Breastfeeding and Feminism

I’ve just finished reading the recent interview in Macleans with author Joan B. Wolf, titled “Why breastfeeding is overrated”.  Wolf is the author of the new book Is Breast best?: Taking on the Breastfeeding Experts and the New High Stakes of Motherhood.  In the interview, Wolf discusses her opinion that “Science has not demonstrated that breastfeeding is medically superior to formula-feeding”

Breastmilk is not a “magical elixir”, it is biologically normal. As much as some people would like to forget the truth, we are all in fact mammals, and mammals nurse their young. Common sense should tell us that milk from our own species is better for us than the milk of a species whose stomach has four chambers. Cow’s milk is meant for baby cows and has to be extensively processed, with some components taken out and others added, in order for it to be somewhat of an approximation of human milk. Formula has it’s place, and thank goodness we have it available in those times when it is truly needed, however the risks of not breastfeeding are well documented and supported by a large body of evidence. You can read more about why Ms. Wolf’s arguments against the breastfeeding research don’t make sense at Analytical Armadillo.

What amazes me though, is the fact that so many people need “evidence” to tell them that  breastmilk is better suited to human biology than formula. How did we, as a society get that so bass ackwards? (I do know the answer to that, but that’s another post). Breastmilk, and breastfeeding are the biological norm for our species and the reason the formula companies spend billions of dollars every year on marketing, is because they don’t have the evidence to prove that their product is better than breastmilk. The research about breastmilk is fascinating, but it shouldn’t be news to anyone that all of the various components of breastmilk have an important impact on the health of our children. It also shouldn’t be news that there are negative consequences to our children missing out on human milk and the breastfeeding relationship.

Ms. Wolf feels that breastfeeding is a feminist issue, and that there is too much pressure on mothers to breastfeed. The article in Macleans got me thinking about my own ideas about feminism, and for me, it isn’t about demanding to be equal to men in every aspect of society. Sure, women can do almost anything a man can, however as women and mothers, we have a unique contribution to make that is different from what a man can contribute (just as men have their own unique contributions that are different from women’s). That unique contribution should be valued and integrated into society without forcing women to reject their own biology.

In trying to conform and be accepted into a patriarchal society, women have learned to ignore their instincts for mothering.  Those who are still able to hear their instincts are not supported in trying to follow them.  Why are we as women so desperate to ignore our own biology in order to fit into an outdated model of what society should be? My idea of an inclusive society is one where mothering is valued for the profound impact it has on our children. Women would be supported and possibly compensated in their choice to stay home, but also supported and included in the workforce if they choose to return to work. On-site daycares, flexible scheduling, dedicated pumping rooms, etc. would allow women to maintain the closeness to their children that is so important for their development, and yet still remain as an active part of the workforce.

All mothers want what is best for their children, and most mothers want to breastfeed (which is why breastfeeding initiation rates are high).  Many women stop breastfeeding however, in the first few weeks after birth. This is not because mothers are failing at breastfeeding, or because breastfeeding isn’t natural. It is because society is failing mothers. Doctors and other health care providers have little to no training about breastfeeding, there is a lack of publicly funded support for breastfeeding mothers, formula marketing and misinformation about breastfeeding are rampant, and mothers are made to feel ashamed to nurse their children in public.  To me it is the opposite of feminism to be trying to fit ourselves into our patriarchal society rather than demanding that society change to welcome and include mothers. The fact that many women in North America still do not have at least one full year of maternity leave shows how little our society values the role of the mother. It also shows how little understanding there is about the importance of mothering.  I don’t think that we expect too much of mothers, I think we expect far too little from society.

Breastfeeding: It’s not just about the food

Babies don’t nurse just for food. This often comes as a surprise to parents, but babies go to the breast for many reasons. They’re hungry, thirsty, tired, hurt, overstimulated, bored, lonely, in the mood for cuddles, etc. All are equally valid reasons to nurse. Believing that babies only nurse because they are hungry can lead to problems if parents try to hold off feedings because “he can’t be hungry he just ate!”. I’m sure most of us have heard someone say “Don’t let your baby use you as a pacifier!”. My response to this is “I’m not pacifying, I’m mothering!” Pacifiers were invented to allow babies to satisfy their sucking needs when mom is not available, not the other way around. Mothers are not meant to nurse their babies only when a pacifier isn’t available!

Rather than becoming “spoiled” as is commonly believed, research shows that babies who are held and nursed frequently, actually go on to be very outgoing and adventurous children. Babies’ first relationships set the tone for all future relationships in life. By responding to our babies’ needs quickly, consistently and with love, we teach our children that the world is a safe and wonderful place. This gives them the courage to go out and explore because they know that they have a safe and loving place to return to.

Breastfeeding is a relationship that is about much more than just food. The whole experience of being close to mom, having skin-to-skin contact, smelling mom’s familiar scent, hearing her voice and seeing her face, receiving the comfort of warm milk, and the biologically specific components of human milk, all work together to provide the necessary environment for healthy growth and development of your baby.

