…Contemplating the Core Elements of a Modern Breastfeeding Lifestyle
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World Breastfeeding Week 2010: Health Care Worker Call To Action

This is the 19′th annual celebration of World Breastfeeding Week.  The Theme of 2010 is commemorating the Innocenti Declaration made by WHO and UNICEF policy-makers in August 1990 to protect, promote and support breastfeeding.

In the past 20 years there has been some progress in the rates of  initiation of breastfeeding.  Yet, only 28% of Maternity facilities world-wide have fully implemented the Ten Steps and have been certified by the Baby Friendly Hospital Initiative.  Were this an analysis of anything else, this would not be a passing grade.

 I’ve been in the trenches throughout this period and beyond.  At first glance, it appears as though we have made great strides.   According to the NYC Dept. of  Health and Mental Hygiene report put out in April 2009,  an impressive 85%  of women initiate breastfeeding.  However, after 2 months the number falls to 32% who are still exclusively breastfeeding their babies.  Surveys reveal that the top two reasons for stopping were related to concerns about the milk supply either having enough (39%) or that it was adequately satisfying their babies (39%).

The fall off rate here in NYC is quite dramatic, but not surprising to me.  Despite health code regulations that prohibit formula discharge packs, many families will leave the hospital with generous samples of formula in tow.  Mothers who have had cesarean sections report that their babies were given at least one bottle, if not more, of formula during the first few days after delivery.  

Many of the New York hospitals have lactation consultants on staff or nurses “trained” to support breastfeeding.  Nonetheless, their focus seems to increasingly be on feeding a measurable amount of fluid to the newborns.  They get  moms to sit on the pump getting drops of colostrum and encourage them to give their babies formula until the “milk comes in”. 

 Using the pump as a  first line of breastfeeding support relegates direct breastfeeding to the back seat.  New mothers leave the hospital knowing how to pump rather than how to achieve a deep, pain-free latch.

New parents are set up to believe that artificial baby milk or formula and human milk can be exchanged ounce for ounce in bottles without consequence .  Unwittingly they are weaning from the beginning or setting themselves up to experience the top two reasons many of them will choose not to breastfeed beyond two months.

Without a doubt, the Ten Steps are a helpful tool to focus our attention on the importance of consistent breastfeeding education and support.

To pack a punch and ensure successful breastfeeding beyond the first few weeks, the Ten Steps must be embraced by unequivocal  and truly breastfeeding-friendly health care workers:  nurses, doctors and lactation consultants. 

To be continued…

August 2, 2010   2 Comments

Breastfeeding and Inception: My Dream Within A Dream

Inception” (2010) is a must-see movie, completely original and thought provoking.

 

It captured my imagination when I saw it this week. I found myself having lucid dreams about the potential of inception.  I was mulling over in my head the fact that subliminal messages enter our minds on a daily basis. Advertising campaigns deliberately harness the power of suggestion to drive our product allegience. Ideas that have found their way into our subconscious are digested and interpreted during our dream life.

Although  it is not yet possible to share actual dreams in the fashion of the movie “Inception”, we often speak of having a shared dream in our conscious life. 

I started to think how marvelous it would be if inception were possible.  World Breastfeeding Week begins today.  It would be awesome if a universal subconscious brand loyalty for breastfeeding would have a viral inception.  To create a model where the dream of all human babies being breastfed, as nature intended, was indeed the reality. 

Edgar Allen Poe

‘All that you see or seem, is but a dream within a dream.’

Sometimes, I feel caught in a dream within a dream.  A place where there is a lack of belief  in a woman’s body being able to nurture her baby after birth and a need to continually prove that human milk is superior to artificial baby milk. I feel like Cobb in the movie trying to instill an idea that breastfeeding is the biologic norm against these objections implanted by the marketing geniuses of Big Pharma.

Inspired by ”Inception” the movie, and the definition of the word according to the World English Dictionary:  the beginning, as of a project or undertaking…

During this month of August, I will be participating in the Ultimate Blog Challenge.  On a daily basis, in my waking life, I will promote conscious breastfeeding and plant the seeds to share the dream of living in a breastfeeding world.   

