Birth Hand Expression Galactagogues

J A N U A R Y | 2 015 |
ISSUE 27
Today
Birth
Galactagogues
The Power of
llli.org
Hand Expression
01
TABLE OF CONTENTS
To day
4
8
10
12
What Joyce Taught Me
About Birth
18
Mom To Mom:
LET GO!
The Power of Hand
Expression
Mother's Stories:
•High Heels and Lipstick
•Was It Worth It?
•Ripples on a Pond
22
24
Galactagogues
Keeping Fit and Well
What’s Cooking ?
Raising Healthy Eaters.
Lessons Learned from
Breastfeeding
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To day
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EDITOR’S NOTE
To day
Issue 27 | 2014 | Volume 12 | Number 27 © 2014,
La Leche League International, Inc.
Managing Editor | Barbara Higham
A New Beginning
Contributing Editors | Review Board |
Lydia de Raad, Gwen Gotsch, Carol Kolar, Kathleen
Whitfield, Lisa Hassan Scott, Johanna Rhys Davies,
Johanna Horton
Art Director | Josh Dobbs
Cover Photo | belleverdiglionephotography.com.au
Photo Credits | pg4&6
belleverdiglionephotography.com.au, pg8 Meave
Haughey, pg12 Jess Wimpenny, pg13 Emma
& Josiah, Photographer Lisa Scott, pg14 www.
istockphoto.com/claudiad, pg18 Shutterstock.
com, pg20 Shutterstock.com, Laura Brown by
jvcphotography, pg23 Monica Duke, pg24&26
Katja Leccisi
Advertising Manager | Barbara Higham
Web Development | Dave Davis, Shelly Stanley
Acceptance of paid advertisements
does not constitute an LLLI endorsement
of the product advertised. LLLI does
not require advertisers to carry product
liability insurance.
How appropriate to start our first issue of the new year with an article about birth! Teresa
Pitman writes about natural birth and the influential role her mother and doctor played in
helping her achieve normal births without the need for medical intervention. Teresa’s story
resonates with me because I have fond memories of giving birth unhurriedly in the comfort
of my own home. My nine-year-old daughter loves to hear and recount the story of her own
gentle birth in water. I hope my happy story will stay with her as she matures and encourage
her to have a positive approach when she embarks on a pregnancy of her own.
Another article that is suited to the January fresh start is Lisa Hassan Scott’s “Keeping Fit and
Well” in which she examines how mothers looking after small children can incorporate caring
for their own important needs for fitness and well-being into the day to day. In our “What’s
Cooking?” column, instead of recipes this time, we have an article from a dietitian about the
lessons we learn from breastfeeding that teach us how to raise healthy eaters.
What is a galactagogue? Philippa Pearson-Glaze explains with herbal and medicinal examples.
And Diana West examines the power of hand expression.
We have mothers’ stories and letters from new moms to grandmothers and the whole magazine
is beautifully illustrated. Please send me your stories and photos for publication to editorbt@llli.
org and join us on Facebook, Twitter and Google+.
Happy New Year!
Mailing Lists: LLLI sometimes makes its mailing list of
members available to reputable outside
groups. If you prefer not to receive these
mailings, notify LLLI at [email protected].
La Leche League International fully supports
the WHO (World Health Organization)
International Code of Marketing of
Breastmilk Substitutes.
LLLI Board of Directors, (2009, 2010)
Barbara
[email protected]
(Photos for publication need to be well lit, at around 300dpi, and have no photo modifications
such as borders/frames, textures, wording or titles, or filters such as sepia tone.)
Barbara Higham has been a La Leche League Leader since 2004 and is the managing editor
of Breastfeeding Today. She lives in the spa town of Ilkley, West Yorkshire, in the north of
England with Simon and their children, Felix (16), Edgar (13) and Amelia (9).
Visit and “like” us on Facebook:
www.facebook.com/BreastfeedingToday
and at www.breastfeeding.today
Breastfeeding Today is published by La Leche League
International Inc., 957 N. Plum Grove Road, Schaumburg, IL.
60173 USA. Telephone 847-519-7730 [email protected]
(9 AM to 5 PM U.S. Central Time). Visit our Website at llli.org.
Canadian subscribers should contact LLL Canada at
PO Box 700, Winchester, ON K0C 2K0, Canada, or
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Follow us on Twitter: https://twitter.com/BreastfeedingT1
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04
belleverdiglionephotography.com.au
What Joyce Taught Me About Birth
My
My dear friend Joyce Barrett died of cancer
in January of 2014. We had been friends
for a long time, although when we first met
she was just the new family doctor who had
been recommended to me. I immediately
loved her warmth and down-to-earth style,
and it was into her hands that my next
two children were born. Over the years,
our doctor-patient relationship became a
true friendship, and eventually we wrote a
book together. By then, Joyce had stopped
being a general practice doctor and was
specializing in caring for women during
pregnancy and birth—her true passion.
Unlike most of her North American peers,
my mother had no medication. She loved
to tell me the story of her labor—how she
walked around the garden paths with her
own mother at her side—and the birth,
where her mother supported one leg and a
midwife supported the other as I was born.
The midwife then laid me on my mother’s
chest and when I headed straight for the
nipple told my mother, “Well, she knows
what she’s doing!”
So I went into pregnancy with that story
in my mind. If my mother had given birth
without drugs and found it a positive
When I had my first baby (in 1977) I was experience—one she liked to share with
lucky. I had been born in England: my us—why couldn’t I?
mother had gone to a local birth center,
where I was delivered by a midwife.
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The doctor I was seeing at the time,
however, had different ideas. He had his
own method of managing labor, one that
was popular with other doctors in our
community at the time. I would be given a
narcotic as soon as I arrived at the hospital
and then an epidural as the time for the
birth approached. He’d delivered lots of
babies, so he knew this was the best way
to do it. I hadn’t even given birth to one, so
he felt I couldn’t possibly know what I was
talking about.
Maybe I was inexperienced, but I knew
I came from a long line of women—as
we all have—who had given birth without
narcotics and epidurals. I decided to find
another doctor, one who was willing to
support me in my plans. My 8 lb 15 oz baby
”
Teresa Pitman
boy was born at 42 weeks and two days
gestation, into the hands of my new doctor.
No narcotics, no epidural. He nursed right
away.
for example) are actually making things
more dangerous, not safer. The “safe side”
when it comes to birth is the side with the
fewest interventions.
The seven women who founded La
Leche League were being pretty radical
for their time when they wrote that
“Alert and active participation by the
mother in childbirth is a help in getting
breastfeeding off to a good start.” In the
1950s, most women were medicated
during labor and birth and most had no
memory of the experience afterwards.
