Introduction to solids: What the heck should can I feed my baby?

Helping mamas thrive in motherhood is my passion and because I have a background in nutrition, health & wellness, mamas will often ask about the introduction of solids for their babies. I’ve decided to address this question in a brief blog post for mamas.  My hope in doing so is that mamas will gain some knowledge and can feel empowered and ultimately thrive in motherhood while raising their little ones. Introducing solids can be stressful and as such, I hope this will help mamas by giving them some insight on a very important topic that is often not spoken about in their well visits with their family physician or paediatrician which is gastrointestinal (gut) health.

Most mamas are advised after 6 months that their breastmilk (if choosing to breastfeed) cannot provide the appropriate amount of iron needed for the development of their babe. While this is absolutely true, mamas are often told the best way to optimize this critical mineral for brain development is through iron fortified cereal. There are a few issues with this suggestion and I will go through them briefly.

Whenever we want to obtain nutrients from our diet for our body to absorb, we must not only consider the quantity of the nutrient in our diet but also the quality of the nutrient within the foods we choose to give our babies and whether the body can absorb these nutrients efficiently. Unfortunately, iron fortified cereals often contain heavy metals such as arsenic and lead in exceeding amounts which are both neurotoxins and affect brain development. A national study in 2017,  found 95% of baby foods that were tested contained toxic chemicals that lower babies’ IQ. The easiest and simplest way to reduce the impact of chemical and neurotoxin exposure to our young babies is to provide them with unprocessed, organic wholesome food.

What does unprocessed, organic wholesome food really mean?

For babies starting solid foods, this means choosing (to the best of your ability) organic foods as these foods will have significantly less chemicals and toxins as they are not sprayed with pesticides, herbicides or other chemicals such as the well known glyphosate (roundup). This is crucial in the first few years of life because heavy toxic exposure on the developing body systems and organs can impact the overall health and wellness as they grow. 

Wholesome foods, for me, refers to the most natural and unrefined state. When introducing foods to your little, think about how much processing has occurred before it hits your baby’s mouth. The processing of food not only removes important nutrients but it usually adds preservatives, sugar, unhealthy fats and other potential chemicals that are not important or healthy for a developing baby. In a time where each bite counts in optimizing their nutritional intake, choosing unrefined whole food increases their nutritional demand for certain nutrients. 

So what about gut health and introduction to solid food?

Heavy toxic exposure through processed foods not only impacts brain development but also impacts our guts. Babies are naturally born with “open guts” which allows antibodies from mom’s milk to pass through the gut lining and reach the baby’s bloodstream. This is a good thing as this is one of the ways that breastmilk provides babies with immune support and protection; however, we want to reduce the amount of other potential proteins that can slip through their “open guts” and create an unwanted inflammatory or immune response. This can create food allergies.  Often, moms will see skin reactions which can be an indicator of a food allergy as the body will create a response to the allergen and it will present on the skin. 

Our skin health can be a good indicator of the integrity of our gut lining as our skin is the largest organ of elimination and detoxification. Our body will push out toxins through the skin and this can be evident in children with food allergies and skin irritations as the body has mounted an immune response to that type of food protein that the body has determined to be a threat as it slipped through the intestinal wall. While this maturing of the gut lining starts to happen after 6 months; being careful with the introduction of solids can reduce the risk of immune responses to certain food proteins.

Additionally, the research has now proven that our gut health plays a significant role on our overall health and wellness but it has now been determined that our gut microbiome is set within the first 2-3 years of life. 

What does this really mean for babies? 

I like to explain this like an ecosystem. We are all born with certain bugs within our guts, our lungs, our skin, etc. and this is determined  how we are birthed into the world (vaginal vs c-section and mother’s flora). An ecosystem that has varying species thrives compared to an ecosystem with very little species. We are made up of way more viruses, bacteria, fungi and protozoa than human cells and just like an ecosystem, diversity is key in flourishing. Our ecosystem can have different “bugs” as we age but they will be transient (meaning they will not colonize and stay in our gut). The exception to this is in the beginning years of development where we can influence “the ecosystem”, or our gut microbiome by introducing as many species as we can to set in a powerful and diversified gut. This is crucial for our babies as we can literally set the stage for their health by influencing their gut and creating a broad spectrum of gut bugs to help them thrive in life. Once that window closes, we cannot change the terrain. 

Science has found a link between the gut bacteria in little ones and the prevalence in health conditions such as asthma, eczema, allergies, ear aches, colds, inflammatory bowel disease to name a few. In my opinion, this is fascinating and although the research in nutrition and the gut microbiome is only scratching the surface, it makes sense to include foods high in probiotics, prebiotics (feed the gut bugs) and foods that nourish the gut lining along with adequate iron, protein and healthy fats as first foods for babies. 