I have heard people say that comfort nursing is bad because it teaches children to associate food with comfort, but breastfed babies aren’t thinking “I need comfort, so I need to eat”. They are thinking (or probably more accurately, feeling) “something’s not right, I need Mom”. Any milk they get while nursing is an added benefit, but what baby really wants and needs is the comfort and security of being close to mom. Research is showing us that babies who are not breastfed are more likely to be obese, and one theory as to why this is, is that breastfed babies have control over how much milk they take in, and they learn to eat only until they are full. For babies who are not being fed at the breast, someone else has control over the feeding, and bottle fed babies often end up taking in more milk than they really need/want. It is theorized that the overeating that bottle fed babies often experience can set the baby up for overeating later in life as well. There are also hormones present in breastmilk that help to control hunger and  metabolism. These hormones are absent in infant formula.

Breastfeeding is the ultimate mothering tool. You can’t go wrong putting your baby back to breast even if he did eat only an hour ago. Your baby may not be looking for food, but rather the comfort and security that comes with breastfeeding. You’re not being a pacifier, and you’re not creating any bad habits, you’re responding to your baby’s needs. The only time that frequent nursing may be cause for concern is if your baby is not gaining weight appropriately, isn’t having lots of wet and dirty diapers, or consistently seems unsatisfied right after coming off the breast. If this is the case, it would be a good idea to follow up with an International Board Certified Lactation Consultant to determine if something else is going on.

Facebook’s contribution to the declining health of society

Photo courtesy of Flickr Creative Commons/Andrew Weinberg

I was very disappointed on the morning of January 2nd, 2011 when I logged on to Twitter and found out that The Leaky B@@b’s Facebook page had been deleted overnight. Her page provided an active forum where moms could find answers to their breastfeeding questions, and support from other moms who have “been there, done that”. In other words, it provided exactly the kind of support that most breastfeeding mothers need. Unfortunately, this is not an isolated incident. Facebook regularly removes breastfeeding pictures or pages, stating that they violate Facebook’s terms of use.

The terms of use state: Facebook does not allow photos that attack an individual or group, or that contain nudity, drug use, violence, or other violations of the Terms of Use. These policies are designed to ensure Facebook remains a safe, secure and trusted environment for all users, including the many children who use the site.

Hmmmm “These policies are designed to ensure Facebook remains a safe, secure and trusted environment for all users, including the many children who use the site.” Interesting. I have no problem with my children seeing the natural act of babies breastfeeding, however I was very glad that my 8 year old wasn’t standing at the computer when I searched the term “breasts” on Facebook. There are far more inappropriate pages for children than The Leaky B@@b (or any other breastfeeding page) on Facebook.

This is not just an issue for breastfeeding moms, this is an issue that all of society should be paying attention to. Breastfeeding is not just something that women do to provide a few extra benefits to their children. It is a public health imperative.  A recent research study concluded that “If 90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80% compliance)”.

Breastfeeding is the biological norm for our species, and when you mess with nature, there are consequences.  Human milk has over 300 ingredients, including white cells, antibacterial and antiviral agents and stem cells (among many others). Researchers are still trying to determine what some of the components of breastmilk are and what they do. It simply cannot be replicated. Formula has only 40 (non-living) ingredients and there are numerous risks associated with not breastfeeding.

These days most mothers have gotten the message that breastfeeding is important, and most moms want to breastfeed (as evidenced by high breastfeeding initiation rates). The problem is that the number of women exclusively breastfeeding drops off dramatically in the first month. Women are repeatedly given the message “breast is best”, but we do not live in a breastfeeding friendly society. How are mothers supposed to get the help and support they need when doctors and other health care providers  have little to no training in breastfeeding, breastfeeding clinics are being closed, and mothers are being kicked out of public places for breastfeeding.

Facebook is a great example of the fact that society really doesn’t support breastfeeding families. How are mothers supposed to feel confident about breastfeeding their babies when they are repeatedly getting the message that breastfeeding is shameful and shouldn’t be seen by others?  By deleting breastfeeding photos and labeling them as obscene, and by deleting pages that provide support and information to thousands of breastfeeding mothers, Facebook is contributing to the struggles that many breastfeeding women face everyday.

So why should you care? Because it’s your tax dollars that are being raised to pay for our society’s declining health. Low breastfeeding rates don’t just impact a few children who happen to get more colds that their breastfed counterparts do. They impact all of us. All you need do is read or watch the news to realize that we are a very unhealthy society, and high health care costs affect everyone. So whether you’re a parent or not, whether you’re breastfeeding or not, this really is an issue for everyone, and shame on Facebook for being part of the problem rather than part of the solution.

Update January 5th 2011 1030 EST:

The deletion of The Leaky Boob’s Facebook page caused a lot of outrage (and rightly so!). Within 48hrs, the Facebook page “Bring Back the Leaky Boob” that had been created, had over 5000 “likes”. It has also been blogged about in numerous places, and a press release was sent out. Yesterday afternoon, those of us who support Jessica at The Leaky Boob, were thrilled that her page had been re-instated by Facebook, only to find out 6 hours later that it had been removed again, along with the Facebook support page. A new page titled Bring Back the Leaky Boob – again has been set up to show support.