Joyce pointed out to me as we reviewed
study after study that anything that stresses
the mother is a risk factor. I should have
known that: I grew up on a farm, and it was
very apparent that animals under stress
slow down or stop their labors. I remember
waiting much of the afternoon with my
sisters for one of our horses to give birth,
hanging around the stall as the mare moved
restlessly and contractions tightened her
belly. Finally my mother insisted we come
in for a bite to eat. We hurriedly ate our
supper then ran back to the barn, where
the mare was already licking clean her
newborn filly.
Over the next few decades, a revolution
began to take shape. Women were asking
for “natural childbirth.” As the Founders of
LLLI suggested, they wanted to be aware
and involved in labor and birth. They were
concerned about the possible effects of
labor medications on themselves and their For some women, moving to the hospital
babies. They started writing birth plans and is stressful. For others, staying at home
hiring doulas. I was one of these women.
would be. Having the right people with you
matters too. When Joyce sat with me during
The doctor I had found who let me have my my second labor, her calm and reassuring
first baby without drugs moved away by the presence gave me confidence. As I
time I was pregnant the second time. My struggled through the intense contractions
hunt for a new caregiver led me to Joyce. I of the transition stage, she said: “Hurts
had lucked out again.
like hell, doesn’t it?” Yes, it did. Then she
added, “But you can get through it.” She
Joyce had a sign in her office that said, was right about that, too.
“Remember, I could be wrong.” She
expected her patients to call her by her first Knowing that interventions have risks
name. And she believed that pregnancy doesn’t mean they should never be used.
and birth were normal, natural processes.
As an experienced doctor, Joyce had been
at births where a cesarean section saved
While that belief was the basis of her the life of the baby or the mother, or where
approach, Joyce also believed very strongly an epidural relieved pain that was beyond
in the importance of high-quality research. that which the mother could cope with.
When we wrote our book on pregnancy Her message was that we should always
and birth, it was based on the Cochrane keep the risks and benefits in mind, so
Reviews—carefully analyzed analyses of that interventions are not used without
published research studies.
due consideration.
I’d read plenty of research before. But as
we worked through the process, going
through study after study, I was actually
surprised to realize something that should
have been obvious: every intervention has
risks. All of them. Even an intervention that
seems as simple as putting a mother on
bed rest has risks for mother and baby.
For example, if a mother is going to have
an epidural, what can be put in place to
help the baby get going with breastfeeding
once it is born, since the epidural can
affect his sucking abilities? If a mother has
a cesarean, who will be available to teach
her how to breastfeed while protecting her
incision? How will we respond to reduce
the risks?
05
Joyce’s great gift to me—and to the
thousands of other women she walked
through labor with—was her confidence
in a mother’s ability to give birth. Many of
the young women I know today are afraid
of birth. They know only that it’s painful and
difficult and they expect to need medication
to get through it.
Joyce would look puzzled if you told her
you felt that way. She’d remind you of the
generations of women in your ancestry
who had birthed without medication
or interventions beyond perhaps the
encouragement of a midwife. She’d remind
you of everything your body had already
done for you in creating and growing a
baby. She’d encourage you to give your
body every possible chance to do its job of
getting the baby out. And she’d promise to
be with you throughout the process.
If my mother
had given birth
without drugs and
found it a positive
experience—one she
liked to share with
us—why couldn’t I?
In labor, she’d encourage you to listen to
your body for every signal, and she’d tell you
about the research that shows how women
who move freely in labor naturally walk or
sit or stand in ways that help the baby move
into a better position for birth. She never
coached you to push, but reminded you that
the research showed women who began
pushing only when they felt the urge were
less likely to have tears in their perineum or
babies with low oxygen levels.
Joyce retired from practice early. I’m glad
she had those extra years with family and
friends because in her late 60s she was
diagnosed with cancer. Even as her health
Many things people do to “just to be on the
safe side” (having a fetal monitor in place,
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To day
06
The Birth-Breastfeeding Connection,
Excerpted from The Womanly Art of
Breastfeeding 8th edition Issue 18 http://
viewer.zmags.com/publication/33d8f1e8#/3
3d8f1e8/22
I Want a Natural Birth Issue 24 http://viewer.
zmags.com/publication/7792b368#/7
792b368/10
My Emergency Cesarean Issue 23 http://
viewer.zmags.com/publication/29d112e6#/
29d112e6/12
Books
Dick-Read, G, Childbirth Without Fear:
The Principles and Practice of Natural
Childbirth, 2013, 4th edition.
belleverdiglionephotography.com.au
deteriorated, she still loved to talk about Further reading
birth and babies and share information from What Your Baby Knows About
the most current research.
Breastfeeding Issue 20 http://viewer.zmags.
com/publication/ed9fb378#/ed9fb378/6
I miss Joyce every day. She made a
profound difference to me and to so many Birth and Breastfeeding Issue 19 http://
other women. I am so grateful to have had viewer.zmags.com/publication/fd9eb27c#/
her as a friend, and to have been able to fd9eb27c/6
learn about birth from her.
Teresa Pitman has been a La Leche League
Leader for 35 years. She is one of the coauthors of the LLLI books The Womanly Art
of Breastfeeding and Sweet Sleep and is the
author of Preparing to Breastfeed: A Pregnant
Woman's Guide, plus 15 other books. Her
book with Dr. Joyce Barrett, Pregnancy and
Birth, is now out of print. Teresa is the mother of
four grown children and the grandmother of six. Teresa came across this article shortly after
writing hers and thought its author was saying
the same things she was.
http://m.theatlantic.com/health/
archive/2012/03/the -most- scientificbirth-is - often-the -least-technologicalbirth/254420/?single_page=true
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Gaskin, Ina May Birth Matters. A midwife’s
manifesta, 2011, Pinter and Martin.
Goer, H. The Thinking Women's Guide to
Better Birth, 1999, Penguin.
Pitman, T. Preparing to Breastfeed.
A Pregnant Woman’s Guide, 2013,
Hale. www.ibreastfeeding.com/books/
preparing-to-breastfeed-a-pregnantwoman39s-guide-333.html
07
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Affiliated with:
•
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Mom to Mom
08
MOTHER’S SITUATION
LET GO!
My nine-month-old son will only fall asleep if I am
breastfeeding him, day and night. For daytime
naps, I have to lie down with him, and if I try to get
up he immediately awakens and starts to fuss until
I lie down with him again. At night it is the same
story, and we spend three-quarters of the night in
the same bed. Breastfeeding has been going well
for us, and he is mostly a happy, healthy boy, but
I am exhausted by his constant need for physical
contact. How can I ever put my baby down to rest
without his needing me to be there? Do other
mothers find this problematic? My mother-in-law
tells me I have “spoiled” him and that I should let
him cry it out, but that is not an option I am prepared
to consider. I am feeling “touched out” and would
appreciate hearing from other mothers who have
dealt with similar feelings.
