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Category: Oh, Mama!

Nursing Tales: Breastfeeding Support for Black Moms

Jan. 18 Oh, Mama!, Our Health, Vitality, Women 1 comment

breastfeeding wk 2

The American Academy of Pediatrics recommends that women exclusively nurse their babies for at least a full six months. Ideally, all women would breastfeed for the first year of their babies’ lives. Why? Research indicates that nursing an infant may lead to a stronger immune system, less diarrhea, less constipation, fewer colds and ear infections, and lower rates of SIDS (Sudden Infant Death Syndrome). “Breast milk is best for babies,” explains Lilburn, Georgia, pediatrician Joyce Lovett, M.D., “because it contains nutritional components that are natural tranquilizers for babies and is always clean and at the right temperature.”

For the nursing mother, Dr. Lovett says, breastfeeding promotes faster loss of pregnancy weight, stimulates the uterus to contract to pre-pregnancy size, produces naturally soothing hormones and may lower the risk of developing some types of cancer and osteoporosis in later life.

Despite all this evidence to support breastfeeding, however, the Centers for Disease Control and Prevention report that only about 32 percent of American children born in 2005 were exclusively breastfed for three months and only 12 percent of American children born that same year were nursed without formula supplementation for the recommended first six months of the infant’s life. Among specific groups of women, particularly African Americans, Latinas, low-income women and women younger than 20, the numbers are even lower.

Black Health Matters talked to Kimberly Seals Allers, creator of MochaManual.com and parenting and breastfeeding advocate, about why we’re so reluctant to breastfeed and what can be done to reverse this phenomenon.

BHM: Is it that we don’t breastfeed at all or that we don’t breastfeed long enough?

Kimberly Seals Allers: It’s a little bit of both. There have been some recent increases in duration, but when it gets to six months, we’re about 20 percent.  Our white counterparts are at about 50 percent.

BHM: What are some of the reasons black women don’t breastfeed?

KSA: There’s not one answer for this. It’s really complicated. There are the leftover nuances of our role as wet nurses during slavery. And then we had a huge disconnect in the 1940s, where the infant formula market was really aggressive. The thinking was if you have money, you buy formula. There’s nothing like African Americans wanting to show that we have arrived, that we have money. White women were really leading the way away from breastfeeding. And we followed them. [In my work as a breastfeeding advocate] I hear a lot of “breastfeeding is for poor people.”

Then white women came back [to breastfeeding]—and have done so in large numbers, with lots of celebrity role models. We have not followed suit.

There are also lifestyle stereotypes surrounding breastfeeding. There’s a perception within our own community is that it’s the girls with head wraps and naturals and eating granola. I call this the National Geographic effect. The only time we used to see black women breastfeeding was in that magazine—half naked, with elongated noses and earrings. And we said, “That’s not us.”

Lack of community support is another reason. A lot of times we don’t have the support. Our men are a huge issue. And if they’re not into it….

BHM: Wait—our men?

KSA: We have a whole sexualization of the breast. We’re OK to see it as a sexual object, but not as a source of food. We’re fine with seeing it used to sell chicken, but breastfeeding? We’re, like, “Ooo, that’s nasty.” And our men don’t want us to show our breasts to other people. There a whole kind of urban legend around how much of your breast is exposed when you breastfeed.

The invisibility of it is yet another reason. We don’t see anybody breastfeeding. It’s why I was so vocal about Beyoncé when she was breastfeeding. Celebrity role models have made it trendy to breastfeed. Whites have Angelina [Jolie] and Gwen [Stefani]. We haven’t had women on that level. We need to see it more in our community so we can normalize it.

BHM: How do we turn this beat around? How do we support black women better so they do breastfeed more, at least until the six-month mark?

KSA: We have to change our own story. I started Black Breastfeeding 360 to combat us not breastfeeding, to share our stories. We need to show us doing it. If I had a dollar for every woman who says to me, “oh, I don’t wanna spoil my baby.” They think the baby will develop just needing them. It’s a very complicated thing to hear a woman think that giving her baby the best food possible will spoil her baby.

When a mother says she’s afraid of spoiling her child, what I hear is, “We know the world is a difficult place and our children have to be tough from birth.”

That breaks my heart the most. It is a tough world. But how about we start worrying about that at six months? It’s not about spoiling your baby. It’s about giving them the best food possible. We have to reframe the conversation.

We need to better educate our men on benefits of breastfeeding. A lot of programs are not including the men. When I speak to men, and say how breastfeeding can make their baby healthier and smarter, they’re on board.

We need more black women working in the lactation field so we can see someone who looks like us dealing with our issues, so moms can have more opportunities to ask questions and make educated decisions about breastfeeding.

