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Breastfeeding and Postpartum Mood Disorders: Milk, Tears, and Hope

While many women experience mood changes during or after the birth of a child, 15 to 20 percent of women experience significant symptoms of postpartum depression and anxiety. This World Breastfeeding Week, UCSD and SDCBC mini-seminar discussed how to treat a women suffering from perinatal mood and anxiety disorders (PMADs) and help her with her breastfeeding goals.

Many healthcare providers have not received adequate refining in how to recognize, screen for PMADs, and refer mothers for help. This is unfortunate because according to Bethany Warren, licensed clinical social worker and the president of Postpartum Health Alliance, “recent research has confirmed that the optimum development of an infants social and emotional health hinges on the responses of and relationships with their caregivers, often the mother.”

There are effective and well-researched treatment options that can prevent worsening of symptoms and help women fully recover. “New moms are going through an identity shift, and our goal is to help them recognize their expectation, reducing the perfectionism and comparison, manage the anger, and resolve the conflict and grief.” explained My Hanh Nguyen, a psychiatric-mental health nurse practitioner of UCSD Dept. of Psychiatry. “Not all expectations happen and that’s okay.” Common strategies including interpersonal psychotherapy, cognitive behavioral therapy, mindfulness, support groups, and of course, medication.

Because of the possibility of exposing the baby to medication through the breastmilk, many are hesitate to treat breastfeeding moms with drugs. However, as Jason Sauberan, Doctor of Pharmacy of Sharp Mary Birch, pointed out, “we don’t want the drug to hurt the baby, but we don’t want to tell moms that you cannot be treated while breastfeeding, either.” The important thing is to help medicated moms reach their breastfeeding goals by understanding the physiochemical drug properties and milk transfer, judging infant risk and making the right decision. This is crucial because breastfeeding has a protective role for both mother and infant.

When supporting a breastfeeding mother with postpartum depression or anxiety, clinicians need to employ messages to all mothers experiencing the symptoms, “You’re not alone. You’re not to blame. With help, you will be well.” When identifying the mom at risk, “the most important aspect of assessment is to listen to the woman’s story,” said SDCBC’s Rose deVigne-Jackiewicz, RN, MPH, IBCLC, “Her story is unique to her.” Moms need to be heard, clarified, validated and categorized. “Sometimes, even what you see tells a lot,” deVigne-Jackiewicz told the seminar attendees. Is the mom holding her baby? How’s she interacting with her husband, boy friend or in-laws?

To understand what PMADs are really like, Jessica Furland, clinical social worker of UCSD recommended three documentaries: The Dark Side of the Full MoonWhen the Bough Breaks and The Emily Effect. Each of the documentary delves into the unseen world of maternal metal health in the U.S, brings attention to this public health issue and illustrates the lack of awareness and appropriate treatment options for postpartum mood disorders by looking into a woman’s journey to recovery.

 

To-wen TsengBreastfeeding and Postpartum Mood Disorders: Milk, Tears, and Hope
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Why Donate Your Breast Milk?

Breastfeeding mothers, have you ever thought about becoming a human milk donor? Maybe you are producing more milk than your baby can eat and you feel responsible for what you have. Maybe you want to help vulnerable infants around the country. Either way, being a human milk donor is a deeply rewarding experience.

When thinking about milk donation, many mothers first consider finding someone in their area who need milk for their babies and casually sharing it with them. But there are safety issues. Last year, the American Academy of Pediatrics issued a policy statement against informal milk sharing because of the risk of bacterial and viral contamination. A 2013 study found that 74 percent of breast milk bought on the Internet had high levels of bacterial growth, particularly strep and staph.

So instead of casual sharing, you may choose to look into human milk banks. There are currently 18 human milk banks in the United States and Canada that are affiliated with the Human Milk Banking Association of North America, which sets guidelines for ensuring donor breast milk safety. Milk banks pasteurize donor milk to kill bacteria, combine it with other donor’s milk to make sure the milk components are well balanced, and test the milk for contamination. They then provide the milk to premature babies and other infants whose mothers may not be able to breastfeed.

Last year, 9.6 percent of U.S. infants were born prematurely, which can cause a host of health issues, including necrotizing enterocolitis (NEC), a serious disease in which babies’ intestines are damaged or die, causing waste to leak into their bloodstream. In 2013, preterm-birth complications were responsible for one third of U.S. infants death, according to the Centers for Disease Control.

The World Health Organization says preemies should drink their own mother’s milk when possible. While donor milk is good for babies, it’s not as powerful as their own mother’s milk, because a mother’s milk composition rapidly changes to meet her baby’s needs. However, WHO does recommend donor milk as the best back-up.

As you prepare to donate, you have to pass a month-long screening process, which included a phone interview, blood test for infectious disease, and releasing your baby’s and your medical records so the milk bank staff could ensure donating wouldn’t be detrimental to either of you.

Your milk can help prevent infections in premature babies and encourage there mothers’ own breastfeeding efforts.

Upcoming milk drive in San Diego area:

Date: Saturday, August 5, 2017

Time: 3pm – 5pm

Location: UC San Diego Health East Campus Office Building

For more information, please visit https://health.ucsd.edu/specialties/obgyn/maternity/newborn/lactation/Pages/Mothers-Milk.aspx

 

Date: Monday, August 7, 2017

Time: 7:30 am – 2pm

Location: Sharp Mary Birch Hospital

For more information, please visit https://www.sharp.com/hospitals/mary-birch/mothers-milk-bank.cfm

 

Read more:

When breast milk goes big business

The dangers of buying breast milk online

Breast milk is love. Share love!

