Addressing breastfeeding myths | womenshealth.gov

Addressing breastfeeding myths | womenshealth.gov

Read this before visiting a new Mom & Baby

Going to Visit Family or Friends Who Have a New Baby? Follow These Tips!

Posted on September 30, 2013


Baby in Hat

Your friend or family member has a new baby. You want to visit. You want to help. You want to meet that amazing new little person! Before you go, read this primer on how to be a good visitor to a family with a newborn in the house — the kind of visitor who will make the family feel loved, supported, and forever grateful!

Included are guidelines that apply to all visitors, plus tips specifically for close friends and family, long-term visitors, and friends and family who live far away but would like to help nonetheless.

In the United States, we shower attention on families during pregnancy, but not during the postpartum period — when in fact the postpartum period is the time when families need the support of their communities the most! Be a gentle, considerate visitor who puts the family’s needs first. Your thoughtfulness will be remembered and appreciated for years to come!

WHEN AND HOW LONG TO VISIT
◾Always call/message in advance to schedule the visit. Do not drop in unannounced. Be on time.
◾Front-porch meal drop-offs or short (10-15-minute) visits are good in the first several weeks, when families are overtired and commonly not feeling up to hosting company.
◾Longer visits (30+ minutes) are good in the later weeks/months, when long-term helpers (grandparents, etc.) have left; other visitors have stopped coming; and spouses have gone back to work. Mothers often report feeling isolated after 1-2-3 months at home with a newborn (and any other children), and welcome longer visits in the later weeks/months.
◾Very close friends/family may be invited to come for longer or more frequent visits to help in the early weeks, but should always ask the mother what type of visit — short or long — would be most helpful to her.
◾If the mother will be home alone with the baby most of the time (single parent, spouse deployed or working long hours), she may wish for visitors to stay longer. Ask.

PREPARING FOR THE VISIT
◾If you are ill in any way — even the tail end of a cold — stay home. Visit when you are well.
◾Do not wear perfume, scented body lotions, or aftershave. These linger for hours or days after your visit and are often overpowering for baby and mother, who have heightened senses of smell.
◾Leave your pets at home.
◾Leave your children at home. This is especially important in the early weeks, when the family is likely to want quiet, rest, and minimal outside germs. One exception is bringing your children over for a playdate or outing with the family’s older children, outside or away from the family’s house, which you plan to supervise.
◾Bring food. See “Bringing Food” below.
◾Bring small gifts for any siblings in the house, if you can. Gifts that do not make noise are best. Special food treats are a nice, inexpensive option.

DURING THE VISIT
◾Remember that the purpose of the visit is for you to help the family, not for you to spend time with the baby. Now is the time for you – not the family — to prepare food and clean up any messes made during the visit.
◾Do not expect or ask to hold the baby. (Yes, this can be difficult — new babies are so snuggle-able!) Wait for the mother to offer. Many won’t. One big exception is offering to hold the baby after a feeding so the mother can take a shower or a nap.
◾Wash your hands when you arrive, and let the mother know that you have washed them before touching her baby.
◾Greet any siblings enthusiastically. Give a big hello and lots of love to the older children before fussing over the baby — it will make them feel special during a time when the baby is the focus of most adults’ attention.
◾Do a chore. Do it without asking. Or say, “It would make me so happy if I could [do chore XYZ]. Will you indulge me?” (Saying something like this helps ease discomfort the family might feel about having someone clean for them.) Load the dishwasher. Wash the dishes in the sink. Wipe down a counter. Sweep the kitchen floor. Fold that basket of laundry you see sitting there. Take out the trash. Excuse yourself to the restroom and scrub the toilet or wipe down the counters.
◾Or, watch the older siblings, or take them out of the house on an outing.
◾Or, offer to take dogs for a walk, if you’re a dog person. Adjusting to a new baby can be hard for pets, too. They need a little extra love at this time, as well!
◾Give advice only if the parents specifically ask for it. Do not criticize.
◾Follow the mother’s cues about how long a visit she’d like. Remember that it can be very difficult for her to ask you to leave once you are there, even if she truly needs privacy to nurse or pump or perform postpartum self-care.
◾If the family has a premature baby in the NICU, they still need support — lots of it! Tell them “Congratulations!” (they do want their new little one to be acknowledged and celebrated). Ask them how they and the baby are doing, and then really listen. Give them gift cards to restaurants near the NICU; gas cards; or a care package of healthy snacks and drinks that do not need refrigeration (dried nuts/fruit/veggies, trail mix, homemade muffins, snack/granola bars, seltzer water, etc.). If they are staying near the hospital, away from home, offer to pick up mail, water plants, care for siblings or pets, or bring needed things from home to the hospital.

BRINGING FOOD

◾Most families welcome food anytime, but it is often especially welcome at these times: after any other long-term helpers (visiting family, etc.) have left; after the first several weeks when other visitors have stopped bringing food; and when the spouse goes back to work or is away on a business trip.
◾Ask whether the family has set up an online meal-delivery calendar, such as Meal Train or Take Them a Meal. If they have not, organizing one is is a great job for a close friend or family member (see below).
◾Check the family’s Meal Train page (or check with the family) for information about food preferences, sensitivities, and allergies, as well as any other preferences (food delivery times, locations, dates). Respect that information.
◾Bonus points: bring a complete meal (main dish, salad/veggie side, and dessert) and/or meals containing ingredients that promote breastmilk production, such as oatmeal (oatmeal lactation cookies are one option), whole grains, dark leafy greens, beans, vegetables, and nuts/seeds.
◾Avoid bringing foods containing large quantities of those herbs which are known to reduce breastmilk production, such as peppermint and sage.
◾If you do not cook, consider bringing a healthy store-bought ready-to-eat meal (such as rotisserie chicken or a complete dinner from the supermarket) or a collection of healthy snacks that the mother can grab and eat one-handed during the day or while nursing, such as nuts or trail mix (unsalted), dried fruit/veggies, healthy snack bars, precut fruits/vegetables, cheese, hummus, and whole-grain crackers. Trader Joe’s and Costco are great places to buy these things inexpensively.
◾Bring the food in disposable containers or in inexpensive reusable Rubbermaid or thrift store dishes that need not be returned.
◾Consider attaching a note to the meal specifying that the dish does not need to be returned and that no thank-you note is necessary.

