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and now a formula shortage?

5/24/2022

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Just when we thought we were coming out of the crazy world of 2020 and 2021, 2022 hits us with a formula shortage. I’m here to answer the most common questions that I am hearing about the formula shortage. 

Why? “Current shortages have been largely caused by supply chain issues and the recent recall of several baby formula products over concerns about contamination.” Basically, there are only a few companies that make baby formula for the big brand names as well as store brand formulas. Unfortunately, if one of these companies has problems, it can lead to massive disruption in production for lots of different brands. In this case, it’s Abbott, and they’re sorry .

What are families supposed to do? 
Well that depends. If you’re already breastfeeding or pumping, continue to do so to the extent that you’re able. If you are having difficulty breastfeeding or pumping, please contact a certified lactation consultant asap to make a plan to get things on the right track. Issues such as painful breastfeeding, painful pumping, low supply, and others, can be solved by working with an expert who knows how to solve them! 


If you’ve been buying retail formula, I know it’s tempting to stock up on formula when you see it in stock, but I recommend that you buy only what you need for 10 to 14 days. Stocking up on formula only adds to the shortage on the shelves for other families. 
If you have been using WIC to obtain formula, North Carolina is now allowing WIC families to use their waivers for different brands of formula according to what they are able to find on the shelves.
You can try to find your formula at smaller local retailers or online. 
Importantly, you can use a different brand of formula than what you have been using. Most babies tolerate a change in formula without difficulty, if the formula is the same type that they have been taking. I also recommend that you make only the amount that the baby needs at that time, to minimize waste.
 
 
It is very important that parents avoid trying to make the can of formula last longer by diluting the formula with extra water when they mix it. Mixing the formula in any way other than what the directions on the can say can be very dangerous to the baby. If the baby is on a specialized formula, or you just can’t find any formula at all, please contact the baby’s medical provider asap.
 

What about donor milk?
There is one certified milk bank in North Carolina, and obtaining milk through the bank is difficult and expensive. The milk is primarily used for babies in the NICU or medically fragile babies, and a prescription is required. 
Another option is casual milk sharing.
 
But is it safe to feed my baby someone else’s breast milk? 
Mothers have been sharing breast milk since the beginning of babies. The better you know the donor, the more likely the donated milk will meet your standards. Start with close friends and family to see if there is anyone who has extra milk that they can share with you. To be sure the donated milk is free from bacteria and viruses, you can pasteurize the milk at home. Please click here for detailed instructions for how to safely prepare donated breast milk. 

​
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Covid-19 vaccination

12/16/2020

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If you are pregnant or breastfeeding, should you get the Covid-19 vaccination when it becomes available to you? 

If you are pregnant or breastfeeding, and have questions about the Covid-19 vaccine, please talk to your health care provider. The following reputable sources can help you in deciding what to do.

Academy of Breastfeeding Medicine:
"During lactation, it is unlikely that the vaccine lipid would enter the blood stream and reach breast tissue. If it does, it is even less likely that either the intact nanoparticle or mRNA transfer into milk. In the unlikely event that mRNA is present in milk, it would be expected to be digested by the child and would be unlikely to have any biological effects."
"While there is little plausible risk for the child, there is a biologically plausible benefit. Antibodies and T-cells stimulated by the vaccine may passively transfer into milk."

https://www.bfmed.org/

Infant Risk Center:
"As for breastfeeding, little or none of these vaccine components would ever reach the milk compartment, or even be transferred into human milk. Even if they were, they would simply be digested like any other protein by the infant. It is our opinion, that the present group of vaccines are probably going to be quite safe for breastfeeding mothers. The infant may even gain a small amount of maternal IgG in the breastmilk, which may even be beneficial."
https://www.infantrisk.com/
ACOG:
ACOG recommends that COVID-19 vaccines should not be withheld from pregnant individuals who meet criteria for vaccination based on ACIP-recommended priority groups.
https://www.acog.org/.../vaccinating-pregnant-and...

​American Academy of Pediatrics:

"Pregnancy and breastfeeding will probably not be contraindications to receiving COVID-19 vaccine; however, there is no safety data in the pregnant woman, her fetus or infants at this time. While these vaccines were not specifically tested in breastfeeding women, it is not likely (based on the mechanisms of action of the vaccines in US trials) that there would be any risk to the child."
https://services.aap.org/.../covid-19-vaccine-frequently.../
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how to survive the holidays with a newborn

12/9/2020

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Congratulations on your new baby! As a mother of a December baby, I understand the courage and the divinely appointed energy that is required to get through the holidays with a newborn.

