 So I'd like to introduce our speaker for today, that is Ros. Yasmin Ros, who is a bath, is passionate about the rights for women. She's opening the Middle East region's first midwife-relayed care option that is Rice Bath Centre to ensure that women have access to the spec tool midwife-relayed care and alternative bath. So she has, in collaboration, she has been able to co-author a book, Bathing with Heart, and co-edited that was published in January 2021. Her contributions are on physiology of bath, bath interventions, water bath, and caesarean bath. And then another book she had worked in collaboration is Hybrid Healthcare that was published in August 2022 by Springer Nature. Yasmin consoles hospital and governments on patient-centered care, water bath, and change implementation. She's a breastfeeding counselor and assists with the English breastfeeding friends helpline in the United Arab Emirates. Yasmin is pursuing her master's in global maternal health from London, and she enjoys speaking and sharing knowledge about bath and angel investing. Join me in welcoming Yasmin to continue with her presentation. Welcome Yasmin, and looking forward to the presentation. Thank you. Thanks Caroline for the introduction. Okay, so we'll just jump in. I'll be covering the birth physiology and cord blood, specifically how the baby first transitions to breathe as well. And just again to reiterate, I'm also a birth doula and breastfeeding counselor here in the UAE. I'm founding the first birth center, RISE birth center, and that will be opening in Abu Dhabi, and I'm also do some consulting. All right, so today we'll cover kind of a few different areas. We'll start with kind of pregnancy, what's happening with the baby in the womb, and then the baby in birth itself, and then the two of them together, the mother baby diet. So a few of the topics, and there's more on top of this is what triggers labor, the hormones released in labor and how they're released, what happens during labor, and the importance of the cord blood and how that baby first breathes, and then the difference that makes between a baby at water birth and a baby at land birth. And some of it I do ask open questions, so I think you're all muted if you can put in the chat box and then I'll read out your answers for, and if you have any questions as well just put them in the chat box as we're going to, and then at the end we'll also have open questions as well. Okay, so to start with in the pregnancy, and what starts labor in the beginning is that an enzyme from the baby's lung is released, and then that goes up to the mother, they read the signal to say, okay start the oxytocin now, and the oxytocin is released. So it's an enzyme from the lung, which is important to understand or remember in case you're thinking of inducing or starting labor early, there's a slight risk that the baby's lungs aren't actually ready. So if possible it's best if you can let the baby start that process on their own. One of the main reasons that that wouldn't happen is if the mother has fear or something like mentally blocking where the body doesn't feel safe enough to go into labor. But it's from an enzyme from the lung and then the oxytocin is released. Okay, so what is the perception in your area in this society that you're living in about birth? What are common things you hear if you don't mind putting something in the chat? I like to be interactive so go ahead. Okay, well generally, and you can keep popping them in and I'll read them as they come up, but a lot of times people hear, yes, okay, fear of being overdue. Yes, a lot of times you hear general fear of birth, a lot of C-sections in the UAE. Yes, I can attest to that. There seems to be quite a high number. A lot of times in general the answer is fear, like they're scared of the pain, they're scared of the process, or they don't know much about the process as well. And it depends, maybe it's different by country but from the answers they're getting in and what I've experienced as well, is that there's fear around it. Anything could go wrong and that it's safest in the hospital, that's commonly a perception as well. Yes, thank you for those. So we need to remember what happens though if there's fear introduced into the body, you actually, you've tightened it up. So if somebody comes into the room and scares you or if you're walking and then you get shocked, like you're going to tense, that's the natural reaction, your body tenses. So if you're tensing while during labor you're meant to be opening and you're trying to open, you're going to feel more pain because of that because you're fighting against yourself where there's this tension when you're trying to open. So introducing fear into the process of labor really makes an impact to the level of pain that we see. And this is called from Dick Grantley Reed, or Dick Reed Grantley, Grantley Reed Dick, anyway, whatever his name, sorry. From the 1900s came up with this cycle which there's, if you're introducing fear, then you have tension in the body and when there's tension in the body you're getting more pain and it continues that way. So when there's more pain you get more fear. And this becomes a cycle where it's hard to break and it makes birth and labor more painful. So what can we do about it? One of the things when things are delayed