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A Breast/Chest Field Trip

Many changes occur in a person’s breast/chest tissue during their pregnancy and after the baby is born. When new parents come to me with breast/chestfeeding difficulties, and I ask them if their nipples are “cracked”, they sometimes are not sure. “I don’t know what my nipples looked like before the baby started to suck on them. Do they look normal now?”

To get a sense of what equipment you are starting out with on your breast/chestfeeding journey, it might be a good idea for you to go on a “Breast/Chest Field Trip” at the end of pregnancy.

(Please note: If you have concerns about your breast health, or if you have had breast surgery or top surgery, some of this may not be relevant to you. Please see your doctor or midwife and consider setting up a prenatal appointment with a Lactation Consultant (IBCLC) to prepare for any challenges you may encounter when breast/chestfeeding your baby.)

1. Take your top and/or bra off and stand in front of a mirror with good lighting.

2. Look at your chest. You may notice:

• Your breasts/chest tissue are bigger than before you got pregnant. Most of the glandular tissue you need to make milk grows during pregnancy. And all the little ducts that are needed to transport the milk grow then too. Some chest/breast tissue grows a lot, and some grows only a little, but they almost all grow some.
• One side is larger that the other. As breasts/chests grow, the difference in size between them (and there is almost always a difference in size) becomes more apparent.
• Your sides are not symmetrical. One nipple may be lower than the other. One may point more to the left, or more to the right. Knowing that your breasts are not symmetrical may help you figure out how to position your baby on your body

3. Look at your nipples. You may notice:

• Your areola (brown or pink part of  around the nipple) has become bigger and darker.
• You may have more visible or darker bumps on the areola. These are sometimes called “Montgomery’s tubercles” but they are more descriptively called Sebaceous Glands of the Areola. They secrete an oily substance that keeps the nipple and areola supple and smells attractive for the baby. The smell helps the baby find the nipple.
• Your nipples may be bigger and darker than before. They may stick out more. The skin may be crinkly (the anatomical term for the crinkles is “rugae”) (These crinkles are not “cracks.” When a baby attaches to the breast too shallowly, and the nipple get pinched, a blood blister may form and then a wound may develop. That is what people mean when they talk about “cracked nipples.”)
• Your nipples may only stick out if they are touched, massaged or get cold. If that is the case, you may have “flat nipples.”
• If your nipples retreat when you compress the areola, you may have “inverted nipples.” This is caused by short connective tissue within the nipple. Check with your doctor or midwife to make sure.
• Inverted or flat nipples make people feel worried about being able to feed their baby. Don’t worry! Babies use the nipple as a guide to tell them where to latch on. Flat and inverted nipples make it a little more difficult for the baby to FIND the nipple, but you are going to be there to help! The baby is supposed to take a big mouthful of tissue, including the nipple and much of the areola, so the size of the nipple or invertedness of the nipple should not matter. Many parents find that after they have been feeding for a few weeks, their nipples stick out and become easy for the baby to find.
• There are gadgets and exercises out there to “fix” inverted nipples. There is no scientific evidence that those gadgets and exercises work. The best way to deal with flat or inverted nipples is to get expert breast/chestfeeding help after your baby is born.

4. Pull gently on your nipples and see how far out they stretch.

• When a baby is connected properly to the breast/chest, the tip of the nipple is all the way at the back of the baby’s mouth – at the soft palate. When I tell pregnant parents this, they imagine that their own little nipple could never reach that far. But nipples and areolas are very stretchy! Check it out!
• A generation or two ago, mothers-to-be were told to “prepare” their nipples by scrubbing them with a rough towel or rubbing them with alcohol! This is no longer recommended. It does nothing to prevent sore nipples, in fact it may damage the skin of the nipples and make them more tender.

5. Try to express a little colostrum. (These directions are given for your right side. Try your left side first if you are left handed!)