So what is an alternative to iron fortified cereal as a first food for baby?

Instead of iron fortified cereal which only has a 4% absorption rate for iron, moms can choose animal protein foods such as liver. The iron in liver will be much better absorbed since baby’s readily make the enzyme necessary to digest protein and fat once introduction to solids begin compared to the starch enzyme, amylase which is not readily available for babies to fully digest starch until later on (closer to 8-12 months or when the first molars come in which is much later). 

Bone broth is another gold star for baby’s first foods. It provides an abundance of nutritional support; however, one main important role is its ability to nourish the gut lining. Without a doubt, I’d encourage moms to introduce fermented foods such a raw unpasteurized sauerkraut to their babies early on. Moms can slowly introduce by giving a tiny amount of the juice from the sauerkraut and the continue with whole sauerkraut. A little amount goes a long way in helping establish a wide range of gut bugs. 

Cod liver oil is also a superfood for babies as it provides healthy DHA for brain health and  nervous system support. It  also provides anti-inflammatory support for the gut lining  and helps colonizes probiotics in the gut. Always ensure it is a high quality supplement when purchasing by looking at the ingredients, the purity and testing of the product. Cod liver oil also naturally provides vitamin A and D. 

Some tips when introducing solid foods the wholesome way:

• Freeze raw liver in small batches, grate frozen liver and add to other animal protein while cooking. Adding breastmilk or bone broth after cooking for desired consistency can help.

• Put homemade bone broth in a cup or sippy cup at meal time instead of water all the time.

• When giving vegetables, ensure they are steamed well and add healthy fats such as butter, ghee, coconut oil or other animal fat to help with absorption and fat intake.

For any moms reading this, my intention is not to place any sort of guilt if this is not the way you have introduced solids to your little ones. What we do not know, we cannot possibly understand and we make choices based on the information we have at hand. When we know better, we do better as cliche as it may sound. So, mama the best thing you can do for your little one is NOT TO STRESS about the introduction of solids as stress greatly impacts our gut health and as I mentioned above, my passion is in helping mama’s thrive in motherhood. Trust your gut and if you have any reservations, questions or doubt, do not hesitate to reach out to your healthcare professional.

Wishing you an abundance of love, peace, health and happiness as you journey through motherhood and get into the messy food stage!

Xo

Karla, BScN, C.H.N.C

Website: https://www.nourishingyoukindly.com/

Instagram: @karla_nourishing_you_kindly

***Karla is a certified holistic nutritional consultant and Registered Nurse with additional training in maternal mental health and owner of Nourishing You Kindly (NYK). NYK is not providing information as a medical doctor, naturopath, psychologist, herbalist or dietitian. The information provided is for educational purposes only with the intent to encourage, empower and teach you how to nourish your little one.***

References

Anderson, S. C., Cryan, J. F., Dinan, T., (2017). The Psychobiotic Revolution. Washington, DC: National Geographic Partners.

Erlich, K. Genzlinger, K. (2018). Super Nutrition for babies: The best to nourish your baby from brith to 24 months. Beverly, MA: Quatro Publishing Group USA Inc.

Houlihan, J. Brody, C. (October 2019) What’s in my baby’s food? Retrieved from: https://www.healthybabyfood.org/sites/healthybabyfoods.org/files/2019-10/BabyFoodReport_FULLREPORT_ENGLISH_R5b.pdf

Walker, A., (May 2019). Microbiome: The first 1000 days. Retrieved from 

https://www.health.harvard.edu/blog/microbiome-the-first-1000-days-2019051516627?fbclid=IwAR1zfR9Gfg34wrrbkX9qsRKZiYtwV3XiiofuZVBka4sQEZ1iYWuNu_ysP4o

a definition of colic is: 

• Crying for more than 3 hours a day

• More than 3 days a week

• Over 3 weeks straight

Colic affects approximately 10 to 40% of infants.  It is associated with high pitched, inconsolable crying, especially in the evening. Colic makes feeding and sleeping VERY challenging, if not impossible.  Colic typically begins in the first few weeks of life and usually resolves by three to six months of age.

Some possible causes of colic include: 

• Stress including prenatal stressors 

• Underfed/overfed

• Overstimulated/overtired

• Altered gut flora leading to cramping and bloating 

• Trapped gas 

Improving feeding techniques can help improve the infant’s comfort and decrease crying. 