IF YOU ARE A CLOSE FRIEND OR CLOSE IN-TOWN FAMILY MEMBER

◾Run an errand. School drop-off, grocery store, Target. For example, call and say, “I am going to the grocery store. What can I get you? I will drop it by on my way home.” Note that it is “What can I get you?” not “Can I get you anything?”
◾Be the one to organize a group of friends/family to deliver meals in the first three weeks (or longer). Use an online organizing service like Meal Train or Take Them A Meal. Be sure to include information about food preferences, sensitivities, and allergies. If the meal-receiving family is not large, have meals delivered every other day so that the backlog of leftovers does not overwhelm the refrigerator before the family can get to them. Spread word of the Meal Train throughout the family’s social circle.
◾Help the family write a Chore/Helper List. This is a list of tasks that other visitors can help with, so that when visitors ask what they can do, the family has immediate answers. Place it in a prominent place, like the refrigerator.
◾Help the family research the baby/parenting information they need, if they would like. With a new baby in the house, it can be hard to find time and energy to research lactation consultants, breastfeeding or postpartum support group meeting information, etc. A list of local maternity and parenting resources can be found here.
◾Lend an ear. Ask the mother how she is feeling, then follow her signals. Do not pry. If she wants to talk about her experiences, she will.
◾Observe the mother for signs that she may be developing postpartum depression (PPD) or anxiety (at least 1 in 5 new moms in the United States do). Know the difference between normal new mom stress and a postpartum mood disorder. Be gentle and compassionate with the mother. Ask her what kind of support would help her feel better. If she wants peer or professional assistance, this page has a list of local and national postpartum support organizations. To better understand what a mother with PPD is experiencing, her friends/family may find it helpful to read Brooke Shields’ memoir, Down Came the Rain: My Journey Through Postpartum Depression.
◾Watch the father for signs of anxiety or depression as well. Postpartum anxiety and depression occur in fathers, too. Like mothers, fathers need sleep, good nutrition, exercise, and alone time to stay well. This page has a great list of resources both for fathers experiencing postpartum depression themselves, and for partners of women experiencing PPD. Additionally, Postpartum Men Online Forum is an online community that these men may find helpful.

IF YOU ARE A FAMILY MEMBER VISITING FOR AN EXTENDED PERIOD
◾Come for an extended visit only if the family has invited you to do so. Never invite yourself.
◾Ask if the family would prefer that you stay in a hotel during your visit. Be gracious if they say yes.
◾Offer nighttime help. Offer to stay up late with baby while they catch a few early-evening hours of sleep. Offer to burp/walk/bounce a fussy baby after a midnight nursing/feeding so that the parents can sleep. Nighttime is often a time when help is scarce but dearly needed.
◾Be their personal assistant. Do whatever they indicate they need. Drive them to appointments or support meetings. Run errands. Grocery shop. Pick up prescriptions. Babysit siblings. Cook. Clean. Do laundry. See “During the Visit” above.
◾Encourage them. Tell them that they are doing a wonderful job. Tell them that you are proud of them. Especially for a nursing mother struggling with breastfeeding, the words, “You are doing a great job,” are magical.
◾If you are a generation older, understand that parenting techniques likely have changed since you last cared for babies. Ask the parents about their parenting philosophies. Follow any specific baby-care instructions they provide. Reading (and following) the same baby-care books that the parents are can be helpful.

IF YOU LIVE FAR AWAY BUT WOULD LIKE TO HELP
◾Pay for the services of someone who can help in person: a postpartum doula, a house cleaner, a diaper service, a grocery delivery service. A list of such local resources is available here.
◾Be part of the family’s virtual support team. Let the mother know that you are a friendly, supportive ear that she can call or Skype at any time, day or night.

IF YOUR SPOUSE OR CHILDREN WANT TO HELP, TOO

As stated above, having a crowd of visitors in the house — or running in and out of the house — can be overwhelming for a family with a new baby. But having a work crew tackle the work literally piling up outdoors? Such a help. If you can bring your own tools (for example, rakes and leaf bags for raking leaves) so you have no need to ask where to find supplies, it’s all the more helpful.
◾Pet care. Walk the dogs. Poop-scoop the yard. Change the litter box or the hamster cage.
◾Yardwork. Mow the lawn. Rake the leaves. Shovel the snow off the driveway and sidewalk. Snow and leaf blowers can be grating on the nerves — avoid them.
◾Garden work. Weed. Pick veggies. Especially good for parents of babies born during harvest season!

FURTHER READING
◾Why Are America’s Postpartum Practices So Rough on New Mothers? (The Daily Beast)
◾A Letter to Grandparents by Penny Simkin
◾After the Birth, What a Family Needs (Gloria Lemay)
◾How To Be the Best Post Partum Visitor in 15 Minutes or Less (There Are No Ordinary Moments)
◾The Answer Is Always “YES!” (Or, How To Help a Struggling New Mom) (Dou-la-la)
◾For Parents: Visitors After the Baby? 10 Tips for New Parents (Huffington Post)
◾For Parents: Is DAD the Ideal Postpartum Doula? (The Birthing Site)
◾For Parents: DONA International’s Postpartum Plan (DONA)

This post has been several years in the making. Sincere gratitude to the many mothers who have contributed, both directly and indirectly, the ideas, suggestions, and wisdom reflected within it!