• Hold your right breast or chest tissue in your right hand.
• Have your little finger all the way back at your chest wall and your other fingers supporting the weight of the tissue.
• Have your thumb on top. Move your finger and thumb back towards your chest, away from the areola, and then slide them forward, compressing the tissue.
• When you get to the base of the nipple, stop and maintain the pressure for a few seconds.
• Don’t pull on the nipple – that just pinches the ducts closed.
• Imagine there little “grapes” under the skin and you have coax the “juice” out of them!
• Move your hand around so you try all different angles – all different points of the compass.
• You may need to try for several minutes before you see a few drops of colostrum. It takes some time to get the knack.
• Some people see little beads of yellow colostrum on their nipples during the second half of pregnancy. Some see little yellow crusts of dried colostrum. Others don’t see colostrum at all. But almost every pregnant person makes colostrum after about 20 weeks.
• Expressing or leaking a little colostrum does not “waste” any, because you will continue to make it until about 10 days after the baby is born.
• The purpose of expressing colostrum here is just for you to develop a better understanding of how your milk producing glands work. You don’t have to do it. If you express colostrum now, it does not mean that you will make more (or less) colostrum later. If you can’t, it doesn’t mean there isn’t any. It probably just means you haven’t figured out how to do it yet. Try again later, or wait for your baby to figure it out.

6. Look at your breasts/chest again and think about what wonderful “equipment”, what beautiful “packaging” they are for making and delivering milk to your baby!

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Pay it Forward

I find myself having to do something I always dread. I have to raise our prices. I always resist doing this – so years go by and our prices stay fixed. I really wanted to keep our Childbirth Classes, especially, affordable, because I know most expectant parents don’t have a lot of spare cash. But it has to be done. We will be raising the prices of our Childbirth Classes, and our Parenting the Newborn Classes on August 1. (So you might want to let your friends, who have not yet registered, know that this month is a great time to do so!)

At Mothering Touch we have always given bursaries to families who are in financial difficulties. These families are referred to us by their midwives, or family docs, or public health nurses. We negotiate a fee they can reasonably afford – sometimes that means $20.

As we raise our prices, I want to make more people aware of our Bursaries, and I would like to make more bursaries available. So we have come up with a plan. When folks register for their classes, they will be given the option of contributing $5 or $10 to our Bursary Fund. As they pay for the classes that help them to prepare for parenthood, they can support another family, who might not be as well off. They can pay it forward.

We’re going to put a Pay it Forward button on our front page too. So that families who have already taken their classes can make a contribution.

When you contribute to our Bursary Fund, you are giving a pregnant parent and their partner or support person the opportunity to get evidence-based information about childbirth, breastfeeding and early parenting, to go on a tour of the hospital where they may be birthing, and to attend two free prenatal yoga classes. You help connect them with Mothering Touch, and resources that will support them all the way through the first years of their baby’s life.

We hope many of you will consider donating to our Bursary Fund, and will pass the word along to families who may be able to benefit from it.
Have a great summer!

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Is a Prenatal Class about Childbirth or about Babies?

Prenatal Childbirth Preparation for Doctors' Patients

This term we use – Prenatal Class – is confusing, isn’t it?

Some parents-to-be are fascinated by, or worried about labour and birth and are wanting to spend a lot of time talking about it. They come to our 12-hour, six-week Childbirth Preparation classes and are happy to spend most of the time on labour and birth, and practicing comfort measures and coping skills, and find that it’s great that we also spend two entire hours talking about babies and breastfeeding.

Other parents, who are more worried about how they are going to cope with the baby once it is out, feel they would like to spend more time talking about babies and breastfeeding.

It’s for this second group of parents that we have designed the Parenting the Newborn series. It’s a three-week, six-hour series in which a postpartum doula and breastfeeding educator takes you though two hours on baby care and two hours on breastfeeding, and then a First Aid Instructor comes and teaches two hours of Infant First Aid and CPR.

