The use of massage during labor is nothing new. Many tribal cultures throughout the world have traditionally incorporated massage into the birthing process. Nurturing touch during labor has been shown to enhance the laboring woman's mood and ability to cope with labor. In 1997 the Touch Research Institute at the University of Miami conducted a study and on the effects of massage during labor. Researchers found that women who received massage during labor experienced decreased levels of anxiety and pain. They needed less medication and their labors were shorter than those of the control group, who received only obstetrical care.


The onset of labor in preparation for birth is an intricate series of hormonal signals and interactions. It is believed that the baby is responsible for initiating labor with the mother's hormones taking over to ensure that labor continues to progress. Two important labor hormones, epinephrine and norepinephrine stimulate uterine muscles to contract. Anxiety in the laboring woman overstimulates the production of both of these hormones, resulting in slow, ineffectual and painful labor. A relaxed woman's hormone levels are more balanced allowing the uterus to be more effective in responding to the body's hormonal signals. In addition to traditional therapeutic massage techniques, Acupressure and reflexology can also be used to help balance hormone levels and stimulate the uterus. The result is contractions that are strong, rhythmic and effective. Body positioning is also important in encouraging the progression of labor. Standing, squatting and sitting are positions that maximize the use of gravity for the laboring woman, and help open up the pelvis in preparation for birth. However, with the use of epidural anesthesia, the laboring woman loses the ability to utilize these various birthing positions.

If a woman desires to birth naturally, without the use of pain medication, how does she endure the pain that accompanies labor? Massage serves as a distraction to labor and contraction pain. It is believed that flooding the brain with pleasurable sensations will help to override pain signals from the uterus. Massage can be very effective between and during contractions. Acupressure points can be utilized during contractions to decrease the level of pain. The time between contractions can be used to massage tired, clenched and cramping muscles. Managing pain during labor decreases the need for epidural anesthesia and therefore the need for later medical intervention.

Epidural anesthesia administered during the early stages of labor doubles the likelihood of a cesarean section. Because massage during labor has been shown to decrease the need for epidural anesthesia, it may also aid in preventing an unnecessary cesarean section birth. Epidurals also decrease the pushing sensation during delivery and therefore the use of forceps and vacuum extraction becomes more likely.

If a cesarean birth is deemed medically necessary prior to the onset of labor, massage can also be beneficial in preparing for the event. The days and weeks prior to surgery may be filled with stress, anxiety and fear of not knowing what to expect. Massage can play a very important role in helping moms cope with these emotions and help in gaining a sense of empowerment.

Massage for the laboring mother can be performed by a massage therapist or by the woman's partner. Partners can consult with their massage therapist prior to the onset of labor and then use the learned techniques from the moment labor begins up to the time of delivery. It is important to remember that a laboring woman's response to touch is unpredictable and may change at any time throughout labor. Open and honest communication with the therapist or partner is essential during the entire laboring process.


References:
Osborne-Sheets, Carole., Pre-and Perinatal Massage Therapy, Body Therapy Associates, San Diego, CA, 1998.

Stillerman, Elaine, LMT, Mother Massage, Dell, New York, NY, 1992.

Field, T., Ph.D.; et al., "Labor Pain is Reduced by Massage Therapy" Journal of Psychosomatic Obstetrics and Gynecology, Vol. 20, Dec 1997

Originally posted on CharloteMommies.com

I met Donna Gilbert at my very first La Leche League meeting in Raleigh, NC in 2007. Since then, she has always been warm and welcoming, and able to answer any questions I have. Despite having two previous failed nursing relationships, Donna and the LLL allowed me to nurse my third child for two years, and my youngest, who was MUCH like my first (refused to nurse) for a year. Thanks to the success she enabled in my own breastfeeding experiences, I decided to interview her in hopes that other nursing mothers can benefit from her knowledge.

When did you decide that you wanted to help other women successfully breastfeed?
I thought about [it] when I realized how little support there is. It was a natural thing for me to want to help. Both my parents are ministers, so I grew up in a home where helping people was akin to breathing. It’s what I do. I guess you could say it’s in my genes.

How long did you breastfeed your own child?
Do you really want me to answer this question? Perhaps it would scare people. lol Well, I think she nursed much like an infant for about 4.5 years. I know it wasn't really like an infant, but at times it felt like it was that intense and that often. Between 4.5 and 5 it decreased to nothing. She basically weaned during that time.

Who was the most positive influence in your life, pertaining to helping other moms?
Helping mothers in particular? I can still remember how wonderful it felt when a La Leche League Leader told me how smart I was. I was about 5 months pregnant and completely unsure of myself. I was a very reluctant mother and it was those few comments she made that gave me a little bit of hope. I’m sure I’m not the only mother out there who felt that way and I would like to do that for other moms.