Update January 6th 2011

The Leaky Boob’s Facebook page was reinstated yesterday afternoon, and is still up! So thank to everyone who showed their support.

Obese 9 month olds?

Several news stories appeared yesterday, based on new research that suggests that almost one third of 9 month old babies are obese (along with 34% of 2 year olds). I haven’t been able to access the original study yet, but according to this news story: “The researchers classified the babies’ weights based on CDC growth charts, which compare a baby’s growth to a standardized growth curve. Kids in the 95th percentile of weight were categorized as “obese,” while kids in the 85th to 95th percentile were counted as “at-risk,” similar to the adult category of “overweight,”.

I see a problem with this. The researchers were using the CDC growth charts when even the CDC itself recommends that the World Health Organization (WHO) growth charts should be used for children ages 0-2. The WHO charts, unlike the CDC charts, are based on the growth of babies under biologically normal conditions (breastfeeding, mother’s who don’t smoke etc). When looking at a child’s growth, it is important to be comparing to the biological norm, not a cultural one (if they had used the WHO charts they likely would have found even higher numbers of “obese” babies!).

The report goes on to say: “The find hints at an unfortunate pattern: Kids who start out heavier end up heavier. Of kids who were normal weight at 9 months old, 75 percent were still normal weight at 2 years. But kids who were at-risk at nine months had only a 50 percent chance of being normal weight at age 2. More than 28 percent of at-risk kids ended up obese by their second birthday.”

Another problem: what is a “normal weight” for a baby? Weight for age growth charts compare a child’s weight to other children of the same age, which really is not very useful. Is your baby healthier than mine because he weighs more or less than mine does? Of course not. All babies are different and someone has to be in the lowest percentile, just like someone has to be in the highest.

The 50th percentile on a growth chart does not equal “normal” weight. It simply means that statistically speaking, 1/2 of all babies of the same age will weigh more, and 1/2 will weigh less. Isolated points on a growth chart have little meaning. What is important is whether or not your not your child is following his/her own curve. If your child falls on the 75th percentile, then he should continue to follow that line on the chart. If your baby falls on the 5th percentile, and is following that curve, then your baby is growing appropriately. A baby on a lower percentile isn’t any more or less healthy than a baby on a higher percentile.

I am curious how the researchers decided that babies who fell in the 95th percentile would be classified as “obese”, and those falling in the 85th-95th would be classified as “at risk”.  Obesity in adults is classified according to Body Mass Index (BMI), not weight. It is not clear from the news story which growth charts the researchers were using in the study (weight for age, weight for length or BMI for age). The type of chart used makes a big difference to how the results should be interpreted.

Childhood obesity is certainly a serious issue that needs to be addressed, but I worry that news stories like these will cause parents to worry unnecessarily about their baby’s weight. Not having a proper understanding of how growth charts work and how they should be used, can lead to parents (and even health care providers!) making changes to a baby’s diet that are usually not in the best interest of the baby. Parents being told to supplement breastfeeding with formula because their baby is on the 3rd percentile and therefore “too small” or being told to restrict feedings or give water between feedings because their baby is “too big” are getting bad advice (and yes, I’ve heard both from parents that I’ve worked with!). Growth patterns can vary widely among young children. Some start out very long and lean and slowly put more weight on, and others start out shorter and heavier and gradually grow into their weight. Labeling a baby as “obese” at 9 months old when most babies haven’t even started walking yet seems absurd.

Thoughts?

Baby-led Bottle Feeding

Unlike breastfeeding, we’ve all seen bottle feeding, and we all know how to do it. We’ve been surrounded by it growing up. If someone handed you a baby and a bottle you would know what to do right? Of course you would, but would you know how to do it without causing a stressful feeding? Despite the large number of parents who use bottles in today’s society (whether those bottles contain breastmilk or formula), there are very few who have actually been taught how to bottle feed their baby in a manner that is respectful of the baby’s airway and natural feeding rhythm.

Bottle feeding may seem like a strange topic for a lactation consultant to be blogging about, but I feel it’s an important one. Conventional bottle feeding methods can cause problems for both breastfed and bottle fed babies, and all babies deserve to be fed in a respectful manner. By “conventional” bottle feeding, I mean the method of bottle feeding that most of us are used to, which is baby more or less on his back, and the bottle being tipped up to ensure there are no air bubbles.

This baby is being overwhelmed with milk and is showing clear stress signs.

Although I work with breastfeeding moms and babies, I do a lot of teaching about bottle feeding. The moms  that come to me, are usually having difficulty with breastfeeding, and are sometimes supplementing breastfeeding with bottles of expressed milk or formula. There are of course alternate methods of supplementing (supplemental nursing system, finger, syringe or cup feeding) but many moms are either already using bottles when I see them, or find that bottles are simply easier to deal with because they are familiar.

