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March 23, 2018

Can You Breastfeed If You Used THESE Surrogate?

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Today, Kim Kardashian West announced that her surrogate gave birth to a baby girl. If you've been paying attention to Kim's social media, you may have noticed that she's been been in full nesting mode for a while now. Last week, for example, Kim posted a Snapchat video of her favorite products that she uses for nursing. The haul included a nightlight that tells time when you're "up feeding in the middle of the night," and a breastfeeding pillow that she says she "literally gets multiples of" to have in every room of the house.

One observant fan asked: "You're going to breastfeed your new baby? Your milk production is coming how??? Wont the surrogate be the one that will produce the milk???" While only Kim can weigh in on her own personal experience, they do bring up a good point: Can you breastfeed if you used a surrogate?

The short answer is "absolutely," according to Jennifer Thomas, MD, IBCLC, a pediatrician and member of the executive board on breastfeeding for the American Academy of Pediatrics. Often, people will choose to breastfeed if they used a surrogate, or if they adopted a baby right after birth, Dr. Thomas says. It's entirely possible to breastfeed in these scenarios, but it requires more preparation, she says.

Typically, during pregnancy and the early stages of lactation, the amount of milk ducts and glandular cells in a person's breast increase to make more milk. Once the baby is out and on the person's breast, hormones signal for the breast to make even more milk, and send it through the nipples. But what if, like Kim, the person wasn't pregnant? Well, doctors can induce lactation.

Most of the time, inducing lactation involves taking certain hormones, herbs, or medications that trick your body into thinking it's pregnant, Dr. Thomas says. Pumping can also be helpful, because breastmilk is produced on a "demand and supply" basis (meaning: the more you extract, the more is produced), Lauren Levine, MD, told Refinery29 in 2017. According to Dr. Thomas, "Once the intended parent has a good milk supply, the maintenance of her milk supply is no different than trying to maintain it in any other circumstance."

The key is, parents using a surrogate have to decide early on that they're going to try to breastfeed the baby, and usually this is sorted out when drafting the surrogate's contract, Dr. Thomas says. It can take two to three weeks to build milk supply, according to the protocol that physicians use when inducing lactation. All of this tends to be easier if the breastfeeding person has given birth before, but it isn't impossible if they've never given birth, Dr. Thomas says.

Of course, breastfeeding a baby born via surrogate is certainly not without its challenges, and sometimes it simply doesn't work. "Some of the same reasons that mothers cannot conceive — as in hormone imbalances — overlap with reasons that moms have difficulty breastfeeding," Dr. Thomas says.

Who knows how it'll go for Kim (and if she's planning on breastfeeding at all), but we can only assume we'll get an update via Snapchat.

Slideshow: Does Lasik Surgery Hurt? Plus, 10 More Of Your Biggest Questions (Courtesy: Refinery29) 

Slide 1 of 12: <p>If you wear glasses or contact lenses, chances are you've wondered about Lasik surgery at some point in your corrective-vision lifetime. Maybe you've routinely slept in your contact lenses. Maybe you've broken your glasses one too many times. Or maybe you've done something like lost a contact lens on a hiking trip and spent the afternoon in a nature-filled haze, which drove you to consider a permanent fix. These are all very valid reasons.</p><p>But, if the thought of shooting laser beams into your eyeballs to forever change your eyesight is just plain scary to you, you're not alone — it's totally normal to have questions. The good news: "Lasik is the most frequently performed elective procedure in the world, and the success rates are greater than 95% in terms of satisfaction for patients," says <a href="http://my.clevelandclinic.org/staff/2934-ronald-krueger">Ronald Krueger</a>, MD, an ophthalmologist at Cleveland Clinic. Not only is it a common procedure, but large analyses have shown that 91% of patients will achieve 20/20 vision after an initial surgery, Dr. Kreuger says.</p><p>Still have questions? Here are 10 more answers to Lasik questions you've probably wondered about (and Googled). First thing's first: No, it doesn't hurt, but more on that ahead.</p>
 
Slide 2 of 12: No, according to <a href="http://www.hopkinsmedicine.org/profiles/results/directory/profile/7335452/kraig-bower">Kraig Scot Bower</a>, MD, associate professor of ophthalmology at Johns Hopkins University. Lasik surgery is considered an outpatient procedure, and most doctors will give you a dose of Valium in addition to numbing drops with novocaine beforehand, so you won't feel a thing. <br><br>"Once the drops and the Valium kick in, there's no pain at all during the procedure — maybe a little pressure," Dr. Bower says.
 
