…Contemplating the Core Elements of a Modern Breastfeeding Lifestyle
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Breastfeeding Success and Gratitude: Priceless

Almost Wordless Wednesday…

I am digitizing over 25+ years of memories.  Today I came across one of my favorite thank-you cards.   The layers of meaning were not lost upon this mother, or me, her lactation consultant.   Tongue-in-cheek, but so powerful.  Her cups, her breasts and both of our hearts runneth over.

There are so  many challenges that face modern breastfeeding mothers; quality lactation support can make such a profound difference.

Your successes are what keep us going.  We are here to assist you.  Getting “feed”-back from families is priceless for those of us who have dedicated our lives to protecting and supporting breastfeeding!

Your positive stories and comments are welcome here.  And…

Don’t forget to let your IBCLC know she/he made a difference for you!

February 22, 2012   No 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

Nipple Monologues: Part 3: What’s Wrong with This Picture?

I found multiple references that led back to this  photo guide  for proper latching technique.   I will address the accompanying directions in the next post.  

What is wrong with this picture? 

Plenty.  I’ll list a few of the issues.  There are limits to any two-dimensional portrayal of a baby latching onto a breast. You are literally getting only snapshots of an activity which often looks similar to the untrained eye. 

www.breastfeeding.com/helpme/helpme_images_latchon.html

Frame 1

Looks like the baby here in Frame 1 is taking the breast as if it were a bottle.    

  • It should be noted that most people would not point a bottle nipple down into a baby’s mouth as it would cause him/her to gag.  They may go in centered, but immediately aim the artificial nipple toward the palate. 
  • This is one of the most common mistakes made by new mothers initiating breastfeeding.  They aim the breast as if it were a bottle and end up putting their nipple on their baby’s tongue. 

The mother’s posture is unclear throughout this photo essay.  

Frame 1 looks like she is upright and in frames 2-4, it looks like she could be lying on her back or side.  Is it even the same baby in all of these shots?  The first baby looks different from frames 2-4. 

Frame 2

Frame 3

Frame 4

The impression is that the nipple should be centered in the baby’s mouth for latch-on.  

  • If it is done this way the nipple will be captured by the tongue and gums causing pain and trauma. (Frame 2 & 3)
  • The breast should be stabilized during the latch.  Nose, not mouth opposite the mother’s nipple.   Move the baby, not the breast.

The angles of the baby to the mother’s body are all wrong. 

  • The nose is in deeper than the chin. The baby is barely past the nipple. (Frames 2-4)
  • Baby should not be parallel to the  mothers body, but rather at a 10-15 degree angle to the plane of her body.

 A well-positioned baby should be tucked in very close to the mother’s body.

  • The chin should be deeply planted on the cleavage side of the breast around ~7 o’clock; the top lip would be around ~1 o’clock. This deep mouth position would tip the nipple up into the palate and there would be no contact with the tongue.
  • The lips would automatically evert or fan out if these angles were corrected. You cannot see the phlanging of a newborn’s lips if there is a good latch. (Frame 2, 3, & 4)

The saying goes…A picture is worth a thousand words.   However, a latch photo series is never as simple as it looks and much can get lost in translation. 

As a conscious breastfeeding coach, I remind you that it is all about perspective.  Ideally, a breastfeeding latch taught  through the eyes of the mother and evaluated by the sensation of her nipples.

June 22, 2010   1 Comment

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

How My Father Made Me a Breastfeeding Advocate

Today is Father’s day. It is a day where we express our gratitude to our dads. For those of us whose fathers are no longer living, it could be a bittersweet occasion. Rather than be sad, I choose to celebrate my dad, Arthur Clements, by dedicating this post to his memory.

I was always a daddy’s girl. Being the first born of five children, I was extremely close to both of my parents. That had its moments. They ushered me into this world and I ushered each of them out.

Dad came to the United States from Ireland in his mid-twenties. He ultimately married my mother, his first love, after a decade of courtship. Those were the real days of “Mad Men”, when the culture was especially sexist and much more formal than it is now. Dad had lost his own father when he was eleven and spent much of his time with nannies or in boarding school. He relished being a father and, later in life, becoming a grandfather.

In many ways my dad was ahead of his time. He was very hands-on, especially when we were babies. My mother had many health challenges over the years, so by necessity, in addition to night school and a full-time job, he did a lot of things that stay-at-home dads do now. He was very comfortable with my mother breastfeeding all of us in a culture that did not support that as normal. His positive attitude toward women being empowered by their bodies and being educated and treated as equals set him apart from many men of his generation.

Brazil is playing this Father’s Day in the World Cup. My dad was so passionate about football and made us fans long before soccer moms and dads became a demographic. Growing up we went to all the matches of the Cosmos with Pelé. He would be thrilled to see the US holding their own and with a great shot to move on to the round of 16. More so to see his eldest daughter such a rabid fan!

My dad Art was very friendly and was a consummate broker. Passion and playfulness were his secret weapons. He had tons of energy for things he believed in and enjoyed. He encouraged me and my siblings to pursue our dreams with the same gusto and urged each of us to make our avocations into our life’s work.

Taking this advice to heart, I have blended all of my life learning and fashioned a new model of conscious breastfeeding. It is my joy to empower mothers and families through an optimized experience of breastfeeding which fits their modern lifestyle.

Thanks to you dad I am a passionate advocate for women. Even if I won the Lotto, I would always keep this passion alive a la your example.

June 20, 2010   1 Comment