Be supportive of mothers who are trying to give their baby that best start. If you see a woman breastfeeding, give her a high five, not a negative story. Not like when you see a pregnant woman and you say, “Girl, when I was in labor for 32 hours.” Don’t do that to breastfeeding women.

Let’s start talking about it. We need to have conversations about it. This is the way we used to feed our babies all the time. It’s how we became wet nurses. We used to be very proactive about breastfeeding. We start by taking small steps within in our own community and with our own friends and family.

 

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Breast Pumps: Don’t Be Misled

 

Breast Pumps: Don’t Be Misled

Jan. 14 Oh, Mama!, Our Health, Vitality no comments

breast pumpThese days, many new mothers return to the workplace with a briefcase in one hand—and a breast pump kit in the other.

For those moms working outside the home who are breastfeeding their babies (and those who travel or for other reasons can’t be with their child throughout the day), using a breast pump to “express” (extract) their milk is a must.

The Food and Drug Administration (FDA) oversees the safety and effectiveness of these medical devices.

New mothers may have a host of questions about choosing a breast pump. What type of breast pump should they get? How do they decide ahead of time which pump will fit in best with their daily routines? Are pumps sold “used” safe?

Choosing the Right Pump for You

Kathryn S. Daws-Kopp, an electrical engineer at FDA, explains that all breast pumps consist of a few basic parts: a breast shield that fits over the nipple, a pump that creates a vacuum to express the milk, and a detachable container for collecting the milk.

There are three basic kinds of pump: manual, battery-powered and electric. Mothers can opt for double pumps, which extract milk from both breasts at the same time, or single, which extract milk from one breast at a time.

Daws-Kopp, who reviews breast pumps and other devices for quality and safety, suggests that mothers talk to a lactation consultant, whose expertise is in breastfeeding, or other health care professional about the type of breast pump that will best fit their needs.  Questions for new moms to keep in mind include:

  • How do I plan to use the pump? Will I pump in addition to breastfeeding? Or will I just pump and store the milk?
  • Where will I use the pump? At work? When I’m traveling?
  • Do I need a pump that’s easy to transport? If it’s electric, will I have access to an outlet?
  • Does the breast shield fit me? If not, will the manufacturer let me exchange it?

Should You Buy or Rent?
There’s also the decision of whether to buy or rent a breast pump. Many hospitals, lactation consultants and specialty medical supply stores rent breast pumps for use by multiple users, Daws-Kopp notes.

These pumps are designed to decrease the risk of spreading contamination from one user to the next, she says, and each renter needs  to buy a new accessories kit that includes breast-shields and tubing.

“Sometimes these pumps are labeled “hospital grade,” says Daws-Kopp. “But that term is not one FDA recognizes, and there is no consistent definition. Consumers need to know it doesn’t mean the pump is safe or hygienic.”

Daws-Kopp adds that different companies may mean different things when they label a pump with this term, and that FDA encourages manufacturers to instead use the terms “multiple user” and “single user” in their labeling. “If you don’t know for sure whether a pump is meant for a single user or multiple users, it’s safer to just not get it,” she says.

The same precaution should be taken for “used” or second-hand pumps.

Even if a used pump looks really clean, says Michael Cummings, M.D., an obstetrician-gynecologist at FDA, potentially infectious particles may survive in the breast pump and/or its accessories for a surprisingly long time and cause disease in the next baby.

Keeping It Clean

According to FDA’s recently released website on breast pumps, the first place to look for information on keeping the pump clean is in the instructions for use. In general, though, the steps for cleaning include:

  • Rinse each piece that comes into contact with breast milk in cool water as soon as possible after pumping.
  • Wash each piece separately using liquid dishwashing soap and plenty of warm water.
  • Rinse each piece thoroughly with hot water for 10-15 seconds.
  • Place the pieces on a clean paper towel or in a clean drying rack and allow them to air dry.

If you are renting a multiple user device, ask the person providing the pump to make sure that all components, such as internal tubing, have been cleaned, disinfected, and sterilized according to the manufacturer’s specifications.

Cummings notes that there are many benefits to both child and mother from breastfeeding.  “Human milk is recommended as the best and exclusive nutrient source for feeding infants for the first six months, and should be continued with the addition of solid foods after six months, ideally until the child is a year of age,” he says.

The benefits are both short- and long-term. In the short-term, babies can benefit from improved gastrointestinal function and development, and fewer respiratory and urinary tract infections. In the long-term, children who have been breast fed may be less obese and, as adults, have less cardiovascular disease, diabetes, inflammatory bowel disease, allergies, and even some cancers.

Cummings adds that moms and their families benefit by the bonding experience and economically as well, since a reduction in acute and chronic diseases in the baby saves money.

This article is from FDA Consumer Health Information.

