How to Know a Healthcare Practitioner is not Supportive of Breastfeeding

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Most healthcare practitioners say they are supportive of breastfeeding. But many are supportive only when breastfeeding is going well, and some, not even then. As soon as breastfeeding, or anything in the life of the new mother is not perfect, too many advise weaning or supplementation. The following is a partial list of clues that help you judge whether the health professional is supportive of breastfeeding, at least supportive enough so that if there is trouble, s/he will make efforts to help you continue breastfeeding.

How To Know A Health Professional Is Not Supportive:

1. S/he gives you formula samples or formula company literature when you are pregnant, or after you have had the baby. These samples and literature are inducements to use the product, and their distribution is called marketing. There is no evidence that any particular formula is better or worse than any other for the normal baby. The literature, CD’s or videos accompanying samples are a means of subtly (and not so subtly) undermining breastfeeding and glorifying formula. If you do not believe this, ask yourself why the formula companies are using cutthroat tactics to make sure that your doctor or hospital gives out their literature and samples and not other companies’? Should you not also wonder why the health professional is not marketing breastfeeding?

2. S/he tells you that breastfeeding and bottle feeding are essentially the same. Most bottle-fed babies grow up healthy and secure and not all breastfed babies grow up healthy and secure. But this does not mean that breastfeeding and bottle feeding are essentially the same. Infant formula is a rough copy of what we knew several years ago about breastmilk which is in itself only a rough approximation of something we are only beginning to get an inkling of and are constantly being surprised by. For example, we have known for many years that DHA and ARA were important to the baby’s brain development, but it took years to get it into formulas. But it doesn’t follow that the addition of these to formulas is doing what they are supposed to, as their absorption from formula is different from breastmilk. The many differences have important health consequences. Many elements in breastmilk are not found in artificial baby milk (formula) even though we have known of their importance to the baby for several years—for example, antibodies and cells for protection of the baby against infection, growth factors that help the immune system, the brain and other organs to mature. And breastfeeding is not the same as bottle feeding; it is a whole different relationship. If you have been unable to breastfeed, that is unfortunate (though most times the problems could have been avoided), but to imply it is of no importance is patronizing and just plain wrong. A baby does not have to be breastfed to grow up happy, healthy and secure, but it does help.

3. S/he tells you that formula x is best. This usually means that s/he is listening too much to a particular formula representative. It may mean that her/his children tolerated this particular formula better than other formulas. It means that s/he has unsubstantiated prejudices.

4. S/he tells you that it is not necessary to feed the baby immediately after the birth since you are (will be) tired and the baby is often not interested anyhow. It isn’t necessary, but it is often very helpful (See handouts Breastfeeding—Starting Out Right and The Importance of Skin to Skin Contact). Babies can breastfeed while the mother is lying down or sleeping, though most mothers do not want to sleep at a moment such as this. Babies do not always show an interest in feeding immediately, but this is not a reason to prevent them from having the opportunity. Many babies latch on in the hour or two after delivery, and this is the time that is most conducive to getting started well, but they can’t do it if they are separated from their mothers. If you are getting the impression that the baby’s getting weighed, eye drops and vitamin K injection have priority over establishing breastfeeding, you might wonder about someone’s commitment to breastfeeding.

5. S/he tells you that there is no such thing as nipple confusion and you should start giving bottles early to your baby to make sure that the baby accepts a bottle nipple. Why do you have to start giving bottles early if there is no such thing as nipple confusion? Arguing that there is no evidence for the existence of nipple confusion is putting the cart before the horse. It is the artificial nipple, which no mammal until man had ever used, and even man, not commonly before the end of the nineteenth century, which needs to be shown to be harmless. But the artificial nipple has not been proved harmless to breastfeeding. The health professional who assumes the artificial nipple is harmless is looking at the world as if bottle feeding, not breastfeeding, were the normal physiologic method of infant feeding. By the way, just because not all, or perhaps even not most, babies who get artificial nipples have trouble with breastfeeding, it does not follow that the early use of these things cannot cause problems for some babies. It is often a combination of factors, one of which could be the using of an artificial nipple, which add up to trouble.

6. S/he tells you that you must stop breastfeeding because you or your baby is sick, or because you will be taking medicine or you will have a medical test done. There are occasional, rare, situations when breastfeeding cannot continue, but often health professionals only assume that the mother cannot continue and very often they are wrong. The health professional who is supportive of breastfeeding will make efforts to find out how to avoid interruption of breastfeeding (the information in white pages of the blue Compendium of Pharmaceutical Specialties and the PDR are not a good references—every drug is contraindicated according to them as the drug companies are more interested in their liability than in the interests of mothers and babies). When a mother must take medicine, the health professional will try to use medication that does not require the mother to stop breastfeeding. (In fact, very few medications require the mother to stop breastfeeding). It is extremely uncommon for there to be only one medication that can be used for a particular problem. If the first choice of the health professional is a medication that requires you to stop breastfeeding, you have a right to be concerned that s/he has not really thought about the importance of breastfeeding.

7. S/he is surprised to learn that your six month old is still breastfeeding. Many health professionals believe that babies should be continued on artificial baby milk for at least nine months and even 12 months (and now that the formula companies sell formulas for up to 18 months and even three years, soon some health professionals will be urging mothers to use formula for three years), but at the same time seem to believe that breastmilk and breastfeeding are unnecessary and even harmful if continued longer than six months. Why is the imitation better than the original? Shouldn’t you wonder what this line of reasoning implies? In most of the world, breastfeeding to two or three years of age is common and normal, though, thanks to good marketing of formula, less and less common.

8. S/he tells you that breastmilk has no nutritional value after the baby is 6 months or older. Even if it were true, there is still value in breastfeeding. Breastfeeding is a unique interaction between two people in love even without the milk. But it is not true. Breastmilk is still milk, with fat, protein, calories, vitamins and the rest, and the antibodies and other elements that protect the baby against infections are still there, some in greater quantities than when the baby was younger. Anyone who tells you this doesn’t know the first thing about breastfeeding.

9. S/he tells you that you must never allow your baby to fall asleep at the breast. Why not? It is fine if a baby can also fall asleep without breastfeeding, but one of the advantages of breastfeeding is that you have a handy way of putting your tired baby to sleep. Mothers around the world since the beginning of mammalian time have done just that. One of the great pleasures of parenthood is having a child fall asleep in your arms, feeling the warmth he gives off as sleep overcomes him. It is one of the pleasures of breastfeeding, both for the mother and probably also for the baby, when the baby falls asleep at the breast.

10. S/he tells you that you should not stay in hospital to breastfeed your sick child because it is important you rest at home. It is important you rest, and the hospital that is supportive of breastfeeding will arrange it so that you can rest while you stay in the hospital to breastfeed your baby. Sick babies do not need breastfeeding less than a healthy baby, they need it more.

11. S/he does not try to get you help if you are having trouble with breastfeeding. Most problems can be prevented or cured, and most of the time the answer to breastfeeding problems is not giving formula. Unfortunately, many health professionals, particularly physicians, and even more particularly pediatricians, do not know how to help. But there is help out there. Insist on getting it. “You don’t have to breastfeed to be a good mother,” is true, but not an answer to a breastfeeding problem.

Questions? First look at the website nbci.ca or drjacknewman.com. If the information you need is not there, go to Contact Us and give us the information listed there in your email. Information is also available in Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA); and/or our DVD, Dr. Jack Newman’s Visual Guide to Breastfeeding (available in French or with subtitles in Spanish, Portuguese and Italian); and/or The Latch Book and Other Keys to Breastfeeding Success; and/or L-eat Latch and Transfer Tool; and/or the GamePlan for Protecting and Supporting Breastfeeding in the First 24 Hours of Life and Beyond.To make an appointment online with our clinic please visit www.nbci.ca. If you do not have easy access to email or internet, you may phone (416) 498-0002.Written and Revised by Jack Newman, MD, FRCPC 1995-2005 Revised 2008

Breastfeeding Does NOT Cause Cavities!

This week, we took our 2 year old to have her teeth examined by a dentist. The dentist pointed out, unfortunately, that Claire has several cavities (front & back). So, of course, we'll schedule Claire to have her teeth fixed as soon as possible. The dentist also recommended we wean her from the breast completely "because night-nursing and nursing after 1 year is the cause of her cavities." I might add that this was a terrible suggestion based on incorrect, inaccurate information printed throughout the brochures given to us *after* our visit.

Night-nursing and nursing after the age of 1 year "does not increase the risk of a child getting cavities enough to cause parents to intentionally wean their babies at night" (http://www.askdrsears.com/), & I (and probably several other nursing mothers) was upset to hear the dentist say this. The dentist also disagreed with me when I mentioned that genes also played a big role in this situation, as well (our oldest child has no cavities at 4.5 years & she nursed for 3.5 years).