I often hear from moms who are afraid that they aren’t producing enough milk because their baby will gulp down a bottle after breastfeeding. It’s important for parents to understand that with conventional bottle feeding methods, babies have no choice but to gulp down everything in their bottle in order to protect their airway. If you hold a bottle upside down (even one with a slow flow nipple), it drips. When a baby being given a bottle swallows, the negative pressure created draws more milk into the baby’s mouth, meaning the baby has to swallow again to avoid choking. This is stressful for the baby, and babies will often display stress cues such as splayed fingers or toes, milk running out of the corner of the baby’s mouth, trying to turn their head away, or trying to push the bottle away. The picture above is a good example of this.

It’s not normal for babies to gulp down their entire feeding in a few minutes. When you watch a baby breastfeeding, you see that they drink for a while then take a little break before drinking again (with the exception perhaps of oversupply/forceful let down, which is a different situation). Breastfeeding is the biological norm for infant feeding. This means that with any other feeding method used, care should be taken to mimic breastfeeding as much as possible.  I have seen conventional bottle feeding methods lead to overfeeding, spitting up, reflux, wheezing and  difficulty breathing while feeding, and even feeding refusal (due to feeding being so stressful). Bottles being given to a breastfed baby can also cause problems with breastfeeding. Babies suck differently from a bottle than they do at the breast, and babies can become accustomed to the faster flow of milk from a bottle, causing them to become impatient at the breast. The tips below can help to minimize some of the problems associated with bottle feeding.

Good positioning for bottle feeding, and a baby who is relaxed and enjoying feeding.

 

Tips for bottle feeding any baby (not just a breastfed one!)

1. Hold your baby sitting upright, and start by placing the nipple of the bottle against your baby’s top lip. Wait for your baby to open up before putting the bottle in his mouth. Never force a bottle into a baby’s mouth.

2. Your baby should be sitting up enough that the bottle is horizontal (parallel to the floor). Tip the bottle just enough to keep the tip of the nipple filled with milk (as the bottle empties, you will have to tip the bottle up more). It’s fine if there is an air bubble at the base of the nipple as long as the tip is filled with milk. This works much better with a straight bottle rather than an angled one.

3. If you are supplementing a breastfed baby, or pumping and bottle feeding in the hopes of getting baby back to nursing, it is beneficial to let your baby suck on the nipple for a minute or two without getting anything, and then tip the bottle so your baby is getting milk. When breastfeeding, babies have to wait a minute or so for mom’s milk to let down, and they have to suck to trigger that let down. Babies who have been bottle fed sometimes get used to the immediate reward from the bottle and then are impatient at the breast and don’t want to wait for let down. By letting baby suck for a short while without getting anything from the bottle, you are mimicking the process at the breast, and it can help with the transition. There is no need to worry about your baby taking in air, one end or the other it will come back out!

4. Watch your baby’s cues All babies, whether breast or bottle fed should be fed whenever they show signs of being hungry, and not according to any kind of schedule. During feeding, if your baby starts to show any signs of stress (splayed fingers and toes, milk spilling out of mouth, turning head away, pushing bottle away – see picture above) then your baby needs a break. Keep the bottle in your baby’s mouth, but tip the bottle so that the nipple is pointing towards the roof of the baby’s mouth. By doing this, your baby knows that the bottle is still there and will start sucking again when ready. At that point you can tip the bottle back up so that baby is again getting milk. It is frustrating for your baby if you take the bottle out of his mouth to give him a break because he doesn’t know where it has gone or if it’s coming back. If your baby is showing signs that he is done (turning head, trying to push bottle away etc), then respect those cues and end the feeding.

5. Alternate sides part way through the feeding to mimic breastfeeding and allow stimulation to both eyes and both sides of the body. This also helps to prevent the development of a side preference when feeding.

6. Find a nipple that works well for your baby. There are no black and white answers as to which bottle nipple is “best” for a breastfed baby, because all babies are different. For young babies, make sure you are using a slow flow nipple. Even with older babies a slow flow nipple may be best if your baby is struggling with the flow of milk. Don’t worry about the recommended ages on the bottle nipple packaging, watch your baby to determine what works best for them. Unfortunately, “slow flow” is not something that is standardized, and some “slow flow” nipples actually flow quite quickly, so again, watch your baby. I do not recommend the “Nuk” or orthodontic type nipples because mom’s nipples don’t look like that! (If mom’s nipples are pinched or flattened after baby feeds, it’s a sign that baby isn’t latched on properly, or some other issue is causing baby to compress the nipple). Your baby should be able to “latch” onto the base of  whichever nipple you use. Some bottle nipples that are advertised as having a wide base and being “more like mom’s breast”, are so wide that baby ends up being just on the nipple, which is something to be avoided. There are some good pictures of how your baby should look when latched onto a bottle nipple on this post from Best for Babes titled How to Bottle-feed as You’d Breastfeed, and more information at the website www.breastandbottlefeeding.com.