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Insurance companies may cover breast pumps, supplies and consults

Healthcare Insurers Graded on Support for Breastfeeding Moms: Anthem and Aetna Score Highly National Breastfeeding Center has released a scorecard of healthcare insurance companies based on coverage policies for breastfeeding support. Share on TwitterShare on FacebookShare on Google+Share on LinkedInEmail a friend . . Insurers are now tasked with making sure that healthcare dollars are spent more wisely and invested in long-term preventive care. To do less than their best for their littlest members is simply not good enough. New York, NY (PRWEB) September 06, 2013 Anthem and Aetna both score highly out of 100 healthcare insurance companies graded by the National Breastfeeding Center (NBfC). Research was conducted to see how the insurance industry is responding to the Patient Protection and Affordable Health Care Act (PPACA), specifically the part of the law concerning coverage of breastfeeding support, a provision which went into effect on August 1, 2012. “It has been a year since the mandate went into effect," says Susanne Madden, COO, of the National Breastfeeding Center, "so there has been plenty of time for insurers to adjust to the law. We wanted to see how insurance companies are performing when it comes to supporting nursing mothers and their babies." Madden says that the NBfC research uncovered a wide range of insurance company policies and compliance. "We were encouraged to find that some insurers really recognize the importance of improving breastfeeding and support the intent of the mandate by covering fully qualified lactation care providers and effective breastfeeding equipment. But many more provide only the bare minimum required by law, such as a manual hand-operated breastpump and advice given during a well care exam by providers that may have little lactation care experience." "We weren't surprised to see Aetna near the top of the score card," says Beverly Curtis, the Executive Director of NBfC. Aetna was quick to open its network to lactation care providers who have certification as International Board Certified Lactation Consultants (a designation awarded by an independently-accredited program). Curtis points out, "it is important that insurance companies support care delivered by independently certified professionals as these are the providers best qualified to address and improve lactation care." Madden said that the Anthem Group of companies came to the top of the list due to such provisions as covering home visits and allowing pumps to be dispensed from both providers and medical supply companies. "Companies should see our score card as a helpful tool for evaluating their breastfeeding support policies," Curtis says, "and like Aetna and Anthem, aspire to be the best in this critical area of mother and infant healthcare insurance coverage.” NBfC assessed commercial insurance companies’ published policies and guidelines and assigned a grade based on the adequacy of coverage provided. Using The Verden Group’s Policy Search tool to locate official Medical Policies and Google to search insurers’ member and public domains for guidelines and newsletters that contained information about each company’s breastfeeding coverage, “we believe we’ve conducted a comprehensive review of the information available,” says Madden. Why grade insurance companies on their breastfeeding support policies at all? "The purpose of the mandate is to improve breastfeeding initiation and duration rates," Curtis replies. "It follows that mothers should receive lactation counseling support from a provider educated in lactation care.” Madden agrees and says "It's the best way to insure that the care provided is appropriate to each mother’s concern or issue and that each has access to breast pumps that perform appropriately according to her medical or societal needs. Insurers are now tasked with making sure that happens, and that healthcare dollars are spent more wisely and invested in preventive care. To do less than their best for their littlest members is simply not good enough. We want to bring attention to that," Madden concludes, "and prompt insurers to do even better going forward." ****** National Breastfeeding Center (NBfC) The National Breastfeeding Center (NBfC) provides expertise to corporations/employers, hospitals/health systems, healthcare providers and organizations to improve breastfeeding promotion and support. Our unparalleled experience in the business of medicine, blended with our broad insurance experience and deep clinical knowledge, delivers powerful insights and innovative solutions. For more information on the NBfC, visit http://www.NBfCenter.com. Share on TwitterShare on FacebookShare on Google+Share on LinkedInEmail a friend PDF Version PDF Printer Friendly VersionPrint Contact Susanne Madden, COO National Breastfeeding Center +1 855-777-6232 1 Email .Beverly Curtis, Executive Director National Breastfeeding Center 855-777-6232 2 Email . Attachments Insurers Breastfeeding Policy Scorecard Insurers Breastfeeding Policy Scorecard Healthcare Insurers Scorecard for Breastfeeding Support Model Policy Model Policy Guidelines for Insurance Company Coverage of Breastfeeding Support and Counseling Services, Pumps and Supplies .

Health Insurance Lactation Assistance

Many Breast-Feeding Moms Unaware Of Health Law Help By Lisa Stiffler and Seattle Times | Kaiser Health News, Published: August 27 . New moms crave information, whether it’s car-seat safety ratings, the pros and cons of pacifiers or how best to sooth a colicky infant. So it’s a little surprising that many moms aren’t up to speed on how the Affordable Care Act could benefit them. The law has specific requirements targeting moms, including coverage for breast pumps and consultants to help breast-feeding mothers. “So many moms don’t know about the benefit,” said Cary Seely, director of provider relations at Pumping Essentials, a California-based company selling supplies and services to assist in breast-feeding. While many of the changes mandated by the Affordable Care Act will benefit low-income Americans by expanding access to health insurance, the Obama administration has tried to build support among a wide swath of the public. Officials routinely tout reforms included in the new law that are designed to help the middle class. Among them are provisions that mandate insurance coverage regardless of pre-existing conditions; allow adult kids to stay on their parents’ insurance plans until they’re 26; require free preventive services such as mammograms, colonoscopies and flu shots — and institute the breast-feeding provisions. But in a recent poll, only 36 percent of Americans surveyed said the law “will make things better” for the middle class. When Whitney Courson, of Seattle, was pregnant earlier this year with her first son, a friend advised her that her insurance might pay for a breast pump, which generally costs $200 to $400 for an electric model. She forgot about the tip, even putting the pump on her baby-gift registry, hoping someone would buy it for her. Then another parent mentioned the benefit at a childbirth class. This time, Courson called a representative at Premera Blue Cross, her insurance provider through her husband’s job at Amazon.com, and learned it would cover the cost of a breast pump. She bought one and had her baby, Nicholas, in July. She loves the ability to pump and store milk so that she can bottle-feed her son when she needs to, or so that someone else can feed him in her absence. “Now I’m telling everybody I know, ‘Call your insurance, this is amazing,’ ” she said. The Affordable Care Act provision supporting breast-feeding went into effect for new health-insurance plans a year ago, but many plans didn’t incorporate the benefit until January 2013, when they were renewed. One hurdle to more widespread use of the provision is the vague language used to describe it, leaving insurance companies to come up with their own interpretations of what it means. Many plans require women to purchase their supplies from an approved medical-device provider, while other others will allow a mom to get reimbursed for a purchase made anywhere. Some will pay only for a handheld, nonelectric device, while others cover more premium pumps. The rule is even more unclear on the lactation-support provision, with no definition of who is qualified to assist a woman trying to breast-feed. When Courson initially found breast-feeding difficult, she again turned to her insurance provider. “I had so many questions and concerns. I wanted to see a lactation consultant so I called insurance just to see.” Courson learned that she had coverage for counseling, and found a provider who would visit her home. Now more than a month after delivering Nicholas, breast-feeding is going well. “Knowing this kind of care is available and covered … that is huge,” she said. Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente. Reprints

