“You don’t need to go on a special diet or be overly restrictive in order to breastfeed, but you should be intentional about your nutritional choices and be aware of foods to avoid when breastfeeding,” said Elizabeth M. Doyle, M.D., lactation consultant and internal medicine physician and pediatrician at Norton Community Medical Associates – Shepherdsville.

Foods to avoid when breastfeeding

Fish

Seafood contains traces of mercury or other toxins, and even though fish is a great source of protein and omega-3 fatty acids, seafood that is high in mercury (including swordfish, king mackerel and tilefish) should be avoided. Too much exposure to mercury is bad for babies and can affect the development of their nervous system. According to the Food and Drug Administration (FDA), it is safe to eat seafood that is low in mercury a couple times a week, including salmon, tuna and shrimp.

Highly processed foods

When babies get all of their daily nutrients through your breast milk, eating a healthy and balanced diet is imperative. Highly processed foods should be avoided when breastfeeding because they lack fiber, vitamins and minerals and often contain too many calories, added sugars and unhealthy fats. Avoid consuming too many sugary drinks, prepackaged foods, frozen meals and desserts.

Caffeine

Caffeinated drinks should be limited to no more than 16-24 ounces per day. Caffeine can cause sleep disruptions and cause the baby to become overly fussy. Caffeine can be found in coffee, tea, soda and chocolate.

Alcohol

Any amount of alcohol in breast milk is considered unsafe. If you know you are going to have a drink, pump breast milk ahead of time. Otherwise, wait for the alcohol to pass through your system before breastfeeding. As a rule of thumb, wait at least three hours after drinking one alcoholic beverage.

Some herbal supplements

Most herbal supplements are not FDA-regulated. Talk to your provider before taking optional medications, such as herbal supplements, vitamins or herbal teas. Seasoning food with kitchen herbs and spices is OK while breastfeeding. Your provider may recommend a specific type of multivitamin to aid in milk production.

Making healthy choices when breastfeeding

Focus on a balanced diet that includes lean meats, eggs, dairy, beans, whole grains, fruit and vegetables. Varying the types of food you eat can change the flavor of your breast milk, which exposes the baby to different flavors before introducing solid foods.

The post Foods to avoid when breastfeeding appeared first on Norton Healthcare.

“We already know that patients who breastfeed have a lower risk of developing breast cancer, Type 2 diabetes, hypertension and rheumatoid arthritis,” said Elizabeth M. Doyle, M.D., system medical director for lactation services at Norton Healthcare and an internal medicine-pediatrics provider at Norton Community Medical Associates – Shepherdsville. “Heart disease is this country’s leading cause of death, so having this confirmed is very important news.”

The study looked at other research involving more than 1 million patients who had ever breastfed, and found those who breastfed had 11% fewer cardiovascular events, a 14% reduction in coronary heart disease, 12% fewer strokes and 17% fewer fatal heart issues. The research also suggested that the longer breastfeeding occurred, the greater the reduction in risks.

Heart disease in Kentucky

Nationally, heart disease is the leading cause of death for women. Kentucky ranks 43rd out of 47 states reporting data for deaths due to heart disease for those identifying as women. Kentucky reports that 4.8% of women ages 35 to 44 have cardiovascular disease, compared with 3.3% nationally. The only states with higher percentages are Alabama, West Virginia, Louisiana and Arkansas. Data was not available for Alaska, New Jersey and North Dakota.

The commonwealth also is one of the worst in heart disease death rates per 100,000 people, with a rate for women of 397.5 for data from 2017 to 2019. Black women in Kentucky saw a higher rate of death (444.6) compared with other races, but were below the national rate (455.8). The death rate for white women in Kentucky was 399.4, compared with 348.3 nationally.

Additional research has shown that a patient having preeclampsia, gestational hypertension, gestational diabetes mellitus, placental abruption, preterm birth and stillbirth are associated with an increased risk of cardiovascular disease and death from cerebrovascular issues.

