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I am drawing on an expanded definition found in Wikipedia, ”a term used to describe, denote or classify culturally outdated or aged trends, modes, or fashions, from the overall postmodern past, but have since that time become functionally or superficially the norm once again.”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

Today is my sister’s birthday.  I vividly remember my mother breastfeeding Daire all those years ago.  She reassured me, as I sat quietly on the bed beside her, that “this is how you feed babies”.  The next three in line would be boys.  By the time our youngest brother arrived, we all understood that breastfeeding was a normal part of taking care of a baby.  For us girls, it was an expectation that when we grew up, that we would follow in mom’s footsteps and breastfeed our own babies. 

Fondly remembering those moments as a child, I wonder what will be the memories of some of the new generation of breastfeeding babies.  Will they remember idyllic feedings at their mother’s breasts? Or will they remember watching and listening to the gentle swishing sound of her pumping out her milk to feed them with a bottle?  Will they see their mother breastfeeding their siblings or see her hooked up to a strange machine? 

What is being modeled these days is not breastfeeding, but some sort of techno version of same.   Mothers often complain, but continue to dutifully pump because they are being told that it will increase their milk supply.  They get up in the middle of the night and are out of synch with their babies; they get up to pump to keep up with the ever increasing amounts of their milk they feel a need to put into bottles.  Their breastfeeding is being driven by measurements of how much they can express and how much their baby takes in a bottle.

Health care professionals regularly urge mothers to supplement with non-human milk, be it from other mammals or soybeans.  The lactation “experts” push back and recommend pumping as necessary in all cases.  Mothers are caught in the middle of this advice and will lose trust in their milk supply when they are focusing more on measured amounts of milk, human or otherwise, given in bottles.  Breastfeeding for them can feel confusing and overwhelming and  early weaning will be a real possibility.

This does not mean that there isn’t a time and place for pumping, such as work outside the home.  What is worrisome is that pumping is being touted as being almost equal to actual breastfeeding.   We all must relate to technology on a regular basis in modern life be it phones, PDA’s, computers, etc..   Although many of us are rather attached to same, we should not be having a relationship with our machines.  Our various gadgets , including pumps, are merely adjuncts to our experience of daily life. 

It is a sad commentary about breastfeeding these days that, for so many women, the attention and fanfare centers around the regimen of pumping.   This is most unfortunate because the magical alchemy is not merely in the liquid gold that is expressed, but in the relationship that exists between the mother and her unique baby as it breastfeeds. 

Mothers, and those in the Lactation community, need to remember that we teach by example. 

I long for the day when we can believe again in the bounty of our female bodies… They are designed to carry our babies for 9 months inside and continue to nourish and protect them long after birth through breastfeeding. 

Single-use, high quality electric pumps have been available for consumer purchase since the early 90’s.  During these intervening years, the amount of pumping has increased exponentially in the United States and across the industrialized world.  Pumping is very much part of the popular culture, often being featured in sitcoms and instructional media geared to expectant parents.  There is a not too subtle imperative to own a deluxe pump before the baby is even born.  Doctors, Nurses and Lactation Consultants encourage pumping as a way to both evaluate and to increase a mother’s milk supply. 

Pumping for some women is their idea of Breastfeeding.  Are you all Pumped Up?

Symptoms include, but are not limited to the following: 

• You Breastfeed and pump after almost all feedings
• You wake up in the middle of the night to pump
• Your are pumping weeks worth of extra milk, just in case
• You “power pump” if you get less milk out than usual in order to increase your supply
• You pump whenever you feel something is wrong with your breasts
• You pump to “empty” your breasts

I field inquiries in all my venues about pump management.  Mothers have been sold on the idea that the pump tells the whole story about their Breastfeeding.  They worry when they can’t extract the same amounts as their friends or in volumes that compete with ready-made formula bottles. 

Those women who do obtain copious amounts of milk when they pump will often have issues in their breasts while breastfeeding.  They tend to be out of sync with the baby and often contend with excessive leaking and engorgement.  Some will report having had Mastitis which was the result of inadequate drainage from only pumping or mixing pumping with direct, but inconsistent patterns of Breastfeeding.

Pumping can actually compound any problem brewing in the breasts.  Women who have sore nipples and engorgement are often advised to pump, rather than to correct the latch.  Congestion can build up and if not relieved the mother will spike a temperature leading to a course of antibiotic therapy.  Whenever, the health of the breast has been compromised it is essential to use the baby and not the pump to solve the problem.

Of course there is a time and place for Pumping…

• Premature Delivery
• Illness of mother or issues with the baby or babies that require a delay or interruption of direct breastfeeding
• To obtain human milk if supplements are medically indicated
• Returning to Work outside the home

Other reasons cited, may include:

•  Mom needs a break from breastfeeding
• Dad/partner wants to participate in feedings
• To know how much the baby is getting at feedings

Since the mother is the only one pumping and Breastfeeding, it is not exactly a vacation.  Pumping will increase her workload and can create additional anxiety as her milk output can vary greatly depending upon when she pumps.  The mother who feels overwhelmed and worried about her milk supply may begin supplementing and make decisions that lead to early weaning. 

If you are pumping or have pumped what has been your experience?  Are you all pumped up?…or more aptly all pumped out?  I invite your comments and concerns related to pumping.

Murphy’s Law : If Something Can Go Wrong. It Will.

Turns out that I am an actual descendant of said Murphy.  Kathleen Clements nee Murphy was my maternal grandmother.  It is true that she had her share of hard knocks being widowed in her mid-thirties.  She had nine children ranging in age from 12 down to 9 months at the time of my grandfather’s fatal car crash on the winding roads of the Wicklow mountains.  Nonetheless, she lived a full life and saw all of her children grow-up to adulthood.  I would like to think that my optimistic spirit is part of her legacy.

Throughout the past 30 years actively working as a Maternal-Child Health Nurse and Lactation Consultant, this feeling of optimism has at times been difficult to maintain.  Being a passionate advocate of breastfeeding has been frustrating.  Often I feel like a salmon swimming upstream against the current of bad advice and token support.

Breastfeeding in the modern era has always had its challenges.  Much like childbirth, yet another natural process of the female body has fallen victim to a medical model which at its core assumes intervention will be needed.  Mothers are confronted with an over-reliance on gadgets, weights and measures and liberal supplementation with formula served up as breastfeeding support.

Anyone who knows me, reads this blog or my articles is very aware of my dismay at this medicalization of breastfeeding.  I am constantly reminded about this sad state of affairs when I teach my prenatal classes and survey the expectant mothers.  It is shocking that the majority know someone, with less than six degrees of separation, who has had a difficult breastfeeding experience.  As a result, these mothers-to-be are tentative and will say “I will try” or “If it works” when they discuss their own breastfeeding goals.  In essence, they are starting with an expectation of failure…Murphy’s Law.

Conscious Breastfeeding is your tool to outwit dear old Murphy.  Your breastfeeding is not a science project nor is it an illness.  It is a natural extension of your pregnancy meant to sustain your baby through its continued growth and development outside of your body.  

You need to be Conscious…put your focus on optimizing your breastfeeding connection.  Get help with the latch. It is skill and a teachable moment for you and your baby.  Don’t be fooled into thinking that your baby can do it without your help.  A baby and a pump are not the same.  When in doubt your baby always trumps the pump when you have a great latch.

By focusing on the fundamentals and keeping things as simple as possible you can replace a fear of failure with a sense of accomplishment.  Replace Murphy’s Law with the positive Universal Laws which see you in all of your glory as… a Conscious Breastfeeding mom.