Breastfeeding and Low Supply: Common and Surprising Causes and Solutions

Breastfeeding and Low Supply: Common and Surprising Causes and Solutions

Press Release from the USLCA

United States Lactation Consultant Association FOR IMMEDIATE RELEASE Celebrity Breastfeeding and the United States Lactation Consultant Association RALEIGH, N.C. --- Somehow it is news that one celebrity is breastfeeding a two-year-old and another "refuses" to breastfeed. The royals are not immune from infant feeding hype as speculation surrounds Kate Middleton. Will she or won't she? That breastfeeding regularly tops tabloid headlines speaks volumes about our cultural conflicts. Breastfeeding is seen as healthy and good...but potentially scandalous if it takes place in public or beyond infancy. Breastfeeding is viewed as good mothering...but may "ruin" the idealized female body. The American Academy of Pediatrics takes the stand that breastfeeding is not a lifestyle choice, but an important public health initiative. It is the desire of the United States Lactation Consultant Association (USLCA) that every woman have the opportunity to be fully informed about breastfeeding so that she may make the best decision for herself and her family. Women need to know that it is not breastfeeding, but rather pregnancy itself that changes breast latitude and longitude. Women need to know that breastfeeding offers significant protection from breast and ovarian cancer and reduces the risk of type 2 diabetes, high blood pressure, and heart disease. And they need to know that breastfeeding offers their children protection from a host of illnesses and chronic diseases such as ear infections, obesity, respiratory infections, sudden infant death syndrome (SIDS), and even some childhood cancers. And once they do make the decision to breastfeed their babies, women need support to do so. A study published in the journal Pediatrics found that only a third of women meet their own breastfeeding goals. A British study recently concluded that breastfeeding may help children climb the social ladder. The child of Prince Charles and Kate Middleton is unlikely to have difficulty with that climb. Children of celebrities have a head start, too. USLCA is concerned for the children whose mothers don't make headlines. We support the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and Michelle Obama in their call for more Baby-Friendly Hospitals so that breastfeeding gets off to a good start. And we urge Congress to continue funding for breastfeeding peer counselors through the Women, Infant, and Children's (WIC) supplemental food program so that the most vulnerable women and children are more likely to benefit from the health, cognitive, emotional, and social perks of breastfeeding. Breastfeeding support comes from employers, businesses, families, and health care providers. Mother-to-mother counseling and encouragement is invaluable. But when designing breastfeeding support policies and programs and when help in overcoming challenges is needed, International Board Certified Lactation Consultants (IBCLC) are the ones to call. In the maze of breastfeeding helpers, only the IBCLC is required to demonstrate completion of specific college-level, health sciences courses, complete ninety hours of education specific to lactation, and spend hundreds if not thousands of hours in clinical practice before sitting for a rigorous international exam. For healthy mothers and babies, for climbing the social ladder, for the health of the nation, breastfeeding is worth the IBCLC. For more information or to find an IBCLC in your area, visit www.uslca.org.

Don't be a "Strong Mom"

