Sunday, July 3, 2016

Breastfeeding: The loss of our basic traditional knowledge

"I saw some women had written that the cloning of Dolly* was wonderful since it showed that women could have children without men.  They didn't understand that this was the ultimate ownership of women, of embryos, of eggs, of bodies by a few men with capital and control technique, that it wasn't freedom from men but total control by men."  Vandana Shiva

*Dolly, the sheep, cloned in 1996 from an egg cell and a mammary gland cell. 

Ah, the versatility of the mammary gland in its ability to help men create life and sustain life.  Yet women nowadays seem totally unaware of this power.    Many women reject it-won't or can't breastfeed, but men are so enamored by the mammary gland that they will patent its powers.  Vandana Shiva understood that the cloning of Dolly is about ownership not liberation.  

Yesterday, I slowly walked around the Duck Pond, the many retention ponds created in order to have this housing development built on a swamp.  They had mowed down those dreadful weeds that grow around the pond, so that those who live on this waterfront property, can see the water.  Some of those dreadful weeds they mowed down were blue-flag irises, a perennial native plant of the wetlands in Florida.  Hell who needs them?  Every 6 months or so they pour some herbicide around the pond.  Then all the plants become a sickly brown color that mingles with the stryofoam cups and beer and soda cans that float so well in the pond.  One day I saw a suitcase floating in the pond.  I wondered if the suitcase contained dead body parts.  Yes, I have watched too many Bones episodes on TV.  Yesterday I picked up a pile of school papers matted around the trees next to the pond.  School's out for summer, some child felt so liberated he or she just tossed those papers into the bushes.  I understand that feeling.  When I was a child, I looked forward to summer all year because school felt like a cement cage.  All I wanted to do was run around outside, play in the dirt, pick dandelions and watch the seeds float all over the yard.  My Dad wondered why our yard had more dandelions than the neighbors.  I could have told him.  I understood about seeds, although I never had a science class.

Nowadays, I never see children running around outside.  They have disappeared, like the endangered species of our world.  Shut up in their rooms, with their glowing electronic equipment.  They live in the virtual, like some science fiction movie.  I do see some adults walking around, many of them running with earplugs oblivious to the sounds of nature.  They don't want to hear the owl who meows like a cat or the frog that croaks in the drains.  They don't want to be in the outdoor environment.  They just want to use the outdoor environment. 

I picked up aluminum cans today, some wrapped in brown paper wrappers.  Just call me the bag lady.  I am tired of seeing trash everywhere in my neighborhood.  Sometimes the neighborhood looks like an environmental disaster drive-by; cans and papers jettisoned from cars, cause no one wants their own cars to be trashed.  Likewise the Duck Pond neighbor who pushes his mounting trash of spent fireworks, broken chairs and trellises, broken toys and 2 by 4's closer to his neighbor's property.  No trash on his property. Not his problem.  This is how we live, enveloped in a world that excludes any environmental concerns.

Those retention ponds in this wonderful suburb connect and eventually go into the Mosquito Lagoon.  And the Lagoon meets with the ocean.  We are currently witnessing an environmental nightmare of a huge algae bloom not so far from us.  But it doesn't touch the neighborhood cause we can live in a bubble away from the degradation of the planet.  

So what has this to do with breastfeeding?  Nothing and everything.  We are a people who have lost our understanding of the connections between nature and ourselves.  We live in our artificial environments connected to a web of artificial intelligence.  Yet we are disconnected from our humanity and our consciousness of the real web of life.  We bring babies into a sterile world in which parents are hooked into their hand-held devices.  Yet the baby, who is new to this sterility, does not understand why their parents love their devices more than them and will hold their devices day and night, but refuse to hold them as much as their devices.  Breastfeeding does not work very well, when moms believe that babies are to be held at arm's length, regulated by artificial time.  Or when parents believe that their pets deserve to co-sleep with them but the baby belongs down the hall in another room by itself.  (As an IBCLC I worked with a number of parents who refused to co-sleep with their infants to help make breastfeeding easier to maintain but welcomed their pets into their beds every night--I still find that very strange).