Many of our parents take both sets of classes. And we encourage this by giving parents a $15 discount if they sign up for both classes at the same time. (We also acknowledge that there will be a little overlap between the classes.) Some parents take only one, or only the other.

I would say, that if you take only one, the Childbirth Preparation Class is the one to take. Experiencing childbirth in a healthy and satisfying way takes knowledge and preparation. Labour and Birth happen all at once, in a big storm. There is little time to consider, or problem solve during labour. The learning and considering and deciding needs to happen before labour starts – even though you may change your mind during labour itself – in fact you probably will.

You can learn baby care and breastfeeding over several week and months. Babies are very patient with fumbly parents, and every parent figures out their own way through the challenges of of the first weeks. In fact, the hormones you make (yes, parents of all genders make hormones when they are around babies) will help you be more attentive and respond more sensitively to your baby.

At Mothering Touch, we believe in people’s basic ability to give birth and care for their babies. We want parents to feel well-prepared and well-supported, to feel satisfied with their birth experience and to be able to enjoy the first weeks with their baby. That is the goal of all our classes and groups.

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Twelve to Sixteen Weeks Pregnant

Twelve Weeks to Sixteen Weeks Pregnant

You’ve come to the end of the First Trimester! You are now entering the Second Trimester – this is the time of the legendary glowing, energetic happy pregnant mama. Of course, that does not happen for everyone. For some, nausea and vomiting do not subside, and fatigue persists even after twelve weeks. This is very difficult.

How you might feel between twelve weeks and sixteen weeks of pregnancy:

  • Nausea and vomiting might start to get better.
  • Heartburn might start or get worse
  • Some women find their sex drive gets stronger at this time – estrogen from the placenta contributes to this.
  • Stuffy nose and nosebleeds
  • Sore back
  • Hair growth – all those growth hormones the placenta is making can make hair grow well on your head – and elsewhere.
  • Headaches. Acetaminophen may be ok (ask your care provider to make sure), but ibuprophen and aspirin are not safe for use in pregnancy. Try a cold compress on your forehead, taking a nap, or having a snack.

Things you may do between twelve weeks and sixteen weeks of pregnancy:

  • Because you are now passed the period of highest risk for miscarriage, this may be when you choose to tell friends and family about your pregnancy. This can be an exciting and happy thing. It can also create a lot of attention and make some women feel shy. Take your time, and tell your news at your own pace.
  • Pregnant women tend to spend a lot of time in the Second Trimester thinking about the baby (some call it daydreaming, or processing, or meditating), wondering what s/he will be like and how it will feel to be a parent.  Use that motivation to learn right now about baby care, and infant development. Some good books include, The Baby Book, by William & Martha Sears and Your Amazing Newborn, by Marshall and Phyllis Klaus.
  • This is alo a good time to learn more about breastfeeding. A good book would be Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, by Kathleen Kendall-Tackett, Nancy Mohrbacher.
  • Consider having a doula at your birth.  A doula is a woman experienced in childbirth who provides physical, informational and emotional support and helps parents to have an easier and more positive childbirth experience.  You can learn more by clicking here.
  • Register for Prenatal Childbirth Preparation Classes.  It’s best to take these after 28 weeks, but you have to schedule them and register for them now or the class you want may not be available. 

 Between twelve weeks and sixteen weeks of pregnancy, your care-provider will probably:

  • be seeing you every month at this stage
  • weigh you at each visit and discuss healthy weight gain
  • palpate and measure your abdomen
  • at this stage, you and your care provider will be able to hear the baby’s heart beat using a hand held Doppler ultrasound device
  • if your prenatal screening tests have shown positive results, you may be offered amniocentesis. You can read about that here.

You’re getting to know your care-provider now, and developing a relationship with him or her.  Keep a list of questions to ask at your monthly appointments.  It’s so easy to forget.

