Breastfeeding may not seem to have anything to do with Earth Day.  However, I beg to differ.  On this occasion, I am emboldened to declare that  it protects our global environment by reducing the demands  on it which are intrinsic to the production of artificial baby milk; when mothers directly breastfeed, sources of waste and pollution are eliminated.

Breastmilk is the bio-available, species-specific food which is perfectly crafted for human babies.  It is delivered by the elegant and  nurturing act of breastfeeding.  Literally organic, it is made by the mother’s body, and delivered to her baby via her breasts.  In contrast to artificial baby milk,  human milk is a raw food that does not require processing and distribution. It does not use valuable resources nor does it pollute the environment .

Breastfeeding is a feeding practice that is almost completely self-contained; the supply depends upon maintaining a synergistic connection between the baby and the breast. The baby, breast and hormones released by the pituitary gland of the mother set up the milk supply after birth. Supply adjusts to removal of milk by the  baby over time.

Unfortunately, the modern practice of pumping and bottle feeding human milk does exert an impact on the environment in terms of use of electricity, cleaning products, bottles and other gadgets that will eventually become waste in a landfill or elsewhere.  However, relative to the elements that go into the production of formula, it is far less of an ecological burden.

Conscious breastfeeding  mothers make a positive contribution to the ecology and environment in which they are raising their children  by actually breastfeeding whenever possible.  A shift in emphasis away from an over-reliance on pumping will reduce their carbon footprint.

On this Earth Day, and everyday, we need to create a world in which breastfeeding is the norm rather than the exception.

‘Breastfeeding Malcontents’ are everywhere these days.  Those of us who advocate for breastfeeding need to come to terms with this reality.   The scorn of the dutiful women who have breastfed but ended up feeling disempowered or unhappy with their experiences must be addressed.

These mothers are typically well-educated, well-heeled women who have literally bought into breastfeeding; they have attended classes, purchased books, pumps, gadgets and other products designed to facilitate a positive breastfeeding experience.  Many of these mothers may have even paid lactation experts to help them, but still ended up being dissatisfied with the pressures and constraints associated with breastfeeding in the 21’st Century.

The core idea of La Leche League, mother-to-mother support, which fueled the renaissance of breastfeeding over the last half century, is beginning to backfire. There is a new wave of mothers whose angst is channeled into active discouragement of their friends and peers and an ever increasing need to disprove the value of breastfeeding.

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Helen Rumbelow, the author of “Exposing the Myths of Breastfeeding” is one of these women with a need to ventilate.  She claims that she wrote this exposé because she wanted,  “…to get to the bottom of the medical evidence”.

Her thesis centers on this quote from Joan Wolf, an American academic writing a book on breastfeeding in the West, “The evidence to date suggests it probably doesn’t make much difference if you breastfeed.”

There is no doubt that this comment has stuck in Ms. Rumbelow’s craw as she shares this personal note, “For someone who prolonged my breastfeeding more out of duty than desire, this made me feel slightly nauseous.”  Apparently she is not alone.  She adds, “Many women — the ones who feel that they jeopardised their jobs, marriages, or sanity for the boob — have a right to feel angry about that”

Ms. Rumbelow does not directly tell us about her own experience with breastfeeding.  I am left wondering if these comments might give us a clue:

“…under the weight of this advice from the Department of Health, doctors, midwives, and breastfeeding activists, millions of Western women bow their heads and unclip their Elle Macpherson Maternelle bras.” or  “Dark thought at 3am, when one’s nipples feel like shards of glass. ..”

She can’t seem to make her mind up.  She criticizes the public health authorities for “heavy-handed encouragement of breastfeeding and then facetiously asks us,  “the medical establishment can’t be wrong, can it?”

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Lest we forget, breastfeeding is the biologic norm.  Whether or not “Breast is Best” has not been a concern of women until the past 50+ years.  The existence of relatively safe, commercial artificial baby milks to be used in lieu of breastfeeding does not negate the fact that human milk is species specific and designed by nature for human babies.  голова болит секс

Apparently the Chinese Melamine debacle of 2008 was not relevant enough science to be included in the discussion.  The “confounding” effect of which Ms. Rumbelow and her “experts” speak could just as easily be applied to an analysis of formula-feeding with regard to its safety and value in human nutrition.

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Medical science is only as good as those funding it and doing the research.  It is interesting to note Dr. Kramer was a speaker at a Nestles conference on infant nutrition held in Beijing, China in 2004.

If doctors were truly that influential in inspiring modern women to breastfeed, why then are the global rates of breastfeeding so abysmal?  Being risk adverse, many doctors do little more than pay lip service to the idea of breastfeeding.  Operating in a managed health care system that stresses conformity, they are often more comfortable managing the intake of formula.

