The Motherwear Breastfeeding Blog

Imagine pumping at work with one of these things.

Last Friday my breastfeeding coalition sponsored a training run by Medela for local WIC agencies and other people involved in breastfeeding support.  We had about 20 WIC and other breastfeeding support people there, plus three babies!

The training was on using pumps to sustain breastfeeding.  Our coalition just donated three hospital grade pumps to our local WIC offices, so this training opportunity was well timed.

For me, the best part of the morning was checking out the many different pumps the trainer brought. 

There were hospital grade pumps (the kind you'd use in the hospital or to increase milk supply), frequent use pumps for working mothers, and manual and basic electric pumps for occasional pumping.

But the most interesting for me were the older manual pumps.  I'd heard of the 'bicycle horn' pumps (to the right) but never seen one.  Note that the 'reservoir' where the milk collects holds about 1/4 of an ounce, so it would have to be emptied pretty frequently.  And there's nothing to prevent milk from going back into the bulb part of the pump, which would be almost impossible to wash.

Don't they look like those bulb syringes for babies' noses?  Can you imagine trying to pump at work with one of these things?  Most mothers would probably have done much better with hand expression.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

Sometimes it takes a village to feed a child.

Here's a truly unusual story, at least here and now.

The Mining Journal reports that Susan Goodrich died eleven hours after giving birth to her son Charles.  Her husband Robbie considered feeding Charles with banked donor milk, but was told that it would be days before it could arrive.

In the meantime, Goodrich received a phone call from family friend Laura Janowski of Marquette, who was still nursing her fourth child, 1-year-old Emily. In her message, Janowski offered Goodrich to nurse Moses.

"That's when it clicked in my head," he said. "I wanted the baby to be nursed. That's something that Susan would have wanted."

One thing led to another when family friend Nicoletta Fraire of Marquette began organizing a group of women who may want to help feed Moses.

"Basically, a couple of phone calls were enough," she said. "I just had to leave my name and phone number and calls started to come in."

She also made contact with Sally Keskey, founder of the Yooper Nursers - a local breast feeding support group. Within a brief time, nearly 20 women were found who offered to breast-feed Moses. Many of them belong to the support group and had never met the Goodrich family before...

A schedule was put together with feeding times at 9 a.m., noon, 1:30 , 4 , 6:30 and 8 p.m. Six times a day a different mother has been feeding Moses for the past two months. During the night, Goodrich bottle-feeds his son breast milk that was pumped by the women.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

Book give away: Permission to Mother

Dr. Denise Punger has generously offered a copy of her book, Permission to Mother, and you can enter to win by leaving a comment below!

You can read my review of the book here.  This book is a personal memoir of Denise's education as a physician and parent, and addresses breastfeeding, birth, and parenting choices. 

To enter, leave a comment by April 3rd, 2009, below.  U.S. addresses only, please.  Winner will be chosen using random.org and announced in the comments section. 

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

Guest post: Amy on weaning with some biblical advice

I'm very happy to share a guest post today from my friend Amy, Jewish educator and author extraordinaire.  Amy writes a Jewish parenting blog called Home-shuling (shul means synagogue).

“The child grew and was weaned, and on the day Isaac was weaned Abraham held a great feast.” Genesis 21:8-21

It might be hard to imagine throwing a party to celebrate weaning. Many of my peers breastfed their children into toddlerhood, and even then had palpable ambivalence about ending the nursing relationship. But when I came across this passage in the Torah, shortly after my daughter Ella stopped nursing, I was struck by the idea. If only I had celebrated reaching this milestone rather than apologizing for it!

My first daughter Ella and I had a very rough start with breastfeeding. She came into the world jaundiced, and consequently, very sleepy. With no lactation support, I didn’t know that I should pump during this time in order to build up a strong milk supply, and at a few weeks old she was diagnosed with failure to thrive. I was deeply committed to exclusively breastfeeding, and met with the lactation consultant at the local hospital (who had been on vacation during our extended hospital stay) as well as every La Leche leader in Southern Oregon. I tried every recommendation, but because of our late start, nothing made a difference. Ultimately, and with a broken heart, I gave into her doctor’s insistence that we supplement with formula. Even then, I continued to seek solutions, and after another month of pumping every three hours, day and night, with a hospital grade pump, I was able to increase my supply to the point where my daughter began refusing the formula.