Response
Both of my children have been
like this at different phases in
their first years of life. Settling
in with a smart phone or a
book helps to pass the time
until they are soundly asleep
(or done napping). I wore my
son in the sling for his nap
and I could keep up with
my preschooler at the same
time. Using a sidecar crib has
helped. It helps with nighttime
feedings because I have the
comfort of my own bed and
do not have to get up to nurse
him. Most important for me
is to remember that this is a
season and does pass. Each
child and the length of time are
different but I consider it an
investment in helping my children be secure and confident
as they grow.
It is helpful to make some
alone ‘me time.’ Find and enjoy
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something renewing. It might
just be 15 minutes a day or
a couple of hours every few
weeks. Find what refreshes
your spirit and make time for it.
Alina Mattson Pohm,
Montgomery, Alabama, USA
Response
I remember being that
touched out. I read that it
takes a baby longer to reach
a deep cycle of sleep during
a daytime nap. I would lie
down with my baby on the
bed, in such a position that
we were only attached at the
breast and not touching at
any other point. Then when
she was really asleep, I would
slide a finger into her mouth,
to detach her, and roll away.
Initially I had a 50% success
rate that went up to 85%,
thwarted by trying to move
before she was fully asleep.
Having a good book by the
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2015
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llli.org
Meave Haughey
bed helped as did accepting
my baby’s needs were just
that, needs. To a baby, if you’re not there,
you’re gone forever and it’s
panic stations. I would try
to listen for her stirring, so I
was there when she woke
up. Mastering back carries with
my wrap sling, so she could nap
on my back was a help. I would
let her feed to sleep, transfer
her from front to back, tie her on,
and get on with what I wanted to
do. Sometimes she would go to
sleep on my back without nursing, which was great.
Nighttimes, well that’s a hard
one. At nine months we tried to
get our baby to settle in the cot
so she would sleep on her own.
For about a week, I would nurse
her to sleep, try to put her down,
only to have those eyes shoot
open and the crying start. After
a week of really bad nights we
decided to go back to co-sleeping fully, but with the cot by the
bed at the same level, so I would
follow the same technique as
daytime naps, getting her to
sleep and then rolling away, with
about the same rate of success.
Babies seem to have heat sensors, and will roll toward you
and end up sleeping under your
armpit, even if they start out in
their own space on the bed. Every child is different, and my
first has a much higher need
for physical contact and is
much more emotionally sensitive than my second. When my
second would happily sleep on
her own in the Moses basket,
I wondered what was wrong
with her! At night she nursed to
sleep, but tandem nursing the
two of them to sleep left me
with nowhere to roll over, so
usually I’d make the best of it
and sleep too.
They do grow out of that
intense need for your presence. It takes a while and the
intensity comes and goes in
phases. Living through it all can
be tough. It’s very tiring and
other peoples’ expectations
can make it more so, but when I
look back on it, it went so fast!
They still like milk and cuddles
to go to sleep, but cuddles
with dad or grandma will do,
and they need me less in the
09
daytime too. I have sometimes
resented that my husband got
to watch TV or chat while I was
settling the kids, but equally
he felt left out and inadequate
when they would settle for me,
while crying for “mummy milk”
when left with him. On the plus
side, I get lots of cuddles.
asleep! It’s also distressing
when you’re having second
thoughts yourself, to hear criticism from others that leaves
you worrying it might be all
your fault! Many moms have
been in your situation!
Sometimes relaxing helps
and accepting that this might
There were a couple of books
be physically good for you,
that helped me particularly,
helping to give you the extra
Nighttime Parenting: How to
rest you need. Meditation,
Get Your Baby and Child to
breathing exercises, and other
Sleep by William Sears and
relaxation techniques can all
Raising Your Spirited Child:
contribute. As unbelievable as
A Guide For Parents Whose
it sounds right now, your child
Child Is More Intense, Sensitive, will outgrow this stage, even if
Perceptive, Persistent,
you do absolutely nothing!
Energetic by Mary Sheedy
Cicely Rodal, Cary, North
Kurcinka which helped me see Carolina, USA
that some children’s needs are
just more intense than others,
Response
not wrong, not right, just differ- My son did the waking up from
ent. I also found the LLL meet- a dead sleep when I rolled
ings very helpful, as most of
away, until we had his food
the other mothers were coping sensitivities all figured out. So
with the same things.
that might be something to
consider investigating.
Hope this helps you realize
Lynn Biberdorf Carter Ofs,
you are not alone. Kirksville, MO, USA
Mary Baxter, Chilwell,
Nottingham, UK
Response
I remember what it was like
Response
when my youngest child
I love taking the opportunity to wanted to breastfeed almost
relax when we nurse to sleep.
ceaselessly. I found it hard
I bring my phone and catch
to devote so much time to
up on emails and Facebook,
breastfeeding while my two
and sniff my little guy’s head
older children also needed my
a few times even after he’s
attention. There were occaasleep. I find that is worth that
sions I felt sheer exhaustion
extra “staying” time so that he
at not being able to break
is deeply asleep when I climb
away from my daughter. The
out of bed.
slightest move was enough
Tova Ovits, Brooklyn, NY, USA
to awaken her or result in her
feeding with increased vigor
Response
while apparently asleep.
It can be so draining, feeling
as if you are tied to your baby! It got easier when I fought it
I remember that antsy feeling,
less. What made it easier at
when you’re forcing yourself to nighttime was not getting up
lie still when all you can think
when she awoke because we
of is all the stuff that needs
shared the same bed for a year.
doing or when you’re resenting the fact that you aren’t
You are responding to your
son's needs and this shows that
he is loved rather than “spoiled.”
Emer Martin, North London, UK
the blanket, so that he still
feels that same warm surface
against his back and isn’t
as likely to startle awake.” A
simple and effective technique!
Jenny Maguire, Glasgow,
Scotland, UK
Response
I found the most recent
book from LLLI Sweet Sleep:
Nighttime & Naptime Strategies
for the Breastfeeding Family
http://www.llli.org/sweetsleepbook full of excellent solutions.
On page 71, the suggestion
to this difficulty is to wait until
your baby has been asleep for
a while. You can tell if he is in
a deep sleep by gently lifting
and dropping his arm. Wait until
his arm is totally limp when you
let go, then he isn’t as likely to
wake up when you “ooze” him
away from your breast.
Response
I empathise! I feel this frustration too when my baby
demands so much physical
presence. I find I cope best
when I let go of my feelings
of resentment and try to treat
myself in small ways to make
up for all the time I no longer
get to spend my way. Oh, and
your mother-in-law is just
plain wrong, because how can
you possibly spoil a baby by
making him feel loved? You are
building his trust in you and
helping him develop a sense of
his own security.
Martha Hansen, Odense,
Denmark
If you are sitting up and want
to lay him down, the authors
say, “you might want to start
by breastfeeding him with
a receiving blanket at his
back. Then you ooze him with
MOTHER’S NEW SITUATION
BONDING WITH DADDY
My husband was initially quite supportive about the
idea of my breastfeeding our baby, agreeing that it
was the healthy choice, but since our son’s birth, two
and a half months ago, he has had a change of heart.
