Interview with NüRoo Pocket founders

As co-founders of NüRoo, Hope and Daniela have 8 kids between them, are certified by the US Institute for Kangaroo Care (USIKC) and passionate about attachment parenting. Hence the tagline of their brand, "Closest to Mom. Best for Baby."

Hope, Daniela, and their eight children

Q: Tell us about you..

Our path to parenting couldn't have been more different. Hope struggled with conceiving and found her way through IVF, adoption and in the end natural child birth. Daniela became a mom to her husband's 1, 4 and 6 year olds prior to delivering their last two daughters. Our families are big, boisterous and nothing short of inspiring. Among the madness, we found each other and found NüRoo from our shared passion for the tie between mom and baby. Society does a good job making us second guess our intuition, and ironically medicine has further complicated the natural process. Instinctively, innately, we KNOW how to care for our babies, and our bodies are equipped with all the tools needed to do so.

Q: What made you think to create the NüRoo Pocket?

Hope: I was introduced to the practice of skin-to-skin contact by a nurse midwife at my time of delivery. Following the birth of my daughter, Elle was immediately placed on my chest, and my midwife began telling me all of the amazing physiologic benefits that skin-to-skin offers. I learned that in order to give and receive all of these advantages, she needed to be on my skin for an uninterrupted 60 minutes. That seemed reasonable until I arrived home and was greeted by my two very excited three-year-olds. I needed something that could help me give my baby the benefits of skin-to-skin, but allowed me to be active with my family.

Daniela: When Hope shared her thoughts for the Pocket, I couldn't stop spouting off ideas. I too practiced Skin-to-Skin for the benefits offered to me and my babies but not nearly as much as I wanted to. I loved the promise of the product and envisioned a brand designed to offer early advantages and foster the bond between mom + baby.

The NüRoo Pocket helps baby transition from the womb to the outside world.

Q: How did you go from concept to finished product?

Over the course of a sleepless 9 months, we conducted countless test fits with moms and newborns, using their feedback and working with a seamstress to perfect our design. We took the final prototypes to an industry veteran to help us land at the right factory . There are so many things to consider (price, standards compliance, labeling, quality of construction, turn around time, duty fees, etc.) that working with someone to guide you through this process is invaluable. To those mompreuners in the making, if you don’t have existing relationships that can help with this, seek out a sourcing agent who can see you through.

Q: You refer to Skin-to-Skin Contact as a "practice" -- why is that? 

Believe it or not, there's a right and wrong way to do it. The benefits of skin-to-skin are derived from stimulating the c-afferent nerves. There are a lot of misconceptions around this. Not all skin-on-skin contact delivers the same benefits (i.e.: baby across mom's belly or their cheek to her chest). Because there's a proper position and suggested duration of time, skin-to-skin Contact is intentional and thus said to be a "practice."

Simply by holding baby vertically on your bare chest, you enhance your baby's immunity, improve sleep and weight gain, and stabilize their heart rate and breathing, all while speeding your own recovery time, reducing your risk for postpartum depression and increasing your milk supply. The benefits begin immediately with less crying/colic and temperature regulation. During the 60 minutes after the birth, skin-to-skin contact accelerates your baby's brain development.

The newborn stage is coined the 4th trimester because of how immature baby is. The American Academy of Pediatrics recommends skin-to-skin immediately after birth until the first feeding and throughout the postpartum period. 40 years of research tells us that skin-to-skin should happen for as often, as long, and as frequently as possible.

Q: With 40 years of research behind the practice, why now?

As you've said, "institutional inertia" is all too common. (Daniela): "With my delivery in 2009, baby was separated immediately after birth for routine procedures then placed skin-to-skin until the first breastfeeding. The benefits of Skin-to-Skin weren't talked about. Thankfully, with the baby friendly initiatives, the surgeon general's call to action and the CDC's recommendation for Skin-to-Skin, hospitals are finally implementing new protocol. After the birth of my youngest in 2011, my baby was immediately placed on my chest and the benefits of skin-to-skin were explained in the mom + baby unit."

In an effort to drive awareness, we're on a mission to educate both moms and providers. We're attending key national organization conferences (ILCA, ACNM, USLCA, etc.) and have met and spoken with amazing women doing tremendous things for the well-being of mom and baby. We're collaborating with those trying to evoke change. There is a direct correlation between skin-to-skin and breastfeeding rates in relation to initiation, duration and exclusivity ties. The research speaks volumes, and finally our nation is responding. Every mom wants what is best for her baby. Once she has the knowledge, the product gives her the time.