Pardon the cliche, but it truly is a magical time, especially for families with littles. The lights! The music! The decorations! The gifts! The food! The parties! The… visitors! There are endless things to dazzle and delight us, but with all that dazzling and delighting comes exhaustion and anxiety… and germs. Is it possible to get to January healthy and sane? I don’t make any promises, but these tips might help.

  1. EAT! A LOT! Keep eating lots of good stuff. If you have recently given birth, you are already used to treating your body kindly for the benefit of your baby. Continue to eat plenty of high quality foods; this is not the time to try to rush back to your pre-pregnancy body by cutting back on healthy calories. You’ll need all that nutrition to keep your immune system strong during the next few weeks. Keeping your body fed with healthy food will help prevent the psycho-binge that we fall victim to when we get hangry.
  2. TAKE A WALK! If your OB or midwife has cleared you for activity, get some exercise. In addition to the obvious physical benefits, exercise can help keep you mentally clear and strong. And light to moderate exercise can help strengthen your immune system and keep you strong for the germ fight ahead. Getting some fresh air can invigorate and energize you, and gentle yoga or stretching will make you feel like a million bucks.
  3. TAKE A NAP! For real. Take a nap. Like now, stop reading this and close your eyes for a few minutes. I’ll wait... There, does that feel better? A 15 minute nap can help clear your mind and improve your mood. Look for and create opportunities to rest your body and eyes and mind for a few minutes, and take naps without guilt. After all, this about being the best mom you can possibly be, and there’s no guilt in that!
  4. BE A SELFISH CONTROL FREAK! Your baby is your baby and no one is entitled to hold, touch, or kiss (eww!) your baby unless you deem them worthy. How do you know who is worthy? If they show up to your house with food and leave with the trash, this is a good indication that they are worthy. Anyway, the neighbors and the sister-in-law’s friend’s cousin and the preacher and the random old lady at Target (precious as she is), these people are *not* entitled to give their icky germs to your tiny, vulnerable baby. Repeat after me: Please don’t touch (or kiss) my baby. No explanation needed; it’s your baby, and it’s not impolite to deny someone else’s invasion of your baby’s space.
  5. SAY NO! Yes, it is ok to say “no”, in fact, it is healthy self-care to skip some of the parties and social engagements and to stay home and snuggle with your brand new little one. It is ok to say “no”, in fact it is a wise protective measure to decline visitors and company to your home. I promise, the people who love you will invite you again if you miss their party, and the people who love you will gladly wait until your baby is a little bigger and stronger before they insist on a visit. Saying “no” to some things will help you stay sane and healthy, and may protect your breasts (see bonus tips below!)
  6. SAY YES! All those people asking what they can do to help you? Allow them the blessing of helping. They can do all the things… get the groceries, wrap the presents, mail the packages, fold the laundry, prepare the teacher gifts, take the older child to the park, make the dinner. The people in your life who love you will gladly take care of all the things while you take care of 1-5 above. When people offer to help, say yes!

Bonus tip for breastfeeding mothers!
  1. During the busy holiday season, it’s easy for moms to lose track of time and get distracted and busy. When this happens, feedings can easily be skipped or delayed. It’s easy to skip feedings by accident, when the baby is being passed around to all the relatives, when you’re out and about doing holiday errands, when you’re at a holiday party and time gets away from you. Missed feeds can lead to pain, engorgement, and even mastitis! Try very hard to avoid missing feedings, or pump if you are separated from your baby during meal time.
  2. If you start to feel like your breasts are getting painful, or if they are red or warm to the touch, or if your baby is having any trouble latching, take a day off from all activities, get some rest at home, offer unlimited breastfeeding to your baby, and call your doctor, midwife, or lactation consultant for help.
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WGHP Features beth on "house calls"

8/4/2020

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Breastfeeding is one of my favorite topics, and today I had the pleasure of speaking with Fox 8 WGHP about it!
It was a FAST interview, and even though I could go on for hours about breastfeeding, we had only 3 minutes to cover some highlights. 
We talked briefly about
  • the benefits of breastfeeding,
  • the uniqueness of human milk to each individual baby,
  • where to find a breastfeeding class during the Covid-19 pandemic, 
  • and what to do if you have any problems or concerns. 
Click here to take a listen!
If you have more questions, or want more information about breastfeeding, shoot me a text to schedule a virtual or phone consult. 
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lunch n learn with doula amelia Mattocks