The practice also has a brochure (attached) that states:

"Do not permit your child to nurse passively on the breast or bottle while sleeping... Your child should be weaned, and solid foods introduced in his diet, soon after the first birthday."

The huge difference between bottle nipples and breastfeeding is that when a child stops breastfeeding, milk stops coming out. This is not the case with a bottle where gravity plays a big part of its continuous flow.

I'm sure you're familiar with the resources below... I intend to night-wean Claire (again) but not fully wean her. Oh, what misinformation is out there!



Is Breastfeeding Linked to Tooth Decay? (from Kellymom)
" In a baby who does have a genetic problem, weaning will not slow down the rate of decay and may speed it up due to lack of lactoferrin. "
(This link contains several additional links of studies...)

Preventive Oral Health Intervention for Pediatricians (from AAP)
"Parents and caregivers should be counseled on the importance of reducing exposure to sugars in foods and drinks. To decrease the risk of dental caries and ensure the best possible health and developmental outcomes, it is recommended that parents do the following:

1. Breastfeed infants during the first year of life and beyond as is mutually desired.29
2. After nursing, remove the breast from a sleeping infant's mouth and cleanse the gums and teeth after feedings and before bedtime..."

Breastfeeding and Oral Health Issues (from LLLI)
"Alternative health care options for dental issues are rarely discussed. Dr. Enzor discussed the use of essential oils, homeopathy, probiotics, and certain foods that she has seen good results with in her practice. Some essential oils with antibacterial properties, such as tea tree, clove, red thyme, cinnamon, and eucalyptus, may be especially useful as nighttime nursing aids. Parents should mix a few drops of the oil with a few ounces of water, and wipe the solution on the child's teeth and gums."


"Does Nighttime Breastfeeding Cause Cavities?" (from Dr. Sears)
"... in general, night-nursing does NOT increase the risk of a child getting cavities enough to cause parents to intentionally wean their babies at night. You may have other reasons to do so, but do not wean at night in order to decrease cavities."

Just to name a few sources. There are plenty more not listed. Knowledge is powerful!

Storm in a D cup

http://www.womens-health.org.nz/index.php?page=storm-in-a-d-cup
(Be sure to check out the photo, too!)

Women's Health Action

World Breastfeeding Week posters have developed a reputation for being controversial and edgy. As we work on our poster for this year, breastfeeding advocate Louise James looks at some of the issues raised by last years poster.

A simple beginning

A quiet morning in the park with a mother, her breastfeeding toddler, a banana and a top class photographer. Mother and daughter look fantastic and all is going well when the photographer asks the mother to take her breast out from the neck of her red top rather than lift it up from the waist. The resulting photograph is elegant, less clumsy and certainly less ungainly. All are pleased with the result. However, the repercussions of that decision were to reverberate again and again as the poster developed and ventured into the public domain.

The theme for World Breastfeeding Week internationally is set by the World Alliance for Breastfeeding Action (WABA). In 2005 the theme was Breastfeeding and Family Foods: Loving and Healthy. The focus was on the continuation of breastfeeding after solids have been introduced. Women's Health Action workshopped this theme with a small working group which grew out of an initial community consultation. The decision was to develop a poster which depicted a mother breastfeeding her toddler. It was agreed, though not unanimously, to have the toddler hold a healthy nutritious food to demonstrate that breastfeeding could happily co-exist with first foods. Across all cultures, the most common first food for young New Zealanders was a banana. It suited the theme beautifully, being easily recognisable, portable, non commercial and healthy.

The resulting photograph was great and mother, photographer and Women's Health Action were happy with the result. Off it went to the working group. These were all people who supported breastfeeding and the WHO Global Strategy supporting breastfeeding exclusively for the first six months and on up to two years and beyond. For some of these people the translation of the words into a real life image proved challenging.

There is one right way
Everybody loves a breastfeeding image when the baby is small and the mother is in a Madonna pose gazing adoringly at her progeny. An older child however is more challenging and the new poster was an affront to the set of unspoken rules and assumptions that many people carry unconsciously in their heads. The revelations started with the working group, but were confirmed by the wider community once the poster was released. The process uncovered a number of unwritten rules and assumptions that form real barriers to mothers breastfeeding older children and they are fascinating. We discuss some of them here.The unwritten rules for breastfeeding older children in public:

If the child being breastfed is not a baby then the child should be 'a little toddler', 'a younger child', 'a 9-10 month child', "I have a problem with a child breastfeeding when they can ask for it".

The act of breastfeeding needs to be: 'discrete', 'private', 'less exposed', 'top pulled up' and 'tasteful'.

The breastfeeding mother and child should be 'loving', 'arm wrapped around the child', 'a more likely feeding posture', 'baby on lap', 'motherly', 'held in mother's arms' the child cuddling up on mum's knees' and 'don't sit with legs apart'.

Everybody should breastfeed in the same way so the image has to conform to personal experiences of breastfeeding: "some of us have breastfed our own children through to toddlerhood but at no time found it necessary to pull our shirts down", "We have never in all our years, seen anyone breastfeeding their toddler in this position." "We are all mothers who have breastfeed our own babies and have nothing against breastfeeding in public if it is done in a sensitive and tasteful way".

Can't have the child holding a banana: 'the banana can be seen as a phallic symbol', 'a banana milk shake?'

Thanks for the mammaries
The reaction to the poster was indeed mixed: the 'Outstandingly Healthy' breastfeeding poster proved overwhelmingly popular with many: WABA from Penang wrote, "Thank you very much for sending us the posters. They are beautiful and the message comes out loud and clear". James Akre formerly of the World Health Organisation wrote, "Splendid new breastfeeding promotion poster. It superbly places the expression 'complementary feeding' into appropriate perspective." Positive comments came from far and wide recognising the great shot that it was, "I think this poster is just wonderful." "Beautiful photo", "looks good": and "She looks gorgeous".

However, given the high level of negative comment, the focus testing was important and would determine whether the poster saw the light of day. We took the image to numerous different places outside of the health profession and asked them what they thought the messages were. While some in the working group, and particularly health professionals, felt it "Could discourage rather than promote breastfeeding", "is not appropriate" and "would put many people off", the take home messages from the focus group were exactly what we were hoping for and more:
Breastfeeding is nothing to be ashamed of.

Fresh air, fresh food and fresh breast milk.
It is OK to feed in public.
The longer you breastfed the better.
Breastfeeding makes mother and child happy and healthy.
Breastfeeding is not difficult or problematic.
Should feed whenever the child needs to.
It's a normal and natural thing to do.
Breast milk is the best.
Doesn't matter where you breastfeed.
Breastfeeding doesn't have to stop with babies.
Women's breasts are put on their bodies to feed babies.
Breastfeeding is clearly part of a healthy diet.
Breastfeeding is just part of life.
We had a second picture up our sleeve for focus testing. In this one the child was on the mother's knee in the more traditionally seen Madonna pose. We ran this image through our focus groups as well: The 'safe' alternative "doesn't grab you", is a "friendlier image", is probably "acceptable to society" and "it looks more of an effort". Surprisingly, and happily, when choosing between the two, focus group participants liked the edgier, challenging version.

What lies beneath?What was going on for many people? Even those who agreed it was a lovely photo and supported breastfeeding, said they would not display it. A childbirth educator said, "Cool, but I wouldn't put it up in my classes." And a nurse felt "it would be demeaning to even ask mums to look at the poster." Different people reacted to different aspects of the poster. For some, it was the size of the breast. With the growing popularity and acceptance of breast augmentation, with magazines and movies showing large breasts in skimpy clothing it is amazing that naturally full breast is seen as somehow remarkable and obscene. "What a big boob!" said some and "The exposed breast is obviously enlarged." And some accused us of digitally enhancing it to make our point. Just for the record, we didn't.

Some disliked the poster at some incoherent level and were then asked to say just what their problem with it was. The most violently opposed immediately seized on the age of the child and inflated that. With no evidence at all, they decided the child was at least three years old and maybe as old as four or five. Again, without any evidence they were also more likely to assume the child was a boy. In fact, the child is 20 months old and a girl.

Clearly the poster brought out some deep seated barriers in attitude that can't help but hinder the widespread freedom to breastfeeding with in our society. A couple of comments on an internet forum about the poster sums it up nicely, "it's important to realise that our discomfort is about US not about what that child is doing. Breastfeeding isn't a 'glorious act' it's a way to nurture a young child, both physically and psychologically. "I am guilty of feeling a little uncomfortable by the poster as it doesn't portray what I thought breastfeeding was about for me." It's a societal issue with women's bodies in Western culture being viewed as sex objects.
Breastfeeding Week 2005 presented New Zealanders with a new image of breastfeeding to begin breaking down the barriers of stereotypes that have been infiltrating us through the years. Taking a look back in history at the images of the Madonna breastfeeding her child, there has been a variety of images. Continuing to only portray breastfeeding in one way, the romantic Madonna look, does not help the acceptance of breastfeeding as a normal and natural function that has many different looks.

