Tuesday, July 19, 2016

MILC Moment: Breast Massage for Plugged Ducts and Mastitis


 When you get a plugged duct, it may start as a little lump in the breast. It may feel a little tender, and the skin over it might look more pink or red. If it doesn’t get better, it may get bigger and the congestion may start to spread to other areas of your breast. More of the skin might look red. You might feel body aches or chills, or get a low grade fever. If the congestion still doesn’t go away, you might start feeling worse – like you have the flu, with a high fever. At that point, you should definitely be calling WBWC (or your OB care provider) – “Help! I think I have mastitis!”

A round of antibiotics will usually clear up mastitis pretty quickly. But we like to avoid antibiotics if we can, and of course we like to avoid you getting sick! Could we prevent a bad case of mastitis? Plugged ducts, engorgement, and mastitis can sometimes be treated with just our hands - just by clearing out those congested areas before your breasts get really inflamed. A lot of the suggestions you read online suggest getting behind the plug and forcing it forward. We used to do this too, until we learned new techniques from an IBCLC named Maya Bolman, who teaches LCs about traditional Russian breast massage and hand expression, which can work much better than pumping for a plugged duct.

If you’re getting a plugged duct, or if you feel like your plugged duct is getting worse, check out this video for techniques from Maya on how to massage and hand express to help clear your breasts: https://vimeo.com/65196007

All the WBWC LCs, and many of the midwives and nurses, have been trained on how to do breast massage to help clear plugged ducts and breast congestion. If you feel like a plugged duct is getting worse, and you’re not able to clear it yourself, you can call for an appointment to get some hands-on help. If you believe you are getting mastitis, or have mastitis, you should always call WBWC (or your OB care provider) for care. Do not delay in getting care for mastitis, as it can become more serious if it is not treated. Some cases of mastitis require the use of antibiotics for treatment.

We hope that you never have to deal with plugged ducts, engorgement, or mastitis, but if you do it’s good to know that you have some very good tools to deal with them – your own two hands!

Best,

Your MILC LCs: Rebecca, Ellen, Elley, Nancy, and Deborah

Grilled Corn, Avocado, and Tomato Salad

Ingredients:

2 ears fresh corn, husk and silk removed
Juice of 1 lime
3 tbsp vegetable oil
1 tbsp honey
1/2 tsp salt
1/2 tsp fresh ground pepper
2 cloves garlic, finely minced
1/4 tsp cayenne pepper
1 pint grape tomatoes, cut into halves
1 ripe Hass avocado, roughly chopped
1/4 cup fresh chopped cilantro


Grill corn over medium heat for 10 to 15 minutes, turning as necessary.  The corn should have some brown spots and be tender but not mushy.  
Cut the corn off the cob, and scrape the cob with the back of your knife to get the juices.  
Set aside and let cool.


In a large bowl, whisk together the lime juice, oil, honey, salt, pepper, garlic, and cayenne. 
Add the grilled corn, tomatoes, and cilantro, and mix well so that everything is coated with the dressing, 
Gently mix in the avocado, being careful not to mash it as you mix.  
Refrigerate for at least 1 hour before serving. 


Monday, July 18, 2016

Sebastian's Birth

by Emily Malpass


     Before I started making lovely little people, I made lovely little pottery. Two years ago, at the height of optimism/naïveté when I was expecting my first child, I agreed to an exhibition just a month after she was born. I had a wonderful pregnancy and impeccable care from WBWC, took an in-depth birth class with my supportive, involved husband, hired a doula, wrote and rewrote our birth plan, ate my 100 grams of protein every day, did everything from yoga to perineal massage. In my mind, I was completely prepared for birth, doing everything “right.” So how did that labor go? One of my pieces from that exhibition tells the story best: it’s a fragile, unfired, handmade clay vessel with thin red sewing thread sewn around it like a crazed cocoon, stuffed with dryer lint and strips of my birth plan, which I had shredded.

     Yikes, I know. Don’t worry. I called the Birth Center when my days turned dark, and Nancy referred me to a therapist specializing with postpartum women (who has dealt with these issues herself). I also met with one of the WBWC midwives who attended our birth. She reviewed the events of my birth and why we had transferred to the hospital, listened compassionately to my concerns, and validated my physical and emotional state as appropriate to what I’d gone through. This extended support from WBWC was critical in my emotional healing process.  As my body eventually came (completely! miraculously!) back together from birth, my mind became clearer and my anxieties calmed. Then the longest shortest year ever had passed, and a few months later, we were expecting Ruby’s baby brother!


