed by at
least twelve hours following birth.

The reasoning behind this correlation is thought to be three-fold: scent, increased skin-to-skin contact, and temperature regulation.

Scent
There have been prior studies that point to the idea that the scent of amniotic fluid left on baby’s skin after birth is similar to that of mother’s breast. By leaving the baby unbathed, this allows baby to use its own familiar scent as a guide to locate and take to mother’s breast for the first
feeding. This provides for a solid-latch to the breast and for successful breastfeeding-initiation.

Increased Skin-to-Skin
What may seem very obvious but is still significant, is that keeping baby with Mom after birth
rather than sending baby away with a nurse for a bath is that Mom and baby are able to have
that much more skin-to-skin contact. It is now widely known that keeping baby directly on Mom’s
chest after birth and even for the months succeeding birth definitely lends to an increase in
nursing and milk production. So, having that extra time to hold baby skin-to-skin directly after
birth can make a big difference in the long-term success of that breastfeeding relationship.

Temperature Regulation
While the increase in skin-to-skin alone also lends to helping baby’s temperature remain
regulated, the absence of immediate bathing also has an effect. One may think a warm bath
wouldn’t cause temperature issues, however it does cause a decrease in temperature which is
not ideal for a newborn. A decrease in temperature of even just one degree diverts energy and
oxygen to increasing temperature. Both that energy and oxygen are better-spent on other bodily
processes such as feeding and healthy respiration.

This study has prompted the Cleveland Clinic to rewrite their newborn-bathing protocol and now
they encourage parents to wait at least twelve full hours for baby’s first bath. Even in a case
where parents prefer an earlier bath, the hospital asks that bathing be delayed for two hours
after-birth. It is encouraging that something so simple is linked to an increase in exclusive
breastfeeding. At a time when new parents may feel like it’s difficult to keep up with all the
recommendations, this is one that takes no effort and even provides extra newborn snuggles.
It’s a win-win situation for all involved!

Sleep Training Considerations Part III: Safe Bed-Sharing

bed sharing

How do I Achieve Safe Bed-Sharing?

There’s a helpful La Leche League-designed infographic, here, highlighting the seven key recommendations for keeping bed-sharing safe for baby. The most important of these, in light of what was mentioned above, would be that mother is not under the influence of any substances, including tobacco-use. Due to the physiological connection between a nursing dyad, mother and baby have similar arousal patterns during sleep. This is precisely what keeps bedsharing safe. If this is dampened by a substance, the likelihood for mother to accidentally harm baby in her sleep, is increased. Many of the co-sleeping tragedies that we hear about in the media are due to this unsafe practice

From zero to four months of age, when there is greatest risk of unexplained death for babies, bed-sharing is not recommended for babies who are not breastfeeding. The absence of breastfeeding lends itself to positional changes during bed-sharing, namely baby being placed up near mother’s face, near or in-between pillows, rather than down at breast-level as a breastfeeding baby would lie. Additionally, mothers who are not breastfeeding, do not naturally sleep with baby in the protective “cuddle curl” position which has been repeatedly observed during sleeping for a breastfeeding pair. However, it is considered safe for any responsible adult to sleep with baby once baby is older than four months of age.

 

Giving it a try and the Adjustment Period

With all the negative hype around bed-sharing, it’s natural for mothers to feel a bit anxious the first several nights of sharing a bed with baby. We’ve been told that this practice is dangerous and we’ve bought into that for so long that our bodies are on high-alert. This may be discouraging for many moms who might find the first couple nights with baby next to her to include more wake-ups than when baby was sleeping independently. You may wake suddenly in the middle-of-the-night feeling panicked that something bad has happened to baby while you were both sleeping. However, it seems after a those first few nights when you’ve “proven” to yourself that you aren’t in fact going to roll on to your baby, the anxiety eases. At that point, you can start to expect more restful sleep.

How can this be? 