Things to avoid:

1. Never prop a bottle. It’s a dangerous practice that is stressful for your baby.

2. Don’t bottle feed your baby while he’s swaddled. You need to be able to see your baby’s hands to watch for stress signs, and your baby needs to have his hands free to participate in feeding.

3. Don’t feed your baby with him facing away from you. Feeding is an important time for the development of social interaction in babies. Make eye contact with your baby, talk to him and enjoy the feeding as a fun interaction with your baby rather than another task to get through as quickly as possible.

4. Don’t force your baby to finish a bottle by twisting it or moving it around in baby’s mouth. Let your baby decide when he’s done. Overfeeding can lead to an uncomfortable and unhappy baby!

 

More information about the baby-led method of bottle feeding can be found in Dee Kassing’s article Bottle-Feeding as a Tool to Reinforce Breastfeeding

 

Use of formula

Along with bottle feeding, I also do a lot of teaching about correct formula preparation because many parents are not informed about the dangers of giving powdered formula to young or ill babies, and haven’t been taught how to prepare powdered formula properly.

Powdered infant formula is not a sterile product and there have been cases of powdered formula being contaminated with the bacteria E. sakazakii which can easily be fatal for young children. Babies under the age of one year are at particular risk of infection with E. sakazakii, with the greatest risk being for those who are less than 28 days old, or who are preterm, low birth weight, or immunocompromised (have a weakened immune system). For these babies, liquid formula should be used because it is sterile.

If you are using  powdered formula it is very important for it to be properly prepared in order to kill any potential bacteria. Powdered formula needs to be mixed with water that is at least than 70 degrees Celsius (boil the water and let it cool for no more than 30 minutes before mixing it with the powder). It can then be cooled to an appropriate temperature for feeding or cooled and stored in the fridge for no more than 24hrs. You can read more detailed information about the proper preparation of powdered infant formula here.

If you are using liquid formula, make sure you follow the directions on the can closely. There are two types of liquid formula – ready to feed and liquid concentrate. The liquid concentrate must be mixed with the proper amount of water (as outlined on the can) before feeding. Failure to mix liquid concentrate formula with the right amount of water can have severe consequences for your baby.

 

 

Expectations

When I was pregnant with our first child, I had a picture in my mind of what it was going to be like staying at home with our baby. I envisioned my husband coming home from work each day to a clean house, with supper ready and our baby peacefully sleeping. Reality was of course a far cry from what I had envisioned! With a baby who nursed every hour and a half for an hour at a time, My husband was lucky if I had managed to get dressed during the day let alone have a shower, clean the house or make dinner.

Looking back, my expectations were of course very unrealistic. I was the first in our family to have a baby however, and also the first of my friends, so I had no experience with the realities of motherhood. My expectations were based on what I had seen on TV, in movies, and in books and magazines. Those idealized images of “Supermom” having a spotless house, dinner on the table, and hair and makeup done all while caring for a young baby, were all I had to go on.

Because of this, the transition of going from working woman to stay at home mom was a difficult one. During the many hours that I spent nursing our son, I would often get frustrated by his frequent nursing. I had other things that I needed to get done. Whatever happened to newborns sleeping most of the day?! I was used to being on the go and busy, so spending most of the day sitting on the couch felt like wasted time, and I felt guilty when the household chores went undone. Other parents could manage a baby, house and husband, so why couldn’t I? My husband was very supportive, and certainly didn’t care that dinner wasn’t ready or that the house hadn’t been tidied up, but I did care, and I felt guilty for not being able to “do it all”.

By the time I was nursing our second child, my expectations were more realistic, however I still struggled with the difference between my expectations and reality (especially with another child to look after!). It was not until our daughter was much older that I came to the realization that during all those hours of sitting on the sofa nursing, I was actually doing something very important. The most important thing I will ever do in my life. I was feeding her, comforting her, stimulating her brain growth and development, and teaching her about trust and loving relationships (all by just nursing!). Once I came to the realization that nursing her was my job, and an important one, it became much easier to ignore the laundry that was piling up and the fact that we were having sandwiches for dinner (again) because I hadn’t had time to cook. I was able to adjust my expectations, and accept the fact that I was going to be spending a lot of the day (and night!) nursing. These days, I really miss those evening periods of cluster nursing when I had an excuse to put my feet up, put the TV on and stay there for 3 hours!

Unrealistic expectations can lead to a lot of problems. They can be damaging to the breastfeeding relationship, and can often lead to early weaning. When a newborn baby is hungry every 2 hours (which is very normal), the expectation that babies only need to eat every 3-4 hours can cause a mother to doubt her ability to produce enough milk for her baby. Expectations can be damaging to a woman’s sense of herself as a mother. It’s easy to feel like a terrible mother when you’re struggling (as I was) with an unrealistic view of what it’s like to be a mom. When you’re out in public and seeing mothers around you who look happy with their perfectly behaved children, you start questioning your abilities as a parent. Expectations can also cause unnecessary struggles with your children, when (for example) you are trying to get your young baby to sleep through the night because that’s what the books say your child should be doing.