Choose the Best Prenatal Vitamin

Dec. 03 Oh, Mama!, Our Health, Vitality, Women no comments

A few years ago, I left my ob/gyn’s office with a big bag full of several brands of prenatal vitamins. “They’re equally effective,” she told me. “Pick the one you like best.” I believed her, but felt a bit overwhelmed and confused about which would be best for me. In the end, I chose the one with the prettiest packaging.

The daily prenatal vitamin helps ensure your body stocks up on all the nutrients necessary for your growing baby. So here are a few tips to help you choose the best prenatal vitamin possible (not the one with the cutest baby on the box).

Check the label. Make sure your vitamin has at least 400 mcg of folic acid. Adequate amounts of this nutrient before and in the early stages of pregnancy reduce the chances your baby will develop a neural-tube defect such as spina bifida. You’ll also need 1,000 milligrams a day of calcium (for baby’s growing bones), 30 to 40 milligrams of iron (more if you’re anemic; talk to your doctor), iodine for your baby’s brain and thyroid development, and vitamin B6 to lessen the potential for morning sickness.

Be sure it dissolves. If your vitamin doesn’t dissolve quickly enough, you’ll lose out on the nutrients. Look for the United States Pharmacopeia seal of approval, or try this test: Place the vitamin in a half-cup of vinegar and gently stir every five minutes. It should dissolve within 30 minutes (45 if it has a gelatin coat).

Can you handle it? Having trouble swallowing your prenatal vitamin? Try one without calcium (these are a little bit smaller); just be sure you get enough of this mineral through milk, yogurt or other calcium-rich foods. You can also try chewable vitamins, but they don’t taste very good.

Don’t get too much of a good thing. Take only the recommended dosage, and don’t take other supplements unless your doctor advises it. The same goes for herbal supplements.

Pregnant? How Much Weight Is Safe to Gain?

Nov. 26 Oh, Mama!, Our Health, Vitality, Women no comments

For many women, a positive pregnancy test signals a license to pig out or “eat for two.” But indulging in everything in sight is not only unnecessary, but also potentially dangerous—for both mom and baby. This is especially true for us, since four out of five black women tend to be overweight or obese long before getting pregnant.

Being heavy at conception puts a pregnant woman at increased risk of having a miscarriage, developing gestational diabetes or pre-eclampsia. They are at higher likelihood of being placed on modified bed rest, developing infections and blood clots, and needing C-section delivery. And packing on the pounds during pregnancy makes it much harder to lose the weight after the baby’s birth. Institute of Medicine (IOM) data show black women retain more pounds after giving birth than our white or Latina sisters.

So how do we get a handle on this growing problem? The IOM recommends normal-weight women gain 25 to 35 pounds during pregnancy, overweight women 15 to 25 pounds and obese women 11 to 20 pounds. “You’re not eating for two,” says Janice Henderson, M.D., an ob/gyn at Johns Hopkins. “Don’t double up every meal.” In fact, Dr. Henderson says pregnant women only need 1,800 to 2,400 calories a day, and they don’t need any extra calories at all during the first trimester. She counsels her patients to take in 340 extra calories a day in the second trimester and 400 in the third. (Think: a slice of bread with peanut butter and a glass of milk.)

Of course, this doesn’t mean pregnant women, inching close to the recommended weight gain, should go on a diet. Nor should you obsess about the numbers. In fact, experts say the focus should be on healthy living before, during and after baby.

Pre-Conception

Fertility, says Dr. Henderson, is often reduced in obese women. She also points out that obese women tend to have nutrient deficiencies, like folate and vitam B12, and many already have health issues. So don’t wait until the pink line shows up on the pregnancy test; schedule an appointment to talk to your ob/gyn or midwife about health status and weight concerns.

“If you are overweight or obese, lose weight pre-conception,” Dr. Henderson says. “If you have other medical problems, get them under control.” (She even suggests you consider weight-loss surgery if your BMI is greater than 40.)

While the Bun Is in the Oven

Don’t eat unlimited amounts of every food under the sun. That thinking is obsolete, explains Yvonne Thornton, M.D., clinical professor of obstetrics and gynecology at New York Medical College. “Focus on healthy eating and portion control,” Dr. Henderson says.

Keep it moving. Unless there’s a medical reason to avoid physical activity, pregnant women should aim for 30 minutes of moderate exercise most days of week. It’ll boost energy and help keep weight gain under control. If you haven’t been exercising regularly before pregnancy, don’t start training for a triathlon. Walking should do the trick. But if you were active before, you can continue aerobic activity and resistance training (light weights only). Consider a prenatal yoga class.

“Set one goal related to eating each week and one for physical activity,” Dr. Henderson says. “Be specific. Instead of ‘I’m going to gym this week,’ say ‘I’m going to the gym Tuesday, Wednesday and Friday.’”