Since baby is directly next to you with easy access to your breast and because you’re biologically in sync with one another, there’s no need for your baby to wake fully and cry out to alert you of the need for a feeding. Rather, as your baby stirs in her sleep, you, sensing this, also stir and awaken just enough to snuggle baby close in the side-lying position and to make sure baby latches on. The need for calming baby down, shushing baby, forcing yourself to stay awake while nursing, and then re-swaddling are all negated. There can definitely be an adjustment period though for those of you who are not accustomed to bed-sharing. Please don’t let this be a deterrent! Better sleep really is right around the corner. 

Final Wrap-Up

This three-part series has touched on a variety of issues today’s mothers are faced with. 

  • Part I discussed the lack of support for new mothers in both the workplace and societally and how that may affect one’s choices regarding sleep-training. 
  • Part II brought to light the fear-mongering surrounding “dangers” of bed-sharing that the the media and many doctors unfairly spout without proper evidence-based backing. 
  • Part III has provided information on how you can safely sleep next to your baby and gain back precious hours of sleep each night. 

Hopefully, you feel encouraged by the information presented and feel as if there are choices that can be made to manage baby’s night-wakings that do not have to include undue distress for either of you. 

 

Read Part I of this series.

Read Part II of this series.

Sleep-Training Considerations Part II: Bed-Sharing as an Alternative to Conventional Sleep-Training

As mentioned in the first part of this series, our society tends to work against us in parenting. New mothers are not well-supported by governmental and employment policies. Because of this, the early return-to-work often often leads to total exhaustion and desperation. This, in turn, leads to desperate measures such as allowing baby to cry-it-out in hopes of resting enough to perform on the job. 

Similarly, our culture is one of unsupportive, fear-based advice from those we trust the most, like our doctors. Bed-sharing (also referred to as co-sleeping), the biological norm for nursing pairs and a simple solution to sleep deprivation, is demonized in our culture. Public Service Announcements deploy warnings likening sleeping with your baby to lying your baby next to a butcher knife. Parents are warned about the dangers of a parent rolling on top a of a baby or baby suffocating in a parent’s bed without being given information on the root of that danger.  

However, studies have repeatedly shown that babies and nursing-mothers get more sleep when able to have close and easy nursing access throughout the night. This is most easily accomplished through bed-sharing, the act of having baby sleep directly next to mother, in bed. Scientific evidence has also confirmed that bed-sharing can be safely achieved and has been, across the world, since the dawn of time. Yet, we are constantly bombarded with information about how dangerous bed-sharing can be and how baby must sleep alone in a crib to avoid suffocation and SIDS. However, when the causes of these deaths are examined, it’s typically a mother who is under-the-influence of a mind-altering substance who tragically rolls over on baby. It’s not the sober mother with intentions of easing night-wakings through bed-sharing who is a danger to her baby. 

Bottom Line

Do you find yourself feeling overly tired and at your wit’s end with the constant up-and-down through the night?  Do you spend your nights trying to convince yourself to keep your eyes open and body upright while nursing? If so, please consider bed-sharing. The increase in sound sleep for both mother and baby is astounding. With the arousal patterns of the nursing pair matched throughout the night, even when waking to latch baby to breast, both mom and baby generally fade right back to sleep with little to no difficulty. 

This lends itself to more restful, restorative sleep for both. Bed-sharing, especially in the first 6-months of baby’s life, can change the course of a mother’s entire existence. This may sound overly-dramatic, but any mother who has suffered through weeks or months of sleep-deprivation, can attest to the impact of even a minimal increase in sleep. Imagine gaining hours of quality sleep per night. It may sound like an unrealistic dream, but it doesn’t have to be. That dream can be made a reality through long, sweet (and safe!) snuggles with your little one through night. 

If you’re feeling like you may want to give bedsharing a try, please check back for Part III of this series that will address how to achieve safe bedsharing. 

Read Part III of this series.

