 Good day and welcome to issues and answers. Today we have two guests to talk about two different topics, one being personal hygiene and breastfeeding, and the other one being sex and breastfeeding, the more controversial of the two topics. And with me we have two registered nurses and midwives from the St. Jude's Hospital, Miss Charlotte Salterbus, and Miss Reena Butcher. Thank you both for coming on the program. So how are you feeling? Feeling good about what we're about to speak about? Yes, we are. We are. We are very excited. Okay, for a lot of people who might not know before we start off, could you explain what a midwife is? What role does a midwife perform? Well, simply put, a midwife is a nurse. She is a registered nurse. She has done advanced schooling in midway free, and of course, having gained those credentials, she now works to help labour and women deliver their babies. Okay, now as the term is called midwife, do you have men who are midwives? Do they perform that function as well, or are we not in that exclusive club? We are not theirs yet. It's not our policy as yet in St. Lucia, but our males are allowed to practice registered nurse, nursing, and one day we'll get there. We have a lot of male registered nurses in St. Lucia. We do. We do have a few. So let's get to the topic at hand. What does personal hygiene involve during breastfeeding, and is there anything you should do before and after breastfeeding? Okay, so we talk about personal hygiene and breastfeeding, and of course you mentioned hygiene, so we think of cleanliness, right? And then there is this famous saying that's two things we always have to do, wash our hands and pray because germs and God, or Jesus and germs rather, are everywhere. I so agree. Okay, so going right into the personal hygiene aspect of breastfeeding, it's a very critical moment for the mother, okay? Paying very close attention to the last time baby was breastfed, counting duty diapers, having to care for other children, and so many other things can cloud her mind, her memory, that the simple thing, simple thing as washing your hands can be something that she forgets, and that is very, very important because of course we do not want to be transferring bacteria, and that's basically the main reason we wash our hands. We want to get germs or dirt off our hands, all right? And when it comes to the baby who is so vulnerable, we need to be the one, or the mother rather, needs to be the one to protect her young one, okay? And of course there are a number of ways she can get that done, okay? So I can delve right into the different guidelines, or, okay, sure, okay? So I did mention washing your hands, and of course you do so frequently before you actually initiate the breastfeeding process, all right? You will be handling the breast, of course you're handling baby as well, and so you need to ensure that your hands are clean, all right? Washing their hands, it will stop germs from passing between mother and baby, and of course when you do so, you don't just wash with water, but ensure that you use soap, especially if you're at home, okay? You use soap and water, clean water, add that, all right? So you wash their hands, the back of their hands, in between your fingers, the palms, way down to the elbow, and of course you dry after. Now when we think of the products also that mother uses, she needs to be careful that these products are not scented products, okay? Scented products, also the nipple creams, some of them they do have those scents that can turn off baby when it comes to putting baby at the breast. They might, the baby will refuse to take the breast and we wonder why, okay? So all of those things we need to bear in mind. The nipples need to be clean, okay, the nipples and the breast, and we encourage our mothers to wash the nipples especially with a clean rug and clean water. We do not encourage the use of soap on the nipples because what can happen is that the soap can dry, the skin dry the nipples and that can give way to the nipples being cracked and of course putting the woman, putting the baby at risk for infection, okay? The use of clothing, her clothing also is important, all right? Breastfeeding mothers are encouraged to wear loose clothing, comfortable clothing and of course we encourage the use of cotton clothing that is breathable and all of that. The breast think of a breastfeeding mother with a tight top, very tight top. So then the breast is restricted, it kind of gives trouble, you don't have that free access to the breast, you're not comfortable and if you are the mother you're not comfortable then you cannot make baby comfortable either. So that's important. Not just the comfort level but with the restriction, you have the, especially if she's wearing breast pads, these breast pads they can be soaked with breast milk and this is pressing against the skin. Now when you have those wet pads on the skin for a long period of time, then it creates that moist environment and of course we know that bacteria tend to thrive in this kind of environment. So then we do not want that happening and of course we do not want any, we do not want any room for bacterial growth so as much as possible these are some of the things that we encourage our breastfeeding mothers. So she needs to change her, I mentioned the breast pads, so she needs to change them regularly. Okay, if it's wet, if it's soaked, she needs to change it because like I mentioned with the presence of that wet breast pad on the skin, it will cause the skin to break down