Breastfeeding promotion efforts could learn much from this lesson taken from retail marketing, “…a brand’s worst nightmare is of being hijacked by disgruntled customers with plenty of attitude, heaps of time, and a high-speed Internet connection.

The rancor expressed in Ms. Rumbelow’s article should be a red flag for all of us who support breastfeeding families.  The issue of concern is not about good, bad or indifferent science being applied to breastfeeding vs. formula-feeding.   It is about the experience of breastfeeding in our modern world.

How would you describe your breastfeeding experience?

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Retro breastfeeding…now there’s a concept.  It could be viewed in many ways, both positive and negative.

Retro is a prefix from the Latin meaning backwards.  Retro, in the common vernacular, refers to the way things were.  Be it a noun, adjective or adverb it describes something from the past. 

For purposes of this post I am drawing on an expanded definition found in Wikipedia, ”a term used to describe, denote or classify culturally outdated or aged trends, modes, or fashions, from the overall postmodern past, but have since that time become functionally or superficially the norm once again.”

Breastfeeding has been around since the dawn of time.  It is the way human babies were meant to be nurtured after birth.  Nonetheless, it fell out of fashion in the 20′th century. 

You could say that the first wave of Retro breastfeeding began with La Leche League in the late 1950’s.  Against much resistance, mothers banded together to support one another and breastfeed their babies.  They were viewed as reactionaries as they seemed opposed to the progress offered by the medical model of birth and childrearing that relied on the drugs and formulas of big Pharma.  Going back to the “basics” was their call to action.

In 1985, the inception of the allied health profession of Lactation Consulting, born out of  La Leche League roots,  fanned the flames of that Retro breastfeeding comeback.  The job of the IBCLC’s (International Board Certified Lactation Consultants) was cut out for them.  In those days, breastfeeding meant timed feedings and supplementation with water or formula.  Those consultants entered in to the fray and began working to change the standards of practice in Western hospitals.  They set out to educate and support women so that breastfeeding would be the rule rather than the exception.   At first there was resistance from some in the medical community who were accustomed to managing infant feeding by manipulating formula intake.   Gradually it became politically incorrect to advocate against breastfeeding.

As we approach the 25′th Anniversary of Lactation Consulting as a profession we are entering yet another wave of Retro breastfeeding.  However, this one merely pays lip service to what began in La Leche and the early days of lactation consulting.   It is a weird amalgam of dogma and old practices, that fundamentally do not support breastfeeding,  blended with touches of tech and pseudo-science.

What is most ridiculous and ironic is that this latest version of Retro breastfeeding can be traced to the the practice of many lactation consultants. Those that have begun to rely too heavily on managing pumps and gadgets and less on the art and skill of breastfeeding have changed the focus from breastfeeding to human milk feeding.

Give me the music any day, but spare me this techno version of breastfeeding from the 1970’s!

Walking On Egg Shells

Had an interesting call this week from a dad.  He wondered what were the chances of relactating at 7 weeks? 

And no, before you go there, it wasn’t a crank trying to get a rise out of this passionate lactation advocate.  This call was legitimate.  He was a friend of a father in my practice who had encouraged him to reach out to me across state lines to sort out his dilemma.

He called me to suss out the situation and shared a very sad, but typical scenario.  His wife, had been buffeted on the seas of lactation support with inconsistent advice, emphasis on pumping and after two weeks was summarily dismissed and told to bottle-feed.  For approximately 6 weeks now his son has been bottle-fed formula.

In general, I always prefer to speak directly with the mother.  However, his voicemail touched a heart string as he confessed that he was calling without having yet broached this subject with his wife.  He was genuinely concerned and felt badly that they were missing out on breastfeeding because of the questionable support and consultation they had received in the early weeks.  

The reason for the abrupt weaning was the usual  ”Not Enough Milk”.  This was determined, of course, by his wife’s inability to pump enough to bottle-feed after the delivery.   More bottles and pumping led to formula and weaning.  The reason it was bothering him so much was that he noticed her leaking tons of milk a few days ago.  He didn’t understand why she didn’t just offer the breast to their son as clearly there was milk.

This dad was walking on egg shells. He was the support team during the initial battles and was now fearful of incurring her wrath by bringing up the notion of trying it again.   

I can empathize.  I’m often called in for these kind of situations and find the solution is not as simple as merely choosing between offering the breast or a bottle filled with human milk or formula.  The weeks of reinforcing a behavior other than breastfeeding and living a bottle-feeding lifestyle with their new baby could make the transition difficult on many levels.  

 I complimented this dad on his thoughtful and loving inquiry.  My suggestions were simple:

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1.  He could now share honestly some of his impressions about that stressful time with his wife.  Sharing empathy without the stress and pressure biting at their heels.