10/2/2019

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Beth was featured on the first episode of this season's Lunch N Learn series by local doula Amelia Mattocks. Have questions about IBCLCs? Want to know what Beth does to care for her clients and what sets her apart? Watch this Lunch N Learn to find out more about Beth and how she can help you! 
​For more information about Amelia and her doula services, click here. 
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wisdom and laughs for all moms!

8/27/2019

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If you are at any stage of parenting, and need helpful information or a little chuckle, check out my friend's website www.mothersrest.com.

Ginny keeps it real in all things parenting, from infertility to potty training to graduation. I encourage moms at any stage of momming to head over to Ginny's blog, take a minute to laugh a little or cry a little while reading wise mom words. No matter what you're going through in this parenting journey, you are in good company! 

If you are struggling with breastfeeding, you are not alone. Check out my guest blog on Ginny's site at https://www.mothersrest.com/breastfeeding-is-hard/. Before I help you with breastfeeding, I'll listen carefully to you to find out how we can get to your goals without making you feel crazy. Reach out if you need help, I'd love to work with you!
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how can i get my body back?

5/29/2019

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With temps hovering in the 90s most days, summer is undeniably here, and here to stay! Trying to keep cool in this heat usually means wearing less clothes, or... a swim suit (gasp!) If you recently had a baby (and by "recently", I mean "ever"), and the thought of putting on a swim suit makes you sweat more than the southern sun at noon, read on! 

​Your body has done amazing things in the last year or so! You grew an entire human being and you are now keeping that tiny human alive. But maybe you miss your old self, your old clothes, your old shape, and you are wondering how to get yourself back. Here are some tips to get you feeling like your old self again.


  1. Eat up! Yes, keep eating! I’m personally not a big fan of diets, but this is an extra bad time to attempt weight loss by cutting calories. Continue to eat plenty of high quality calories, including proteins, healthy fats, and yes, carbohydrates. Fruits, veggies, lean meats, nuts, avocado, beans, eggs, and oatmeal provide great flavors, tons of nutrition, and fill you up. If you are breastfeeding, avocado may be especially beneficial as a source of healthy fats and the oatmeal may help increase your supply. I recommend that breastfeeding mothers resist the temptation to go on a juice fast or any other restrictive diet. Breastfeeding will use about 500 calories a day, so you can safely lose about a pound a week without ever feeling hungry!
  2. Drink up! Your body may need more than you used to drink, so drink to thirst. No need to force fluids, your body will tell you when it is thirsty. Take a water bottle with you when you leave the house and have one nearby when you breastfeed or pump.
  3. Cut the garbage! Most of it, anyway. Treats can be very satisfying and make you feel happy and normal, and there’s no need to eliminate every non-perfect food. Plan for a treat after a meal, and take the time to savor and enjoy it. But mindlessly eating piles of garbage food will probably just make you feel yucky and guilty.
  4. Get some exercise! A little fresh air can make a huge difference in how you feel mentally and physically. Once your OB has cleared you for normal activity, take a walk! Light and moderate exercise is safe and healthy while breastfeeding, and it is a fun way to spend time with your baby. In Greensboro, there are mom-and-me exercise groups that provide friendship, fun, and support for moms of young babies. If you would like more information about these groups, please reach out to me and I can get you in touch with them!
  5. Be as kind to yourself as you are to your best friend! Self talk matters, so be mindful of what messages you tell yourself about your body and your abilities. Would you tell a friend the things you tell yourself? Most likely you are telling your friends things like, “you are amazing”, and “you are beautiful”, and “you’re a superhero because you just had a baby and you are keeping it alive with your breast milk!” The truths that you speak to your BFF apply to you as well, so be sure to speak truth to yourself!

Bonus tip: To get the perfect beach body:
  1. Have a body.
  2. Go to the beach!
  3. There it is… the perfect beach body! ​
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Losing weight while breastfeeding

1/7/2019

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How Can I Get This Baby Weight Off Safely?

