Is pumping being used as a new "magic fix" for breastfeeding concerns?

If I asked myself if pumping was being used as a magic fix for common, yet easily managed, breastfeeding concerns I would have to say yes, it is. The idea to pump instead of, or in conjunction with, breastfeeding is often suggested to mothers by their support people. These support people include other new mothers and experienced mothers at places like Mommy and Baby Yoga, Mommy and Me time, Kinder Music, Baby Signs, the museum, StarBucks, any place mom's and babies hang out together; you all know where mommy's go. Other support people are their mothers and mother-in-laws, sisters, sisters-in-laws, aunts, grandma's, that old family friend; again, you know who these people are. Of course, other new mother's support people include Health Care Providers like doctors, nurses, midwives and the complementary support people like doula's and childbirth educators. And, in case you are not aware, these people include many that did not breastfeed themselves or were not successful in their attempts to breastfeed.

Most moms new moms have the intention of breastfeeding, as so as expected, it comes up in conversation. People feel the need to ask new moms how breastfeeding is going, new moms feel compelled to seek out support in these early weeks or health care providers are following up mom and baby. When moms are asked about breastfeeding they share the concerns they have with breastfeeding in hopes that someone can help them. Here is the list of common complaints and one likely answer they will receive to alleviate that concern.

Sore Nipples -> Pump and bottle feed
Baby not effectively sucking -> Pump and bottle feed
Thrush -> Pump and bottle feed
Engorged -> Pump between feeds
Plugged Duct -> Pump between feeds or pump and bottle feed
Needing to feed in public -> Pump and bottle feed
Over Active Let Down -> Pump before feeding
Low supply -> Pump between feeds or after feeds
Baby not sleeping -> Pump and bottle feed or have someone else feed
Colic -> Pump and have someone else feed
Foremilk/Hindmilk concerns -> Pump before feeding

It appears that pumping can be a common suggestion to alleviate the most probable breastfeeding issues. We need to be aware it is not a magic fix, it is most likely to be a band-aid, and it does not "fix" anything. We also need to be aware that pumping can create more issues.

These are just a few ways this pumping band-aid could create more issues for mom and baby.

With sore nipples, generally the most common concern, generally easy to fix, pumping only results in double the work. Why would a new mother want to add in all the extra work of pumping and bottle feeding when getting some assistance with position and latch could make the problem go away, in even the very next feed? Often long term pumping is not going to sustain a babies needs and milk supply like breastfeeding directly from the breast would. Often breastfeeding relationships end far sooner than mother's intended due to supply issues because it leads to supplementation or another feeding method all together. This might not be the case all the time, as some mothers, do exclusively pump, but there is unique difference between a mother who makes the decision to exclusively pump compared to one who is trying to get baby nursing pain free at the breast and needing to pump in addition to. 

How about that baby that just is not sucking effectively or will not latch? Let's see, how do people learn? We learn by doing. If we take baby away from the breast, how does he learn? Again, we need to support moms and babies in positioning and latch and innate instincts that babies have to feed and let them learn together. If habitual placement is still not getting baby latching and sucking, we need to further evaluate what might be going on with that baby. Ignoring the difficulty baby is having and turning solely to the pump does not make the original issue baby was having go away.

Thrush is no reason to stop feeding at the breast. The reality with pumping with thrush is that mothers now have more parts and equipment to treat or throw away. Thrush can sometimes take time to clear up but it spreads so easily, we need to restrict what comes into contact with the thrush to stop the spread of it, not add more to it. There are medication and alternatives that we can use to treat thrush and the discomfort of thrush as we are trying to eliminate the nasty little bug it is.