Stay tuned for my review of the NüRoo Pocket in a few days!

Ivy is 3 months!

We're enjoying grandparents and cousins for the next week and a half. Zari, Dio, and Inga are collapsing at night, exhausted from full days of riding bikes and scooters, jumping on the trampoline, catching butterflies (Zari), and playing nonstop with cousins.

Ivy is such an alert, curious, and interactive baby now. She smiles and vocalizes and has made some noises that are getting close to laughs.

She is super strong and super wiggly. A few nights ago, I woke up to nurse her. She was on the floor next to the bed (not enough room on the queen bed at my parent's house). She had wiggled down a few feet, turned 90 degrees, flipped over onto her stomach, and somehow put a blanket over her head. All while secured snugly in her straightjacket swaddle wrap. And I had placed rolled-up towels on either side to keep her from rolling over!

She always wants to stand up and watch what's going on. Some of the cousins were watching Planet Earth today. I sat her in the corner of the couch, and she stared at the screen, transfixed. Now she knows a lot about penguins and polar bears.

She definitely knows who her parents are! She fusses if I hand her over to my sister (which is hilarious, because she also has 4 kids and adores babies). First Ivy will get a pouty face, then her lips will quiver, and then she will start crying. As soon as Eric or I scoop her back up, she's fine again. 

She's started grabbing onto things: hair, clothes. She also clings on to me. I love her little "hugs." She loves taking baths, often in the kitchen sink and sometimes with her siblings. She loves sitting on our laps, too. 

Review of Ameda & Medela breast pumps

Until recently, I've been using an Ameda Purely Yours double electric breast pump. It's an old hand-me-down pump from a friend, loaned to my sister for a while, and then mailed back to me. Despite its age, it still performs perfectly.

I have the no-frills pump only version that retails for around $160. You can also buy the pump with a backpack or carryall; both come with lots of accessories. A One-Hand Breast Pump adapter (around $20) lets you turn the pump into a hand pump.

The Ameda Purely Yours pump runs on AC power and does not have battery backup. You can adjust both the suction and the cycle frequency. The cycle frequency can be set at 30, 40, 50, or 60 cycles per minute. (Cycle frequency, or how many times the machine pumps per minute, turns out to be crucial in expressing milk efficiently. More on this later.)

The Ameda breast pump has a sealed system. It has a silicone diaphragm that slips inside the top of the flange part. This means that no liquids, mold spores, or bacteria can get from the pump into the tubing/motor or vice-versa.

You can unplug one of the tubes and pump just one breast at a time. I sometimes did this during morning pumping sessions when Ivy is nursing on the other side. I now double pump right before I go to bed.

The Ameda pump has very few parts and is easy to clean: silicone diphraghm, pump flange, valve, and bottle. You can machine wash the flange and bottle. I usually hand wash the valves.

One of the pump flanges started to crack last month. Not bad considering many, many years of use.

Pros of the Ameda Purely Yours:

• Reliable design that lasts for many years (my own anecdotal experience and from talking with other women who've used it)
• Easy to clean with few parts
• Sealed, hygenic design to prevent contamination
• Could be a multi-user pump (not FDA-approved for this purpose, but I would be comfortable doing so)

Cons

• Cycle frequency, even at the highest setting, is fairly low

After Ivy was born, I took advantage of the new health insurance regulations that mandate breast pump coverage. I had no choice about which model or brand I received. I tried to get a Hygeia EnJoye ($239 and up), since I've heard such good things about them (very durable, FDA-approved for multiple users) but had no luck despite many phone calls to my insurance company.

I ended up receiving a Medela Personal Double Pump. It's similar to the Medela Pump In Style Advanced ($239 and up), except you can adjust the suction but not the cycle frequency. (FYI, you can't find the Personal Double Pump on the Medela website. It's sold only through medical supply companies, usually via health insurance plans. There's also an "Advanced" model of this pump that lets you select the cycle frequency.)

I tried to find a retail price for this specific pump, but had no luck. It's only available through medical supply companies and not sold directly to consumers. I've seen some listed on Ebay for around $150.