Safe weight loss is healthy and realistic for breastfeeding women. Breastfeeding uses calories stored up during pregnancy, and a breastfeeding mother will lose 1-2 pounds a month with a normal, healthy diet (eating to hunger) and normal activity. If you want to lose weight faster, you can safely lose 1 pound a week through changes in diet and moderate exercise.

A weight loss of 1 pound a week with a healthy diet (at least 1500 to 1800 high quality calories) and moderate exercise has no effect on the fat content of the breast milk or on the baby’s growth. When you make healthy nutritional choices like eating lean meat, and cutting sugary or salty, high-fat junk food, refined flour, and high calorie drinks, you will experience healthy weight loss. Small changes can make a big difference. For example, cutting out a can of soda per day eliminates 140 calories, or 14 pounds a year!

You may begin a moderate exercise program after getting clearance from your OB or midwife 6 to 8 weeks after delivery. You can safely cut 500 calories from your diet and add a moderate 45 minute exercise routine 4 days a week and lose weight without affecting the quality of your breast milk or the growth of your baby. 

I recommend slow, healthy, natural weigh loss through healthy nutrition and moderate exercise. If you have questions, or would like a personalized plan, I can help you! Call or email me if you would like to discuss healthy postpartum weight loss. 

This article from the New York Times has more information. 

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bottle feeding your breastfed baby

10/2/2017

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Breastfeeding mom, are you ready for a break? Are you dreaming of a night out without your baby, or a night of sleep? Are you returning to work soon?

First of all, congratulations on exclusively breastfeeding your baby! That is a huge accomplishment and you deserve a medal! But now, you may have some questions about introducing a bottle to your breastfed baby.

These tips are not meant to be rules, or make you feel guilty if you do bottle feeding a different way. They are just meant for you to pick what works for you to make bottle feeding easy and pleasant for you and your baby.

Getting Started
  • Introduce a bottle when your baby is between 4 and 6 weeks of life. This allows time for your baby to get really good at breastfeeding, and it allows your milk supply to be established.
  • Try to make bottle feeding feel sort of like breastfeeding to your baby:
  • Use breast milk in the bottle instead of formula if possible
  • Use a silicone  (not rubber) nipple, with a large base, and encourage a wide open mouth
  • Switch sides during the feeding
  • Use skin to skin when possible
  • Cuddle your baby after feeding
  • Hold your baby in a slightly upright position, so that the head is above the stomach
  • Touch your baby’s upper lip with the bottle nipple and allow your baby to root and pull the nipple into his mouth

Keeping it Safe
  • Hold the bottle horizontally so that the milk doesn’t flow too fast
  • Feeding should take 15 to 20 minutes, just like in breastfeeding
  • Gulping can be a sign that the milk is flowing too fast; the baby is gulping in order to catch a breath. If your baby is gulping, remove the bottle from your baby’s mouth after 3 to 5 sucks to slow the feeding and allow your baby to get into a suck-swallow-breathe pattern.
  • If your baby is clamping down on the nipple, the flow may be too fast and your baby is trying to slow it down to breathe.
  • Observe for signs of stress: furrowed brow, tense shoulders, arms, hands, yawning, sneezing, crying. If your baby is stressed, pause the feed and allow your baby to regroup.
​

For Babies who are Like, Nah, I Only Eat from the Breast!
If your baby is not taking a bottle, try these tips:
  • Touch the corner of your baby’s mouth to stimulate sucking
  • Have someone else offer the bottle to your baby when your baby is against the caregiver’s chest, facing outward.
  • Move around – sway, walk,or rock
  • Offer the bottle when your baby is sleepy- just waking up but not fully awake yet, and when your baby is not very hungry
  • Wrap the mom’s shirt or something that smells like mom around the bottle

Keep it Fun!
  • Make sure you make the feeding experience pleasant by singing or cooing to your baby, smile and make eye contact with your baby
  • If you or your baby get stressed, pause the feeding, and don’t try for more than 10 minutes
  • Most babies will accept a bottle with time and persistence. In the meantime, see if your baby can be fed with a cup; a sippy cup can be used at around 4 months.

Get Help!
  • If you have questions or concerns about bottle feeding, contact your baby’s pediatrician or an IBCLC for help! ​
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Got (enough) milk?

9/13/2017

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Can I nurse with a pierced nipple?
Nursing mommas ask lactation consultants all kinds of things. Other faqs include: Can I drink coffee? and How does a pump work?