Milk supply works on supply and demand so as well as pumping to relieve engorgement seems like a good idea right now, later on the fullness comes back and generally more full then the previous time, as a mother's body thinks that is milk that baby needed. If moms are engorged because a baby is not eating, then the answer is to get the baby eating, not pumping. The more baby is at the breast the less engorged mother's will be, assuming baby is eating well. Again, back up to latch and sucking. If baby is not waking to feed and mom is starting to fill up, mom can put baby to breast and encourage that baby to eat, to play his role in this breastfeeding relationship. Another concern with engorgement is that as much as it may seem logical that when mothers are engorged, it means they have a good, healthy milk supply, in fact the opposite can occur. The more often a women is engorged, the faster her milk supply will start to decreased. When breasts are full it sends a signal to the part of moms brain responsible for milk supply to slow production down and milk making cells start to shut down, resulting in less milk in the days ahead. Pumping when engorged can also pull more fluid, and not just milk, into the breast, resulting in edema. Often that fullness is confused for milk and "good supply".

Plugged ducts are uncomfortable, in fact down right painful, and yes moms want them out, but pumping is not the most effective way to unplug a plugged duct. In fact it can lead mom right back to the engorgement stage and create the spiral onwards from there, when the easiest way to get rid of that plug is by using baby, again.

I am starting to see a larger amount of women pumping so they can feed their baby while out and about. First, people that want to go out in public just need to accept that mothers and babies go out in public, too, and mothers and babies use breasts to feed. Secondly, mothers need to be informed about how this "solution" really is only one that is feasible for a small time. Each feed mom misses at the breast impacts that supply and demand mechanism again. If mom is out and is not feeding baby or replacing a feeding session without pumping again her body and brain communicate this to each other and the process of milk supply slows down. This again goes back to what I mention early about keeping up supply, supplementing and ending the relationship early than expected.


Over Active Let Down is a problem that some moms struggle with but again pumping can just aggravate this problem. It is an easy problem to aggravate as it can lead to the engorgement issue and when baby is ready to feed, mom is ready to burst with milk and when the let down occurs it is like opening up a dam. Baby gets flooded with milk, has trouble managing flow, staying latched, becomes upset and this all causes frustration in mom and baby. Positioning, latch and frequent feeds are the easy fix here. On the other side of it, some babies have a hard time handling a normal let down, but it mimics and over-active let down. We need to be sure that we know if we have a baby that is struggling with a normal flow or a true over active let down.

For the healthy, full-term infant pumping for primary low supply should be the last resort. Babies truly are the best solution here again; baby to breast = more milk in breast. Secondary low milk supply is a different issue and does not fall into the category of common yet easily managed breastfeeding concerns., which is what I am addressing here.

Pumping to top up or to force more milk into that non-sleeping baby:. Fuller tummy does not equal more sleep in babies. Babies have very small tummies, breastmilk is readily absorbed and digested so babies feed frequently. The issue here is not the amount of milk the baby takes, but rather unrealistic expectations and misunderstandings babies. If babies are really struggling with sleep, it is worthwhile seeking out a feeding assessment to ensure all the things above are not an issue.

Colicky babies are much better soothed at the breast than any other way, pumping to feed another way removes that comfort source from this already high needs baby and can make the baby even more upset. There is no real understanding behind colic and why some babies are colicky and some are not but there is good understanding that skin-to-skin and mothering at the breast calms these babies best. Again, all things above should be ruled out before we just assume we have a colicky baby.

Foremilk/hindmilk imbalance or what is being perceived as such seems to be rampant these days. It seems like a viral condition that has spread. So many moms seem to feel they have this issue, when in fact it is very rare. However, if a mother thinks this is an issue she has and pumps to get to the hindmilk, we go back to the engorgement cycle where mom has too much milk, can have a forceful let-down and then babies do get more foremilk than hindmilk, they are upset by the flow of milk and we end up in a vicious cycle. Worst case scenario, in fact, this could create that colicky baby we all fear. Foremilk/ hindmilk is best controlled by frequent feeds and proper positioning.

I am pleased to see fewer mom's grabbing for a formula can when breastfeeding challenges arise but I am not thrilled to see more mom's grabbing for the pumps.

Mom's please seek out appropriate, knowledgeable, support when you encounter these easily managed breastfeeding concerns.

Foremilk! Hindmilk! Baby MUST feed for 20 minutes a side.

“You need to nurse for 20 minutes on the first side and then move baby to the other side for twenty minutes.” Did anyone ever tell you this? What if your baby only nursed for ten minutes? Did you ask what would happen? I suspect you may have been told that is not long enough for your baby to get the hindmilk (higher fat milk). Is 20 minutes that magic “long enough” time frame? What if baby wanted to be there for 25 minutes? What happens then? Do you have no more milk?  