Slide 3 of 12: Yes, but there's really no reason to worry about that — though it's understandable if the thought of having to "hold still" while people shoot lasers into your eyes makes you panic. <br><br>"The patient is awake, but has had Valium, so it takes the edge off," Dr. Krueger says. "It doesn't knock you out, but makes you not care, so you're just like, Cool, I'm having a laser." Cool, cool, very chill.
 
Slide 4 of 12: Two lasers, actually, Dr. Bower says. After the drugs have kicked in, the doctor will bring you under the first of two lasers. A suction ring is placed over the eye, which presses on the surface of the eye. During that time, a laser delivers millions of pulses, which cut a flap on a layer of the cornea, he explains. <br><br>Then, the doctor will put something on your eyelid so you can't close it, and then bring you to the second laser. With the flap lifted, the second laser reshapes the cornea and vaporizes the tissue on it. After that, the doctor closes the flap and you're done.
 
Slide 5 of 12: You might. "The large majority of people are glasses- or contact lens-free afterwards," Dr. Bower says. <br><br>Some people might need to use glasses for driving at night or reading, he says, but for most of the day, they can be glasses-free. However, many years after your laser surgery, you may need to get glasses for reading, because your eyes naturally change as you age, Dr. Kreuger says. "You can always go back and get touch-ups," he says.
 
Slide 6 of 12: It doesn't really matter how bad your eyesight is, as long as you have healthy eyes (meaning: you don't have cataracts, chronic dry eye condition, or glaucoma), Dr. Bower says. Lasik is very customizable, so you can get it if you're nearsighted, farsighted, or have an astigmatism. You'll work with your ophthalmologist to figure out what the best plan is for your eyes. <br><br>There's even new technology called "topographic guided laser surgery," in which doctors download a map of the front surface of your eye and tailor the lasers to your unique eye shape, Dr. Krueger says.
 
Slide 7 of 12: Usually not, since Lasik is considered an "elective cosmetic" surgery, says Dr. Bower. It's a bummer, but the only people who can really have a case to negotiate with insurance companies are professional athletes, fire fighters, performers, and people who serve in special forces, because they can argue that they need it for work. (Definitely don't bother trying to lie to your insurance company; it's not worth it.)<br><br>Dr. Bower suggests you set aside flexible spending account dollars (if you have them) to pay for it. Typically, the procedure costs around $2,000 to $2,500 per eye.
 
Slide 8 of 12: Nope! You'll see the results a few hours after the procedure, Dr. Krueger says. The whole process is relatively fast for a surgery, and you can expect to be at the doctor's for about two hours, and in the actual operating room for a half hour, he says. <br><br>Immediately after you get Lasik, you'll be able to see things at a distance that before you couldn't see without glasses. "It's still hazy and fuzzy, like you're in a blizzard or underwater," Dr. Krueger says. <br><br>For a few hours after, your eyes can sting, or feel light-sensitive or gritty, but after you take a nap (remember, you're on Valium), you can wake up and see. "When you wake up from that nap, it really is miraculous, because you can see and your eyes feel comfortable," Dr. Krueger says.
 
Slide 9 of 12: Overall, age doesn't matter. The ideal candidate for Lasik is someone in their 20s or 30s, and technically the FDA stipulates you have to be 21 or over, Dr. Bower says. By this age, your prescription is usually stabilized, which means it hasn't changed in at least three years or has only changed slightly in the past 12 months, Dr. Krueger says. <br><br>Doctors have even developed strategies to treat people in their 50s, who may need bifocals. "We can take the strongest of the two eyes and correct that for distance, and leave the other one as a near-sighted option for computers," Dr. Krueger says. "It's a really practical option for people over 40."
 
