Nursing Through Pregnancy 10/05/2012
Today, I'm sharing an article I've written on nursing through pregnancy. This is something that is close to my heart because I myself have nursed through 3 pregnancies. Many mothers also think about nursing through a subsequent pregnancy but end up feeling lost and alone. The majority of breastfeeding mothers in our Singaporean context have weaned their babies off breastfeeding by the time the next pregnancy is conceived. Sadly, we do not have enough mother-to-mother or community support for mothers nursing through a pregnancy or tandem nursing 2 babies. These mothers pretty much 'go it alone', and often don't share their nursing arrangements/challenges with curious doubters. I'm hoping my article raises awareness, helps mothers know that it can be done, and diffuse some of the misconceptions about breastfeeding while pregnant. You can read the article here. The article is also related to an earlier blog post I wrote about breastfeeding agitation, often experienced when nursing while pregnant or nursing an older child. Add Comment I recently read some material on suppressing lactation after a stillbirth or the passing of a nursing baby. Although it has been emotionally challenging to deal with this, I see how the work I do with a woman during this season in her life will inevitably change me as a mother and a birth professional. I want to share with you a book review that I have written of a wonderful book on pregnancy loss and grief. I hope that this book review will reach someone who needs to hear about the book, and its message will make a difference somewhere. ******************************************************************************************** Unspeakable Losses - Healing from Miscarriage, Abortion, & Other Pregnancy LossBy Kim Kluger-Bell Published by Harper Collins Publishers, 1998 This books offers an intimate look at miscarriage and pregnancy loss. These issues touch a raw nerve, and there is something heart-stopping about losing a baby. For parents coming to terms with the loss of an unborn child, and the accompanying dreams and hopes, this book offers companionship, reassurance and hope. Kluger-Bell’s writing is inspired by her personal journey, in the aftermath of her own pregnancy loss. Included in the book are anecdotes of parents’ experiences, feelings and thoughts, written in the first-person, and scattered at relevant points throughout the chapters. These give the book a very real and personal feel, adding depth and perspective. The emotional pain that comes from an early miscarriage or a later miscarriage is not spoken of in today's society; it remains a taboo subject. This book sets out to acknowledge that pain and affirm to mothers that, indeed, it is oftentimes tremendously painful to have to say goodbye, before having had the chance to say hello. The chapter on the Dilemma of Choice discusses the sense of loss after an abortion; this too is a taboo subject. Even if a woman chose to terminate her pregnancy, the reality or potency of her grief is not any less. Conflicting emotions, a feeling of imagined failure, or the inherent moral dilemma all contribute to feelings of deep sadness and confusion. Unfortunately, there are few resources for women in the wake of abortion, so this book may well meet an unspoken need. One chapter deals with fathers’ experiences of pregnancy loss. Many couples will appreciate this perspective. This book is also tremendously valuable for those supporting a mother who has experienced a loss. Family members, friends and birthworkers sometimes feel like ‘outsiders’ looking in on an intensely private pain. This is made much worse because grieving is a very individual experience, and every mother finds her own way to cope with the pain. Most are familiar with popular ideas about grief such as its 'stages'; however in reality, grief ebbs and flows in waves, and these ideas feel irrelevant. This book shares glimpses into the lives, emotions and grief work which parents go through after pregnancy loss, enabling supporters to experience that grieving through Kluger-Bell’s eyes, and journey alongside a grieving mother. While I knew this book would help me connect with mothers who have experienced loss, I could not bring myself to read it; it sat, untouched, for weeks before I finally had the courage to open it. Yet, as I began reading, I learnt so much about life, love, and new hope. Unspeakable Losses is truly a testament to the strength of the human spirit and to the power of life itself. ******************************************************************************************* Have you experienced a pregnancy loss? How did you find comfort and hope? Or maybe producing and donating your milk has helped you heal? Would it help you to share about it here (or possibly, send me a private message)? Have you chosen to suppress lactation for any reason, maybe because you needed to have an urgent medical procedure? Tell me your story, I'm eager to listen... Birth Around The World 05/04/2012