Have you ever expressed breastmilk? What does it look like? Have you expressed more than one time? Did your milk look the same each time? I suspect it varied from thin, watery and blue, to yellow and thick. Did you notice a difference with the time of the day you pumped? How about before a feed or after a feed?

What does the research say?  In point form the basics are:

·   As the baby feeds the content of the milk the baby receives is higher in fat

·   Each feeding can vary in fat content

·  The fattiest part of one feed might actually contain the same fat content of the start of another feed

·  Milk is milk; no real need to differentiate foremilk and hindmilk. Some is more concentrated, some less so, but your baby needs it all.

·   Babies all stay at the breast for different lengths of time and what satisfies them varies

·   The breast is not a reservoir. It is never “out” of milk. If babe hangs out nursing more milk will “let down”. It will flow faster if you switched breast, perhaps, but there is no rule to have to take a baby off one side to put him on the other

 

Is there a time when we might pay more attention to foremilk and hindmilk?

·  Is there an issue with baby sleeping at the breast?

·  Is there an issue with baby being fussy at the breast?

·  Is there an issue with babes weight?

·  Is baby swallowing at breast?

·  Is baby relaxed, with wide open hands and content at the end of feeds or no?

If there are any of these types of concerns, seek out an IBCLC to address the concerns. It may be somewhat related to the so called foremilk/hindmilk. It can sometimes be ONE factor to take into account for the whole picture when some of the above issues are seen. But it would not solely be a foremilk/hindmilk issue.

 

Breastfeeding, Formula Samples & the Food Bank

Very few days of my previous career stick with me like the one I am about to share. At the time, I didn’t realize to what extent that day would change my opinion and outlook on many things.

 

A couple brought their very ill young infant to the emergency room. I was called down to do blood work which was standard procedure. After having a difficult time drawing the blood I returned to the lab to run the tests & analyze the results, hoping to shed some light on why this infant was so ill.

Some of the initial tests gave results that led to further testing. One of these further tests was a “blood smear”, where we smear blood onto a slide and look at it under a microscope. As I was looking at the smear, I started to think that something was wrong with my equipment or my reagents; something was greatly wrong. My blood smear looked like something I had never seen before. I made a new slide and the same thing happened. I changed all the reagents that could be contributing to the bizarre results. each test gave the same outcome. I needed to accept that this was how this child's smear was. This told me why he was so ill. The baby’s treatment continued. Testing continued. My shift ended.

I returned the next evening still thinking about this infant and wondering if we had any more answers. I wasn’t prepared for what I heard and couldn’t believe it when I heard it; the infant has passed away, and the cause of death was malnutrition. He had been fed Coffee Mate and water in place of infant formula. I asked myself, as you may be asking yourself, how does this happen?

 

It turns out it happened, because the family became dependent on the food bank for food, including infant formula. When there was a shortage of infant formula, the parents decided to substitute with Coffee Mate and water. Some will say that it was because they were illiterate and didn’t know the difference. Some would say it was because it resembled infant formula. Some will say it’s because a milk-like product equals milk-like product.

 

This experience stays with me, and I reflect on and react to the action of infant formula being distributed at the food bank. Food security is a basic need, and, for an infant, it’s one of the few things they need and they need often.

 

How does formula get to the food bank? Often the samples that are sent to new parents end up there. Women who choose to -and successfully- breastfeed then have these cans and bottles of formula sitting in their homes in dark cupboards, on top of the fridge, and other out of the way places. They know they will never use it, but the idea of letting it go to waste or ending up in the garbage isn’t something they want. They think about all the moms who have less than they do, less support to breastfed and use the food bank - and think that if they take it there, they can help a mom. Moms who need the food bank go there, they say that formula is available, and they take it. That helps the family budget. Formula is expensive and is likely a large part of the financial stress of the family. What’s wrong with that? The samples don’t come consistently and frequently enough to sustain the food bank supply.  There will be times when the food bank doesn’t have a supply of formula but the mothers are assuming it will be available so the income gets budgeted to other items. Now, the food bank has no formula, and the family has no money. They still need to feed the baby.

