Tag Archive for: motherhood

How to Set Yourself and Baby up for Breastfeeding Success During COVID-19

 

Author: Carrie Miller, Ph.D., RN, CNE, CHSE, IBCLC, Seattle University-College of Nursing | Editors: Negin Nia, Arrthy Thayaparan (Blog Coordinators), and Kiranjot Jhajj (Blog Reviewer) 

Published: May 6th, 2022

We exist because someone fed us when we were born. In the beginning of our lives, our caregivers make the best decisions possible on our behalf. A newborn is influenced by the environment that they are born in, and COVID-19 can impact that, whether they like it or not. So, how can the breastfeeding relationship thrive as we continue to battle the COVID-19 pandemic? 

Birth Practices

The goal is for labour to be as safe as possible for the birthing parent and the baby. No matter how delivery occurs, it is essential there is time for the baby and parent to bond, feel safe, and protected. Birth practices vary globally, and giving birth is intimate, personal, and remembered forever. Hospital and Birthing Center policies are intended to protect and maintain safety, but we have to carefully consider the impact of these practices. 

In March 2020, COVID-19 was declared a pandemic. Birthing parents were isolated without adequate labour support because of fear of transmission. Parents and newborns were separated if the parent was COVID-19 positive or suspected to have the virus. Hospitals and Birth Centers scrambled to change policies out of safety concerns. COVID-19 policies removed trusted support from the labouring person’s side and reduced their ability to be part of the overall decision-making process.

There are four tenets any parent needs to consider before giving birth: being able to know what to expect during labour and delivery, having trusted support persons in attendance, being cared for by skilled and competent caregivers, and being part of the decision-making process. So, what is essential to get breastfeeding off to the best start with COVID-19 around?

Golden Hour

The first moments of life set the tone for the next several days, weeks, and months. The Golden Hour is when a medically stable infant is placed on the birthing parents’ chest right after birth. Throughout Golden Hour, a newborn will self-regulate heart rate and respiratory rate and stay warm against a birth parents’ chest. The first feeding at the breast can also take place during this time. During the height of COVID-19, babies were separated from their birth parents if there was a confirmed or suspected diagnosis. 

If a parent is COVID-19 positive, an infant can still be placed on the birthing parent’s chest if the parent is well enough. Currently, the Centers for Disease Control and Prevention recommends being masked if an infant is placed skin-to-skin.The American Academy of Pediatrics recommends maintaining normal couplet care [parent-infant dyad] with confirmed or suspected COVID-19 status. However, policies are constantly changing given the evolving knowledge around COVID-19.

Breastfeeding

The current recommendations recognize the importance of providing human milk to infants during COVID-19. The World Health Organization’s current recommendation is to initiate breastfeeding no matter what the COVID-19 status is. The Centers for Disease Control and Prevention reports breastmilk is not likely to spread the virus to infants. If a lactating parent chooses to breastfeed, handwashing and wearing a mask is strongly recommended. 

Furthermore, if a parent chooses to provide pumped milk, a trusted caregiver should provide the pumped milk to the infant if the lactating parent is COVID-19 positive. Parents can also discuss options with caregivers about protective practices. These include having someone help to care for the infant if needed, rooming-in with the infant, using good handwashing, wearing a mask when providing care to the infant, and staying six feet away whenever possible.  

The possibility of transmitting COVID-19 through breastfeeding is uncertain. However, multiple studies such as ones by the American Academy of Pediatrics and Reproductive Health Journal suggest that the risk is low. The science also reveals that the benefits of breastfeeding outweigh the risk of not breastfeeding. Breast milk provides antibodies to protect a newborn against disease. The first feedings with colostrum establish the immune system, which is what protects the baby from the beginning well into childhood and ultimately adulthood. Colostrum contains the key immunologic components to establish the immune system and gut as it is rich in protein and nutrient-dense. 

The first feedings to the newborn are small. The newborn has a tummy the size of a cranberry for the first few days, so a teaspoon can be a full feeding on day one. By day three of life, the newborn has a tummy as big as a ping pong ball and can most likely take about an ounce in a feeding. A newborn does not eat on a schedule either, so one must watch for feeding cues. A newborn may eat 6 to 8 times on the first day and may want to eat 12 times on the second day. 