What are some websites or other resources that you point moms to when they need their questions answered?
I absolutely love Dr. Jack Newman’s website and videos. A picture is worth a thousand words. DrJackNewman.com

How often and how long should baby nurse?
Babies are just like other people when it comes to eating. Some people eat quickly and some people eat slowly. Some people like a few big meals and some like to nibble all day. Your baby may have just gotten the milk flowing and you think it’s time to change sides because you are looking at the clock. So the real answer to this question of how long should my baby nurse is this: Let your baby suck until they are satisfied. If they seem fussy, try compressing your breast to see if you can help the flow a little and once baby is done on that breast, either because they aren’t getting any more milk or aren’t getting it quickly enough, or because they’ve fallen asleep, then you switch sides. Your baby will let you know when they want to eat and when they want to stop eating. In the early days, if baby is awake, offer your breast. They only have so much energy and all of that energy should be geared to survival – in this case, breastfeeding. As they get older, they will spend more and more time discovering the world around them.

A newborn’s tummy is very small, especially in the early days, so it takes very little to fill them – only about 1 teaspoon on days one and two. By day three, baby’s tummy can hold almost an ounce and by day ten, baby’s tummy can hold about 2 ounces. This is why a baby nurses so often, especially at first.

How do I know my baby is getting enough to eat?
First and foremost check is to see that your baby has a good latch and is swallowing. You should see or hear your baby swallowing. Their ears will wiggle slightly while they are nursing and their lips will be turned out. Your breasts should feel softer after you feed your baby.

If your baby is gaining weight steadily after the first week of age, is passing enough clear or pale urine (about 6 wet diapers per day after the first two days), and is having about 3 bowel movements a day, is having short sleeping periods and wakeful, alert periods, your baby is likely getting plenty of milk.

It’s important to note that it is common for babies to lose some weight right after birth (up to 10% of their birth weight), so you needn’t be concerned. Keep nursing them and they should have regained that weight by day ten. Most babies gain from 2/3 to 1 ounce per day during the first 3 months.


What does a breastfeeding mother need to succeed?
Support.

When is the best time for breastfeeding to start?
Within the first hour after birth.

What is the best breastfeeding position?
Whatever position is the most comfortable for you and your baby. I will often get mothers to do a few swallows with their head in a different position to demonstrate how difficult it is to swallow if you are not looking straight ahead. Go ahead. Try swallowing with your head turned one way or the other, or with your head tilted up or down. Difficult, right? Remember that when you are positioning your baby to nurse. Another interesting thing I noticed is if I hang my head face down and open my mouth, my jaw falls forward and my tongue naturally falls down to the floor of my mouth. That is the position you want your baby’s jaw and tongue to be in when they nurse. If I tried to do that sitting up or lying on my side, it’s much harder. Many moms find nursing in the early days is much easier if baby is lying face down. Find a place where you can recline far enough back so that gravity will hold your baby on your chest. Put baby between the breasts. The baby will wiggle themselves toward the breast and all mom has to do is help them out a little by sliding their bottom to one side and the baby virtually latches themselves. It’s called laid-back nursing and you can check it out here: biologicalnurturing.com

What can Dad do?
Offer support. That’s the most important thing he can do. You need someone beside you at 3 am who will remind you that this is a learning curve, not to give up too soon, and most importantly, give you a hearty and reassuring “you can do it”!

Dad can also spend special skin-to-skin time with baby while mom takes a bath or a shower, burp and change baby, and basically anything and everything else!

What can I do before my baby is born?
Get good prenatal care. This can help you avoid early delivery which makes breastfeeding harder. Get as much breastfeeding information as you can. Take a class or two and attend a support group for nursing moms. Take a class from a lactation consultant. Then you can establish a relationship before the baby comes and you may not be so hesitant to ask for help when you need it. Talk to your doctor and/or lactation consultant about any breast surgery or chest injury you may have had. Make sure your doctor knows you intend to breastfeed your newborn and would like to do that within the first hour of life.

Can I breastfeed even if I am sick?
I suppose we should define ‘sick’, but generally, yes. If you are sick, your breast milk will have antibodies that will help protect your baby from getting the same sickness. There are very few exceptions. For example, radiation therapies require a temporary break from breastfeeding.

Can I take medicines if I am breastfeeding?
Yes, with a few exceptions, cancer chemotherapy agents being one of them. Check with a lactation consultant, La Leche League Leader or with “Medications and Mothers’ Milk”, a book by Thomas Hale found in bookstores and libraries. You can also go online to http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT

Some medications have a drying effect on breast milk, such as some over the counter cold medications and allergy medications, so you will want to use those sparingly if possible.

Do I have to restrict my sex life while breastfeeding?
No. If vaginal dryness is an issue, try more foreplay and water-based lubricants. You can feed your baby or express some milk beforehand so your breasts will be more comfortable. If your breasts leak, put pressure on the nipple and have a towel handy to catch the milk.

Do I still need birth control if I am breastfeeding?
Breastfeeding can delay the return of normal ovulation and menstrual cycles. This is called lactation amenorrhea method, or LAM. Like other forms of birth control, it is not 100% effective. LAM is 98% effective in preventing pregnancy during the first 6 months only if the infant is exclusively breastfed, the interval between feedings is less than 6 hours and the mother has not resumed menstruation. The use of pacifiers and infant formula are associated with an earlier return to menstruation.