A few strategies to try with colic:

• Frequent burping during a feed

• “Paced bottle” feeding

• Remain in an upright position for 20 to 30 minutes following feeds

• Feeding on demand

• Feeding with early cues such as, mouth opening, stirring, turning head/stirring

• Improving latch at the breast

• Ensuring bottles and equipment are sterilized 

To help soothe a crying baby 

• Warm baths

• “Tiger in a tree” positioning (holding baby facing outwards, with your hand on their tummy for pressure)

• Massage

• Frequent, small feeds instead of large feeds infrequently

• Loosen clothing around abdomen

• Burping frequently during breastfeeds (every few minutes with a fast let-down) 

• Change burping positions

• Multi-sensory techniques such as shushing, rocking, sucking and swaddling

• Optimizing naps and paying close attention to “early” sleep cues 

• Try lying them on his/her back, bend the knees and legs toward the abdomen and apply gentle pressure to help pass gas.

I hope that this information helps bring some comfort, even just a little bit. The first year can be a very stressful time. Remember to breath. You will make it through this. Check out our Community Page for a quick access to trained Edmonton healthcare professionals who specialize in infant care.

Just a quick reminder, you are amazing!

Mychelle RN, IBCLC

Hope you enjoyed your summer! We have had some great times together since the “self isolation” rules were set in place. I’m looking forward to the kids back in school and a little nervous about it, all at the same time. The house is going to be quiet.

I thought I’d talk a bit about oral restricted tissues or “tongue ties”. I feel like we see this as an issue in about 75% of our home visits.  Unfortunately in Edmonton right now there are very few specially trained practitioners that do a FULL release (anterior and posterior).  It’s not only about the appearance but about the function of the tongue. There are tongue ties that aren’t visible to the eye but are present and cause problems.  There are also obvious tongue ties that anyone can see by looking but if the function of the tongue is normal there is no need to intervene.  

Tongue ties can be controversial.  Please note that an International Board Certified Lactation Consultant (IBCLC) can NOT diagnose a tongue tie! We can only assess oral function and refer to a healthcare professional. 

Mychelle and I have extensive training with assessing normal oral function and identifying tethered oral tissues.  One of the assessment tools we always use is the The Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF).  We were trained to use the HATLFF by Dr. Hazelbaker herself! We do, however, use multiple assessment tools to do a complete oral exam at each visit.  

From personal experience, when my son was born 10 years ago I didn’t really know about tongue ties.  I had enough knowledge as a Labour and Delivery Registered Nurse to know what a good latch was and how to achieve various breastfeeding positions. Breastfeeding was something I knew I wanted to do but I had so much pain. Toe curling pain.  The pain was so bad I dreaded the next feed. I tried all the nipple creams available. At one point we thought it could be yeast. I don’t recall if anyone looked in his mouth.  I wish I had the knowledge that I do now! However I persevered, breastfeeding my son until he was 18 months old because I am stubborn and I wanted him to have breastmilk.  I would never wish that pain on anyone.  So how did I find out he has a tongue tie? His orthodontist recently said, “He has quite a tongue tie!!!!!” My mouth dropped.

What is a frenulum?

A frenulum is the membrane underneath the tongue connecting it to the bottom of the mouth.  

What is a tongue tie?

A tongue tie is when the frenulum is too short, which affects tongue movement.  A baby needs to be able to stick their tongue out and move it high enough to breastfeed effectively, otherwise it is almost impossible to breastfeed.  

Signs of a tongue tie

• Shallow latch

• Your nipples are painful

• Gassy baby/reflux

• You feel as though you aren’t making enough milk 

• Slow weight gain

• Frequent feeding

• Baby might latch well then slide off

• Short feeds that are tiring for them  

• Very long feeds in order to get enough milk

• Persistent, painful feeds often described as chomping, grinding

• After feeds your nipple may look flattened or lipstick-shaped

• Tongue may be heart-shaped or forked in appearance

• Baby can’t open wide to latch to the breast

• Clicking/smacking sound while breast or bottle feeding

• Cough or choke on the “letdown”

• Frustration at the breast if milk supply is low or if flow slows

It is so important to work with an IBCLC before and after treatment of a tongue tie. If you choose to have your baby diagnosed we will refer you to the most trusted and experienced professionals in the city. While you are awaiting your appointment, your number one priority is protecting your milk supply, We will give you advice on how to best do that.  Mychelle and I will teach oral exercises to be done before and after treatment and ensure you are prepared for the treatment day by reviewing the procedure.  After a tongue tie release, babies need to learn how to use their “new” tongues and often you are starting from the beginning with latch and positioning.  We will be there for you after the treatment to ensure latch, positioning and post care exercises are done correctly and also to teach suck training exercises.  

It is important to note that not all babies treated for tongue tie will breastfeed with ease!  Keep it in the back of your mind that it might not work and be prepared to explore other avenues if need be (we have suggestions for that too). If this is something you have been anxious about or have struggled with previous babies, you are not alone! Many other moms struggle with this “under discussed” issue and we have the information you need to support and assist you!