   This time, a trusted friend recommended Hypnobabies as a different way to prepare for birth, and I worked through the home course. I listened to the meditations and relaxation tracks during naps with my toddler, and played the affirmations aloud on my drive home from work and while I did housework or fiddled around in my clay studio at night. I immediately latched onto the mantra, “this is a new birth and a new baby, unique unto itself,” but I scoffed when I heard things like, “my body knows how to give birth, nice and easy.” One night several weeks into the daily affirmation practice, I had an “aha.” The body that was going to give birth to Sebastian was a totally different body than the one I had labored with before! I began to accept that perhaps this was true, that this kind of birth was possible for me. “I believe my baby’s birth will come quickly, quietly, and without complications.” I began to internalize these thoughts and clear my fears. I soaked up the time with my daughter while she was still the only child. I napped when I could, stocked the freezer and purged our closets, and thought back wistfully on the quiet simplicity of being pregnant the first time!

     The weeks tumbled along and I found myself getting the BPP and NST at 41 weeks just like before, eating fistfuls of dates and whole pineapples and climbing stairs and dousing myself with clary sage and hammering on my pressure points, trying everything short of castor oil. And there I was, getting my membranes swept (again) at 41 weeks and 5 days, hoping the next bout of contractions wouldn’t fade away like so many in the weeks before. I ate a huge lunch and sent Matt back to work after our uneventful appointment that day, then laid down in the guest room to “nap” with my two-year-old and my mom, who had been staying with us since a few days after I was due, just in case. I turned on the Hypnobabies relaxation music, and Ruby tumbled around and giggled and chatted, and my mom kept working on my acupressure points. I laid there trying not to pout, and some light contractions began around 2pm. I didn’t say anything and just ignored them, sure they’d just go away. My mom took Ruby out of the room to let me rest by myself, and soon I was getting restless. I moved to my own bed and started playing the Birthing Day Affirmations just for good measure, and the contractions didn’t relent. I started timing them and realized they were ten minutes apart exactly, lasting a full minute, and had been that way almost an hour! I texted my husband and he immediately replied, “I’M COMING HOME,” and I sent back, “ok, if you think so, no rush.” In my mind I was still thinking it would all just go away!

As soon as I’d hit send, the waves were 6 minutes apart, then 5, and I decided I’d better see if they went away (!) when I walked around. Um, no. I found my mom and Ruby snacking on the back porch; one of them knew exactly what was going on when she saw me, and the other was focused on her yogurt. Matt was home soon, and found me on my hands and knees with my head against the wall in the hallway! I told him not to rush, but that we’d probably better pack our cooler of food.  My mom asked if we had called the Birth Center! Whoops. Needless to say, we didn’t wait for the “ok” to pack up, since we live in North Raleigh and had a 40 minute drive ahead of us! My contractions never slowed while we were on our way, and around the exit for 15-501 I actually said out loud, in my “mom” voice, “Sebastian, you need to SETTLE DOWN. Mommy needs about twenty more minutes!” I vocalized loudly through my waves, gripped Matt’s arm, stared at a spot on the ceiling, and lamented the enormous car seat behind me for making me sit upright. It was about 4 PM when we pulled into WBWC. I had three contractions on my way into the building, and we were whisked into the peach room (where, before transferring to UNC, I had labored for 36 hours with Ruby two years before).

Maureen came into the room with Kristen, the student midwife who I’d met that morning during my sweep, and I hugged Maureen and shouted, “It’s really happening!” Someone asked me if I wanted music playing and I couldn’t even articulate an answer. I realize now that as soon as I was in my safe birthing place, my body got the message and the pace picked up like wildfire. My friend and doula Kacy arrived minutes after us and held me up when a contraction kept me from walking to the bed. Kristen checked me and I was at 7 cm, and I tried not to flail around while I was given the fastest ever dose of IV antibiotics due to being GBS+. Our nurse, Kerry, had to scramble all the way up onto the bed to reach me, and said “I feel like I’m in a pit crew!”

