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It seems that everything in the parenting realm is up for debate, as differing opinions and standards may ultimately drive a wedge of fear between many mothers and mother’s intuition. “Recommendations” change with the season it seems, like the first introduction of solid food, and guidelines for car seat safety. The majority adapt to the changes and use them as a guide, even as a common ground among other mothers in social settings.

                                                                                                                                                                               Photo copyright: Jennifer Canvasser
Jennifer Canvasser breastfeeding son, Zachary. Why, then, when it comes to the health and well-being of the most fragile among us (babies born prematurely), does a lack of basic rights (especially for life-saving human milk) prevail? Statistically, it is clear that breastmilk is best. The American Academy of Pediatrics (AAP) advises that breast milk can help prevent or treat diseases such as necrotizing enterocolitis (almost 90% reduction, compared to formula1), gastrointestinal tract infections (64% reduction, and lasting two months post breastfeeding), and type 1 and 2 diabetes (30%; 40% reduction, respectively), to name a few, and that ”the potent benefits of human milk are such that all preterm infants should receive human milk”. Furthermore, per the AAP, “Lower rates of sepsis and NEC indicate that human milk contributes to the development of the preterm infant’s immature host defense.”2 Jane Morton, MD, FAAP states, “Unquestionably, breast milk is far superior to any formula designed for babies, and even more critical for the health of the premature baby.”3 Yet, the majority of hospitals (as much as 60%4) in the United States do not use donor milk, and many take it a step further by supplementing with conventional cow-based formula-fortifier, sometimes against the wishes of parents.


Barriers to human milk for those in NICU span beyond hospital regulation. Most insurance plans in the United States do not cover the costs associated with using donated breast milk (from a milk bank), which can be a hefty financial load to bare when already faced with medical expenses related to birth and the NICU. Few, if any, financial resources are available to parents in regards to donor milk.
A lack of resources, support, and education can also be a deterrent for anyone when it comes to providing breast milk to NICU babies in particular. For example, not knowing how or where to donate milk; how or where to obtain pasteurized donor milk, or not being informed of the benefits of breast milk (especially breastfeeding) for premature babies.

 A mother may experience a delay in lactation immediately following birth. Her supply may not easily increase (especially in an emergency situation, or a preterm birth) as it would if baby were directly breastfeeding on demand. New moms, especially in a critical situation, do not know how to breastfeed, nor how to pump. Providing resources, education, and assistance for mothers in a hospital setting will help both physically and emotionally for a mother to flourish in feeding her child. Hospital NICUs undeniably need to revamp lactation support policies, as well as provide a comfortable environment in which a mother can express milk or breastfeed.


Babies may be taken quickly from mother after birth (as in an emergency situation). It may be days before mom and baby are reunited, and possibly longer still before mom is able to touch or hold baby. During this time especially, support and education from the hospital itself is vital… for comforting mom, for preparing her and helping establish a milk supply, and for giving both mom and baby the freedom and ability to cuddle via skin-to-skin, bond, and thrive. Allowing as much skin-to-skin as possible leads to higher success of breastfeeding and/or pumping and provides numerous benefits to baby.5

Milk Banks typically provide monetary assistance for the shipment of milk from a donor to the bank. These organizations work with individuals to ensure that the process is stress and worry free. Donors are screened, and milk is pasteurized and cultured, to ensure the highest quality for fragile babies. The Human Milk Banking Association of North America provides a list of milk banks. Human Milk for Human Babies is an organization that provides informal breast milk donation, allowing mothers to connect personally. Milk donated exchanges hands directly between donor and recipient.

 

Jennifer Canvasser, founder of NEC Society, and mother of twins born prematurely, both of whom spent a length of time in the NICU at the University of Michigan Motts Hospital, knows firsthand the challenge of fighting for the right to human milk for babies. When faced with aversion, what can be done? With whatever energy a parent of a NICU infant has, Canvasser suggests, “Ask what are the policies around human milk for fragile babies? Do you have a program? Do you provide the infants with an exclusive human milk diet?”

Having an infant in a NICU is emotionally and physically demanding. Readily available resources for parents in regards to providing human milk for their baby (whether via mom or donor) could lessen some of the burden for parents. In addition, raising awareness of the need for human milk for fragile infants, sharing stories and experiences publicly, and working with healthcare professionals and administrations can be a start to ensuring the basic rights of those born prematurely: a safe environment, access to proper nutrition, and a fighting chance!

Organizations such as NEC Society and Best for Babes, along with recent documentary “The Milky Way” are actively doing just that. Says Canvasser of NEC Society’s current mission, “Our focus is on changing practices and reducing the incidence of necrotizing enterocolitis. We strive to empower NICU families and create real change in NICU practices that will better protect fragile babies. The first step is awareness and empowering families.”