When Big Pharma “Strong” Arms Mothers, We All Lose By Contributor on May 6, 2013 Mother feeding newborn sonCorporations have a very bad habit of telling moms how to be. Or better yet, co-opting some very common “mom” archetypes for their marketing pursuits. For decades, we were told “Choosy Moms Choose Jif.” More recently, “It Moms” were more likely to choose a particular fabric softener. This week, infant formula maker Similac has taken on the dubious role of connecting their brand to “Strong Moms” — those supportive, they say, of a less judgmental environment for mothers. This new affinity for strength is being launched with a Strong Moms Summit on May 7th in New York City featuring a number of high-profile mom bloggers. Please forgive me for being suspect. It is certainly true that there is way too much pressure on mothers today, and we all could take a proverbial “chill pill” on the mommy-bashing. But when a multi-million dollar pharmaceutical giant (Similac is owned by Abbott Laboratories) plows millions of dollars into telling mothers to be “strong” and “non-judgmental,” I think I’m rightfully engaged in a side-eye glance. Selling women messages that sound good on the surface but actually undermine them has been a corporate tactic since at least the 1950s. We aren’t really being supported to be strong moms–whatever that means anyway — we are being sold the idea of “strong” as a marketing tool for corporate interests. There’s a big difference and all parents should take note of the dangerous undercurrents. What I typically find most insulting is that these corporations are counting on moms not knowing better. That we are so weary from the pressures of motherhood, that we will hang on to any messaging that appears to be a “release valve” without delving one centimeter beneath the surface to find the real facts. Apparently “strong” does not mean savvy. Because one centimeter beneath the surface of Similac’s “Strong Moms” Summit and online campaign you will find that framing of infant formula use around a “lifestyle choice” that is not to be judged has been its primary marketing strategy for decades. Ah, choice. It used to be such a powerful word–one that conjured up women’s suffrage, the feminist movement and our battle for reproductive rights. The problem today is that “choice” has been taken out of the context of women’s rights and misconstrued into a dirty and insidious word. In its most disgusting reiteration it is being marketed to women and girls by corporations — in this case, by infant formula marketers, who are more concerned with profits than infant health outcomes. Women have been led to believe that the “choice” between formula feeding and breastfeeding is merely a matter of inclination–a personal decision, a feather in the cap of liberation. And since choices are individual, they have no social consequences; women are therefore relieved of responsibility of considering the broader implications of their decisions. And once I make my choice, no one is to challenge me. We can’t talk about it. And if you do, you are judging me. This is dangerous territory for all women and mothers as the issue of breastfeeding vs. formula feeding is turned into a mere lifestyle choice as opposed to a child health matter. No wonder Similac is supporting so-called non-judgment. What is really happening is that by leaving each other alone in our so-called non-judgmental circles, we are simply leaving the current unjust system in place and discouraged from forming opinions about the value of different choices. With this type of continuous marketing messaging, we lose the ability to have critical discussions about where the real choices lie and which “choices” are merely illusions. Most problematically for the future of mothers, it deters us from addressing the systemic problems such as improving child care options, increasing the market for part-time work, the lack of a paid federal maternity leave, and other deep-rooted, anti-family policies that actually devalue mothering and shape our infant feeding choices, and prevent us from being active agents of change because we are being told that many aspects of mothering from our infant feeding to work decisions are “choices” and, therefore, private matters. Choice becomes the silencer on a dangerous handgun. In this context, choice is not liberation. It is suffocation. In this context, Similac is asking moms to be strong when they really want us weak and silenced. Framing the infant feeding conversation as an empowerment experience erases the context of corporate interests and deep pocketed marketing machines that have always put profit motive ahead of infant health and the health of mothers and our actual empowerment, for that matter. Let’s face it, this isn’t the first time that women have been sold on an ideal that sounded good on the surface but was actually manipulated to undermine them. It’s been over 50 years since Betty Friedan’s The Feminine Mystique ripped the veil off the problem behind a very good-looking pretense of waxed floors, perfectly applied lipstick and domestic bliss in the 1950s to help women breakthrough a malaise they didn’t know existed. At that time, the idea that women were naturally fulfilled by devoting their lives to being housewives and mothers was borne out of similar cultural forces and commercial interests. It was presented as if this was the woman’s choice, when in fact cultural forces dictated that preparing for marriage and motherhood even from the teenage years was her only option. Meanwhile, the dialogue around the real issues that could actually significantly impact our lives and the health of all infants has been suffocated while we clamor behind choice and non-judgment and use it as a shield to deflect our mommy guilt. Our ability to build conversation and support among each other has been quashed because we won’t discuss what we have been told is a private choice. With so much individualism embedded in our views about choice, there is little room for examining interdependence or acknowledging individual fallibility of our choices. It is women and infants who are paying the price for this so-called freedom of choice. Until “choice” is presented with accurate information, then choice is just a mirage. What’s more, we have to understand the difference between choice and options. Having unequal options doesn’t make for true choice. And truly strong moms don’t need big pharma’s underhanded and predatory marketing ploys under the guise of a summit. Thanks, but no thanks.

Breastfeeding...It's only natural

HHS offers moms knowledge, help, and support through a new breastfeeding initiative, It’s Only Natural Today, Surgeon General Regina M. Benjamin, MD, MBA announced the launch of It’s Only Natural, a new public education campaign that aims to raise awareness among African American women of the importance of and benefits associated with breastfeeding and provide helpful tips. It's only natural. mother's love. mother's milk “One of the most highly effective preventive measures a mother can take to protect the health of her infant and herself is to breastfeed,” said Surgeon General Benjamin. “By raising awareness, the success rate among mothers who want to breastfeed can be greatly improved through active support from their families, their friends and the community.” Breastfeeding offers mothers and their babies a healthy start. According to the Centers for Disease Control and Prevention, nearly 80 percent of all women in the United States—regardless of status, race, or income — start out breastfeeding. Among African American women, the breastfeeding rate is almost 55 percent — up from just 35 percent in the 1970s. However, while these rates are improving, breastfeeding rates among African American women remain lower than the rates of other ethnicities in the U.S., particularly among those living in the south. This gap may indicate that African American mothers face barriers to meeting breastfeeding goals and need additional support to start and continue breastfeeding. It’s Only Natural was specifically designed to provide materials that reflect the experience of African American moms. It’s Only Natural was developed to equip new moms with practical information and emotional support from peers, as well as tips and education about the benefits of breastfeeding and how to make it work in their own lives. All of the material is uniquely crafted for African American women. Materials include: •video testimonials from new moms talking about the challenges they have overcome, providing breastfeeding tips, sharing their individual stories, and much more; •articles on a variety of topics ranging from laws supporting breastfeeding to how to fit breastfeeding into your daily life; •two fact sheets, which contain proper holding and latching techniques, as well as information on managing discomfort and how much milk is enough; and •radio public service announcements. To learn more about the campaign, visit www.womenshealth.gov/ItsOnlyNatural. ###

