​As I get out of the shower and look back at the drain, there is enough hair left behind to weave a wig. Long strands end up wrapped around my baby’s fingers and toes. Somehow they even get caught in the chubby little rolls of his legs. Postpartum hair loss. So real. So annoying.

This phenomenon, like so many other changes to our bodies, starts in pregnancy. Normally, our hair goes through growth and shedding phases on a daily, monthly, and annual basis. The shifts in hormones during pregnancy cause a perpetual growth phase with minimal shedding phases, which is why our hair often looks shiny and luxurious during pregnancy. Then comes baby. Hormones shift again. This time, the shedding phase resumes, but by now, we’ve accumulated months of hair growth and all that extra hair decides it has made its home on your head for long enough and it’s time to drop. Onto the floor. Onto the back of your sweater. Stuck in your hairbrush. Embedded into the rug. You get it. Scientifically speaking, this process is called telogen effluvium. Most women notice this shift in hair loss happen around the 3-month post-partum mark.

Thankfully, it doesn’t last forever. For most, extreme hair shedding usually lasts 3-6 months, but it can last up to a year. You won’t go bald (although it may feel like it). Hair loss after giving birth is totally normal, but if you are noticing extreme hair loss or are unsure what is considered normal versus abnormal, you can talk to your doctor about checking for thyroid conditions.

You can’t stop it, but you can help yourself by making sure you are eating well, with plenty of protein and iron. You can mask the thinning with different hair styles by adding texture and layers of length—ask your stylist for ideas. And remember, it’s just a phase and it will return to normal soon.

​There will likely come a time when you will need to express breastmilk, either by hand or with a pump, and that liquid gold should not go to waste!  Proper breastmilk handling procedures are key to keeping the milk safe for consumption.  The chart below by the CDC lists the recommend optimal storage time frames. 
 
Containers
Milk should be stored in BPA-free containers, either bottles or breastmilk bags.  They even make breastmilk ice cube trays that freeze the milk in thin tubes so you can pop them directly into a bottle.  Don’t fill bags and bottles all the way because the milk will expand when it freezes.  I learned this the hard way with my first son and I wondered why my milk was leaking everywhere when it thawed—the bag had split open in the freezing process!
 
The further away from the door (whether the fridge or freezer), the better, so aim to stick that milk way in the back of the refrigerator or at the bottom of a deep freezer.
 
Thawing
Ideally, milk should be thawed overnight in the refrigerator.  Once thawed, it needs to be used within the next day or two.  Do not refreeze it!  Speaking of which, what constitutes “frozen”?  A contacted me the other day who had lost her electricity during a bad storm and did not regain it for almost 24 hours. Cue: panic mode.  She was afraid she would have to use all of her stored milk within 48 hours or dump it. Some of the milk had started to thaw.  The good news is, as long as there are still some ice crystals in the milk, it is still considered “frozen” and can be refrozen.  Milk that is completely thawed but still cold can be used within 48 hours.  Milk that has been thawed and is no longer cold should be discarded.  Some new studies are coming out that are testing the nutrient-content and bacteria levels of milk that has been thawed and re-frozen, and it is looking promising to give moms a bit more leeway with milk storage, but this is still preliminary.  More to come on that topic at a later date.  In the meantime, err on the side of caution.
 
Handling and Warming
Breastmilk naturally separates and the fat/cream floats to the top.  Gently swirl it to mix. (Don’t shake it or it will create air bubbles that can upset baby’s tummy).  Milk can be warmed gently in a bottle warmer, or by placing in a bowl of warm water.  Always test the temperature of the milk before giving it to the baby.  Never warm milk in the microwave.  If the baby does not finish the bottle during the feeding, you can offer it again within 2 hours, but it should be discarded after that.
 
Lastly, always date the milk you’ve expressed so you can keep track of how long it has been stored! 