So, what can you do if a birthing parent needs to be separated from a newborn? Well, you can hand express or pump breastmilk. Even if you are COVID-19 positive, your colostrum and breastmilk are essential for a baby to have a good start. 

Conclusion

A nourished newborn sets the tone for the future. Providing colostrum and human milk to an infant can create a pathway to a healthy start. The journey may be different than planned, but having a solid start is possible, no matter the circumstances. Even with COVID-19, the breastfeeding relationship can thrive if you take the right steps. 

Behind the Science with Bonnie Lee

Authors: Arrthy Thayaparan and Alex Lukey (Blog Coordinators) Interviewing: Bonnie Lee, PhD Student, UBC 

Published: December 25th, 2020

At the Women’s Health Research Cluster, we strive to close the gaps in communication and knowledge between the public and scientific community. As such, our newest blog series, Behind the Science, will take a sneak peek into the world of science through a series of interviews with some amazing women’s health researchers. We hope that this series will spark interest in the general public and young students by understanding the journeys of these researchers

So we’re starting off with a BANG and introducing our very first interviewee! She is a future leader in the study of women’s health and a beloved colleague of the WHRC team. As a graduate neuroscience researcher at UBC, her work primarily looks at the impacts of motherhood and Alzheimer’s on cognition and the ageing brain. 

If that didn’t make any sense to you, then not to worry! The following interview will simplify the research, whilst also breaking down misconceptions of the research field. Without furtherado, it is our pleasure to introduce Bonnie Lee

How did you become interested in women’s health research?

So I guess I first became interested in women’s health research when, in my undergrad, I realized that none of my courses really talked about sex differences. Like how different phenomena that we’re studying may be different, or even the same in males or females. It’s kind of been ignored or glossed over.

During undergrad, I was working on a research project that looked at sex differences in the relationship between stress and neurogenesis. That’s kind of how I stumbled into the world of sex differences. Then in my fourth year, I took a course with Dr. Liisa Galea on neuroplasticity. She brought up a lot of interesting ideas about sex differences and women’s health, which really opened my mind and got me fascinated about women’s health research.

Then, of course, later on, being part of Liisa’s lab as a grad student even furthered my interest as I learned more about the intricacies and nuances of women’s health research.

Why do you think we need to focus on women’s health?

Well, I think just the woman’s lifespan is so interesting. From the menstrual cycle to pregnancy and motherhood to menopause — there is so much we have yet to learn about these life events. Even besides that, so many diseases are more prevalent or more severe in females. There’s so much we don’t know about those topics. 

We all know someone who gave birth — like your mom, for example. So the fact that we don’t know much about [women’s health], it’s just crazy. Speaking of diseases that are more prevalent in females, my research is focused on Alzheimer’s disease. It is known that females have a greater lifetime risk of Alzheimer’s disease, but more intriguing to me is the fact that pregnancy and motherhood play an interesting role in the manifestation of the disease — with earlier onset, more severe pathology in the brain, and so on, in women with previous reproductive experience. It makes me wonder, why is that? And I think it’s not just about women’s health, right? The fact that we are able to learn something about why it’s more prevalent in females will tell us more about the disease in general. We’ll know more about different treatment options. So it’s not just going to benefit women, it’s going to benefit everyone, including men.

How did you decide to research Alzheimer’s, like in the scope of all possible diseases? 

I was always interested in Alzheimer’s disease. A little personal background, I used to volunteer in a senior home where I played piano for them every weekend. I became really close to a senior who had Alzheimer’s disease. I guess that kind of put a seed in my brain and made me want to learn more about the disease.

I think a lot of people can relate because it is a really prevalent disease — many have family members or friends who might have been diagnosed with Alzheimer’s or experienced taking care of someone with Alzheimer’s disease. When I realized all the sex differences and long-term effects of pregnancy and motherhood in relation to Alzheimer’s disease, I think that’s when I really felt like this is something I want to dive deeper into and try to figure out why.

So, what drew you to neuroscience and to study the impacts on motherhood, especially?

So this goes all the way back to first year. In my first year, we had something called Imagine Day at UBC. My leader was actually a neuroscience major. I never knew that you could major in neuroscience at UBC! When I first got in, I thought “Okay, I’m going to be in science, I’m going to learn either chemistry or biology or physics.”  I was actually interested in psychology, too, though, in high school. I always wanted to learn more about the brain so after finding out there’s a major for that, it was no brainer for me [pun intended]. So I did my undergrad in neuroscience, and then the rest is history.

