Straight from the tap is optimal, but when you can't, expressed human milk is a great option for babies.

I love calling breastmilk human milk, and cow’s milk bovine milk. Makes so much sense. It doesn’t need to make mothers feel guilty about feeding their baby formula, as we are doing what we need to do to feed our baby: offering baby the safest milk that is readily available, even though it is from a different species. Just one little tidbit I learned at the Breastfeeding Coalition conference at OHSU.

Dr. Jae Kim and Dr. Lisa Stellwagen gave multiple presentations on the use and research on our tiniest preemies and their feeding options. Here are some more of the things I learned:

The amount a 150 lb adult would have to gain to grow similarly to a preemie would average about 3lbs a day! That makes feeding a preemie essentially a nutritional emergency. (And preemie parents feel that!)

Vit D deficiency seems not just to be the vitamine de jour, but a very needed factor for pregnant moms to ensure that their baby gets a adequate amount (and even more crucial for preemies). Supplementing with Vit D is done at much higher doses in European countries with no ill effects, and it also takes weeks to build up the stores just to get back to normal when you are deficient. It is not just important for infants, but mommies too!

There are no studies reflecting the quality of diet in relation to the quality of human milk, other than the studies on fatty acids. So the kind of  fat that you eat does matter…choose the best options available.

A normal milk production is 800 mls in 24 hrs (that is just shy of 27 oz for the non metric world). However, even moms of preemies who make 300 mls can fully feed their baby, at least during their stay in the NICU (when it is most crucial).

There are 250 compounds in breastmilk, and that is just the known ones! There is a lot of research currently being done on oligosaccarides, just one  in the growing list of known compounds. For formula companies to make even a few of these in a lab somewhere and then try to market them would be in the millions, billions if they were to address all of them.

First I just have to say that these are not intuitive techniques. Neither is  anyone taught how to operate a pump in college (at least no programs I know of!) so don’t be upset if you are not an expert on this. I’ll  share just a little evidence-based info and what I have learned from mamas who do a lot of pumping (and know all the tricks).

These bags are just not nearly as cute as the babies they help provide milk for!

#1 Make sure you pump is working right. If you have a hand me down pump, check all the parts for wear and tear and replace as needed. You might even want to get the pump checked for suction at your local lactation clinic.

#2 Make sure the fit is right for you, both in parts and in usage. Hand pumps are great…for some moms. But most moms who are away from their babes for more than a few hours a week need a double electric pump that makes quick work of milk extraction during their short breaks. And the flanges have to fit (they make 6 different sizes now). Check with your lactation clinic for resizing info.

#3 Use the pump as much like a baby as possible. Meaning that you have to mimic how the baby eats so your body responds to it.  If you don’t have the advanced (new pre-programmed version) start with the speed quick and suction light. Once the milk starts to drip, move to a slower speed and higher suction. (The newer and/or hospital rental pumps do this for you.) Here’s the kicker. You might have to go through this cycle a few times to get all the milk out. Some women only need one, but most of the mamas who are working for more milk use multiple cycles of this quick and light moving to slow and higher suction throughout their pumping session.

And lastly,

 #4 Use your 5 senses to try to imagine nursing your baby. It is hard to hormonally respond to a black bag who wants more milk. So smell your baby’s sweet smelling blanket, look at photos of your baby, listen to recordings of your baby cooing (or crying), drink water from your ‘nursing’ water bottle, and use your hands to massage out some of the (sometimes stubborn) hindmilk.

Here is a great little video for mamas who are working to increase their pumping output:

Hands on Pumping

There is so much more, but this covers many of the things I teach when talking pumps with new mamas. Have something you think is worth adding?

I skip the hot peppers, but I know some of you prefer to spice it up a bit!

Shredded Chicken Chili

Take the shredded chicken you made in the slow cooker this week and add:

1 qt chicken broth (I like Pacific Foods; a local company)

1 can beans (rinsed)–we used black but white is more traditional

1 can diced tomatoes (plain or Mexican flavored)

1 sm can chopped green chilies

Optional: Avocado, shredded cheese, or sour cream for topping.

I also like a little chopped cilantro for garnish, but that is just me (literally; the family WILL NOT  eat cilantro…yet).

We served it with corn bread (a mix, super easy) and crumbled it in our chili. It was fantastic.