Nightwaking Info

Nightwaking By Teresa Pitman "I slept like a baby." It's a phrase we use to describe a particularly sound sleep. But any parent knows that sleeping like a baby really means waking every few hours...all night long! Babies' sleep cycles differ from those of their parents. Babies spend more time in rapid eye movement (REM) sleep, when they are more likely to waken, and less time in deeper sleep states than children and adults. They also cycle between light and deep sleep stages more quickly than adults do. Nature has designed babies to awaken more frequently to ensure their survival; feeding around the clock gives them the nourishment they need to sustain the rapid growth of infancy. Coping with nightwaking Since babies do wake up at night, parents need strategies to get the rest they need. Keeping baby close, in a crib or bassinet, will make nighttime feeding easier and allow new moms to get a better night’s sleep. Nursing the baby in bed allows mom to relax while feeding the baby. When the baby is close by at night, you can respond quickly before she fully awakens. This tends to help babies fall back to sleep more readily after they've been fed. On the other hand, some babies do fuss a bit as they surface from a light sleep phase, without really waking up. If her eyes are closed and she seems to be trying to get comfortable, don't disturb her by picking her up right away. It might be more helpful to just pat her back gently. You'll soon know if she’s going to "really" wake up. Many parents feel that keeping nighttime interaction very low key encourages their baby to go back to sleep promptly: keep lights, diaper changes and conversation to a bare minimum. Catch up on your sleep by napping when the baby sleeps if you can. Partners can also spell each other off for short periods. Should you train your baby to sleep? Parents, understandably, look forward to getting more rest. But many young infants — particularly those who are breastfed — really need their night feedings, so younger babies should not be pushed to sleep through the night. Reducing the number of feedings will also reduce the milk supply, and it may not be possible to make up the extra milk during the day. After the middle of the first year, some parents may want to teach their baby to sleep more independently. The goal of most sleep-training methods is to have the baby learn to fall asleep on his own, so that when he wakes at night, he won't need his parents to settle him. While some parents have had success with this method, others report that their babies cried for long periods without sleeping any longer. Babies all have their own individual temperaments, and while some adapt easily to a new sleep routine, others seem to need nighttime comforting for a longer time. Parents are all different, too. Some just don't believe in leaving their baby to cry, night or day. Others don't feel nightwaking is much of a problem — especially if the baby only wakes up once or twice for a quick feeding and goes right back to sleep. What works for your family? Sleep researcher and anthropologist James McKenna says parents often feel pressured to get their baby sleeping through the night. "If one thing has damaged parents' enjoyment of their babies, it's rigid expectations about how and when the baby should sleep," he says. "There is nothing wrong with a baby who wakes at night and wants to be with his parents." How you handle nightwaking will depend on your own needs and feelings as well as your baby's temperament and sleep habits. Some parents adapt easily to their baby's nightwaking and continue to function well during the day; others feel desperately exhausted. Some babies will easily learn to settle themselves with just a little nudge from mom and dad; others will become frantically upset if left alone and will cry, literally, for hours. Each family has to work out an approach that best meets everyone's needs. Nightwaking is a challenge for many new parents. Any strategies that help you get enough sleep — bringing baby into bed, napping when the baby naps, taking turns in the night or encouraging baby to sleep longer — can be lifesavers. The good news is that all babies eventually develop more mature sleep patterns, though there is plenty of individual variation in the timing. And, one morning, you'll wake up and realize that it finally happened: your nightwaking baby slept all night. Myths about nightwaking Myth: Most babies are sleeping through the night by two or three months. Some do, but plenty don't. In one survey, less than one-third of babies slept through until morning by four months of age (and nearly one in four took more than a year). Myth: Once the baby sleeps through the night once, nightwaking is over. Baby's patterns are always changing. Many babies who sleep through early on begin waking again later. Myth: Giving the baby cereal will make her sleep through the night. All the available research shows that this is not so. In fact, many older babies who are enjoying a wide variety of foods still wake up at night. Copyright Teresa Pitman. Used with permission. Originally published in Today's Parent. Teresa Pitman is the author of 15 books, including co-author of The Womanly Art of Breastfeeding, 8th revised edition. . . . . . . . . . . Facebook Tumblr Twitter .. Get Involved Join