Sleep-Training Considerations: Part I

sleep training

If you’re a parent, you know sleep-training is a hot topic. Fueled with passion from both sides, some swear by it and claim that it’s the only thing that can be done to teach a child to sleep, while others say it’s not necessary and that baby will learn over time, without it. There’s so much talk about whether it’s right or wrong that folks don’t sit back, take a deep breath, and consider the implications of sleep-training and how it feels for them personally, away from all the chatter.

The two most-recommended sleep training methods are: 1) extinction, often referred to as cry-it-out (CIO), where a parent puts a child down awake and does not return until morning, and 2) the Ferber-method, where a parent puts down a drowsy child and increases the duration of time baby is left alone while periodically checking-in when baby is distressed; offering some reassurances (verbally, picking-up and putting back down, pats on the head or back, etc) until eventually the parent stops re-entering the room at all. Being that these two are the most popular and the methods that come with such heated debate, these are the two being considered for the purpose of this post. Now that we’re on the same page, let’s unpack what this looks like.

Night-feedings
It’s no secret that babies need to eat frequently. Some people try to convince parents that once babies have achieved a given weight or once babies hit a certain age, night-feedings are no longer necessary. The issue with this, particularly for nursing babies up to a year old, is that the intervals at which they feed and the number of feedings needed in a 24-hour period depends largely on Mom’s biology, namely her breast storage capacity and breast fullness. By prematurely cutting out night-feedings in the hopes of more sleep, baby’s total daily caloric intake is reduced. This has the potential to negatively affect baby’s growth, mood, and overall well-being. Additionally, it introduces the possibility of creating clogged ducts, mastitis, or supply issues for Mom.

Nighttime Parenting
As parents, clocking-in and clocking-out just isn’t an option. We need to have a realistic expectation that we’ll be up through the night with our babies for at least the first year, perhaps even longer. Reframing the idea of the often frustrating parental night-waking into “nighttime parenting” is helpful. While the sun is no longer shining and the goings-on of the day have wound down, the parent is still on-call, the baby is still fully dependent on the caregiver for all of the same things the caregiver provides during daylight hours. With that in mind, it’s important to reflect on how you respond to baby during the day. Do you let baby fuss for several minutes before responding? Do you wait to respond until baby is crying heartily, obviously needing attention? Do you tune out the cries and wait for baby to sort it out on her own? As parents, while we may deeply desire uninterrupted sleep, we don’t clock out at the end of the day. We’re always on and babies are relying on us. When considering how differently nighttime presents itself; the dark, the quiet, baby is often totally alone; one can clearly see how baby’s needs are likely to increase, rather than decrease. Instead of nighttime lending itself to a hands-off approach to parenting, nighttime is a time of high need for baby. High need for baby means the need for high responsiveness from parents.

Physiology of Distress and Self-Soothing
Babies are tiny humans so their bodily systems operate similarly to an adult’s. Being so much smaller however, babies’ bodies are more easily overcome by physiological changes than are our adults’ bodies. As babies cry and then cry harder, their physiology responds the way ours would as we get increasingly upset. Blood pressure increases, body temperature increases, heart rate increases, cortisol levels rise, respiration increases, skin may flush, sweating ensues. Baby may begin to get a headache, nose will run, voice will become hoarse.

No parent wishes this type of physical distress on their baby. However parents will willingly allow this to occur when convinced that baby is manipulating them or that baby is “only” frustrated and needs no intervention. Parents, with broken hearts and large glasses of wine, sit outside the door of their hysterical baby because they’ve been told that without this, baby will simply never learn to sleep-through-the-night.

The phrase “self-soothe” is mentioned again and again; along with the idea that babies can only learn this skill by working it out alone through tears, screams, and sobs. However, when taking a step back, one can see, as is pointed out in the chart here, that a baby’s capacity for soothing is virtually totally limited to reliance on the parent. And of course, the younger the baby, the higher that reliance.