Considering the fact that most of us have grown up in a society where detached parenting has been the norm, and the supermom stereotype is readily perpetuated, it’s not surprising that many of us do have very unrealistic expectations. Combine this with the fact that many women have never even held a newborn baby, let alone seeing someone else breastfeed or parent their child, and many of us are sadly unprepared for the realities of motherhood. We are not meant to parent in isolation. We learn from watching others, and sharing ideas and experiences. This is why it is so important to establish a good support system. In my early days as a parent I found a lot of support on-line, and eventually with my daughter, I found La Leche League. As friends and family started having babies of their own, they also became a valuable source of support.

As I grew as a mother, and saw those around me struggling with the same things I had struggled with, I realized that when you see those happy mothers in the store with their perfect children, there is something you haven’t seen. You haven’t seen that same mother yelling at her perfectly behaved children moments before they entered the store because she’s having a rough day and her children were fighting non-stop in the car. During my time as a La Leche League Leader, I would often hear mothers who were new to our group comment on how well behaved the children were and how relaxed the mothers were during meetings. Usually they were commenting because they felt like that would never be them, and they were feeling insecure about their abilities as a mother. That is why I used to make it a point during some meetings to talk about the things that we are less than proud of as mothers. Those were the times when you would hear about those calm mothers yelling at their children because they just can’t take the whining anymore, or the frustrations of constant tantrums. You would hear about the less than healthy meals that their children have had during those times when the moms are so tired from late night feedings, or being up with a sick child that they can’t find the energy to cook. You would hear about the piles of laundry and the fact that they hadn’t cleaned their bathroom for 2 weeks, and you would start to realize that you’re not such a bad mother after all!

There is no such thing as a perfect parent, and we certainly do ourselves no favours as a society by holding up an unattainable ideal for mothers. I still struggle at times with my own expectations of myself as a mother, but I have made a lot of progress. I have surrounded myself with a strong support system, I’ve learned to listen more to my heart and my instincts, and most importantly, and I’ve learned to be gentle on myself when reality doesn’t live up to my expectations.

Beware of Holiday Weaning

With the holiday season fast approaching, I am anticipating getting calls about fussy babies and low milk production. Why does the holiday season bring about these calls? Because moms get busy. There’s Christmas shopping to do, cards to write and mail, parties to attend, groceries to do, meals to be planned and prepared, traveling and visiting with friends and family etc. The holidays are a busy time, and sometimes in all the hustle and bustle and excitement, breastfeeding is often (unintentionally) disrupted.

It’s easy for feedings to be missed when your baby is being passed from family member to family member. For some babies this might not be a problem if they are the type of baby who will protest loudly (usually prompting a quick return to mom). For babies who tend to be very easy going however, two things can happen in this situation. One, is that your baby becomes overwhelmed by the stimulation and shuts down by going to sleep. The other is that well meaning family members, in an attempt to “give you a break”, try to soothe your baby rather than handing him over for you to nurse, and again, your baby shuts down and goes to sleep (and misses a feeding). Older babies may be too distracted by all the excitement to actually settle down and nurse. Sometimes feedings may be missed or held off because you’re in the car (out shopping etc), and it’s not a convenient time to nurse.

Because milk production works according to supply and demand, these missed feedings can have an impact on the amount of milk you produce. Another factor is that stress can inhibit letdown (and lets face it, the holidays are often a stressful time!). If letdown is slow, this can result in a baby who is fussing at the breast which can cause a mom to doubt her ability to feed her child. Baby is fussing not because milk production is low, but because the milk isn’t letting down fast enough and he’s getting impatient. Sometimes however, depending on how patient your baby is, he may not take in as much milk as usual. This sends a signal to your body to slow down milk production and if the situation is prolonged, it can result in true low production of milk.

Along with this is the inevitable unsolicited advice from family members and friends which can sometimes shake a mother’s confidence that she is doing the right thing “How can he be hungry again? You just fed him!” “You’re going to spoil him by nursing him and holding him so much”. “Are you sure you have enough milk?” Comments like these can cause a mother to question her abilities and choices.

A temporary dip in milk production due to a few missed feedings and holiday stress, is usually easily fixed by increasing the frequency of nursing and spending as much time as possible skin-to-skin with your baby. Sometimes however, the holidays are a slippery slope to early weaning. Missed feedings, fussiness due to over stimulation and a mom’s decreased confidence in herself due to comments from friends and family can lead to the introduction of bottles. If mom is not pumping every time her baby gets a bottle, her body gets the message to slow down milk production. Combine this with the possibility of baby developing a preference for the fast flow of milk from a bottle, and soon you have a baby that isn’t happy at the breast. With perseverance the situation can usually be resolved, but more often than not it leads to complete weaning from breastfeeding, and can leave mom with a lot of self doubt.