Barrier methods, like condoms, do not contain synthetic hormones and therefore do not interfere with milk production.

Estrogen can decrease milk production. Progestin can decrease milk production if introduced before a mother’s milk supply is established. Most manufacturers recommend waiting at least 6 weeks. A trial period of taking the oral medication is preferable to having more potent procedures like injections so you can stop taking them if you notice a decrease in your milk supply.

Do you have anything else to say to new or expecting moms, or moms that want to try to nurse again, after not having such a great experience with previous children?
Yes! Give it a try! Every pregnancy, every baby and every breastfeeding experience is different. Gather as much information as possible and do your best to find a support group. Believe it or not, support is the number one predictor of success. If you can get past the learning curve of 6 to 8 weeks and establish your milk supply it is well worth it for the ease that follows.


Donna has a Diploma in Dental Hygiene (1986) from Dalhousie University in Halifax, Nova Scotia, Canada, and she is an International Board Certified Lactation Consultant (2009). She has had personal experience breastfeeding and she has coached births. She has been a La Leche League Leader since 2004 and is a retired leader with Attachment Parenting International.

Originally posted by Becka from SaratogaCountyMommies on The Mommies Network National Blog, 3/25/11

The class I’d like to see childbirth educators add to their list.

When I was pregnant with my first child, I took every class the hospital offered, from Breastfeeding to Taking Care of Baby. But what really would have helped me is a class that doesn’t exist. A class I’d like to call “Taking Care of Mama.” You know the old saying, “If mama ain’t happy, ain’t nobody happy.”



About a week after I got home from the hospital with my perfect little baby, nobody in my house was happy because I was miserable. I remember standing at the window in the early morning darkness of a cold rainy Monday watching my husband’s car leave our driveway his first day back to work. All I could think was “The world is going on without me.” I’d given up my career to stay at home with my baby, but suddenly found myself wondering what the hell I was thinking. My days now consisted of changing diapers, trying to (unsuccessfully) breastfeed a fussy baby every 15 minutes, washing endless loads of laundry and watching way too much mindless daytime television. I signed up for this?

Two weeks later I was consumed with dark feelings. When I had to force myself to eat, I knew this was a problem bigger than the “baby blues.” I knew this was postpartum depression, even though I couldn’t make my mouth form the words.

You have to understand, I was the woman who couldn’t wait to be a stay-at-home mom. So when the dark feelings came out of nowhere, I was completely unprepared. I went to all those classes to learn how to diaper and swaddle a baby. I knew how to give the baby a bath and I was even prepared for that ugly umbilical cord stump thing, but I wasn’t prepared for this.

At least one out of every ten women who give birth experience some form of postpartum depression. It’s all over the news. You’d think someone might have at least mentioned it in one of those classes. Nope. Did anyone ever say, “For the next six weeks your hormones will be on a roller coaster ride that will make you feel, at the very least, not yourself. Your body will be recovering from the trauma of birth, while at the same time being more deprived of sleep than a Marine at boot camp. Oh, and you are also now responsible for the health and well being of another human. Life as you knew it is over. Therefore, do not be surprised if you experience an adjustment period.” C’mon. Would a little warning have been so hard?

Yet, alas, none of those healthcare professionals ever seem to mention taking care of yourself as a new mama except for instructing you to wait six weeks before having sex (as if anyone who’s just passed a seven-pound baby through her nether regions needed to be told that). No, all the classes are about the baby. Taking care of the baby, feeding the baby, massaging the baby, diapering the baby and (God-forbid) administering CPR to the baby. The mother is completely left out of the equation. What about the major emotional, financial and psychological turn your life has just taken? Sorry. You’re on your own there sister.

After a few weeks of feeling awful, I went to see my doctor. He knew exactly what I was going through. He told me if I hated breastfeeding, I should stop trying (and not to feel guilty about it), to get out of the house every day and to exercise. Then he gave me a prescription for an antidepressant. I left his office feeling like I might actually survive. And that was a feeling I hadn’t had in what seemed like a really long time.

I had no idea so many other women had gone through the same thing. It sure would have helped to know I wasn’t alone and to hear stories of success from other new moms who suffered from postpartum depression. To be reassured that I wasn’t destined to be a horrible mother and feel like crap the rest of my life. But sadly, few mothers admit publicly or even to their close friends what they are going through.


So here’s what I would tell moms-to-be in my “Taking Care of Mama” class: First, you have to make time for yourself. Get out with your friends, your husband. Get a babysitter. Not only is it okay to take time for yourself, but you’ll be a better mother if you take some time to recharge. Second, everything is a stage. As new moms we have a tendency to think of now as being forever. But the baby will eventually sleep through
the night and smile back at you and laugh and life will get better. And if you are feeling depressed, it’s nothing to be ashamed of. Go talk to your doctor. He or she can help. Be empowered to do what works for you. Just because something worked for someone else doesn’t mean it’s right for you.

I’m glad I learned all those lessons. It just would have been nice if someone had given me the Cliff-Notes version ahead of time.

(Post originally submitted to CharlotteMommies)



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