How can an individual help to raise awareness? Simply put: talk. Discuss openly the benefits of breastmilk (especially for infants born prematurely) to friends and family, speak with the local hospital about policy, reach out to local media about possibly covering the story, meet with healthcare professionals to ensure accurate information is being spread and used, advocate on behalf of someone who’s experienced a loss as a result, or is currently in the midst of the battle. When emotionally ready, share with others. As the late Maya Angelou asserted, “There is no greater agony than bearing an untold story inside you.”

Human milk nourishes, protects, and heals. Every baby, regardless of circumstance, deserves the right to thrive.

 


Sources:

1
“Necrotizing Entercolitis Risk”. US National Library of Medicine National Institutes of Health. NCBI. April 2012. Web. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3357630/>
2
“Breastfeeding and the Use of Human Milk”. Pediatrics. Vol. 129. pp. e827-e841. Official Journal of the American Academy of Pediatrics. 27 Feb 2012/1 March 2012. Web. <http://pediatrics.aappublications.org/content/129/3/e827.full#content-block>
3
“AAP Policy on Breastfeeding and the Use of Human Milk”. Breastfeeding Initiatives. 28 May 2014. American Academy of Pediatrics. Web. <http://www2.aap.org/breastfeeding/policyonbreastfeedinganduseofhumanmilk.html>
4
“Fast Facts: Miracle Milk”. NEC Society. 06 May 2014. Web. <http://necsociety.org/>

“Holding your baby close: Kangaroo Care”. March of Dimes. Web. 2014. <http://www.marchofdimes.com/baby/holding-your-baby-close-kangaroo-care.aspx>

Published in Feeding Baby
Monday, 25 November 2013 10:53

Pediatric Massage

We all know how good a massage can feel. It can help decrease muscle tension after a long day at work, minimize headache pain, and help facilitate the healing of soft tissue injuries. So, if it feels good and can help us heal, what about our little ones?  

We can incur tissue trauma at any stage of life, in the womb, during the birthing process, and of course, all the bumps and bruises we get as we learn to crawl, walk, and run. All of this trauma, as small as it may seem, can have physical (as well as mental) effects on the body. These effects can manifest themselves later on in life, creating postural change, undue stress on ligaments, tendons and nerves, and muscle tension, as well as some mental health disorders. Massage Therapy can be very beneficial throughout the pediatric years to help with tissue healing, postural concerns (scoliosis, leg length discrepancies, etc.), latching difficulties, digestive issues, restlessness and insomnia, as well as many other issues.

How does pediatric massage differ from regular massage?  Depending on the symptoms that your child may present with, many of the same techniques can be applied to the infant that would be applied to an adult but with a much gentler touch and treatment intention. Treatments can involve simple Swedish (relaxation) massage techniques, or be more specific. CranioSacral techniques can help a newborn latch onto the mother’s breast or decrease intracranial pressure that may be high due to some birthing processes such as C-section delivery. Visceral (organ) mobilization techniques may be used to help with digestion. These techniques should be performed by an experienced CranioSacral Therapist or Visceral Therapist that has had specific education towards pediatrics.

How do I know if my baby needs Massage? Obviously a newborn cannot express through voice that he/she has an upset tummy or that they are experiencing tension throughout their body. But noticing movement patterns that seem unbalanced from side-to-side, such as one arm reaching higher than another, or excessive arching of the back when being picked up, can be signs of tissue tightness within the body. Latching problems can be another sign that there may be some problem with the palate and/or the muscles that help with latching (possibly due to a difficult/long birthing process, C-section, or breech position). An overly fussy baby can be telling us that something may be uncomfortable also. Our little ones communicate in many different ways without speech. As long as you are attentive and trust your parental intuition, you will pick up on these little communication cues. Even if you think everything is okay, your baby can always benefit from massage.                

When can massage be done on an infant? Massage therapy can be very effective and applied at any time from the moment of birth onwards. Pre-natal massage experienced by the mother can create a more comfortable pregnancy as issues with postural change, mood, and overall health can be addressed. This has a direct impact on the birthing process as a relaxed mother with very little discomfort going into child birth is more likely to succeed at providing a positive birthing experience for her and her baby.

It is also important to note that massage therapy is a great bonding tool for parents and their newborn. Touch builds trust for the newborn towards his/her parents, it helps to comfort, and is a great tool to be used for bedtime routines. Infant massage classes can teach parents the basics of applying massage to their infants and is something I highly recommend.

Pediatric massage can help with a variety of issues and can be done at any time. It is an amazing tool to help parents bond with their child and can be very beneficial with the developmental process of the baby. There are a variety of techniques that can be applied by the parent or massage therapist, and some that need advanced education to help our little ones developmental process flourish.

 

Jason Dvorak, RMT, NSCA-CPT

 

 

Published in Newborn Health

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