​But by far, the most common question we get is:
Am I making enough milk for my baby?

​Here are 5 signs your baby’s GOT (enough breast) MILK:

1. Baby likes to eat. A LOT.
Feed your baby very frequently. As in, every time she acts hungry. Typically, 8 to 12 times (or more) a day. Even if baby just finished a meal, she might need more (otherwise known as cluster feeding). Frequent feedings help establish your milk supply and get nursing off to a great start!
Frequent, on-demand, unlimited feedings at an early age ensure baby gets all the milk she needs. This also triggers your body to MAKE LOTS OF MILK in the coming weeks and months. Every time baby latches, your baby is telling your breasts to make more milk. More feeds in the early days means more milk in the coming months.

But how do you know baby has a good latch and is actually getting milk?
2. You can hear baby swallowing.
All that chugging? That’s the sound of baby getting lots of milk!
If you can hear baby swallow frequently from Day 5 on, baby is drinking. Babies who get plenty of milk from breastfeeding suck once or twice, then swallow.

Baby repeats this suck-swallow pattern until…
3. Baby is content and relaxed. 
Baby gets tense when she shows hunger cues. Because, um, she’s hungry. (Can you relate? Remember how crazed you felt when you were pregnant and hungry? Like, drop everything and FEED THIS MOM-TO-BE NOW?!) Before they nurse, many babies clench their fists and pull their arms in tight against their bodies.
As you feed baby and you hear that lovely, frequent swallowing, watch her arm and hand. They will begin to loosen and relax, and her fingers will splay open. A hungry baby will pull her arm in if you (gently) pull her hand away from her body. A full, satisfied baby has wet-noddle arms. Baby’s arm is a good gauge as to how satisfied she is after eating.

And a contented momma is another good sign.
4. Your breasts and nipples feel good. 
Your baby needs to have a wide mouth and a deep latch to make sure she gets enough milk. If baby has a shallow latch, you can experience sore, painful nipples and engorgement.
You might notice your breasts fill up right before you nurse, and then they get softer during a feeding. This is a good sign that baby is getting lots of milk. She’s emptied the tanks.
In the early days and weeks of breastfeeding, a little discomfort and tugging on the nipples is common, but toe-curling pain is NOT normal. If your nipples hurt so much that it takes your breath away, seek help to adjust baby’s latch. Resources include International Board Certified Lactation Consultants, your OB, baby’s pediatrician, a home health nurse, La Leche League, Mommy & Baby breastfeeding groups at your local hospital.
Healthy, comfortable nipples are a sign that baby is latching well.
Happy baby = happy nipples
.
Besides frequent feeds, lots of swallowing, a content baby, and content nipples, there’s one other thing to look for.
5. Baby likes to pee and poop. A LOT.
And thus begins your parenting adventure with all things potty related.
What comes out of baby says a lot about what went into baby. If you’re changing a lot of wet diapers and at least a few yellow poopy diapers every day, congrats! Those diaper blowouts, plus all the great signs we’ve already covered, mean you’ve got a happy, satisfied baby. You can be confident she’s getting plenty of milk and your body’s making exactly what baby needs. Your baby definitely has GOT (enough breast) MILK!
Now you can stop worrying about baby’s feeding habits and spend your time trying to catch a little extra sleep. (Good luck with that!) I promise one day baby will sleep through the night – and you can kick sleep deprivation to the curb.

In case you’re still anxious, here are some BONUS TIPS!
Frequent feeding.
Seems like baby wants to eat all.the.time? See #1 above. This is not a sign baby is starving. It’s normal for baby to want to feed very frequently, which ensures she gets fed enough and your body makes enough milk. More sucking = more milk!
Your friend’s baby takes more formula than you pump for YOUR baby. 
YOU BE YOU. Moms are valuable resources for each other, but comparing YOUR baby to another baby isn’t a good idea. Babies who drink formula require more than babies who take breast milk.

If you aren’t seeing all 5 signs that your baby’s GOT (enough breast) MILK, or if you have any concerns about it, call baby’s pediatrician or a lactation consultant and get some help. It’s always ok to call and request a weight check.
Nurse on, momma!
​
This blog post was originally featured on MothersRest.com. Go ahead and check it out for more great articles on all things momming!
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    Beth Sanders, BSN, RN, IBCLC

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