“With high rates of heart disease already, and additional risks during pregnancy, breastfeeding can play an even more important role in improving patients’ health after childbirth,” said Lyndsey D. Neese, M.D., OB/GYN with Norton Children’s Maternal-Fetal Medicine and medical director of quality for women’s services at Norton Healthcare.

Kentucky breastfeeding facts

According to the Centers for Disease Control and Prevention’s 2020 Breastfeeding Report Card, which is published every two years and reflects data from 2018, the number of patients in Kentucky who have ever breastfed has increased 4.6% over the previous report that reflected 2016 data. But that still leaves Kentucky 47th out of 52 (50 states plus the District of Columbia and Guam). In Kentucky, 72.6 % in 2018 breastfed their infants at one point, compared with the national average of 84.1%. Still fewer — 44.5% — were breastfeeding at six months, compared with the national average of 58.3%.

Breastfeeding benefits for children

Breastfed children have a reduced incidence of ear infections, pneumonia, diarrhea/vomiting, leukemia and diabetes. Breastfeeding at least two months can cut the risk of sudden infant death syndrome (SIDS) in half. In fact, the longer a baby is breastfed, the more protection against SIDS.

“Human milk is species-specific and changes to meet an infant’s needs at every stage,” Dr. Doyle said. “Formula is made from cow’s milk, and it doesn’t contain the same benefits. Breastfeeding is truly an investment worth making.”

Need help with breastfeeding?

While not all babies and moms take to breastfeeding as easily as others, help is available. Norton Healthcare lactation services, a part of Norton Women’s Care, offers one-on-one assistance with breastfeeding issues. Help includes pumping and back-to-work consultations, individual prenatal consultations and assistance with special needs infants. The specialists also can offer advice on feeding multiples and dealing with babies having difficulty gaining weight. In addition, specialists can analyze breast milk for fat and caloric content.

Norton eCare also provides online video visits for breastfeeding support. If you have a MyNortonChart account, you have access to free, face-to-face secure video visits with a provider for breastfeeding help any time of the day or night.

The Baby Bistro & Boutique sells and rents breastfeeding supplies and equipment. That includes breast pumps and parts, breastfeeding bras, and breastfeeding pillows. It is located on the Norton Healthcare – St. Matthews campus and was established with support from the Norton Healthcare Foundation.

The post Study: Breastfeeding reduces risk of heart disease appeared first on Norton Healthcare.

If you are pregnant or planning a pregnancy, you may wonder how the coronavirus/COVID-19 could affect you and your baby. The OB/GYNs, midwives and other staff providing obstetric care with Norton Healthcare are closely monitoring the COVID-19 pandemic. As the situation continues to evolve, patient safety remains our top priority. We have plans and protocols in place that are consistent with recommendations from the Centers for Disease Control and Prevention (CDC), and we continue to update them as needed. Additionally, our obstetric providers are following recommendations from the American College of Obstetricians and Gynecologists.

Does a pregnancy make me more at risk for COVID-19?

According to the CDC, pregnant and recently pregnant people are at an increased risk for severe illness from COVID-19 — including illness that requires hospitalization, intensive care, or a ventilator or special equipment to breathe, or results in death — compared with nonpregnant people. Additionally, pregnant people with COVID-19 are at increased risk for preterm birth and might be at increased risk for other poor pregnancy outcomes.

It’s always important to protect yourself from illnesses while pregnant. If you’re pregnant, you can follow the same precautions as everyone else to protect yourself and prevent the spread of COVID-19. It is especially important for pregnant people, and those who live with or visit them, to take steps to protect themselves from getting and spreading COVID-19.

Can I pass COVID-19 to my baby in the womb or through breast milk?

According to the CDC, mother-to-child transmission of coronavirus during pregnancy is unlikely, but after birth a newborn is susceptible to person-to-person spread. The virus has not been detected in amniotic fluid or breast milk. A very small number of babies have tested positive for the virus shortly after birth. However, it is unknown if these babies got the virus before or after birth.

If I’m pregnant, should I get the COVID-19 vaccine?