He seems to resent the time I spend breastfeeding
and appears frustrated and jealous that he is unable
to calm the baby as easily as I can. Breastfeeding
is going quite well but, of course, takes up so much
time that my husband perhaps feels excluded. He
keeps telling me I should introduce a bottle and that
I need to get back to “normal.” I want to continue
exclusively breastfeeding until six months and don’t
want any one else (not even my husband) to feed
my baby. Am I being selfish? How do other fathers
of breastfed babies behave in the early months?
How can I help him bond with our baby and carry
on breastfeeding without causing a rift between us?
Please send your responses by January 12th to
[email protected]
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10
The Power of Hand Expression
By Diana West, BA, IBCLC
I was a new mother struggling with
low milk production and a baby
who wouldn’t nurse when the first
effective “consumer grade” breast
pumps were invented. I’d been
renting a hospital-grade pump to
remove my milk, but the idea of
owning a good quality pump that
was more portable enticed me
to buy a double-sided electrical
model. It looked so cool! It was in
a black bag designed to look like a
briefcase so it could be carried to
work discreetly. I wasn’t working,
but I loved the way it made me
feel efficient and smart. I was in
the first wave of breastfeeding
mothers to flock to this type of
pump, and millions have been
sold over the years.
Knowing what I’ve learned since
those days, my heart sinks to think
I put such stock in a cool looking
pump when my own two hands
could have done a better job.
But expressing my milk by hand
never crossed my mind then. My
impression of hand expression
in those days was as a last
resort when a good pump wasn’t
available. My mind has changed
quite a bit since then.
11
I now see hand expression as far more
powerful than pumping in many ways.
Research has shown that it can be more
effective at removing milk in the first days
after birth when the colostrum is thick
and the breasts are swollen. 1 Pumping
colostrum leaves only sprays on the side
of the bottle that are hard to give to the
baby, but hand expression into a spoon
saves every drop. Hand expression can
also be used as a technique during and
after pumping to increase caloric content2
and remove more milk.3 It can be more
reliable than a pump when electricity is
scarce. It’s quieter than a pump when
privacy is needed. It’s certainly less
expensive than a pump. But I think the
most powerful aspect of hand expression
is the way it affects our perception of our
breasts and what they can do.
breastfeeding confidence, but also how
long they breastfed. 5 Experimenting
slowly with hand expression to figure out
what it takes to get drops of milk can be
empowering, especially during pregnancy
before there’s any pressure to express milk
for the baby.
In my experience, there’s no one right way
to hand express. When I was nursing my
first baby almost 20 years ago, I remember
being taught the Marmet Method of Milk
Expression, which was developed by Chele
Marmet, one of the pioneers of the lactation
consultation field. Over the years, there
have been several other official methods,
many of which are now demonstrated
on YouTube. But I think hand expression
methods are best used as a starting point
to figuring out what works best on your own
individual breasts. We’re all different, and
Many young women have an uncomfortable what works for you might be different than
relationship with their breasts before they what works for me. The one movement
become mothers. They’re usually aware of that I find helps no matter what else you do
the sexual aspects of their breasts before is to move the skin over the breast tissue
they think about their ability to make milk. instead of sliding your fingers over the skin.
As an erogenous zone, women often feel You’ll also almost always get milk to spray
it’s more appropriate for their partners to by compressing just behind the areola
handle their breasts than to touch them where there’s a sort of “sweet spot.”
themselves. There can be a delicate
balance between breasts as sexual power Getting to know the landscape of your
and targets of sexual vulnerability.
breasts and the way they work can help
you start to think of them as your breasts.
You may feel a slowly growing pride as
you see that they can feed and soothe
your baby. You’ll start to appreciate their
superpower. After a few days of nursing,
you may realize that your breasts are your
connection to this baby with whom you are
falling so deeply in love. That’s the power of
hand expression.
”
I think hand expression
methods are best used
as a starting point
to figuring out what
works best on your own
individual breasts.
Many women have discovered that learning
how to hand express during pregnancy
helps them feel more comfortable touching
and handling their breasts. I jokingly call
this “making friends with the girls” when I
suggest the idea to a client. That usually
makes her laugh and lightens the mood,
but there’s some real truth to it. One study
found that learning hand expression during
pregnancy increased mothers’ confidence
and readiness for breastfeeding.4 Another
study found that it increased not only
Footnotes
1 Ohyama M, Watabe H, Hayasaka Y. Manual
expression and electric breast pumping in
the first 48 h after delivery. Pediatr Int. 2010
Feb;52(1):39-43.
2 Morton, J., et al. "Combining hand
techniques with electric pumping
increases the caloric content of milk in
mothers of preterm infants." Journal of
Perinatology 32.10 (2012): 791-796.
3 Morton J, Hall JY, Wong RJ, Thairu L,
Benitz WE, Rhine WD. Combining hand
techniques with electric pumping increases
milk production in mothers of preterm
infants. Journal of Perinatology 29.11
(2009): 757-764.
4 Forster DA, McEgan K, Ford R, Moorhead
A, Opie G, Walker S, McNamara C. Diabetes
and antenatal milk expressing: a pilot
project to inform the development of a
randomised controlled trial. Midwifery. 2011
Apr;27(2):209-14.
5 Flaherman VJ, Gay B, Scott C, Avins A,
Lee KA, Newman TB. Randomised trial
comparing hand expression with breast
pumping for mothers of term newborns
feeding poorly. Arch Dis Child Fetal
Neonatal Ed. 2012;97:F18-23.
Resources
See http://newborns.stanford.edu/Breastfeeding/
HandExpression.html for a demonstration video.
Maya Bolman, IBCLC and Ann Witt, MD, FABM,
IBCLC: http://bfmedneo.com/BreastmassageVideo.aspx
Diana West is a La Leche League Leader and
The Womanly Art of Breastfeeding 8th edition, 292–293
an International Board Certified Lactation
Consultant in private practice. She is the co- http://www.llli.org/thewomanlyartofbreastfeeding
author of three La Leche League International Tear-Sheet Toolkit: http://www.llli.org/toolkit
books: Sweet Sleep: Nighttime and Naptime
Strategies for the Breastfeeding Family, The
Womanly Art of Breastfeeding, 8th edition,
and Defining Your Own Success: Breastfeeding
After Breast Reduction Surgery. She is also
the co-author of The Breastfeeding Mother's
Guide to Making More Milk. She lives with
her husband and three teenage sons in the
picturesque mountains of western New Jersey
in the United States.
