The use of massage during labor is nothing new. Many tribal cultures throughout the world have traditionally incorporated massage into the birthing process. Nurturing touch during labor has been shown to enhance the laboring woman's mood and ability to cope with labor. In 1997 the Touch Research Institute at the University of Miami conducted a study and on the effects of massage during labor. Researchers found that women who received massage during labor experienced decreased levels of anxiety and pain. They needed less medication and their labors were shorter than those of the control group, who received only obstetrical care.


The onset of labor in preparation for birth is an intricate series of hormonal signals and interactions. It is believed that the baby is responsible for initiating labor with the mother's hormones taking over to ensure that labor continues to progress. Two important labor hormones, epinephrine and norepinephrine stimulate uterine muscles to contract. Anxiety in the laboring woman overstimulates the production of both of these hormones, resulting in slow, ineffectual and painful labor. A relaxed woman's hormone levels are more balanced allowing the uterus to be more effective in responding to the body's hormonal signals. In addition to traditional therapeutic massage techniques, Acupressure and reflexology can also be used to help balance hormone levels and stimulate the uterus. The result is contractions that are strong, rhythmic and effective. Body positioning is also important in encouraging the progression of labor. Standing, squatting and sitting are positions that maximize the use of gravity for the laboring woman, and help open up the pelvis in preparation for birth. However, with the use of epidural anesthesia, the laboring woman loses the ability to utilize these various birthing positions.

If a woman desires to birth naturally, without the use of pain medication, how does she endure the pain that accompanies labor? Massage serves as a distraction to labor and contraction pain. It is believed that flooding the brain with pleasurable sensations will help to override pain signals from the uterus. Massage can be very effective between and during contractions. Acupressure points can be utilized during contractions to decrease the level of pain. The time between contractions can be used to massage tired, clenched and cramping muscles. Managing pain during labor decreases the need for epidural anesthesia and therefore the need for later medical intervention.

Epidural anesthesia administered during the early stages of labor doubles the likelihood of a cesarean section. Because massage during labor has been shown to decrease the need for epidural anesthesia, it may also aid in preventing an unnecessary cesarean section birth. Epidurals also decrease the pushing sensation during delivery and therefore the use of forceps and vacuum extraction becomes more likely.

If a cesarean birth is deemed medically necessary prior to the onset of labor, massage can also be beneficial in preparing for the event. The days and weeks prior to surgery may be filled with stress, anxiety and fear of not knowing what to expect. Massage can play a very important role in helping moms cope with these emotions and help in gaining a sense of empowerment.

Massage for the laboring mother can be performed by a massage therapist or by the woman's partner. Partners can consult with their massage therapist prior to the onset of labor and then use the learned techniques from the moment labor begins up to the time of delivery. It is important to remember that a laboring woman's response to touch is unpredictable and may change at any time throughout labor. Open and honest communication with the therapist or partner is essential during the entire laboring process.


References:
Osborne-Sheets, Carole., Pre-and Perinatal Massage Therapy, Body Therapy Associates, San Diego, CA, 1998.

Stillerman, Elaine, LMT, Mother Massage, Dell, New York, NY, 1992.

Field, T., Ph.D.; et al., "Labor Pain is Reduced by Massage Therapy" Journal of Psychosomatic Obstetrics and Gynecology, Vol. 20, Dec 1997

Originally posted on CharloteMommies.com

I met Donna Gilbert at my very first La Leche League meeting in Raleigh, NC in 2007. Since then, she has always been warm and welcoming, and able to answer any questions I have. Despite having two previous failed nursing relationships, Donna and the LLL allowed me to nurse my third child for two years, and my youngest, who was MUCH like my first (refused to nurse) for a year. Thanks to the success she enabled in my own breastfeeding experiences, I decided to interview her in hopes that other nursing mothers can benefit from her knowledge.

When did you decide that you wanted to help other women successfully breastfeed?
I thought about [it] when I realized how little support there is. It was a natural thing for me to want to help. Both my parents are ministers, so I grew up in a home where helping people was akin to breathing. It’s what I do. I guess you could say it’s in my genes.

How long did you breastfeed your own child?
Do you really want me to answer this question? Perhaps it would scare people. lol Well, I think she nursed much like an infant for about 4.5 years. I know it wasn't really like an infant, but at times it felt like it was that intense and that often. Between 4.5 and 5 it decreased to nothing. She basically weaned during that time.

Who was the most positive influence in your life, pertaining to helping other moms?
Helping mothers in particular? I can still remember how wonderful it felt when a La Leche League Leader told me how smart I was. I was about 5 months pregnant and completely unsure of myself. I was a very reluctant mother and it was those few comments she made that gave me a little bit of hope. I’m sure I’m not the only mother out there who felt that way and I would like to do that for other moms.