In order to avoid holiday weaning, remember: family first, and people before things. It’s OK to set limits and say no to family and friends if you feel that you (or your baby!) can’t cope. Try to make sure that your baby is nursing according to his/her usual pattern, and be alert to your baby’s cues. Be prepared to intervene if your baby is getting over stimulated, needs some extra nursing etc. If necessary, find a quiet place to nurse so that your baby is not distracted while nursing, and most important of all, don’t allow yourself to feel guilty if nursing is preventing you from “helping out”. Your baby doesn’t know it’s the holidays, and his needs don’t change just because it’s a busy time of the year. Frequent nursing will make sure that your baby continues to get what he needs, will help to protect both of you from the stresses of the holiday season, and will prevent holiday weaning. Happy Holidays!

 

 

Why breastfeeding help should be hands off

When helping moms who are struggling with breastfeeding, it can be very hard to resist the temptation to get right in there and help latch the baby on. It is important however for breastfeeding helpers, whether IBCLC, nurse, midwife, LLL Leader, peer counselor etc, to be hands off when it comes to helping mothers with breastfeeding.
The most important thing we can do when working with breastfeeding families, is to help empower the mother to believe in herself and her ability to feed her baby. If we latch the baby on for her, we take her power away. I’ve spoken to too many moms who say to me “It worked fine when the LC (midwife, nurse etc) was here, but now I can’t get him latched on and I don’t know what to do”. How long is a mother going to breastfeed if she feels like she can only do it with someone beside her to help latch her baby on? What does that do to the mother’s self-esteem? Many women feel like failures if breastfeeding doesn’t work out, or they are having difficulties. “I can’t even do something as natural as feed my own baby” (this is even worse if the mother is already feeling like a “failure” due to a birth that didn’t go as planned). Breastfeeding help certainly should not be contributing to feelings such as these!
Hands on help can also cause other problems beside the damage it can cause to the mother’s self-esteem and confidence. Babies who have been roughly handled at the breast (“The nurse grabbed his head and shoved him on there”) can develop an aversion to nursing. This of course further erodes the mother’s self confidence and many mothers take it personally, thinking things such as “he’s pushing away so he must not like me”. Babies who are latched on this way seldom have a good latch, and then you are also adding sore nipples into the mix which further decreases the chance that mom is going to continue breastfeeding.
Something else to consider is the effect that hands on help might have on a woman who is a survivor of sexual abuse. Breastfeeding can sometimes trigger strong reactions in survivors of abuse (it can also be very healing as well). Too many times I’ve heard or read the words “she just grabbed my breast and latched him on” and I cringe when I think about how extremely damaging that kind of “help” could be.
If you want to teach someone how to do something, you don’t do it for them. You provide information, support and encouragement and allow them to work out the fine details for themselves. Mothers and babies already have all the instincts they need to breastfeed effectively, but these can sometimes be drowned out by our culture. Mothers need to be empowered to embrace their instincts. A skilled breastfeeding helper should be able to describe to a mother how to assist her baby to get a good latch. I find that my “teaching doll” (as my daughter calls her) is a wonderful tool because mothers learn by watching other mothers (a reason why it is a wonderful idea to attend La Leche League meetings while still pregnant, or while trying to refine latch and positioning). I use the doll to demonstrate positioning and latching technique. Rarely do I use my hands on mother or baby, other than occasionally supporting mom’s movements as she latches her baby on herself.
So what can breastfeeding helpers and mothers do? To start with, breastfeeding helpers should sit on their hands if necessary! I know that the urge to latch a baby on comes from a feeling of wanting to help, but as I hope I’ve pointed out here, it can do more harm than good.
For moms, let your breastfeeding helpers know that all you need is instruction and demonstration, and that you want to be able to do it yourself. Don’t be afraid to tell them “Hands off!”.