​Does breastfeeding make you feel like you’re on a long trek through the Sahara Dessert?  You’re not alone.  Breastfeeding triggers the thirst sensation, but the exact reasons why remain unknown.  There are two likely causes identified by researchers:

1. Suckling by baby sends nerve impulses to the brain, which in turn, stimulates the central nervous system to trigger a thirst response as soon as the oxytocin release happens.  Oxytocin is the magical hormone that triggers the let-down response, and is also responsible for making you and baby feel sleepy and relaxed during nursing sessions.
2. Your body develops a learned response to anticipate increased fluid needs in conjunction with fluid loss during breastfeeding.

Okay, so, whatever the cause is that might make you feel like you should fill up the tub and grab a straw, there are some things you can do to help you meet your fluid needs while breastfeeding.  Fluid needs increase slightly during lactation, although it is not necessary to over-hydrate; just drink to satisfy your thirst!  According to the Institute of Medicine, breastfeeding moms drink, on average, almost a whole liter more per day than non-breastfeeding women (13 cups versus 9 cups).

• All fluids count.  Naturally, water is the best drink option, but other beverages and foods count toward your total fluid intake too.  While caffeine was once thought to count against fluid intake because it can have a diuretic effect, that notion has long been dissolved, so your cup of coffee in the morning counts as a cup of fluid intake.  Foods with high water contents, such as popsicles, gelatin, and soup, can also count toward fluid intake.
• Make a conscious effort to drink during the day.  This is especially important for moms who may be spending time away from their babies and are pumping.  Pumping does not always trigger the same type of thirst response, and if you are pumping because you are at work all day, or for whatever reason, it is possible your busyness results in forgetfulness to hydrate.
• Watch the weather.  Warm weather, or any activity/exercising that causes sweating will also mean you must drink more to replace additional fluid loss.
• Keep water nearby.  Before you sit down to nurse, have a drink handy.  Helpful partners are another great resource to remind you to drink and/or bring you a glass of water while you’re breastfeeding.

We always hear about the benefits of breastfeeding—it truly IS liquid gold!  The list of health benefits for both mom and baby is a mile long.  But what isn’t discussed as often is the mental fortitude required for breastfeeding.  One of the most common times moms express emotional fatigue during their breastfeeding journey is in the beginning, when their hormones are fluctuating, they may be experiencing discomfort from newly nursing, and uncertainty about whether they are doing it correctly.  Add on the sleep deprivation factor, and breastfeeding can be a trying time.  Moms may feel particularly isolated for several reasons.

The first couple weeks after giving birth, as the baby started crying and I got up, in the dark, to feed him, I would look over at my husband, who was sound asleep.  How do you not hear him? And it’s not his fault—he told me over and over again to wake him up so he could help with the baby in the middle of the night, but there is something we do as moms that sometimes makes us feel like we have to do it all.  Like we need to be superwomen.  (And we are!). So while he slept, and the older children slept, and the dogs slept, and the house was totally dark and quiet except for the baby suckling away and me wide awake, an overwhelming sense of isolation bloomed.  Surrounded by people who love me and are willing to help, and yet I felt so alone.  I’m the mom with the breasts who has the responsibility of feeding the baby…all day and all night long.

This isolation effect can also manifest at any other time of the day too.  With my first child, wherever I was (even in my own home), if there were other people around I would hide away to a private place to feed the baby.  By the second child, I was more likely to feed the baby around people I was comfortable with, but still in the corner of the room.  By the third baby, I told myself I was not going to miss out on socializing when company is over, or lock away in a room by myself for what could sometimes be 30-45 minutes during a feeding while everyone else continued on, so I feed him wherever I need to.
           
How can you overcome the isolation effect of breastfeeding?