According to the CDC, COVID-19 vaccination is recommended for all people ages 12 and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future. The Society for Maternal-Fetal Medicine strongly recommends that pregnant, postpartum and lactating people and those considering pregnancy receive the COVID-19 vaccination. Vaccination is the best method to reduce maternal and fetal complications of COVID-19. Likewise, the American College of Obstetricians and Gynecologists states that that all eligible persons, including pregnant and lactating individuals, should receive a COVID-19 vaccine or vaccine series. Be sure to talk to your OB/GYN or midwife to discuss what’s best for you and your baby.

Do I need to stay away from my baby if I have COVID-19 or think I could have COVID-19?

The risk that a newborn will get COVID-19 from their mother appears low, especially when the mother takes steps such as wearing a mask and washing hands when caring for the newborn. Discuss with your health care provider the risks and benefits of having your newborn stay in the same room with you.

Should I breastfeed if I have COVID-19?

Current evidence suggests that breast milk is not likely to spread the virus to babies.

You, along with your family and health care providers, should decide whether and how to start or continue breastfeeding. Breast milk provides protection against many illnesses and is the best source of nutrition for most babies.

Should I keep my prenatal and postnatal appointments?

Your prenatal and postnatal care is important for your health and your baby’s. We urge all pregnant patients who are well to attend their appointments. If, however, you are pregnant and have symptoms of possible coronavirus infection, call your OB/GYN or midwife for advice. You may need to delay your routine visits.

Can someone come with me to my prenatal and postnatal appointments?

Please refer to our visitor policy for the latest information before you visit.

It’s time to go to the hospital. Will my delivery be affected by visitor policies?

We understand the unique need of families during the birth of a child. Please refer to our visitor policy for the latest information before you visit.

Coping with stress

A pandemic can be stressful for everyone. Fear and anxiety about a disease can be overwhelming and cause strong emotions in both adults and children. Coping successfully with stress will make you and the people you care about stronger.

Depression during and after pregnancy is common and can be treated. Postpartum depression is depression that can happen after having a baby. If you think you may be experiencing depression, seek treatment from your health care provider as soon as possible. Find more information on depression during and after pregnancy.

The post Coronavirus and pregnancy: What you need to know appeared first on Norton Healthcare.

In March 2019, Abbey learned she was pregnant. She worked with Kathryn Kersting, M.D.,  OB/GYN with Advocates for Women’s Health, a Part of Norton Women’s Care, during her entire pregnancy, including delivery. Abbey called her pregnancy “textbook,” with no issues. She knew she wanted to breastfeed, but as she did research about it, she began to feel anxious.

“I would read things, and I was like — I know I want to breastfeed, but I’m just going to wing it, and I’ll get there when I get there,” Abbey said.

Breastfeeding journey uncovers tongue-tie issue

According to Abbey, daughter Adalynn was born in November 2019 without complications, at Norton Women’s & Children’s Hospital. Abbey began her breastfeeding journey soon after. Adalynn had trouble latching on one side, so lactation consultant Natalie Brown, R.N., IBCLC, RLC, worked with Abbey to address the issue.

“She helped me learn how to use the nipple shield,” Abbey said.

Abbey went home from the hospital feeling confident about breastfeeding. However, she was experiencing a lot of pain. She had never planned to pump, as she wanted to nurse exclusively, but in talking to Adalynn’s pediatrician, they suggested that Abbey pump and offer Adalynn pumped milk afterward to see how much she would take. In doing so, Abbey said she experienced an overflow of breastmilk.

“I thought everything was fine,” Abbey said. “But I was in a lot of pain, and I thought that’s how it was supposed to be, without having done this before. Two weeks after Adalynn was born, I went to my OB to get checked, and she saw what my nipples looked like. They looked like they had holes. And she was like, ‘Oh my gosh, no! This isn’t right.’”

Abbey’s obstetrician referred her to lactation consultant Tina Martin, LPN, IBCLC, RLC. Tina performed a functional  breastfeeding assessment and weighed Adalynn before and after a feeding to see how much milk she took in. In working with Tina, Abbey learned Adalynn was experiencing breastfeeding difficulties from a posterior tongue-tie. A tongue-tie, also called ankyloglossia, is fairly common, affecting about 5% of newborns. A tongue-tie is more common in boys and frequently runs in families.