Getting Over it
From the amount of debate and dialogue that has occurred from the release of the poster it became apparent that the image presented challenges to some peoples' way of thinking about breastfeeding. "At least it has promoted discussion, which is very healthy for our Public Health Unit." "It has created a lot of discussion about breastfeeding which is a good achievement."
Many people who were first taken back by the image, on reflection came to see its value: "Well done, at first I thought too much breast was showing, but you can almost see that amount on some people so I say go for it." "Throws you back a bit at first, but hey it's natural, it's acceptable to show the breast." One mother of a young baby suggested that the image should have been more discrete then went on to ask, "any tips for being able to feed that long?"

Just like me!
There was a wonderful unanticipated reward from the release of the image - the validation that small talking breastfeeding children received. The image remains of one such child excitedly tugging her mother to see the poster and beaming at her as she pointed to it with a big smile on her face saying "like me". Another child was determined to know the name of the child in the photo - the little girl breastfeeding in the park was her hero. A mother related; "Two and a half year old Clayton (still breastfeeding) saw the toddler breastfeeding poster and immediately said Nana and Nan-na. He had no trouble seeing it as an advertisement for food with his breastmilk.
Getting On with itBreastfeeding is the biological norm. However success is at least as reliant on the many non-biological social factors in our modern society. One of those factors is people's views, expectations and tolerance for what is seen as normal. The focus on breasts as sex symbols and their extensive use in selling almost everything is seen as normal by most and desirable by many. At the same time, the tendency to hide breastfeeding away and portray it as normal only for babies who are held in a Madonna pose, creates a situation where breasts are seen as indecent when they are being used for their designated purpose and decent when their display is gratuitous.

Variety is normal. Some mothers' breastfeed by lifting their tops up, others by pulling them down, both are acceptable. Mothers breastfeed two year olds, two month old babies and sometimes tandem feed new babies alongside pre-schoolers. All are acceptable practices. Babies feed comfortably in their mother's arms. Toddlers however are active and curious. Many feed 'on the run' and most have a wandering eye - they just hate to miss anything! Many a mother breastfeeding a toddler will testify to the fact that few breastfeeding toddlers focus entirely on the job at hand. Mothers sometimes look adoringly at their infants when they feed. Other times they take no notice of the child at the breast as they talk freely to friends. In this they are not unusual - most animals with suckling young pay them little heed as they get older!

For breastfeeding to move from a biological norm to a widespread and accepted cultural norm, we all need to look at how we react to the different breastfeeding styles and images that we see. When it is no big deal or nothing out of the ordinary we will have made progress. While we still gape and uncomfortably shift and shuffle at the exposed breast or the feeding child (in any position), we still have a way to go. And while we still have a way to go, children miss being breastfed and gaining major health benefits. Every one of us has a role in creating a breastfeeding society.

Breast is best for weight loss? Breast-feeding guilt trips aren't limited to talk of babies' health.

Hmmm... This is an interesting article, but there was some important info left out.

Breastfeeding moms *can* safely lose about one pound per week in a healthy manner. Basically, a breastfeeding mom needs to "eat to hunger" and "drink to thirst" in most situations and she'll lose weight. Usually, just making sure snacks are healthy can be the main thing to focus on... a bowel of fruit is probably a healthier choice than the quick and easy candy bar. A brisk walk during the day, with baby in a carrier or stroller, can help mom get over any weight loss plateaus... and perhaps help her feel better, too!

There are lots of reliable weight loss programs out there specific to breastfeeding moms. These can help her safely lose weight without affecting her milk supply. Working with her doctor is also a good idea.

Here are a couple of good resources:

http://kellymom.com/nutrition/mom/mom-weightloss.html
http://www.llli.org/FAQ/diet.html

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Breast is best for weight loss?
Breast-feeding guilt trips aren't limited to talk of babies' health.
What about the new mom's figure?
Tracy Clark-Flory
Nov. 12, 2009

Today, the New York Times introduces us to a new reason to make mothers feel bad about not breast-feeding: all that fat around their bellies. "Breast is best" used to be just the ticket to send a new mom directly to Guilt Island, but now you don't even need to invoke the health of her formula-fed baby. Instead, just point out that she's still wearing those stretchy maternity pants to hide her post-baby pooch -- because, apparently, the hot new regimen for postpartum weight loss is expelling milk. That's right: Breast pumping instead of pumping iron.

The Times' Catherine Saint Louis begins the article with the tale of Jessica Jochim, a woman who "was the envy of her co-workers at Babies 'R' Us" because she returned after three months of maternity leave wearing size 4 jeans. "Yet, exercise was a pre-baby relic. She wasn’t dieting, either," says Saint Louis. "In fact, every two hours, she snacked as if on cue." Intrigued? Jealous? Feeling homicidal? Salivating in anticipation of her weight loss trick? She continues: "What was her secret? Breast-feeding her newborn James on demand, and using a breast pump to take milk home to him." Voilà! Babies: The new miracle weight loss pill. Or, as Saint Louis calls it, it's the "Get Out of Dieting Jail Free card."

Click here to read more...

How do I respond to and avoid criticism about breastfeeding?

A wonderful article called "Responding to Criticism" from La Leche League International magazine for families, NEW BEGINNINGS. The chart at the end of the article summarizes five methods for responding.

http://www.llli.org/FAQ/criticism.html

Your attitude and tone of voice can make a world of difference in how people accept your responses. The approaches and phrases listed below are helpful for dealing with criticism.
Review them and choose the ones that are most comfortable for you.

• Use "I" messages instead of "YOU" messages. (Rather than "You always criticize me" try "I really don't like to be criticized.")
• I'd like to discuss something. Is this a good time for you?
• I feel (angry, hurt, etc.) when...
• Having your support means so much to me.
• It's amazing how much research has been done over the years. It must surprise you to see me doing _______. I hope I'll be able to handle it well when Abbey starts her own family.
• Everyone has to make the decision they feel is best for their situation.
• I'm glad that you care so much about the baby. I've thoroughly researched the topic and feel comfortable with my decision. I'd be glad to share my info with you.
• I realize that this is an individual decision, and I'd really appreciate your giving me a chance at this.
• My doctor has stated...
• The American Academy of Pediatrics feels...
• That gives me a lot to think about!
• Your love and concern for the baby really shows.
• That's certainly another way of approaching it.
• I'm glad that ___________ worked well for you and your baby.
• We're really at odds here. Let's just agree to disagree and still stay friends, OK?
• I think we're losing sight of our goal here, which is the baby's well-being. Let's back up a little.
• This is a topic that has been debated and argued for generations. Let's not fall into that trap, OK?
• There are some valid points to both sides here.
• You could be right.
• I'd like some time to think about what you just said.
• Let's remember that we're both on the same side here.
• Can we save the arguments for truly vital topics?
• It's a very individual decision, and I'd never try to impose my viewpoints on someone else.
• Maybe the topic of _______ should go along with religion and politics: Not a good conversation topic for us.
• Discussing __________ can really get me worked up. I'm sorry if I said anything out of line. Let's change the subject.
• How about a compromise? You don't mention __________and I won't criticize your driving anymore.
• We're Abbey's parents and this is the decision we've made.
• You feel very strongly about this, I can see.
• This works for our family in our situation, but it might not work for you.
• Just Smile. :-)
  

Ways To Prevent Criticism:

1. Be discreet if at all possible.
2. Don't set yourself up for a discussion you don't really want to have.
3. Avoid issues where you anticipate disagreement. Focus instead on areas where you have something in common.
4. Offer an explanation of why you do things before you are asked. Do this in a gentle way, letting them know how happy you and the baby are. Be sure you give them permission to do things differently. (See #6 & 29 above)
5. Appear confident and happy with the way you do things, even if you are not. Don't express doubts to people who don't agree with you.

Finally:

Rise above criticism as much as you can without a "holier than thou" attitude. A positive non-threatening reply works best. In rising above criticism, making light of things often works.
Sometimes it's best to ignore the criticism and consider the source. People often feel defensive and attack when someone is doing things differently.

If you know you will be in a situation where your actions will be criticized, prepare ahead of time by practicing some of these responses. Create your own as needed. Practicing the responses you prefer in front of a mirror or with an understanding friend, will help you to be more confident.

When you are in the situation, pause a moment and take a deep, relaxing breath before answering.

Iron Levels of the Breastfed Baby

So, my little pumpkin is now 2 years old and she didn't really start eating solids until she was about 14 mos or so... (all the while being in the 99th percentile in height & weight). There was a little bit of worry since I knew she might fall short in the iron department and become anemic. A hemoglobin test showed this to be true...


