Breastfeeding – a medical mystery????

Breastfeeding Bond

How can Doctors know how to help a Mother with breastfeeding issues when they only briefly touch on the topic during their training?  Perhaps we should be asking how this is possible when so much disease can be prevented by a Mother breastfeeding her child?  The benefits to the Mother include decreasing the risk of breast, ovarian and uterine cancer as well as diabetes and obesity.  A breastfed baby has decreased risk of Upper Respiratory infections, Middle ear infections and obesity and diabetes later in life.  There are also the benefits of antibodies passed from Mother to baby so they don’t catch everything that’s going around.  A premature baby needs breastmilk so much – often determining survival – that donor breastmilk is in demand to help supplement his own Mother’s milk.

I recently attended an education session for Medical Students, given by a fellow Lactation Consultant.  I was amazed that the content had to be squeezed into 2 hours (reduced from 4 hours previously), so you can imagine the content was very limited and the Educator told us she had selected things she knew would make impact. Some of these were:

  • Breastmilk is NOT the same as formula!
  • A Mother makes the unique milk HER baby needs.
  • There is a list of “Acceptable Medical Reasons for use of Breastmilk Substitutes” – become familiar with them.
  • Refer to a Lactation Consultant or a Child Health Centre if the Mother needs help.
  • You DON’T need plastic surgery to fix your breasts after breastfeeding.
  • You don’t need to poke holes in the nipple for the milk to get out.
  • When prescribing medications for a breastfeeding Mother – DON’T routinely tell the Mother to stop breastfeeding. Seek help with decision making, there are many texts available, specific to Medication and Mother’s Milk.

Some of these topics were introduced to answer questions from previous students????? I hate to think how this lack of information impacts the vulnerable and desperate Mothers who seek out their GP or Paediatrician for help.  It is obvious that nobody can know enough about breastfeeding in 2 hours to actually offer the support these Mums and babies need so please, please, please SUPPORT them and refer to the experts who can help them continue their very important breastfeeding journey.

In the words of a wonderful lady:

“I am Audrey Hepburn.  I am a mother.  Mother’s milk is the best gift that any mother can give to her child.  It’s for his whole life.”

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Mother Mindfulness

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A new Mother is on the phone.  She says, “My baby is a week old and I don’t think she’s feeding right!”  My heart beats a little faster immediately but I calmly ask her what’s been happening. She may say, “He takes so long to get on and then falls asleep!” or she might say, “She latches on but falls off and I have to keep re-latching” and “my nipples are so sore, last night they were cracked and this morning they’re bleeding!”

There are many other things the Mother of a one week old can say over the phone and it’s only once I’m  with her and her baby, that I can “see” what issues there may be. Sometimes when I hear the Mum telling her story so quickly, I feel that she has been containing all of the words for far too long; that no one has been listening.  Time is money when you work in Private Practice but I never have the heart nor the desire to cut the Mum off.  Waiting until she has said what she wants to before asking if she would like to make an appointment is the first, best thing I can do for her at that moment.  I then let her know when I can see her, which is usually pretty quickly. One day is an eternity in the life of a Mother with a poorly feeding baby and bleeding nipples!!

An email address is great to have as well, so I can send the Mum a confirmation letter and some information relating to what we have briefly spoken about. This isn’t going to solve the issues but I think the contact is reassuring and I invite the Mum to tell me her story in greater detail if she wants to. As previously stated, I will probably help her a lot when I see her and her baby but until then, I feel very strongly that the connection cannot be broken.  A phone call or an email can really let the Mum know she is not on her own with this any longer.  By emailing me her story, she has told someone that there is something not right and for a Mum that is huge.

I love to have a chat with new Mums. One thing I don’t ask is, “Is he a good baby?”  I like to find out how they are experiencing Motherhood.  I like to hear all of the positives as well as the negatives.  I love to share Mother-stories (no names of course) so they know they are not on their own.  It’s ok to feel overwhelmed and to ask for help.  It’s also ok to have none of the issues your friends talk about.  As human women, some Mothers, some not, we need to make sure we are mindful of the art of listening.  New Mothers need to talk, ask questions and express their joys and fears.  They should never feel alone but sadly many are.

Next time you see a young Mother in a plane struggling with her baby, her nappy bag, her carry-on and her handbag – offer to help.  If her baby screams during the entire flight try to think of the possibility that his little ears feel like they’re about to burst – don’t huff and puff and tsk tsk tsk.  Babies crying in a crowded shopping centre is common place but do you really want that poor Mum to walk from one end to the other trying to find a Mother’s room or will you be tolerant when you see her feeding her little one discreetly in a coffee shop or on a bench?  Be Mindful please!!!