 

In my ideal dream world, the supports these families would receive would be breastfeeding support  as well as prenatal and postnatal education. Breastmilk is virtually free. With even suboptimal nutrition, mothers still produce a perfect, free food for their infants. Infants can be sustained for a significant amount of time on just breastmilk.. The recommendation from WHO and CPA is 6 months exclusively and then continued to two years or beyond, with the introduction of solids at around 6 months. In the event of a food crisis, a mother could sustain her infant for the better part of its first year through breastfeeding alone.

The support aspect would be important for that to happen. These mothers also need the education. Many of them believe that without an optimal diet, their breastmilk isn’t good for their baby and that formula is better. All mothers want the best for their babies. They need to be taught that they’re what’s best for their babies. They also need to be taught what normal infant behaviour is. If they don’t understand normal infant behaviour , they  may feel like they’re starving their baby. Without access to infant formula, they would likely plug along and make it work. With formula being free and on the shelf at the food bank, however, they may grab it and feed that to the baby. Many of us know, when we start supplementing, we can quickly lose that breastfeeding relationship. The food bank may continue to have formula or they may not and we end up in situation like the above. How do we feed the baby in this situation?

The staff at the food bank could use some education on breastfeeding and formula feeding. Many of them may still hold the belief that mothers with a low-quality diet shouldn't breastfeed, that it isn’t good for them or their baby. When formula is available, they may encourage that to a mother who’s breastfeeding because of this belief.

 

Don't get me wrong here; the issue isn’t the people donating the formula to the food bank. They have good intentions and likely don’t realize the damage that can be done. The issue here is that this is exactly one of the things the formula companies want to happen. They want their products in the hands of the vulnerable new mother and father. This is why they send packages out, and they do it in the manner of “Breastfeeding is best; however when the time comes, introduce formula”. If the time comes to introduce it and continue with it, you will buy the kind that was free and came with coupons and other swag items like a backpack or change mat. It’s all marketing. How free do you think all that stuff was to produce and mail out? Not free at all; in fact, it’s in the high price of the formula. Let’s look at what formula is and why it costs so much. Those sending it out are a business and they need to make a profit.  After all the free packages they give away, they need to increase the cost of formula drastically to make a profit.  They’re so profitable, in fact, that not only are they giving parents free stuff, they buy the names and contact info of  parents from the likes of maternity stores and giving all kinds of free stuff to hospitals and doctors’ offices. When a family legitimately needs formula, it’s so drastically overpriced that it creates hardships for them.  

 

 

What do I suggest we do with the free samples? I suggest they be returned to the stores where they came from with a note explaining why it’s being returned. Imagine if just a small percentage of moms did this. Would the stores start to think twice about their partnerships if they had a large number of packages to deal with?

 

Another option is return to sender. I don't think this would have near the impact as the above option, but it would show them that you don’t want their products.

As far as the moms who need the additional supports and are at higher risk of needing to use formula, there’s a better way to help those mothers feed their babies safely and reliably.

This should go without saying, but the need to say it is always there. This isn’t about formula vs breast milk, nor about a mother’s choice to breastfeed or not. This is about an infant’s nutrition and food security, one of the basic hierarchical needs of the human race and a primary building block of children's futures. Breastfeeding can almost always guarantee an infant and child can be sustained.

Doula and Lactation Support Packages Expanded August 2013

I have recently update my services and broken them into packages to be more effective and also give a clearer picture of what I offer parents. I have added additional prenatal meetings to ensure that we have plenty of time to get to know each and also go over as much information as we can as well as have plenty of time for me to answer questions you might have. There are two categories of packages with options within them; Birth & Birth and Breastfeeding.