because of fear is you can do hypnotherapy, for example, and Julie's a hypnoburthing instructor so if you have anything to add you can put it in the chat. But I look at hypnotherapy as subconscious reprogramming. It's not as if you're on a stage and acting like a chicken because you don't remember what's going on or know what's happening. It's very much you're still aware, aware, but in a relaxed state while you're aware. So you're just kind of exploring what has happened in your past maybe, or what is it that your beliefs are in your subconscious that are making you scared and giving you a bit of fear around the birthing process. So it's to also get into relaxed states. It's like if you've done yoga or at the end you're in the Shavasana where you either feel your body feels light or it feels heavy but either way you don't really want to move. It's kind of that feeling of relaxed state. So doing hypnoburthing or hypnotherapy techniques for birth is to be able to get your body to relax to that state as well. There's different techniques within hypnoburthing where maybe you have an anchor point so maybe somebody touches your shoulder and while you're doing the techniques when you're pregnant or when the mother's pregnant she kind of gets that feeling or she's putting an anchor point maybe with her fingers together and that's just you're kind of programming yourself to say when this is happening I feel like this. I'm in this state, you're in a relaxed state and then you do the anchor point so that it starts programming that when I'm doing this that means I'm remembering how my body feels right now that it's nice and relaxed, that it's a very calming state. You can also do techniques like counting. So maybe counting down from 10, counting up. Visualization is if maybe a balloon's tied to your wrist and it's just kind of floating up. There's quite a few different techniques if you want to get into techniques side of hypnoburthing but overall it's to reprogram, it's to give you some techniques. Maybe they work, maybe they don't. Maybe the mom feels a little bit more aligned with some or resonates more with some than others. There's also tracks so it's meditation tracks to get you into that relaxed state. It's maybe like walking through a forest and going downstairs so that you're to symbolize going into your subconscious and then gets you more in a relaxed state. So any meditation it doesn't even have to be about birthing can help you get into these relaxed state. As I tell my clients as a doula it's just another tool in the toolkit. Maybe it works for you, maybe it doesn't but it's worth trying if you do have a lot of fear around birth. So that's an option for some of the moms that you're helping with to look into. How birth can be pain-free is because of the hormones you're getting. So what we're wanting for women is that they first of all don't have fear as we kind of discussed but then also that they understand what the physiology process is so that it's possible for them to understand it and believe in having a less painful birth. Sometimes it's pain-free, sometimes not. I mean there's many things but to know that that's a possibility is a good thing I think for mothers. So why it is a possibility is that we get endorphins. So the same way that when you're exercising how you feel after, you might have been tired during the exercise but afterwards you feel pretty good and that's endorphins. And then we have adrenaline which they've introduced that the wrong time is tough because adrenaline is giving you that surge of power but it can also then like put too much tension on your body. So at the end when moms are pushing that's when we're wanting to see the adrenaline but if it's introduced because they're scared earlier it again kind of messes things up and makes you tense. So we want to keep them as calm as possible. There's also the other main hormones are prolactin but that's for producing the milk so when the baby is born they can latch and feed right away and then oxytocin. So oxytocin is known as the love hormone. It's also the same one that will cause an orgasm. So it's a similar hormone set as when you're creating the baby as when you're birthing the baby and those hormones are what make it possible to then have a birth that's less painful. So it's good to know in general. Okay this is a little less known but how they're released. So if you're laboring naturally the hormones are released in a different pattern. They come in pulses it's not flooding the system so if you're introducing an outside drug it's going to be different than the natural process. So naturally you're kind of going in a pattern. It's building up. It's coming and going in pulses. There's a lot of like reading that receptors are taking in the oxytocin and then they're sending signals back. You're getting a cross blood vein barrier to say like oxytocin arrived. I want my pain relief which is the endorphins. So the cycle is continuing and it's going across and you're getting more pain relief naturally. The natural pulses is important as well because if it's too much stress on the baby you'll see things slow down or change pattern so that everybody's accommodating and both the mother and the baby, the mother's body and the baby are adjusting well to the process. So those natural pulses are nice because there's