Just thought that it would be nice to have one more things to do with that fabulous chicken…since it has likely become a staple at your house too.

Obviously you can use anything to wipe tiny bottoms, and a plain paper towel with water also works well. This is just one way to make these, and a simple way to make a bunch at once.

Remember to put the cut side down so it looks neat on the top.

Easy Baby Wipes

1  3 quart re-useable plastic tub (cylinder shaped)

1 roll Bounty Select A size paper towels

3  T olive oil or baby oil (finally a use for that stuff!)

1 T baby bath (or any baby-safe liquid soap)

2 c. warm water

Cut paper towel roll in half (an electric knife works great for this, but if not a serrated knife works too). Remove the cardboard tube.

Mix the liquids and pour over the towels. Let sit a few minutes.

Pull wipes from the center. Keep lid on most of the time, but don’t leave unattended for too many days; they can mold a bit if not refreshed or aired out.

I have seen many versions of these over the years, so feel free to vary it with your preferences. Some families keep a roll in the car for on the go cleanup, and another at home (or one on each floor of the house).

I even suggest washing these a time or two (with your diapers) to see how long they hold up (and then reuse them again if you can!). Different paper towels work differently, so you can experiment with brands as well.

You can also use the solution over cloth wipes, and use an old plastic wipe container, as I have seen many families recycle them this way.

Any other ideas? Send ‘em my way…

Lettuce Wraps
I lb ground turkey
1 c. walnuts, chopped fine
3 lg carrots chopped fine
1 can water chestnuts chopped
1/4 to 1/2 c.  Asian style sauce (I use a mixture of wok sauce from TJ’s, teriyaki, hoisin, oyster, or whatever sauce I have on hand)

I lg head lettuce, either Bibb or Butter works best, but we use Romaine too.

Sesame seeds, crunchy noodles, spicy chili sauce, etc, to garnish.

This is a one pot meal, I just cook things in stages. I brown the ground turkey and add walnuts just until mixed (they don’t really need to cook). See this mixture aside in a bowl and cook the grated or finely chopped carrot with a little of the sauce. Add the chopped water chestnuts, meat mixture, and sauce or seasoning to taste. Cook 2 min and serve warm on clean lettuce leaves with garnishes.

Enjoy this meal as a group if possible; it is far more fun shared. Also works great as yummy lunch leftovers (if you have fresh lettuce).
Takes about 20 min to cook, and all the chopping can be done with a food processor (I use a hand chopper) which speeds things up considerably.

I have experimented with adding ingredients and I haven’t made a bad batch yet…this is just my favorite version so far. (Both my mom and my aunt make killer versions of this, so I have tried to simulate their approach, but of course mine is different each time!)

I think this might make a nice meal to bring over to a new family; it interrupts the flow of lasagna or pasta each night (not complaining, just sayin’) and provides lean protein and some good fiber which is great for a mom recovering from birth. And it is not boring!

Have a better version? Give me a shout on Facebook or comment here.

Moments like this can happen even on a short break to the bathroom…you just need to leave someone else with a camera while you hand off the baby to her daddy!

Sometimes when a mama “graduates” from moms group at 6 months, she leaves us with a gem of wisdom. This one is a from a bit ago, but something jarred my memory tonight that I haven’t shared this on the blog yet. Here is what she said:

Advice from one new mama graduate:

“Go to the bathroom when anyone is around to hold your baby. Just like your moms use to say: Even if you don’t have to go then, just go anyway. Take the opportunity to have a few minutes to yourself in the bathroom while you have the extra hands. Because later you will wish you would have.”

Precious. Don’t think I could have said this better if I had tried.

If you have everything you need, you can sit and focus on the sweet moments of feeding your baby (big or small!).

Bottle feeding twins these last few nights has reminded me of something I sometimes forget to tell parents. As much as I believe that responding to baby’s cues is so important, I also have to add that preparing things ahead of time is probably just as helpful.
When I teach breastfeeding classes, I cover how babies give feeding cues that can be identified pretty early on in their life. Rooting, hand sucking, mouthing, turning head from side to side, grunting, etc, are all ways that babies tell us they are ready to eat. If they can be caught before the hunger escalates, then a peaceful transition to feeds usually follows. I find you generally have about 5 to 15 minutes warning before that happens. (Although for a few babies, you have approximately 60 seconds to get something food related in their mouth!)
If you do have a few minutes warning, setting up the lactation or bottle feeding station makes all the difference.