Won’t you join me and share the ride?

August 1, 2010   No Comments

Pamplona Memories: I’m Bullish on Breastfeeding

I had always wanted to go to ‘the Running of the Bulls’ since I first read James Michener’s novel ‘The Drifters’.  I finally made that dream a reality when I went with two of my brothers and my sister-in-law during The World Cup of 1998.

Today is the first day of the feast of St. Fermin, the patron of the festival which runs annually from 7.7-7.14 in Pamplona, Spain.

Pamplona Memories flood back to me.  I vividly remember cheering for Holland with the legions of orange clad fans that followed their matches in the local pubs.  Now, 12 years later, the Dutch have made it into the finals of the World Cup.  Spain plays Germany in the semi-finals on this auspicious Spanish feast day for the other slot.  This 2010 World Cup will be an all Europe final falling within the week of ‘the Running of the Bulls’.

Leather wine flasks, Botas, were being used by many of the festival goers.  My teaching mind saw an immediate and workable analogy between the human breast and those popular items of the festival of St. Fermin.  It occurred to me that the breast also expands and contracts with the volume of milk within it.  Both a wine sack and the breast are never really empty, but will always have some residual left at the bottom once filled with liquid.  To new moms who might be tempted to think of their breasts in terms of being full or empty this new frame of reference makes much better sense and alleviates much unnecessary anxiety.

As you may have noticed in the video above, the assembled crowds all got the memo and were unified in wearing a garb of white and red.  It was difficult to distinguish ourselves among the sea of people dressed the same way.  People were assembled from all over the world.  We were all part of one big family, more alike than different.  A unity that should also apply to breastfeeding.

The notion of solidarity by costume or color is not new.  Pink is for Breast Cancer awareness.  Purple is worn by those who support research for Alzheimers.  The lactation consulting world has made efforts to make Gold be the color of breastfeeding promotion to represent the liquid gold of human milk as the gold standard of infant feeding.

I watched from the sidelines while my brothers joined the ranks of those actually running with the bulls. I may have been a mere observer for those runs, but the same thing cannot be said about my participation in breastfeeding promotion.  I am steadfast in my efforts to inspire, educate, support and empower mothers to revel in the grandeur of their bodies which are so perfectly designed to nurture their babies for 9 months and beyond through the miracle of breastfeeding.

I envision the day, in the not too distant future, when the same fervor I witnessed for the running of the bulls of Pamplona will be expended on being bullish for breastfeeding.

Won’t you join me?  Be part of the change we want to see…Be Bullish for Breastfeeding!

July 7, 2010   No Comments

Nipple Monologues: Part 1: What Sucks is Really Nipplefeeding

There are two things that you absolutely need in order to breastfeed…a baby and breasts. The way in which human milk is dispensed to the baby is through a fine spray that flows through its mother’s nipples. The nipples and areola are visually attractive to babies and, in combination with the scent of milk, they help them to find their way onto their mother’s breasts for feeding.

Therein lies the problem.

1. Nipples come in many shapes and sizes and are not standardized like the rubber and silicone models that can be purchased at your local drug store.

2. Nipples have nerve endings which carry messages from the baby to the mother’s brain causing the release of prolactin and oxytocin which are the hormones that guide milk production and release of milk.

3. Nipples can feel pleasure and pain sensations depending upon what is being done to them.

4. Unfortunately everyone seems to think it’s all about the nipples.

The real truth of the matter is that the nipples are only a means to an end. They are meant to serve as a guide for the mother to draw her baby onto the breast during latch-on and are the exit through which the milk flows. If too much focus is put on the nipples by the baby’s tongue and gums they will become sore and may crack and bleed. Sore nipples are one of the top reasons a mother will stop breastfeeding.

New mothers will often be subjected to an ongoing commentary about their anatomy when they begin breastfeeding; much will be said about the shape or size of their nipples. They never seem to be just right. Many health care workers make faulty assumptions, or have been taught, that the baby will not be able to latch without a prominent nipple. This is absolutely not true.

Can anything be done?

