The Motherwear Breastfeeding Blog

The things they say.

Last year we did a great Carnival on the things that babies and toddlers say about breastfeeding.  Recently some of you have emailed me some hilarious things your kids have said about breastfeeding, and it made me think that I should do a post on it again.

So please email me and tell me what your kids have said about breastfeeding.  You can tell me what they call nursing, and the things they say (or sign) about it.  Can't wait to read them!

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Free breastfeeding stuff.

Here are a few free breastfeeding items for you to check out:

For those of you who work in breastfeeding promotion and support, check out these free "Fathers Supporting Breastfeeding" posters and videos from WIC.

A free breastfeeding kids book, called "What Babies Eat," is available to download.  Click on "Kid's Book Download."  It's available in English, Spanish, and German.

"The Business Case for Breastfeeding" toolkit.  This brand new toolkit, which comes in an impressive box with information for employees and employers, includes information on breastfeeding support, breastfeeding and working, and materials to help mothers approach their supervisors.  You can order up to 10 copies for free, with no charge for shipping.

Free downloadable copy of Motherwear's Essential Breastfeeding Guide.

A pattern for knitting a breast. 

A recipe for lactation cookies - the ones I wrote about recently.  They're great!

For those of you who live in Pennsylvania, copies of these great breastfeeding posters.  I especially like the "Mother's Milk for Daddy's Baby" ones.  One is shown above.

Medela and Ameda breastfeeding information sheets on topics like latch and positioning, working and breastfeeding, engorgement, milk collection and storage.  Available in several languages.  Ameda's site also has this great new video on latch.

Free breastfeeding screensavers and a downloadable poster from Breastfeeding.com

Free sample issue of the Journal of Human Lactation, the journal of the International Lactation Consultants Association.

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The 16th Carnival of Breastfeeding: A breastfeeding-friendly birth plan.

Welcome to the 16th Carnival of Breastfeeding!  This month's theme is pregnancy and breastfeeding.  Be sure to check out the great posts from other bloggers at the bottom of this post.

When I was pregnant I worked pretty hard on developing a birth plan, and it was worth every minute.  Everyone involved with the labor and birth were knowledgeable and respectful of our choices.

I recently re-read our birth plan and found that it didn't contain much in the way of breastfeeding.  I did make it clear that I was aiming for a natural delivery with as few interventions as possible.  It did say that I wanted no pacifiers or bottles if the baby had to be separated from me.  But there was nothing about how I wanted things to go immediately after the birth, or how I'd like to be supported in establishing breastfeeding.

So when we decided on the theme of pregnancy and breastfeeding for this carnival, I decided to try to list some elements of a birth plan which focus on breastfeeding.

To create the list below, I've taken elements of breastfeeding-friendly care from three well-referenced sources:  the International Lactation Consultants Association's Clinical Guidelines for the Establishment of Exclusive Breastfeeding, the Academy of Breastfeeding Medicine's Model Breastfeeding Policy, and UNICEF's 10 Steps to Successful Breastfeeding.  Research has shown that these things matter in the success of breastfeeding.  You'll likely find all of these things at a hospital that has been certified as Baby Friendly.  I added a few things based on my experience, and I hope that you'll leave additional ideas in the comments section.

Since this list doesn't address birth itself, I should say aiming for a low intervention birth is also breastfeeding-friendly.  For most women, this means choosing care providers and exploring birthing options carefully, as well as having a doula or other skilled support person present.  You'll find that this list assumes a hospital birth, but many of these elements are relevant to home birth as well.

• I would like the baby to be placed skin-to-skin with me immediately after the birth.
• If I have a c-section I would like to hold the baby skin-to-skin as soon as possible after the operation.  If I am unable to for some time, I would like my partner to hold my baby skin-to-skin.
• I want to initiate breastfeeding within the first hour.  I would like to give the baby an opportunity to self-attach, and I do not want the baby forced into the first feeding.
• I would like all newborn procedures delayed until after the first feeding, and done with the baby lying on me or being held by me.
• I want my baby to stay in my room with me, and I want to hold my baby skin-to-skin as much as possible during our stay.
• I would like help in establishing a comfortable and effective latch, and learn different positions for nursing my baby.  I would also like assistance in learning hand expression, how to recognize swallowing, and what to expect in the days following discharge.
• If I encounter any breastfeeding problems, I would like help from an International Board Certified Lactation Consultant (hereafter 'lactation consultant').
• I do not want any water, glucose water, formula, bottles, or pacifiers given to my baby.  If there is a medical need for supplementation, I would like the opportunity to discuss it with a pediatrician and lactation consultant first.
• If I am separated from my baby for medical reasons, I want to use a breastpump to help establish my milk supply.
• I do not want any formula promotional material to be given or shown to me, including formula diaper bags and crib cards.
• I would like to receive information on sources of breastfeeding support in my community.

We have some great posts from other bloggers on the topic of breastfeeding and pregnancy.  Check them out!  (List will be updated throughout the day).

