Breastfeeding is Wonderful! . . . And Sometimes Hard

Genevieve Neeley with her three children.

Genevieve Neeley with her three children.

When I was pregnant with my first child there was no question of whether I would breastfeed. At the time I had been a nurse practitioner in the Neonatal Intensive Care Unit (NICU) for over 6 years, so I had naturally become a strong believer in breast milk and breastfeeding. We practically treat breast milk like liquid gold in the NICU because it is so beneficial for our tiny and fragile population. I also knew from my experience in the NICU that breast milk production and breast feeding could have its challenges. It turned out I was one of those moms who would be challenged – with each of my three kids.

In November 2010 my first child was born. At first it seemed she was hungry all the time, and I worried my breast milk supply was not satisfying her. It was frustrating. So I pumped and supplemented with bottles of either breast milk or formula. I’m not sure now if she actually needed it, but at the time I certainly thought she did. During my 24-hour shifts I would pump in place of breastfeeding. I was prone to clogged ducts during those days, so I would rush home in hopes that breastfeeding or a strong breast massage in the shower would help clear the duct before I got mastitis (breast tissue inflammation). I remember thinking during those times that I understood why people quit breastfeeding. It can be hard. But I stuck with it, and breastfed my baby 14 months.

Twenty-one months later my second little one made his appearance. This time I believed things would be easier. This was, after all, my second kid. Surely I got the kinks worked out with the first one. Sure enough, my milk came in and it felt much better than before (yes!), but then I start getting cracked nipples. This type of pain is incredible. The last thing you want to do is allow your newborn to latch onto your sore nipples, yet they still need to eat every two-three hours. I remember closing my eyes and clenching my fists in pain at the start of every breastfeeding session. And the shower! You finally get a few moments to enjoy a shower, but the water hurts almost as much as breastfeeding. I seriously contemplated quitting, but I persevered. And it paid off. My son, 7 lbs at birth, was 19 lbs at 4 months – exclusively from breast milk. Incredible! He breastfed until 15 months of age.

My third child was born almost exactly a year ago. While she has been a joyful addition to our family, the breastfeeding struggles were the same. My milk supply was definitely the best it had ever been, but I went through a month or longer with very sore, cracked and bleeding nipples again. Baby also was unable to get milk from the breast very well in her first month of life. So I breastfed, pumped, supplemented with a bottle and visited the Overlake Mom & Baby Care Center and my pediatrician regularly to check her weight. This time I thought it was all the pumping that would do me in. Still, I knew there was a light at the end of the tunnel, in spite of all the work! I kept on and by two months of age she was breastfeeding exclusively. Whew!

Don’t get me wrong. I didn’t write this as a message that everyone must breastfeed. I have many friends who for one reason or another were unable to breastfeed at all or only for a short period. Rather, I want to encourage those of you who may encounter challenges with breastfeeding. Persistence can pay off. Once these problems were resolved I was able to enjoy breastfeeding. As the babies became more social it is such a special time to bond with them. The time spent breastfeeding becomes mutually enjoyable – a special time for just mom and baby.

Editor’s note: If you or someone you know experiences these or other problems associated with breastfeeding, please contact a lactation consultant, as most nipple pain can be easily resolved. Modern nipple shields make is possible for women with cracked nipples to heal and breastfeed at the same time. Additionally, when the baby has trouble latching or getting milk from the breast, there are things a lactation consultant can recommend to painlessly help both mom and baby. The Mom & Baby Care Center at Overlake Medical Center can help. Make your appointment by calling 425.688.5389.

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Follow the Milk

When mom’s milk isn’t available, Overlake Medical Center’s Neonatal Intensive Care Unit (NICU) uses donated human milk to help critically-ill premature babies.

We’d like you to know about the journey that donor milk makes before it can be given to our fragile preemies.

The Overlake NICU uses donor milk from Northwest Mothers Milk Bank (NWMMB) in Portland, OR. NWMMB partners with the Human Milk Banking Association of North America (HMBANA), which follows strict guidelines established by the FDA and CDC for processing donor milk. Overlake is also a depot for moms to drop off donations if they qualify.

First, potential donors have a phone screen with staff at the milk bank to share a brief health history and determine if any factors might prevent donation, such as a recent blood transfusion or taking certain medications or supplements.

If approved to move forward, moms have blood work done similar to what’s done for donating blood. Moms pack up their frozen surplus breast milk and drop it off at a depot such as Overlake .

The depot freezes and then ships the milk to the nearest milk bank (Portland, in our case), where it is stored until results from mom’s lab work confirm her milk is safe to use.

Milk banks then pasteurize all donated milk. Donations are pooled from several donors to make a batch big enough to process. Bacterial cultures are taken from random samples after pasteurization to assure no contamination occurred in processing.

After that, the donor milk is refrozen in small bottles appropriate for feeding volumes of preemies. When hospitals like us request the milk, it is shipped frozen on dry ice from the bank to us for feeding our fragile NICU babies.