As most know, iron levels for the exclusively breastfed baby, who was born healthy and full-term, are generally in great shape those first 6 mos (generally breastfed babies do fine the 1st nine mos). Foods high in iron are generallyrecommended (before iron supplements) at this age since iron in foods are better absorbed into their little bodies, etc. I like to also cook as much food in my iron skillets (seasoned from years of use by my mom!) and combine iron rich foods with Vitamin C foods:

* spaghetti with meat and tomato sauce
* meat and potatoes
* chicken fajitas with broccoli, sweet pepper, and tomatoes
* hamburger and coleslaw
* nitrate-free hot dogs and orange juice
* fruit, iron-fortified cereal, and raisins
* fresh fruit with raisins

For more info:

(A thorough description on anemia...)
http://askdrsears.com/html/4/t043100.asp#T043106
"PUMPING UP YOUR IRON"

www.llli.org/FAQ/firstfoods.html
"First foods for babies"

http://www.kellymom.com/nutrition/vitamins/iron.html
"Is Iron-Supplementation Necessary?"


Some additional info on solids from the AAP:

http://aappolicy.aappublications.org/cgi/content/full/pediatrics;115/2/496*

"Pediatricians and parents should be aware that exclusive breastfeeding is sufficient to support optimal growth and development for approximately the first 6 months of life and provides continuing protection against diarrhea and respiratory tract infection. Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child.

* Complementary foods rich in iron should be introduced gradually beginning around 6 months of age. Preterm and low birth weight infants and infants with hematologic disorders or infants who had inadequate iron stores at birth generally require iron supplementation before 6 months of age. Iron may be administered while continuing exclusive breastfeeding.

* Unique needs or feeding behaviors of individual infants may indicate a need for introduction of complementary foods as early as 4 months of age, whereas other infants may not be ready to accept other foods until approximately 8 months of age.

* Introduction of complementary feedings before 6 months of age generally does not increase total caloric intake or rate of growth and only substitutes foods that lack the protective components of human milk.

* During the first 6 months of age, even in hot climates, water and juice are unnecessary for breastfed infants and may introduce contaminants or allergens.

* Increased duration of breastfeeding confers significant health and developmental benefits for the child and the mother, especially in delaying return of fertility (thereby promoting optimal intervals between births).

* There is no upper limit to the duration of breastfeeding and no evidence of psychologic or developmental harm from breastfeeding into the third year of lifeor longer.

* Infants weaned before 12 months of age should not receive cow's milk but should receive iron-fortified infant formula.


So, here's a recipe I found that is quite yummy (below)... If you try it out, let us know what you think (and what your baby/toddler think!).


"Coconut-Apple Sweet Potatoes

Ingredients:

* 1 apple, peeled, cored and chopped
* 1/2 C. sweet potato, peeled and chopped
* 1/2 T. dried coconut
* water as needed

Instructions: Place the chopped sweet potato pieces in a steamer over boiling water. After 5 minutes, add the chopped apples and steam until tender. Place potato and apple pieces into a food processor with coconut. Process until baby food consistency, adding water as necessary. Note: You can use a potato masher, fork, or baby food grinder to prepare this recipe, though the mixture won't be as smooth. This is also a great side dish for a toddler meal. Try using coconut milk instead of water for a creamier, more coconutty flavor.

10 Tips to Breastfeeding for a Year

Christine FosterMountain View CA USAFrom: NEW BEGINNINGS, Vol. 23 No. 1, January-February 2006, pp. 4-8

The recommendation from the American Academy of Pediatrics and other medical groups is clear—babies should be breastfed until at least their first birthday. But few mothers and babies make it that far. Although more than 70 percent of new mothers in the USA breastfeed just after birth, just 16 percent are still breastfeeding at one year (Ruowei et al. 2005). The reasons that so few make it to that goal are complex— a society that doesn't always support breastfeeding; alternatives that can seem easier during difficult times; a lack of education or understanding about the significant differences between the health of breastfed babies and bottle-fed babies. But most mothers who really want to can make it to a year, and beyond. This article provides some tips to help you get there.

1. Find Support
Although many mothers initiate breastfeeding after birth, it's still unusual for a new mother to have a lot of experience with seeing breastfeeding in action. The changes a new mother experiences after the birth of a baby are hard to anticipate and oftentimes surprising. The theoretical notion of planning to breastfeed can be radically different from caring for a real, live baby at the breast. For that reason, it's comforting to be around people who know about breastfeeding.

One of the easiest ways to find supportive people is to attend La Leche League meetings during your pregnancy. Experienced Leaders often note that mothers who are involved with LLL before birth tend to have an easier time because they are more educated about the normal course of breastfeeding. Plus, if there are unexpected issues, mothers who have already attended meetings are often more comfortable calling a Leader they already know.

It can also be helpful to educate family and friends about your goal. When Unity Dienes, a Leader in New Hampshire, was expecting twins, she made sure that her husband, Klee, understood her goals by writing up a list of reasons why it was so important for their boys to get her milk. Unity's advance work meant that when they encountered challenges in those early weeks, she had his full support. "He was amazed at how many different reasons there were," she says.

2. Learn to Breastfeed in Public
Learning how to breastfeed in public can be a big challenge—especially in communities where breastfeeding isn't as common. Women who can't get comfortable breastfeeding in public generally find it harder to make it to a year or beyond. If she doesn't want to nurse in public, a mother would either need to limit her excursions or pump her milk for bottles. Either of those can be frustrating and can limit the breastfeeding relationship.

Some mothers find nursing clothing to be helpful when they need to nurse in public, while others find it just as easy to breastfeed discreetly by lifting their shirt from the bottom and making sure their baby covers all of the exposed skin. Many mothers gain confidence by practicing in comfortable environments —such as a La Leche League meeting—or by watching themselves in a mirror so they know what they look like to those who may be watching. Sometimes enlisting a friend to come along for early outings can make a mother more comfortable. "Even if someone can tell you are breastfeeding, it's not a big deal," says Unity. "Try to develop that mind set. You are feeding your baby. You are comforting your baby. That's what your breasts are for."

Often a mother will actually be encouraged in her breastfeeding relationship by strangers who see her breastfeeding. "I was very nervous about breastfeeding in public with my first baby," says Dawn Burke, a Leader in Georgia. Once, when her daughter was about eight months old and the pair was out at a farmers' market, her baby became desperate to breastfeed. Dawn found a secluded spot on a milk crate at the edge of the public/employee area and sat down to breastfeed. An older male employee approached and loudly praised her for breastfeeding. "It is good to see you nursing your baby!" Dawn remembers him saying. "I am from India," he continued, "and breastfeeding is very important there. You keep nursing your baby. It's very good!" Now, Dawn says, "I tell mothers at meetings to take support wherever they find it!" (For more suggestions about breastfeeding in public, see the November-December 2005 issue of NEW BEGINNINGS.)

3. Limit the Use of Bottles and Pacifiers
Some babies clearly do use bottles and pacifiers and manage to continue breastfeeding for at least a year. But, as stated in THE BREASTFEEDING ANSWER BOOK, getting sucking needs met somewhere other than the breast is a risk factor for early weaning. Using artificial nipples during the early weeks can interfere with a baby's ability to breastfeed effectively.

La Leche League suggests limiting pacifier use in the early weeks, which can seem confusing to some mothers in light of the recent recommendation of the American Academy of Pediatrics that babies should sleep with pacifiers to reduce the risk of Sudden Infant Death Syndrome. LLL believes that the recommendation did not take basic breastfeeding management into account and could threaten the development of longer-term breastfeeding relationships. According to a statement issued by LLL:

Pacifiers are artificial substitutes for what the breast does naturally. Breastfed babies often nurse to sleep for naps and bedtime. The recommended pacifier usage could cause a reduction in milk supply due to reduced stimulation of the breasts and may affect breastfeeding duration.
In other words, if pacifiers are good for babies, why not use the best—the breast?

4. Find Ways to Involve Dad
One of the most common reasons new mothers give for pumping milk is that they want their baby's father to be able to give the baby a bottle. Frequent bottles, however, can lead to early weaning, so finding another way for daddy to connect with his baby can be crucial. In many families, bath time or an infant massage is a special daddy-baby bonding opportunity that offers skin-to-skin contact and comfort.

Cindy Howard, a Leader in California, recalls that her husband disliked giving their daughters bottles because his daughters seemed to behave as if they were getting second-best. When their youngest daughter, Gwen, was a baby, John connected with her by rubbing her feet to comfort her when his wife attended an early morning exercise class.

Jennifer Moquin, a Leader in Pennsylvania, let her husband, Anthony, take the late shift with their night owl baby. She would breastfeed the baby and then lie down to sleep a bit while daddy walked the baby around, played special songs to her, and showed her pictures on the wall. "She was mellow, but wide awake," Jennifer recalls. "It was always a really nice time for them."