Breastmilk is a gift

www.askthelactationconsultant.com

Too Few Breastfeeding Studies Done

Is the Medical Community Failing Breastfeeding Moms? By Lisa Selin DavisJan. 02, 20130 Share inShare2 Tamar Levine / Gallery Stock Email Print Share Facebook Twitter Tumblr LinkedIn StumbleUpon Reddit Digg Mixx Delicious Google+ Comment Follow @TIMEHealthland The doctor blamed it on the baby. “She’s not absorbing your milk,” he told Colleen Kelly, in the days after he daughter was born, as the baby lost too much weight and cried constantly. Lactation consultants said, “She’s not latching properly.” Kelly drove through rural Maine for hours to attend breast-feeding support groups and La Leche League meetings, yet the baby went from eight to six pounds and was diagnosed as “failure to thrive.” The baby’s kidneys were x-rayed and blood taken, but doctors found nothing wrong. Not once in her travels did someone suggest that perhaps the problem was Kelly herself, rather than her baby or her ability to latch on. She told doctors that her mother hadn’t been able to produce enough breast milk—could that be happening to her? No, they said. That was an old wives’ tale. But they never even looked at her breasts. “It was clear that none of the doctors or nurses knew enough about breast-feeding to figure out what was happening,” Kelly says. That’s because lactation is probably the only bodily function for which modern medicine has almost no training, protocol or knowledge. When women have trouble breast-feeding, they’re either prodded to try harder by well-meaning lactation consultants or told to give up by doctors. They’re almost never told, “Perhaps there’s an underlying medical problem—let’s do some tests.” (MORE: Breast-Milk Donors Come to the Rescue of a New Mom with Breast Cancer) When women have trouble breast-feeding, they are often confronted with two divergent directives: well-meaning lactation consultants urge them to try harder, while some doctors might advise them to simply give up and go the bottle-and-formula route. “We just give women a pat on the head and tell them their kids will be fine,” if they don’t breastfeed, says Dr. Alison Stuebe, an OB who treats breast-feeding problems in North Carolina. “Can you imagine if we did that to men with erectile dysfunction?” ED, she points out, is within the purview of many doctors’ services, and insurance will cover Viagra, but lactation dysfunction? It doesn’t even exist as a diagnosis, no accompanying health insurance code for which doctors can bill. Within the database of federally funded medical research, there are 70 studies on erectile dysfunction; there are 10 on lactation failure. No one argues that breast is best, but the truth is that breast-feeding is very difficult for many women, and for some, medical problems make it almost impossible without intervention. With the recent bans on giveaways of formula samples in some hospitals, it’s all the more important that the medical community have the tools and knowledge to help mothers breastfeed—or to figure out why they can’t. Until doctors and nurses are properly trained to help, women like Kelly will experience all of the pressure to breastfeed, with none of the support to figure out how. (MORE: 20 Ways To Make Breast-Feeding Easier) What do doctors learn about breast-feeding in medical school? “We learned that it’s what’s best for baby,” said my own pediatrician. “But that’s it.” They’re introduced to evidence that prolonged breast-feeding reduces the possibilities of obesity, SIDS and allergies, but the science of it, what’s happening at the anatomical level? Not so much. “It’s an hour, or a half a day, and [students] don’t remember anything,” says Dr. Todd Wolynn, a Pittsburgh pediatrician and executive director of the Breastfeeding Center of Pittsburgh. There were years, he says, when there was literally nothing said about breast-feeding at all. Why so little heed? “When most of the people who are currently leaders were in training, breast-feeding was really uncommon,” says Stuebe. Many teaching in medical schools today were raised in the better-living-though-chemistry age, when infant formula was thought to trump the attributes of breast milk. (Formula was certainly an improvement over the non-pasteurized cow’s milk that killed many infants at the turn of the 20th century, when breast-feeding was not in vogue). “It’s generational for doctors to think it would be necessary to know anything about breast-feeding.” It didn’t help that formula companies famously sidled up to doctors and nurses and insinuated themselves into hospital protocol; there’s a reason that, until the bans enacted in the last few weeks in some cities, new moms left the hospital with so much Similac swag. In addition, doctors practicing today don’t know where to place breast-feeding problems—breasts are attached to the women, so shouldn’t they be the province of OBs, say pediatricians. And OBs note that breast-feeding is for infants; shouldn’t the baby’s doctor handle it? This leaves breast-feeding problems either to the rare family physicians, or more commonly to lactation consultants who can assist with technical issues—improving the baby’s latch and such—but can’t write prescriptions, check hormone levels or offer a diagnosis. (MORE: Bloomberg’s Breast-Feeding Plan: Will Locking Up Formula Help New Moms?) That’s what a breast-feeding doctor—an OB, pediatrician or family physician with a subspecialty in breast-feeding medicine—would have done in Kelly’s case: a complete physical and medical history (yes, in fact, it is relevant if your mother couldn’t make milk) on mom and baby to see if any physical or anatomical factors were affecting supply. In the mother, they might check the shape of her breasts, to see if they were hypoplastic—a tubular shape that can indicate underdevelopment of the glandular tissue needed to make breast milk—or evaluate her hormone levels, ask if her breast size had increased during pregnancy. Perhaps they’d prescribe a galactogogue, a drug that promotes lactation. Today there are 88 physicians in the entire world who are fellows of the Academy of Breastfeeding Medicine, and have “demonstrated evidence of advanced knowledge and skills in the fields of breast-feeding and human lactation.” But Kelly’s doctors weren’t trained in human lactation, and they told her what many women with lactation failure have been told before: “We’ve never seen this before. You’re the only one.” Yet Kelly is clearly not alone. Dr. Amy Evans, a pediatrician and medical director of the Center for Breastfeeding Medicine in Fresno, CA, says that as many as five percent of all women have underlying medical conditions that prevent or seriously hinder lactation: hypoplasia, thyroid problems, hormonal imbalances, insufficient glandular tissue, among others. But even Dr. Wolynn, who is also a certified lactation consultant, seemed skeptical when I related Kelly’s tale—usually women struggle because they haven’t had enough support in the first few days after giving birth, in his experience. “Very few women really can’t breastfeed,” he said. “That’s very, very, uncommon.” It’s a “normal mammalian function,” he said. Almost everyone can do it. (MORE: Q&A With Breast-Feeding Mom Jamie Lynne Grumet) Because the complexities of lactation failure are so little studied and so often misunderstood, women can often feel that they are at fault, rather feeling like they are suffering from a medical issue for which they need and deserve professional help. Dr. Marianne Neifert writes in her article, Prevention of Breastfeeding Tragedies, “The bold claims made about the infallibility of lactation are not cited about any other physiologic processes. A health care professional would never tell a diabetic woman that ‘every pancreas can make insulin’ or insist to a devastated infertility patient that ‘every woman can get pregnant.’” Luckily, doctors are beginning to take breast-feeding on. Wolynn, Evans and Stuebe are all fellows of the physicians’ organization Academy of Breastfeeding Medicine (ABM). At Wolynn’s practice, all six of the pediatricians on staff are also certified lactation consultants. ABM has developed 25 protocols to guide physicians in treating breast-feeding problems. They’ve successfully lobbied to include breast-feeding issues on the exams for the American Board of Obstetrics and Gynecology and the American Academy of Pediatrics. And the Affordable Health Care Act advises that, as of August 1, health insurance companies should provide “comprehensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breast-feeding equipment.” Of course, we’re low on those trained providers, but there are more every day, as medical schools begin to adopt breast-feeding curricula. “It’s probably the most promising times we’ve seen,” says Wolynn. “We’re in the early phases of what I’m hoping in the next five to 10 years will be more appreciated and more considered a real subspecialty,” says Evans. “It’s a whole new area of medicine.” (MORE: Why Most Moms Don’t Reach Their Own Breast-Feeding Goals) Still, there’s work to be done. Health insurance companies need to reimburse doctors for the time they spend attending to breast-feeding issues, to cover galactogogues, and to cover donor breast milk for women with lactation failure. And if we’re going to remove formula samples for women to promote breast-feeding, we better come up with a plan to feed the babies of that 5% of women who can’t sustain them—with 4 million births a year, that’s 200,000 moms who need extra help. Doctors practicing today—especially those treating pregnant women and new mothers—need to know that lactation failure really does happen, and to be familiar with the potential causes of it, so that they can intervene early. Perhaps most importantly, we need to stop demonizing mothers who can’t breastfeed, guilting them into starving their kids with insufficient milk supplies rather than supplementing with formula. Yes, breast-feeding can help prevent SIDS, obesity, childhood leukemia, asthma, and lowered IQ…but none of those matter if your baby is failing to thrive because of malnutrition. In Kelly’s case, once the baby was admitted to the hospital, she began to use formula, fed through a syringe—she was told to avoid bottles because the baby would reject the breast. She stuck with formula, her baby gained weight, and today, “she’s happy, healthy and fine,” Kelly says. But her guilt and shame continued long after the baby recovered. It wasn’t until weeks later, in another doctor’s office, that Colleen happened upon an article that calmed her: some women, it said, can’t breastfeed, for physical reasons. If only her doctors had read that article, too. MORE: Can a Formula Company Really Promote Breast-Feeding and Fight Child Obesity? Read more: http://healthland.time.com/2013/01/02/is-the-medical-community-failing-breastfeeding-moms/#ixzz2GyaT1Ekh