As soon as the IV was out, I was fully in transformation. I ping-ponged around on the bed, pushing my feet and head into the nearest person at each contraction. I can remember completely physically relying on every person in the room at some point, my body weight and grip and force being supported by each of them. I will never, ever forget the next contraction taking over my whole body, kneeling at the edge of the bed, trying to bury myself in my husband’s chest, thinking the words “I don’t know what to do!” but being totally unable to speak. Kacy and Matt prompted me to make low moans (what, was I screaming or something!?), and Maureen started to fill the tub. Then my loud caterwauling was suddenly replaced by near silence in the room as I curled over my belly and started to push. After birthing with an epidural the last time, I kept expecting someone to stop me, check me and tell me it was “okay to push!” but I just kept inching toward the tub in the minute or so between contractions, getting help from the whole birth team to go from all fours on the bath mat and get down fully into the water.

Just a few contractions later, Sebastian’s head was crowning, and I reached down to feel him coming Earthside. Kristen and Maureen swept him up and onto my chest and the tears and laughter and crying ensued! (I think Sebastian was the only one not doing all three!) I couldn’t believe how big he seemed, with his warm, wet, squishy cheek on my chest and his toes past my belly button. Sebastian Christopher Malpass was born on May 11, 2016 at 5:17 PM, 9 pounds 5.5 ounces, and 22 ¼ inches long. He arrived just over 3 hours after the start of my contractions. My mom brought Ruby to meet her baby brother just over an hour later, and Matt and I were carrying our (sleeping!) newborn son into our quiet house exactly 12 hours after my labor had begun.

Two months later, I’m still reeling when I think about this birth experience. In fact, I had a little trouble falling asleep whenever I would lay down in bed for the week or so after Sebastian was born; vivid moments from the birth would replay themselves, and I’d be filled with an excited, electrified feeling. The pace of everything was so quick, but never felt out of control. My birth team supported and attended to me, allowing for a totally mother-directed birth experience. This birth changed the way I think about myself and what is possible for me, and even the way I think about and remember Ruby’s birth. This is what Barbara Katz Rothman is talking about when she says, “Birth is not only about making babies. Birth is about making mothers--strong, competent, capable mothers who trust themselves and know their inner strength.” Ruby and Sebastian’s wildly different births tell one story: of me becoming the mother I am, and all of us becoming the family we are. I’ll never be able to thank WBWC enough for their role in every chapter of our story, and I hope every woman and family experiences this level of care as theirs unfolds.


Birth Announcements



Welcome, Sweet Babies!

*Ellis Turner Smith – May 27 – 7 lbs., 6.5 oz.
*Isobel Magdalen Airey – May 27 – 7 lbs., 7 oz.
Kai Micah Willford – June 3 – 7 lbs., 13 oz.
Isabel Dewberry – June 5 – 7 lbs., 15 oz.
*Walter Eberhard Rosin – June 6 – 7 lbs., 4 oz.
Owen Matthew Fomin – June 6 – 7 lbs., 15 oz.
Iliana Hope Segnere – June 8 –
*Ramona Jane Mebane – 8 lbs., 3oz. – June 8
Leaf Eiffel Hooker – June 8 - 8 lbs.
Charlotte Joanna Ralph – June 8 - 5 lbs., 5 oz.
Samuel Philip Bennett – June 10 - 7 lbs., 11 oz.
Lukas Nathaniel Beazlie – June 10 – 7 lbs., 6 oz.
Tinson Kove Wilson-Houghtalen – June 11 – 7 lbs., 7.5 oz.
Violet Joy West – June 12 - 7 lbs., 9.5 oz.
Skylar Kern – June 12 – 6 lbs., 11.5 oz.
Adeline Towne – June 13 – 6 lbs., 10 oz.
*Caroline Rose Allen – June 16 – 7 lbs., 2 oz.
Ryan Rocky Masse – June 16 – 8 lbs., 2 oz.
Maya Genevieve Kligerman – June 16 – 8 lbs., 9 oz.
Jane Sairfax Preyer – June 16 – 8 lbs., 1 oz.
Hailey Claire Coffey – June 19 – 10 lbs., 3 oz.
*Iris Marie Young – June 19 - 6 lbs., 15 oz.
Mason Michael Marsh – June 20 – 6 lbs., 11 oz.
Avi Maier Guajardo – June 22 – 8 lbs., 3 oz.
Parker Leevi Burns – June 22 – 10 lbs., 2.5 oz.
Ellis Lee Johnson – June 24 – 8 lbs., 1 oz.
Torrance Ezekiel-Eden Dumas – June 24 – 8 lbs., 6 oz.
Lydia McClellan Lobdell – June 24 – 9 lbs., 3 oz.            
Eliora Eunice Nishimwe – June 27 – 8 lbs., 12 oz.
Alexander Luke Heineman – June 28 – 8 lbs., 14 oz.