 

 

 

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Lactation Consultants do what?

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Ever wondered what a Lactation Consultant (LC) does?

This is my official title and my qualification is International Board Certified Lactation Consultant or IBCLC.  Every year the International Board of Lactation Consultant Examiners (IBLCE) hold an exam all around the world.  First of all, a candidate must have applied to sit this exam, showing proof of recent and up-to-date study as well as many hours of experience helping Mothers and babies.  It is really tough to qualify but then you have to sit the exam which runs for 2-3 hours in the morning then another 2-3 hours in the afternoon.  Phew, it sounds huge, complicated and difficult.- and it is all of those things.  I studied really hard, even though I had years and years of experience working with Mums and babies.  I had heard it wasn’t easy to pass the first time but I did and I’m really proud of myself.

As an IBCLC or LC for short, I help Mothers with breastfeeding their new babies.  Sometimes these little ones are full term and sometimes they are very premature.  There may be one baby or there might be two or three.  The Mother might be experiencing pain or feel that she has inadequate supply.  Baby might have sucking issues, tongue tie or be a bit overwhelmed by breathing and feeding at the same time.  There are thousands of Mothers and babies and each dyad is unique, so not surprisingly, there can be an equal number of issues to do with breastfeeding and early Motherhood.

Apart from being qualified to help Mothers with breastfeeding I am also certified as an Infant and young child feeding therapist.  I have studied with Kay Toomey from the USA who runs a huge food therapy clinic to help with all types feeding issues from birth to 18 years.

Many of the Mums I have worked with refer to me as the “baby whisperer” but I think I have just been taught really well by all of the babies I’ve cared for.  My son passed away when he was 6 days old but that’s a story all of it’s own. I also have two grown daughters and I absolutely love being their Mother.  I loved Motherhood from the first second and feel very blessed to have this relationship with my girls.  My Mum died after my son – so she never got to meet my daughters. Another story to come later.

So, I suppose having always loved babies, it was inevitable that I would work with them.  I considered being a school teacher or a child care worker and have even spent some time as a nanny.  I was drawn to nursing though and worked mostly with babies during my hospital career.  A few things happened which will be yet another story and here I am as an LC and loving it.

I really want to write lots of helpful articles about how to care for a new baby and a new Mum.  I might even add some videos so it’s easy to see what I’m talking about.  One thing’s for sure – I’ll never be bored and hopefully you won’t be either.  Watch this space, there are great things to come.

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Mother’s intuition

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For over 30 years I have seen hundreds and hundreds of Mothers and their babies – both as a Paediatric Nurse and as a Lactation Consultant. Most Mothers are like sponges, sucking information into their brains, trying to make sense of early Motherhood. Over the years I have noticed an enormous shift from face to face learning and interaction, to using technology to investigate, research and “talk” to other Mums. Groups like “Nursing Mothers”, now the ABA (Australian Breastfeeding Association) have offered support, as have “Play groups” and “Mother’s groups” but the “web” now gives Mums the opportunity to sit at home and “chat” to other Mums whenever they have the time.  The problem some Mums have with sharing in any of these face to face or online forums is that they feel judged or compared to other Mums and that their babies are also compared.  At a time when they feel very vulnerable and in need of reassurance, some Mums lose their belief in themselves.  They forget that nobody knows their unique little baby the way they do.

It’s fascinating that a Mum could believe that someone else can tell them what’s going on with their baby when they’ve never met them.  Babies are not the same, they are all different.  I recall working in a Maternity Hospital Nursery one night with 17 babies coming in and out over 10 hours. There were little worriers, wizened old men, squealers, screamers, grizzlies, contented, alert, spaced out and chilled faces while some slept, twitched or sucked .  I was fascinated and would have loved the chance to follow each and every one of them to see whether their personality stayed that way.

I should clarify myself here, I’m not saying Mums shouldn’t ask for help.  There are lots of issues that can crop up in the early days and early intervention can make all the difference – especially with breastfeeding or serious medical issues.  What I’m trying to say is that Mums can learn about their babies and know what they need by watching and observing their cues.  (Cues are signs that let you know whether your baby is hungry, tired, uncomfortable or just needing a cuddle.)

In the beginning it seems like crying is the only way a baby can communicate.  This is true but as a Mum watches her baby really closely, she will start to notice that there are subtle differences in the cries and there are other little signs that often appear before the crying. Soon, the Mum is saying –  “She’s tired”, “He’s hungry” and if she believes in herself, she will act on these cues and meet her baby’s needs without delay.  Every time she does this, her confidence builds, routines are formed and motherhood gets a little easier.