How would you explain your research if you were explaining it to a second-grader?

So Alzheimer’s disease is a brain disorder that impairs cognition and your brain. I am interested in looking at females who were either pregnant or not pregnant, and then how Alzheimer’s disease affects their brain and their cognition in middle age.

Do you have any early findings? Or any interesting leads yet?

Yeah, we do. But it’s a bit more complicated, so it’s not going to be for the second-grader. We found some differences that have to do with the APOE epsilon 4 (APOEe4) allele, which is a genetic risk factor for late-onset sporadic Alzheimer’s disease. 

The rats that had the genetic risk for Alzheimer’s disease made more errors in the spatial working memory task compared to healthy wildtype rats – which is what we expected to find. What’s interesting is that there were differences in search strategies in the memory task between groups of rats that had been pregnant vs never pregnant. Basically, the rats that had been pregnant before were less efficient than rats that had never been pregnant before. This shows the long-term effects that pregnancy can have on the brain, which is always exciting to see. We also found differences in neurogenesis and neuroinflammation measures between the groups. APOEe4 rats (the rats that had the genetic risk) had more neural stem cells but fewer new neurons in the brain compared to wildtypes — suggesting that perhaps their neural stem cells weren’t very active in the sense that they didn’t become new neurons, or maybe they became something else, like astrocytes or other neural stem cells. On the other hand, rats that had been pregnant saw the opposite effect: they had fewer neural stem cells but more new neurons compared to rats that had never been pregnant. This could mean that rats that had been pregnant had neural stem cells that were really active and were able to become new neurons. I won’t go into any more detail here, but if anyone has any follow-up questions or anything, they can email me anytime [bonnie_lee@psych.ubc.ca].

So, what stage of research are you in right now? 

So my first chapter, I guess, my first big experiment has been done. I am dealing with brain samples now and processing the tissue to finish up analyses of different measures. Specifically, I have been looking at measures of neurogenesis, neuroinflammation, and a little bit of tryptophan metabolomics as well. So just finishing up those analyses. I am hoping to start my next chapter in January, where we will be looking closer at sex differences this time and differences between rats with either APOEe3 or APOEe4.

What makes you excited about the future in women’s health research?

I think things like the Woman’s Health Research Cluster. The WHRC is helping diverse and multidisciplinary trainees and researchers find each other and collaborate on new projects, which is really exciting. I am looking forward to seeing what kind of research comes out of those collaborations. 

I am also really hopeful about the fact that the cluster is targeting a wide audience. We don’t just involve trainees and researchers, but also policymakers, patient partners, health practitioners … getting the public involved and making them aware that women’s health is important. I think that is a huge step and an important one.

Practicing knowledge translation in science is still new to me. But I think it’s so important because you could be doing all this work, but we need people to be aware of the work so it can be applied appropriately. And that way, your research becomes more meaningful, I think.

After talking about your journey, do you have any advice for people just starting or interested in research?

Practically speaking, I would say, do your research. Look into different topics that you might be interested in, but also different researchers and their body of work. Try talking to graduate students and early-career professors. For me, at least, talking to different people and getting their perspective has been very insightful.

Before I started, I used to think, “[research] is so boring, I would never want to do this.” But, as I started to talk to more principal investigators and graduate students, and as I started to become involved in labs as a volunteer, I began to realize what it’s really to be in research, and I began to really like it! So I would suggest talking to people, keeping an open mind, and find ways to get involved in research early on.

Is there something that people can look forward to coming from you in the future? 

I do have a chapter that should be published soon. It is a chapter on the sex differences in neurogenesis and the implications for Alzheimer’s disease, and I wrote it with another member of my lab and the research cluster, Tanvi Puri as well as Dr. Liisa Galea. Yeah, I guess other than that, just more experiments and hoping to publish more papers soon!

Alex and Arrthy (Women’s Health Blog Coordinators) would like to thank Bonnie for taking the time for this interview. To our readers: keep an eye out for more blogs and interviews! If you would like to be featured, please don’t hesitate to reach out to us at womenshealth.blog@ubc.ca!