lots of receptors and the body is communicating with itself. If you're introducing again so if there's an augmentation or an induction where outside drugs are coming in so it's an outside oxytocin chemical then you're not getting that blood brain crossing. You're not getting the natural pain relief of endorphins coming through and it's flooding the system. So instead of going in kind of levels of where the receptors are normally getting the receptors are all flooded at once and all of the uterus receptors are getting the drug instead of in layers in the buildup which you would normally have. So this is what causes things like fatigue. This is why the uterus might get too tired because it's flooded and all of it is all the time instead of just in stages like you would normally have. So there's a risk as well with the outside drugs because then you might fatigue the uterine muscles because the receptors stop being as receptive. So when I'm saying that things are going in stages where the receptors go first is the cervix and it's because this is what the cervix does in the picture. You can see that first the cervix is quite long. It's quite hard. It needs to soften. It needs to open. It needs to efface. So a lot of things are happening to the cervix at once. So the receptors in the cervix are what's getting the oxytocin first so that it can come up, soften up and open up. Okay, so this is all in stages. Which is why it's important also to remember that the dilation isn't the biggest deal. You can go from 3 to 10 in an hour and I'm sure a lot of you have seen that it's not like a good indicator of how things are progressing. A much better indicator is actually where the baby's head is in the pelvis. How far down is the baby? How much more does the baby have to come? So if you're measuring the station or the location of the baby's head in relation to the pelvis whether it's in the inlet, the mid-pelvis or the outlet then you're getting a better idea of how labor is progressing. Whereas dilation, you could be softening and if facing at the same time your dilation will be faster or but the baby's head is still high or you might be doing one of those things at a time there's a lot that needs to happen. So just keep this in mind that the first of all that the uterine receptors are going first to the cervix so that this can kind of open up and soften and second that the dilation isn't the only indicator to see how things are going with the labor process. It's much better to just understand where the baby's head is in the pelvis. So the uterus is fibers both vertically and horizontally. So the horizontal fibers, the ones in the cervix all those horizontal fibers are going to be coming up the vertical fibers. So this is what is actually happening during labor. Your fibers are moving and shifting. So you have all the ones from the cervix coming up and coming around the sides. So when I say that things are going in layers first you're going to have the uterine receptors taking the oxytocin where the purple ones are and then as labor progresses you're getting them more in the middle as well and then at the end you're having them more at the top or getting more of the oxytocin. So it's coming in stages, it's coming in levels and it's going with the process of the fibers moving those fibers up, moving those horizontal fibers up and around the vertical fibers which is kind of indicated with this bright yellow color if you can notice. Okay, so why do you think the fibers come to the top of the uterus? If you can pop that in the chat what's the purpose of bringing all those fibers from the cervix up the side all the horizontal fibers and moving up the vertical fibers why is it that they're coming to the top of the uterus? What is that designed for? To push the baby down? Yes, like what a cool design the placenta release to push the baby, yes. Thank you, what a design that it's coming in stages to move those fibers to get the cervix open and then reusing that same fiber and design to help push the baby down so it's also something for the baby's legs to kick against it's much harder surface for the baby's legs to kick against to push themselves out as well because it's a process both of them are working the baby and the body so it's a thicker area then to help push the baby down and also for the legs to kick against Okay, as the baby's moving down and out the sacrum also opens so you're getting naturally the sacrum will come out of it so that you're making space for the head whereas what would happen if you're on a flat surface or something hard is that that sacrum won't open your head kind of has to push against it more and it's a bit harder so how it actually will look is the baby has to go up and over something to get out so the head will have to come up and over if you're on your back for example that is coming up and over it to get out so it's a bit more of a road block then if they're upright this will open and there's that much more space for babies to come out so it would also be that much less painful as well so really upright positions are helping for this purpose that pushing it's helping to get that baby's head out or even hands and knees works because again you're leaving that sacrum free so you can see in the photo here how the sacrum normally looks it curls in but then during labor