Melissa, RN, IBCLC

Photography credit: Littles and Lenses

In 2017, I had my first baby, Lucca. He struggled to latch and I nursed hourly around the clock. By day 5, my milk still didn't seem to have come in despite nursing on demand and pumping. My midwife referred me to a lactation consultant and I was then diagnosed with Breast Hypoplasia, also known as Insufficient Glandular Tissue (IGT). This meant that I would never be able to make enough milk to feed my babies, no matter what I did. I was beyond devastated. Luckily, I had lots of support, he received a tongue tie revision and I had access to donor milk, so I was able to successfully nurse him until he was 8 months old, with supplementation, medication and an supplemental nursing system (SNS).

Photography credit: Littles and Lenses

Fast forward to 2019, I had my second son, Matteo. I was much more empowered with information (as I was now a Certified Lactation Educator and Birth Doula at Beautiful Blessings) and had 500+ oz of frozen donor milk ready to go (thanks to two amazing mothers in my life), had expressed colostrum in the freezer, an SNS and a robust nursing and supplementation plan. When Matteo was born, he had a tongue tie which was corrected on day 10 and I was able to start my medications immediately. I supplemented until day 5 with my own frozen colostrum on a spoon. From there, I continued to feed on demand and offer donor milk and formula, as needed. We went on to experience challenges including issues with him having a high palate and a horrible, month long bout of mastitis, but we pulled through.

I am so proud to say that I am still nursing Matteo at almost 13 months old, with no medication and little to no supplementation. I am now working towards becoming a Le Leche Leader as I am very passionate about supporting breastfeeding/chestfeeding individuals, particularly if they are dealing with low supply or hypoplasia.

“I am happy that I reached my breastfeeding goals and I am excited to continue our journey”

- Lauren Calleja Birth Doula, CLE

Photography credit: Jillian Henry Photography

With having had 3 kids I can say that my experience breast feeding them was as different as they are. Before having kids I had a bit of an advantage, or so I thought, having had 2 older sisters with 6 kids between them and 4 years of labour and delivery experience as a nurse. I was encouraging and teaching new moms how to make this unique connection before I had gone through the steps myself.

I knew I wanted to give breastfeeding my all because it was what I knew the most about. I knew it had many benefits for my baby and hopefully me! I wanted the connection, the weight loss, the immunity for my baby and the lack of expense (vs formula feeding).

My first baby threw all my confidence out the window by coming early. Once he was born I was given a pump and told how to use it, clean it and encouraged to pump every 2-4 hours to bring my milk in and have a supply the nurses could use to feed my son through his naso-gastric tube. His blood sugars were low at birth so they needed him to start eating. His first feeds of formula he rejected making me strangely proud! My milk came in (and didn’t stop!) with all of my pumping and my son kept it down and increased feeds just as expected. I was given a nipple shield that I had never seen before, the next addition to my challenges! I had to learn how this big chunk of plastic was supposed to fit into my premies mouth (and function without choking him when it filled up!) while learning how and when to hold him, when to pump, when to go home and when be at the hospital…

The first lesson for me in motherhood was to keep my expectations very flexible!

I had not prepared for anything I was facing and had to use all the help I could get which was difficult to accept with my independent (controlling?) personality. As for the benefits I had hoped for, the “bond” was there from birth and it would have been regardless of what I fed him. His health was good though every “cold” was a cough or wheeze and I’ll never know if that might have been different if he had been full term. I did lose the weight and saved money without needing formula that first 8 (?) months. He did start to nurse without the shield after a few months and after that all ran smoothly but during those months I did a mix of previously pumped and frozen milk and the nipple shield.  I also pumped and brought a bottle to places that I thought would just be easier to keep my shirt on!

I felt protective of my new little love. I liked that when he cried I was the one with the answer. We went to some BBQs that summer and family events I intentionally did not bring a pumped bottle just so he would have to be with me. I felt like I missed out on so many tiny moments in those first few weeks that I wanted him in my arms as much as possible (see..control..).

Looking back on it all, and especially after having two more kids, I wish I could go back and tell myself “Just do what works for you!”. I spent so much time worrying if I was doing the right or best thing and I could have saved myself so much stress if I just relaxed and did what worked, what felt right.  Those were the most empowering actions that brought me so much pride. That and watching those babies chunk up from all that milk! 

After note- all my kids ate every 1.5-2 hrs. It was embarrassing that in one visit I had to feed…again. People would say “Didn’t you just feed him/her?” Sometimes I would leave early just to avoid the possible judgement.

