…Contemplating the Core Elements of a Modern Breastfeeding Lifestyle
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Breastfeeding Office Memorabilia

It has been many years since I first donned this button from the Florida Lactation Consultant Association (FLCA).  I found it doing the August Cleanup suggested by Dr. Jeanette Cates on her blog.

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I wore it on my lab coat while I was the first lactation consultant at a major NYC hospital.  It was a conversation starter.  People were intrigued and wondered what it meant.  The nurses thought it was a great button for me to wear as the representative of breastfeeding on our maternity unit.

I have to laugh as its message was unclear to anyone who was unfamiliar with my passion for breastfeeding promotion and support.  One day on the elevator a man asked me, “Are you a vegetarian?” His companion chimed in, “Are you Hindu?”   My Irish eyes were smiling as I explained to them the meaning of my button.  “Human babies should not drink cow’s milk which is for cow’s.  They should be breastfed by their mothers.”

Believe it or not, not long after that comical incident, I was called into the office of the Director of Maternal Child Health.  She told me that I was offending formula feeding families with my FLCA pin and demanded that I should remove it from my lapel.  I explained  its purpose in detail, but my protests fell upon deaf ears.

It should be of no great surprise that I resigned soon after that encounter to go into a full time private lactation consulting practice.  I figured I would be better able to help new moms and breastfeeding families on the “outside”.

To still keep a foot in the system, I  moved to another hospital to teach all their prenatal breastfeeding classes.   I felt that empowering mothers with information before birth, one of the Ten Steps, would be the best way to set them up for success.

What continues to distress me after all these years is that there still seems to be a need. here in NYC, to temper the endorsement of breastfeeding when dealing with the consumers of maternity hospital services.

You’ve come a long way baby or NOT?

Is this an only in New York phenomena?  Or have you also received  mixed messages about breastfeeding in the hospital or from members of your health care team?

Can you share what approaches helped or hindered you as you began your journey as a breastfeeding mother?

August 15, 2010   5 Comments

Breastfeeding Instruction: What Gets Lost in Translation?

I have taught thousands of hours of breastfeeding classes in the multicultural, urban environment of New York City. 

We live in a world that revolves around information; knowledge on any given subject appears to be just one google search or click away.  This may explain why an increasing number of students who come to my classes lately seem to be there merely to confirm what they think they already know versus wanting to actually learn something new.  

Adult learners, often find it difficult to be open to the richness of a learning experience when they fear judgement or criticism.  It is often more important to be right than to risk being wrong or feeling like a complete newbie.

I am reminded of my first day in Japanese class. 

The appearance of a diminutive teacher who immediately began speaking in a foreign tongue made me feel at loose ends.  I ultimately mastered enough spoken Japanese that I was able to spend several wondrous holidays travelling throughout Japan.  I immersed myself in the culture and made many new friends.  My language skills have gotten rusty, but rudimentary communication is still  possible for me with little effort. 

A love of learning has impacted my approach to teaching.  There are several learning styles auditory, visual, kinesthetic.  It is not uncommon for some of us to use more than one at any given time to learn and anchor an experience into our memory. 

When your brain is under the misimpression that it already knows something you tend to filter for new data or for things that do not fit your preconceived notions.  Often that filtering process impedes learning because the mind is only attentive to parts of the whole. 

When participants ask me questions using terms and words that I have not uttered and ascribe them to me, it becomes clear that they are at best only selectively listening during class.  When these queries come from their own internal dialogue and are not directly related to content delivered, I thank them and clarify what I had actually said.  Hopefully, this helps them to take in a piece of new information. 

It turns out that cultural differences, apart from language, can also have a bearing on how the students in my classroom may interpret and receive the information.  According to the article published in the Winter edition of Tufts Magazine, ‘The Brain in the World-A Burgeoning Science Explores the Deep Imprint of Culture’, the field of cultural neuroscience is only about two years old. 

Tufts psychology professor Nalini Ambady puts it this way: cultural neuroscience shows that “there is malleability in the neural structure depending on cultural exposure.” The brain, she says, is a “sponge that absorbs cultural information.” What she and other cultural neuroscientists have discovered is that although the brains of people from different cultures do not exhibit large structural differences, certain neural pathways do become more ingrained from immersion in a particular culture. They’ve also learned that those differences in brain function can influence our emotions, our behavior, and our attitudes toward people from cultures other than our own.

It goes on to describe a study done with American and Japanese subjects who were shown groups of photographs and asked to rate them according to the characteristics of dominance, maturity, likeability and trustworthiness.  The researcher, Rule, then broke those down into two sub-groups of power and warmth.  The Americans overwhelmingly favored the powerful faces and the Japanese the warm ones.  When fMRI scans were done it was noted that the Americans were using the analytical parts of their brains and the Japanese the emotional areas.

But what he discovered surprised him: both groups were using the same part of the brain—the amygdala. Sometimes called the “lizard brain,” the amygdala, which has been with us since the early days of our evolutionary journey, helps us detect threats, but it has a more general function as well, signifying increased attention to any object in the outside world. In this case, the amygdala was firing for both the American and the Japanese groups when they saw the picture of the leader they preferred.

It should be noted that the amygdala is also a prime area for the infant’s experience of breastfeeding.  

As a teacher, I am left to wonder how I might better engage these amygdalas, the cultural command central of the brains of these mothers-to-be? The answer may lie in the common thread of child-like wonder that is a constant in every culture while we are young. 

So it not just the words, visuals and the practice of positions, but a cultural sensitivity that may ensure breastfeeding instruction does not get lost in translation.

What do you think? What has worked for you?

