In my Bat Mitzvah speech many years ago I said, “Even when it’s time to move on, it’s hard to let go.” I remember that now, as I am closing my lactation practice in order to take on a new role at the Massachusetts Health Policy Commission. It’s time. I’m excited about the opportunity to work on the health care system as a whole. At the same time, I will miss working directly with families. Helping parents and babies at such a vulnerable time has been an incredible joy and privilege. I’ve been immersed in the hope, anxiety, excitement, frustration, exhaustion, determination, and wholehearted love of new parents.
I’m so grateful for the families that I’ve worked with and learned from. So many lovely memories.
- A couple singing together “Will you still need me, will you still feed me” as they coaxed their daughter to latch.
- A dad peeling off his shirt to snuggle his baby skin-to-skin while giving a bottle feeding.
- A relieved mom saying “that gives me so much comfort” as her husband finger-fed her breastmilk to their newborn, who couldn’t yet latch.
- A grandma who was thrilled to learn to finger-feed her grandchild.
- A proud mom, who induced lactation in order to share breastfeeding with her wife, describing how their new baby had milk from both mothers in her first days.
- A high-producing and diligent mother of a premature baby who had pumped so much milk that she ran out of freezer space. She decided to donate her surplus to a family she had come to know in the NICU, who were so grateful for her special gift.
- An adoptive mom who was expecting to be matched with an older child, but got surprised with a newborn. A lovely nurse suggested she try breastfeeding, and she jumped in with both breasts.
It helps that I have a fabulous group of IBCLC colleagues at the LC Home Visits Association – I’m confident sending families into their capable hands. But I am a baby addict, and I need my fix regularly, so I will continue to volunteer with nursing moms, co-leading the Boston La Leche League group. At the last meeting, I got the wonderful surprise of seeing a former client. Seeing the newborns transform into toddlers is fun. And witnessing the transformation of stressed-out new mothers into confident moms enjoying their kids – this makes me incredibly happy.
I’ve written before about times when I’ve grappled with how mothering and other projects fit together in my life. I’m reminded now by my own mother’s blog that this is really a subset of a larger question that didn’t begin or end with having kids. The question I contemplated as a child, as a new mother, and as a divorced forty-something, is now my mother’s question again as a widowed sorta-retired-but-needing-a-project young senior. Life is finite. How do we make the most of it?
The first time I saw a toddler breastfeeding I was in my twenties, and sitting shiva after my father passed away. A friend of my stepmother’s came by the house with her two-and-a-half year old twins, and nursed them on the living room sofa. After they left, someone commented that she found it strange for children that age to be nursing. Then Albert, a man born in New York City in 1921, spoke up. His story stayed with me, so I do my best here to reproduce it from memory. I will let his words stand on their own:
You think it’s strange? Well, I’ll tell you something. My mother breastfed me until I was three and a half. That was normal. In those days, everybody in our community did. They were immigrants. They were poor. They had no money for baby food or formula. And they had no birth control. Breastfeeding helps with that, it does.
And you know, I’ll tell you something. If every child was fed that way, that long, there would be no domestic violence. Because when a man has had that kind of relationship with his mother, he can never be abusive to a woman.
I’ll tell you one more thing. My mother had several abortions. It was common, that’s how it was, I told you, they had no birth control. But the last one, she got an infection, and she died. If she could have gone to a doctor, she could have lived another forty years, but that’s how it was then.
I was fourteen when she died, and not a single day has gone by that I didn’t think of her, because she was the sweetest thing I ever knew.”
In addition to working directly with breastfeeding families, I teach professional lactation education. Here’s some reasons I love this part of my work:
I get to stop breastfeeding problems before they start.
As an IBCLC, I’m usually called in when things have gone off course. The lactation educators I train are on the front lines, often as nurses, doulas, or childbirth educators. They are in position to get good information and suggestions to mothers that heads off problems.
I get to be there, in spirit, at the magic moment of birth.
I used to be a birth doula. I miss the raw human intensity of birth. The doulas and nurses I train can be there, and they can be proactive, protecting that special time and helping mom and baby get the party started.
I get to reach mothers who aren’t already sold on breastfeeding.
Any woman who calls an IBCLC or LLL leader is motivated to breastfeed, and knows that help is out there. So I may not get a call from the single mother who wonders if breastfeeding is really possible given her lack of maternity leave, the first-time mom who knows nobody that is breastfeeding, or the mother who has been told not to bother with breastfeeding, because it’s too hard. WIC counselors, nurses, and health educators hear this all the time. They can offer non-judgmental counseling that speaks to a the concerns of a woman who didn’t have breastfeeding at the top of her to-do list.
I get to be a part of Baby-Friendly, improving hospital care and reducing racial disparities.
The Baby-Friendly Hospital Initiative is a certification program created by UNICEF and WHO to improve perinatal care. The program identified ten steps that demonstrably improve breastfeeding and infant health outcomes. One of those is for healthcare providers to be trained in specific core competencies, and that 20hr curriculum is included in the lactation educator course. Best for Babes has a great review here of the studies showing that when hospitals go Baby-Friendly, not only does overall care improve, but racial disparities dwindle away.