giving rise to bacterial growth. So how often should you change the breast pad? Okay, so once it gets wet, you should do away with it and get another one, okay? As well as the bras, alright? Because we know that some persons tend to keep on their bras for how long or change it after how many days, that is not hygienic, okay? And so we definitely want to move away from that practice so we encourage our mothers to change their bras as well as their breast pads regularly. Wearing a clean bra every day is what we encourage and of course if it gets wet, you have to change it, don't keep it on, alright? We mentioned about the breast pads, the breast pads on the skin so we want to move away from that as well. We're not creating any environment for bacteria to thrive and of course with the sugar because breast milk is sweet so that sugary content, that sugary aspect of it too can welcome the growth of bacteria especially yeast and how we see it is in the mouths of the babies, that white substance we call it thrush. Some people know it as shirk, alright? It can get the baby sick, especially those babies sucking finger and so forth. I want to come back to that because we're due for our first break so when we come back you continue. Sure. You're watching Issues and Answers, a production of the Government Information Service. Please stay tuned, we'll be back in a moment. We are working parents and we breastfed both babies exclusively. Mother's breast milk is naturally the best milk for baby. Love yourself and love your baby. Breastfeeding saves me money and it's free. Every moment I breastfeed strengthens the bond between me and my baby. I breastfed twin boys and lost all my baby fats. We are breastfed and we have breast milk power. I am Pastor Alvin and I support breastfeeding. For more information, call the Nutrition Unit of the Ministry of Health and Wellness at 468-5359. Welcome back to Issues and Answers. I'm Jacques Kingston Compton. We're talking about personal hygiene during breastfeeding as well as sex during breastfeeding. Right, so Ms. Busher, let us start off from where we left. So we were discussing about the yeast, that's a type of bacteria which especially can be found in the mouths of the babies. So it is important to clean the baby's mouth, especially after their feed, their finished feeding, we burped them and so forth. It's important that we clean the mouth, clean the tongue. So then there is nothing to encourage bacterial growth. I mentioned earlier about the bras. One thing I did not make mention of was ensuring that the mother wears the right bra size. That is important. We spoke about the restrictions. If you do not have the proper bra size, that too can play a role in putting excessive pressure on the breast and giving rise to further problems such as plug ducts, mastitis which is inflammation of the breast tissue and so forth. And all of those things, if not taken care of, then can cause greater problems. I know that some of our women are very active, so some of them participate in sports, some of them they love exercising and so it's okay to do all of that, but just ensure that after you have done your exercise and your chores, you clean the breast. If you are going to breastfeed after you make sure you clean the breast, you need to wash the sweat off, all of those odors that can interfere with the quality of the breast milk, the breast milk can be salty. And there you are thinking that baby does not want to feed, baby is not taking the milk, so what is the issue? And that could very well be what's wrong. So all of those things, it's important for us to ensure that we put a clean breast in our baby's mouth so that they can enjoy their feeding. You've mentioned exercise, that it's okay to exercise while your breastfeeding, which leads me to questions now about sex, engaging in sexual activity during the breastfeeding phase. Before we get to Ms. Salterbus, is there anything else that you want to add before we move on to this very interesting topic that I want to get to? Sometimes we have women, especially when they have to go back to work, they would express the breast milk so that baby can have it, so we can store them in bottles, we store them in bags. Just need to make mention that it's okay for us to express, but we need to ensure that these containers, our breast pumps, whatever it is that we're going to use, they are clean. All right, we need to sterilize them, okay? You have the sterilizing tablets, you can put in the warm water and place your... You wash the bottles, wash the pumps, whatever it is that you're going to use and you put it in there. It's also important for you to change that water, you don't put the water once and then that's it, you need to change that water, okay, every day, okay, yes. And of course, whoever is going to be handling that, make sure of our hands are clean, clean hands, clean hands. Okay, Ms. Salterbus, is it, this is the question I think all men are dying to know, is it okay to have sex during the breastfeeding period? Once your body is healed and you are ready, yes, it is safe and it's okay. But sometimes when you are breastfeeding, the constant breastfeeding the nipples are sore, they are also the breast is a bit engorged, it's a bit painful and the women don't want you to touch there. So before you become intimate or get all mavin gay, I believe you can say to your partner or your husband, hey, please don't touch this. Can we stay away from these for now and do the other things that we want to and we love? Also we have to