With a tongue-tie, the frenulum (stringlike tissue that attaches the tongue to the floor of the mouth) is tight, short or thick and can impede the tongue’s movement. The tongue can be  prevented from sticking out past the gums, look heart-shaped, or have difficulty  lifting up to the hard palate. A tongue-tie can pose issues for breastfeeding, because a baby may not be able to open their mouth wide or extend the tongue enough to adequately cup the breast tissue. Also, the tongue’s tightness may keep the baby from doing the necessary movement required to create a vacuum for removal of milk from the breast.

“In December, we got her tongue clipped. I remember the doctor telling me, ‘You might not notice a difference right away; it sometimes it takes a few weeks to see a difference because they’re not used to it, they have to exercise it,’” Abbey said. “At first, I didn’t notice a difference, except she kept making this clicking sound even more because she didn’t know what to do with her tongue. But soon after, she was a completely different baby, just amazing at nursing.”

In January 2020, Abbey returned to see Tina.

“She showed me exercises that I can do to help [Adalynn] figure out what to do with her tongue,” Abbey said. “And I mentioned to her that I wanted to wean off of the pump. So we talked and she told me to just cut out one pumping session at a time and go longer periods between pumping. I did that, and it took me two months to completely wean off of the pump, where I was exclusively nursing. And I got to donate 3,000 ounces that I had stored that [Adalynn] didn’t use. I was able to finally exclusively nurse without the pump, and her tongue-tie was fixed.”

While weaning off of the pump, Abbey needed extra support as she became concerned about a suspected clogged milk duct or mastitis.

“I got my first clogged duct, and I woke up at four o’clock in the morning with it, and I was freaking out thinking it was mastitis,” Abbey said. “I called my OB/GYN office’s after-hours line and I spoke to Regina Mash APRN, CNM, certified nurse midwife with Advocates for Women’s Health] for 15 or 20 minutes. She suggested that I try gravity nursing, where you kind of go over top of [the baby] and let her do it. And the clogged duct was gone within 30 minutes. I remember I talked to Tina pretty late one night because I thought that I was getting a fever or a clogged duct at one point. You can call in the middle of the night and talk to somebody if you need to, which is an amazing comfort.”

For other mothers, Abbey suggests finding out what your OB/GYN’s office offers in terms of lactation consulting.

“It was a support system for me,” Abbey said. “Everyone’s different, and some people have issues and others don’t. Know what resources there are to help you, so that if you need that help in the middle of the night, you can get it.”

Adalynn is approaching her second birthday, and according to her mother is very independent.

“She started crawling at 5 months old, and ever since then when she learned she could do things herself, she just goes,” Abbey said. “She won’t touch a bottle, so I think weaning her might pose a challenge. I’m definitely not complaining; it’s what I wanted.”

The post Lactation consultants help mom achieve breastfeeding goal appeared first on Norton Healthcare.

Just in time for National Breastfeeding Month, Baby Bistro & Boutique is marking its fifth anniversary of providing advice, supplies and support to breastfeeding moms.

Moms and their families can buy and rent breast pumps and parts, breastfeeding bras, breastfeeding pillows and many other breastfeeding supplies. Mothers also can make an appointment with a lactation consultant for one-on-one assistance with any issues they’re having breastfeeding.

To ensure safe access to breastfeeding supplies and lactation consulting services during the coronavirus outbreak, we have modified our operations at Baby Bistro & Boutique on the Norton Healthcare – St. Matthews campus. Now you can prepay for your items over the phone with your credit card and wait in your vehicle outside the store, and we will bring them out to you. To rent a hospital-grade breast pump, call (502) 899-6530. Baby Bistro & Boutique is open Monday through Friday, 8 a.m. to noon and 1 to 4 p.m.

