Monthly Archives: August 2013

Go Mediterranean!

Many adults with type 2 diabetes struggle to lose weight and lower their blood sugar. Following a Mediterranean diet may help, concludes a study reported recently in The American Journal of Clinical Nutrition.

Researchers compared the effects of seven popular diets on adults with type 2 diabetes. In addition to a Mediterranean diet, the study’s authors found that low-carbohydrate, high-protein and low-glycemic-index diets—which rank foods by how quickly their carbohydrates turn into glucose—also helped to lower blood sugar in people with diabetes. However, only a Mediterranean diet also led to significant weight loss when followed for at least six months.

A typical Mediterranean diet includes:
• Olive oil: Use abundantly for cooking and dressing dishes.
• Vegetables: Eat at least two to three servings a day.
• Fruits: Eat at least two to three servings a day.
• Beans: Eat three or more servings a week.
• Fish or seafood: Eat three or more servings a week. Fatty fish, such as mackerel, lake trout, herring, sardines, albacore tuna and salmon are good choices.
• Nuts or seeds: Eat at least one serving a week.
• Poultry: Eat sparingly instead of red meat or processed meats. Keep portion sizes small.
• Tomato, garlic and onion: Cook with them at least twice a week.
• Grains: Replace most refined grains with whole grains.
• Wine: Drink in moderation (for those who drink alcohol).

 

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Breastfeeding Month: Breastfeeding difficulties related to having a special care/NICU baby

Jennifer Majors, IBCLC, RN, is a Lactation Consultant at Rex Healthcare. Prior to being an IBCLC, she was a Pediatric RN. Jennifer and her husband have three boys.


When things don’t go as planned: Breastfeeding difficulties related to having a special care/NICU baby

Breastfeeding can be challenging for moms who have perfectly normal and healthy babies, but having a NICU baby has all kinds of challenges. Whether it’s prematurity, blood sugar issues or something entirely different, there are many things you can do to try and ensure that your baby gets the breastmilk and breastfeeding experience they deserve.

Baby Noah meets his brothers Reed and Logan for the first time

My first two sons were healthy and of normal size. We had our breastfeeding issues, but overall things went as expected. Noah, my third son, was found to have severe growth restriction at my 35 week prenatal visit. It was decided that he would be delivered at 36 weeks and 6 days because he would likely grow better outside than inside. He was born via c-section weighing 4lbs 2oz.

Shortly after he was born he began having difficulty breathing and keeping up his oxygen level. He spent 3 days on a ventilator, then some time on cpap, and needed oxygen for a few more days. Once his breathing stabilized, I was able to hold and even nurse him.

Nursing a NICU baby came with many challenges and I’m grateful for the knowledge base and training I’ve had. I often asked colleagues of mine for advice and support through our journey, so I couldn’t have done it without their help. Noah is a happy, busy, and healthy 15-month-old now.

I would like to share some of the things I learned through this process that may help any moms who may go through this or anything similar. There may be some tips to encourage moms who have perfectly healthy babies too!

Jennifer’s oldest son Logan “nursing his baby”

  • The pump is your new best friend if you are separated from your baby!
  • Try to start pumping ASAP, and definitely within 6 hours of delivery when physically possible
  • You should be pumping 8-12 times in 24 hours. If you accidentally have a longer stretch than intended, pump a couple of times more frequently to make up for it
  • When possible, use a hospital grade pump. They are more reliable for establishing and maintaining a good milk supply. Renting one until nursing is well established is a great way to go if it is within your budget. If it isn’t, contact a lactation consult to discuss all options. I used to be skeptical about this one, but I ended up renting a hospital grade pump for a year because it did make a difference. It came with a price, but was certainly worth it!
  • pump at baby’s bedside when possible, often you will find that helps increase the amount you are able to pump. If not, look at pictures while listening to relaxing music or even a tape of some recorded sounds of your baby
  • Try not to “watch” the pump. I would often cover up w/a receiving blanket once the pump was in place. It made it easier to relax and would easily get better output
  • use the highest level of suction that is COMFORTABLE. It doesn’t do anyone any good if it hurts. I found I would start on a low setting but gradually increase to a higher setting as my body got used to the suction
  • Don’t forget to squeeze/massage/compress. You often get better output by doing these. If you find this difficult while double pumping, either invest in a hands free pumping bra or do a search on the internet about how to make your own. The hands free bra was a game changer for me(for the better!)
  • Learn how to hand express. Often in the beginning, moms don’t pump a lot of colostrum out, but can easily hand express. Hand expressing after a pumping session has been proven to also boost milk supply and it is rewarding to see the colostrum and have something to give baby. Here is a great tutorial : http://newborns.stanford.edu/Breastfeeding/HandExpression.html