Breast Shells worn during the pregnancy will help soften the tight bands of tissue that cause inverted nipples. They also can be worn in the early days after giving birth if swelling of the breast changes the shape of the breast and makes the nipple appear to be flat or less defined.

Pumping can reshape the nipple and breast tissue temporarily so that the mother can draw the baby on past the nipple. However, this can cause some discomfort as the pump primarily pulls on the nipple.

Proper hand postitions using preferably a C-Hold, or alternately a U-Hold to shape the breast will help the mother to steady the breast during latch-on. She should actively put the baby on the breast rather than the nipple.

Nipples are the guides, not the destination. They should be used as a stationary navigational tool that will help the mother with her visual line up for a great latch. The mother’s nipple should be opposite the baby’s nose rather than in front of its mouth during latch-on. *More on this point in Part 2*

A piece of candy has the juice extracted from it by rubbing it between the tongue and palate. This is one image that comes to mind when we use the verb sucking. Given that definition, the breastfeeding baby would seem to be focusing its attention solely on the nipples. Milk, however, can actually be expressed without any direct manipulation of the nipples; compressing deeply with the hands where the jaws would be situated will produce milk flow.

Babies are really not sucking but using their jaws to compress the breast with a “chewing” action and swallowing as needed. The tongue should be under the breast covering the bottom gum and not manipulating the nipple at all as this will cause injury and pain.

It is all about the depth and angles. Ultimately the baby needs to be guided past the edges of the nipple to a place deep on the breast. It is here that they will access a great flow without hurting their mother. You want them to be oblivious to the fact that a nipple exists. You want them to be breast-centric rather than nipple-centric.

They call it Breastfeeding and not Nipplefeeding for a reason!

June 21, 2010   1 Comment

Conscious Breastfeeding Food For Thought: Where’s Our Saint Francis?

Today, they are blessing animals in many churches here in the States and most likely around the world in honor of the feast day of St. Francis of Assisi, the Patron Saint of Pets and the Environment.

It is doubtful that many cows will be waltzing in for a blessing, but you never know.

In India, no thanks to St. Francis, cows are sacred…

It makes me remember a funny incident that happened to me two decades ago when I was the first lactation consultant in a major hospital here in New York City.  On the lapel of my lab coat I wore a button that I had bought to support the Florida Lactation Consultant Association.   It was simple and powerful…or so I thought.

This button depicted a cow with a big red slash through it.  The International Symbol for a warning not to do something.  Travelling up to the maternity floor one afternoon a fellow passenger queried me on my button.   Shockingly, it was not the comment/question I had been expecting.  “Don’t kill the cows…are you Hindu? ” was what he asked.  I laughed and pointed out that my freckles were not Bindis and that the purpose of the button was to spark a conversation about breastfeeding.  He got off the lift to go see his wife and child and I went back to work.

A few days later, I was called into the office of the Director of Maternal Child Health and told to stop wearing my button.  I was shocked, but refrained from going ballistic at that moment.  I asked meekly why she was giving this directive to me.  Her answer was incredible.  She told me that, “by wearing this button you are offending formula feeding families.”

I would not be long for that job as the “Powers to Be” in that hospital did not truly support breastfeeding mothers.  As I began my resignation letter in my head, I told her what was the true intention of my wearing that button.  It was simply to open up a light-hearted dialogue about species specific milk…Cows milk for calves and human milk for human babies.

Here in the Western world,  cows are valued merely as a source food.   These cows are often horribly mistreated in an effort to maximize their production of milk and meat for consumption by humans.  Ironically, there are growing numbers who question whether the consumption of a cow’s milk is a valid option to promote human health.

Fast forward twenty years to 2008.  PETA, people for the ethical treatment of animals, continues its crusade to protect animals a la St. Francis.   Recently in their blog, The PETA Files, attention was focused on cows when they spoke of a letter they had sent to Ben and Jerry’s, a major maker of ice cream, asking them to substitue human milk for cow milk in the production of their ice creams.

All of this made me wonder…

Breastfeeding has all of us Breastfeeding Advocates and Lactivists.

Would Breastfeeding fair better if it also had a Patron Saint?

October 4, 2008   1 Comment