• Ask for help. Reaching out for help and support from your partner does not make you any less of a superwoman. 
• Practice makes perfect (or at least somewhat more comfortable).  Comfort and modesty levels vary from person to person, and if you are one to shy away from showing any skin while nursing (although remind yourself you are just feeding your baby), invest in a nursing scarf or cover—they are generally inexpensive and easy to find.  You can also toss a blanket over your shoulder or use the two shirt method (where you wear a tank under another shirt so you can lift up the top layer and still be mostly covered.  And remember—the law is on your side so you can breastfeed whenever and wherever you need to.  As your breastfeeding journey continues, so will your confidence in your breastfeeding ability and your level of comfort; it's hard to feel secure when you are fumbling around with trying to get the baby to latch properly, so naturally, many moms would rather struggle alone in private, but this can contribute to those feelings of isolation.
•  Include your partner.  While it may sometimes seem that breastfeeding is solely your responsibility, breastfeeding is not a one-parent-only job.  Enlist the support of your partner or a family member to participate in ways they can, such as bringing the baby to you, getting you some water (oh, the thirst!), or burping the baby.
• Enlist the help of a lactation consultant.  Feeling confident in your breastfeeding abilities may help you feel more empowered in doing so.
• Understand you are not alone!  Thousands of moms are breastfeeding right this second.  I’m breastfeeding as I write this.  And it does get easier.  

It started with a conversation about a zombie apocalypse, because what good conversation about breastfeeding doesn’t bring up zombies?  The following exchange happened on the way to school yesterday and I took it as a good opportunity to explain to my two elementary-school aged boys what to expect when the new baby comes and mommy breastfeeds:
 
John: “You know, in a zombie apocalypse, the biggest danger is running out of food to eat. And babies cry too much so I think this new baby wouldn’t do too well.”
Mom: “But at least we wouldn’t have to worry about getting groceries for the baby—Baby will get all the food he or she needs from mommy’s milk.”
Conner: “What?! That’s crazy! Is the baby a cow?”
Mom: “No, but all mammals can drink milk from their mommies.  Don’t you remember seeing the goats at the zoo drink from their mommy’s teats?  And puppies drink from mommies.  And all the animals do, just like humans.”
Conner: “So, do you just pee out the milk??”
Mom: “No, it comes from my boobies.  Why do you think girls have breasts? Just for decoration?”
John: “Yes.”
Mom: “Well they don’t.  It’s to feed their babies, and that’s how your baby brother or sister will be fed too.”
Conner: “That’s cool.”
John: “But that doesn’t solve the baby crying and giving away our location to the zombies.”
 
Talking to kids about breastfeeding can be an uncomfortable subject for some parents, but why?  For most, at least subconsciously, it is because breasts have been sexualized, and we project our own feelings about that onto the subject of something as natural as breastfeeding.  But there are a few tips to help your older children understand breastfeeding.

• Start the conversation before the baby arrives.
• Use language that is simple and straight forward.
• Keep the older kids from feeling left out during the frequent and time-consuming breastfeeding sessions—this may involve reading a story to them while you are nursing, or letting them play for a quiet toy nearby.
• If applicable, tell them stories about how they were breastfed as a baby too.
• Relate breastfeeding back to something more tangible that they may have seen before, like animals feeding their babies.
• Several childrens’ books have been written on the subject.  One of these might help you approach the subject.

Have you had to explain breastfeeding to an older child, whether to prepare them for a new sibling, or to explain a mom nursing in public?  What techniques have you used?  In most cases, kids are unfazed by breastfeeding once they understand what is going on.  And then they’ll go back to more important topics, like how to survive a zombie apocalypse. 

December 4th is National Cookie Day!  Let's celebrate with a yummy cookie recipe that may help promote milk production.  And let's face it--they are downright delicious!  This recipe, along with many others for during pregnancy and lactation, can be found in the cookbook "Eating from Bump to Baby", on sale now at Amazon at: http://a.co/d/8QGuk2w

Oatmeal “Lactation” Cookies
 
Yields: 2 ½ dozen
 
Some people spend big bucks on buying so-called “Lactation Cookies”.  They are so popular because they usually contain three common galactagogues: flaxseed, oatmeal, and brewer’s yeast. Whip up a batch of your own for a fraction of the cost and 100% certainty of the ingredients you’re getting.  In place of the chocolate chips, you can substitute raisins or dried cranberries.  A big batch of these can be made in advance and frozen for up to 3 months, so you can make them before baby arrives and have them ready to go!