Things you can do for your health and your baby’s health:

  • As the nausea starts to go away, experiment with new, nutritious foods.  You may feel hungry in a way you have not experienced before.
  • Keep up with regular physical activity.  As you get bigger around the middle, you may feel a little awkward in your regular classes and decide to join a pregnancy yoga, fitness or aquafit class.  Or not!  The best way to get exercise is to do what you love in an environment you feel comfortable with.  Don’t let anyone else tell you where that should be.
  • If you have not yet joined the Pregnancy Happy Hour on Fridays evenings at the Mothering Touch Centre come and try it out!

Resources:

Infant development: https://www.healthyfamiliesbc.ca/home/articles/babies-physical-development-0-6-months
Breastfeeding videos: https://www.healthyfamiliesbc.ca/home/articles/topic/feeding
Doulas: http://www.doulasofvictoria.ca/
Doulas: http://doulamatch.net/
Genetic testing: 
http://www.perinatalservicesbc.ca/ScreeningPrograms/PrenatalGeneticScreening/family-resources/default.htm

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Thirty-Two to Thirty-Six Weeks Pregnant

Thirty-two to Thirty-six weeks pregnant

Thirty Two to Thirty-Six weeks Pregnant

As baby gets bigger, the issue of how you are going to get the baby out may start to feel more relevant. Many mothers find that they become quite preoccupied with planning and daydreaming and thinking about their impending labour. Talk to your partner or birth helper, meet with your doula. This is a good time to be taking childbirth classes.

How you might feel between thirty-two and thirty-six weeks of pregnancy:

  • Your growing belly and growing baby are putting more strain on your body. You may start to feel quite weary, especially towards the end of the day. Napping is a useful skill to start cultivating now!
  • Back pain, caused by the increasing weight of the baby and softening joints, may get worse. Consider seeing a massage therapist, physiotherapist or chiropractor.
  • Baby is moving a lot. The baby’s movements may keep you up at night, or wake you up even. Baby’s hiccups – a little, slow, pulse-like feeling, deep inside you.
  • As baby moves, and your back hurts, and you get less exercise during the day, you may start to find it difficult to sleep at night. Try having a high-protein snack before you go to bed. Practice your breathing exercises and isten to soothing music. Think of it as free time to rehearse for labour.
  • Constipation may become a problem. Remember to eat lots of high-fiber vegetables and whole grains. Make sure you drink enough water too.
  • Braxton-Hicks contractions, also called pregnancy contractions, may start to become more intense. Remember your uterus contracts more if you are dehydated or over-active. Take it easy and have a glass of water if the tightenings start to bother you.

Things you may do between thirty-two and thirty-six weeks weeks of pregnancy:

  • Planning for your baby’s birth. What is really important to you about the experience of giving birth? Where will you give birth?
  • Consider your preferences and values with regards to your baby’s birth. How would you like things to go? How would you like to cope with labour pain? What interventions would you like to avoid, if possible?
  • Discuss your birth preferences and values with your partner or birth-helper.
  • Gather home birth supplies and/or start to pack your hospital birth bag.
  • Are you having the support of a doula? You will probably meet with her in this month, if you have not already done so.She will want to know about your plans and preferences for your baby’s birth so that she can help you carry out those plans.
  • Plan for the postpartum period. Who will help with household tasks after you have the baby? Who will visit? How much time will your partner take off?

 Between thirty-two and thirty-six weeks of pregnancy, your care-provider will probably:

  • Be seeing you every two-three weeks at this stage.
  • Weigh you at each visit and discuss healthy weight gain.
  • Check your blood pressure.
  • Check your urine for protein and infection.
  • Palpate and measure your abdomen.
  • Listen to the baby’s heart beat using a hand held Doppler ultrasound device.
  • Review test results.
  • Check the position of your baby to screen for breech presentation (bum first) or other variations in presentation.
  • Offer screening for Group B Strep.
  • Provide you with information about how to reach your care provider when you do go into labour.
  • Provide information about when yo go to the hospital – if that is where you are having your baby.
  • Discuss the possibility of a VBAC (Vaginal Birth After Caesarean) if you had a Caesarean at the end of your last pregnancy.

