Breastfeeding Guidelines for Pediatricians

I was recently emailed an article that I wanted to share with the blog readers.
This article was published in Pediatrics : The Official Journal of the Academy of Pediatrics almost a year ago, but as far as I know it is the most up to date recommendation from the American Academy of Pediatrics to pediatricians. The part that I found the most interesting was the section on the contraindications of breastfeeding(medical reasons why some people should not breastfeed). There were a few very specific conditions where it was unsafe for the mother to be around the child, but even in many of these situations it was still recommended that the child be given expressed breastmilk for his/her health.

No where did it say that children should not be breastfed because of low milk supply. I have heard from so many women that they were unable to breastfeed because of low milk supply. This article seems to indicate that "low milk supply" is medically speaking a non issue. I have heard this in the past from La Leche League leaders, but I was glad to see it from the American Academy of Pediatrics.

I also found the following statistics amazing. This is a direct quote from the article : "It has been calculated that more than 900 infant lives per year may be saved in the United States if 90% of mothers exclusively breastfed for 6 months.

In the 42 developing countries in which 90% of the worlds childhood deaths occur, exclusive breastfeeding for 6 months and weaning after 1 year is the most effective intervention, with the potential of preventing more than 1 million infant deaths per year, equal to preventing 13% of the worlds childhood mortality. "

When this sort of information is being given to pediatricians, how does it happen that they are still sending mothers home with formula samples and talking about "low milk supply"?  How is it possible that in a literate society like the United States only 13% of children are being exclusively breastfed for 6 months?

The article also contains hopeful information about the goals that are being set to increase breastfeeding in this country and improvements in initial breastfeeding rates. I encourage everyone to read the full article. It contains useful information about a number of health issues that are positively affected  by breastfeeding.

Here is the link to the article:
 http://pediatrics.aappublications.org/content/129/3/e827.full.pdf+html

Can I have a Drink?

Breastfeeding and Alcohol Consumption

A response to the waitress fired for reporting mom drinking and breastfeeding.

http://www.nydailynews.com/news/national/waitress-fired-reporting-mom-drinking-breastfeeding-article-1.1532626

This story of a waitress being fired for reporting a mother to police for drinking while breastfeeding caught my eye.  As a breastfeeding mother who enjoys the occasional glass of wine this story and made me worry.  Do people judge ME because I drink as a breastfeeding mother?
The story reports that the waitress watched as the mother allegedly consumed drink after drink while breastfeeding her 7 month old baby.The waitress acted in the interest of safety for the baby. Unfortunately, we will not be able to hear the mother’s side until her trial but she does try to say that it's been blown out of proportion and she’s not a horrible person .  Also, as for the waitress, she was let go from her job a few days after the incident. It seemed like the action against her was in response to her calling the police.  Maybe it was not handled correctly according to restaurant policy or was there another reason she was let go?
As for “rules” on alcohol consumption and breastfeeding, there are some conflicting views. However, to simplify things I decided to go with what I saw on LaLeche League https://www.llli.org/faq/alcohol.html

As  Dr. Jack Newman, member of the LLLI Health Advisory Council, says this in his handout

"More Breastfeeding Myths":

“Reasonable alcohol intake should not be discouraged at all. As is the case with most drugs, very little alcohol comes out in the milk. The mother can take some alcohol and continue breastfeeding as she normally does. Prohibiting alcohol is another way we make life unnecessarily restrictive for nursing mothers.”

Another great source is http://kellymom.com/bf/can-i-breastfeed/lifestyle/alcohol/

I personally do not drink and breastfeed simultaneously or for 1-2 hours following consumption and my daughter is just fine. Plus if it helps you to relax after a long hard day, a relaxed mommy is way better than a tense, stressed out one. The positive results can outweigh the potential negative ones.

For more details and information see the recommended websites as well as check with your physician or pediatrician.

What Would You Do?

If you noticed something that didn't look right involving a child and parent in public would you act to make it right or would you let it go thinking it's not your place? Was calling the police without first trying to speak to the woman the best response in this situation?