Reflect on how it Feels
You’ve waited 40 long weeks (give or take) to hold this sweet baby in your arms. Now that your baby has arrived it seems like everyone is encouraging you to treat her like a hot potato. Don’t hold the baby while he sleeps, you must get baby sleeping in her own room, you must teach the baby to self-soothe, you’re going to spoil him, the baby will never learn to sleep along if you’re always holding her. How does that advice feel for you? When you hear your baby crying, does it feel in your heart like you want to tune the cries out or do you feel drawn to your baby? Do you feel a strong urge to snuggle your baby up and soothe the baby through nursing or rocking or patting? If there weren’t all the outside noise blaring well-intended advice at you, what would you do instinctually?

We need to find our way back to our natural leanings as parents rather than listening to so-called “sleep experts” and well-meaning friends and family members. We are physiologically hard-wired to be hear and respond to our children. To attempt to desensitize one’s self to the calls of our offspring can prove detrimental to both parent and child. This period of such high physical need, while admittedly challenging, is short-lived but vital to a child’s attachment to parents and overall trust and security.

How did we get here?
If the claim is that we’re being coerced to deviate from natural responses to our children, it begs the question why. What has happened in our culture that some parents have made a choice to tune out a crying infant in order to catch some Z’s of their own? Are these heartless parents? No. These are desperate parents! Parents desperate for sleep, desperate for routine, desperate for the ability to function on the job.

This desperation is at least, in part, rooted in the fact that our society does not value parents in actionable ways. There is a major lack of support for parents in our country. Mothers are expected go back to work at 6 weeks postpartum; the “lucky” ones who can manage financially without pay, go back around 3-4 months postpartum. Neither is enough time to establish one’s position as a parent, let alone get the hang of breastfeeding, become accustomed to frequent night-waking, fully embrace the notion of being totally responsible for sustaining another human life. These are all huge emotional and physical undertakings and there is little to no cultural understanding of that. Then when returning to work, it’s often a struggle for breastfeeding mothers to fit in time for pumping and can require a lot of legwork upfront to get approval and space for pumping breaks.

The challenge for mothers to be able to perform at work without falling asleep at their desks in-between their rushed pumping sessions is very real. This weighs heavily on these women who are trying so hard to manage a very new and very stressful lifestyle. Going home at night only to lose precious sleep once again is enough to wear anyone down. Something has to give and oftentimes the promise of more sleep makes sleep-training seem like the only option.

Is there an Alternative?
There is an alternative to traditional sleep-training that improves sleep for both Mother and baby! Keep an eye out for Part II of this post which will address that.

5 reasons you should be practicing tummy time with your baby

tummy time

What exactly is Tummy Time?

Tummy Time is the ability for a baby to hold his/her head up without assistance. This skill is important for a baby to properly develop. You can begin as early as two weeks after baby is born.

How do I do it?

All you need is a flat surface and a small mat. Place baby on belly and allow baby to strengthen neck and back muscles for 3-5 minutes at a time. Increase time as baby gets stronger. Place small toys in front of baby or get down on his/her level to play.

What are the benefits?

    *Increases hand/eye coordination: Babies are typically staring at the ceiling but Tummy Time allows babies to have a different perspective. Tummy Time strengthens different muscles that don’t get worked when they are on their backs. They also have a better range of movement and motion that allows them to reach and grasp for objects.

    *Aids in Gross Motor Development: When placing baby on their bellies, they will kick and push and this is precisely what helps with gross motor development. It will also be the stepping-stone to crawling, standing up and even walking.

    *Fosters Independence: While skin-to-skin with caregivers is so very vital for baby’s development, this practice also helps baby to realize that he/she can be independent. Of course, babies on their tummies should be supervised at all times but baby can explore and learn without your help when on their bellies.

    *Stimulates Senses: Because baby is so close to the ground, he/she is able to focus their eyes on what’s in front of them. Baby is able to turn neck when hearing sounds. Baby can touch and grab for toys in front of them.

