WBW: Who Are the Experts?

Most women have some desire to breastfeed.  Many have told me, “I tried to breastfeed, but [I had problems, I didn’t make enough milk, etc.]”  Many people do not have extended networks of family and friends who breastfed and don’t have much support.  Nursing isn’t as easy as it seems like it should be.  Honestly, I believe it’s a bit challenging at first because God designed it to slow down new mothers to keep them resting and healing and not running around.  Anyway, it’s not easy and people have problems.  Who do they turn to?  Their pediatricians.

Several doctors and medical school students have confirmed for me recently that medical school education does talk about the importance of breastfeeding for the health of babies and some of the general advantages to babies and mothers, but the mechanics of it?  How to troubleshoot nursing problems?  Those are not generally well discussed in medical school curricula.

So, who should people call when they need help?  Breastfeeding experts, particularly international board certified lactation consultants and lay helpers like your local La Leche League leaders.  LLL is a great place to get breastfeeding support, before or after you have a baby.

19 responses to “WBW: Who Are the Experts?

  1. I have been wondering why most of the women I know with babies are supplementing brestfeeding with formula. They say that their milk supply dropped. I know that there are women who have this problem and need to supplement. It is just odd that I have met at least two in the last year when eight years ago when I first started breastfeeding I knew at least 20 breastfeeding moms who didn’t supplement or complain about low milk supply (at least they didn’t tell me about it).

    Breastfeeding is hard at first. There were many times I wanted to throw in the towel and use formula. If it weren’t for a terrific breastfeeding support group at the hospital I wouldn’t have continued. Everyone struggled with problems but I always left more determined than ever to continue exclusively breastfeeding.

  2. It’s probably a good idea to get plugged in with a good lactation consultant before you ever leave the hospital with the baby (or in Kristen’s case, before you you homebirth :-) … you never know when something will come up- thrush, colic, slow weight gain, etc. It helped me out a lot to meet the ladies in person that I would talk to every now and then on the phone for support.

  3. We supplement because I’m not able to consistently pump enough while I’m at work, and I can’t imagine trying to find the time to pump while I’m at home. I’m blessed to be able to only be away three days a week (for 7.5 hrs each), but for moms who have to work full-time, I can only imagine how hard it would be. When I get frustrated that I’m not pumping enough, I just have to remind myself that at least I’m keeping my supply up as best I can.

    BTW, our hospital did a great job both times sending the lactation consultant in repeatedly until we had things working. That REALLY helped me.

  4. Pumping IS hard, there is no doubt about that. I have a lot of respect for working moms and moms of special needs babies (cleft palates, etc.) who pump. Pumping is far less efficient than nursing, so keeping up supply is rough.

  5. Most hospitals ought to at least have contact information, if not an in-house lactation consultant for you to talk to. some nurses/nurse practitioners are also lactation consultants as well. A lot of it just depends on your local network of OBs, nurses, midwives, consultants, etc. I know the local hospitals here definitely have in-house consultants, especially since we’re a big medical center.

  6. Kristen….let me know what you think of Parenting in the Pew. We haven’t read it yet, but as Theia gets older, I’m having to do more and more pew parenting. Also, does it address single parenting?

    ~ Moriah

  7. Lenise…It is hard to keep up a good supply while working. I worked for about 3 months and my supply dropped. I forgot to say in my earlier comment that the moms I know now stay at home and don’t work. I’m sorry if I offended you. :)

  8. I don’t think people realize how hard breastfeeding is until they do it. It took two and a half months to get it down to the point that I wasn’t sick and all my sores had healed. I had no idea what I was getting into. I don’t think most people do.

  9. I am a medical student and one of the lectures from my third year pediatrics rotation that I remember best was by a lactation consultant. I definitely learned a lot, and although I do not feel qualified to give breastfeeding advice, I am certainly much more comfortable with terms and a knowledge to encourage and help moms in their desires to breastfeed. I would definitely recommend people talk to lactation specialists before they leave the hospital if at all possible. I know my hospital, MUSC, has 2 full time nurses who do nothing but help the women there with breastfeeding. Plus, if at all possible, women should ask when they have a baby to breastfeed the baby before it goes to the nursery, or at least in the first hour or so of life. Many hospitals (MUSC included)just whisk the baby away to the nursery and then by the time the mom gets to see the baby again, the baby is asleep.