I met nurse-midwife and filmmaker Mayra Calvette earlier today at a get-together at ParentLink. Mayra is making a documentary, Birth Around The World; she is travelling to 30 countries around the world over a period of 9 months to document how women are nurtured during birth, how babies are born and birth practices in different cultures. Birth practices are influenced by tradition, religious or cultural beliefs, attitudes and ideas that may have existed over generations as well as technological advances. This film is as much an anthropological study as it is a discovery of birth worldwide! Mayra's travelling has, no doubt, been life-changing for her; she was eager to ask many questions for her film, but I simply wanted to ask her questions in return! I can only guess at what Mayra has learnt so far about life, people and the world we birth and mother in! It is inspiring to meet an individual who lives her life with so much purpose and passion. This is the Birth Around The World website, join me in following Mayra on her round-the-world journey on her blog. I'm excited to see the documentary when it is completed. It will offer a glimpse of the Singaporean birth landscape from an outsider perspective, alongside birth elsewhere in the world. I'm certain this will give mothers and birthworkers clarity and inspiration! Thoughts On Nursing 29/03/2012
Mother of 4 and personal development coach, Kim Constable, shares her personal breastfeeding story, and how she found her groove as a breastfeeding mother. Thanks, Kim! Best of the Breast, & All the Rest When I was pregnant with my first child, I remember everyone asking me if intended to breastfeed. My answer was always that I would try if I could but that I wasn’t going to beat myself up if it didn’t work for me. Yet, I remember wondering why it was that some women couldn’t breastfeed? Surely all babies had mouths and their mothers had breasts, so what would prevent a mother from feeding her baby? I spent some time reading and researching breastfeeding, and potential pitfalls and problems so I felt well-equipped to give it a go. When I gave birth to Corey, he made it very easy for me and latched on immediately. I clearly remember looking down at his beautiful little head as he sucked gently and being so overwhelmed with love and emotion that it took my breath away! At that moment, I knew that it would’ve been very difficult for me to put a rubber teat in his mouth, as feeding him my own milk from my own body seemed to me the most natural thing in the world. Holding him close and feeling like we were still connected as we had been in the womb, was worth every second of the tender nipples that ensued over the next few days. I would never judge any woman for her decisions. We all have our unique set of circumstances and experiences that have made us who we are today, and ultimately we can only choose what we can choose in any given moment. Yet, I did find it hard to understand why a woman wouldn’t choose it. There was a closeness I felt with my baby and a love that poured out of me when I looked down at him that I didn’t expect, and could never have expected. I felt proud to feed him myself and my self-esteem grew. I have since had another 3 babies, and have breastfed them all, for around two and a half years each. Mothers often ask me how I have been successful with breast-feeding. Part of the reason is that I never saw it as a be-all and end-all kind of thing. I fed my babies on a pattern early on and found that I didn't have to be attached to them 24 hours a day. I introduced bottles of expressed milk after a few weeks so that they could be left in the care of someone else for short periods if needed. I bought an expensive expressing machine so that I could pump efficiently and maintain a good milk supply. Breastmilk is the most important nutrition I can give my babies, so I wanted to ensure that I was able to do this easily. Too many mothers put pressure on themselves to achieve some high breastfeeding standard. In my opinion, this is one of the main reasons why many women choose not to breastfeed. The advice given by health professionals often does not fit with our current lifestyles; women can think up creative ways to have the best of both worlds, and give their babies the nutrition they deserve.  People laugh and say that I am a paradox when I recount my breastfeeding experiences! On one hand, I co-slept with my babies until they slept through the night, carried them in a sling close to my body for many naps and outings, and breastfed for a long time. On the other hand, I followed a pattern for their nursings, slept them in their cots for naps and at bedtime, and was happy to leave them in the care of others with a bottle of expressed milk. I believe that it is this flexibility coupled with motivation, that has allowed me to continue successfully. I wasn’t prepared for breastfeeding not to work, so I just did everything in my power to ensure it worked for me. My advice to other mothers is to always do what feels right for you. Don’t feel judged for your choices, and don’t think that there is a right or a wrong way. Breastfeeding is not hard, nor does it have to be. If more mothers knew this, they might not give up so easily.   