• Take a minute and get yourself ready first:
  Go to the bathroom (you might be under a baby for over an hour…go now!).
  Grab some water and a snack if you can.
  Get your mobile device(s), a pad of paper and pen, & TV remote.
  Gather feeding supplies (pillows, extra blankets, breast pads, burp cloths, nipple shield, bottles, bibs, pacifiers, etc).

Now you can sit down!
Once you get everything assembled, sitting down to feed can be sweet AND efficient. If you forget something and have a need for it, you might feel trapped. This goes double for feeding twins.
I have found making parents a feeding basket with handle to keep all their items can be an easy fix for feeding in multiple locations.
I hope this helps…now off to gather items for a double feed…

A simple bowl of goodness: something to be thankful for on a rainy winter day.

I tried something new this week and wanted to share it. I thawed out some beef stew meat with plans for a beef and barley stew, but before I could get it made, I got to go serve a family who surprisingly had some thawed out as well and wanted ‘something’ made out of it. So I made one for them, which turned out really well, and then came home to make one for us, which turned out not quite as good, but got better with each day of leftovers. Here is the basic recipe:

Beef and Barley Stew

1/2 onion, diced

3 lg carrots, cut into 1/2 inch rounds

3 stalks celery, chopped

3 russet potatoes, cubed

1 c. frozen green beans, chopped into 1 inch sections

1 lb stew meat, cubed into 1/4 inch pieces (for a bit in each bite!)

2 quarts beef broth

1 sm can of tomato paste

2/3 c. pearl barley, uncooked

I would love to say I just threw it all in the crock pot and left it all day…but I put a bit more work into it (that might be worth your time.

I am a de-glazer. I admit it. Since the first person tasted my soup and said, “It has flavor!” I have been hooked on deglazing. You might like it too.

All I do to deglaze is to lightly saute one of the veggies in some olive oil until they are a bit crisp, and then add broth to deglaze the pan. When the soup turns really fantastic, it is usually because I do this with each veggie before addiing it to the pot.

Today I ran out of time after the onions, carrots and celery and had Mark just throw everything else into the pot, minus the barley.

And evidently if you sear the meat first (even in tiny cubes) and then use the crock pot, you come out with some pretty tender bits of meat. So didn’t skip that step. (Yes, and I deglazed too.)

Barley goes in about an hour before dinner is served, otherwise it gets glue-y. Or so I have been told.

Otherwise, the crock pot is ready to roll dinner out in about 6 hours on high or 8+ hrs on low.

For my clients I served cornbread on the side, but at home, we just toasted bread and were thankful for a homemade meal to share together on a rainy night. And again for lunch the next two days.

Hope it inspires you.

I have folded one load of laundry and washed, dried, and folded a second.

I was able to chat with both parents about their extreme fatigue and what great helpers they have had in their lives so far. We trouble shot a bit, discussing long term sleep habit for their babies, and I tried to give them a little ray of hope about what was coming in the next few weeks and months.

And I have cuddled, snuggled, fed, burped, changed and re-swaddled 3 babies all night long. And enjoyed it. But I am tired, and I will truly enjoy heading back home to my bed for a few uninterrupted hours of deep sleep.

I won’t have to do too many of these per week, but I do call it a privilege to support families in this intimate role of being present at night when the world seems most scary and fragile. It is my joy, and worth being tired for.

Every night is a little different, and I am happy to say that ABC has a diverse team of doulas who support families during everything from difficult recovery after a hard birth, sleep deprivation, and babies on separate nighttime schedules, to moms with postpartum depression or anxiety, even supporting moms while dads/partners are traveling out of town.

Just like any other kind of doula care, overnights are a flexible time of non judgemental support. And they can make a big difference. (Did you know that healthy sleep in the first weeks of recovery helps to diminish postpartum depression and anxiety?)

Still wondering what a night doula does? Ask away. We are happy to tell you more.

Welcoming a new sibling is a big event…

Thought I might start this year with a blog about adding a new baby to the family. As we have welcomed so many new babies this season with older siblings, I thought it would be appropriate to share a few of the things we are learning from the families.