Getting Ready to Breastfeed

A while back, Mama in the City did a post on preparing for breastfeeding. Mama Andrea, who is a perinatal nurse, had some great advice (read it here). The first tip, and probably the most important, is to make the decision to breastfeed.

Make the decision to breastfeed.

As a breastfeeding mom (going on 8 mos), a daughter of a mom who breastfed and a wife of a man who wishes he could breastfeed, I get it. I know how hard it is to plan ahead and get started.

We had our own struggles, encountering many 'booby traps' along the way. I also have many friends that were committed, tried extremely hard and weren't as successful. Often, they talk about hard it was to give up on breastfeeding and what they'll do differently next time.

It isn't enough to try. You will need help.

With those moms in mind, if you are an expecting mom or are helping an expecting mom prepare for her new babe, here are my tips on preparing for successful breastfeeding:

• Get yourself some support.
• Talk to breastfeeding moms: Do you know anyone who has breastfed? Is currently breastfeeding? By talking to them ahead of time, you open up the lines of communication for when you'll need help (and you probably will and that's perfectly okay).
• Tell your support group your intention to breastfeed: Tell your partner, parents, family and friends that you will breastfeed. Tell them that you only want support. If you are going to stop trying, tell them that it will be your decision. If they disagree, they can keep it to themselves (that includes looks, whispers, comments and offers to feed the baby).
• Do a little research: Who supports breastfeeding in your community? Do you have a local Le Leche League chapter? Who does your doctor or midwife use as a lactation consultant? If you can, get that information ahead of time. Ideally, attend a Le Leche League meeting - you may be surprised at who you meet there.
• Get yourself in fashion.
• Get one good nursing bra at 30 weeks: I followed the common advice to buy 2 nursing bras at 37 weeks... I had a baby at 34 weeks. Imagine this: You've just had an emergency cesarean. You're in pain. You're also braless, engorged, and exhausted with hospital face cloths stuffed down your shirt to absorb the incessant leaking. All the while, you're fumbling with hospital gowns and trying to feed in a very public NICU. Sucks? Like I said, buy a nursing bra at 30 weeks.
• Explore ways to nurse in public: 

• Nursing top: For me, the best top was a nursing tank. Parent By Nature has a great selection of nursing gear online. Local shops include Room for 2 Maternity on Commercial Drive and Boomers and Echoes in North Vancouver.
• Here's a tip from a friend: Wear a cheap camisole under your shirt. To nurse, simply undo the clasp on your nursing bra, pull down your camisole and lift your shirt. This lets you nurse while still covering your torso and breast.
• Will you cover? No woman should be ashamed to openly nurse in public. However, nursing covers can give you freedom to fumble - invaluable in the early weeks. If you plan to use a cover, try it out ahead of time. Figure out if you need to undo your bra before you put the cover on or after. How will you see the baby?

• Get some good nursing pads: You will leak. All over the place. For several months. I picked up 8 pairs of super-absorbent washable cotton nursing pads to stuff in my bra. These were great for the first months of heavy leaking. Later on, after I needed less protection, I opted for some chic coloured nursing pads from KenziNoelle. 
• Consider getting yourself a pump.
• Difficulty with breastfeeding is common and many women need to pump at the beginning. You can rent pumps but rentals can be expensive and hard to locate (take it from a pharmacist who has rented out many a pump at 11pm). Instead of all the fancy bedding and toys and stroller systems and swings, consider investing in a high quality electronic double pump. At the very least, find out who sells them and how much they'll cost.
• My preference: I personally prefer the Ameda Purely Yours pump but there are several models on the market. The beauty of a good pump is that it can free you to go out for the day or to head back to work even if you're still breastfeeding. If you buy a closed system pump like the Ameda, you can lend it to a friend provided they buy their own attachments.
• Get yourself learned.
• Even if you are committed to breastfeeding, you will encounter challenges. Whether it's latching difficulties, soreness, nursing strikes, early weaning, teething or mastitis, it happens to most moms at some point. Having a good reference on hand is invaluable. Here are some great ones:
• Website: Dr. Jack Newman's website has several information sheets and videos on common breastfeeding issues.
• Website: Kellymom.com is a fantastic reference for expecting and breastfeeding moms
• Book: Also from Dr. Newman, 'Dr. Jack Newman's Guide to Breastfeeding' is a also a fantastic resource. You may even get it from your local library.
• Book: Midwifery maven Ina May has just published her own guide: Ina May's Guide to Breastfeeding

While this list is not exhaustive, it should help you plan ahead. I'm sure there are many other items that I missed - if you have one, please leave a comment.