What makes Baby Bistro & Boutique special

• Convenient one-stop shopping for breast pumps and parts, breastfeeding bras, nursing pillows and many other items that make life easier for breastfeeding moms
• Certified lactation consultant available by appointment to answer questions and teach new moms to use breast-pumping equipment
• Breastfeeding services, including individual counseling, breast milk analysis to determine fat and calorie content, and follow-up for infants having trouble gaining weight
• Services for moms with special needs, such as feeding multiples, hearing impairment, vision impairment or needing interpreter services
• Services for babies with special needs

Outpatient lactation services for moms and babies who need extra help

Here’s what you need to know about making an appointment with our certified lactation consultant:

• You will need to request from your physician an appointment to see the lactation consultant to address any issues you may be having with breastfeeding.
• Arrive with your baby 15 minutes before your appointment to register.
• From Dutchmans Lane, take Entrance 3 to Norton Healthcare – St. Matthews campus.
• Pull up to the doors marked Labor and Delivery (Norton Medical Plaza 3 – St. Matthews).
• Enter and proceed straight ahead to the elevators.
• Take an elevator to the second floor to the Labor and Delivery waiting room.
• Register for a lactation services (breastfeeding) visit at the Labor and Delivery registration desk.
• Return to the first floor and follow the signs to the Baby Bistro & Boutique. It will be on your right off the elevator and past the information desk.
• Enter and tell the clerk that you have an appointment for lactation services.
• If the Baby Bistro & Boutique is closed, call (502) 559-1733 and wait by the information desk.

The post Baby Bistro & Boutique celebrates milestone in offering breastfeeding supplies and help appeared first on Norton Healthcare.

According to Jamil T. Elfarra, M.D., maternal-fetal medicine specialist with Norton Children’s Maternal-Fetal Medicine, while this study adds to the ongoing literature about COVID-19, the prevailing opinion at this time is that there is little risk of transmission.

“There is some emerging evidence that babies may be affected,” said Dr. Elfarra, who treats patients considered at high risk for pregnancy complications not necessarily related to the pandemic. “But I also want to point out that there are a few things that we have to keep in mind. The majority of the data that is out there is showing that there is little risk of transmission to the baby. However, as further studies emerge, we will have more knowledge and understanding of how this virus truly affects pregnancy and vigilance and caution at this time remain key.

“Also, mom having the virus does not necessarily mean the baby’s always going to get the virus. The other thing is that babies, even if they get it — it doesn’t mean that they’re going to have long-term complications. And that’s something that we still don’t know and we’re looking at.”

The study from Italy comes just as the Centers for Disease Control and Prevention (CDC) released a study stating that pregnant women may be at an increased risk for severe illness from the coronavirus, compared with women who aren’t pregnant, including increased risk for intensive care unit (ICU) admission and needing a ventilator.

“I want to stress that even though the data is showing that there’s an increased risk that moms need to go to the ICU to be monitored more carefully, that doctors in general look at the pregnant population very differently,” Dr. Elfarra said. “We have a much, much lower threshold to place pregnant women in observation, knowing that there are two patients, mom and the baby, and knowing the risks of pregnancy itself.”

Should pregnant women take extra precautions against COVID-19?

“I recommend that patients should be very vigilant, irrespective of what trimester they are at,” Dr. Elfarra said. “Our goal is to prevent the virus from getting to the mom in the first place.”

Precautions include going to their prenatal appointments as advised, as well as wearing a face mask. Constant hand hygiene and social distancing are key.

“We encourage washing their hands very frequently, maintaining social distancing, and also only going out and socializing with the people that they absolutely have to socialize with, and going to the things that they absolutely need to go to within reason,” Dr. Elfarra said. “Because this outbreak has been going on for a prolonged period of time, and people need to adapt and cautiously go back to their basic life needs.”

Dr. Elfarra emphasized to those who live with and are part of a pregnant woman’s community, their actions are important to protecting them, too.

“If you’re in contact with someone pregnant, you need to stick to wearing masks when you’re near them and make sure that you have washed your hands,” Dr. Elfarra said.