  10. I’m new to this site, but my wife has mentioned several of your breastfeeding posts. We had a rough start with it in mid-May when our first was born, and you are right about the outcome of medical schooling: probably 6 nurses tried to help her in the hospital, and they had 6 different opinions (or maybe 7) on best breastfeeding mechanics.

    But I’m not sure the experts are as unified as you indicate. Our certified lactation consultant suggested we supplement for the first week or so. This ended up being a blessing, because our son has been able to switch between breast and bottle without issue. This has given me some opportunities to bond with him during feeding, and given us added flexibility. Now he gets maybe 1 bottle a week (plus or minus 1, sometimes pumped milk, sometimes formula). I think the health drive for “exclusive” breastfeeding for 6 mos is more related to getting the right antibodies and other things that won’t be damaged by missing it 3 or 4 out of 35-50 feedings a week.

    Anyway, from some of your posts I’m reading, this is clearly quite important to you, but may I urge you to not let it become out of balance. Your identity is in Christ, not in your children or in breastfeeding.

  11. Yes, of course my wife finds her identity in Christ. This is simply one week out of the year that she posts regularly about breastfeeding (as it is World Breastfeeding Week). As her husband and head of our family, I take my responsibilies of the spiritual well-being of my family seriously.

    As to your point, while exceptions and certain isolated case studies are important to remember (as all experiences in parenting are unique), they certainly do not disprove the general thrust of her post. As she notes in her comments above, there are times to pump and supplement, but the tendency in this country to pump and/or supplement when it is not necessary, due to lack of training/knowledge on the parts of medical colleges.

  12. It’s not a general lack of knowledge, but a lack of practical knowledge to actually help mothers breastfeed better. We all know it’s better to breastfeed. We’re all taught that in Ob and peds, but the question is how to convey that well to mothers and their social circles (that significantly influences whether or not a woman will breast feed – they’ve done studies on that, the prototypical situation being low SES urban African-American women) such that they will breast feed and seek help when they have difficulty.

  13. I guess I just haven’t done the research or spent time in the circles in which breast-feeding is poo-pooed, so I don’t see the need to focus on it. In what specific circles is it still frowned upon?

  14. Phil,
    That’s what I meant, practical knowledge. It’s hard to support people having trouble without a lot of practical knowledge. One of my dear friends from college (and an occasional reader of this blog) just graduated from Mount Sinai and she actually took lactation consulting classes concurrently which is think is AWESOME. Anyhow, I wish more practicing peds were more helpful and informed about the mechanics of breastfeeding.

    Kibble,
    If you look at the first post of this series, I link to the statistics and they are still very lackluster. Lower income circles are still lagging very far behind those numbers, too. As far as my identity, I don’t think reading my blog is really the best way to judge where I find my identity. It’s not even a good indication of my personality or interests. It’s world breastfeeding week and I’m blogging about breastfeeding. After almost six years of blogging, I blog about a lot of crazy things, and far less spiritual, personal and emotional things than I did long ago, which is a personal choice. I urge you not to judge people based on the subject of their blog posts.

  15. The problem is that very few medical schools, if any, offer lactation consulting as a part of either medical school or even peds/ob residency. Your friend may or may not have done that as part of the curriculum, or they may have sought it out on their own (I’d bet on the latter, in all likelihood). If they at least would offer it, I’m sure many peds/ob interested folk would do it. Additionally, one driving force in today’s practice of medicine is what is billable. For MDs, talking, is generally not billable, and therefore not done very often for things such as breast-feeding. Not justifying such a lack of talking, but explaining certain driving forces in today’s culture.

    In our experience, in several different settings in and outside of the US, lower SES generally tends to trail upper SES in BF for many different reasons, and not the same ones everywhere.

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  17. Phil, when we were in Austin the lactation consultant got down and physical w/ Kristen when getting Kate to nurse. Perhaps that would be billable? J/k.

  18. The Mt. Sinai student took the lc classes on her own. She’s awesome!

    Some pediatricians pay a few nurses in the practice to take LC classes so that someone in the office can give good practical advice. (Our wonderful ped in Austin springs to mind.) Since time = money for docs (both classes and in the office later) this seems like a decent middle ground.

  19. Yeah, if I were an FP, OB, or pediatrician, that would be what I’d do as well.

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