Your care provider is one of your best sources of information.  Keep a list of questions to ask at your monthly appointments.

Things you can do for your health and your baby’s health:

  • Pay attention to self-care. Take time for a massage or acupuncture session.
  • A very large amount of calcium is transferred to the baby in the third trimester. Focus on good sources of calcium: dairy, tofu, leafy greens, dried fruit and nuts.
  • You may want to start doing some perineal massage to increase health of perineal tissues and give you practice relaxing as perineum stretches.
  • Aquafit classes or swimming really help with swollen feet and legs, and backache.

Resources:

Finding a Doula in Victoria, BC: Greater Victoria Doula Directory

Deciding where to have your baby – Hospital or Home? Hospital or Home?

Deciding where to have your baby – Hospital or Home? Place of Birth Handbook

What to pack in your hospital bag: Packing for the Hospital.

Home Birth Supplies – an example: Access Midwifery, Victoria

Group B Strep: HealthLink BC

Group B Strep: BC women’s Hospital

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Twenty-Eight to Thirty-Two Weeks Pregnant

Twenty-Eight to Thirty-Two Weeks Pregnant

Twenty-Eight to Thirty Two Weeks Pregnant

You are officially in the Third Trimester now. The baby is bigger and movements are stronger. You may be starting to think of this baby as a separate person from you.

How you might feel between twenty-eight weeks and thirty-two weeks of pregnancy:

  • The baby is bigger and movements are stronger. You may be starting to think of this baby as a separate person from you. Some mothers find that they like this feeling of always having a loved one close, inside. Some mothers start to feel a little crowded.
  • Your softening ligaments and growing belly may cause sciatic pain which starts in your low back and goes down the back of one leg. Mention this to your care-provider who may recommend seeing a chiropractor or physiotherapist.
  • As you body slows down, your brain may feel like ti’s slowing down too, because the higher levels of endorphins you are producing. You may experience some absentmindedness or “baby brain.” Carry a notebook, make a to-do list.
  • Heartburn may become more severe. Small meals, pineapple, yogurt, kefir, sauerkraut are some remedies women have tried. Ask your care provider about what antacids you an safely use.

Things you may do between twenty-eight weeks and thirty-two weeks of pregnancy:

  • This is when you may start to attend childbirth classes. Make sure you talk to the other parents and make connections. This is the beginning of creating your group of mommy-friends.
  • You are probably thinking about getting your home ready for baby. Setting up the nursery, shopping, gathering hand-me-downs.
  • Where will your baby sleep? Have you thought about room-sharing? Bed-sharing? Bassinet? Crib?
  • Get your pets ready for baby. If you have not done obedience training, it miht be time. Expose them to other babies, decide where they will sleep when baby comes, take them to the vet for a check-up.

 Between twenty-eight weeks and thirty-two weeks of pregnancy, your care-provider will probably:

  • Be seeing you every two-three weeks at this stage.
  • Weigh you at each visit and discuss healthy weight gain.
  • Check your blood pressure.
  • Check your urine for protein and infection.
  • Palpate and measure your abdomen.
  • Listen to the baby’s heart beat using a hand held Doppler ultrasound device.
  • Discuss your emotional health and adaptation to your pregnancy.
  • Discuss postpartum depression and preparations for postpartum support.
  • Review test results.

Your care provider is one of your best sources of information.  Keep a list of questions to ask at your monthly appointments.