What are some websites or other resources that you point moms to when they need their questions answered?
I absolutely love Dr. Jack Newman’s website and videos. A picture is worth a thousand words. DrJackNewman.com

How often and how long should baby nurse?
Babies are just like other people when it comes to eating. Some people eat quickly and some people eat slowly. Some people like a few big meals and some like to nibble all day. Your baby may have just gotten the milk flowing and you think it’s time to change sides because you are looking at the clock. So the real answer to this question of how long should my baby nurse is this: Let your baby suck until they are satisfied. If they seem fussy, try compressing your breast to see if you can help the flow a little and once baby is done on that breast, either because they aren’t getting any more milk or aren’t getting it quickly enough, or because they’ve fallen asleep, then you switch sides. Your baby will let you know when they want to eat and when they want to stop eating. In the early days, if baby is awake, offer your breast. They only have so much energy and all of that energy should be geared to survival – in this case, breastfeeding. As they get older, they will spend more and more time discovering the world around them.

A newborn’s tummy is very small, especially in the early days, so it takes very little to fill them – only about 1 teaspoon on days one and two. By day three, baby’s tummy can hold almost an ounce and by day ten, baby’s tummy can hold about 2 ounces. This is why a baby nurses so often, especially at first.

How do I know my baby is getting enough to eat?
First and foremost check is to see that your baby has a good latch and is swallowing. You should see or hear your baby swallowing. Their ears will wiggle slightly while they are nursing and their lips will be turned out. Your breasts should feel softer after you feed your baby.

If your baby is gaining weight steadily after the first week of age, is passing enough clear or pale urine (about 6 wet diapers per day after the first two days), and is having about 3 bowel movements a day, is having short sleeping periods and wakeful, alert periods, your baby is likely getting plenty of milk.

It’s important to note that it is common for babies to lose some weight right after birth (up to 10% of their birth weight), so you needn’t be concerned. Keep nursing them and they should have regained that weight by day ten. Most babies gain from 2/3 to 1 ounce per day during the first 3 months.


What does a breastfeeding mother need to succeed?
Support.

When is the best time for breastfeeding to start?
Within the first hour after birth.

What is the best breastfeeding position?
Whatever position is the most comfortable for you and your baby. I will often get mothers to do a few swallows with their head in a different position to demonstrate how difficult it is to swallow if you are not looking straight ahead. Go ahead. Try swallowing with your head turned one way or the other, or with your head tilted up or down. Difficult, right? Remember that when you are positioning your baby to nurse. Another interesting thing I noticed is if I hang my head face down and open my mouth, my jaw falls forward and my tongue naturally falls down to the floor of my mouth. That is the position you want your baby’s jaw and tongue to be in when they nurse. If I tried to do that sitting up or lying on my side, it’s much harder. Many moms find nursing in the early days is much easier if baby is lying face down. Find a place where you can recline far enough back so that gravity will hold your baby on your chest. Put baby between the breasts. The baby will wiggle themselves toward the breast and all mom has to do is help them out a little by sliding their bottom to one side and the baby virtually latches themselves. It’s called laid-back nursing and you can check it out here: biologicalnurturing.com

What can Dad do?
Offer support. That’s the most important thing he can do. You need someone beside you at 3 am who will remind you that this is a learning curve, not to give up too soon, and most importantly, give you a hearty and reassuring “you can do it”!

Dad can also spend special skin-to-skin time with baby while mom takes a bath or a shower, burp and change baby, and basically anything and everything else!

What can I do before my baby is born?
Get good prenatal care. This can help you avoid early delivery which makes breastfeeding harder. Get as much breastfeeding information as you can. Take a class or two and attend a support group for nursing moms. Take a class from a lactation consultant. Then you can establish a relationship before the baby comes and you may not be so hesitant to ask for help when you need it. Talk to your doctor and/or lactation consultant about any breast surgery or chest injury you may have had. Make sure your doctor knows you intend to breastfeed your newborn and would like to do that within the first hour of life.

Can I breastfeed even if I am sick?
I suppose we should define ‘sick’, but generally, yes. If you are sick, your breast milk will have antibodies that will help protect your baby from getting the same sickness. There are very few exceptions. For example, radiation therapies require a temporary break from breastfeeding.

Can I take medicines if I am breastfeeding?
Yes, with a few exceptions, cancer chemotherapy agents being one of them. Check with a lactation consultant, La Leche League Leader or with “Medications and Mothers’ Milk”, a book by Thomas Hale found in bookstores and libraries. You can also go online to http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT

Some medications have a drying effect on breast milk, such as some over the counter cold medications and allergy medications, so you will want to use those sparingly if possible.

Do I have to restrict my sex life while breastfeeding?
No. If vaginal dryness is an issue, try more foreplay and water-based lubricants. You can feed your baby or express some milk beforehand so your breasts will be more comfortable. If your breasts leak, put pressure on the nipple and have a towel handy to catch the milk.

Do I still need birth control if I am breastfeeding?
Breastfeeding can delay the return of normal ovulation and menstrual cycles. This is called lactation amenorrhea method, or LAM. Like other forms of birth control, it is not 100% effective. LAM is 98% effective in preventing pregnancy during the first 6 months only if the infant is exclusively breastfed, the interval between feedings is less than 6 hours and the mother has not resumed menstruation. The use of pacifiers and infant formula are associated with an earlier return to menstruation.

Barrier methods, like condoms, do not contain synthetic hormones and therefore do not interfere with milk production.