I share this to say that I fought hard for the privilege of breastfeeding my daughter. But, on her first birthday, when she refused the breast, I breathed a sigh of relief. While I probably wasn’t ready to initiate the weaning process, I was really, truly ready to stop breastfeeding. Despite all the progress I had made, I never stopped being anxious about breastfeeding. I never stopped worrying about how much milk she was getting, and I never really gained confidence as a nursing mom. So when she refused the breast, with the stubbornness that she now displays as a kindergartener, I comfortably glided into “don’t offer, don’t refuse” mode. She never reached for the breast again.

I poured my attention and energy into other forms of care-giving. I felt liberated, confident, and ready to try to get pregnant again. But I also felt self-conscious, just as I did in those early weeks of her life, when I would take out a bottle of supplemental formula. I worried other mothers thought I wasn’t quite committed enough to giving my daughter “the best.” I delivered long explanations about self-weaning to anyone who would listen, and they felt an awful lot like excuses.

Instead, we could have thrown a party, as Abraham did for Issac. Dear friends, let’s celebrate this child who has grown and thrived despite impossible odds (according to the Torah, Sarah was 90 when she conceived.)  While at first I questioned why Abraham held the party instead of Sarah, I realized that party must have been meant to honor her as well. Loved ones gathered to celebrate a mother who found joy late in life, and would probably not live to bear another child. Yet, she was allowing her son to move on with grace to the next of many stages of increasing independence.

Zoe was born 10 months later. Determined to do a better job, I pulled out my Medela pump at the first sign of jaundice and had her weighed several times a week until we were convinced that all was well. I was jubilant and for the first time, felt great about breastfeeding. But at her six-month checkup, when she was still nursing exclusively and on demand (and refusing any kind of bottle with a now familiar stubbornness), we discovered she had actually lost weight over the last two months. All my anxieties returned, and once again, I became a slave to the baby scale.

I didn’t have a party when Zoe weaned, either. But I learned something from Sarah and Abraham. Weaning didn’t need to be a time of mourning, but instead of time of celebration. I gave myself permission to initiate the “don’t offer, don’t refuse” process as Zoe approached one year. When she quickly weaned, I didn’t make excuses and I didn’t feel remorse. I was proud of the obstacles I had overcome to raise two beautiful, healthy daughters and was pleased to take a tiny step back to watch them grow.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

Podcast: Early sexual abuse and breastfeeding, with Penny Simkin.

I'm very pleased to post a podcast interview with childbirth pioneer Penny Simkin, on the topic of breastfeeding and early sexual abuse.

Penny is the author of When Survivors Give Birth, on early sexual abuse and birth, and has recently been lecturing on breastfeeding and sexual abuse.

This is a topic that no one talks about, but sexual abuse is frighteningly common, and undoubtedly affects many women's breastfeeding experiences.

A note about comments:  If you'd like to comment but want to do so more anonymously, feel free to email me, and I'll be happy to post the comment for you.

You can listen to the podcast through the player below, download it and listen with another player, or download it through our free iTunes store.

Early sexual abuse and breastfeeding podcast

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

Where to donate your used nursing clothes.

A while ago I got an email from a reader asking where she could donate her used nursing clothes. 

Of course, there is a good trade in used nursing clothes on eBay (Motherwear also has their factory outlet store there, too) and probably on Craig's List.  I often see nursing clothes at our local consignment and thrift shops, too.

But if you'd rather give them away and try to get them into the hands of another nursing mom, here are some thoughts.  You could give them to:

• Friends and relatives (obviously)
• Your local WIC program, which serves lots of nursing moms
• A local La Leche League leader, who could give them away
• A lactation consultant 
• A doula
• A midwife or OB practice

I once had a mom drop off a huge bag of really nice quality used nursing tops at the breastfeeding support group I run.  It was a wonderful surprise!  Do you have any more ideas?

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

California legislation would require insurance to pay for breastpumps, lactation consults.

Two new bills in the California legislature would require insurance companies to pay for breastfeeding help. 

AB 513 requires the rental of breastpumps and for consultation with board-certified lactation consultants.  AB 514 (not amended to reflect this yet) requires employers to provide two paid 20 minute breaks for mothers to pump at work. 

California law currently requires employers to provide a reasonable amount of unpaid break time and a sanitary place to pump.  It looks like the intent of provision giving mothers access to rental pumps is to help them pump at work, since there's no mention of medical necessity.  As far as I know, these would be the first laws of their kind in the U.S.  For more information on breastfeeding and the law, check out this podcast.  The video below makes the argument for these changes to the law.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

Do you have questions for the founder of the Celebrity Baby Blog?