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others’
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Emma & Josiah, Photographer Lisa Scott
High Heels and Lipstick
Rachel O’Leary, Cambridge, UK
Clickety-clack,
clickety-clack. Must be ten o’clock. There
goes Carol from up the road in her high
heels, lipstick bright, hair neat, covers on
the pram spotless. I twitch the curtain so
she can’t see me – still in my dressinggown, hair all over the place, house
covered in laundry – and sit on the stairs to
feed the baby… again.
How does she do it? Why can’t I be like
that—organized? Am I “coping”? Doesn’t
feel like it. Sometimes it’s blissful, when the
baby relaxes in my arms and falls asleep at
the breast. Often it’s stressful—when she
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screams and I can’t understand why and
don’t know what to do about it…
Somehow, we got through those days, and
nights, and sometimes I even made it out
of the front door—to a La Leche League
meeting on good days! (I was always late,
but they didn’t seem to mind).
to get out of the door, and the high heels
and lipstick were to make me feel as if I was
“coping” when I wasn’t at all!’
I wished I’d known; we could have had
a laugh about it when we needed to. I
wish I hadn’t assumed I was the only one
drowning in isolation. I wish I’d got to know
her better, and allowed her to know me
Years later I met Carol at work, when our with all my failings. I wish women could
children were teenagers. With a wry smile, I help each other more and compete less.
told her how I’d been so impressed by her,
all those years ago. She chuckled and said, From Musings on Mothering (Mother’s
‘That’s the only way I could stay halfway Milk Books, 2012) store.llli.org/public/
sane! I was falling to bits at home, I just had profile/671
llli.org
Mothers’ Stories
13
Jess Wimpenny
providing one-to-one support, information
and encouragement. I have one Leader in
particular to thank: Jo, you were fantastic,
being there for me when I needed you
the most. How can I ever repay your
knowledge, care and kindness? When you
came to my home to watch me feed and
offer help—that was special, beyond words.
It’s no coincidence you have the digits 999
in your phone number—you are the fourth
emergency service! Thank you to my supportive boyfriend
Adam for being with me every step of the
way, providing encouragement whenever I
needed it. Thanks mum and dad for being
there for me, to my sister Natalie for her
advice when I didn't know which way to
turn and to Sue for taking time off work to
help look after Isabella while I attended my
doctor’s appointments. ”
Was It Worth It?
Jessica Wimpenny, Silsden, West Yorkshire, UK
Prior
to my baby’s birth I
decided to opt for
breastfeeding her. This decision was
based on the apparent ease of it as a
feeding method, the knowledge that
I could be anywhere at any time and be
able to feed my baby.
I remember shopping with my sister and
looking for clothes that would be suitable
for feeding in and my sister saying that not
everyone is able to breastfeed, so not to
spend loads of money on special clothes in
case I didn’t manage to do it. Before I actually came to try breastfeeding,
I imagined you just put your baby to your
breast and he would suck away. The first
challenging eight weeks were proof this
was not necessarily the case. The demands of motherhood soon became
reality. My breasts were extremely full of
milk, making a good latch very difficult. Then
a dreadful fever set in. We had a Sunday
evening trip to Accident & Emergency at
the hospital, where the doctor confirmed
I had mastitis and prescribed a course of
antibiotics. Mastitis was very persistent and
I was on antibiotics for a total of five weeks,
which led to my immune system being
A recent LLL meeting I went to had the
theme “Was it worth it?” Any mother who
has experienced that incredible feeling of
sorely tested. Then I gained a burning the warm connection with her baby, the
sensation in my nipples and sat in bed best cuddle ever, will know that even with
with tears streaming down my face. The all the struggles and tears, breastfeeding is
pain was unbearable. At another trip to an definitely the best thing to have mastered. out-of-hours clinic, the doctor diagnosed
thrush. After this cleared up, my breasts I have continued to attend the monthly LLL
began to feel lumpy, so I booked another meetings, as they are a great way to make
doctor’s appointment. I was referred to new friends, share experiences, and chat
hospital and after various doctors prodded with like-minded people. and poked me, I was told I had cysts caused
by blocked ducts. The cysts were drained. I I hope my story provides others who are
had to attend a breast clinic weekly to have struggling with comfort that there is light
this unpleasant procedure carried out.
at the end of the tunnel. You can be tested
to the limit yet overcome such problems to
The final feeding issue I had to overcome reach your breastfeeding goal.
was an overproduction of milk, which was
tricky to get under control, but necessary
to prevent Isabella from choking on the
fast flow of my milk. And my clothes were
continually drenched in milk! When you
have recently given birth to a baby, you
want most of all to be at home having
cuddles, getting to know your new family
member. Instead, I found myself on a roller
coaster journey having to overcome all the
challenges thrown at me. I had never felt more pain, emotion and
exhaustion. At the same time, I had never
felt such drive, determination and passion.
La Leche League mothers were amazing in
Before I actually
came to try
breastfeeding, I
imagined you just
put your baby to
your breast and he
would suck away.
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Ripples on a Pond
Kathy Dettwyler, Newark, Delaware, USA
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www.istockphoto.com/claudiad
”
Mothe
rs’ St
15o
In
October last, one of the Founders
of La Leche League died at the
age of 87. Mary Ann Cahill was one of
the original seven women who nearly
six decades ago were sitting around in
Franklin Park, Illinois, talking about how
to support each other in their mothering
journey through breastfeeding and how
to extend that support to other women.
Today, La Leche League International is
a vibrant organization with information
and support available for women all
over the world, in many languages, and
through many different media. I have only
had the good fortune to meet two of the
Founders in person, Edwina Froehlich
and Marian Tompson, but the importance
of all seven of these women to my life—
both my career as an anthropologist and
my experiences as a mother—cannot be
overstated. I owe them a debt of gratitude
that I can never repay directly: I can only
try to pay it forward, extending the ripples
they started on a pond when I was just a
nursing infant myself.
Growing up, I was the youngest of three
girls. I had only babysat for other people on
a handful of occasions, and neither of my
older sisters had children. I had never given
a moment’s thought to having children,
or to how I would feed them, how I would
care for them, or where they would sleep.
I had no knowledge, and no opinions,
about child care. Fortunately for me, Martha
Toomey came into my life in 1977, when I
left California and headed off to graduate
school. Along with her husband Ron, and
my soon-to-be-husband Steven, Martha had
moved to Bloomington, Indiana, and had
given birth to her son Brian in the summer
of 1979. My own journey as a mother began
on a fall day that year. I had just found out
I was pregnant, and after telling the fatherto-be, I next went to see my friend Martha,
who had a four-month-old son. When I told
her the good news, she gave me a hug and
said, “Oh, that’s great! You’ll have to come
to a La Leche League meeting with me.” I
responded, “What’s La Leche League?”
And the rest, as they say, is history.