October 1st, Child Health Day

United States Lactation Consultant Association Press Release

Date: October 2012 Contact: Scott Sherwood For immediate release Tel. 919-861-4543 Email:executivedirector@uslca.org Child Health Day The United States Lactation Consultant Association (USLCA) joins the nation in celebrating Child Health Day on Monday, October 1. For 90 years, the United States Health Resources and Services Administration (HRSA) has set aside the first Monday in October to focus the nation's attention on children's health. It is sobering to consider that for the first time in history type two diabetes is emerging as a significant chronic disease in children and childhood obesity continues its upward trend. Breastfeeding is the primary way to promote optimal health for children. Breastfeeding offers varying degrees of protection from obesity, diabetes, infections, some childhood cancers, and Sudden Infant Death Syndrome (SIDS). An analysis of studies related to breastfeeding and obesity found a 30% decrease in the odds of overweight for a child breastfed for 9 months when compared with a child never breastfed. Additionally, a study published in the journal Pediatrics found that the risk of SIDS almost doubles in infants who are not breastfed. School performance is important to children's health and well-being. Several studies have found that breastfed children have higher IQs and do better in school from the early grades through adolescence, even when parents' IQ and education and the child's living conditions are taken into consideration. According to the Center for Disease Control and Prevention's 2012 Breastfeeding Report Card, breastfeeding initiation is on the rise. This is good news. However the number of babies who are exclusively breastfed for six months as recommended by the American Academy of Pediatrics and other major health-related organizations remains low. From the first prenatal appointment, to the mother's return to school or work, and throughout the baby's first year, breastfeeding must be promoted, protected, and supported until it becomes the cultural norm. It is everyone's job to promote breastfeeding, support mothers, and protect families. As Surgeon General Dr. Regina Benjamin says,"The time has come to set forth the important roles and responsibilities of clinicians, employers, communities, researchers, and government leaders and to urge us all to take on a commitment to enable mothers to meet their personal goals for breastfeeding." International Board Certified Lactation Consultants (IBCLCs) are health care professionals with the expertise to help families at every step of the way. IBCLCs teach breastfeeding classes, work in hospitals to help get mothers and babies off to a good start, problem-solve in out-patient sites such as physician offices, health centers, WIC sites and home care to help overcome breastfeeding trials, and work with employers to facilitate a successful back-to-work experience. IBCLCs help mothers achieve their breastfeeding goals and can help meet national goals related to child health. For more information or to locate an IBCLC, visit www.uslca.org

USLCA message

USLCA

Message from the President This is a great time for IBCLCs. With the Affordable Care Act including lactation care as a covered health benefit, the services of IBCLCs may be accessible to more mothers than ever before. USLCA is advocating for IBCLCs and bringing information to you as it becomes available. At the Board of Directors meeting held just prior to the ILCA conference, we updated our mission, vision, values, and strategic plan. You will note the strong emphasis on the IBCLC. Take a look at the new Mission, Vision, and Values Statement: MISSION To advance the IBCLC within the United States through leadership, advocacy, professional development, and research. VISION The IBCLC is the recognized professional authority in lactation in the United States. VALUES: 1. Uphold high standards of professional practice 2. Respect and promote cultural diversity 3. Collaborate with integrity in relationships 4. Operate nationally while being mindful of regional, local and Individual needs 5. Demonstrate responsibility to our community by promoting the best lactation care for the foundation of good health

The Florida Breastfeeding Law & You

You have the right to breastfeed in public - it is the law.
Florida Legislation February 1993
Section 1. The breastfeeding of a baby is an important and basic act of nurture which must be encouraged in the interests of maternal and child health and family values. A mother may breastfeed her baby in any location, public or private, where the mother is otherwise authorized to be, irrespective of whether or not the nipple of the mother's breast is covered during or incidental to the breastfeeding.
House Bill  #HB 231 Fl. ALS 4; 1993 Fl. Laws ch. 4; 1993 Fl. HB 231 Fl. Stat. 383.015 /
800.02 - 800.04 / 847.001(later 827.071)
 For further info please contact The Florida Lactation Consultant Association
www.flca.info
or www.babyfirstlactation.com