Mom’s Night Out

Mom’s Night Out

    I did something nice for myself the other night and it was much needed.  Local shop owner and self-claimed “mompreneur”, Jessica Walsh of Illuminated Baby hosted a Mommy Mixer in Woodstock at Oriole 9.  As stated in a recent article in the Chronogram, Jessica is looking to create a community and I think she’s got the right idea. http://m.chronogram.com/hudsonvalley/the-amazing-adventures-of-the-marvelous-mompreneurs/Content?oid=2214810&issue=2214726

    She really has a way of putting together a great group of people and facilitating new friendships.  When I arrived at the restaurant  I was greeted by some familiar and some new faces. I was then directed to a table with name tags where I was to write my name, my child’s name and age. This along with another of paper of questions was  an icebreaker type of game. Not seconds after I was done putting on my name tag I was grabbed into a conversation with two moms eager to fill in their sheets.  “How old were you when you gave birth to your first child?” one lady asked. “What month was your child born?” asked the other, and then the next question, and the next.  Very quickly we warmed up and began chatting away.  

    Even though the intention was for moms to get out by themselves and be with other moms, I did notice there were actually many women with their sweet little ones and even some dads. The dads were great, walking around chatting, taking care of babies while the women got together, and just being supportive. Also amongst the crowd we had doulas, midwives, and lactation consultants mingling about.  I met women who had just very recently given birth, some who had toddlers, some stay at home moms and some who have returned to work. 

     I am tending to see more and more women reinventing their careers to suit their family life.  Jessica Walsh, for instance, is a local shop owner who offers unique and luxury baby products, is a lactation counselor and a community breastfeeding advocate.  She is able to be with her child the majority of the time while still being very active in her career and in the community. I met another mom who is a financial advisor and she is interested in reaching out in the mom community specifically, to give guidance and resources for the growing family. Another mom uses her skills in knitting and crocheting to create hats and other cozy articles of clothing.  

     I say I am among that group of reinventors. I loved what I did before becoming a mom and I put all of myself into it. Now that I have a child I cannot see myself doing that anymore so I’d like to use my skills and talents in a way that I can have a more balanced work and family life. I have so many ideas and blogging right now is my great start to where I want to be.  For me having the independence to get things done within a more flexible time frame than if I were in a traditional work environment is most comfortable for right now. I can be there for my baby all day and go out and explore the world with her. In my downtime I can write.

    The Mommy Mixer was a great event and it was a nice feeling to talk with other women who have a similar mindset to exchange ideas and encourage each other to go for it.

    Not only did I walk away with a wonderful door prize of handmade baby hats, I also walked away with a great feeling of confidence and camaraderie.  While I was gone, daddy and baby bonded and he was able to put her to bed by himself for the first time. Win Win!

Brestfeeding Tent at the Farmer's Market

 The Breastfeeding Initiative of Ulster County (BIUC) in New York had a breastfeeding tent every week at the farmer's market. With chairs and a baby changing table women felt supported. We had poster boards and markers and asked people to share their breastfeeding experiences. Here are some of the shares.


I make milk. What's your super power. 16 mos. n still going strong.

Hi! Brestfed my son for 2 years, he weaned himself, my daughter for 4 years. She weaned herself. The best time of our lives. Reggi

Breastfeeding promotes good maternal and child health and it's a wonderful bond between mother and child.

18 mos. and 17 mos. YES!

I nursed y son for three years, he is 40 now. He is very successful and very healthy! Never been really sick in his life. None of my friends breastfed but I persisted and loved it! It was the best part of having a baby. Susan Friedman

Go Breast Power! What a gift!

Breastfeeding is the best way to feed, nourish, and nurture your children.

Do it in the food court!

Ben breastfed many years ago -Now 24...years old!

Yeah; Mommy milk is breast/best!!!

Until 2 1/2!

Eric until 10 months Inez until 16 moths, Wonderful experience!

Rebecca Shea and Kaya Butterfly 2 1/2 yrs of Beboo!

I nursed my baby in line at a military commissary.

While walking along, giving a children's tour of a 100 yr old ship my little one in back pack climbed over my shoulder to nurse.

Nurse everywhere.

Nursed for 2 yrs- easy.

Breastfed three for a total of 3 years! Best for kids!

Power of women

Breastfeeding sucked my uterus back into shape.

I support this work. Joanne

Recycle yarmulkes as breast pads.

My sister nursed my niece- wonderful experience for both.

Recipe for healthy kids.

Cabbage leaves really work.

I nursed 2 children- (self weaning)  for 9 1/4 years! LOVED IT. Very close with them as adults.


More to come in a future blog.