About Kim: Kim Constable is a 33-year-old mother of 4 young children. She owns and runs a multilingual children’s company called The Rainbow Garden and her own kids are fluent in 4 languages and cultures. She has been a coach with personal development company, Executive Success Programs, for 8 years and coaches people all over the world in overcoming their self-imposed limitations that stop them from having the kind of life they have always dreamt of. Kim is also in the process of founding an Association of Enterprising Women which aims to educate women on how to become successful time managers and strategize to plan their time effectively and achieve maximum output from minimum input. Visit Kim’s blog to read more of her inspiring wit and down to earth style of writing! How Do You Define 'Breastfeeding Success'? 27/03/2012
Mothers, caregivers and breastfeeding helpers use terms such as successful breastfeeding, breastfeeding failure and successful efforts. Numerous other phrases have been used to describe how much of a baby's daily nutrition intake is provided by breastfeeding, and whether a baby is fed only through breastfeeding (exclusive breastfeeding), fed expressed breastmilk (breastmilk feeding) or fed exclusively with formula. Breastfeeding As Much More Than Delivering Food Breastfeeding is much more than providing food to a baby. It is an emotional exchange; a baby is emotionally and psychologically nurtured from suckling at his mother's chest. It is no coincidence that cradling a baby to breastfeed is similar to holding him in one-half of an embrace! The benefits of breastfeeding cannot be quantified, just as the measure of how well breastfeeding is going extends beyond how much milk the mother is producing. Thinking of breastfeeding this way helps us realise that the standards for 'success' are only half the story. Breastfeeding As An Emotion-Laden Topic For Mothers It is crucial to say, that talk about breastfeeding brings up visceral feelings for many mothers! Framing a woman's breastfeeding experience using terms like 'failure' imply judgement and negativity. For many new mothers, their identity as mothers are influenced by how breastfeeding proceeds. Breastfeeding is, but one aspect of the overall postpartum experience. It seems insensitive then, to somehow try to label those early breastfeeding efforts. Every mother defines, for herself, what breastfeeding success means. What may seem to outsiders as an inadequate attempt often is an overwhelming success for this particular mother because of the circumstances she has dealt with and the journey she has walked. Every individual mother's experience of breastfeeding will be different. While many mothers aspire to breastfeed exclusively for the first 6 months and this is, of course, the ideal scenario, it makes sense that we give women the space to find what works best for them. The Role Of Breastfeeding Helpers An alternative paradigm for thinking about breastfeeding outcome may be considering the degree of fulfilment a woman feels with how breastfeeding is going for her baby and her family. And of course, this is something that the woman herself defines, according to her own expectations, goals and beliefs. Often, though, breastfeeding helpers or counsellors do well to remind mothers of their initial breastfeeding goals, and help them reflect and clarify their options. Many breastfeeding advocates insist that mothers breastfeed according to their ideals. This is, most likely, well-intentioned; breastfeeding supporters often want change and awareness about breastfeeding. They often want other women to experience the precious things that they themselves have discovered. I myself sometimes feel this way. Yet, I realise that empowerment and change come when women themselves go the journey, make their own choices and work out for themselves, what it is that they want. Our role as support people is to facilitate that self-discovery. Mothers benefit from taking responsibility for each of their breastfeeding choices, instead of feeling like they 'were told to supplement' or 'made to wean' their babies. However, it is important that we acknowledge their conflicted emotions and provide a safe space for them to reflect and debrief, ultimately supporting women as they grow as individuals and become conscious parents. Feeling Touched-Out Or Gived-Out? 24/03/2012