In the past decade, breastfeeding has become more about bottling human milk than breastfeeding.  Mothers let down to the sound of their pumps, not the cry of their infants and yet no one finds that strange.  Many mothers leave their infants with strangers.  What mammal in nature, gives her babies to another mammal to raise?  We know in nature that if you take a mammal baby away from its mother, the mother often will reject that baby if it is returned.  Yet we assume there is no ramification to separating mothers and babies.  Strange this artificial world.

Years ago I was called to help a mom breastfeed her baby.  The mom was in tears, frustrated with breastfeeding and the after-effects of a c-section delivery in which she was separated from her baby for over 24 hours.  The dad who was holding the very contented baby in his arms, told me that lucky for them that the hospital allowed him to be with the baby during those hours.  

Like all first time parents they spent enormous amounts of time changing the baby's diaper.  Which, of course, got the baby crying and then screaming because the parents were new to changing diapers.  Then the Dad held the baby again and the baby settled right down.  I asked the mom if she would like to breastfeed the baby now.  And the father handed the mother the baby while giving the mother instructions on how to hold the baby.  The mother held the baby as far away from her body as possible and her awkwardness increased as the father hoovered over the pair.  The infant began to cry and then scream.  The father obviously felt the mother wasn't doing it right and took the baby back into his arms.  The baby immediately stopped crying and began rooting at his breast.  I sat there in total astonishment.  And at that moment realized that this baby had bonded with his father not the mother.  And the father had bonded with his baby.  But the mother was left out of this circle of love and attachment.  I asked the father to leave for awhile so that the mom could have some time alone with her baby.  At first he became angry with me for asking him to leaveBut then he left abruptly.  The mother started to relax and she began to hold the baby closer.  Just when it seemed like the baby would breastfeed, the father burst in and said he could not stay away from his baby.  And from there the session disintegrated with the mother getting hysterical and saying that the baby hated her.  The father decided bottlefeeding was obviously the answer and I left because the mother accepted the father's decision.  I thought about this case on and off for many years.  At a critical moment after birth, this baby made a perfectly logical choice to bond with the father because of the absence of the mother.  The father happened to be a very domineering person and the mother saw that the infant appeared to prefer the Dad.  When we interfere with attachment at the birth of infants, we can create emotional scars that may last a lifetime.  While I support fathers being at births, I think it is critical for breastfeeding that mothers get to hold their babies before anyone else.  And of course their are circumstances where mothers cannot medically be the first to hold their infants. 

I remember the question I got over and over again with my first baby regarding breastfeeding.  "Are you nursing that baby again?"  I tuned it out because I had attended La Leche League meetings and knew that breastfeed babies nursed often.  But what I still didn't really understand was that breastfeeding was not just about nutrition, about eating.  It was about connecting, the infant's need to be skin-to-skin with its mother.  In reflection this need is just as critical as the need for food or water.  I call it the human need for connection, for love.  I remember my frustration when the baby nursed and an hour later (yes I was carefully watching a clock) the baby needed to nurse again.  Being an adult I made the judgment call that the baby could not possibly need to eat again.  So I walked around, holding an increasingly upset baby. And by the time I realized that very upset baby needed to nurse, the baby was too upset to nurse.  By my second baby, I simply nursed the baby without making an adult judgment call.  Instead I followed instinctual behavior and nursed the baby despite her having nursed an hour ago or 5 minutes ago.  Life became simple the moment that I suspended my rational mind and followed my heart or what I call traditional knowledge of breastfeeding.  

Breastfeeding works quite well, when we understand that babies don't easily fit into our technological world.  Making a baby fit into that world of artificial light, air, food, clothes, clocks and schedules is difficult and sometimes impossible.  When we accept that babies know what they want and need and that this has worked for thousands of years; then life becomes easier.  When we presume to know what babies need and want, we create are own worse nightmares.  Babies are simple creatures, they want the closeness of mom, they want her warmth and milk.  This is basic traditional knowledge (and a La Leche League truism). 