• Natural Moms Talk Radio - Carrie shares practical information on breastfeeding while pregnant.
• Permission to Mother - Dr. Denise writes about a milk supply mystery.
• Crunchy Domestic Goddess - Amy writes about the ups and downs of nursing during pregnancy.
• Breastfeeding Mums - Sinead shares advice on preparing for breastfeeding.
• Attachment Parenting International Speaks - Julie writes about breastfeeding during her pregnancy.
• Breastfeeding 1-2-3 - Angela contributes 10 tips for pregnant women preparing for breastfeeding.
• Milk Donor Mama - Jessica writes about her breastfeeding experience and shares advice for pregnant women. 
  

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A breastfeeding heroine.

Well, when eight different people email you about a story in the news, it's probably a sign that you should post about it!  Thank you to everyone who sent emails about this amazing story.

Earlier in the week I posted about breastfeeding in emergencies, prompted by the disasters in Burma and China.  Later, a story emerged about a mother (and policewoman) who has been nursing nine different babies in the wake of the earthquake in China.  Five were orphaned, and some had mothers who were unable to produce enough milk for them.

Here's the video on CNN.  The Chinese press have named her "China's Mother #1."

According to the Emergency Nutrition Network, wet nursing is an option to be explored in cases of disaster:

Mothers who have stopped breastfeeding should be encouraged and provided with assistance to start breastfeeding again (i.e. to relactate). In cases where there are babies whose mothers have died or cannot be located, the option of wet nursing, where another woman breastfeeds the baby, should be explored. In such situations babies may be breastfed by a woman who is already breastfeeding, or a friend or relative may relactate.

Of course, HIV can be passed through breastmilk, so the preferred option is screened and pasteurized donor milk.  Unfortunately, supplies of donor milk are often not available in emergencies.  So the question in these cases becomes: what is the risk to the baby from wet nursing, versus the risk of life-threatening diarrhea/dehydration caused by unclean water, or even starvation?

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More Baby Blues breastfeeding cartoons.

Thanks to reader Jennifer, I have more Baby Blues breastfeeding cartoons to share!  She's been collecting them and was kind enough to send them to me. 

For others Baby Blues breastfeeding cartoons, see this post.

• Gross
• Hints
• Open up
• Tire tracks
• Waiter
• A year

And here's another great one from the comic Rubes, send by reader Beth:  Nursing in public

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Book review: The Nursing Mother's Guide to Weaning, and a copy to give away.

*To learn how to win a copy of this book, see the directions at the bottom of this post.

A friend of mine who grew up on a farm once told me how she knew that their cats' kittens were being weaned.  One day, she said, the kittens would try to nurse, and the mother cat would just start batting them away.  That was it. 

For us humans, weaning is often quite a bit more complicated.  How do you know when the time is right?  Should you do it gradually?  What if you can't?  What if your baby or toddler shows signs of distress?  What do you use to fill the nutritional and/or emotional space that weaning occupied?  How will you feel after you've weaned?  If you don't want to wean but feel you must, what are some ways of keeping the nursing relationship going?

The Nursing Mother's Guide to Weaning (Kathleen Huggins and Linda Ziedrich, Harvard Common Press, 2007, 2nd ed.) is a book for mothers who want to spend some time thinking and exploring the process of weaning.

The introduction to the book provides a history of weaning practices in the Western world.  This walk through weaning history may be more than most mothers might need, but those with a broader interest in breastfeeding will find it fascinating. 

The main section of the book is divided into chapters tailored to the age of the baby at weaning, from infants to age three and beyond.  This is helpful in that the issues are quite different depending upon the age of the child at weaning.  Each of these sections concludes with several color-tabbed pages of the nitty gritty practical information a mother needs.

A good portion of the book is devoted to trouble-shooting problems that might lead a mother to wean before she wants to.  For mothers exploring the idea or on the fence about weaning, these sections may prove quite helpful.  If a mother has already made the decision to wean, this emphasis may be a bit troubling.  There is an interesting section at the end of the book - a post-weaning epilogue of sorts - that discusses life after weaning.  The authors write that there is little written about the physical and emotional changes mothers experience after breastfeeding is concluded, but I still found their discussion very interesting.

This is the second edition of this book, and in addition to some attractive graphic changes, the book has been made easier to read by highlighted boxes which summarize main points, and color coded pages of practical information.

Not everyone needs to read an entire book about weaning, but for mothers who want to explore the idea in depth and get detailed practical advice, The Nursing Mother's Guide to Weaning is a good investment.

I have a copy of this book to give away.  To enter to win it, please leave a comment below by the end of the day on May 25th.  I'll pick a winner randomly and notify you by email if you've won.  Please remember to use a "real" email address so I can contact you.  U.S. addresses only, please.

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Check our our new iTunes store!

When I tell people that I run this blog they always assume that I'm technologically savvy.  I'm really not.  I know no HTML and almost nothing about Photoshop.  The fact that I can do this is just a testament to how easy blogging software has become.

So, it took me quite a while to do it, but I finally set up an iTunes store for the Motherwear Podcasts, and I've been patting myself on the back ever since.