5. Create a Daily Rhythm
Strict schedules can make it hard for a mother to respond to her own baby's cues. They can also lead to decreased milk supply, because milk is removed from a mother's breasts less often. It can be confusing for mothers to hear that babies are "supposed to" breastfeed eight to 12 times in a 24 hour period or that babies "should" breastfeed for 10 or 15 minutes on each breast when their baby is doing something different. According to THE BREASTFEEDING ANSWER BOOK, "Length of feedings varies with the baby's personality and age. A baby's breastfeeding style also may change as he grows." Many mothers find it helpful to spend less time looking at the clock and counting the number of times their babies go to the breast. As long as your baby is gaining enough weight, simply watching his or her cues is enough.

For some mothers and babies, though, having some sort of predictability to the day is important. A mother can gradually provide some structure by giving her baby predictable cues. Having a specific order to the day—a time for baths, walks, or books, for example—can help the baby and the mother find a rhythm that works for them. Some babies will fall into a more regular breastfeeding pattern as they grow older. Others will continue to want to breastfeed frequently throughout the day.

6. Breastfeed for Comfort
Some mothers worry that offering the breast for comfort when baby is upset will create an inappropriate emotional connection with food. They worry that their child will turn to food for comfort, rather than eating to satisfy physical hunger. They might believe that it's better to try to separate food from emotions. If we are honest with ourselves, though, we will realize that all of us associate certain emotions with certain foods. Cindy Howard, who is also an International Board Certified Lactation Consultant, gives the example of the traditional birthday cake. There is rarely much nutritional value in the cake. It's the emotional component of celebrating with others that matters.

When you offer the breast for comfort, you are encouraging your baby to turn to you for comfort instead of a non-human object. The human contact matters more than the milk. Plus, breastfeeding for comfort keeps your supply plentiful and reminds the baby that by breastfeeding he can help himself to feel good again.

7. Recognize the Signs of a Nursing Strike
Babies often have periods during which they seem more or less interested in breastfeeding, but it is very unusual for a baby to actually choose to wean before one year. It is not uncommon, however, for a mother to say her young baby is "weaning" when the baby is actually in the midst of a nursing strike or making a developmental leap that is distracting him from breastfeeding. According to THE BREASTFEEDING ANSWER BOOK, the most typical age for a nursing strike is between three and eight months.

The key to avoiding weaning inadvertently is to recognize and deal appropriately with a nursing strike. Molly Remer, a Leader in Missouri, remembers that when her son, Lann, was five months old, he stopped breastfeeding during waking hours for a week due to having a cold. Apparently frustrated because he was congested and having trouble breathing while breastfeeding, Lann simply refused. Molly breastfed him while he slept and tried various tricks to get him back to the breast during the day. Breastfeeding while in motion worked best, so she walked and breastfed. Lann is now two years old and still breastfeeding regularly.

Another very typical time for something that can look like weaning, but isn't, is the second half of the first year as babies start to move and be more aware of their environment. Some are so distracted that they never stop to breastfeed. Some mothers find that offering to breastfeed more often, bringing a baby into a dark room to breastfeed, or taking advantage of nighttime nursing opportunities can get them through this stage. Frequently, when babies refuse to breastfeed, though, there is something else going on that has upset the babies' lives, such as an illness or teething or a big change in the family, such as a move. And, sometimes, rarely, babies will wean naturally before a year. The benefits of breastfeeding to a baby's health are so strong, however, that it is worth efforts to make sure that a baby is not simply going through a short-lived stage before stopping breastfeeding.

8. Handle One Day at a Time
Some mothers are planners: they want to decide how long they will breastfeed before their baby is even born. They think, "I don't really want to nurse a three-year-old, so I will wean now." Others may plan to breastfeed until a year or beyond, but may feel overwhelmed during the early days and fear that they can't possibly make it to their goal.

Instead of making a firm decision in advance, try taking it one day at a time. When your baby is a newborn the idea of breastfeeding an enormous 12-month-old can seem daunting. When you are helping her blow out her candles on her first birthday, your baby won't seem nearly so huge.
Ariel Valencia, a mother in California, has used the "one day at a time" approach to help her continue to give her son, Evren, only her milk. Ariel works outside the home and finds it difficult to pump enough milk for him while she is away. She sets two-week goals and has already made it to five months.

9. Don't View Breastfeeding as an "All-or-Nothing" Proposition
Occasionally mothers introduce formula—perhaps to cope with a supply deficit while they are working or because they choose not to pump milk when they are separated from their baby.
Julie Nelson, a mother in New York, introduced formula to her son, Nicholas, at nine months when she stopped being able to pump enough for him while she was at work. She continued to breastfeed during the evenings and on weekends and Nicholas continued to breastfeed through his first birthday.

10. Enjoy the Moment
Remember, it's okay to fall in love with breastfeeding. "It's going to be your heart, not your mind that makes you continue," says Unity Dienes. So prime your heart to love breastfeeding. Unity suggests that mothers:

Make sure breastfeeding doesn't hurt—you can't fall in love with something that hurts.
Avoid having anything in between you and your baby, including a nipple shield or a bottle with pumped milk. Whenever something is between you, it makes things more difficult.

Snuggle with your baby. Savor his sweet smell and his fuzzy head. Watch to see the milk your body made dripping out the corner of his mouth. Falling in love involves all the senses.
When a mother embraces breastfeeding, it becomes that much easier to breastfeed for a full year and beyond. That's the true "secret" to breastfeeding. If a mother enjoys breastfeeding or commits herself to it, it's likely that it will be easier for her to allow comfort nursing, figure out how to nurse in the presence of others, and get the support she needs.

This period in your baby's life is fleeting. As you adjust to this new experience, remember to take things as they come and try to enjoy the moment.

7 WAYS BREASTFEEDING BENEFITS MOTHERS

from www.askdrsears.com

What's good for baby is also good for mother. When mothers follow nature's lead and breastfeed their babies, their own bodies benefit--so do their budgets!

Reduces the risk of breast cancer. Women who breastfeed reduce their risk of developing breast cancer by as much as 25 percent. The reduction in cancer risk comes in proportion to the cumulative lifetime duration of breastfeeding. That is, the more months or years a mother breastfeeds, the lower her risk of breast cancer.

Reduces the risk of uterine and ovarian cancer. One of the reasons for the cancer-fighting effects of breastfeeding is that estrogen levels are lower during lactation. It is thought that the less estrogen available to stimulate the lining of the uterus and perhaps breast tissue also, the less the risk of these tissues becoming cancerous.

Lessens osteoporosis. Non-breastfeeding women have a four times greater chance of developing osteoporosis than breastfeeding women and are more likely to suffer from hip fractures in the post-menopausal years.

Benefits child spacing. Since breastfeeding delays ovulation, the longer a mother breastfeeds the more she is able to practice natural childspacing, if she desires. How long a woman remains infertile depends on her baby's nursing pattern and her own individual baby.

Promotes emotional health. Not only is breastfeeding good for mother's body, it's good for her mind. Studies show that breastfeeding mothers show less postpartum anxiety and depression than do formula-feeding mothers.

Promotes postpartum weight loss. Breastfeeding mothers showed significantly larger reductions in hip circumference and more fat loss by one month postpartum when compared with formula-feeding moms. Breastfeeding mothers tend to have an earlier return to their pre-pregnant weight.

Costs less to breastfeed. It costs around $1,200 a year to formula-feed your baby. Even taking into consideration the slight increase in food costs to a breastfeeding mother, the American Academy of Pediatrics estimates that a breastfeeding mother will save around $400 during the first year of breastfeeding.

How Bottle Feeding Affects Mothering Traditions

by Vicky York

Today there is often a generation gap when a mother sees her daughter struggling, often in tears, with breastfeeding and suggests she "just give the baby a bottle" though her daughter has been reading research about the benefits of breastfeeding rather than formula feeding.

As a postpartum doula I frequently witness firsthand this new turn of events for the grandmother/mother relationship. Frequently distant grandmothers without nursing experience are asked by daughters to stay home until their daughters have a handle on the breastfeeding situation. Some grandmothers are present but sit in a corner quietly listening to us talk, learning for the first time themselves how to handle nursing situations.

Too often tearful new moms are alone at home, sometimes self-conscious about their awkward first efforts at nursing. Some are feeling they aren't good mothers because they are having trouble and they perceive that instant success should come naturally, not realizing that the only way women have ever known how to nurse is by watching other females. Babies know instinctually how to suck and seek the nipple, but many details of the art of breastfeeding are learned from other mothers. It's one of the gifts mothers receive from the family elders, the keepers of the heritage.

But grandma has competition. No need for baby to depend on mothers milk. No reason why moms can't skip the learning curve hassles of breastfeeding when she's heard formula is just as good. Thank formula company's marketing tactics, and hospitals' willingness to support formula feeding by giving their patients gifts of free formula. This has produced at least a couple generations of bottle feeders, breaking the cycle of the continuous and precious handing down of breastfeeding knowledge from generation to generation. Some breast feeders think they can also bottle feed just to make sure baby's gets enough, not understanding that this interruption in the emptying of the breasts compromises future milk supply and for many it's extremely difficult to build up that supply later. Every grandma who's "been there, did that" knows this fact. This is not to mention nipple confusion and the irritation that cows milk protein creates in newly initiated intestines.