Things you can do for your health and your baby’s health:

  • Arrange to have a dental checkup – it will be more difficult to find time after baby comes and healthy teeth mean healthy mom.
  • Make sure you include lots of fiber in your diet to help with constipation, which gets worse as pregnancy continues.
  • Take an evening walk after supper. It can help with morning blood-sugar levels.
  • Essential fatty acids (Omega 3 fatty acids, fish oil) can help with depression and general health. Ask you care provider whether they are appropriate for you.
  • Start attending your childbirth preparation classes (prenatal classes).
  • Consider taking Baby Care classes.

Resources:

Depression in Pregnancy and the Postpartum Period: Here to Help BC

Eating Fish in Pregnancy: Health Canada

Dental Care in pregnancy: HealthLink BC

Pets and Babies: HealthLinkBC

Heartburn: HealthLinkBC

Childbirth Classes: Mothering Touch

Baby Care Classes: Parenting the Newborn

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Yoga for Labour and Birth

 

exp-yoga

Come and try out our Monday night Drop-In Class taught by Yoga Teacher and Therapist and DONA-trained Birth Doula, Ann-Kathrin Martins.

Yoga for Labour and Birth focuses on preparing, toning and stretching muscles and joints which will be supporting and working for you through labour. We will practice yoga postures for various stages of labour. We will practice relaxation and breathing techniques as well as visualization, affirmations, mantras and helping the mother learn self-healing methods to allow for mind/body/breath connection.

Yoga for Labour & Birth is suitable for mothers at any stage of pregnancy who are ready to think about and prepare for labour and birth.

Monday Evenings : 5:15pm – 6:30pm

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Elle TENS Machine Rentals

Have you considered using a TENS machine in labour? Or maybe you’ve heard of it but do not know what it is?

Elle TENS Machine Rentals

The Elle TENS machine is a small handheld device that uses mild electrical impulses through the skin to stimulate nerve fibers.  In labour, a woman can use a TENS machine to help reduce back pain while having full control over the machine and the impulses.

We are excited to now offer our clients Elle TENS machine rentals!

Click here to learn more about the Elle TENS and how it might help you during your labour.

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Yoga & Preparing for Childbirth

Yoga is an excellent form of exercise in pregnancy.  While gently stretching and exercising the body it also quiets the mind.  Prenatal Yoga classes are carefully planned to include postures (aasanas) which as safe for the pregnant woman and her baby within.  The principles of yoga include a respect of and compassion for the body and its troubles and limitations.  Through prenatal yoga, a pregnant women learns to listen to her body and treat it gently.  She learns to respect her body’s strength and resilience.  She learns to relax and breather and quiet her mind, important skills for coping with the stress and sleeplessness of pregnancy and parenting.  Although few scientific studies of yoga in pregnancy have been carried out, those that have (like this one from Bangalore, India) show positive effects of yoga on both mother and baby.

For a woman who has been very active and fit before she became pregnant, prenatal yoga may not feel strenuous enough in the first and second trimester.  An active woman with a low-risk pregnancy is encouraged to maintain her usual activities as long as she can through her pregnancy.  But even a very fit woman will find, sometime around her 6th or 7th month, that she is feeling a little heavy and a little slow, and that a more relaxing form of exercise would be welcome.

Besides exercise and relaxation, prenatal yoga provides pregnant women with a place to meet other women who are at the same stage in life.  Meeting and talking to other pregnant women is important in a woman’s development of her identity as a mother-to-be.  It helps her to feel pregnant.  It also helps her to realize that she is not alone in her experience, that other women are having the same sensations and emotions.

Click here to read about the pre and postnatal yoga and fitness options available at The Mothering Touch Centre.

* This article is an update to our post from September 2010.

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Knowing What’s Important

"I really want to thank you for teaching us about having a birth plan and being open and ready for change.  Our plan went from a natural water birth at home to finding out baby had flipped into a frank breach position at 38 weeks then going into labour on Christmas Eve and having to have an emergency C-section.  I guess we got all of our cards flipped except the most important one, Healthy Baby!" Having that plan and knowing what was most important really helped us get though all of the surprise twists and turns."

~ Rachael