La Leche League philosophies of mothering
through breastfeeding, along with baby
wearing and co-sleeping, just made sense
to me. I met a variety of women from
all walks of life who were truly enjoying
their infants and toddlers, and who were
friendly, supportive, and just all-round
wonderful people. I embraced LLL and
never looked back. My daughter Miranda
was born in 1980 and we nursed without
any problems. When she was ten months
old, we traveled with her throughout
Europe, and then to Egypt. Eventually
we ended up in Mali, when she was 15
months old, and I devoted my ethnographic
field research to breastfeeding, weaning
beliefs and practices and the growth and
health of children among the Bambara
people of Mali. I wasn’t really surprised to
note how much of Bambara child-rearing
philosophy reflected what I had learned in
LLL meetings. I was pleasantly surprised
to spend two years in a culture where
everyone breastfed for several years,
where nursing problems were virtually
unknown, and where children seldom
cried or fussed. It was, of course, sobering
to see children who were malnourished,
or who suffered from polio, or who died
from measles, diphtheria, and malaria.
Why couldn’t we create a world where all
children got to breastfeed for several years,
where every mother knew how to prevent
or solve common problems, but also where
vaccines, antibiotics and sufficient highquality foods were available to all?
As I had more children, and my career
unfolded, I pursued various avenues of
research related to breastfeeding and
weaning, and the impact of La Leche
League has only grown. Through my
writings (books, scholarly articles, popular
articles, and website), my lectures at
conferences (for physicians, lactation
consultants, health departments, and LLL
groups), and my university classroom
teaching (I manage to work this material
into every class, no matter what the official
topic might be), I have been able to pass
along the lessons I learned from LLL to
ries
thousands of people, who in turn have
passed them along. My daughter Miranda
has continued the legacy, giving talks on
breastfeeding to a variety of groups and
through the example of her own mothering
of my two breastfed grandchildren, Henry
and Eleanor. I expect my son Alexander and
his wife Shenin to continue the legacy in
the years to come.
As I had more children,
and my career unfolded,
I pursued various
avenues of research
related to breastfeeding
and weaning, and the
impact of La Leche
League has only grown.
The seven founding mothers of La Leche
League sent out the first ripples in a tiny
pond. Those ripples have reached far
beyond their wildest imaginings. I am
honored to have served as an amplifier of
their original ripples, which continue on into
the future, indefinitely.
Dr. Katherine A. Dettwyler is an anthropology
professor at the University of Delaware, Newark,
DE. She is the author of Dancing Skeletons: Life
and Death in West Africa 1993, and the coeditor of Breastfeeding: Biocultural Perspectives
(1995), which includes her chapters “Beauty and
the Breast: The Cultural Context of Breastfeeding
in the United States,” and “A Time to Wean: The
Hominid Blueprint for a Natural Age of Weaning
in Modern Human Populations.” See some of
her scholarly peer reviewed publications here:
http://kathydettwyler.weebly.com
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Quality Healthcare
Begins with
Breastfeeding
Support the Mission of LLLI Today!
During the month of December, generous LLLI donors, Sue Ann Kendall and her husband, Ernest Lee Bruns, will match your
gift dollar-for-dollar up to $10,000. Combined with our current matching gift offer, your gift will be matched $2 for every $1
you give to LLLI today!
“We support La Leche League International, because the organization has helped Sue Ann and so many of her friends
breastfeed their children. We also are committed to the organization, because the LLL philosophy has helped us
and so many others become better parents. We want the organization to continue to help future generations and be
there when our children have their own babies to love. It’s especially important to help LLLI now, as it enters a new
era with an even stronger focus on the mission and commitment to openness in all its operations. We are proud of
the work being done by LLLI today.”
Donate online or by check made out to LLLI at 957 N. Plum Grove Road, Schaumburg, IL 60173
Your support will have triple the impact in helping mothers and babies!
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LLLI Recognized by the Better Business Bureau Wise Giving Alliance
LLLI is proud to be recognized in the recent issue of USA Today by the Better Business Bureau Wise Giving Alliance as a
national Accredited Charity Seal Holder having met rigorous standards for charity accountability. Click here for a pdf version.
The BBB Wise Giving Alliance is a national charity watchdog affiliated with the Better Business Bureau system. Unlike other
charity monitoring groups that focus solely on charity finances, the Alliance completes comprehensive, in-depth evaluations
of the charity’s governance, fundraising practices, solicitations and informational materials, as well as how it spends its
money. As voluntary standards, they go beyond the requirements of local, state, and federal laws and regulations.
This accreditation demonstrates the continued commitment of La Leche League International to strengthen our position as
a viable charitable organization.
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a
l
a
G
s
e
u
g
o
ctag
earso
Philippa P
What is a galactagogue?
A galactagogue is something that increases the
production of breastmilk such as certain herbs,
foods, and a few prescription medicines. Most
mothers won’t need galactagogues (from the
Greek “galacta” which means milk) as there
are several ways to increase or maintain a milk
supply without using herbs or medicines. If you are
worried about your milk supply and whether your
baby is getting enough milk, see an LLL Leader or
IBCLC for a full assessment.
Laura Brown by jvcphotography
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Do I need a galcatagogue?
If your milk supply is still not responding with skin-to-skin
contact, breast compression, good positioning, frequent feeds,
and pumping—then it might be a good time to try a galactagogue
alongside. However, using a galactagogue on its own won’t
normally increase your milk supply without efficient milk removal
by your baby or a pump.
The Womanly Art of Breastfeeding, p 355 provides:
“One option to speed things along is to use a galactagogue,
an herb or medication that increases milk production. It is
important to take these ONLY after you’re nursing or pumping
regularly to remove the milk that they will help create. When it
comes to building a supply, galactagogues are the frosting on
the milk removal cake. They never substitute for milk removal
itself. Many mothers have been successful in increasing their
milk by nursing and expressing alone, so it is worth trying this
before you go to galactagogues.”
Milk production is usually a robust process. Not only will most
mothers not need a galactagogue, many mothers have induced
lactation for adopted babies or relactated for their own baby
by pumping and supplementing their baby at the breast—
their hormones respond to demand by producing milk.
Telling your medical professional is particularly important for
pregnant mothers considering a galactagogue. Sheila Humphrey,
author of The Nursing Mother's Herbal suggests avoiding most
herbs during pregnancy or discussing their use with a herbalist
midwife or knowledgeable obstetrician.
On page 237 she says:
“I recommend caution when using herbs during pregnancy,
particularly the first and early second trimester. Many of
the herbs used to increase milk supply (fenugreek and
blessed thistle, for example) are also uterine stimulants; they
may have strong enough actions to cause a miscarriage.”
”
Which herbs increase human milk?
There are over 30 herbs that are thought to increase human
milk. Great resources that cover them in more detail include The
Nursing Mother's Herbal and also The Breastfeeding
Mother's Guide to Making More Milk by Diana West and Lisa
Marasco. Experienced breastfeeding experts suggest choosing
a herb that has a dual role of stimulating mammary growth, and
giving hormonal support in some way.