Donors are not paid for their milk donations through HMBANA. But because supplies of donor human milk are in such demand, HMBANA pays for all donor blood work and any shipping costs to get milk to the bank. HMBANA then charges hospitals $4-6 per ounce to cover processing costs.

Thanks to donors everywhere for making this generous gift available for feeding fragile babies who don’t have mother’s milk!

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Overlake Designated a Breastfeeding Friendly Washington Hospital

Breastfeeding Friendly Washington logoAt Overlake, we encourage and support each woman’s decision to breastfeed. We are happy to share that our commitment was recently recognized by the Washington State Department of Health, which named Overlake a Breastfeeding Friendly Washington Hospital.

Breastfeeding Friendly Washington is a new initiative encouraging organizations to promote and support breastfeeding through changes in their policies and procedures. The voluntary program celebrates the commitment organizations are making to ensure future generations are the healthiest ever. Overlake received bronze-level recognition on Sept. 21, 2016.

Babies who are breastfed are at less risk for infections, Sudden Infant Death Syndrome (SIDS), chronic conditions, asthma, obesity and ear infections, according to the Centers for Disease Control and Prevention. Breastfeeding also benefits the child’s mom, who has a lower risk of Type 2 diabetes, cardiac disease, certain types of breast cancer and ovarian cancer.

Physicians, nurses and other Overlake providers are working diligently to create the healthiest next generation by establishing best practices when caring for moms and babies. One way we do this is by following the World Health Organization’s 10 Steps to Successful Breastfeeding, which are endorsed and promoted by the major maternal and child health authorities in the United States. Since adopting these recognized best practices, we are seeing many more mothers achieve their goals to exclusively breastfeed.

The 10 steps are:

  1. Have a written breastfeeding policy that is routinely communicated to all healthcare staff.
  2. Train all healthcare staff in the skills necessary to implement this policy.
  3. Inform all pregnant women about the benefits and management of breastfeeding.
  4. Place babies skin-to-skin with their mothers for 60 minutes immediately after birth and help mothers recognize and respond to feeding cues.
  5. Show mothers how to breastfeed and how to maintain lactation even if they are separated from their infants.
  6. Give infants no food or drink other than breast milk unless medically indicated.
  7. Practice rooming-in to allow mothers and infants to remain together 24 hours a day.
  8. Encourage breastfeeding on demand. Teach mothers cue-based feeding regardless of feeding method.
  9. Give no artificial nipples or pacifiers to breastfeeding infants.
  10. Establish a system for referring mothers to out-patient and community support.

We are committed to continue this work for our patients and our community. Join the conversation! #HealthiestNextGen

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We Love Our Animal Babies, Too!

Isolette in new home at the zoo.

The pictures show the zoo’s lab/nursery where the isolette will live and a stuffed animal as a prop to show off the zoo’s newly acquired item.

On Sept. 1, 2016, the Overlake Medical Center NICU donated an older isolette to the Seattle Woodland Park Zoo. (An isolette is an incubator for premature infants, and since we recently upgraded ours, we had one to donate). The zoo will use it the same way we did —to keep small ones warm when they can’t maintain their temperature. Rita, a longtime NICU nurse who recently retired, gave zookeepers directions on how to use the isolette properly. We have a promise from the zoo that they will send us a picture when they put an actual baby animal in the isolette. We can hardly wait!

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Ava’s Birthday Gifts

Ava's Birthday GiftsLast month, NICU graduate Ava returned to Overlake Medical Center to celebrate her 10th birthday.  She brought 25 gift bags to be handed out to our current NICU (neonatal intensive care unit) patients’ mothers. Each gift bag came with a note from Ava that read:

“On July 25, 2006, I was born at Overlake Hospital and I spent the first two weeks of my life here in the NICU. I know that it is difficult when you have a baby in the hospital and so to celebrate my 10th birthday I wanted to do something special. I hope you will enjoy this bag that will have some essentials you might need. I had many friends and family donate and I want you to know that we are thinking of you. With love, Ava” (She signed each one.)

It brought a big smile to Ava’s beautiful face to personally give a bag to the mothers who were here when she visited; they, too, were touched by her generosity.

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Save the Date for the 2016 NICU Reunion

The Overlake NICU staff is busy planning the 4th Annual NICU Reunion. It will be held Sunday, September 18, 2016, from 1 – 4 p.m. We all look forward to seeing our graduates with their parents and siblings!!!

Please join us for a little food, lots of fun and renewed friendships!!

NICU - heart-small


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Happy World Breastfeeding Week!

intl_india_andrea_Gore2_103_4x3-breastfeeding-momAugust 1-7, is World Breastfeeding Week, which provides a great opportunity to celebrate and consider the myriad advantages of breastfeeding.