Mothers who have been nursing on their babies' cues, for long periods of time past their baby's 1st birthday, or nursing more than one child for consecutive years sometimes feel 'touched-out'. This feels different to different mothers, and ranges from a vague sense of irritation when your child asks to nurse to a full-blown feeling of annoyance. It is perfectly normal and understandable to feel this way; it's wearying to be on-call for another human being all day, and cheerfully obliging with a breastfeed despite feeling tired, sweaty or having a headache. Your nursing child's scratching, twiddling, toe-pinching, kneading and similar behaviours, while usually tolerable, can become unbearable! Many nursing mothers often feel like they just don't want to be touched at all at the end of the day, in a sexual way, in a hug or even with a massage. Breastfeeding agitation is a related scenario for nursing mothers. This refers to negative feelings when breastfeeding. This could be a creepy-crawly physical sensation, like your skin crawling when your nursling latches on, or a tense and anxious feeling, like how you feel when you hear a heavy chair being dragged across the floor. Agitation tends to be more common among mothers who are nursing through pregnancy, nursing a toddler or tandem nursing.  Feelings Of Confusion Or Guilt Any aversion towards breastfeeding or feeling 'touched-out' sends a nursing mother into a quagmire of conflicting thoughts and feelings! We feel confused; how can we feel so irritated towards nursing a child that we love so much? How can we not want to nurse anymore when we feel so strongly about breastfeeding? Negative feelings towards nursing are not a measure of a mother's feelings towards her child or towards breastfeeding itself! They may simply be from wanting our personal space, from being overwhelmed by the constant demands on our bodies and time or originating from our mammalian roots (like mother dogs who throw off their little nursing puppies for unknown reasons). They may also be left over from cultural biases that we ourselves may have but not be aware of - after all, much of mainstream culture has told us for decades that nursing older babies or through pregnancy is 'different' or 'weird'. Self-Care When you have conflicting feelings about breastfeeding, reflect whether you have been taking care of your needs as an individual. Feeling gived-out may be a clue that you have given so much, and you need to replenish yourself. A whole-foods diet, physical activity and taking time to nurture your mind and spirit are important for you to be in a good place to mother your child. Setting Limits As an attached, nursing mother, you may feel like you have to be everything all the time for your baby. You can find ways to meet your child's needs, your own needs and those of your family's. Setting limits around breastfeeding calls for lots of sensitivity and creativity. Often, mothers who want to establish boundaries use many weaning ideas. You may find it easier if your child is older, able to understand and willing to oblige. You may be able to nurse for as long as it takes to sing a song (singing it slowly or quickly, depending on how you are feeling). One mother chose to nurse for as long as it took for her to finish saying the alphabet. Some mothers say that nursies are for going to sleep or while the sun is down, using simple 'rules' that their nurslings can understand.  On A Personal Note I have been pregnant, breastfeeding, or both, for over 10 years now. Through my breastfeeding journey, I've experienced breastfeeding agitation as well as feeling 'touched-out' often. I still don't quite understand these feelings but I've learnt that I feel far more 'touched-out' when I'm physically tired, when I haven't spent time interacting with other like-minded mothers or adults (since I am a people-person!) or when I haven't spent time alone, reflecting to make sense of things, reading or just being. Breastfeeding is an emotional interaction with my babies; it is how we connect. Hence, how I feel about nursing at that particular moment matters a great deal. Feeling irritated, 'tied' to my baby or nursing out of obligation or a desire to 'do the right thing' takes away from the emotional quality of breastfeeding. When I first began toddler nursing, I hadn't thought of it that way, and shouldered on through my antsy feelings. I soon began to see breastfeeding an older baby as a two-way interaction. Letting go of my ideas about having to ignore my needs while breastfeeding has ultimately enabled me to nurse each of my babies through their toddler years! Have you experienced nursing irritation? When do you feel most 'touched-out'? How have you dealt with it? DOULA! 23/03/2012
Yesterday evening, I attended the screening of DOULA! The Ultimate Birth Companion Documentary, hosted by ParentLink. The event included a brief talk by midwife Deb Fox on midwifery care and the role of doulas as well as a question-and-answer session on labour, birth, and all things doula-related. I am heartened by the growing awareness about doulas in Singapore. More couples are informed about the role of a doula and the benefits of having one. Having a doula directly affects a mother's breastfeeding experience after birth. This idea is less well-known amongst mothers-to-be. Doulas offer postpartum visits and help guide a mother's breastfeeding efforts during the early days. A doula will often be a mother's earliest point of resource if breastfeeding challenges arise soon after birth. The benefits of having a doula for breastfeeding go far beyond this, however. A