The Medela pump has slightly more parts than the Ameda, but it's still fairly simple to clean (unlike the Avent Isis manual pump, which I tried once. It had about 200* different small parts and was its own jigsaw puzzle.)

When I started using the Medela Personal Double Pump, I immediately noticed that I could pump super quickly and express a lot more volume during each session. Was it the vacuum pressure? The cycle frequency? The way a Medela pumps compared to an Ameda? I did some experimentation and concluded that it boiled down to cycle frequency.

The Medela Personal Double Pump comes pre-set at approximately 75 cycles/minute (by my highly scientific method of counting while watching a clock!). I called Medela to confirm cycle frequency, but they were unable to quote me an exact number. Ameda's customer service confirmed that cycle frequencies are 30, 40, 50, and 60 cycles/minute. I'd been pumping at 50 cycles/minute with the Ameda and hadn't thought of adjusting cycle frequency.

FYI: the Pump In Style Advance model offers a two-stage pumping action. The first stage has a range of 50-200 mmHg and 120 cycles/minute, then the second stage has 100-250 mmHg and 54-78 cycles/minute.

The Medela pumps are not sealed systems, so any number of fluids or bacteria can travel through the tubing and into the motor...and then back out into your breastmilk. This is the biggest drawback to any Medela pump. I'm still using it more than the Ameda because the higher cycle frequency is so much more effective at getting my milk to let down. But if I had a pump that offered both a sealed system AND higher cycle frequency, I'd jump on it.

Pros of the Medela Personal Double Pump:

• Motor and plug come in a carrying case
• Higher cycle frequency than the Ameda (75 cycles/minute); more efficient at expressing milk

Cons

• Not a sealed system; potential for contamination via tubing and motor
• Not suitable for mulitple users
• Cannot adjust cycle frequency, only vacuum pressure

Overall, I don't have a clear preference for one over the other. I definitely like a faster cycle frequency and wish the Ameda offered a higher range. On the other hand, I really dislike that Medela's pumps are not sealed. Either of these will do the job, so if your insurance only provides one or the other, you will be fine. But I'm still on the search for a pump that gives me both higher cycle frequencies AND the assurance that my milk will not be contaminated. Any recommendations?

* slight exaggeration

Disclosure: I was not paid to write this review, and I did not receive either of these pumps as review items. The Ameda was a hand-me-down and the Medela was provide through my insurance company. 

"Birth Story" giveaway winner

Liz (comment #75) won a copy of the documentary Birth Story! If you didn't win, head to the website and buy your own copy. I think you'll enjoy it :)

360 ounces

I donated a large grocery sack full of pumped milk to my CNM's practice. I've been pumping for about 2 months and getting around 6-8 oz/session. That's at least 360 fluid ounces or close to 3 gallons/12 liters. I finally have freezer space again!

I pump once a day. I used to pump in the morning, but just switched over to pumping right before bed. Ivy has a long stretch when she first goes down at night, so it keeps me from getting too engorged.

Even though I have a lot going on, I really wanted to donate breastmilk this time. And since I'm not planning on getting pregnant again, I could probably keep pumping & donating for a long time if I wanted to (my milk supply plummets when I'm pregnant).

Here's Ivy on 2 1/2 months of breastmilk. I love her big button eyes.

If I were to have another baby...

...I'd have someone make a professional birth video. Like this one by Ceci Jane:



It makes me want to do it all over again. Except, as Eric reminds me, "babies grow up and you have to take care of them." Oh yeah.

What are some of your favorite birth videos? Please share!
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Review and giveaway of the documentary "Birth Story: Ina May Gaskin and the Farm Midwives"

I finally had the chance to watch Birth Story: Ina May Gaskin and The Farm Midwives last night. It was such a pleasure. I came away with the impression--sappy as it might seem--that we really need more love and gentleness in this world.

The DVD follows the development of the Farm in Summertown, TN and the growth of Ina May Gaskin and other midwives at the Farm. It combines contemporary footage of Ina May's work as a midwife, wife, and globe-trotting activist with amazing archival footage of life and births at the Farm.

I knew a lot about the history behind Ina May and the Farm, yet I learned so much from watching this. I loved watching the "old" births back in the early days of the Farm. So much hair everywhere! Huge beards, waist-long braids, and of course body hair :)

The movie closed with a lovely modern-day birth attended by Ina May and another younger midwife from The Farm. I watched the mama push our her baby in the tub, almost exactly as I did with my last three children, and remembered all over again the sensations of birth. It made me want to do it all over again.