it will curl out you will have that space there's a joint where I don't know if it's the right word but there's a joint well it will a ligament that it can open up it's flexible for women which is good to know there are still many many countries where women are on their back and it's not helping the process actually I had done a birth even myself where the doctor wanted the mother on the back and she was insisting and the doctor left the room the mother got up had her baby immediately and the doctor was upset because she's like you can't be out of bed it's not safe but like clearly the doctor had just said it's going to be another 20 minutes before the baby's born and that's why she left the room but then the mother stood up and had the baby well why do you think that is because there's no more there's no more road block and also she's upright the gravity is helping as well alright so now we'll look at the baby and a lot of this now is going to be that transition of how they first breathe so when the baby is in the fetus they have avioli in the lungs so you can see I've tried to emulate what this kind of looks like they will do practice breathing but it's with a liquid so this avioli is filled with liquid and they do practice breathing while there neonates if we zoom in really closely the avioli is shown here in the circles to be able to take that first inhale all that liquid needs to leave so what happens is the fluid from the lung capillaries the fluid goes to the lung capillaries and joins the blood so it's increasing the blood volume out into the bloodstream essentially because it's joining the lung capillaries and joining the blood volume so the fluid is getting absorbed into the blood so you're increasing the blood volume from the fluid that's in the avioli in the lungs here so we have a fluid it's getting absorbed into the bloodstream increasing the blood volume so that baby can take that first breath in and it has to leave so that they're empty so that air sacs are empty so that air can come in I hope everybody's with me so far if you're not please ask a question okay so we have fluid then coming in from the lungs it's going to increase the blood volume overall for the baby system when they're born because again the fluid from the lung capillaries is going into the bloodstream it's increasing the blood volume of the placenta so there's two forms of blood coming in to the baby that's increasing the volume right at birth so now we'll get into more of the placenta just a side note that this photo is actually a zoomed in picture of a placenta okay so fetal circulation when the baby's in the womb there's a shunt that is open and that is essentially bypassing the overall circulation in the baby's body so as blood circulates as everybody does for a human and a neonate it's going through the full body coming up and down, going all over when fetuses are not getting that full circulation about only 8% of the blood is coming through the lungs while they're in neonate so it's mostly bypassing the lungs not much activity is happening there because the lungs are filled with liquid not so much blood and it's going back out to the placenta and that's where the blood is getting cleaned through the placenta and getting oxygenated and coming back in so we have a two way flow with that shunt that's open and it's bypassing the lungs for the most part this is when they're a fetus now when they are in neonate that shunt is closing so you're getting only blood in from the placenta you're not getting blood going back out to the placenta so blood is coming from the placenta back into the baby still after they're born the shunt is closing so that means blood is only coming from the placenta and nothing is going back out and it's a one way direction more blood is coming into the baby after they're born from the placenta into the baby so this is again bringing up that blood volume in general now we need more blood volume because that circulation to start for the lungs to work it needs to get up to 55% so as I said when their fetus the blood circulation is at 8% but when they are when they're born we need that blood circulation to increase to get up to 55% so that they're able to take their first breath so we have again the, I'm just going to show you actually a I think this is the right time to do this I'm just going to increase like a short demonstration so that it's really set in your minds about what needs to happen so when they're a fetus you're having an 8% way down here you're having 8% of the circulation in the lungs and we're getting blood from we're getting blood from from the avioli that was in the lungs is coming and joining into the blood stream okay, that's some of it but then we also have the blood that's coming from the placenta after the baby's born in one direction so we need both of these we need both of this blood volume to get up to that full 55% which is where that black line is so you need the blood for both of them to get the lungs all the way up to the 55% to make to make the lungs work appropriately when the circulation gets up to 55% that is what will turn on the system to say you need to continuously breathe now so if they're not getting all of that blood volume, if they're not getting all the blood from the placenta it might be harder for them to switch on to say they