Copyright 2016 Valerie W. McClain


Thursday, May 26, 2016

Breast pumps: A Blessing and A Curse

Loyd-B breast pump by Lopuco.

 "Eight breast pumps commonly seen in clinical practice were measured and ranked for desirability in eight categories, pressure range, pressure control, size and shape of nipple cup, volume accommodation, visual feedback, ease of handling and cost.  Three scored relatively high (Egnell, Kaneson, and Loyd-B), three scored low (Gomco, Davol, and Bintner), and two appeared to be frequently ineffective (Evenflo and Ora'lac)."  --abstract from paper entitled "An evaluation of breast pumps currently available on the American market."  Clin Pediatr (Phila), 1983 Jan; 22 (1): 40-5.

Breast pumps, either you love them or ya hate them!  The above pump was donated to me, in the 1990's.  The flange and bottle are glass, rubber stopper for bottle but the pump handle and tubing is plastic.  The working mom who donated this pump to me (at one time I had quite a collection--even a glass bicycle horn pump) loved it and highly recommended this pump.  It was a highly recommended hand pump in the 80's and 90's.  It had some drawbacks in that it was made of glass and so breakable.  And it required considerable hand strength.  So if a mom had carpal tunnel syndrome, the pump would be difficult to use. 

As you can see most of the pump companies in that study time period are no longer in business or have changed ownership and have a different name.  Evenflo pumps have the same complaints from consumers that this study mentioned:  frequently ineffective.  So a lot can change over the years but some things never change.  One of the problems with pumps is that after you buy them and undo the packaging they are no longer returnable.  They are considered a personal care product that cannot be returned, if opened.  Many of the consumer complaints about Evenflo pumps are that they worked for 1-3 times but then no longer worked.  So moms are stuck with a pump that doesn't work and they can't return it to the store and must deal directly with the company.  Moms have to have the purchase receipt to get a refund.  All this takes time and in the meantime the mom is without a pump.  If the mom has limited income, purchasing another pump maybe out of the question.

As an IBCLC before my retirement, I made recommendations to moms about pumping.  One of my main recommendations regarding pumping is that in the early weeks pumping should be avoided unless a mom was going back to employment early or had an infant that was refusing the breast or an infant that was hospitalized due to prematurity or medical conditions which created separation.  Why?  Because pumping means that a mom and her baby will be out of sync with each otherA breast milk supply is tied to the baby, the more the baby nurses the more milk is produced and the less the baby nurses the less that is produced.  Pumping increases a supply that a baby doesn't want or need(which is great if you need to build a milk supply to store because of future separation).  The baby controls supply unlike bottlefeeding (either infant formula or breast milk) where the mother controls the supply.  Unless the baby has some underlying medical condition or the mother disregards an infant's cues, the baby will signal the need for the breast.  The need for the breast is not just physical hunger but emotional hunger, the need for physical contact with the mother.  Disregarding either physical or emotional need in the baby will impact a mother's supply.  Learning to follow the baby's cues is at least a 6-week learning period for the first time mom.  If the mom is spending a lot of her time pumping and storing her milk in the early days, she may miss those cues entirely and rigidly follow a feeding schedule based on her belief system of what is appropriate.  I believe some of obesity problem is related to caregivers determining "hunger" in infants rather than looking for cues in their babies.  (bottlefeeding cannot satisfy all sucking needs in babies or the emotional need to be with mom if with a caregiver)  Mothers who disregard or misread the early signs of hunger in the baby, restlessness and mouthing fingers often have milk supply problems.  Mothers often wait til the infant is into full-blown screaming to bring the infant to breast.  Babies who are screaming are not ready to feed until they calm down.  Babies often refuse the breast and then some moms believe that the baby does not want to breastfeed.  There was a study done some years ago and breastfeeding problems are concentrated in the first 6 weeks.  Mothers and babies need those first six weeks to get to know each other and to have the time to solve the many problems that may occur during that time.  If moms start pumping and storing milk or they have to go back to employment prior to the 6 weeks, breastfeeding will often end before the mom and baby had a chance to get it working.