remember that touching, feeling those breasts because it's a stinging sensation and you can get squids. So there's breast milk leaking everywhere and sometimes it can be a turn off for some men, sometimes it can be sexy for some men, they like it. So we don't know what your partner likes unless you know. But just touching it and playing with it to constimulate milk from coming up from there. So you can't actually, it could be a situation where you have to end up drinking milk. What does the milk taste like to the men? It varies. Some people have said it's sweet, some people say it's nice, but it's for the babies. You have to remember that, not for you guys. So other than it's sort of, I don't know, putting off men, can it affect intimacy for the women? Well, the only way we can think of is that you know the breasts before you start lactating, it was in gorge, it's preparing, it's sensitive during pregnancy, but postpartum, which is after you have the baby, sometimes it's swollen, sometimes it's small, sometimes the ever-changing size sometimes. You know sometimes it's up there, sometimes it's down there. You know it makes her less sexy. So sometimes a body image may not, she may not want to. I want to get to body image, but before that, there was actually something you mentioned that I did forget to follow up on you about. When you mentioned that the mother has to heal, what did you mean by that? Postpartum, after you have the baby, you have to take four to six weeks, allow your body to go back to its normal pre-pregnancy state. So when this happens, then you are ready mentally, physically, then yes. You can go ahead. And I just want to say that it would be six weeks in the case of a normal vaginal delivery. But for persons who have had a C-section, it would take more than that to three months. Is why the difference between the two, why, is it because of the, I guess the cutting of the abdomen? That's right. Right. And also the uterus. Okay. Because you have to cut that uterus to get that baby out, so you have to let it heal. Right. I see. Okay, so we're due for our final break. Stay tuned. We'll continue to talk about engaging in sex during breastfeeding. You're watching Issues and Answers. Please stay tuned. We'll be back in a moment. Breast milk is the gold standard that cannot be emulated. It is the perfect food for your baby. Breast milk provides antibodies and protective factors which may fight against COVID-19 should your baby be exposed. Breast feeding reduces the risk for premenopausal, breast and ovarian cancers. Breast feeding is the most natural way to feed your baby. Breast milk provides all the nutrients your baby needs for the first six months of life. It requires patience, however, your baby deserves the best and it's worth the effort. Breast feeding a baby up to 12 months improves job-own development, thereby reducing misalignment of the teeth. Breast milk is baby's first immunization. It protects against viruses, bacteria, and also prevents some chronic diseases. If your child becomes sick with any illness, including COVID-19, it is very important that you continue breastfeeding. A woman with COVID-19 should be supported to breastfeed her baby safely, hold her newborn skin to skin, and share a room with her baby. After giving your baby only breast milk for the first six months of life, you can now slowly start introducing solid foods at the right textures. These include pureed vegetables, fruits, peas, and healthy cereals. For more information, call the Nutrition Unit of the Ministry of Health and Wellness at 468-5359. Welcome back to Issues and Answers. We're talking about personal hygiene and sex during breastfeeding, or both personal hygiene during breastfeeding and sex during breastfeeding. We're talking with two registered nurses at the St. Jude Hospital, that is Ms. Reena Butcher and Ms. Charlotte Saltibus. So let's go back to what we were talking about before, with, I guess, engaging in sex after birth. You said it takes about, I guess, about four to six weeks for vaginal delivery and then three months after a caesarean when you're completely healed. So, alright, we've also spoken about how breastfeeding can affect intimacy. Can a woman's body image after pregnancy affect sex? I know you kind of brushed over it a little bit, but can we just elaborate on that a little more? Yes, it can in some instances. Some women who are very conscious about how they look, because remember, when you met this lady, everything was, wow, all plumped or lashed. But then after she delivers, you know, with pregnancy you get the stretch marks, you get that breast engorge with all the stretch marks on it, you get weight gain, your feet gets bigger. So everything changes for her. For her to go back to that pre-pregnancy state, and you feel like she's still looking sexy, in her mind she doesn't. She doesn't. So some women, it does affect them, others they move on and they do it. Yeah. In that case, what can a man do to assure his partner that you're still sexy to me? Just compliment her every day. Whatever she wears, you look nice in that, babe. Or whatever she does in terms of, oh wow, I really like what you did with your hair today, just constantly compliment her, touch her, a little peck on the cheek, you know, these kind of things really will get the groove on. Sometimes, sometimes, you know, baby is asleep, you understand, you say, come, come on, let me touch you, let me rub you, let me give you a little massage. Maybe that might get you into the mood. And as you mentioned, the