Good Morning America Breastmilk

Breastfeeding in the news

Just when I was thinking the world was mine.  Just when I’m thinking all the world can breastfeed freely in public…. I saw a piece on Good Morning America covering the topic and they were emphasizing a spot in the movie, Breastmilk, with the man who is uncomfortable with women nursing in public.  Then it hits me! We still have a lot of work to do to make breastfeeding normal and commonplace.

Here is the link to the ABC news blog in which the story is covered.

http://gma.yahoo.com/blogs/abc-blogs/does-breastfeeding-men-uncomfortable-203913874--abc-news-parenting.html

They’re actually talking about the documentary by Ricki Lake and Dana Ben-Ari and they’ve chosen to focus on the husband who confesses his embarrassment about seeing women, even his own wife, nursing in public. Ricki Lake was quoted, "I believe this film will start an important conversation about how we can better support all new mothers, whether they breastfeed or not, and evolve to a place where breastfeeding is not so politically charged." I agree this is raising some good public discussion.  The comments section on ABCs blog shows some interesting ideas from the general public. Many people are supportive and just ask that mothers be modest or discreet about it.  The people that have a hard time separating the sexuality of the breast from feeding an infant seem to be the ones who are embarrassed by it the most and would rather it be done in private or completely covered up.

I agree with Mother of two and Café Mom contributor, Sasha Brown-Worsham, who breastfed both of her children. She can only hope, as quoted in ABC's blog, "The more that women do breastfeed in public, and are able to do that, the better, because it normalizes the situation," she explained.  "I’m just going to keep on doing what I’m doing and feel happy and blessed that in this very supportive community that we live in, in the Hudson Valley of NY, that I have not yet had any confrontation about my public breastfeeding.  Lets keep supporting each other and educate those who are confused about feeding babies".

Breastmilk The Movie

This post was written in October shortly after the screening, there will be a new screening on February 8th at the Rosendale Theatre. Get ready for a night of discussion and revelation. This film is so thought provoking that it was very difficult to write about after only one viewing. I look forward to seeing it again. It is truly revolutionary.
Marie

Breastmilk is a truly amazing film that was screened October 4th at the Woodstock Film Festival. This film is so revolutionary that it is difficult to describe, so I will start by paraphrasing the film's official website:  Director/producer Dana Ben-Ari, after the birth of her first child, became fascinated with breastfeeding then decided to cover the subject of breastmilk and breastfeeding, after the birth of her second child, on film. The intent of the film is to provoke discussion and examine why, while breastmilk is touted as the best thing for babies and mothers, are there still so many women who are not successful at exclusively breastfeeding for the recommended first 6 months or more. (www.breastmilkthemovie.com)

The film followed the stories of several different families and their experiences with breastfeeding, or obtaining breastmilk for their babies. In addition to the wonderful images of happy nursing babies and toddlers,there were thought provoking and delightful images, like a child drinking her mama milk with a straw while blowing bubbles into it and a mother adding breast milk to her morning omelet. The film sadly shows however, that there are still issues in our society surrounding the subject and perception of breastfeeding. Nursing in public is sometimes seen as obscene, and all too many of the mothers struggled with the fear of not producing enough milk. These mothers were advised to supplement with or completely switch over to infant formula by medical professionals or by well-meaning but misinformed fathers. Some women simply lacked the confidence and support to continue to breastfeed. One of the younger mothers, in the end, stated that going to school and working made it too difficult to successfully breastfeed and pump even though she tried and her initial plan was to breastfeed.  She ended up exclusively using formula fairly early on. 

I found the story about a lesbian couple from Australia who co-nursed their daughter to be fascinating. The non-gestational mother was able to induce lactation naturally and they both successfully shared the nursing duties. It was amazing to hear their story.  I knew that with hormone prescriptions lactation could be induced ,but I had no idea that it could be done without any artificial hormones or drugs. This couple also shared their feelings on nursing and how different Americans’ attitudes toward breastfeeding are from Australians’. They couldn't understand how so many American women seem to have supply issues. They speculated that it is a cultural issue because milk supply issues are almost unheard of in Australia. 

The movie  also gave a glimpse into the challenges low income mothers face by showing a discussion between a WIC counsellor and a mother. The mother was at a WIC office to obtain a new formula for her child because she had been allergic to a few of the others she had tried. The counsellor asked the woman if she felt confused about the messages sent by WIC about breastfeeding because they offer  free formula. The mother felt that her decision to use formula was very clear and there was no confusion at all.  A community educator from WIC who is very pro-breastfeeding mentioned that it would be interesting to see what would happen if WIC no longer offered formula.  Would it force more women to at least try to breastfeed? Did they really want to “force” women to breastfeed?  She knows all they can do really is offer the info, educate, and support the women’s choices.  