Estrogen can decrease milk production. Progestin can decrease milk production if introduced before a mother’s milk supply is established. Most manufacturers recommend waiting at least 6 weeks. A trial period of taking the oral medication is preferable to having more potent procedures like injections so you can stop taking them if you notice a decrease in your milk supply.

Do you have anything else to say to new or expecting moms, or moms that want to try to nurse again, after not having such a great experience with previous children?
Yes! Give it a try! Every pregnancy, every baby and every breastfeeding experience is different. Gather as much information as possible and do your best to find a support group. Believe it or not, support is the number one predictor of success. If you can get past the learning curve of 6 to 8 weeks and establish your milk supply it is well worth it for the ease that follows.


Donna has a Diploma in Dental Hygiene (1986) from Dalhousie University in Halifax, Nova Scotia, Canada, and she is an International Board Certified Lactation Consultant (2009). She has had personal experience breastfeeding and she has coached births. She has been a La Leche League Leader since 2004 and is a retired leader with Attachment Parenting International.

Originally posted by Becka from SaratogaCountyMommies on The Mommies Network National Blog, 3/25/11

Pregnancy is a time of physical and emotional transformation. Besides the obvious physical changes, the myriad emotions a pregnant woman experiences can often leave her feeling confused, overwhelmed, stressed or anxious. With so much attention focused on the arrival of the baby, moms-to-be often overlook the importance of nurturing their physical and emotional needs. Massage therapy is a safe, effective way to nurture mom and baby through a very special time.


Massage can be effective in relieving many of the common physical complaints experienced during pregnancy. Morning sickness, joint and muscle pain, headaches, constipation, heartburn, leg cramps and fluid retention are some of the classic complaints that can be alleviated through massage.

It is estimated that nearly 80% of all pregnant women experience morning sickness. It is extremely common during the first trimester of pregnancy and can range from a very mild moment of queasiness to recurrent vomiting. Acupressure can be safely and effectively used to alleviate the feeling of nausea. This technique can be learned and then used anytime nausea occurs.

Other common complaints during pregnancy are joint pain and muscle soreness. This is largely due to the added and redistributed weight. With the added weight concentrated in the abdominal area, a woman’s center of gravity shifts, and it results in postural changes that impact the hip and low back area. It is also common for pregnant moms to experience joint pain in other areas, especially in the knees and feet. Massage helps to alleviate these aches and pains by gently stretching and releasing tight muscles. It also enhances circulation and the delivery of oxygen and blood to the affected areas.

Constipation, gas and heartburn are also inconveniences that pregnant moms often contend with. The relaxation effect of massage stimulates the parasympathetic nervous system, which translates into increased digestion and intestinal movement.

Massage can also help alleviate leg cramps, headaches and excess swelling. The movement of blood, lymph and metabolic wastes is stimulated by massage and is put back into circulation where it can be eliminated by the body.

Stress plays a significant role in how a pregnancy progresses as well as the birth itself. If a mother perceives a situation as being stressful, her body reacts by releasing stress hormones, which cross the placenta. A 1999 study done at the University of Kentucky College of Medicine in Lexington indicated that the fetal heart rates of stressed mothers remained higher longer, suggesting a heightened reaction to stress. Continued exposure to stressful situations during pregnancy has been shown to negatively impact birth weight and may lead to pre-eclampsia and pre-term labor. Studies also show that when pregnant women receive massage, the urinary output of stress hormone levels decrease. Massage has an overall calming effect on mother and baby.

Overall emotional health of pregnant mothers is extremely important. Some mothers may experience anxiety during pregnancy. Maternal anxiety and depression during this time has been shown to have negative postnatal impacts. These feelings in new mothers are often associated with feeding problems, and mothers perceive their babies as being fussy and more demanding. According to a study done by the Touch Research Institute, women who received massage while pregnant reported reduced anxiety, improved mood and better sleep patterns.

Traditional oriental therapies such as Shiatsu and Acupressure can also be very effective in use throughout pregnancy, childbirth and during the postpartum period as well. These therapies are based on Traditional Chinese Medicine theory and influence the energy meridians (pathways) in the body. It is believed that when the body's energy (chi) is blocked or imbalanced in some way, pain and disease results. A massage practitioner who employs Shiatsu or Acupressure techniques helps to restore energetic balance in the body, thereby alleviating physical as well as emotional discomforts. The practitioner should have advanced training in these modalities for use during pregnancy.

Massage therapy can be an integral component of pregnancy and childbirth. Research has shown us that pregnant moms who receive massage have fewer physical complaints, suffer from less pain during labor, give birth to calmer babies, and experience less postpartum depression. Massage can be a safe and effective method of treatment for the many emotional and physical issues surrounding pregnancy. It will undoubtedly contribute to mom experiencing a happier and healthier pregnancy. It is also a priceless gift for the baby to come!


References:

Elaine Stillerman, L.M.T., Touch for Happier, Healthier Pregnancies, Massage Magazine, September/October 2000.

Field, T., Ph.D.; et al., Pregnant Women Benefit From Massage Therapy, Journal of Psychosomatic Obstetrics and Gynecology, Vol. 20, March 1999

{Originally posted on CharlotteMommies}