To-wen TsengWhy Donate Your Breast Milk?
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“Milk & Marijuana: First Do No Harm”

When California voters approved Proposition 64 and legalize marijuana last year, the basic idea was simple: a majority of people in the state believe that adults should be able to consume marijuana if they feel like it, just like a glass of wine at 5 o’clock. But how about pregnant and/or breastfeeding women? Shall we tell mothers not to breastfeed if they use marijuana?

According to Dr. Lisa Stellwagen (MD, FAAP) of UCSD Medical Center, it’s complicated.

To-wen Tseng“Milk & Marijuana: First Do No Harm”
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A Quick Guide to Successful Breastfeeding

There’s a big global push in from experts to have mothers of newborns breastfeed exclusively for at least six months.

 

And many new moms want to. But only about 60 percent who start off breastfeeding keep it up for six moths or more, according to the Centers for Disease Control and Prevention.

Here’s a quick guide to advice from lactation consultants, pediatricians and researchers who had tips for women on how to reach their breastfeeding goals.

To-wen TsengA Quick Guide to Successful Breastfeeding
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Breastfeeding: It Takes a Whole Village

When my first child was born, I did not have a breastfeeding plan. Then my pediatrician advised me about the American Academy of Pediatrics guidelines: exclusive breastfeeding for the baby’s first six months. Then, as foods are introduced, continuing breastfeeding until at least baby’s first birthday.

A friend gave me an electric breast pump. Another friend gave me a cooler and some ice packs. I got serious.

I breastfed my child, relied on pre-pumped breastmilk to get through day care days. I faced breastfeeding discrimination situation at work by six months. I had four business trips by one year. But I insisted.

I insisted not because I am a true believer in the benefits of breastfeeding, though I myself was bottle-fed, along with many in my cohort. But my insistence was mostly because of the support I had.

To-wen TsengBreastfeeding: It Takes a Whole Village
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Things To Know About Storing Breast Milk For A Flight

A horror story about a mom being forced to dump her breast milk in an airport is circulating on Internet. It reminds me about the two years when I was breastfeeding. I travel frequently for work and flew a few times with my breast pumps during that two years. My impression is that traveling as a breastfeeding mom can be challenging, but not impossible. Most agents do understand breast milk security procedures, and mothers should be good if they know the TSA guidelines in regards to breast milk storage.

Here are several things to keep in mind when carrying breast milk on a flight.

To-wen TsengThings To Know About Storing Breast Milk For A Flight
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Baby-Friendly Hospital Initiative Practices: Challenges and Strategies, by To-wen Tseng

Baby-Friendly Hospital Initiative Practices: Challenges and Strategies

There has been lots of discussion about Baby-Friendly Hospital Initiative, a global initiative of WHO and UNICEF. How mommy-friendly is the Baby-Friendly Hospital Initiative? Is the breastmilk-only mandate putting babies in danger?

SDCBC’s recent Spring Mini-Seminar focused on this hot topic. Dr. Nancy Wight (MD, FAAP, FABM, IBCLC), Rose de Vigne-Jackiewicz (RN, MPH, IBCLC), Ruth Fletcher (BSN, RN, IBCLC) and Nancy White (BSN, RN, IBCLC) talked about the challenges and strategies practicing Baby-Friendly Hospital Initiative.

To-wen TsengBaby-Friendly Hospital Initiative Practices: Challenges and Strategies, by To-wen Tseng
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Highlights of California Breastfeeding Summit 2017: Culture, Trauma, and Marijuana, by To-Wen Tseng

Themed “California Dreamin,” this year’s California Breastfeeding Summit took place at Anaheim, CA in January. At a recent San Diego County Breastfeeding Coalition’s general meeting, the coalition’s Kim Speckhahn (BS, IBCLC), Kimberly Elkins (EdM, IBCLC) and Dr. James Murphy (MD, IBCLC, FABM, FAAP) shared what they took home from the Summit.

Heidi Burke-PevneyHighlights of California Breastfeeding Summit 2017: Culture, Trauma, and Marijuana, by To-Wen Tseng
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Breastfeeding in flu season, by To-wen Tseng

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As San Diego flu cases reach new high this season, many mothers are asking, “Can sick moms breastfeed?”

From my personal experience, sick moms can totally breastfeed—I once breastfed in an emergency room when down with stomach flu. And my husband was attacked the second day. Our breastfed son, then eight month old, turned out to be the only one of the family who didn’t get sick. Our pediatrician said the antibodies in breast milk protected our child.

Of course, I’m not a medical personal and may not be persuasive enough. Here is what experts have to say.

Heidi Burke-PevneyBreastfeeding in flu season, by To-wen Tseng
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Partners in Narrowing Breastfeeding Support Gaps in Communities, by To-wen Tseng

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Once again, it’s a new year with new hope and new challenge. While many of lactation consultants in San Diego County are continue to support breastfeeding families, it is very helpful to learn about the “RBLs”—Regional Breastfeeding Liaisons—at WIC.

Having that in mind, San Diego County Breastfeeding Coalition invited four local RBLs to talk about the program at a recent coalition general meeting. They are Kimberley Elkins (EdM, IBCLC, RBL) and Jennifer Nolan (RD, IBCLC, RBL) from American Red Cross WIC, and Laurel Hiroshige (RD, CLE, RBL) and Kim Speckhahn (BS, IBCLC) from North County Health Services WIC.

Heidi Burke-PevneyPartners in Narrowing Breastfeeding Support Gaps in Communities, by To-wen Tseng
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