I'm planning a podcast interview with Danielle Friedland, founder of the Celebrity Baby Blog.  Danielle has posted a lot of breastfeeding information and advocacy on her blog.  

Do you have a question you'd like to ask her?  I'd like to focus on breastfeeding and celebrities, so please submit your questions on that topic. 

To ask a question, just leave a comment below by Thursday, March 19th.  I'll see how many I can ask during the interview.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

"The Case Against Breastfeeding"

This month's edition of The Atlantic Monthly features an article by Hanna Rosin entitled "The Case Against Breastfeeding."  Thanks to many of you for emailing me about it!

There are several pieces to the argument she presents, and they roughly follow the perspective of one school of feminist thought (you can read about different feminist perspectives on breastfeeding here):

1) The evidence of better health outcomes for breastfed babies is "thin."
2) Women in some communities feel a lot of pressure to breastfeed.
3) Breastfeeding "keeps women down," and is "a serious time commitment that pretty much guarantees that you will not work in any meaningful way."

I'm going to tackle the first one here, though I have some strong feelings about the others, especially the third. Breastfeeding mothers can't do meaningful work?  It's going to be hard to break that news to the many, many breastfeeding mothers I meet who are working as doctors, teachers, professors, and nurses.  And of course this argument assumes that being a parent is not "meaningful work."

But back to the "thin" evidence for breastfeeding.  I'd like to point out a few things about her argument:

1) The author says that there are so many methodological problems in the research as to undermine the credibility of health claims.  As evidence of this, she points to a meta analysis published in...1984.

I wonder why she didn't cite the 2007 U.S. Department of Health and Human Services (AHRQ) meta analysis, "Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries," which reviewed over 9,000 abstracts, 43 preliminary studies, 43 primary studies on maternal health outcomes, and 29 systematic reviews or meta-analyses that covered approximately 400 individual studies on breastfeeding. The analysis graded each study for methodological quality.  The report states,

"We found that a history of breastfeeding was associated with a reduction in the risk of acute otitis media, non-specific gastroenteritis, severe lower respiratory tract infections, atopic dermatitis, asthma (young children), obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis."

And while this topic wasn't raised in the article at all, the study found: "For maternal outcomes, a history of lactation was associated with a reduced risk of type 2 diabetes, breast, and ovarian cancer...Early cessation of breastfeeding or not breastfeeding was associated with an increased risk of maternal postpartum depression."

2) The article argues that breastfeeding provides limited protection against infection because "they never get into the blood." Right.  That's because the components in milk prevent the pathogens from getting into the baby's bloodstream to begin with.  The antibodies in breastmilk coat the lining of the baby's intestine and are pathogen-specific - blocking the bad bacteria and leaving the good bacteria alone, based on messages from the mother's immune system.  The bad bacteria can't get in to the baby's tissues, and leaves the baby's body in its poop.  This is a more efficient form of infection protection, says Dr. Lars Hanson, in The Immunobiology of Human Milk, because when a virus or bacteria does enter tissues, it requires an inflammatory response which involves symptoms of infection (fever, for example) and a higher energy requirement. 

3) But beyond this site-specific immune protection, there is the overall development of the baby's immune system.  Think of it this way: your baby's body is taking notes about what your milk fights in its system, and is remembering it for the next time it encounters that pathogen.  That's called active immunity.  It does this in part through memory T cells, through cytokines and chemokines, which do enter the baby's system through gut, and regulate activation of the immune system, and through other pathways. There are many more ways in which breastfeeding protects babies, but I don't have space for them here. 

I did find a couple of things to agree with in her article:  that there is irony in the fact that the movement to take back infant feeding from the medical establishment is now justified on the basis of medical research; and that women feel trapped between health recommendations and the reality of maternity leave policy in this country.

But all in all, I found this article to be a very selective reading of the research, with comments reflecting a highly specific experience of American motherhood, with a dollop of judgement on top.

If you're like me, this article raised some pretty strong feelings.  I'm going to encourage all of us to be respectful in our comments here.  However you view this article, try to address the arguments, not the person making them, please.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

Another great breastfeeding ad.

To see the add, (opens in player) click here.

And there are radio ads, too.

This ad is from the National Health Service in the UK.  I like how comfortable the mom on the right is nursing in the park, how skeptical the mom on the left is initially, and how the whole conversation seems like it could actually happen.

Mom to mom encouragement and support is so important, and this ad really showcases that.

I wish we were as good as Scotland, Australia, and the U.K. when it comes to breastfeeding ads.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.