We are the only species that drinks the milk of another species. It took some fancy marketing and billions of dollars for formula makers to create the illusion that their artificial baby milk was the "next best thing to breastmilk". We have a situation in which bottle-feeding has become a more common sight than breastfeeding and mothers are actually self-conscious when publicly providing sustenance for their infants in the natural way. Little girls today expect dolls to come with bottles. Dads sometimes feel cheated if they can't give their baby a bottle. And Grandma's are cheated of their role as bringers of the art of breastfeeding.

Women of yesteryear didn't know why breastmilk was best; they simply nursed for the same reasons all mammals nurse their young and they learned from others. When a woman sits down and pulls her baby to her breast she carries on a tradition of many generations of mothers before her providing the perfect nourishment to ensure that her offspring survives. We have heard that natural childbirth is empowering; it teaches a woman that she can trust her body to grow a child within her and withstand the rigors of labor to bring that child into the world. Surely realizing her capability of supporting this new life with the milk of her blood and the warmth of her body is another form of empowerment. It may be the first time she imagines her mother feeding her in this way a generation prior. In this way emotional healing often occurs in strained mother/daughter relationships.

Where it was once enough that grandma demonstrated how to feed a baby, new moms are now confused by the contradicting advice of friends, books, and physicians who don't have faith in mothers, babies, or ancient history.

Husbands are stymied as to why their wives are struggling with something they thought came naturally. Fathers 50 years ago left it up to the womenfolk to teach each other while they went off to work, knowing their wives were learning from the pros.

But breastfeeding is making a comeback. Though free food, trinkets and trips given to hospitals and doctors by formula makers has been persuasive the trend is changing as protestors cite a shameful conflict of interest. It may take another couple of generations to repair the damage done and revert back to natural behavior in feeding by getting formula companies to step out from between mother and child and pediatricians to add breastfeeding to their training.

But as it stands now many of today's grandmothers don't have the knowledge or experience to help their daughters because they bottle-fed their own children during a time when it had become popular to give their own babies artificial baby's milk. In the 60's pediatricians, happy to have a calibrated method to see and chart how much babies were drinking, usually recommended either formula, basically a concoction of tropical oils, cows milk and a few vitamins and minerals required by the government. Now the World Health Organization recommends nursing for one year. More of today's mothers nurse than the last generation and with their help their daughters won't miss one of the most unforgettable and empowering experiences mothers enjoy.

Lactation consultants are very often necessary if a new mother is to get any help at all when her baby is placed in her arms for his first feedings. Doctors are usually untrained in lactation and depend on lactation consultants to advise them. Therefore lactation clinics are set up in or near most hospitals and mothers who go home with problems can bring the baby back in to get help, if they are able. Hospitals hire as few lactation consultants as they can get away with and those are often busy doing paperwork, arranging classes and even working on the labor and delivery floor. Many women never see a lactation consultant in the hospital and if they do it may be brief and they may only have time to send struggling mothers home with breastfeeding accessories, such as nipple shields and hope for the best. This situation is regrettable to lactation consultants as much as anyone as they have the training and the heart to do so much more.

Doctors are feeling pressure to come up with answers about a subject they know little about unless they are females who successfully nursed their own, and therefore too often resort to taking the more legally accountable route of recommending prescribed amounts of formula. Midwives need to be more informed than ever about breastfeeding if they want their clients to avoid suggestions of formula supplementation from all sides as soon as they encounter a potential problem.

Mothers in larger cities now often pay for postpartum doula services to fill a void in their own ability to solve specific challenges with the techniques of breastfeeding. While doulas and lactation consultants can save the day, this really should be a time when mother and daughter come together in a new relationship with one another, forming a bond through the "handing down of knowledge" from mother to mother.

While sitting next to a new mom explaining some of the amazing facts about breastmilk to keep her inspired, many a grandmother has leaned over my shoulder and expressed regret that she used formula by the influence of her pediatrician, formula company ads, the availability of free formula samples, and her peers. Older women today often confess feeling great regret at having "failed" at breastfeeding because they "just didn't make enough milk" or "the baby didn't like their milk" and so on. We now know that if their own mothers and their peers had breastfed they would have received information about early and frequent nursing, supply and demand, and the proper latch that pediatricians today don't have the time or training to teach mothers. It's grandma's place. Grandma's who had the will but not the help can feel psychological pain and sometimes embarrassment over missing out on this experience. And the ones who did successfully nurse all their children exclaim that fact with pure pride. Having to give up is no small thing and those mothers never forget it. With a little initial support they would have seen their babies not only thrive on their milk but love nursing to the point of outright rejecting formula. They could have bypassed bisphenol-A laden bottles with their latex nipples and pacifiers and probably gone straight from the breast to a cup, with guidance all the way by their own mamas. Guidance any grandmother who nursed can give to the great appreciation of an apprehensive daughter. Grandmothers also know that breastfeeding ensures that mothers stay close to their infants physically and emotionally and that this in itself takes care of so many issues.

Native Americans and other ethnic groups must particularly feel the sting of having modern American industrial society replace older customs and traditions. They're missing yet another route of handing down knowledge and skills from generation to generation that can keep them tied as a culture or a tribe. Where the natural inclination used to be to call grandma because of her nursing experience now parents go to the market for formulas, bottles, nipples, bottle-washing brushes and sterilizing accessories. And if they breastfeed, hiring help can be expensive.

At a time when some grandmothers may begin to feel that their worth in society and to the family is waning, their daughters and sons produce an opportunity for them to impart their knowledge, skills and experience in mothering and providing for babies. According to each culture grandmother knows which foods to feed her daughter, which herbal teas are best for breastfeeding initiation, how to ensure plenty of milk, etc. Valuable information and handed down wisdom that has no place in a bottle-feeding society. However-much mothers and daughters may differ in ideas about parenting a deeper bond is created between them, as a daughter trusts her mother's ideas and knowledge at a time when she feels vulnerable and unsure. After a few weeks of reassurance from mom there is a sense that all is well in the family when the new young mother feels pride in being the only one who can give her baby his birthright straight from her bosom. The largely unrecognized effect of aggressive marketing ploys of formula makers, and resultant prevalence of bottle-feeding is the loss of the natural family tradition of grandma being able to pass on her art of breastfeeding, truly mothering the mother as no one else could.

Vicky York, IBCLC, CPD is an independent lactation consultant and has worked with nearly 600 families in the Oregon as a postpartum doula. She has taught postpartum doula training workshops, newborn care classes, breastfeeding classes and grandma classes and is a published author of postpartum related articles. Vicky York, IBCLC, CPDPostpartum Care ServicesPortland, Oregon
http://mypeoplepc.com/members/vmyork/www.ikarma.com/user/vmyork


(Note: The World Health Organization suggests breastfeeding for 2 years.

"... infants should receive complementary foods with continued breastfeeding up to 2 years of age or beyond."
http://www.who.int/nutrition/topics/exclusive_breastfeeding/en/index.html

Also, there's available free breastfeeding help available through a woman's local La Leche League Group... www.llli.org

A to Z: 26 Reasons to Nurse Your Baby

From: www.llli.org

Amenorrhea
Bonding
Colostrum... the perfect first food
Decreased risk of breast cancer
Easy baby care
Few allergies
Good for the whole family
Human milk is specially designed for human babies
Immunities
Jaw development
Kids get lots of attention when the new baby is breastfed
Laundry is a breeze
Mental development
Natural
Oxytocin and prolactin
Protection against many diseases
Quick weight loss for mother
Rest
Saves money
Traveling is easy
Understanding the baby's needs
Vitamins and minerals
Working goes smoothly when the nursing relationship is maintained
eXactly what baby needs
You get to take care of your baby
Zero waste

Only the Best Is Good Enough - Breastfeed!

Cold War Remnant: Cancer for Baby Boomers

"Even with a half-century’s hindsight, the
U.S. government’s willingness to risk the
health of the nation’s children seems somewhere
between unfathomable and unconscionable.
Between 1951 and 1962, the Atomic Energy
Commission detonated more than 100
nuclear bombs in the atmosphere over its
Nevada Test Site, just 65 miles from Las
Vegas. The radioactive fallout menaced not
only the ranchers and the miners unlucky
enough to live in that remote area of southern
Nevada, but — as a new study unveiled
Tuesday demonstrated — untold millions
of unsuspecting Americans as well.

The winds carried Strontium-90, Iodine-
129 and other lethal particles across a
broad swath of the country. Infants who
were bottle-fed, which was then considered
the modern approach, were particularly
vulnerable to the Strontium-90 that ended
up in cows’ milk."

(Read more...)

Do Nursing Moms Need Protection?