Of course there are always exceptions because all babies are different, as are all Mothers.  The thing is – if a Mother watches her baby she will also recognise when her baby is not ok and will learn when she needs to ask for help.

When a Mum comes to me and says there’s something not right – there usually is.

 

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Calming Mothers to calm babies

One thing that struck me throughout my nursing career was that looking after a sick baby meant looking after very very anxious parents.  Understandably, when a tiny baby is unwell and then ends up in hospital, the parents are thrown into a whirlpool of emotion. At first they really don’t know what’s happening because often if the baby is quite unwell, the medical staff are completely focused on sorting him/her first.  They fire questions at the parents and whilst they are acutely aware of the pain on their faces, they have to get the information they need to help the baby.  There are administration staff popping in to get paperwork filled in, nurses bustling around sorting bloods, fluids, medications and filling in observation charts: all while the Doctors are poking and prodding their precious little baby.  I’m surprised such fear doesn’t escalate til the heart just stops.  I have been on both sides of the emergency room and it is terrifying.

When there was a new baby admitted to our ward I tried really hard to reassure the parents as soon as they arrived.  One look at them told their story of a very long day or night in the children’s emergency.  They looked deflated, like an airbed the morning after a restless night camping.  I could tell they hadn’t slept a wink for days and probably hadn’t eaten, too scared to take their eyes from their sick baby.  I imagined they were so relieved to finally be in the ward and before their eyes the poking and prodding starts all over again.  Ward Doctors needed to admit the baby and blood ladies arrive again and nurses attach oxygen and fluids and and and………………the baby is crying and the parents dissolve – defeated, their hearts might not be able to take much more.

Amazingly, at this point in time, if a very kind, gentle person offers them reassurance and explains everything that is going on, they can be persuaded to follow that kind, gentle person out of their baby’s sight and enjoy a short but desperately needed cuppa and something to eat.  It may only last 10 minutes but it is enough to witness something incredible.  The second the distressed parents leave the room – the baby calms and goes to sleep – also incredibly exhausted.  You see the baby feels the parents distress just as the parents feel their baby’s distress and the tension is palpable.  When the baby can no-longer feel that in close proximity, he/she can calm and settle.  One of the nurses always stayed until the parents returned. It was really helpful to explain the importance of trying to be calm and relaxed around their sick baby.  The proof was there in front of their eyes.  Their baby had settled and when he/she opened her eyes and saw Mum and Dad looking a bit calmer and feeling a bit calmer – they too relaxed and became CALM.

This is an extreme example but even on a day to day basis  babies feel what their Mums and /Dads are feeling and reflect this back.  If you can find any way to relax yourself – perhaps using music or walking or even having a nap when your baby naps – you will find your baby relaxing too.

 

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Mothering Babies

I sometimes try to imagine what it feels like to be a newborn, exhausted from the effort of birth, awakening to a strange world.  He would leave the warmth of his Mother’s body and enter a lottery of possible new beginnings.  He could slip peacefully into a warm watery sensation before being lifted to take his first breath or he could pass into the waiting hands of a midwife and then find himself next to a familiar sound, his Mother’s heartbeat as he is gently placed on her chest skin to skin.  I like to think of this as the “norm’ but we all know many, many babies don’t have this beautiful, nurturing experience.  Some are lifted to life through their Mother’s open bellies while others are pulled urgently from the dangers of distress.  Some breathe quietly, some scream and others have to be encouraged to take their first breath with some or lots of help.  Tragically, for some it goes terribly wrong.

Mothers-to-be often have no idea of what lies ahead as they grow this new life within them.  For some it will be what they dreamed it would be, with an on-time labour and an “easy” birth.  Expectations are high, there’s lots of information confirming the path a pregnancy and birth should take.  We’ve all been to baby showers where horror stories abound and Mothers share all with the Mother-to-be. I’m sure it’s not meant to be harmful or hurtful but nobody can know what’s in store for that Mother-to-be before her time comes.

I do know this: all Mothers deserve knowledge and all babies need Mothers who feel capable and supported.  I have read many parenting/baby books recently and there is a common theme amongst them.  Babies need someone to respond to their needs and care for them gently in order to grow into adults with the same ability to nurture.  Mothers need to be able to talk and share their feelings with other Mothers without fear of insult or injury.  It is so important for Mums to know there is help when they need it, or maybe just a kind ear listening to them over a cuppa, so they don’t feel alone.

There will be lots of information posted here over time.  If you need a personal consultation don’t hesitate to contact me Joanna Molloy.

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