Doula & Your Identity As A Woman & Mother Labour & birth are deeply personal experiences for a woman; they create vivid and long-term images and memories in her mind. Having been treated with care, respect and gentleness through labour and birth helps a new mother emerge, feeling supported and stronger for the experience. A doula's role is to provide emotional support and nurturance for a mother in labour, ultimately enhancing her birth experience. Doulas offer up ideas and information about all the other choices mothers may have at various points in pregnancy and labour. Being aware of alternatives that are available to them give a couple clarity and objectivity as they navigate labour. Women gain a sense of control and empowerment when they are encouraged to make their own choices. After birth, how a woman sees herself as a mother and her feelings of confidence and self-worth determine how she faces breastfeeding, newborn care and other aspects of motherhood. The sense of motivation that a new mother feels as she perseveres through early breastfeeding and parenting challenges is largely determined by her birth experience. A Doula & Birth Interventions In labour, a woman's mind, emotions and body are deeply interconnected. Labour is as much an emotional experience as a physical one. Labour progresses better and the need to intervene in labour is reduced with the presence of a doula. Labour is regulated by a delicate synchrony of hormones. One intervention upsets the intimate hormonal interplay, typically beginning a snowball of further interventions. Mother-baby bonding and togetherness immediately after birth, the beginning of milk production and your baby's first nursings are influenced by your hormones, and potentially affected by labour interventions. It goes to say, then, that having a doula with you as you labour makes a difference to how breastfeeding goes. Do You Need A Doula? Many parents-to-be wonder if they need a doula. It is an added expense. For many women, labour and birth are very private moments; many mothers worry about having another person in the labour room; 'how can I open up and let myself be emotionally supported by someone who is virtually a stranger anyway?' Doulas understand and respect a labouring mother's need for space and privacy. If you need calm, quiet and complete silence to birth your child, your doula will do that for you. If you need to be held in your most intense moments, she can do that too. Your doula understands the rhythm of your birth dance. Could you do without a doula? Chances are, yes. However, having a doula is not simply a privilege, a nice add-on to maternity care. It is how a woman gives birth and becomes a mother. It is how a baby is welcomed into a gentle and warm community. Having a doula is really about our human need for connection during one of our most vulnerable moments. There has been quite a lot of talk about the different types of breastfeeding helpers, their roles, their background, levels of training and credentials. Many breastfeeding helpers have varied training and expertise, and overinflating one's qualifications or being less-than-specific about one's training is most definitely unethical and questionable. My purpose for this post is not really to discuss the various qualifications and the standards for lactation training; rather, I want to talk about the value of different types of support for nursing mothers. Solving Specific Concerns When a mother has just birthed her new baby, she benefits from specific care from a suitably trained breastfeeding helper, preferably within her birth team or in a related unit, to guide her efforts as she learns new skills and learns to fit breastfeeding in with other aspects of newborn care. In the early weeks or later months, as specific breastfeeding concerns come up, a nursing mother benefits from specific hands-on problem-solving guidance from breastfeeding supporters. Lactation consultants often provide excellent care, as do numerous breastfeeding helpers. This sort of targeted, problem-oriented care helps resolve new challenges that may have arisen as well as helps mothers and families iron out problems that may have come from unknowingly neglecting basic breastfeeding principles such as feeding on baby's cues. Breastfeeding counsellors often provide ongoing follow-up, sometimes spanning weeks or months, as 'breastfeeding doulas'. Mothers thrive with this sort of continuity and community-level support.  