Did you know breastfeeding benefits the baby, mom and society? Here are just a few benefits to breastfeeding, according to

  • Babies who are breastfed have a lower risk of a number of health conditions, including asthma, obesity, ear infections and Type 2 diabetes.
  • Moms who breastfeed their babies have a lower risk of Type 2 diabetes, cardiac disease, certain types of breast cancer and ovarian cancer.
  • Breastfeeding saves money. Breastfed infants usually need fewer sick care visits, prescriptions and hospitalizations, and you don’t have to purchase their meals at the store.
  • Breastfeeding is better for the environment. Formula cans and bottle supplies create more trash and plastic waste. Your milk is a renewable resource that comes packaged and warmed.

If you or someone you know needs help breastfeeding, contact Overlake Mom & Baby Care Center Lactation Line: 425.688.5516.

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Helping Children Create a Positive Relationship With Food

The development of lifelong eating habits begins in infancy. Children who have a positive relationship with food struggle less with poor food choices and body image concerns.  The Division of Responsibility is an approach to raising healthy eaters developed by Ellyn Satter, a renowned Registered Dietitian Nutritionist and Family Therapist.

The Division of Responsibility is tailored to a child’s developmental stage. Parents and children are responsible for different aspects of feeding, and children assume more responsibility as they age. Infants choose feeding times and volumes, while parents select breast milk or formula. Parents of toddlers are responsible for offering balanced meals and snacks at regular intervals, and the child is allowed to determine what food items they would like and how much. In addition to giving children autonomy of choice, Satter also recommends occasionally offering chips and sweets to prevent children from prioritizing them over other foods.

Satter’s approach to feeding capitalizes on children’s innate ability to regulate their food intake and gradually accept new foods. Studies have shown some infants adjust how much formula they drink depending on the calorie concentration. The higher the calories, the less volume they take in. On average, children must be exposed to a new food 10 times before they will choose to taste it, and possibly a few more times before they accept it. The process is slow, but when children experiment with new foods at their own pace they develop a positive relationship with food and gravitate toward balanced meals.

Whether you are just starting to plan your approach to feeding, or are currently embroiled in conflict at the dinner table, Ellyn Satter has a multitude of resources to help. Free information is available through The Ellyn Satter Institute.

Other good resources include Fearless Feeding and Creating Healthy Eaters.

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We’re updating our space!

We always want the very best for our patients and their families–you deserve it! That’s why we are updating the entire Childbirth Center with new flooring, new paint, new fixtures and a remodeled lobby.

We are working on the unit in sections, so if you are visiting us within the next two months, you may notice some parts of the floor look different from others. So far, we’ve completed the lobby renovation and a couple of the patient hallways. In these next several months we will continue the updates.  The contrast between old and new is easy to see, and we’re so pleased with the fresh new look. We hope you like it, too.

Thank you for your patience during this project that will last until October. Overlake remains committed to your experience throughout this renovation, while also building toward the upcoming Project FutureCARE and an entirely new Childbirth Center in 2020.


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Pelvic Floor Therapy

You may have heard about or even experienced physical therapy (PT) for back, shoulder, knee and foot issues, but have you heard of PT for your pelvic floor?

Many women suffer from pelvic floor pain after giving birth. Some women have pain even before they get pregnant. Injury to the pelvic floor muscle can lead to leaking of urine, feces or pelvic joint pain over a period of time.

Your Pelvic Floor – Why it Might Hurt

Your pelvic floor consists of the group of muscles between your hips, which cradle your bladder, uterus and rectum. After giving birth, those muscles are sometimes injured or torn and can be tender. Pain in this area can also be from spasms and scarring following birth. Additionally, women may also experience pain during sex.

Pelvic Floor Therapy to the Rescue

The good news is that there are trained PT professionals—pelvic floor therapists—who specifically treat pelvic floor dysfunction including pain in the vagina, leaking and pelvic joint problems (also known as pelvic girdle pain). A pelvic floor therapist can help you stay healthy and pain-free before, during and after pregnancy. During pregnancy, she can treat pelvic, back, shoulder and foot pain. Some women see a pelvic floor therapist during late pregnancy for help stretching the pelvic floor muscles in preparation for birth.

Therapy treatments vary based on your particular circumstances. You may only need pelvic floor exercises (often called Kegel exercises), which often require specialized instruction to be done correctly. Or, treatment can be much more extensive, including pelvic floor massage and pelvic girdle joint treatment using various PT techniques. More advanced treatment, especially if you have sexual pain, involves working with you and your partner to help reduce sexual pain to meet your intimacy goals.

Finding Help

If you think you would benefit from pelvic floor therapy, ask your health care provider for a referral. Overlake has several  physical therapists trained as pelvic floor therapists who can help.

You might also consider taking a Pelvic Floor Fitness class geared specifically for expectant and new moms. For more information, contact Family & Community Education at 425.688.5259 or send an email.

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