According to Dr. Elfarra, having an open line of communication with your OB/GYN or midwife to share your fears can help no matter which trimester you are in.

“For our pregnant patients, I want to reassure them that we as health care providers are always there for them,” Dr. Elfarra said. “The line of communication is open. They can relay any fears — anything that they’re worried about, they need to communicate to us.”

The post COVID-19 transmission risk for moms and babies appeared first on Norton Healthcare.

What should you do if you are breastfeeding and have COVID-19 symptoms or a confirmed infection?

• Wash your hands before touching your baby.
• Wear a cloth face covering, if possible, while feeding at the breast.
• Do not put a face covering on any child under age 2.
• Wash your hands before touching pump or bottle parts, and clean all parts after each use.

“Breast milk is still the best source of nutrition for babies and can protect against many diseases,” said Kristina A. Bryant, M.D., pediatric infectious disease specialist with Norton Children’s Infectious Diseases, affiliated with the UofL School of Medicine. “While it appears that transmitting the coronavirus to a baby while feeding with breast milk is unlikely, you should take precautions. One option is for a mother to express breast milk and have a healthy caregiver feed it to her baby until her own infectious period ends.”

If you are breastfeeding and suspect you have COVID-19 or have had confirmation through a nasal swab test, your baby should remain in isolation with you for the duration of your isolation period and for 14 days after that, according to the CDC. The same applies to a baby who has had any other ongoing close contact with a suspected or confirmed COVID-19 patient.

It is still important for your newborn to be seen for all recommended medical visits, so inform your doctor that your baby has potential risk for COVID-19 when making the appointment — so the office can take appropriate precautions.

Premature babies often are fed pasteurized breast milk from a donor. While there is no information available about what pasteurization does to the coronavirus, similar viruses are inactivated through pasteurization, according to the CDC.

And, remember, do not put a mask on a child under age 2.

The post Breastfeeding and coronavirus: What you need to know appeared first on Norton Healthcare.

The latest data show that 73.9 percent of Kentucky mothers have breastfed at some point, an increase from 66.9 percent in the previous report card, released in 2016.

Six months after giving birth, 48.6 percent of Kentucky moms are still breastfeeding, an increase from 35.3 percent in the previous report.

Kentucky lags behind many states

Arkansas, West Virginia, Louisiana and Mississippi were the only states with lower rates of mother who have ever breastfed. The study looked at all 50 states plus the District of Columbia, U.S. Virgin Islands and Puerto Rico.

“I’m encouraged that we have seen a 7 (percentage point) increase in the number of women who are at least starting their babies off by breastfeeding,” said Elizabeth M. Doyle, M.D., director of lactation services for Norton Healthcare. “The report also shows that more women are still breastfeeding their babies at 6 months — a fantastic increase.”

Breastfeeding helps mother and baby

Studies show that breastfeeding has numerous health benefits for baby and mother. Breastfeeding can reduce ear infections, pneumonia, diarrhea/vomiting and sudden infant death syndrome. It also decreases a mother’s risk of breast and ovarian cancers, as well as diabetes, high blood pressure and heart disease.

A study even discovered that more than 800,000 children’s lives would be saved worldwide each year if nearly every mother breastfed her baby at birth. Studies also have shown that breastfeeding in the first hour of life is crucial for baby.

“It’s incredibly important that we do everything we can to support mothers who wish to breastfeed,” Dr. Doyle said. “That means providing any assistance they may need, whether it’s simple words of encouragement, professional advice from a lactation consultant or even time to pump while at work.”

Norton Healthcare provides several resources to help breastfeeding mothers. Lactation consultants are on hand when babies are born in a Norton Healthcare hospital, and appointments are available through the Baby Bistro & Boutique at Norton Women’s & Children’s Hospital on an outpatient basis. The Baby Bistro & Boutique also offers breastfeeding supplies, breast pumps and help for mothers with special needs.

In addition, Norton eCare offers 24/7 breastfeeding support through video visits for a wide array of breastfeeding questions and concerns.

The post Breastfeeding jumps among Kentucky women appeared first on Norton Healthcare.