Day-to-Day Support & Friendship Nursing a baby can be rough-going at times, and as a nursing baby grows older, challenges change. He may be one of the few babies nursing, amongst peers of similar age. Being a nursing mother can be a lonely path to walk, or depending on circle of mothers you spend time with, may simply be a 'different' sort of way to nurture your child. Nursing mothers benefit from spending time on a regular basis with other breastfeeding families. As we are surrounded by other families where breastfeeding has become a norm in daily life, our ideas of 'normal' grow, and we feel confident and whole as parents. Breastfeeding support groups and communities that meet weekly, fortnightly or monthly help to create this sort of setting for nursing mothers to find friendship and companionship. Breastfeeding helpers and counsellors who run these groups offer this type of support. This may well be beyond the scope and time availability for many lactation consultants, but has no less value for nursing moms. Such helpers are more than a resource for breastfeeding information but a channel to guide mothers who need more help towards lactation consultants who can provide more tailored or in-depth care. Whoever You Are In The Breastfeeding Landscape, Nursing Mother, Peer Counsellor, Lactation Consultant, You Do Make A Difference For Every Mother-Baby Breastfeeding Dyad You Touch! I signed a pledge this morning. It is a pledge to support breastfeeding mothers without judgement, and with integrity. With this pledge, I am saying that I will support and work with a mother who wants to breastfeed her baby, regardless of her choices about the technique, position and equipment she uses, how long she breastfeeds for or whichever organisation she chooses. This pledge is especially relevant because there is a huge amount of debate on breastfeeding issues such as scheduling feeds and night-weaning, as well as on parenting styles such as techniques to teach self-soothing and co-sleeping. Although I make personal choices regarding these things with my own children, this should not and do not carry over into the support I offer women. There are practices that facilitate breastfeeding such as skin-to-skin contact after birth and being responsive to a baby's cues to feed; I will offer these ideas to women. However, it is still a mother's choice if she wants to do these things and no matter, I will work with her to reach her goals :). Breastfeeding Is Not An Exact Science! 21/10/2011
In pregnancy as well as in the weeks after, new mothers are inundated with breastfeeding information; information on how to breastfeed, tips for breastfeeding success, breastfeeding rules, techniques for latching and positioning, signs of a good latch...Much of this is necessary for the new mother; the art of breastfeeding a baby is somewhat lost in our culture and many women have never seen a mother breastfeeding before she has her own baby! A set of how-tos and pictures of positions guide new mothers in the early days of breastfeeding. Yet, every mother-baby pair finds its own unique style, and dances to its own rhythm. Latch & Positioning Despite how the latch looks from the outside, the 2 biggest issues that determine whether the latch is 'right' are yours and your baby's comfort, and how effectively milk is transferred to your baby. Soreness, pain and discomfort on your part OR fussing and coming off the breast and rooting for it once again mean that the latch needs to be evaluated. Getting an effective latch also depends on the size of the mother's nipples, areola, and breast as well as the size and shape of the infant's mouth cavity. What constitutes a good latch is really not set in stone, and varies with each mum and bub. The mother's body size and infant's size and age also matter. Specific health issues such as reflux that we onlookers may not be privvy to also influence the baby's comfort in any one position. Choosing the right positions for individual mother-nursling pairs then involves a broad understanding of breastfeeding basics, flexibility, and a willingness to learn from the mother and baby. Prescriptive descriptions may or may not work! Considering the baby's diaper output, weight gain, observing his general well-being and watching for signs of effective sucking and swallowing all collectively let us know about the baby's milk intake. Watching the baby also gives clues about the effectiveness of the latch. Nursing - The Language Between A Mother & Her Baby It's often been said that breastfeeding is more than delivering food to a baby. It is about mothering and nurturing a child; it is about communication. After an intense labour and birth, holding and nursing your baby may be the perfect treat. In the early postpartum days, breastfeeding helps new parents 'find their feet' and sets a pattern and a focus for the days. In the weeks and months after, breastfeeding remains an effective parenting tool.  The Breastfeeding Family What does a breastfeeding family look like? Does the mother work? Do they co-sleep or not? Do they homeschool? Do the parents go out together without the baby? There is no one breastfeeding family prototype-it really is a question of doing what works for that individual family, at that point in time! | AuthorI have 4 young children; I work, study, read and write, organising my day around their needs. I find myself in mothering; I enjoy being around mothers with babies and nursing mothers. I'm a breastfeeding counsellor and childbirth educator. I also write on parenting topics.  Get in touch with me if you'd like me to write for you!
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