Jennifer holds Noah for the first time at three days old

  • Skin-to-skin contact; I can’t say it enough. There is so much research that shows this benefits babies in so many ways. If the baby is medically stable and the doctors and nurses are okay with it, then do this all the time. Dad can do it too. Don’t sit at their bedside and hang out. Hold them skin to skin as much as possible. It helps that baby regulate their body systems, vital signs, breathing, temperature and metabolism, and has so many psychological and social benefits. It also encourages breastfeeding when ready.
  • try to wear buttoned shirts, zip hoodies, or cardigans that allow for easy access, but the ability to stay modest if you haven’t already lost all modesty through the childbirthing process

All in all, be patient. Breastfeeding can rock your world and throw your confidence in a way nothing else can. Remember that babies aren’t born with instructions and they have no idea what they are doing yet. If you are dealing with a preemie especially, then expecting them to breastfeed with ease is like expecting a 3-year-old to read a book cover to cover. Celebrate the tiny baby steps and DO NOT EVER let yourself feel like a failure. Show that baby that you are a fighter just like they are and that you can handle difficulties under pressure. Breastfeeding success no matter what depends on patience.

Noah at 4 months

Finally, follow up and get support. I encourage you to ask lots of questions, accept help daily if needed from nurses and lactation consultants. When baby goes home, it doesn’t have to end there. Many pediatricians have lactation consultants on staff who can help you with feeding plans and adjust them as baby grows and gets older. Le Leche League and Nursing Mothers of Raleigh have meetings and telephone support as well. There are also local lactation consultants that can come to your home if needed as well. Check out www.zipmilk.org if you are looking for local breastfeeding resources.

There are many, many more tips and advice for breastfeeding and pumping in addition to this. Here are some of my favorite breastfeeding websites:

Best wishes on your journey into parenthood! Having a special care or NICU baby can be challenging and emotional in so many ways but is also so rewarding to watch your baby overcome and thrive. I have such a great amount of admiration and respect for my youngest son, and a bond with him that is so strong. Spending those 13 days, many for hours on end with him snuggled on my chest is something I consider a blessing that I may not have had otherwise.

Jennifer and her boys

 

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Breastfeeding Month: It takes a village!

Sheri Taylor RN BSN IBCLC CIMI is a Lactation Specialist at Rex Healthcare. She has been a nurse for over 30 years caring for babies and their families. She has been a certified lactation consultant for over 20 years. She and her husband Ken have 2 adult children and one beautiful granddaughter.

As I talk with new families each day, I often hear from new fathers and new grandparents: “There is no way for me to help Mom with the baby. Mom is breastfeeding.”

Nothing could be further from the truth! New moms and babies need the support of their families and friends not only to be successful, but also to feel successful with their breastfeeding experience.

There are lots of ways to make things go more smoothly for mom and baby. Whether you are a new dad, grandparent, family member, or friend, you want to show you care and are excited about the new baby. Here are some possible suggestions on ways you can show support:

  •  Keep Mom and Baby together. Everyone loves to hold babies, and babies love to be held too. But remember that the new baby needs to be with the new mom and dad so they can learn to be comfortable with their new bundle of joy. Ask before picking up the baby, and remember to wash your hands. If the baby begins to show hunger cues such as trying to suck on anything close to his face, by smacking his lips, or by turning towards his mother, give the baby to Mom so she can breastfeed. You may want to offer to give the parents and baby privacy to breastfeed and plan to come back at a later time.
  • Sheri and her granddaughter, Elaine

    Offer to watch the baby while Mom and Dad sleep. This is a great way to be able to admire the cute new baby while sleep-deprived parents catch up on rest. When the baby wakes up, go ahead and change the baby’s diaper and take the baby to Mom. When Baby is finished eating, start over with the baby-watching. (It’s so much fun.)

  • Help Mom get comfortable. Often moms find it difficult to get comfortable when they are nursing. Helping Mom with a footstool, extra support pillows, or blanket rolls. Also keep water or other fluids available for Mom. Most moms are very thirsty when they are breastfeeding.
  • Bring treats for the parents. Call or text Mom/Dad and find out if you can bring them anything. Treats like fresh fruit, breakfast bars, juice boxes, or even Mom’s favorite milks shake are great treats for a nursing mom who is beginning to get hungry or thirsty. If the family is already home from the hospital, offer to bring a meal. Having things prepared and ready to heat in the microwave is a blessing for new families. The last thing they may think about is feeding themselves when mom is so busy with feeding the baby.
  • Sheri’s son, Ben with his daughter, Elaine

    Remember to be encouraging. Every parent wants things to be perfect for their new bundle of joy. Saying things like, “you look so comfortable with your baby” or “your baby looks so content” speak volumes to new parents – especially moms. Remember new babies do eat frequently and they will often cry to communicate to their parents. Avoid questioning baby’s appetite or mom’s milk supply. Mom is probably already questioning these things herself.

  • Offer to babysit older children so Mom and Dad can have uninterrupted time with the new baby. Get the older children involved in household chores to help mom.
  • Ask mom what she needs! Many mothers are so used to doing things on their own that it is hard to ask for assistance. Asking Mom what you can do for her will often make her feel more comfortable receiving assistance and support.

