Thanks to all of you who sent me the link to the New York Times article "The Breast Whisperer." It's obviously been a popular article, remaining in their list of top ten emailed articles for several days!
The article profiles Freda Rosenfeld, the "go to" lactation consultant in Brooklyn. One of you told me that everyone, from pediatricians to La Leche League leaders to parents in the park recommends her, and others of you told me that she was a true life saver in times of need.
Here's a taste of the article:
Ms. Rosenfeld is part medical professional, part therapist and part
sleuth; a hand-holder, tongue-coaxer, savior of sore nipples. At 52,
she wears her chestnut hair in an ageless ponytail and bangs, dressing
in long denim skirts — the better to get spit up on — and cruises the
borough with a “got breastmilk?” bumper sticker on her minivan.
A certified lactation
consultant, she swoops in at one of the most vulnerable moments in many
women’s lives, charging $200 ($160 if you come to her) for help with
what is supposed to be the most natural and instinctive of acts but
often is simply not.
...She has coached novices so anxious they tried to schedule a session
before giving birth (“Just enjoy being pregnant,” she counseled) and
Hasidic women suddenly unable to nurse baby No. 7, 8 or 9. She has
succeeded with babies with Down syndrome, despite their poor muscle tone, and with adoptive mothers, using a gizmo called a supplemental nurser to bring in their breast milk
(“Isn’t that cool?” she marveled). She has rooted out problems like
reflux and thyroid disorder, and stroked thousands of tiny tongues in
service of “the perfect suck.” She prescribes teas and herbs to
increase milk supply, along with exercise
regimens for newborn mouths, and sometimes recommends that a doctor
clip a baby’s frenulum, the tissue beneath the tongue. In 2007, she
worked with 80 sets of twins.
I thought that this was a pretty flattering look at the profession of lactation consultants. I loved Freda's maxim: Rule 1: Enjoy the baby; Rule 2: Feed the baby. The only thing that made me raise an eyebrow was the recommendation to nurse for 12 minutes on one side and 18 minutes on the second.* It was certainly a more positive look at this field than an article the Times published a few years ago about conflicts parents have with lactation consultants and doulas.
It also brought up several disparate thoughts for me about lactation consultants.
1. You don't have to be a little nutty, but... Once a few years ago I was shadowing a lactation consultant at a big hospital in California. At one point she started talking about some topic of controversy among lactation consultants. She paused, and said, "This profession attracts strong personalities." Uh, huh. The article says that if Freda Rosenberg were to write a book it would be called "You Suck," and she occasionally utters nonsense words like "Bu-ja-boo!" to lighten the mood. We're not all prone to silliness, but some degree of craziness just comes with the territory when one minute you're fighting to change a hospital policy and the next you're getting squirted with milk.
2. Love breastfeeding, love the people. Freda clearly loves what she does. She loves moms, she loves babies, she loves breastfeeding. But just like librarians who get into their profession because they love books and find themselves having to work with people all the time, I think that some of us get into breastfeeding support because we love breastfeeding, and then find ourselves unprepared, or poorly suited, to actually relate to the people we try to help. I'll admit that I was drawn to this line of work because of the awe I felt the more I understood about how breastfeeding works. Did I think through how it would feel to be working with moms and babies all day? Not really. Luckily, it worked out well, but it doesn't always. And if I've learned one thing it's that the way you relate to someone can make more difference than all the knowledge in the world.
3. No one should have to pay a dime - let alone $200 - for the basics. If I had one wish for breastfeeding, it would be that a mother could learn the basics - getting a comfortable and effective latch, for example - from any nurse at her hospital, not just the lactation consultant. Or that she could learn the evidence-based answers to the most common breastfeeding questions - feeding frequency and duration, for example - from her pediatrician. Or, better yet, that she could get the support and help she needed from her friends, who had breastfed, too. Lactation consultants can be a huge help when it comes to complicated issues, but for the system to really work, mothers should be able to rely on any provider for good support when it comes to the basics.
* One size fits all numbers like this just don't work. For mothers with
a fast let down and babies who can keep up, sometimes 5 or 6 minutes is the max. For
mothers whose babies are slow eaters or who let down milk slowly, it might require 45 minutes. And it can change from feeding to
feeding. Want to know how long your baby should be nursing for? Watch your baby, not the clock. If she's actively swallowing milk, keep her on, whatever the clock says. If she's sucking but swallowing infrequently, she's either ready for the next side or nursing for comfort, and you read your baby's cues to help you decide what to do next. You and your baby know a lot more than the clock does.