If you use iTunes (which you can download for free), check out the new Motherwear iTunes store.  You can download all of the podcasts to your iPod or other mp3 player for free, and you can also subscribe to the podcast feed so you'll never miss an episode!  The little icon to the left on the sidebar will also take you there.

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My heritage, as represented in file folders.

We're just through a rash of celebrations including two birthdays, an anniversary, and two Passover Seders.  Last week brought Childrens' Day, a Japanese holiday which is sometimes celebrated in the Japanese American community.

For Passover I was asked to lead an activity which involve hiding the afikoman - a piece of matzoh which the kids hide during the Seder and is later returned in exchange for a small prize.  Since the kids who were attending aren't old enough to sew with cloth and needle, I punched holes in blue file folders and they sewed them together with yarn.  I found some clip art for them to glue on one side, too.

For Childrens' Day I wanted to do an activity with my son's preschool class.  With some help from my mom I settled on making koi wind socks (koi nobori), which are traditionally put outside houses for this holiday.  Here are directions if you'd like to make your own.

So I cut carp bodies out of yellow file folders and had the kids glue on scales and eyes and stuff them with newspaper.  They also added streamers to blow in the wind. 

You never know what to expect from file folders.

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Breastfeeding in emergencies.

It's been a week of disasters in Burma and China, and I've been thinking a lot about the victims of these horrific events. 

I traveled in Burma in the early 1990's with a good friend.  The country was beautiful (especially Pagan, shown to the right) and the political repression was palpable.  One memory:  My friend became quite ill, and we found a doctor who came to our hotel and treated her.  When we asked how much we could pay her, she refused to accept anything.  We were so grateful for her help, and asked for her address so that we could send her a gift when we got home.  She wouldn't give us her address, telling us that she didn't want to be seen as connected in any way to people outside the country. 

But back to the disasters, and the importance of breastfeeding in emergencies.  In a disaster such as the one in Burma, breastfeeding can be a life-saving act.  Why?  In emergencies formula is often not available.  If it is available, water supplies are often compromised.  Formula mixed with contaminated water can cause diarrhea and dehydration, which can quickly become life-threatening to infants.  Power to sterilize and refrigerate formula is also often not available.

Sometimes, well meaning humanitarian efforts result in such an influx of formula that efforts to protect and support breastfeeding are disrupted.  This is such a concern that in 1994 the World Health Organization adopted the following policy, urging member states to "exercise extreme caution when planning, implementing, or supporting emergency relief operations, by protecting, promoting, and supporting breastfeeding for infants," and to ensure that formula is distributed only under specific conditions.

Still, there is a lot of confusion about the role of breastfeeding in these situations.  INFACT Canada has a great write up taking on myths about breastfeeding in emergencies, which I've posted below:

MYTH 1:  Malnourished mothers cannot breastfeed.

In virtually all cases, a sub-optimally nourished mother can breastfeed her child.  The important response is to feed the mother so that she can feed her child.  It is far safe and more effective to provide nutritional support for the mother than to risk her infant's health by feeding breastmilk subsitutes.  Mothers in these situations need help and support to enable them to breastfeed.

MYTH 2:  Stress makes a mother's milk dry up.

Although extreme stress or fear may temporarily reduce a mother's milk supply, this response is often of short duration.  On the other hand, breastfeeding produces hormones that have a calming effect on mother and baby and creates an inseparable bond between the mother and her child.  There is virtually no abandonment of babies in emergency situations when mother and baby are breastfeeding and kept together.

MYTH 3:  Babies with diarrheal disease need water or tea.

Breastmilk contains about 90% water.  Exclusive breastfeeding provides all the water, nutrition and immunology a baby needs, without the risk of contamination.  Feeding an infant water can introduce disease-causing bacteria and other contaminants, especially if safe water is scarce or unavailable.  It is only in the case of severe diarrhea that infants may need rehydration fluids in addition to breastmilk.

MYTH 4:  Mothers cannot resume lactation once breastfeeding has stopped.

Mothers and babies can restart breastfeeding even after a period of not breastfeeding.  Increased skin-to-skin contact and frequent access to the breast helps to increase milk supply and enables mothers to resume full breastfeeding.  This can be critical for babies during emergencies.

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Making More Milk: Diana West talks about milk supply and answers your questions.

Welcome to another Motherwear Podcast!  This episode features Diana West, IBCLC.  Diana is best known for her work supporting mothers who have had breast surgeries through her website Breastfeeding after Reduction Surgery and her book, Defining your own Success.

Diana is co-author of a new book, The Breastfeeding Mother's Guide to Making More Milk, which will be out in December of this year and is available now for pre-order.  This is the first book to focus solely and in great detail on milk supply, and it looks like a wonderful resource.

This interview is divided into two parts.

Part One discusses what determines milk supply, what causes low milk supply, what mothers can do to increase milk supply, and what feelings are common among mothers with low milk supply.  You can listen to it on the player below, or download it.

In Part Two Diana answers your excellent questions about milk supply (shown in the comments section of this post), on topics including the impact of birth on milk supply, suggestions for maintaining milk supply when pumping at work, how stress and periods impact milk supply.  You can listen to it on the player below, download it.

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