Birth Doula Packages

 

Also called a childbirth or labour assistant, a labour/birth doula is a trained woman who will stay with you throughout labour and birth. The word "doula" is a Greek word meaning "woman caregiver". Labor/birth doulas attend to the emotional and physical comfort needs of laboring women to smooth the labour process.
 Birth is unpredictable and because of that I have a wide range of experiences from precipitous births to post-term inductions to VBAC’s to c-sections to hypnobirthing, at home births and in hospital births. No matter how birth is done, it is your journey and your doula should be honored to be chosen to be there. I am honored and changed with each birth I experience.
Prenatal meetings topics and discussions include getting to know you, your health history and maintaining good health, what you want to learn, your hopes and dreams for this birth, your concerns, normal labour and birth process (how it looks, feels, and sounds like), coping skills, hospital & midwifery care protocols, the moments after birth, breastfeeding, parenting once at home with your baby. Prenatal meetings take anywhere from 1.5 to 2 hours depending upon your questions and needs.  My goal is to make you feel as confident as possible and as well informed as possible. As a labour/birth doula I give you information about what is happening, facilitate communication between you and medical staff and support your decisions

 The New Parent Package

(Also for Vaginal Birth After Caesarean VBAC)

·         three prenatal meetings (1.5-2 hours each)
·         attendance at your birth
·         one postpartum meeting
·         email and phone support as needed for your unique situation

$850

 

Experienced Parent Package

 

·         2 prenatal meetings
·         attendance at your birth
·         1 postpartum meeting
·         email and phone support as needed for your unique situation

$750

 

Repeat Parents Package

This package is for parents who have already given birth with Kim Smith and includes:

·         2 prenatal meetings
·         attendance at your birth
·         a postpartum follow up meeting within a week
·         phone and email support as needed

 

    $650

 

 Only Birth Support

A mother/couple will only be interested in hiring a doula for labour support, without the prenatal or postpartum contact.

   $500

 

 

Birth Support and Continuous Breastfeeding Support Packages:

 

The New Parent Package

(Also for Vaginal Birth After Caesarean VBAC)
 
·         three prenatal meetings (1.5-2 hours each)
·         attendance at your birth
·         Stay with you until you are settled in Mother-Baby Unit or comfortable in bed at home with breastfeeding being established
·         Check in within 12 hours to assess breastfeeding
·         In person within 24-36 hours to assess breastfeeding
·         Follow up during the first week to assess breastfeeding (both mom and baby)***
·         one postpartum meeting to reflect on the entire experience
·         Email and phone support as needed for your unique situation

 

$1200

 

Experienced Mother Package

·         2 prenatal meetings
·         Attendance at your birth
·         Stay with you until you are settled in Mother-Baby Unit or comfortable in bed at home with breastfeeding being established
·         Check in within 12 hours to assess breastfeeding
·         In person within 24-36 hours to assess breastfeeding
·         Follow up during the first week to assess breastfeeding (both mom and baby)***
·         1 postpartum meeting
·         Email and phone support as needed  for your unique situation

 

$1100

 

Repeat Mother Package

This package is for mothers who have already given birth with Kim Smith and includes:

·         2 prenatal meetings to reconnect and discuss what you want for this birth
·         attendance at your birth
·         Stay with you until you are settled in Mother-Baby Unit or comfortable in bed at home with breastfeeding being established
·         Check in within 12 hours to assess breastfeeding
·         In person within 24-36 hours to assess breastfeeding
·         Follow up during the first week to assess breastfeeding (both mom and baby)***
·         a postpartum follow up meeting within a week
·         phone and email support as needed

 

$950

 

***additional breastfeeding consults can be booked

 

Sleep Trainer Phenomenon

I am going to start with the disclaimer that I am not judging mothers in this post. Mother are free to, and in fact I encourage them to, gather information that is out there & do what they feel they need to do after being informed. I would hope they gather the information needed know what normal behavior is for babies. It may seem like I am judging and in a sense I am. More realistically, I am evaluating supports available to moms in our community. I do this because as a professional working with moms I need to stay informed. Parents ask me about resources and expect me to be in the know. Other professional bodies ask me also, as a way to learn and grow and stay informed.