(See the list of popular herbs below.)
Which foods can help my milk supply?
Herbal galactagogues
Herbs have been used to help milk supply for thousands
of years. And while there isn’t much scientific research on
their effects, many mothers who have taken them, felt that
their milk supply improved. Many of the herbs and foods
used to help milk supply today were recorded in a book
some 2000 years ago by a Greek physician Dioscorides.
They included medicinals for increasing milk, “bringing
down” the milk, keeping the milk “fresh,” helping mastitis,
engorgement, weaning, and even relactation. So while using
herbs is not a new idea, how effective they are is not certain.
Discuss with your doctor
The quality of herbal products can vary a great deal, so it is
important to buy them from a good reputable source. Many herbs
can have side effects, so it’s important to know how they work,
what dose to take, and which ones might be more suitable for
you. Seek the advice of someone knowledgeable.
The Womanly Art of Breastfeeding, p 397–8:
“If you choose to use a galactagogue, it’s important to tell your
doctor, even if she or he disagrees with your use of it, because
there is always the possibility that it can interfere with other
medications or cause reactions. Avoid herbs that can decrease
your supply, such as parsley, sage, and peppermint (in large
quantities), and medications such as pseudoephedrine, hormonal
birth control (especially when introduced before four months
postpartum), bromocriptine, ergotamine, and Methergine.”
Many authors covering the topic of nutrition for breastfeeding
mothers give the impression that you can have quite a poor
diet and still make perfectly good breastmilk. They may
mention a passing caution that the type of fats in human milk
will differ depending on your diet, but it’s never made into a big
deal. And up until the 1990s many experts thought dietary
galactagogues worked by a placebo effect (mind over matter).
Yet special milk-promoting foods have been eaten by newly
breastfeeding mothers for more than 2000 years across
history and all cultures. These women held a strong belief in
the connection of diet and quality and abundance of breastmilk.
“When it comes to building
a supply, galactagogues
are the frosting on the
milk removal cake. They
never substitute for milk
removal itself.”
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Popular herbs in the breastfeeding literature include:
Goat’s rue belongs to the legume family with alfalfa and
fenugreek and is often suggested for insufficient glandular tissue
and breast surgery situations. It is widely used as a galactagogue
across the world.
Wild asparagus is often used for hormonal support
and stomach problems and is widely used for increasing milk
in India (called shatavari). It is a different plant species from the
asparagus commonly used as a food.
Fennel is often used for milk release (let-down) problems. Fennel
seed is said to increase milk supply and improve mother's
digestion. In Mother Food Hilary Jacobson suggests a baby’s
digestion may also be improved through her mother’s milk.
Alfalfa leaf is a very nutritious herb full of minerals, numerous
vitamins, and essential and non-essential amino acids. Alfalfa is
said to have many medicinal uses such as reducing inflammation.
However, alfalfa is linked with triggering auto-immune
disease so take in moderation and avoid it if you suffer from
lupus or another auto-immune disorder.
Fenugreek is one of the best known and most popular
galactagogues. It is a common middle-eastern spice and one of
the oldest medicinal herbs known. It can be used in conjunction
with blessed thistle.
Blessed thistle is recommended by Canadian pediatrician and
breastfeeding specialist Jack Newman as a galactagogue to be
tried in conjunction with fenugreek. It is traditionally used for
indigestion and loss of appetite. There is sometimes confusion
between blessed thistle and milk thistle. They are not the same
herb, but they are both members of the Asteraceae family and
both are said to be galactagogues. Milk thistle has traditionally
been used as a food (peeled, tender shoots).
Nettle has a long history as a powerful galactagogue along with
various other medicinal uses. It contains all the essential nutrients
and this may be how it supports lactation.
In Mother Food, Hilary Jacobson looks at different cultures’
traditional milk-making (lactogenic) foods through history.
She believes there is a connection between a very poor diet and
breastmilk supply and composition. And if you are one of the
mothers who has a low supply it is important to know what you
can do to help it. As the composition of fats in breastmilk can alter
depending on mother’s diet, it might well be that eating the right
essential fatty acids (EFAs) could potentially change mothers’
milk from skimmed to fuller fat.
In Mother Food, p 277 Jacobson says:
“Many mothers find that supplementing with EFAs, such as
borage seed oil, evening primrose seed oil, black currant seed
oil, or flax seed oil, increases their milk production. These oils
contain hormonal precursors which may influence the chemistry
of lactation.”
In The Breastfeeding Mother's Guide to Making More Milk, p172
many foods are mentioned that support good milk production, for
example almonds, coconut, sesame seeds, millet, rice, anise,
fennel, dill, barley, oats, chickpeas, and many more.
Laura Brown by jvcphotography
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Which medicines can increase breastmilk?
There are no drugs specifically licensed as galactagogues or
for “making more milk.” However there are a few drugs which
are known for causing extra or spontaneous milk flow (known
as galactorrhea) as a side effect of their intended medical use.
For example, domperidone and metoclopramide are usually
prescribed for stomach problems such as sickness or reflux but
can influence milk supply.
How can I find out more about the effects
of herbs and medicines on me and my breastmilk?
There is more information about each of these herbs and
medications online at Diana West and Lisa Marasco's website:
www.lowmilksupply.org, at e-lactancia http://e-lactancia.org/en/
and on the Lactmed website http://toxnet.nlm.nih.gov/newtoxnet/
lactmed.htm
Which one shall I choose?
How do they work?
Most of the medications that can help milk supply work
by indirectly increasing prolactin levels in the body (a
hormone important in producing breastmilk) for example,
domperidone, metoclopramide, and sulpiride. These drugs
are available on prescription only. Discuss with your health
professional whether they might be suitable for your specific
situation and medical history.
Domperidone (Motilium). This drug has historically been used for
controlling indigestion, nausea and reflux but recent changes
recommend it only to be prescribed for nausea in future. It is not
available in the U.S.
Canadian pediatrician Jack Newman has comprehensive
information about the safety of domperidone and how it may help
milk supply on his website. Maternal side effects may include
dry mouth, itching, headache, and abdominal cramps. Rated L1
'Safest' limited data—compatible with breastfeeding by Thomas
Hale’s Medications and Mothers’ Milk.
Metoclopramide (Maxolon, Maxeran, Reglan). This drug
has several uses but mainly it is used for patients with
reflux. Maternal side effects may include gastric cramping,
diarrhea, tremors, slurred speech, anxiety, and severe
depression. Rated L2 'Safer' significant data—compatible with
breastfeeding by Hale’s Medications and Mothers’ Milk.
Metformin (Glucophage). This drug stabilises blood sugar in noninsulin dependent diabetics and is used to treat polycystic ovary
syndrome (PCOS). Metformin can help improve milk supply for
some PCOS mothers. Maternal side effects may include headache,
dizziness, nausea, abdominal pain, hypoglycaemia, and vitamin
B12 deficiency. Rated L1 'Safest' limited data—compatible with
breastfeeding by Hale’s Medications and Mothers’ Milk.