Are mothers getting correct information regarding pumping and breastfeeding?  The other day I read a breastfeeding blog where the IBCLC made a comment that annoyed me greatly.  She stated that if a baby slept too long a mother should pump her breasts.  No qualifications regarding the reason to pump.  Again, pumping puts a mom and baby out of snyc with each other.  Having a bigger milk supply than an infant can handle can lead to mastitis and can lead to more pumping because the infant cannot handle all the extra milk.  My answer for a baby sleeping too long is to wake the babyBabies have a light sleep and  a deeper sleep in which you cannot wake them.  If they are in a light sleep, they will often nurse without you fully awakening them.  The other possibility is to do nothing and wait and see what happens.  Some babies will sleep longer at times and your milk production will adjust to these variations.  Hand expression is also an answer to overly full breasts, pumps don't have to be used. 

I remember a home visit I made many years ago for a mom who asked for help because she was employed and her pump wasn't collecting enough milk.  She showed me her battery operated pump.  I tested it for suction and it had none.  So I was quite amazed that she was collecting any milk.  So I asked her if I could watch her use the pump and she agreed to show me.  The mom was literally hand expressing into the pump.  The pump was doing absolutely nothing.  I explained to her that she had excellent hand expression technique but her pump was useless.  She got another pump.

What happens to defective pumps, moms sometimes pass them onto friends but more often they end up in the trash can (unless the mom is able to return the pump to the company).  Most pumps nowadays are made of plastic and plastic in landfills does not biodegrade.  Only heat and sunlight degrade plastic, although scientists are working on creating bacteria that will degrade plastic.  Plastic material is a real problem for landfills and we now recognize an environmental problem in our oceans.  It takes a plastic bottle 450 years to degrade in the environment.

So manufacturing defective pumps in which moms cannot return to the manufacturer is not helpful environmentally (besides being a frustrating experience for mothers and possibly causing a mother to use infant formula).
But its not just defective pumps that end up in our landfills but also the fact that every year a set of new moms buy breast pumps, use them for a limited time and then add them to our landfills.  Although various pump companies (Hygeia and Medela) now will recycle your pump. But it is up to the mother to take responsibility to recycle.

And its not just breast pumps but all the plastic tubing (electric pump kits), bottles, teats (nipples) and pacifiers that are needed when a mom is separated from her baby that will end up in landfills.  "Plastics are produced from natural gas, feedstocks from natural gas processing and feedstocks from crude oil refining." 

Thus separating moms and babies has an environmental cost that goes unrecognized.  We don't think about the car that is needed for employment because public transportation in our smaller cities and towns is poor to nonexistent.  Thus there are more people on the road creating a larger carbon footprint on earth.  Or that an employed mom will need a more extensive wardrobe.  Or that a huge part of her paycheck will go for childcare and infant care. According to an article in the Gainesville Sun (dated in 2014) the average cost of infant care in Florida is $8300.  The title of this article was, "Compared with day care, college is a bargain."

Maybe it is time to rethink the ideology that separates mothers and babies. The improvement of the quality of life on this planet is a basic need that should be given due consideration.  Currently many employed moms have no choice but to be separated from their babies. But it is our society that has limited those choices or made them nonexistent.  Paying a parent to stay home with their babies and children, is an environmentally smart option.  And not just a smart environmental option but emotionally beneficial to mothers and their babies.

PS:  Yes we will still need breast pumps because separation of moms and babies will happen due to various medical issues or mothers who for various reasons do not want to breastfeed.  But does every new breastfeeding mom on this planet need a breast pump?  An article in The Atlantic should make us very aware of what we are creating when we have a society that believes that all breastfeeding mothers need a breast pump.  The article was entitled, A Brief History of Breast Pumps," by Megan Garber  in larger and bolder type than the rest of the article it states, "THE BREAST PUMP IS THE MACHINE THAT MAKES HUMAN MILK, IN ITS WAY, MARKETABLE."

Copyright 2016 Valerie W. McClain