Breastfeeding is a small action with a steep learning curve and a huge weight of expectation. Your mental health is as important as your baby’s physical health. What would that look like on a growth curve??! What percentile is your mental health in?

Lindy Akins

Hoping all you mamas are doing okay and making it through life during a pandemic.

Just a little of an update on how my family has been doing. My daughter just had her 8th birthday and we opened our doors to another family that is close to us and has been pretty strict with the isolation guidelines. Boy, was that ever a fun day! I missed my friends so much. I’m looking forward to and hoping for more “freedom” in the coming days.  Looking forward to drinks on the patio, playground dates and camping together! I’m also counting down the days to no “school”! 16 days to go, in case you weren’t already counting! I have to say that my kids have managed pretty well at home. My son Jack is in grade 4 and he despises doing schoolwork and it is a chore for both of us to get it done.  But he loves being home and staying in his housecoat all day. He’s done lots of cooking with me, built a treehouse with my husband and earned money helping my mom with yard work. I'd say he’s learning lots of life skills. My middle daughter, Molly, is in grade 2 and loves learning and loves doing her schoolwork on the computer. It’s so cute listening to her read stories to her teacher and the conversations she has with her friends on Kids Messenger. She also enjoys being in her pyjamas all day! My youngest, Hannah, is in kindergarten so she’s already used to being home most days. She’s enjoying having her siblings home all the time and keeps herself busy playing/crafting all day.  We’ve kinda (100%) stopped doing the assigned activities from her teacher (sshhhh) and life is way easier. This mama is not creative and does not enjoy crafts!! She went to an amazing preschool that prepared her so well. She’s ready for grade 1! (and yes, I have the teachers approval). Of course they all miss their friends but they also understand that this “new normal” isn’t forever and we need to keep ourselves and everyone else safe.   

How are all of you? I would love to hear how you are all coping and the positives that are coming from being home. Our days are starting to warm up and often we get this question:

Does my breastfed baby need water? 

The simple answer is, a breastfed baby does not need extra water or fluids. No matter how warm it gets breast milk is food and drink. If the newborn baby is thirsty, continue to feed on demand. Research shows that even in extremely hot countries, breast milk alone is good for keeping a baby hydrated.  

• Breast milk is over 90% water

• Our bodies are so smart! In hot weather, our bodies make milk that has a higher water content

• Babies might fill up on water, which has no nutrients or calories

• Giving anything other than breastmilk can affect milk supply

• Water may interfere with breastfeeding, and can actually contribute to weight loss and jaundice.  

• Although very rare, if babies under the age of 1 drink too much water, it can lead to water intoxication which can lead to brain seizures.

So mama’s, drink lots of water!  It is normal for your baby to have lots of short feeds on a hot day. This is because breastmilk is higher in water at the start of a feed therefore thirst quenching. It is okay to start giving a little water around 6 months of age, when your baby starts sampling solids, but always offer breast milk first.

Enjoy June!

Melissa, RN, Lactation Consultant

When I finally became pregnant, I didn’t think that I would become what I call a “breastfeeding warrior”. I simply thought I would feed the babies and do whatever was in their best interest.

My journey started when I was 24; I was with my ex husband, who had paraplegia. Our fertility journey began with in vitro fertilization due to his disability. If I had a crystal ball, I would have realized that my own fertility journey was beginning due to the course of events that were about to unfold. It was easier to let him shoulder the reason for our infertility at that time.

With two fresh embryo transfers, and one frozen, we were still without a pregnancy. Being 26 at the time, we decided to move on. I remember the fertility doctors commenting that I had “sluggish ovaries” since I was producing a minimal amount of eggs even on the highest dose of FSH. At 28, the marriage ended and while I recovered, I looked forward to becoming a mother “naturally”.

With a new partner, we began trying to conceive when I was 30. Due to my scars from my first journey with infertility, part of choosing my new partner was his family’s fertility history. One of six children, with each sister being a mother. I was excited to finally become a mother.

So began my second infertility journey. Eventually, the twins were conceived via Clomid and IUI. I carried the twins to 37 weeks and 4 days. I was 33 and had been on an almost decade long journey with infertility. Along with this came crippling anxiety, irrational fears, and constant worry about the babies.

Being pregnant with twins, I rationally knew that I might need help with feeding them. I was very open to receiving help and supplement what I could not produce. I was eager to get the babies out since I began to worry about squished cords, etc. The moment they were born, the real anxiety set in and I realized they were much safer inside me. Hence, I was very particular who could hold them, nevermind feeding them!