June Stats:
44 Babies Born
Biggest June Baby: 10 lbs., 3 oz.
Smallest June Baby: 5 lbs., 5 oz.

 To be included in this celebratory list, please email Missy at missy@ncbirthcenter.org 
with your baby's birth announcement information that includes 
their name, date of birth, and birth weight as well as a photo, if available.
If you would like to send us your birth story along with photos,
we are happy to include that in a future newsletter!

Spotlight: Wendy Fields, FNP

WBWC has a new Family Nurse Practitioner! We are excited to annouce that Wendy Fields, FNP, has recently joined our staff.Wendy grew up in the Boston area. She began her journey in women's health after giving birth to her first child in 2000 with the assistance of a certified nurse-midwife in Philadelphia. For Wendy, the experience of becoming a mother was so life-altering that she left her career as a writer and PhD student in English to pursue a career that would come to revolve around partnering with people and communities to improve their health and well-being.
    
   While mostly staying at home with her first two young children, she became a childbirth educator and birth doula. She taught Birthing from Within at her home, and later Prepared Childbirth at UNC Hospitals. She also attended births as a doula at hospitals, homes, and birth centers, including WBWC, after she moved to Durham in 2005. She returned to school for her ABSN degree at Duke University, graduating in 2009, and worked as an RN at UNC Hospitals. She then returned to school and earned her MSN and Family Nurse Practitioner certification at UNC in 2013.

    Her third child was born at WBWC, with Allison and Emily in attendance, in 2012. Prior to joining WBWC, she worked as a family nurse practitioner for two years, providing full-scope primary care to families at the Caswell County Health Department. She joins WBWC thrilled to be "coming home" to the holistic model of health. She is happy to provide all of your primary care needs, whether or not pregnancy is in your future plans. Particular interests include preventive healthcare and wellness, and working with marginalized communities, including people of color, religious minorities, and LGBT individuals. Wherever you are today with your health, Wendy looks forward to walking with you toward better health and more happiness!

New Class at WBWC! Caring for Your Newborn

Women’s Birth and Wellness is now offering a Caring for Your Newborn class for expecting parents! This class is taught by two of our own labor and delivery nurses. Asha Oakes, RN and Emily Slaughterbeck, RN will help you learn the basic baby care you need to know before heading home with your newborn. 

     This is a hands-on class where you will practice diapering, dressing and swaddling. Topics will also include preparing for your baby, you and your baby’s postpartum stay at the birth center, newborn procedures, bathing, safe sleep, basic breastfeeding info, baby communication, meeting your baby’s needs, your baby’s health in the first days and weeks, and taking care of yourselves!

Photo credit: Heart in Hands Photography
     
     This class is offered every other month on the second Thursday of the month from 6:30-8:30 here at the Birth Center. The price of $30 dollars includes mom plus a support person for the individual class, or save money and purchase a class bundle for $100.  The class bundle includes four classes: Breastfeeding Basics, Express Yourself (pumping and bottle feeding), Caring for Your Newborn, and Pass the Puree (starting solids with your baby).  There is a sliding scale for Medicaid/Strong Start Participants. 

You can find out dates and times and sign up for these classes by stopping by or calling the front desk!

What people are saying about the Caring for Your Newborn class:

“The most important part to me was the swaddling and cloth diaper presentation. Great class!”- Class Participant

“I really enjoyed the info about baby communication and swaddling. All of the info in the class was helpful and important!” –Expectant Mother

“I thought this class was well worth the time. Thanks!”-Expectant Father


“The most important part to me was what to expect as soon as the baby is born and in the first few days!” –Class Participant

At the Boutique





Come on by and get some sweet NC gear for your locally-grown baby! These adorable onesies and shirts are made by a mom in Durham.  We've got onesies in size 3-6 months or 6-12 months, and tanks and 3/4 length shirts in size 2T. Fun colors and designs available!

Stop by the Boutique. You won't regret it.