might need some help when they're born with breathing because they don't have the full blood amount to get that circulation up to 55% and start going around the full system also if you don't have that full 55% to the lungs and there's less blood volume than the body's expecting they'll shut down the smaller capillaries so you're more at risk of the small capillaries in the fingers aren't going to get the blood because all the main organs are going to take the blood first so you're at risk of collapsing some of the other capillaries in the body in the baby's body because there's not enough blood volume to get there so it's really important that the blood volume is full up, the lungs are getting to the 55% so that they know they have to turn on and start breathing oh I'm sorry I should have had I should have reminded you to put me on full screen so you could see that but mainly the point is that you're getting blood both from the lungs from the fluid that's turning in and getting absorbed into the blood volume and you're also getting that blood from the placenta so you need both of them to get up to that 55% level turn on the lungs make sure your smaller capillaries are getting enough blood and that the overall system is working okay now this is important to think about when you're considering when you clamp the cord so the cord should be white to make sure all the blood is coming all the way through and that one way travel is completely done the cord will be white because there's no more blood going through it anymore so if we're I wouldn't even say delayed cord clamping I would say optimal cord clamping is when the cord is white is best if there's some situation you also need to understand why there's a situation is it because the baby's not breathing well knowing and understanding now everything that's going on it takes time to make that transition it takes time for the baby to you know they need to open and close the shunt get the one way blood get all the fluid out of the lungs into the blood system so there's a lot happening and it's a huge transition for the baby it takes some time so a lot of times you just need to be patient you don't necessarily need to then be messing with anything and if you are it's still important that that blood is coming in from the placenta because that's the source of oxygen that is bringing in more blood for the baby and that blood specifically from the placenta is more oxygenated there's more red blood cells from that and that's helping the overall system and you're wanting that another thing to consider is that if you're taking a vitamin if the baby's taking a vitamin for iron it's not getting it's not getting absorbed as well so it's better you're at higher risk of anemia if the baby doesn't get that full placental blood either because they can't absorb the outside sources of iron as well as they can absorb their own blood from their own placenta alright so to cover how and let me know again good I'm glad you didn't know that's the whole point and that's why I thought it was important to do this topic specifically is that people don't understand what a role that the placental blood plays in the overall starting of the lungs and how the baby first breathes but how it all triggers and what closes that shot and starts the sole process is that the signal is sent to the baby to start transitioning once this area of their face hits air so it's the nitrogen molecules and its gravity that's activating sensors in this part of their phase that is then going to close that shot considering that what's the difference between a land born baby and a water baby and what would you think in that shot considering that the face is what triggers this system and what starts the process what's going to be the difference between a land born baby and a water birth baby or even a breech birth and a land birth and a head down birth okay so if the face is coming out first with a head down baby in a land birth that face is going to come out first it might be one contraction it might be two it might be three before the rest of the body is born so in that one contraction when the head is just there this is will this will get activated so that the shot closes and the blood is going one direction from the placenta already before the full baby is born because it's a head start let's say the head is out first and they're getting activated that blood is starting to come and fill up and the blood from the fluid in the lungs is also starting to go out so the baby might breathe faster or it's yes storage or the baby will breathe later in a water birth and not quite immediately there's also going to be because that blood is starting a bit later in a water birth because the head comes out and the same and the body comes out at the same time so they're going to start this process later than a land born baby also with water birth they're not starting the process there's no risk of the baby trying to breathe under water because that hasn't been activated they still are getting the feeling they still don't have that signal they're still as if they were in the womb as far as the circulation goes and the breathing goes they're still getting the blood from the placenta they're getting the blood from the placenta they have no signal to start that transition and there's no air leaving