Dear Childbirth Educator:

Lately I am hearing so much about fatty acids and how important they are in the development of a baby, both in the uterus and while being breast fed. I just found out I am pregnant. I’d like to know why they are so important and what I should be taking to ensure my growing fetus is getting everything it needs.

Lorraine Wells
Wilmington, DE

Dear Lorraine:

Great question!  Omega-3 fatty acids, aka polyunsaturated fatty acids or PUFAS, are important for fetal/newborn development.  They will be given to you to take during your pregnancy and you will continue to take them while you are breast feeding.  If you are formula feeding, today’s formulas have DHA and AHA in them.

There are several common Omega-3 fatty acids needed by the body.  Long-chain versions of them, like DHA and EPA, are critical for fetal brain and organ development.  These fatty acids also ensure the elasticity of the cell wall membranes of the human eye, brain and sperm cells.  Large amounts have been of DHA have been traced being transferred from the mother through the placenta to the fetus in the third trimester, having important roles in retinal and brain function.

Direct DHA Food Sources include:

Dear Childbirth Educator:

My sister had her first baby earlier this year and was so looking forward to his arrival.  She had what her doctor said was a great labor (18 hours, an epidural, pushed for a little less than 2 hours,) and came home after staying in the hospital one night after delivery.  Everything seemed to be going well with breast feeding, although she did have someone come to the house to help her.  Her husband was a tremendous help and my parents, and I took turns helping as well.

On about day 8 everything changed.  All she did was lay in bed.  She wouldn’t eat. She only held the baby at feeding times.  She didn’t shower or change her clothes and wanted no company.  The entire family became worried and her husband decided to call her doctor, who recommended a therapist who specialized in post partum depression.  My mom and I took turns sleeping at their house to help out and after several weeks of therapy and medication (which the therapist assured her was safe while breast feeding). Things started to get better.  But this was all so frightening.  I have never seen my sister like this before, and no one in my family has had any history of depression.

I am extremely anxious because I am now pregnant and fearful of the same thing happening to me. Is post partum depression hereditary? Is there anything I can to to prevent it from happening to me?

Julia Bunch
St Louis, MO

Dear Julia:

Dear Lactation Consultant:

I will be flying several times in the next few months for business and would like to know if I can pump on board planes and also, if I can carry pumped milk with me on the planes. I really do not want to have to toss any of my very precious milk.

Thank you for an answer.

Elana Krauss
Evanston, IL

Dear Elana:

IThe Transportation Security Administration (TSA) regulations regarding transporting breast milk changed in 2007 and were recently modified again this summer. While it is subject to inspection, you should have no difficulty getting it through security.  I would recommend that you make a copy of the TSA policy printed with this answer and carry it with you just in case anyone questions you.

(You can read about the 2007 TSA regulation changes HERE, and see the 2008 revised regulations HERE.)

Unfortunately, when it comes to pumping in airports and on planes, that’s a very different story.  The TSA has no regulations to cover this and most airlines/airports have no policies of their own. You might want to contact the airline in advance of your travel to see if they will accommodate you.  I had a client who recently was able to go to the first class area in the airport to pump while waiting for her delayed flight. Courtesy of American Airlines.

Dear Lactation Consultant:

I love my in-laws but I am not looking forward to the pressure I anticipate from them when it comes to breast feeding. They are older, from another country, did not breast feed their five children and already I am hearing talk about buying a scale so we know how much weight the baby is gaining since we will not be able to see what the baby is getting from my breasts.  What should I do so I don’t insult them?

Marina Maravilla
Glendale, CA

Dear Marina:

Yours is a very common concern and I understand your anxiety.  I often find asking your pediatrician or lactation consultant to spend a few minutes with your in-laws to discuss their interest in their grandchild’s feeding, which hopefully will make them more comfortable.  Take them to a prenatal breastfeeding class with you, if you do not feel they are imposing on your private time.

Dear Lactation Consultant:

I am so confused. I just came out of my local Babies R Us unsuccessful in my intent to purchase a breast pump.  There are so many available that I didn’t know which one to get. Prices vary greatly and I know some manufacturers tend to be more reliable than others, but I am totally confused. I know I want an electric pump, but other than that, I am lost as to which is the best.  What would you recommend?

Jane Penshaw
The Woodlands, TX

Dear Jane:

I don’t blame you for your confusion.  What you need to do is ask yourself the following questions:

• 1. What is the purpose for pumping?
  •     a; are you returning to work or school and will need to be pumping at least several times a day, all week long?
    
  •     b; will you be pumping so baby gets a bottle a day and perhaps an occasional extra one?
    
• 2:  What is your budget?
  
• 3:  Have you contacted your health insurance to see if they will cover any part of the pump cost?  Some companies will reimburse you for rental pumps only.  Other companies will reimburse for “expendible goods” (purchased pumps), so you definitely want to check on this before investing.
  
• 4:  Does your employer have a lactation program?  More and more companies have programs that include pump rentals. In Los Angeles, for example, The Dept. of Water and Power has a program where they will give the employer or spouse a rental pump to use as long as she is working and breastfeeding.  What a great deal!

Dear Lactation Consultant:

My baby is 3 weeks old and has become extremely fussy over the last week.  She gets very hungry, latches well, but after 3 or 4 minutes starts wriggling and pulling.  I take her off because she is hurting me and relatch her but she’ll continue to do herky-jerky nursing (I hear her swallowing so I know she is getting milk) for about another 3-4 minutes, then she pulls off and cries uncontrollably.  I have tried burping her, sometimes as long as 10 minutes and sometimes I will get a burp (dry) but most of the time she spits up a lot.  After calming her (this usually takes about 10-20 minutes) she goes to the other breast without fussing, for about 15 minutes.  She usually falls asleep, but I feel it’s important to burp her and the burp is usually spit up. She does go back to sleep after that.  Her poops are always green and she poops at every nursing.  She only takes cat naps and wants to eat every hour to hour and a half.  We are going to see the pediatrician next week but I thought I’d ask you first because you have been so helpful when I have called you with questions in the past. I’m glad you have the blog up and running now so I don’t always have to call you.