When moms are looking for resources, supports and information I would hope for acknowledgement that babies have needs beyond sleep and the occasional feed. I want moms to be able to rule out feeding issues, whether that is a breastfeeding relationship that is not going well or formula feeding. I encourage moms to looks at the body structure of themselves and their babies; it is possible that during birth there was some moved out of alignment or maybe just baby playing or sitting in a car seat funny. These things might actually be causing baby pain, making them unable to sleep or feed well. I encourage moms to look at the stress she is under; perhaps to have a perfect house, a perfect kid, a perfect meal. Maybe she is struggling with postpartum depression or upset from the birth experience, etc. I want moms to understand that human babies are born very immature and rely heavily on us for the better part of the first year to meet their every need (be that food, sleep, touch) and then slowly less and less during the next few years. Parenting is very hard and there are kinds of things that need to be looked at when things are challenging. What I know for certain is that putting your baby "away", as if it is jacket you hang up, at the same time every evening will not solve any of these things. 

When a sleep trainer presents to a group of moms you can bet there will be lots of sleepy eyed mama's there. I would guess a wide range of babies to be in tow. In my limited experience observing sleep training presentation and discussing with a few friends and clients what I have observed is the vast majority of them have babies under 4 months, a few under 6 and not many between 6 months and a year and a handful of toddlers.  What stands out more to me is how many babies were left, awake, in their bucket car seats, how many babies were crying and showing feeding cues, and how many babies looked hungry and had identifiable feeding issues. As a Lactation Consultant you get to know the look of the baby that is having feeding struggles. I do not want to stereotype but there are some unique characteristics that are observed. This alerts me to something else that could be happening with babies and something that impacts their ability to sleep. Where is the connection between the moms and babies? Why are we leaving babies to sit in car seats while we engage others? Why are we missing/ignoring feeding cues of our babies and feeding only once baby cries? And why are babies getting to the point of a Lactation Consultant being able to just visually look at a baby and know that baby needs supports before even asking questions yet? Why are moms so much more willing to ask a sleep trainer for help than seek out a Lactation Consultant?  

During presentations I see moms bounce awake babies in car seats, rather than take them out and hold them. I see soothers in mouths rather than nursing. I see babies eyes wide open looking to make a connection, hopefully to moms. Is this now what society says is the way to parent? Repeatedly moms are offered moms places to take babies to feed if they needed space because maybe mom is just not comfortable in public and all said "My baby should not be hungry" or “he is fine” even though they were screaming over the presenter. Is my opinion of “fine” different?  

When I talk about the look that some of the babies have that can alert me to feeding concerns what I mean is they have a lower tone, they don’t have “fat pads” in places I would expect, like the cheeks and thighs. Some have darker eyes or swollen looking eyes. Upon further assessment it is usually found that these babies have adrenals and livers that are working really hard. This can create an inability to sleep. These babies want to sleep and get rest but because of the stress on their bodies they cannot get into a “parasympathetic” state, which is the state we go into to sleep, but also where we heal and repair and recharge. It is also known as the “rest and digest” state. Instead these babies stay in the sympathetic state. This is the state where we are awake and stimulated. This is why these babies may appear to cry and just go-go-go. It is a “flight” response. It is also known as a “hyper-arousal”. Hopefully this helps set the stage of the babies I see that have moms asking for sleep help. And it sort of makes sense, right? These are not plump little babies with milk (be that breast or formula) running down their faces. I need to say this again; I am not judging the moms. They know NO different. I am judging society and how we support or rather don't support maternal/infant health. This is about how we are teaching people to parents. This is about what we now think is normal. I beg to differ and say that it not normal but rather what is more common. But what is common shapes our normal. What is normal seems to have shifted.

Babies (and adults, please apply this same logic to your own life and sleep patterns) will sleep when they feel full, content and safe, for the most part. This is why I encourage moms to first rule out feeding issues. 98% of mother report wanting to breastfeed and go onto initiate that. Babies will also sleep better when they feel secure, so on mom chest, snuggled into mom, able to smell a t-shirt mom was wearing if mom wants to sneak away during a nap. Sleep trainers will suggest that no more than 30% of babies are born good sleepers. So in theory 70% of babies have parents that need support with sleeping. But we have less than 20% of babies being breastfeed by about 6 months. It makes me ask the question that maybe what they needed earlier was breastfeeding support. Moms and babies would be better rested vs sleep deprived and desperate for an answer and someone waving a sleep flag their way. Getting little sleep is challenging for sure, but are we ignoring the consequences of not breastfeeding?