or there's no fluid leaving those long air capillaries so that there's room for the air to come in until their face is out of water and they're getting the signal so the whole transition for a water birth baby is starting a bit later that means their color is going to be a bit different they'll stay a bit dusty for a bit longer because again they need the extra blood volume to come through all of their capillaries and that's when they start picking up that's when they start getting the color because they're getting blood to some parts of their body for the first time and they're getting more blood in general once they're out once this is activated so water birth babies are going to be a slightly different color because they didn't have that head start and they're going to start breathing a bit later than a land born baby because again the face didn't come out first and didn't get activated first to start this transition and start trying to breathe on your own now I'm glad you find it interesting just reading the chat okay and it's good to know that if you're servicing water birth not to be like smacking the baby sometimes water birth babies it's a very calm transition sometimes they won't even cry you don't need to smack them you don't need to section them which I think we get to in a minute because also I think I forgot to mention when for them to breathe take that first breath in they need to exhale first so they're going to sputter they're going to spit they take care of what they need to do first it goes out and then the breath can come in they need to clear the system out and then it comes in so we don't need to be sectioning them because it has some microbiome and things which I do have a slide on somewhere somewhere later so I'll just repeat and kind of summarize what we covered as far as this full transition for breathing you have the shunts are open in the fetal state that means blood's going in both directions to the placenta in back the blood is bypassing the lungs it's only getting that 8% not the full 55% and the blood goes to the placenta in back we said and then for birth that shunt closes blood is coming only from the placenta one direction and the lungs are getting filled with blood so that it can breathe it's getting up to that 55% mark of taking the circulation up to 55% and the blood is coming again just from the placenta there's still blood coming from the placenta alright so now we'll look at them together the mom and the baby so different capabilities that our bodies have which is very interesting is that both the mom and the baby if it's an all natural birth we'll get a surge of oxytocin so this is the moment that you will have the biggest natural high that is possible for any human is during birth because you're getting this extra surge of oxytocin so this is why again it's possible to have even an orgasmic birth and definitely a pain free birth because you're getting all these extra hormones but it's at that point where both the mom and the baby get this extra oxytocin which is also a bonding hormone so the bond sometimes is stronger when you're having a natural birth between the mom and the baby then if there's any other interferences during the birth and having had medicated breast myself I even myself notice that difference anecdotally when the baby is on the mother's chest which is usually right after a baby is born the ideal place to put them is on the chest because you're getting all the same things for that baby as they have in the womb they hear the mom's heartbeat still the temperature stays the same because the mother's chest will change temperature to match whatever the baby needs even if there's twins and you put one on each side that if one baby if baby A needs a different temperature than baby B the left and right side of your chest will also change temperatures to match what the baby needs so that temperature is a bit more regulated when the baby is on the chest they are close to the breast so they can get food when they want which in the womb they're getting food constantly they don't know this feeling of hunger they don't know the feeling of cold they don't know what light is so it's as close as you can get when you're putting the baby on the chest that's why babies really like it on the mother's chest and sometimes why babies are unhappy unless they're on the mother's chest which is where I would say get a carrier if they're quite picky like that there's also a scent similarity so the amniotic fluid the baby's hands and the nipples all smell the same it's a cool system that helps the baby find where to go and do their their natural breast crawl I'm not sure if somebody else is covering that but babies can have their own head and find the breast by themselves it's called the breast crawl given that the position is in a way that the gravity is helping baby and it can help move around but it's because they can follow the scent and of course the nipples get a bit darker when the baby is formed so that it helps the baby to find it as well what's cool about the areola so the nipple that outer spot is the areola that will analyze the saliva breast milk is going to change as for whatever the baby needs you have if the baby's sick it will change during COVID there was research on what the breast milk was changing to so that they could understand