Ingredients
 
2 sticks butter, softened
¾ cup brown sugar, packed
¾ cup granulated sugar
2 eggs
1 teaspoon vanilla
1 ¼ cup flour
¼ cup flaxseed meal (ground flaxseeds)
½ teaspoon salt
½ teaspoon baking powder
¼ cup brewer’s yeast
3 cups old-fashioned quick oats
1 ½ cups mini chocolate chips or raisins
 
Directions:
Preheat the oven to 350 F degrees.
Beat together the butter and sugars until light and fluffy.  Beat in the eggs one at a time until smooth.  Add the vanilla.
 
In a separate bowl, whisk together the flour, flaxseed meal, salt, baking powder, and brewer’s yeast. Add the dry ingredients to the butter mixture and mix until combined.
 
Stir in the oats and chocolate chips or raisins. Drop cookies by the tablespoon onto a baking sheet lined with a silicone mat or parchment paper. 
Bake 10-12 minutes or until just slightly brown.
 
Cool on the baking sheet for 5 minutes before removing to a wire rack to cool completely.
 
Store in an airtight container for up to a week or freeze for up to 3 months.
 

Those first few moments after giving birth are some of the most important in a baby’s life.  In times past in the United States, babies—even healthy ones--were often given a minute or so with mom and then whisked away to be cleaned, weighed and measured.  As more and more hospitals transition to Baby Friendly hospitals (ie. hospitals that promote and support breastfeeding using the WHO standards) and understand the importance of those first moments after birth to the physical and emotional health of both mom and baby, skin-to-skin contact, or kangaroo care, is becoming more commonplace.
 
What is Skin-to-Skin?
Just as the name implies, skin-to-skin contact is when the naked baby (or clothed in just a diaper) is placed on a bare chest. The concept was first recognized in the 1970s in Bogota, Colombia when there was a shortage of incubators and skin-to-skin contact was used to help keep babies warm. During this time, they noticed many other benefits that were happening while babies were engaging in kangaroo care. 
 
Who Can Do Skin-to-Skin?
Traditionally, the mom is usually the one to first experience skin-to-skin contact, but any parent or caregiver can also participate!  As part of some birth plans, dads wear a button-down shirt to be able to easily engage in skin-to-skin contact with the newborn, which is particularly helpful if the mom needs to be whisked away for surgical or other health reasons.
 
What are the Benefits of Skin-to-Skin?
The benefits of kangaroo care are numerous to both mother and baby.

• It helps babies regulate their body temperature after birth much more quickly.  When baby goes from not needing to regulate his own temperature in the womb to suddenly having to do so in the outside world, thermal regulation can be difficult.  Skin-to-skin contact makes that transition easier.
• It improves brain development.  It also helps release hormones and endorphins that reduce stress and pain in both the baby and mother.
• It encourages and eases breastfeeding.  The American Academy of Pediatrics recommends that all breastfed babies participate in kangaroo care immediately after birth. Babies instinctively want to breastfeed, and when placed on their mother’s bare chest, they will often complete an “instinctive crawl” using their sense of smell to find the nipple and independently start feeding.  The hormones released during kangaroo care also promote the production of breastmilk.  Babies who are held skin-to-skin have also been shown to have breastfeed longer than babies that aren’t.
• It improves heart rates of babies and healthy respirations.
• It promotes bonding between the baby and whoever is participating in the kangaroo care!

 
How do I do Kangaroo Care?
Talk with your healthcare provider about your birth plan and your wish for skin-to-skin contact immediately after birth.  Have the baby placed belly-down on your bare chest.  The nurses may wish to dry off the baby and put on a hat first.  You can then wrap a blanket around the both of you to keep you warm.  For skin-to-skin contact at later times, you can leave the baby diapered.  Moms and dads can both participate in skin-to-skin contact, and the benefits will continue, providing a naturally calming way to bond with your baby.

You’re out at a restaurant with your little one who decides you shouldn’t be the only one eating right now.  Can you breastfeed at the table in public?