I get to talk about my favorite studies.
Like this one about fathers and the “breastfeeding team.” And this one, about how mothers breastfeeding at night actually get more sleep and lower their risk of postpartum depression.
I get to teach simple, practical things.
Like nursing in a sling or carrier, and ergonomic positioning for easier breastfeeding.
I get to meet such a diverse group of people passionate about supporting mothers and families!
Nurses, birth doulas, postpartum doulas, childbirth educators, massage therapists, childcare providers, WIC counselors, mental health counselors, dietitians, midwives, HR work-family specialists – so many backgrounds, so many roles, so much to contribute.
More info and registration about the CAPPA Lactation Educator course
Info about the CAPPA certification program
Info about the Baby-Friendly Hospital Initiative and the core competencies
What I love: a bunch of friends and family getting together to celebrate an upcoming baby.
What I don’t love: everyone dropping a bunch of money on heavily marketed consumer products that may or may not end up being useful, or enjoyed. Superstores are full of gear, much of it is cute, all of it is overpriced, and virtually none of it is essential.
What I really hate: seeing overwhelmed new parents trying to fend for themselves, getting exhausted, frustrated, and generally bummed out by the needs of the baby and household. For thousands of years, extended families lived together, and pitched in with each others kids. Nobody became a mother without already having plenty of experience with newborns beforehand, and once she gave birth she had other experienced parents in the household to lend a hand. Today, most new parents have to pick it up as they go along, and few have another pair of hands in the house. I’ve seen too many new moms in tears, afraid they won’t be able to manage when their spouse goes back to work or visiting grandmother goes home.
So here’s how I’d like to see parents-to-be celebrated:
1) Expectant parents make a postpartum plan. The shower host prints out a list of tasks they will need help with, like meals, or picking up older kids.
2) At the shower, instead of buying stuff, friends sign up to help during the postpartum period, and/or contribute financially towards hiring help. Believe me, a postpartum doula, a cleaning service, or a meal will be more valuable than that baby wipe warmer.
3) But what about the adorable outfits?! You can still do wardrobe. The shower host can buy a bunch of plain onesies (get a few each in several sizes so they won’t all be outgrown right away.) Get a big pack of fabric markers. Maybe some iron-on appliqués, or even those photo print-out sheets if you want to get fancy. Guests all decorate onesies with a drawing, picture, or note to the baby. Sign them. Seriously, its fun. They’ll be totally cute, more distinctive than anything from Baby Gap, and a reminder to the parents that they have a village behind them.
I was heading out for a day-long conference of the Nursing Mothers’ Counsel, and excited to see the first talk. That meant getting my three kids out the door earlier than usual. So there was my youngest, dawdling over her breakfast, while the older kids remembered a series of homework assignments, permission slips they needed signed, lunch essentials we were out of, laundry needs, and other agenda items that would have been useful to hear about the previous day.
In between attending to these, I monitor the progress of the preschooler’s breakfast. I breathe deeply, and resist nudging, holding in mind this key law of physics: any attempt to hurry a small child magnifies the forces of inertia. Telling a toddler “Come on, we need to go!” can slow the child’s movement down to slothlike. Referencing the need to catch a bus or plane, or an appointment that a parent or sibling needs to arrive on time for, can produce an exponential effect. The child will appear to be operating within a gravitational field so intense that picking up a single shoe can take ten minutes.
So I breathe. No hurry. No pressure. Enjoy your breakfast.
It’s a lot like the advice I’m often giving to new mothers who are struggling with a baby that won’t latch: Don’t work so hard.
A common scenario goes like this: at first, the baby takes the breast easily. Mom is thrilled – breastfeeding is a breeze. Then it goes off course. A common culprit is engorgement and edema in the mother’s breasts. It’s not easy for a baby to latch onto a watermelon!
When the baby doesn’t latch, mom gets worried and frustrated. She tries her best to get that nipple in there. Baby expects to draw the nipple into her mouth, not have it poked in, so she pulls away. She’s hungry. She gets upset. Mom tries harder. Baby gets more upset. Sometimes, after a long struggle, it works. Sometimes it winds up with a frantic baby accepting a bottle from a crying mother.
The first step is to break the cycle. Stop pushing it. No more stress at the breast! Get some breastmilk into the baby by another route if need be. We all learn better when we aren’t famished. Relax. Breathe. Snuggle. Sniff the baby’s head.
Then, a relaxed mom and baby can work together.
When a mother reframes her goal from “get the baby to latch” to “create lots of opportunity and a positive environment for the baby to breastfeed”, the situation often turns around. Sometimes the baby latches right away, sometimes slowly over time, and sometimes there are physical obstacles that need to be addressed as well. Engorgement, tongue tie, and other problems can be dealt with. Regardless, breaking out of the panic is critical. Stress inhibits oxytocin, the “love hormone”, which is so important for both mom and baby. Suckling and milk flow both depend on oxytocin.
So latching, like a slow moving toddler, only gets worse when pushed. Some things you just can’t rush.