Here's an interesting video from Cambell Brown, a working, breastfeeding mom who pumps...

http://www.cnn.com/video/?/video/bestoftv/2009/09/17/cb.breast.mom.cnn


(Just fyi... here's the original article about the Isotoner mom posted earlier... http://campbellbrown.blogs.cnn.com/2009/09/17/mom-breastfeeding-cost-me-my-job/#more-1486 )


Yes, we certainly need more laws and protection for pumping moms.

As a mom who pumped/worked for her baby, I think more opportunities should be made to help moms in similar situations... almost like "smoking breaks," or the like, for others. :O) More positive stories and solutions should also be distributed and possibly sought...

All in all, a good, open communication with an employer is probably one of the better things to keep in mind in these type situations. And, presenting a well-thought out, positive plan *ahead* of time which shows an employer how future pumping will *not* have a negative impact on job efficiency, etc., might be another idea.

But, do we pick our battles right now while the foundations are being laid down?

I pumped in a dirty, small storage room... this was the only availability at the time. I did pump in a counselor's office with a sign on the door politely asking to "please knock, I'm breastfeeding" but was still walked in on. Of course, the "intrusion" wasn't on purpose, but it was an uncomfortable situation, to say the least. O)

Anyhow, I did survive... I just closed my eyes and thought of my little girl (probably helping my let-down reflex, too!).If needed, the art of a well-written complaint letter might also be beneficial....

Lack of current information on breastfeeding is so prevalent these days.

Beyond the Nursery: Nursing with Confidence

www.breastfeeding.com/reading_room/behrmann.html

by Barbara L. Behrmann, Ph. D.

Niesha, a young mother in Arizona, was nursing her three week-old son in the baby department of a large discount store when the manager politely asked her to nurse in the bathroom because there were male customers who were their with their wives.

Amy, enjoying a lunch out with her mother, discreetly nursed her daughter under her shirt. The waiter avoided eye contact with her and asked her mother, instead of her, for her lunch order.

Patti, a modest woman in Washington, used to nurse in public bathrooms. She would put a lot of toilet seat covers on the seat and nurse on the toilet completely dressed. This kind of judgment, however, is not universal. Originally from Jamaica, Opal compared nursing in the US to her experiences overseas: "I remember going to Mexico when Shola was a baby and sitting on the side of the road, nursing. I didn't cover my breast and nobody said anything to me. Nor did anyone say anything to me in Jamaica and St. Croix."

In a culture that encourages us to show cleavage but god forbid, our nipples, we typically try to be as discrete as possible. Ironically this means that the less visible we become and the more we hide the early work of mothering, the more approval we earn. We sling blankets over our shoulders, purchase special nursing tops, turn our backs to others, and ultimately try to disguise what we are doing. These, of course, may be good personal solutions, but they don't help us change the culture.

The challenge we face is to nurse discreetly, but not invisibly. This way, we not only meet out babies' all-important needs, but we also help each other; that is, the more others see mothers nursing publicly, the easier it will be for the next nursing mom.

Increase Your Confidence

Chances are, nobody will give you a hard time about nursing in public. But just in case, here are a few things to remember to boot your confidence.

You may start out feeling awkward and insecure, but over time you are likely to develop confidence and become more assertive.

This is what happened with Stephanie. A first-time mother in Pennsylvania, she practiced nursing discreetly in front of mirrors and her husband. "I wanted to go places and do things but was so nervous that someone might get a glimpse of my bra as I opened it or god forbid, a flash of skin," she recalls. Her attitude changed after a few weeks and she became resentful and angry. "I never intended to fully disrobe in the mall but I hated the fact that I couldn't focus on my daughter's needs - I had to focus on whether somebody might be seeing more than they should." Stephanie became increasingly defiant and after a few months would actually seek out places "That might ruffle a few feathers."

The law is on your side! In fact over 20 states have enacted legislation to clarify that women have the right to nurse in public without being accused of indecent exposure, lewd behavior or obscenity. : So...if anyone suggests you move to the bathroom to nurse, simply ask them if they'd like to eat their meal in a toilet stall and share with them this link: Http://www.lalecheleague.org/LawMain.html

Don't feel pressured to feed your baby expressed milk in a bottle. Not only is a pump less effective than a baby at removing milk form the breast, but lactation works on the principle of supply and demand. In some cases, pumping, instead of nursing, can diminish your milk supply. Besides, if you baby is nursing for comfort - or any other "non-nutritional" reason, he or she doesn't want a bottle when your warm body is right there!

If you're nurslings past the baby-in-arms stage, he or she won't care if you're at home or in a shopping mall. You may want to nurse ahead of time and eventually you may be able to explain to your child that there are places where it's ok to nurse and places where you have to wait. But again, know that you have the legal right to breastfeed. And international health organizations recommend nursing a child for at least two years. So if someone gives you a hard time, gently inform them that nurslings suckle for reasons beyond the milk. It calms them, comforts them, and meets their emotional needs. Humor may help. You can be pretty sure that by the time your child starts college he or she will be off the breast. In short, there is no reason to feel embarrassed for meeting your child's nutritional and emotional needs.

Generally, the more comfortable you are, the less likely others will challenge you. Remember the words of Nina, a first-time mother in upstate New York. "I love nursing in public and I don't put a ton of effort into hiding it," she admits. "I'm not saying breastfeeding should be about shock value, but I feel strongly about nursing and am proud of it. I don't look down, I don't feel embarrassed, and I look people right in the eye."

Remember, be discreet, but not invisible, confident but not aggressive. Use a blanket as a cover up, if you like, but if your baby won't tolerate warm flannel over his head, who can blame him? Remember that nursing in public not only meets your baby's needs, but does a public service.

Finding A Breastfeeding Support Person

from Dr. Jack Newman

Finding a Lactation Consultant or breastfeeding-support person may seem like a daunting task but it is well worth the effort. First, a few things to know:

(click here to go to article)


La Leche League is an international group of women who give mother-to-mother peer support. They are a wonderful resource for support and information and run support groups in cities all around the world. http://www.lalecheleague.org/

La Leche League Canada
Mother to mother information and support by phone & email
Community Groups for pregnant and nursing mothers.
Website information and publications for families and health professionals....


Lactation Consultants are International Board Certified Lactation Consultants this means they are registered Lactation Consultants, IBCLC, RLC who are required to keep current with breastfeeding information and must recertify every five years. We provide hands-on clinical support and are trained to work with all breastfeeding-related problems. In order to certify we must have many thousands of hours of practical hands-on training and must have completed many education credits to write the international exam in the first place.

To find a Lactation Consultant, contact http://www.ilca.org/ for a worldwide search or IBLCE http://www.iblce.org/international%20registry.htm or your local Lactation Consultant association: or, in Canada, the Canadian Lactation Consultants Association is also a good resource: http://www.clca-accl.ca/. In the USA, http://www.uslcaonline.org/

Breastfeeding Clinics may be found in many hospitals. Most clinics are staffed by IBCLCs, though not always.

Of course, getting the best start is the way to go, and having as few interventions during labour and delivery will help a mother to get that best start. Having a Midwife and/or Doula as support during labour is usually a good assurance that the labour will go as naturally as possible.

Midwives: though experts in pregnancy and labour support, they are also trained to counsel mothers in getting a good breastfeeding start.

In Ontario: Association of Ontario midwives: www.aom.on.ca (“find a midwife” function).
In Canada: Canadian Association of Midwives: www.canadianmidwives.org

Doulas may also be trained in breastfeeding support. A Doula is a labour-support person. Doulas may be found through DONA at http://www.dona.org or through CAPPA at http://www.cappa.net or in Canada: http://www.cappacanada.ca .


HOW TO CHOOSE A GOOD and HELPFUL BREASTFEEDING-SUPPORT PERSON

1. When you seek help from a Lactation Consultant (LC), you should not feel that she is mainly trying to rent or sell you some product. The Lactation Consultant is there to help you with your breastfeeding problem, and very often help does not require any products. Even if you do need to rent a pump, for example, you should not feel that the lactation consultant is focussing on sales or rentals. Certainly, if she does sell you a pump or product, this sale time should not be included in her hourly fee.

2. No matter what your problem, a good LC should not be telling you that you cannot breastfeed. We hear of some Lactation Consultants and doctors telling mothers they cannot breastfeed. Do not believe them. If you have nipples you can breastfeed. Women are often told they must stop or interrupt breastfeeding due to illness or a medication they are taking or a test they must undergo--this is only very rarely true. See handouts You Should Continue Breastfeeding 1 and 2.

3. No LC or breastfeeding-support person should ever bring formula with her to your home. LCs are not allowed to distribute formula samples or recommend a formula by name. Ask her ahead of time if she intends to bring some formula samples with her. This may be an indication of her true support for breastfeeding.