There was also a wonderful montage of bountiful squirting lactating breasts of all sizes, shapes, colors and amounts of milk.  It was a great representation of how every mother and baby are similar but unique.  We mothers have a kinship but we can all mother differently and still have great thriving families just the same.

At the Q&A portion of the evening with the film maker, one man stood up to say that he thinks that men will LOVE this film.  Secretly I groaned inside thinking, “what a pig”…and then he redeemed himself by saying there is so much a man can learn from this film. He felt that men will be fascinated by the “mechanics” behind lactation that they might not otherwise be informed about.  I was excited to hear that, and I totally agree that if more men saw this it would help society see breastfeeding as normal and there would be more support for it. A successful breastfeeding relationship between mother and child largely depends on the partner’s comfort level with it and overall support.  One family in the film spoke about how when they became pregnant the father’s attitude totally changed. This self described "rock and roll slacker" suddenly kicked into full gear to work hard and  provide for his family. Once the baby was born he did all that he could to make sure the mother was taken care of so that she could do what she needed to do for their child.  That was the best example of fatherly support I could imagine.

Overall, I think the movie points out that in society ideas about breasts are all over the place.  Are they sexual, are they mothering, are they comforting, are they for babies?  I think that the answer is that they are all these things and that’s wonderful.  

“The Mom-mune”

As I’ve said before, everyone needs a little support once in awhile and I found the best circle of moms to turn to.  No, I didn’t just happen to have friends who all had babies around the same time together. I did, however, have one co-worker/friend who gave birth 2 months after I did.  She had to get back to work much sooner than I chose to so that makes things a little awkward between us.  What I did end up doing was reaching out in the mom community. To use a term my friend coined, I needed to create a "mom-mune".  You know, a commune of moms to turn to.

In the first month I hit some bumps in the road.  I was on an emotional roller coaster, a touch of postpartum depression mixed with SAD, in the frigid month of January.  Motherhood was not a magical switch that turns on after you hold and nurse your baby for the first time as I had hoped. Everyone was always asking how I was doing and saying how amazing it must be to be at home with our baby. I would say it was great but really I felt, well, a bit scared.  I was only going to have help from my mom for a little while and my husband was going back to work in a week. Anytime someone close to me said something nice or asked how I was I would cry.  My first line of support my first week alone was my chiropractor and friend, Emily.  She is a mother of 3 and heard in my voice that I needed some help; mother’s intuition. She, without hesitation, told me we are going out to lunch tomorrow. That was it, she was the one who got us out of the house.  After that I realized I cannot stay home feeling so isolated and expect to get better.

I searched for and found my local La Leche League group.  I arrived to the meeting late even after trying so very hard to get out the door early enough.  I walked in wearing my darling daughter, clumsily carrying a diaper bag, and water bottle then just melted into a puddle of tears when I tried to  introduce myself to the group.  I had been struggling with night feedings.  It was a combination of having a difficult latch on the left side and a lack of sleep.  Everyone looked at me and I felt so much compassion and understanding from everyone there.  Evidently, I am not the only mom who's ever had some difficulty adjusting to this new role.  The LLL leader Donna Bruschi is also a board certified lactation consultant.  She took some extra time to work with me after the meeting to help me figure out some good night nursing positions and even let me stay for a much needed nap.

I also have to say Facebook has been a great way to connect for me.  I was chatting with a lady in a local shop who was admiring my baby girl.  -Something I’ve realized, babies are great conversation starters.  You can’t be shy for long if you go out in public with your baby.-  This lady was telling me about how her daughter is always looking for new mom friends and we exchanged information.  Two days later on a beautiful spring morning I got a phone call from this mom saying she and some other friends were meeting up for a playdate at the park and I should join them.  After meeting everyone, there were a few ladies that I connected with. We wanted to stay connected so we found each other on Facebook. They also told me about a social mom’s group on Facebook as well as a nursing mother’s support group right at our local hospital.  Since that day I believe in the importance of surrounding yourself with other wise women for fun, support, and friendship. We still organize outings together and we share so much information and really help each other. I know that if I really needed someone just to come over, I have a commune of moms.