This current phenomenon presents the question “Does our society value sleep or breastfeeding more?” Right now in our society there is an alternative to breastfeeding. There is no alternative to sleep. Could this be where the start of the phenomenon we see today?

In Defence of the Hospital Staff

I am often asked by moms and dads why it is that nobody at the hospital told them what I was able to tell them. It is large part is because of timing. The time spent at the hospital is short. The time is not enough to really see how breastfeeding is going. The time is not enough to see if patterns will develop. There are lots of moms and babies at the hospital so the time you get one-on-one is short and cramped. It is mostly just quick checks. And sometimes things actually look really good in hospital.

You get home and things start to go sour. This is not uncommon. This is why there are lactation professionals in the community, because this is where you will breastfeed the most. Yes, you breastfeed in hospital but you do not live & carry out normal life there, that is where you spend 24-48 hours, sometimes up to 5 or 7 days. Most mothers intend to breastfeed for a year, many longer than that. So, yes you need support in hospital, but it makes sense that you would have support and knowledge about breastfeeding in the community, the place you live and carry out your life. That is where you need to learn about breastfeeding and where you need to learn to make breastfeeding sustainable.

You learn the most about breastfeeding by learning what is normal infant behaviors and what is normal for breastfeeding. Once you know normal really well you can recognize abnormal pretty quick and know when to get help. So do some research and know who your community resources are. Let’s make a list together:

Disease care model for your lifelong health?

Canadian parents need some awareness about the health and future health of their children.

It is said about 98% of mothers “initiate” breastfeeding after birth, in home and in hospital. At six months about 14% are still breastfeeding.

We are all familiar with the arguments of “But, some moms just don’t make enough”, “I will try to breastfeed but if I am one of those mothers that cannot produce than I guess I cannot breastfeed”. Correct, some moms do not produce milk, but certainly not 84% of women. When worded that way, hopefully more people say, “yes, that can’t be possible”.

Lots of women do have low supply. Low supply does not equal no supply. Low supply does not equal not having any ability to make milk. Low supply can be avoided, turned into full supply, or can be worked with supplementation. Low supply does not need to end all breastfeeding.

What is going on then? That is not an easy answer and cases are all unique and need to be assessed however, there can be underlying answers that are similar or related.  Some examples (the list could be much bigger)

·         Birth experience (trauma, separation, medications)

·         supports (hospital staff, family, friends),

·         Education (parents, grandparents, doctors, nurses, midwives)

·         back to school or work

We seem to be setting the aim for optimal starts for our babies and children but we are not often striving to reach them. If we become derailed why are we not getting back on track? Luckily, we can get back on track when we find ourselves off track. You need to know this.

We need to get serious about giving our babies the best start. Old arguments do not hold much weight anymore. “I was formula feed and I am ok (fine, survived)”. What is ok? What is fine? What is survived?

We have overcrowded health care systems. And we have normalized this situtaion. Surprising to some, breastfeeding or rather lack thereof, can be linked back to the majority of the health conditions that patients have. We need to normalize breastfeeding to reduce the strain on our health and wellbeing. We cannot rely on the system of disease care to be the system that is going to help support our babies getting off on the right foot – being exclusively breastfeed for the first 6 months and continuing to 2 years or beyond as suggested to be optimal buy the authorities of children health. (AAP, CPA, UNICEF/WHO)

It is time to take charge of our own bodies and our children’s future. It is up to us to give our kids the best start that only we can give them.

We need to move past the idea that we have free health care. We simply do not have free health care. We have access to (some) free disease care. Healthcare would be disease and illness prevention. This certainly is not free. We need to start being accountable for our own healthcare. This lack of accountability is why we have maxed out healthcare facilities and resources. If we had more accountability we would make better choices.

  

With that awareness we need to start at the very beginning of an infant’s life and choose breastfeeding as a key to lifelong health.

There are lots of old arguments. It is time to let go of those. This is not about past choices, which were based on “what we knew then”. We know more/better now and when we know better we do better.