baby is asleep. I know in a lot of cases, the children tend to keep up both parents, especially the mother. And you're tired all the time. What can you do in that case? You want to remain intimate with your partner, but you're both exhausted. What do you suggest to parents, new parents? What I can say is you rest when baby is rested, and then, by then, your energy will be up. So when he's up, you are up. And sometimes, the babies have their play time. They have the little moments where you feed them and you put them down. At that time, you can make time for your partner or your husband. You can make time for them. And then you can be intimate with them at that time when. But at the same time, you have to remember that this is an addition to this family. Your mind sometimes is, I hope this child is okay. I hope this child didn't get out of the playpen. I hope this child didn't roll or didn't vomit, you understand? But you try your best, you understand, to make it. Even if it's five minutes you spend with this man, you talk to him, or you could spend time together with just playing with the baby or just sitting there and watching the baby. The baby is sitting together. Can that phase of breastfeeding affect her sexual mood in any way or her desire? It can. It can decrease your libido because the hormones that are responsible for breastfeeding, which is prolactin, oxytocin, and progesterone, are increased. And the one for sex, which is estrogen, it decreases at that time. So sometimes, because it's decreased, her libido, her urge, her desire to be intimate, sometimes it's not there. And also, there is decreased blood flow to down there. And the glans, the lubricating glands, may not do what they're supposed to do. So there's a bit of dryness, a little bit of sensitivity down there, a little bit of tenderness down there. And she may not want to be intimate at that time. So the partner, on the other hand, has to be a little compassionate towards that and understand that patient with her as well and allow her to heal psychologically and physically and give her time so that she can start doing this thing again, you know, being intimate with him. And even then, you know, she would take, it would take her a little longer to actually get aroused and so forth. So when she mentioned about being patient, that's one of the things that you would consider. So where it would have taken her maybe one to two minutes to get into the mood, get aroused and so forth, you know, you would have to go longer than that. So you start with the fondling or whatever it is, you know, and work your way up, but you do it with her as a team. So are there sort of any other means that you would need to utilize to, as her libido has decreased, are there any other means you would need to utilize maybe to try to increase the libido? Another follow-up question, you mentioned dryness as well. Is there a route to around that? Well, like she said, you can foreplay. Foreplay is important and with the foreplay, maybe that might help bring the dryness, take the dryness away. Also, some people, K-Y might be their best friend. So you say lubricants, right? Lubricants, K-Y might be their best friend. And they can use that as well. Also, even if she doesn't want to be intimate, where there is penetration, but there are also other ways we can be intimate with each other, where you fondle, you kiss, you hug, you know, the hugging. You play a little bit of music, a little bit of candlelight, things like that. And also remember, she may not want you to touch these. So these are outer bonds. For some of them who don't want you to. Can you get pregnant during this time, during the breastfeeding phase? Your body does not say it's not ovulating. But if you do exclusive breastfeeding, where you don't use any supplemental feed for that baby, then yes, you can use it as a form of contraceptive. You need to do at least six to eight feeds at night. Continuously, no milk, no formula, no water for that baby's only breast milk. You can use it as a form of contraceptive. But that doesn't mean your body is not ovulated. I get you. So we are at the end of the program. Is there anything else that you want to add before we go off? We have a few seconds left. Well, just remember that with the woman, the ever-so-going changes of the body before and after during, sorry, pregnancy and after pregnancy, you have to understand that the image that you had and the image you have now and how her body is feeling and reacting, those constantly changing hormones in there that we the partner, not we, I feel like I have a partner, like I have a partner to some woman, but the men, just be mindful that, you know, give her time, allow her. It's not like she is forgetting you and she's putting you in the back and focus on that new addition, which is the infant. But yes, you are there, but just be patient with her and be a team, help each other. OK, I want to thank you both very much for coming on the program. I learned a lot in the event that one day maybe I might be a father, you never know. Thank you very much. And I hope that you can come on another day and speak about some other topic with regards to breastfeeding. Thank you for having us. You're watching Issues and Answers, a production of the Government Information Service. I am your host for today, Jacques Kingston Compton. Please look at our television station, the National Television Network for this and other programming like this, as well as our YouTube channel and our Government of St. Lucia Facebook page.