What my children learned at my breast

Breastfeeding has taught me many things about being a mother, but I was thinking recently about what it taught my children. As I thought about it, I realized that it taught them much more than I realized at the time.
My son nursed until he was 5 months, at which time we weaned due to undiagnosed tongue tie that led to severe biting. Although it was a short time compared to the 3 years and 3 months that my daughter nursed, the many hours that we spent nursing taught my son that I was there for him and that his needs would be met. The skin-to-skin contact, my scent, the sound of my voice, along with my milk, all helped to nourish and grow his body and brain. My son learned that the world is a safe and wonderful place, and those emotional memories will be the place from which he approaches the world.
My daughter learned the same lessons as a young baby, and as a toddler, she learned many other lessons at the breast. My daughter learned to share at the breast. Little did I realize at the time that nursing all those stuffed animals, dolls and plastic toys was actually helping my daughter learn to share and wait her turn! My daughter learned to be gentle. The bruises and scratches on my arms from my daughter pinching me while nursing just couldn’t continue, so I taught her nursing manners. Whenever she started to pinch, I would take her hand and stroke my arm with it while saying “gentle”. When she started to bite I would say no biting, put her down and walk away for a moment. She would cry and then we would sit down again for her to nurse. She learned that there are limits on what we can do to each other, and that certain behaviours are not acceptable.
During those times of toddler nursing when I was feeling touched out and had to limit nursing for my own sanity, I would tell her “Mommy’s going to sing the alphabet (or count to 10) and then we’re done” My goal was to finish nursing as quickly as possible with as little fuss as possible, but during those trying times of me feeling touched out by a toddler who was nursing like a newborn again, my daughter learned the alphabet and how to count to 10.
During the wonderful, peaceful times that we had in the rocking chair as I was nursing her to sleep, I would sing to her. I am certainly no singer, but I sang because I had read that it could help to ease the transition to going to sleep without nursing. When she was ready, we gradually replaced nursing to sleep with just cuddles and songs. I was doing it to make things easier on myself and my husband, but I realize now that all of my singing helped my daughter to develop a love of music. My daughter is now 7 and my son is 9, and singing is still a part of our bedtime routine that all of us look forward to.
My daughter learned to be patient at the breast. As she got older and I became less comfortable nursing her in public, she sometimes had to wait to nurse. If I was feeling stressed, sometimes she had to wait for my milk to letdown. Although it may have been frustrating for her at times, those moments taught her that patience has its rewards.
At the time, as I dealt with the trials of a nursing toddler, I didn’t realize that I was also teaching my daughter life lessons. Looking back I can see that there are many things that she learned during our time spent nursing, and I am thankful that simply putting her to breast taught her the most important lesson of all. She learned to trust. I was always there, ready and willing to nurse her whenever she needed to. Whether she was hungry or thirsty, hurt or scared, tired or overwhelmed, I was there to nurse her and help her feel better. She learned that she was safe and secure and that her needs would always be met. Because of that, she is a very adventurous, outgoing and social child. It is certainly possible to teach children the same thing without breastfeeding (as evidenced by the fact that my son is also securely attached, outgoing and adventurous) but nursing just makes the whole process so much easier. I really miss the days of being able to soothe a tantrum or settle my daughter to sleep just by nursing. It often felt like I wasn’t doing anything other than sitting around all day, but looking back I can see that I was teaching my daughter some very important lessons, and laying a strong foundation from which she can fearlessly go out and meet the world, knowing that she has a safe place to come back to.

 

If Only I Had Known

While trying to get started with my blog, I found myself getting really stuck with my first post. While struggling with my writing, I started to think about what my goals are with my blog. In short, my main goal is to try to provide parents with the information that I wish I had been given before having my own children.
During my journey so far as a mother, I’ve had plenty of moments where I’ve found myself thinking “I wish I had known this when my children were babies”. The more I learn about breastfeeding, mothering and attachment parenting, the more I realize how little I knew when I first brought a new life into this world. When I was pregnant with our first child, I was working as an RN on the obstetrics unit of the local hospital, and I thought I was well prepared to birth, and care for a baby. I’m well educated, I had read the typical books, and taken a prenatal class with my husband. I figured I was ready! Time has taught me however just how wrong I was.
Breastfeeding seemed to go well with our son, although feedings usually took about an hour and he was feeding every hour and a half. Around 5 months, he started biting me badly at every feed. It got to the point that I dreaded feeding him, and eventually, we weaned him to bottles of formula (I know now that his biting was due to an undiagnosed tongue tie) .
Looking back, I find myself thinking “If only I had known then what I know now”. None of the resources I read before the birth of our son explained about the risks of artificial feeding. Everything I read or was told, suggested that breastfeeding was best, but formula was OK if it didn’t work out. At the time, no one told me that there are numerous risks to artificial feeding (the increased risk of asthma for example, which our son has) . No one taught me baby-led bottle feeding to avoid overfeeding, or that rice cereal isn’t a necessary first food and that it’s not necessary to puree everything. I didn’t know about the advantages of co-bedding or babywearing. I didn’t know about a lot of things.
We muddled through of course, and thanks to the fact that my husband and I at least trusted our instincts and ignored the constant warnings that we were holding him too much, our son is securely attached, and a very happy and outgoing child.
Looking back at the choices we made, I don’t feel guilty about the fact that I weaned him to formula, I feel angry. Angry that with all the evidence based information about breastfeeding and parenting that is out there, for some reason, it is not getting to the people who need it the most – the parents!
All of my information came from mainstream books and magazines that contained questionable information, booklets from formula companies that are designed to undermine breastfeeding, and doctors and nurses who had little to no training about infant feeding. It’s no wonder I didn’t make it past 5 months of breastfeeding with my son.
With our daughter, who was born 27 months later, I knew more, but we still struggled for the first four months of breastfeeding (undiagnosed posterior tongue tie). The only reason we made it to just over 3 years of breastfeeding was because of my extreme stubbornness the second time around. I was determined it was going to work, and it did, but the first few months were horrible, and would have been so much easier if only I had known….
So my goal at the moment is to try to make sure that the next generation of parents have fewer “If only I had known!” moments than my husband and I have had (and will continue to have, I’m sure) with our children.