Slide 10 of 12: It sure does, and Dr. Krueger says to look for three things when choosing a provider: a facility or doctor with a great reputation and lots of experience; the latest technology, meaning they use two lasers; and a doctor who you can continue to see afterwards. <br><br>"Some will make it an assembly line, so you see the surgeon for the first time on the day of surgery," he says. "You want a personalized touch so you can go back and make adjustments or check up on your eyes months after the fact." <br><br>You've probably heard or seen advertisements for Lasik sales or discounts, but be careful with those, because most people won't qualify for those discounts and they don't include a post-op plan, he says.
 
Slide 11 of 12: Besides vision improvements, you might experience dry eye symptoms for the first few months after surgery, but it probably won't become a permanent thing, Dr. Bower says. Immediately after surgery, you'll start a very aggressive artificial tear drop regimen, and you'll have to use them for at least three months after the surgery. The drops help to heal the flap on your eyeball, and prevent bacteria from getting inside and causing an infection. <br><br>"Like any surgery, it's not guaranteed to be risk-free," Dr. Bower says. "We treat complications on a case-by-case basis, but dry eyes is the most common complaint."
 
Slide 12 of 12: The best thing about Lasik is that it's close to impossible to screw up, Dr. Bower says, because they use such high-tech machines. In other words, a doctor can't flinch and make a permanent mistake (like a tattoo artist). <br><br>"You could lose vision [after getting Lasik], but you could also lose vision from wearing contact lenses," Dr. Bower says. <br><br>The Valium you take beforehand ensures that your eyes won't tense up and your eyelids won't close. When you're under the second laser, you have to look at a blinking light, and doing so adjusts the laser to the correct position, he says. "Even if you were to sit up and move, which you can't really because of the Valium, the laser can't fire the pulse of the laser if you're not positioned properly," he says.
Slide 1 of 12: <p>If you wear glasses or contact lenses, chances are you've wondered about Lasik surgery at some point in your corrective-vision lifetime. Maybe you've routinely slept in your contact lenses. Maybe you've broken your glasses one too many times. Or maybe you've done something like lost a contact lens on a hiking trip and spent the afternoon in a nature-filled haze, which drove you to consider a permanent fix. These are all very valid reasons.</p><p>But, if the thought of shooting laser beams into your eyeballs to forever change your eyesight is just plain scary to you, you're not alone — it's totally normal to have questions. The good news: "Lasik is the most frequently performed elective procedure in the world, and the success rates are greater than 95% in terms of satisfaction for patients," says <a href="http://my.clevelandclinic.org/staff/2934-ronald-krueger">Ronald Krueger</a>, MD, an ophthalmologist at Cleveland Clinic. Not only is it a common procedure, but large analyses have shown that 91% of patients will achieve 20/20 vision after an initial surgery, Dr. Kreuger says.</p><p>Still have questions? Here are 10 more answers to Lasik questions you've probably wondered about (and Googled). First thing's first: No, it doesn't hurt, but more on that ahead.</p>
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1/12 SLIDES © Refinery29
DOES LASIK SURGERY HURT? PLUS, 10 MORE OF YOUR BIGGEST QUESTIONS
If you wear glasses or contact lenses, chances are you've wondered about Lasik surgery at some point in your corrective-vision lifetime. Maybe you've routinely slept in your contact lenses. Maybe you've broken your glasses one too many times. Or maybe you've done something like lost a contact lens on a hiking trip and spent the afternoon in a nature-filled haze, which drove you to consider a permanent fix. These are all very valid reasons.

But, if the thought of shooting laser beams into your eyeballs to forever change your eyesight is just plain scary to you, you're not alone — it's totally normal to have questions. The good news: "Lasik is the most frequently performed elective procedure in the world, and the success rates are greater than 95% in terms of satisfaction for patients," says Ronald Krueger, MD, an ophthalmologist at Cleveland Clinic. Not only is it a common procedure, but large analyses have shown that 91% of patients will achieve 20/20 vision after an initial surgery, Dr. Kreuger says.

Still have questions? Here are 10 more answers to Lasik questions you've probably wondered about. First thing's first: No, it doesn't hurt, but more on that ahead.
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