4. Nipple shields and bottles are being used much too often to try to fix breastfeeding problems, even though they can, very occasionally, be useful. Nipple shields should never be used for the baby who refuses to latch on before the mother's milk 'comes in' on day three or four (or sometimes later). Once the milk 'comes in', many babies will latch on easily without a nipple shield. There are usually better ways of supplementing or feeding babies than using a bottle. Be sceptical if you LC is quick to use a nipple shield. Patience, perseverance, and good technique are almost always good enough to get any baby latched. See handout When Baby Refuses To Latch On.

5. REMEMBER to Get the best Start: Try to ensure and aim for the most natural labour possible. A good Midwife or Doula may be an invaluable way to achieve that goal.

BE WARY IF:

1. You are told to feed x number of minutes per side
•Babies can feed well being on the breast short periods of time, and can feed poorly being on the breast all day
•Timing is meaningless and tells us nothing about what the baby is actually getting and whether or not it is enough

2. You are told to feed x number of times per day

•A baby who feeds well 6 times a day is better off than a baby who feeds poorly 12 times a day
•There are no studies to support the claim that a baby must feed 8-12 x/24 hour period. None whatsoever.

3. You are told to wake the baby every x number of hours

•A baby who feeds well will wake up when he's ready; if a baby feeds so poorly that he won't wake up on his own, there is no point in waking him up so he feeds poorly more times a day; the point is to get the baby feeding well.

4. Your breastfeeding-support person weighs the baby before and after each feeding

•What does this tell us? Even if the scales could be relied on as always accurate—so what? A 15 gm gain, for example, may mean baby consumed 15 mls of breastmilk—but what kind of breastmilk? 10 am breastmilk? 3pm breastmilk? Tuesday’s breastmilk? The beginning of the feeding breastmilk? The end? What? Ensure baby is actually drinking instead of just sucking, and follow our Protocol to Increase Intake of Breastmilk. Watch the video clips at www.drjacknewman.com. That’s how you will know baby has had enough.
•Test weighs have been known to show many false negatives. See Handout Is my Baby Getting Enough?

5. Your breastfeeding-support person tells you that sore nipples are normal and you need to endure it, or that your nipples need to “toughen” up or that your skin is overly sensitive, or, if you are a red-head, that you are supposed to have overly-sensitive nipples

•A good latch prevents and fixes sore nipples
•Pain that endures for many weeks may mean there is something else going on—please see a Lactation Consultant to get this checked out
•Nipple shields are not usually an appropriate remedy for sore nipples
•Skin colour is irrelevant

6. Your breastfeeding support person asks you to finger feed after you breastfeed your baby

•If a baby needs supplementation then that baby should be supplemented at the breast as long as the baby is latching. Finger feeding is not an appropriate method of feeding a latching baby. See Handout Finger and Cup Feeding

How Much Should An IBCLC Charge For A Home Visit?

There really is no set rate for IBCLCs and the fees for home visits range dramatically. In Toronto, there are some support people doing home visits for $35/hr and some going as high as $180/hr. Please do not let price fool you—the most expensive IBCLC is not necessarily the best. Do a little home work and research and ask her over the phone about some of the points listed above. An average rate is probably around $100/150 for a visit lasting around 2 hours. This may seem excessive but it is not—keep in mind that a good IBCLC will save you money in the long run by keeping you and baby breastfeeding and off expensive formula.

Questions?

First look at the website nbci.ca or drjacknewman.com. If the information you need is not there, go to Contact Us and give us the information listed there in your email. Information is also available in Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA); and/or our DVD, Dr. Jack Newman’s Visual Guide to Breastfeeding (available in French or with subtitles in Spanish, Portuguese and Italian); and/or The Latch Book and Other Keys to Breastfeeding Success; and/or L-eat Latch and Transfer Tool; and/or the GamePlan for Protecting and Supporting Breastfeeding in the First 24 Hours of Life and Beyond.

To make an appointment online with our clinic please visit www.nbci.ca. If you do not have easy access to email or internet, you may phone (416) 498-0002.

Advice regarding breastfeeding for mothers with possible H1N1 infection

http://aapnews.aappublications.org/cgi/content/full/aapnews.20091012-1v1

I wish more health professionals agreed with this statement from the article...

"Although the most effective way to prevent influenza transmission is complete
separation from her infant when a mother is receiving antiviral treatment,
separation may create more long-term problems in breastfeeding success and
mother-infant bonding than any potential benefit achieved from avoiding
infection in the newborn infant."

While recently in the hospital, during my entire stay it was suggested that I not nurse for 14 days. Hu? 14 days would mean possibly having my daughter wean. Would she be better off if her immature immune system tried fighting any type of virus on her own? Weighing the pros and cons in this situation can certainly be helpful! Information can be powerful!

Read more...

Parents of "chunky" infant weigh in on health insurance reform

http://www.denverpost.com/ci_13530098

Oh, my! Crazy, Crazy!! My babies have been over 95% in height and weight. I can only imagine what our weight conscience society might do.... I'm afraid someone just might "put their baby on the Slim Fast diet" (or just withhold food) when they start solids.

Ay, Caramba!!

GRAND JUNCTION — Alex Lange is a chubby, dimpled, healthy and happy 4-month-old.

But in the cold, calculating numbered charts of insurance companies, he is fat. That's why he is being turned down for health insurance. And that's why he is a weighty symbol of a problem in the health care reform debate.

Insurance companies can turn down people with pre-existing conditions who aren't covered in a group health care plan.

Alex's pre-existing condition — "obesity" — makes him a financial risk. Health insurance reform measures are trying to do away with such denials that come from a process called "underwriting."

"If health care reform occurs, underwriting will go away. We do it because everybody else in the industry does it," said Dr. Doug Speedie, medical director at Rocky Mountain Health Plans, the company that turned down Alex.

By the numbers, Alex is in the 99th percentile for height and weight for babies his age. Insurers don't take babies above the 95th percentile, no matter how healthy they are otherwise.

"I could understand if we could control what he's eating. But he's 4 months old. He's breast-feeding. We can't put him on the Atkins diet or on a treadmill," joked his frustrated father, Bernie Lange, a part-time news anchor at KKCO-TV in Grand Junction. "There is just something absurd about denying an infant."

Bernie and Kelli Lange tried to get insurance for their growing family with Rocky Mountain Health Plans when their current insurer raised their rates 40 percent after Alex was born. They filled out the paperwork and awaited approval, figuring their family is young and healthy. But the broker who was helping them find new insurance called Thursday with news that shocked them.

" 'Your baby is too fat,' she told me," Bernie said.

Up until then, the Langes had been happy with Alex's healthy appetite and prodigious weight gain. His pediatrician had never mentioned any weight concerns about the baby they call their "happy little chunky monkey."

His 2-year-old brother, Vincent, had been a colicky baby who had trouble putting on pounds.

At birth, Alex weighed a normal 8 1/4 pounds. On a diet of strictly breast milk, his weight has more than doubled. He weighs about 17 pounds and is about 25 inches long.

"I'm not going to withhold food to get him down below that number of 95," Kelli Lange said. "I'm not going to have him screaming because he's hungry."

Speedie said not many people seeking individual health insurance are turned down because of weight. But it does happen. Some babies less hefty than Alex have had to get health endorsements from their pediatricians. Adults who have a body-mass index of 30 and above are turned down because they are considered obese.

The Langes, both slender, don't know where Alex's propensity for pounds came from. Their other child is thin. No one in their families has a weight problem.

The Langes are counting on the fact that Alex will start shedding pounds when he starts crawling. He is already a kinetic bundle of arm- and leg-waving energy in a baby suit sized for a 9-month-old.

They joked that when he is ready for solid food, they will start him on Slim-Fast.

Meanwhile, they made Alex's plight public on KKCO this week. They plan to appeal Rocky Mountain's denial.

If that doesn't work, they plan to take their case to the Colorado Division of Insurance.

"My gripe is not with Rocky Mountain," Bernie said. "It's with the general state of the health care system."

Nancy Lofholm: 970-256-1957 or nlofholm@denverpost.com

NADA COMO MAMÁ, NADA COMO MAMAR

Click here to watch this wonderfully inspiring YouTube video made in Spain.

Literally, this translates to "Nothing like mommy, nothing like breastfeeding." What a beautiful video about breastfeeding! One doesn't necessarily need to understand Spanish to understand the message being sent. I love the nursing toddlers and insightful thoughts from fathers, too. Worth watching! Can't wait to share this with my Spanish speaking breastfeeding group.


Just in case, here's the translation:

"If I told you a new formula has been released that increases your baby's
defenses, would you give it to your baby?

If I told you we can have free nourishment for the first six months of your
baby's life, would you believe me?

If I told you a company has patented packaging that keeps food ready 24hrs a
day, keeping all its properties, would you buy it?

That formula exists. That food exists. That company exists.

Breastmilk is the best nourishment for your baby. It adapts to suit all your
baby's needs, increasing his/her immune system. And besides, it is free.

Nothing like mom. Nothing like breastfeeding."