    *Builds Endurance: Tummy Time will make your baby stronger and stronger. He/She will be able to last longer and longer each time. It’s similar to running a marathon. With practice and endurance, baby will be moving in no time.

 

As your baby gets older, try to give him/her around 15 minutes a day on tummies.

 

15 Facts about the Foreskin and Circumcision

Circumcision

Circumcision, the surgical removal of the foreskin from the penis, is most commonly performed on newborns.  With a global circumcision rate of approximately 30%, the United States in the only country in the world that circumcises infant for non-religious reasons.

FACTS ABOUT CIRCUMCISION

  1. Originally, the goal of circumcision was to desensitize the penis to curb masturbation. Dr. Kellogg, inventor of the corn flakes, was a major promoter of the procedure.
  2. The foreskin, containing 20,000 nerve endings as opposed to the 8,000 in a clitoris, is a highly sensitive, functioning part of the male anatomy.  It’s purpose is to protect the glans, or the head of the penis from abrasions and to keep dirt and bacteria from the urinary tract.
  3.  The average adult foreskin consists of 1½ inches of outer skin, 1½ inches of inner mucosal lining – totaling a length of 3 inches – and is 5 inches in circumference when erect. This amounts to a surface area of 15 square inches, or a surface area equivalent to that of a 3″ by 5″ inch index card.
  4. Circumcision is not routinely practiced in most countries.  In fact, The United States is the ONLY country where circumcision is done routinely for non-religious reasons. Aside from being a Muslim and Jewish cultural practice, it is a very American practice.
  5. After reviewing 40 years of research, it has been determined by the American Academy of Pediatrics that routine infant circumcision cannot be recommended.  In fact, no professional medical association in the world recommends routine infant circumcision, nor do they state it is medically necessary.
  6. When the foreskin is removed, the head of the penis can develop a thick layer of skin to protect it, making it much less sensitive.  As a result, circumcised men are 3 times more likely to have issues with erectile dysfunction.
  7. Circumcision can reduce a baby’s risk of getting an urinary tract infection (UTI) by 1%.  In other words, in order to prevent 1 UTI, 100 circumcisions would need to be performed.
  8. It has been claimed that circumcision can reduce one’s risk of contracting HIV/AIDS. The United States has one of the highest incidence of HIV/AIDS, yet we are the only country that routinely circumcises male babies.
  9. A foreskin doesn’t separate from the head of the penis until adolescence, sometime between 3 and 15 years of age.  Until this separation occurs, you only need to clean the outside of the penis.  You clean it just as you would any other part of your body.  In fact, a newly circumcised penis, which has an open wound, may be more difficult to clean and care for during diapering.
  10. 117 babies die each year as a result of circumcision complications. The foreskin and penis is a highly vascularized area that contains a significant amount of blood flow. A newborn only has a total of  11.5 ounces of blood.  That’s just shy of a cup-and-a-half.  A newborn only needs to lose 1 ounce to hemorrhage, and 2.3 ounces, which is a the amount in a shot glass, to bleed to death.  You can read more about it here from DrMomma.org.
  11. According to the CDC, circumcision rates have fallen to 55.4% in the United States.
  12. A Mohel, a person specially trained  in circumcision techniques, can perform the circumcision, even on non-Jews.  It has been argued the Mohels perform the procedure more quickly and gently than in clinical settings.
  13. Cortisol levels, a stress hormone, are 3-4 times higher during circumcision than prior to the procedure, which can contribute to post-op breastfeeding challenges.  It is also thought that the pain and trauma from undergoing circumcision may impact the child’s response to pain or stress throughout their life.  Canadian investigators report that during vaccinations at age 4-6 months, circumcised boys had an increased behavioral pain response and cried for significantly longer periods than did intact boys. For more information about this click here.
  14. Foreskins are harvested to make high-end face creams and are often used for cosmetic testing to determine a product’s safety.
  15. Anti-circumsicion activists are referred to as intactivists.

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