After my cesarean section, in the recovery room, a baby was put on each breast and my breastfeeding journey began. I was surprised at how much it hurt. I wasn’t anticipating pain. After a couple days in the hospital, my nipples were both scabbed over, I remember cringing when they latched; my sister encouraged me that it would pass. In the hospital, my son was losing weight, tremorous, and fussy. My daughter had jaundice and needed treatment. A nurse came in one night and helped me with the hospital pump, weighed the babies, and based on my son’s weight loss, suggested that we supplement. I remember, at that moment, my babies were 2 days old and I already felt like a failure. It hit me that not only did I not want them to have formula, I had a hard time with anyone giving it to them. 

After my daughter received treatment for jaundice, we were on our way home. The first 3 months is a blur. All I remember is being awake, babies on my breasts, cluster feeding, and quickly losing my mind. I was determined to exclusively nurse the twins. No one slept. No one was sane. We did use formula at times. Especially for my son who seemed to be starving. My husband was determined to make them sleep. I recall one night he fed my son so much formula in hopes of him sleeping, that my son vomited everywhere and we were back to square one. My anger in this moment was immeasurable. I couldn’t seem to nurse them or supplement them without feeling some sort of failure.

I sought help from a lactation consultant. I finally felt relief weighing the twins before and after nursing, knowing that I was producing, but they needed a little more. I kept a bracelet on my wrist to remind myself which baby was on which breast last. The problem was that my daughter was more efficient, and my son was smaller. I was bouncing them from breast to breast hoping they were getting enough. I was also pumping like a crazy person. Working on building a stash, just in case. But I didn’t want to use the stash to feed them. It was official: I had lost my mind. I saw my consultant on a fairly regular basis. I was taking motilium to increase my supply which also increased my appetite. I was doing everything I could in order to continue to nurse the babies.

At 4 months, I was at a consultation and she suggested a new plan: assign one breast to a baby for 24 hours, then switch. Within a week, the babies were gaining, and I was starting to feel an ounce of success. At this point, it was like a cloud lifted and breastfeeding became easy.

At 6 months, after an average of 4 hours of sleep (for me) in 24 hours...in increments, it was time to bring in a sleep consultant. When the twins were 7 months, my daughter was finally sleeping through the night and my son was feeding once. This was the first time that I ever felt engorged. I woke up in the middle of the night and I could feel the “flower petals” of milk in my breasts and I was shocked at the feeling. Everyone talked about the let down and I never felt it. Until 7 months postpartum. I was still pumping, but this time once a day. The collection of milk in the freezer went to two friends. One who was unable to nurse and the other was unable to pump and was back to work.

The encouragement I received from people was “stop nursing” or “use formula”. Only one person was supportive. My sister, a labor and delivery nurse. I was shocked at the overall lack of support. No one knew how to help me. I’m glad I pushed on, but I learned some valuable lessons.

Breastfeeding was the unexpected hill that I died on. I paid a very big price for it. My mental health suffered greatly; I have PTSD from the lack of sleep and the deep postpartum depression I was in. When the babies were two, I finally got help. Once I got help, I realized that I probably should have been admitted when the babies were about 3 months. The help came much too late to avoid long term consequences. I am grateful that I pressed on since it eventually became easy, but I still wonder if my mental health would have been better if I accepted the help and let it go. However, now, in a state of clarity, I look back with pride and love of breastfeeding my children. I breastfed for 19 months. I feel like when the babies turned one, I lost most support. My sister remained supportive which I will always appreciate, but it seems like society expects an end to it on a child’s first birthday. I would have kept going if I felt like I had more support. Everyone had a comment like “oh you’re still nursing?” My breastfeeding also wasn't subtle - I always tandem nursed and as the babies got older, it was a full shirt off experience. I received many comments when I nursed. Some about the size of my breasts, some about their age. I felt like it was time to end it. 

At the time, I didn’t know how anyone could support me. I encourage partners and other support people to help a nursing mother get sleep. Bring the baby to her to nurse and take away to burp and calm, so she can get some sleep. Keep comments at bay, unless they’re of support. Don’t just suggest they quit. Suggest lactation consultants; give positive encouragement. I tell struggling mothers that it does get easier, because it does. It was emotional, difficult and beautiful. I am so proud of myself that I persevered! My babies and I experienced that journey together. It didn’t have to be the hill that I died on, but I’m glad it was. For my 35th birthday, the babies were almost 18 months, I honoured our journey with a nursing photoshoot. This is my favourite picture ever taken of us. It makes me teary looking at it, 3 years later. I am so grateful I got this opportunity.

Adelle Stelmaschuk

Hi Everyone,

I just wanted to write a note about Covid-19 and Breastfeeding. There is a lot of confusing and contradictory information in the world right now.  I have researched the most credible sources such as the Centers for Disease Control and Prevention (CDC), International Lactation Consultant Association (ILCA), World Health Organization (WHO) & Academy of Breastfeeding Medicine (ABM). I’m hoping this will be useful to you in some way. Of course, there seems to be new information about Covid-19 emerging daily;  the information below is current as of today.  