how to help combat it there's also by the age and by the gender of the baby the breast milk is different so if you're donating milk or if you're using expressed milk from someone else it's nice if it matches the sex and the age of the baby as well because it's specifically catered for that and that's all from the areola that the baby saliva is getting analyzed oh I thought you found it breast milk is amazing I agree so back to the microbiome the vaginal canal is where the immunity gets set 80% I heard just the other day actually 80% of what your immunity will look like and how the microbiome is set is from birth which is a big percentage so the vaginal microbes are getting picked up through the canal as the baby's coming out which is again why you don't want to section the baby you want all of this stuff to go down and into the baby and have the baby deal with it naturally so that they're getting as much as possible into their system you don't want to be sectioning the water out of the baby because you're also sectioning out the microbiome so leave everything unless you're going to be doing resuscitation and using a machine you're not going to need to be sectioning there's no reason for it you just let that microbiome go into the baby and get as much as they can from it breastfeeding also supports the microbiome growth and so even I mean even if they do have to have a sterile environment to be born into a caesarean it has been a study to show that it matches much closer after one year if the baby was breastfed for the full year so the breast milk is also giving a lot of good nutrients and bacteria to the baby and just to explain I guess a bit microbiome is what's setting like the immunity in the baby's gut so when a baby's born the gut is quite open it's not like this let's say it's a bit like this so bacteria can get up and be setting it you don't want bad bacteria or antibiotics or a cleaned out system to be setting it you want the neighborhood of the microbiome to be diverse and have all sorts of plants and have beautiful houses you don't want it to be like wiped out as if the fire just went through so this is the difference here that microbiome is really important when I say setting the immunity it's things like allergies and type 2 diabetes and different things that are associated with the microbiome now that they're finding and a lot more studies are coming out so we'll see a lot more in this space I think but asthma allergies, type 2 diabetes even associations with ADHD is all linked to that microbiome and it's because of an imbalance in the microbiome you're not getting the healthy gut bacteria that you're needing antibiotics also likes this out so if you can avoid it during pregnancy and early infancy that's probably best alright one last thing I think this is the last thing is milk capacity so there's a big misconception about breast milk in general that a lot of moms the most common thing I hear anyways I don't have enough milk well you probably do have enough milk there's a difference in what things look like so if you have a milk capacity that's like this your baby's going to be able to go for longer than if you have a milk capacity like this there's a marked difference but there's always free refills so the breast will always be reproducing more milk as soon as the breast is emptied it gets a signal it will still keep refilling so this mother might need to be breastfeeding every hour, every 90 minutes but there's going to be enough milk because it refills it's just they need to do it more frequently than this mother so just a little side about breast milk capacity I had read it's best for babies to be wrapped in towels and blankets from their own family yeah also because you're getting the microbiome like different good bacteria it's not a sterile environment for them so that concludes what I had prepared for you if you have any questions or want a discussion I'm open to it this is how to find me, reach me rice birth center is what I'm opening and delta strength doula is how I've been operating yes most don't realize about the capacity and they do compare their feedings to others which is tough so the more we're talking about the breast milk capacity or the breast capacity it's not based on the size of the breast either so a small chested woman might have a capacity because their milk ducks are up to her armpits versus a large chested woman might have just an average or slightly smaller capacity nothing's right but wrong it's just that you need to understand it so that you know you would be feeding more frequently thank you very much Yasmin thank you very much I think we have a few minutes to wrap up a very informative session quite practical and I have seen the comments in terms of what's coming up on the public chat about that it's an amazing and interesting presentation do we have any questions kindly type on the public chat just before we finalize and wrap up if you have any questions any additional comments I think I've read reading through this most people they're saying they're just saying that this is an interesting and amazing presentation if you have any questions kindly post them on the chat before we wrap up and finalize I know we have just a few more minutes to wrap up and thank you again Yasmin quite a great presentation for us to read through