And don’t try to go it alone. Keep regular prenatal visits and talk to your provider about diet and exercise.

Reducing Preterm Births in the Black Community

Nov. 12 Babies/Children/Teens, Oh, Mama!, Our Health, Vitality no comments

 

Preterm births are the leading cause of newborn death in the United States, with nearly half a million babies (just less than 12 percent) born too soon each year. Even babies who survive an early birth often face lifetime health complications such as blindness, breathing difficulties, cerebral palsy and hearing problems. And though the Centers for Disease Control and Prevention notes an overall decline in the number of preterm births nationwide, African Americans still have double the rates of prematurity. We spoke to Gerson Weiss, M.D., chair of the department of OB/GYN at UMDNJ, about what causes preterm birth and what’s being done to reduce risks.

 

What is preterm birth?

Gerson Weiss, M.D.: It’s a premature rupture of the membranes [before 37 weeks of pregnancy].

 

What causes preterm births?

There are many causes. If a woman is severely hypertensive and develops pre-eclampsia, the uterine environment becomes detrimental; we’re better off taking the baby. If the uterus is overstretched—this is more common with twins and triplets. Stress is a very major factor. Stressors of need, produced by racism, by difficulty having to work too hard, not having enough rest, money problems. Smoking—because that decreases the amount of oxygen to baby. Drugs can do it. Some [drugs] almost immediately trigger labor. Cocaine, for instance, causes uterine contractions. Illnesses—diabetics will have to be delivered early. Abnormalities of uterus. Too short a cervix. What we don’t know sometimes is how to prevent preterm births.

 

Why are African-American women at higher risk of preterm births?

There are likely many reasons; we probably don’t know all of them. Racial stress is pretty major in long-lasting stress. This is a burden for many minorities. That can produce preterm birth. Many are poor, which will translate to mean they have poor nutrition. They may have a bad diet—too many calories without a lot of protein. They may be obese, which puts them at major risk of developing gestational diabetes.

African Americans, as a group, have higher risk of hypertension. This is another reason why pre-term birth can happen. We aren’t that aware of all of the causes, but clearly, this is an issue that is a problem for all socioeconomic groups. By way of example: Socioeconomic level is a risk factor for prematurity, however, a middle-class African-American woman has higher risk of preterm birth than an impoverished white woman.

It’s hard to get away from the fact that racism is an issue. The United States has one of highest prematurity rates in world, certainly one of highest in developed countries. We have women come to this country from places where there is poverty, but they have lower risk of preterm delivery than in the U.S. For example, a Mexican woman comes to the U.S. and improves her socioeconomic status, income and education, but her children will still have higher preterm risk than she does, which would point to a something in our society. Racism rises to top of that issue.

 

What can a woman do to lower her risk of a preterm birth?

Stay healthy. Come up with methods to avoid stress. Get more sleep. Stop smoking. Stop using illicit drugs. Take a multivitamin with a high level of folic acid, which also decreases risk of birth defects. Get to a healthy weight.

 

What health risks do preterm babies face?

A preterm baby is small and all its organs may not be developed. So it has the risk of respiratory problems, as lungs may not be developed. May need more time in the NICU [neonatal ICU], where a variety of sophisticated therapies are necessary to help the baby. They may have trouble catching up. There may not be enough neurological development. Later in life, preterm babies are at increased risk of hypertension and diabetes—at much greater risk [than normal birth babies] when they are adults.

 

The March of Dimes Healthy Babies Are Worth the Wait campaign (launched earlier this year in Newark, New Jersey, following a similar pilot program in Kentucky) seems to be helping reduce the numbers of preterm births. Why? What is the program doing specifically?

The program is sometimes providing vitamins; increasing awareness of problems; educating nurses, physicians and patients about self-care. It is encouraging patients to come in early to correct or prevent problems early. It is taking care of patients with specific programs, such as centering programs, where patients are seen anti-partum in groups. If a patient doesn’t have partner, she runs the risk of being isolated, but participating in groups helps with bonding. The last thing you want to see is a woman present for delivery alone. The program screens for partner violence. They look for infections that may produce preterm delivery. They increase nutritional competence. They treat periodontal disease, which is related to preterm delivery.

 

What else can be done to fight preterm births?

Share [with women] the important messages: They need to have support, care and live as healthy a life as they can. They need appropriate diet, weight control, physical activity.

And we need to keep this message alive. This isn’t something you can tell on one day and assume women have it forever. To assure someone takes instructions of caregivers to heart and avoids dangerous activities. Every woman who’s pregnant and who’s keeping the pregnancy really wants the best baby she can get. If a woman is doing things that are harmful to her pregnancy, there’s a likelihood that she really doesn’t understand that what she is doing is harmful.