The short answer: Absolutely.
 
All 50 states and Puerto Rico and the Virgin Islands, protect a woman’s right to breastfeed in any public or private location.  No nursing cover is necessary.  Of course, because many women feel less exposed (and their baby less distracted) if they can nurse in a more private area, many states and private companies have gone a step further and require certain places to have designated lactation rooms, such as airports and malls. 
 
Not all babies are willing to nurse while they have a cover over their heads—it’s hot and dark and impersonal. For this, among other reasons, moms may choose to nurse al fresco, and that is their 100% legal right to do so.  Remind nay-sayers of this if you are ever unfortunate enough to have negative comments thrown your way while you are feeding your child in public.
 
Below is the National Conference of State Legislature’s most recent update of breastfeeding laws by state.  And remember, breastfeeding your child is a natural act that you should be proud of; do not let uneducated individuals shame you into thinking you have to hide in a bathroom to feed them.  Your baby has just as much right to eat whenever and wherever as a bottle-fed child.      
 
http://www.ncsl.org/research/health/breastfeeding-state-laws.aspx

​In families where there is a non-breastfeeding parent, whether that is a father or other partner or family member, some moms may feel alone in the breastfeeding process, since they are the sole source of nutrition for their exclusively breastfed infants.  And many partners feel helpless or clueless as to their role when the other parent is breastfeeding.  How can the non-breastfeeding parent get involved in breastfeeding?

• Communicate.  Let your partner know the importance of breastfeeding (well-informed partners often bring another level of support), and your breastfeeding goals. 
• Partners can also be hands-on in other ways, such as bringing mom some water while she is breastfeeding (hello thirst like no other), or snacks.
• If your baby gets breastmilk from a bottle, have your partner participate in those feedings.
• Skin-to-skin is not just for moms.  Encourage your partner to spend as much skin-to-skin time with the baby as possible to help them strengthen their own bond.

Breastfeeding truly is a joint effort and studies have shown better breastfeeding success rates in families where both partners were on-board and involved with the breastfeeding.  So even though it may feel like a one-woman show, tackle it like a team and everyone wins--especially Baby!

So, you’re ready to go back to work.  Or maybe have a kid-free date night out planned.  Or maybe you just need a few hours to yourself.  For most breastfeeding mothers, there will come a time when their babies will need to use a bottle.  You may pump and pump, making sure you have enough milk to feed your baby when you’re away, only to realize that the issue wasn’t going to be the milk, but the bottle.  It’s fairly common that exclusively breastfed babies reject bottles at first.  After all, why have a rubbery nipple and lukewarm reheated milk when you can have the real thing at the perfect temperature?  So, what should you do if your baby is experiencing a bottle strike?

• Introduce the bottle after the baby has had a little bit to nurse first; if he is too hungry, the new sensation of a bottle may only him more cranky.  And try giving a bottle several days before the bottle is officially needed.  This way, you can try and try over the next few days until he gets used to it.
• Have someone else give the baby the bottle.  Babies have a great sense of smell, and if they can smell mama, but aren’t getting milk directly from the boobies, the baby may get frustrated and refuse to take the bottle.
• If you don’t have a helper nearby to feed the baby, hold the baby in a position that is different from how you would hold her while breastfeeding.
• Experiment with different bottles and nipples.  There are SO MANY different types of baby bottles on the market, with several different nipple flows.  Choose the right flow nipple for your little one; one that mimics the natural breast as much as possible.  Many bottle companies are now making bottles directly marketed to breastfeeding moms, and they often have angled and/or shaped nipples.
•  Put a small amount of expressed milk on the bottle’s nipple.  If the baby knows the good stuff is inside by getting a sneak peek (or taste), they might be more willing to give it a go.
• Try a cup or spoon.  Some babies just will not drink from an artificial nipple.  Alternative serving devices such as cups and spoons are totally acceptable.
• Keep trying!  Babies need to be fed, no matter the method, so in the practice phases of introducing the bottle, if the baby gets too frustrated, nurse the baby and try the bottle again another time!