COVID-19:

• It is a respiratory virus.

• Primary mode of transmission is through respiratory droplets when an infected person coughs or sneezes.

• Is NOT found in breastmilk.

• There is no evidence of vertical transmission (passage of a pathogen from mother to baby during the period immediately before or after birth through placenta, breastmilk or direct contact.).

• Is highly infectious! On average, 1 person who has the virus infects about 2.5 people. 

• Up to 44% of transmission occurs during the pre-symptomatic stage (a person who does not know they are sick but they are shedding the virus and transmitting to others).

Limit transmission by:

• Handwashing often with soap and water- it is the most effective tool

• Avoid touching face and eyes

• Cleaning surfaces of frequently used areas

• Wearing masks to limit exposure to droplets that a person may be exhale (controversy remains over the effectiveness of masks)

• Physical distancing aka social distancing to interrupt chain of transmission

The concern among infants is due to their immature immune system. Breast milk provides protection against many illnesses and is the best source of nutrition for most infants.

The recommendation from the CDC & WHO is that mothers with COVID-19 CAN breastfeed.  Mothers should :

• Practice respiratory hygiene/cough etiquette (cover nose/mouth with a tissue when coughing or sneezing, when coughing use a mask, use disposable tissues and discard after use, practice hand hygiene after having contact with respiratory secretions)

• Wash hands before and after touching baby

• Routinely clean and disinfect surfaces they touch

If a mother with COVID-19 is too unwell to directly breastfeed she should be supported to safely provide her baby with breastmilk in other ways such as :

• Expressing milk with hands or pump to establish and maintain milk supply. Wash hands before touching any pump or bottle parts and before expressing breast milk.

• Follow recommendations for proper pump cleaning

• Relactation

• Donor human milk

If you are from Edmonton, AB area here is a great resource from Alberta Health Services.   

Prenatal and Postpartum Information Covid-19

I hope this helps clear up any misinformation. We are in this for the long haul! We will be dealing with issues and the aftermath from COVID-19 for months to come and need to be thinking of how to best support families in the short and long term.  We will get through this together! 

In the meantime, STAY HOME! Stay safe and stay healthy. Be humble and listen to the experts!

Wishing you love and patience,

Melissa & Mychelle 

Lindy (Editor in Chief)

COVID-19 Resources:

CDC Coronavirus Pregnancy & Breastfeeding

WHO Breastfeeding Covid-19

ABM Coronavirus

ILCA Covid-19 and Lactation

Hey all you lovely ladies,

It’s Melissa from Little Nursing Company. How is everyone? I hope you are all staying healthy and safe. Wow, what a time we are living in right now! So much uncertainty it’s overwhelming. I’ve been watching Frozen 2, on repeat, with my girls and the song “Into the Unknown” is SO relevant for 2020 thus far.  Mychelle and I are still working at an Edmonton labour and delivery hospital and are experiencing first hand the demands of this virus! 

I’ve been wanting to write for a while now but have been struggling to prioritize what is worth reading during these stressful times! I considered writing a blog on how breastmilk is the best choice for your baby, as it gives immune protection. Who doesn’t want the best immune protection right now?!!   But why “beat a dead horse?” Everyone is aware of that and now is not the time to make any mama feel unsupported for choices made. I thought of writing specifically about HMOs (human milk oligosaccharides) found in breastmilk. There is fascinating new research about how HMOs keep your baby healthy. But that didn’t seem right either.  How about tips on how to help a mother relactate…. Some moms who have stopped breastfeeding might want to start up again during these uncertain times?   

I had all these topics on my mind but just couldn’t sit down and write.  Until a good friend of mine said “keep it short and supportive- less is more right now.”-LA

So all I have for you this month is a couple self care tips, that don’t even involve breastfeeding. Just surviving as humans :)

1. Go outside! Go for a walk or if it's warm enough, just sit outside with a coffee. The Vitamin D on your face is guaranteed to lighten your day

2. FaceTime friends and loved ones to combat loneliness

3. Do the thing that has been on your “when I have time” list: binge watching a series, cleaning out the fridge, organizing photos

4. Spend “quality” time with your kids/family- bring out the puzzles/games/books/movies. And genuinely take the time to enjoy being together

5. Have a relaxing bath

6. Allow and release all the feelings during this time; with yourself and your kids, so it doesn’t remain in the body

7. Do nothing! And don’t feel guilty about it! 

These self care tips are as much a reminder for you as they are for me. 