MamaMed Series: Medications & Summer Holidays

Summer holidays are around the corner. For many, June is the time for planning beach holidays, family vacations, travels abroad and weeks at the cottage.

When I work in pharmacies, it's common to have parents stop by looking for advice on what to pack. I usually start with a few recommendations.

The first is to stay away from combination products like the multi-symptom cough & cold pills or cough syrups. It's easier to manage health issues and avoid accidental overdoses if you know what you're taking.

I also suggest buying a small travel bag where you can keep all your travel medications. This way, every time you take a day trip or an overnight trip, everything is quickly accessible.You should also keep all medications in their original packaging. At some point you'll need to know the directions, maximum dosages and information on contraindications. 

Finally, I suggest that anyone who has any major health conditions or who takes any prescriptions medications talk to their family physician or their family pharmacist before buying a new non-prescription product.

With that in mind, here are a few medication tips to make sure your trip doesn't suck:

• Check your dates: Before packing pills, bug sprays and sunscreens, check the expiry dates. Replace expired products from last summer (pharmacies will dispose of your expired medications).
• Plan to get sick: There's a good chance you'll end up with a headache, stuffy nose, minor injury, sunburn or stomach upset at some point. That's the reality of air travel, restaurant food and outdoor activity. To minimize your discomfort, keep the following products on hand:
• Non-prescription pain reliever tablets (acetaminophen or ibuprofen): Will treat pain, sore throats, headaches, fevers and sinus pain.
• GI Medications: Bismuth subsalicylate (Pepto-Bismol) tablets will treat most GI complaints, including nausea, diarrhea, heartburn and indigestion. If you cannot take this medication, pack an antacid (Tums, Rolaids) and an anti-diarrheal medication like loperamide (Imodium).
• Nasal decongestant tablets: Pseudoephedrine (Sudafed) will treat sinus congestion or ear pain during airplane flights (few things suck more than flying with plugged ears).
• Sedating antihistamine tablets: Dimenhydrinate (Gravol) or diphenhydramine (Benadryl) will treat bug bites and runny noses. They can also prevent motion sickness. As a side effect, they'll make you tired which is why they're also sold as non-prescription sleep aids.
• Topical anti-itch cream: Will treat bug bites and rashes. Sarna-P contains pramoxine, which is a topical anesthetic, and is calamine free (calamine can be drying, leading to more itching).
• Pack a small first aid kit with moleskin (for blisters), band-aids, antibacterial cream, tweezers, gauze and an elastic bandage. 
•   Mind the little ones: For infants and young children, bring the following:
• Infant acetaminophen can go a long way for teething pain and fevers.
• A bottle of nasal saline is your best bet for stuffed noses. 
• For your free-range kids: Bring enough sunblock and bug spray to last your entire family for at least 3 days. This will give you enough time to find more if you need it.
• Prescription medications:
• Check out the Canadian Pharmacists Association's excellent info sheet on traveling with prescription medications.
• Keep it obvious: Store all your medications in their original vials.
• Keep a list: Have a list of all your medications in your wallet. This can be used to replace any lost or stolen medications or in the event of an emergency.
• Keep it on-hand: If you are flying, store your medications in your carry-on luggage.
• Keep it safe: Store your medications away from extreme temperatures.

While the hope is that won't need to use any of your stash, there's a good chance you will.

Shit happen.

Bon voyage and happy travels!

For more information on general travel health, check out these sites:

• Healthlink BC: Travel Health
• Public Health Agency of Canada: Travel Health
• US Centers for Disease Control and Prevention: Travelers' Health
• FamilyDoctor.org: Air Travel Health Tips

Photo by Davide Schiano.

Note: The MamaMed series is intended to provide general information on medication use. If you have specific questions about your care or the care of a loved one, contact your pharmacist or physician. (My disclosure statement can be found here.)