Sheri and her son Ben at the hospital with their family’s new arrival, Elaine

Enjoy having a new baby as a part of your family, extended family, and network of friends. Show you care by supporting mom’s choice to breastfeed her baby. Your support can make the adjustment to having a new baby much easier.

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Happy Breastfeeding Month! Subscribe to the Rex Pregnancy Newsletter today if you are expecting or have a family member who is expecting!

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Breastfeeding Month: Power to the Pump

Robin Deal, BSN, RN, CCE is the Perinatal Services Manager for Lactation Services at Rex and has over 34 years of nursing experience in women’s health.

There are many questions about breast pumps, insurance and the Affordable Care Act. Unfortunately, there are no clear answers. Each insurance company is different, as companies grandfathered in under specific regulations are not required to provide one.

Since August of 2012, insurance companies have developed policies to be compliant in providing breast pumps for new mothers. Each company has taken this to mean something a little different. Here are some tips to help you ask the right questions when you talk to your insurance company about your specific benefits.

Use these guidelines to help you decide about a breast pump purchase or rental:

  • Each insurance company is different in the type of pump they provide, and you may or may not have a choice in the type or brand of pump you want
  • Most companies only pay for a hospital grade pump (rental) if the baby is separated from mom
  • Some companies only allow a mother to order a pump after delivery, which means you may not have it at home before you deliver
  • Certain companies require you purchase a pump from a specific provider of medical equipment
  • Generally, pumps purchased at retail stores are not covered under insurance plans
  • If you buy a particular type of pump, your company may not fully reimburse you
  • Check to see if there is a deductible to meet or if it has been met
  • You may be able to upgrade but your cost may be more and reimbursement less
  • Most companies require a prescription for the pump, a diagnosis code, and procedure code in order to file your claim with your insurance carrier. Diagnosis codes and prescriptions can only be provided by your doctor or primary care giver.
  • Ask if prior authorization is required and what the steps are
  • Insurance companies may provide you with a list of places providing durable medical equipment (DME) but not all of them sell breast pumps. Ask them for only the ones who sell breast pumps
  • Pump replacement parts and accessories are not usually a covered benefit
  • Outpatient consultations may only be covered by a certified lactation consultant if they practice under the direction of a physician or within the hospital
  • Always check with your insurance company about benefits related to breast pumps and lactation consultations once you leave the hospital

Before purchasing a pump, review your policy to know what your benefits are. Then call your insurance company and ask detailed questions about the purchase process. Use the tips above as a guide to forming your questions. The Rex Lactation Station staff can be reached at 919-784-3224. We are happy to answer your questions!

Subscribe to the Rex Pregnancy Newsletter today if you are expecting or have a family member who is expecting!

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Destined for Obesity?

Prevent your child from packing on the pounds
Not too long ago, obesity and related conditions like high cholesterol, high blood pressure and diabetes were problems only adults had to worry about. But with about one in five children carrying extra weight, today’s kids are facing the same serious health issues as their parents and grandparents.

Behind the weight gain

In rare cases, medical problems such as endocrine disorders may cause a child to be overweight. And some kids may be genetically predisposed to gain weight. But most children aren’t destined to be fat. More often, an unhealthy diet and an inactive lifestyle are to blame.

Slim-down solutions

If you’re concerned about your child’s weight, talk with his or her pediatrician or ask for a referral to a nutritionist. You can also try a few of these lifestyle adjustments:

  • Stock up on staples. Offer a wide variety of healthy foods so children can pick and choose which foods they like. Keep the fridge stocked with apples, low-fat cheese and other easy-to-eat foods. Or take your children grocery shopping. Involving them in the experience can make them feel like they have more control over what they eat.
  • Make it a family affair. Don’t single out an overweight child by making him or her eat healthy fare while the rest of the family has burgers and fries. You should all be eating healthy foods. Be a role model!
  • Turn off the TV. Eating in front of the television encourages mindless noshing, and spending too much time watching cartoons or playing video games takes away from active pursuits. If your child loves video games, suggest interactive games that get players moving.
  • Let there be snacks. Allowing children small snacks such as fresh or dried fruit, nuts, low-fat yogurt and air-popped popcorn is a great way to add nutrients to their diets and prevent overeating at mealtimes.
  • Slow it down. Teach them to eat slowly and watch for the stomach’s “full” signal. With this in mind, don’t force children to clean their plates.
  • Skip the rewards. Don’t reward children with candy for good behavior. Likewise, don’t attempt to curb bad behavior with the promise of a favorite dessert.
  • Don’t hold back. Unless your pediatrician says otherwise, never limit the amount of food children eat—it could interfere with their development.
  • Go outside. Take walks as a family after dinner, play catch or miniature golf or do something fun together. Experts recommend an hour of activity on most or all days.
  • Be supportive. Let your children know that you love them no matter what.

 

For more great ideas about how you can get your kids active and eating right, check out the National Heart, Lung, and Blood Institute’s “We Can!” website.

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