The DVD is available for $19.95. You can also access it online and as a HD download for $12.99. If you buy the online version for any amount over $13.99, you will receive extra bonus content!



I'm thrilled to offer a giveaway of this DVD to any North American resident! If you'd like to enter, leave a comment below. If you've already seen the film, please share your impressions and reactions.  If not, tell me why you'd like to see it. Be sure to leave contact info in case you are the winner.

Giveaway ends Friday, June 14 at 5 pm EST.

Upcoming reviews

I've been testing out all sorts of items with this last pregnancy, birth, and postpartum period since it probably is the last time . . . sniffle . . . Some I bought, some were passed down to me, and others were given to me to review.

Here's a peek at the things I'll be reviewing over the next several weeks:

Nursing pajamas and nightgowns
Leading Lady nursing chemise in Azalea Pink
Breast is Best Gray Angel Maternity & Nursing Nightgown
Eliseo Satin Rosabella Nightgown
Majamas Blossom Nursing Pajama Set

Leading Lady nursing bras

Books & DVDs
Memoirs of a Singing Birth (ebook)
Bumptabulous: 20 Moms Expose Pregnancy (book)
The Face of Birth (DVD)
Dance of the Womb (DVD)
Birth Story; Ina May Gaskin & The Farm (DVD)

Breast Pumps
Medela double electric breast pump
Ameda Purely Yours breast pump

Postpartum belly wraps and hip stabilizers
Shrinkx Hips Post Pregnancy Belt
Vespa & the Ladybird Post Pregnancy Belly Wrap

NuRoo Pocket babywearing shirt

The Birth Relaxation Kit
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Climbers

What do you do about climbers (otherwise known as 2-year-olds who climb out of their cribs and come downstairs at night multiple times when they should be sleeping)? It might be time to put Inga in a real bed, since she can easily climb in and out of her crib. But still wouldn't solve the not-staying-in-bed issue.

What do you suggest? Lock her door from the outside? Put a child-proof cover over the doorknob? Zari slept in a real bed from early on and never really had issues "sneaking" out. Dio stayed in his crib until he was 3 and never figured out how to climb out. So this is a new problem for us, even though we have 4 kids!

I also wonder if I should cut out Inga's nap and hope that she's so tired at night she won't stay up for several hours escaping. But then I'd lose my quiet time in the afternoon. Not sure if I'm ready to give that up yet!
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Obstetrician seeking a job in the Nashville area

A few days ago I had the pleasure of chatting on the phone with an obstetrician. He's a wonderful (and wickedly funny) physician who strongly supports patient choice, autonomy, and informed consent. He's currently looking to relocate to the Nashville area and would love any leads on job opportunities there.

A bit more about the obstetrician: he's been practicing OB/GYN for over two decades. He is currently the only physician in a large metropolitan area offering vaginal breech, VBAC, and vaginal twins. He strongly values keeping these choices available to women. He also practices cost containment and keeping unnecessary procedures and tests to a minimum. This hasn't kept him in good graces with his peers and the hospitals he works at, since both physicians and health care institutions profit from doing more procedures, not fewer. He is a skilled vaginal surgeon and prides himself on continuing to offer things like vaginal hysterectomies, rather than turning to robotic surgery.

He loves working with midwives and doing consultations. He especially enjoys patients who bring in midwives to serve as doulas in the hospital. He likes finding reasons to be "late" so the midwife gets to do the catching :)

Some awesome quotes from our telephone conversation:

"My favorite delivery is the one that I miss."

"I like being useless."

What he's looking for in Nashville:

He wants to live and work within a 60-mile radius of Nashville, TN (one of his daughters lives there, and he'd like to be close to family). This includes Bowling Green, OH to the N, Clarksville to the NW, Lewisburg to the S, and Manchester to the SE.

He wants to join a practice that appreciates the skills and values he has to offer. He's also interested in being involved with birth centers and in working with midwives.

If you're a physician, nurse, midwife, doula, lactation consultant, or other associated health care professional in or near Nashville, please let me know if you have any suggestions or leads on job openings. He'd also like recommendations on specific hospitals or practices that would be a good fit for his skills and practice philosophies. If you email me, I can put you in touch with him directly. Let's do our best to find him a fulfilling new job!