Somehow I managed to get out of my “slump” and had a pretty good day, the best one so far! The kids and I baked cinnamon buns, started a puzzle and I enjoyed the best coffee & Bailey’s on the deck in the warm sun.

Please let us know if you would like more infant feeding and/or breastfeeding information on the topics mentioned above. 

Thanks for reading, you’ve got this and you are not as alone as you might feel!

Melissa, RN, IBCLC

“Taking care of yourself is part of taking care of your kids”- Unknown Source

One of the top concerns of breastfeeding moms is latching pain! It is also one of the biggest reasons Edmonton mothers quit breastfeeding and rightfully so, it hurts! No one wants extra pain when you are already so exhausted with a new baby. 

So let’s talk about it for a bit...What does “latching on” mean?  Does a traumatic or difficult birth affect latching on? What could you do if the baby doesn’t latch?  What is a good latch anyway? We can help if you want to ask these questions directly to an Alberta registered nurse. Contact Us.

“Latching on” simply means the baby taking the breast into his or her mouth. However, sometimes it's not this simple!  Not all babies are the same; not all breasts are the same; not all nipples are the same.  Sometimes the baby prefers one position on one breast and another position for the other; sometimes the baby prefers only one breast and not the other and sometimes the mother prefers one position over the other. The baby could be tongue tied or extra sleepy or have a tiny mouth.  There are so many reasons why latching can be difficult.

A good latch for a breastfeeding baby is taking a large mouthful of nipple and areola, bringing the nipple to the very back of their mouth and massaging the areola with the tongue.

A good latch is not only pain free but it also means the baby is getting more milk.  A mother might have an abundant milk supply and her baby is growing but overtime a poor latch can lead to decreased milk supply.  A poor latch might also result in nipple pain and damage, long feeds with low weight gain or long term low milk supply.

This can have a traumatic or difficult birth experience can definitely have an effect on bonding and breastfeeding.  Being able to recognize this is a huge step in the right direction. Also, forgive yourself! You have been through a lot too!   

Many babies won’t latch after a difficult birth and you may not want them too. Here are some ideas to help with bonding:

• Remain skin to skin for as long as possible.  Smell, touch and enjoy each other!

• If you are home, take a warm bath together alone.  Enjoy the time together.

• Limit visitors or simply tell them you need time with your baby. If he/she won’t latch, be patient. Try not to get upset or frustrated. 

Three “MUST-DO’S” if baby won’t latch:

• Hand express colostrum! By removing colostrum from your breasts it is telling your body to produce more now and also to continue making milk for the future.  In the first 1-2 days you’ll want to hand express every 2-3 hours around the clock. If your “milk” is in on day 3 you can choose to continue hand expressing or try pumping. Continue with breast massage and breast compression to encourage more milk. 

• Feed your baby! In the early days, this can be with a spoon, a medicine cup or a syringe. 

• Stay skin to skin! Direct skin to skin contact helps with bonding and keeps your baby warm. It also keeps their heartbeat and breathing steady while his/her food source is close by! It feels amazing!

Tips to achieve a good latch 

• Your nipple level to baby’s nose

• Ensure the neck is extended so the chin touches the breast first

• Tickle the babe’s top lip with your nipple 

• Be patient and wait for the wide open mouth

• Once opened like a yawn, bring your baby in extra close and seal the latch. Picture your nipple at the back and roof of your baby’s mouth

• Top and bottom lip should be flanged out, not tucked in

• Do not hold the back of the head.  Your hand can go at the shoulder blades for stability

Getting support with your latch is very important. Ask your nurses/midwives/doctors for help while you are in the hospital.  Sometimes hospitals will have a lactation consultant on staff. Don’t be afraid to ask for help as many times as you need. There are community supports such as Le Leche League and private practice lactation consultants to contact once you are home.  

Check out youtube videos such as:

How to Breastfeed - Deep Latch Technique

Global Health Media- Attaching Your Baby at the Breast

International Breastfeeding Centre- Breastfeeding Videos

Melissa Alexander RN, IBCLC, Mychelle Gagne RN, IBCLC

Edited by: Lindy Akins RN & mother of 3 breastfed babes

References

Biancuzzo, M. (2003). Breastfeeding the newborn: clinical strategies for nurses. St. Louis, MO: Mosby.

Brown, A. B. (2018). The positive breastfeeding book: everything you need to feed your baby with confidence. London: Pinter & Martin.

Newman, J., & Pitman, T. (2014). Dr. Jack Newmans guide to breastfeeding. London: Pinter & Martin.

Wiessinger, D., West, D., & Pitman, T. (2011). The womanly art of breastfeeding. London, England: Pinter & Martin.