July 9, 2010   No Comments

Breastfeeding Class of Distinction

I have been teaching breastfeeding classes in New York City since the 1980’s. For more than 10 years, I have exlusively taught at the premier prenatal program for expectant families in NYC at St. Luke’s- Roosevelt Hospital
                                                                           
I have been surveying the participants of all of my classes to find out what are their expectations of their upcoming breastfeeding experience. This has been enlightening, and at times a bit disturbing, to see that so many of these moms continue to worry about whether they will be able to breastfeed and/or like it. Pain, having enough milk, difficulties with latch-on, infections, pumping, weaning and returning to work were among their top concerns. Many reported having received both positive and negative feedback from close family members and friends who have breastfed. Everywhere they turn they find inconsistent information and support leading them to believe that breastfeeding is a matter of opinion.

One of my pet peeves is that most classes are teaching “Generic Breastfeeding”. This is patently ridiculous since pregnancies are not the same from conception to completion. There are different ways to conceive, a variety of types of delivery and babies come in all different sizes. Most classes give too much information without practical, simple specifics; there is a tremendous emphasis on the use of gadgets and equipment. This “Pseudo-Science of Lactation” does not translate well across the board into positive outcomes.

Some of you may have attended a prenatal breastfeeding class, perhaps you may even be an alumni of one of my classes or of The Breastfeeding Salon. I am trying to track and fill in the gaps between the fantasy and reality of breastfeeding. I invite you and your breastfeeding friends to join in the conversation.

What information or tips did you find helpful, confusing or plain wrong? Did you get these ideas from a class, a book, word of mouth, the hospital staff or your OB or Ped? Your feedback and comments contrasting pre and post breastfeeding class impressions should make a this a lively discussion!

We cannot change things if we continue to maintain the status quo.

June 21, 2010   1 Comment

Breastfeeding: To Drink or Not is the Question

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I am often asked in my prenatal breastfeeding classes whether it is ok to drink and breastfeed.   

Being true to my Irish roots, with a wee twinkle in my eye, I answer this question with a question.  I ask,” Have you heard about Guinness?”  I quickly follow up with this disclaimer, ” I am a nurse and a health care professional. It is my duty to recommend that you examine your own relationship with alcohol and act accordingly to moderate or avoid it while breastfeeding.  Alcohol is not brain food nor is it acceptable to be impaired if you are caring for an innocent child.”

I deliberately bring up the Guinness because it shows the mixed messages being bandied about with regard to alcohol.  

Against the backdrop of my heritage, a la Sonia Sotomayer, I can bring out the various aspects of this debate.

I am well versed on the supposed merits of Guinness having been to the brewery in Dublin.  Indeed, I can share with them information straight from the Guinness website which is currently celebrating the 250′th anniversary of the brew.   Apparently the water comes from near the place of my father’s birth in Wicklow.  According to their FAQ, “Key ingredients -other than inspiration-are roasted, malted barley, hops, yeast and water”  (This would explain its strong association with promoting a mother’s milk supply.) 

In fact, ad campaigns from the 1930’s touted Guinness as being “Good for Health”.  Such claims are no longer legal, but the lore persists especially outside Ireland.

Believe it or not, some of these expectant mothers in my classes claim they heard you should drink Guinness in order to have enough milk.  “Like Water to Chocolate” even if drinking the Guinness could make milk flow in abundance-it is best done on a case by case basis. 

If a future mom ever enjoyed a beer or stout before becoming pregnant, she might enjoy a Guinness, on occasion, while breastfeeding.  If she does not like beer or stout, or has issues with alcohol in general, then she should not begin drinking it while breastfeeding.  It should be noted that there is a non-alcoholic version of Guinness that contains the main ingredients, sans the alcohol, which may increase milk supply.

It is human nature to want to do things that are forbidden. Pregnancy lasts 9 months and is a time frame during which most moms can maintain  healthy lifestyle choices.  However, if this period of refraining from certain foods and alcohol extends well beyond birth, it may impact their resolve to continue breastfeeding.  A just say no policy on alcohol consumption while breastfeeding may lead some to wean early. 

On the other hand, mothers should not be encouraged to drink with reckless abandon.  The use of dip-sticks to check on alcohol content in breastmilk and/or the common practice of  “pumping and dumping” does not do much to encourage moderation.   I point out to the moms-to-be in my classes that most of them will be the proverbial “cheap date”.  Having abstained from alcohol for a long time they will have a lower tolerance for its effects.  To savor the social experience and slow the absorption rate, they should be sure to eat whenever they consume alcoholic beverages.  In college frats when they intend to become inebriated, they avoid food.

Studies do show that alcohol is processed rapidly into the blood stream; the speed will vary depending upon the amounts they have drunk and whether they have eaten.  What ends up in the milk will also be affected by where it falls in relation to the breastfeeding patterns of their babies.  What is pumped is not necessarily the same as what their baby would access from direct breastfeeding.  So I am suspicious of the results of these dip sticks.

I encourage the mothers in my practice to examine their drinking history honestly when deciding whether or not to drink while breastfeeding.  The consequences go far beyond the risk of a hangover now that they will be parents.  Annie, from PhdinParenting, has a wonderful post which sums it up so well You Should Not Be Drunk While Caring For Your Baby

I view breastfeeding as a golden opportunity for mothers to further expand upon the conscious choices they made while pregnant to promote their own health and the well-being of their child. 

The question has come full circle. It is not merely whether it is ok to drink and breastfeed.  The old adage of eating for two while pregnant could be expanded to drinking while breastfeeding.

You need to think before you drink because it’s not just about you now…you have become a parent.

July 18, 2009   1 Comment