2.  He could share some of his conversation with his friend that led him to call me.  It would be helpful to emphasize that these situations are usually not truly black and white, but rather if she were empowered and given consistent support much would be possible.

3.  He could gently suggest that she offer their son the breast without worrying now if she had enough. Without pressuring her, he could point out it would be a shame if what she was still producing for their son would ultimately go to waste.

4.  He could share what he intuitively knew, and I corroborated, that milk supply is not increased by the pump, but rather by the baby breastfeeding.  Any amount of breastfeeding would greatly increase the odds of them being able to shift the balance of feeds away from the bottle and back to the breast.

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5.  He could continue to offer his love and support reassuring her that it was ultimately her decision.  Sometimes knowing that it is a real team effort can make these transitions seem more possible.

Breastfeeding is a relationship and is relational.    It is the mother who ultimately breastfeeds and chooses whether or not she will continue or resume if there have been challenges.  However, her choices do indeed have an impact on everyone in her inner circle.  Breastfeeding does not exist in a vacuum and is very much a family affair.

How many of us sisters, moms, friends, partners, spouses, and  even lactation consultants, can identify with this dad? Have you ever been afraid to further encourage or advise a mom who had been beaten down and had weaned because of a negative experience with breastfeeding ?

Have you ever felt like you were walking on egg shells?  And what did you do?

I have been noticing an alarming trend among the mothers calling me for lactation support. Almost all of them are actively supplementing their breastfeeding. Of great concern to me is that they are using more and more formula and reporting they feel pressured into doing so by their pediatricians.  Driven by concerns over weights and measures, these mothers have no confidence in their own milk and are finding little support for exclusive breastfeeding from the medical establishment.

I caution you to remember the old adage…actions speak louder than words.  I have yet to meet or hear of a pediatrician in my tri-state area who blatantly discourages breastfeeding to consumers who are planning on breastfeeding their babies.  But they are wolves in sheeps clothing.  While paying lip service to breastfeeding, they manage formula feeding. 

This problem often starts in the hospital.  One of the loop holes of the 10 Steps for Baby Friendly Hospitals is that formula can be offered when medically indicated.  Tired after labor and left largely on their own with a new baby, the parents are often scared into supplementing for “health reasons”.  Under the guise of a medical need for formula : ”your milk is not in yet” “your baby seems very hungry” “you need your rest” “your baby is dehydrated” “your baby has lost too much weight”…The dye is cast.

Once parents succumb to the pressure, their baby’s patterns of digestion and state will have changed.  They quickly notice that after supplements, especially of formula, that their baby sleeps much of the time between feedings.  Their expectation of what a successful breastfeeding session looks like has thus been altered.

When they resume exclusive breastfeeding, after days of supplementation, they may find their baby is fretful or awake after a feeding.  This may prompt them to pump to check if they have enough milk; they often get negligible results since they have just breastfed.  If a breastfeeding session has been skipped, they may pump a larger amount the first time, but the amounts will drop and/or plateau if pumping is done in lieu of breastfeeding during the early days of developing a milk supply.

I was thrilled a while back to see a thread on this topic going back and forth among my friends on Twitter.  Sadly, it does seem that you may have to defend your decision to breastfeed every step of the way.  Tara, on Growing Up Green outlines 5 strategies that can help counteract medical misinformation and questionable support.

Doctors express, no pun intended, their shock and awe when exclusively breastfed babies grow as well or better than their formula-fed peers.  If the growth patterns are different, they assume it is a problem with the mother’s milk or her baby’s digestion of her milk and immediately suggest formula.  

It is disappointing to me that fewer pediatricians these days even suggest pumping and giving extra human milk when the only issue is weight gain.  When they do include adding extra EBM after breastfeeding as part of their care plan, they often recommend amounts that ensure the need to make up the difference with formula. 

 A local doctor used her trump card, or so she thought, on one of my moms by telling her it would damage her baby’s brain because her daughter had gained only 4 oz in about 5 days. She tried to instill guilt and scare her into using formula when her baby was gaining too slowly for her taste.  Brain cells by the ounce?

It appears that this reliance on weights alone for assessing the health of newborns has gone global. Danielle from Born.In.Japan.net wrote of a similar experience in recent months. She did not mention supplementation in her post, but shared feeling that the doctor wanted her baby to “fit in a box”.

So many babies are now being double-fed that no one really knows what is a normal growth pattern.  We are mixing gene pools and methods of feeding and are expecting standardized outcomes.

An important breastfeeding survival strategy must be for us all to question this one-size-fits-all model of management.  The emphasis should always be on achieving a conscious breastfeeding connection that is optimized to be pain-free. 

As long as there is evidence of steady growth, even if it is slow, there should be no reason to be concerned if your baby isn’t the “fattest baby on the block”.