Sincerely,

Susan Sweet,
Great Neck, New York

Dear Susan:

First of all, you never have to feel guilty for calling me with questions, but I also like the blog because it is a way to share common concerns with all our readers. From what you are describing and from other questions we have discussed before (foamy poop, blood in her stool)  it sounds like your baby may have a true dairy protein allergy.  Although not always the case, it is usually hereditary, so if there is a family history of such an allergy, it would make my assumption more likely.

Dear Childbirth Educator:

I have a dilemma I don’t know quite how to handle.

I am 32 weeks pregnant with my first baby and have become more and more unhappy with my obstetrician. He seems disinterested, rushes me through exams, will not discuss my birth plan with me and has bluntly let my husband and I know that I’ve had a healthy “textbook” pregnancy and that’s the way he expects labor to go so there won’t be any need to make changes in his usual protocol at the hospital. When I have asked what he means by that, he simply states that all the nurses know what he likes done and therefore not to worry. He was referred to me by a colleague who said he wasn’t like this 3 years ago, but for whatever reason, he is no longer taking the same interest in his patients as before. I like the hospital, but I am really not looking to going through labor with this doctor, even though I know he won’t be there throughout the entire labor. What is your recommendation?

Linda Reynolds
Chicago, IL

Dear Linda:

You are right at the cut off time when it will become difficult to find another doctor to take you on but you may be able to if you act quickly.

Dear Childbirth Educator:

I just found out I am pregnant and I know there are so many things I need to be concerned with that are obviously more important than manicures and pedicures, but I am the manager of a large spa and it is important that my nails always look perfect. I am very concerned about inhaling the fumes in the nail salon as well as the products used on my nails. The owner of the spa has said I can limit the amount of time I spend in or near the nail salon, but I still inhale the fumes regularly when I am escorting clients or getting my own nails done. I know I sound very spoiled but it is my job. How can I take precautions?

Lindsey Bratman
New York City, New York

Dear Lindsey,

If it part of your job, you are certainly not “spoiled” since it is expected of you to look your best and it may actually help you to look better on those pregnancy days when you may not feel your best. Your clients at the spa pamper themselves with all sorts of treatments (and you may want to suggest to your employer that she consider catering to pregnant women, a trend many salons are doing successfully here in Los Angeles) and there is no reason you shouldn’t look and feel as good as your clients do.

This list should help you when you are being taken care of at the nail salon or spa:

Dear Lactation Consultant:

I have a real problem. I have checked out your website and I feel you are the kind of person I can talk to about it. Please do not judge me like so many others have. I am pregnant with baby #3. I am a smoker and did not breast feed my other 2 children because I was told by their doctor that it was bad for them. But thinking I might want to try this time. I took a breast feeding class where I learned it would be healthier for the baby to be breast fed than not to be. I asked the pediatrician and he said absolutely not so I was wondering if you had anything to back up the breast feeding teacher’s comment. I emailed her but she has not gotten back to me yet.

Kay Lewis
Brooklyn, NY

Dear Kay:

There is plenty of evidence that breastfeeding is even more important for babies of smoking moms since the breastmilk can improve some of the ill effects of second hand smoke. The protection provided by breastmilk will hopefully prevent against asthma, pneumonia, ear infections and even SIDS, all of which babies of mothers who smoke are of greater risk of. Your baby will develop appropriate immune responses to protect her and these responses can only be gotten from breastmilk, not from formula.

Dear Lactation Consultant:

I am expecting my second child any day now and although I successfully breastfed my first for one year, my one major problem was chronic mastitis. There were no lactation services in my local area but I have since moved and there will be help available this time, yet I am still very nervous. Last time my doctor kept giving me antibiotics, which after a while were not even working and I am afraid they may have had an effect on my son as well. I really do not want a repeat of this situation this time. What do you think I should do to prevent a repeat?

Lynn Rice
Saskatchewan, Canada

Dear Lynn:

Take a deep breath and be thankful you are now living in an area where you will be able to get lactation assistance. It can mean all the difference to you and you should try not to worry.

I have a few questions to ask you that might shed some light as to why you had recurring mastitis:

Dear Lactation Consultant:

I am due to have my baby in about a month and everything I have been taught in my breast feeding class, (which, by the way, I did not take in the hospital I will be delivering at because I was warned by friends not to,) encourages putting the baby to the breast immediately after it is born, unless there is a medical reason not to. When we went on the hospital tour, we were told that the baby goes to the nursery after delivery and that I will not be able to breast feed until we are in our post-recovery room. What can I do to keep my baby in the delivery room so I can breast feed?

Amee Ashton
Washington, D.C.

Dear Amee:

You are asking for an answer I am often asked, but one which is difficult to reply to without repercussions, as every hospital has their own policies when it comes to how long the baby can stay with you after delivery. If the hospital is baby-friendly, there is no issue, as the baby will remain with you for at least an hour, but otherwise it be anything from what you might experience to 15-20 minutes to a full hour. Working in Los Angeles, where most hospitals allow babies to breastfeed immediately after birth, it is indeed frustrating to hear of your situation. Research has shown over and again that encouraging good breastfeeding, which includes getting off to a good start quickly after delivery, putting the baby to the breast skin to skin and allowing the baby to remain that way for as long as possible will lead to success at the breast when the baby has become interested after they recover from the labor experience, which may be as long as 72 hours later.