Sulpiride (Eglonyl, Equemote, Dolmatil, Sulpor). This drug
is primarily an anti-depressant and antipsychotic but may
increase human milk production during breastfeeding as a side
effect. Sulpiride is used to help lactation in Zimbabwe, South
Africa and Chile, but is almost never used in the U.S., Europe or
Australia. Maternal side effects may include physical symptoms
such as tremors, slurred speech, feeling restless or anxious, and
sedation. Rated L2 'Safer' limited data - probably compatible with
breastfeeding by Hale's Medications and Mothers' Milk.
The choice of herbs, foods, and medications that can help a
milk supply, not to mention ideas about pumping and breast
compression, can be quite confusing. Bear in mind that herbs
and medications are not a substitute for careful evaluation by
a breastfeeding specialist as their safety and efficiency have
not been proven in reliable randomized control trials. Working
with your LLL Leader or IBCLC is recommended to find the best
combination of ideas to increase your breastmilk while the safety
of galactagogues can be discussed with your health professional.
Have a look at Making more milk for self-help ideas.
Philippa Pearson-Glaze lives in the West Midlands of England in the
UK and has four children. She is an LLL Leader, International Board
Certified Lactation Consultant and graphic designer. [email protected]
Resources
Hale, T. Medications and Mothers’ Milk, 16th edition, 2014. http://www.
ibreastfeeding.com/books/2014-medications-and-mothers39-milk-345.html
Humphrey, S. The Nursing Mother's Herbal, 2003, Fairview Press.
Jacobson, H. Mother Food: A Breastfeeding Diet Guide with Lactogenic Foods and Herbs
for a Mom and Baby's Best Health, 2007, Rosalind Press.
LLLI, The Womanly Art of Breastfeeding, 8th edition. Schaumburg, IL: La Leche League
International, 2010.
West, D. & Marasco, L. The Breastfeeding Mother's Guide to Making More Milk, 2008,
McGraw Hill.
ABM Protocol Committee. Use of Galactogogues in Initiating or Augmenting the Rate of
Maternal Milk Secretion
http://www.bfmed.org/Media/Files/Protocols/Protocol%209%20-%20English%20
1st%20Rev.%20Jan%202011.pdf Anderson, P. The Galactagogue Bandwagon J Hum Lact 2013 29:7 http://jhl.sagepub.
com/content/29/1/7.full.pdf+html
Gribble, K. Breastfeeding the Adopted Child. https://www.breastfeeding.asn.au/bfinfo/
adoption.html
Jacobson, H. Motherhood International. Lactogenic Foods and Herbs http://www.
mobimotherhood.org/lactogenic-foods-and-herbs.html
Zuppa, A, Sindico, P, Orchi, C et al. Safety and Efficacy of Galactogogues: Substances
that Induce, Maintain and Increase Breast Milk Production J Pharm Pharm Sci, 13 (2):
162-174, 2010.
http://ejournals.library.ualberta.ca/index.php/JPPS/article/view/6663
llli.org
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2015
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JANUARY
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To day
22
Keeping Fit and Well
Lisa Hassan Scott, Wales, UK
Monica Duke
A baby changes everything.
A mother’s daily routines change
completely, her nights may be restless and
old habits necessarily have to alter to work
around the newest, neediest member of the
household. Self-care and keeping fit often
drop off the to-do list altogether. But for
a mother’s well-being, and for the benefit
of her whole family, it’s worth taking small
steps to try to fit a well-being practice into
the day, even for just a few minutes.
I led a fairly active life before having
children. Cycling, hill-walking, yoga and
swimming were my favorite ways to keep
fit and clear my head. Like many people, I
took it for granted that I could just nip out
for a swim for a few hours. When my first
child was born, I found myself struggling
with poor latch and a baby who needed to
be held almost constantly. “Nipping out”
were words I no longer uttered. Just getting
out the door was a military-style operation,
and when I got out into the wintry cold I’d
often find that in my focus on the baby, I’d
completely forgotten to wear a coat!
To day
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JANUARY
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2015
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If I couldn’t even remember to wear a
coat in a snowstorm, how on earth could
I look after my own needs for fitness and
well-being?
Running/jogging is the most efficient
form of exercise around. Even a 15–30
minute-run a couple of times a week can
confer awesome benefits. If your baby has
a reliably sound nap and you have a caring
Over the years of mothering, and realizing helper, consider a short run right from your
that my self-care was essential to the front door. Or, take your baby with you!
happiness of my entire family, I have found Jogging strollers can be expensive, but
several ways of fitting in a well-being used ones often come up on online auction
practice to keep myself feeling fit and sites or through local connections.
calm, while still attending to the needs of
my babies. Here are a few ideas that might 2. Start the habit of an at-home practice.
work for you.
In inclement weather, or if you have
several children’s needs to attend to,
1. Try going for a walk and consider
a short, frequent at-home practice can
progressing to a run. Getting out
reap rewards. The market is awash with
of the house, with baby in a sling or
fitness DVDs and podcasts, including
pushchair, and having a brisk walk can
aerobics and yoga. I have some great
be a great way of staying close but
memories of my children bouncing
also getting time for yourself. There
around the living room with me, trying
is something so invigorating about
to imitate the lycra-clad instructor on
a fast walk in the sun or crunching
the screen. The belly laughs we had
over autumn leaves. Time outdoors
made me feel good and once I got into
will clear your head, offer a change
a daily habit of serving their breakfast,
of scenery, and may even help a napthen doing my exercise, they came to
resistant baby doze off.
accept that “this is what mummy does”
and I’d be free in a few minutes. I have
even practiced gentle yoga with my
llli.org
23
baby in a wrap sling, relishing a chance
to breathe with awareness and stretch
my body.*
3. Walk or cycle as much as possible. If
you can, ditch the car for short trips.
Walk to the bank, cycle to the store. It
takes a little extra planning and time,
but building a habit of using your body
to get you around can help you feel
really good. And walking with a toddler
or young child, there is so much to
discover: sycamore seed ‘helicopters’
to throw in the air, autumn leaves
to jump in, snow to crunch through,
puddles to splash in. If cycling is more
your speed, or your distances are
greater, there are baby bike-seats and
trailers and some amazing cargo bikes
on the market. I have a friend who
cycles her six children around her city
every day! Even if you live in a place
”
If I couldn’t even
remember to
wear a coat in a
snowstorm, how on
earth could I look
after my own needs
for fitness and
well-being?
Monica Duke
where you need to use your car for
most trips, try parking a little farther
away from the store entrance, walking
from errand to errand, or simply make
a stop along the way at a local park,
field, nature reserve or woodland for
some outside time.
spite of what celebrity magazines might
tell us, it is natural for a mother’s body to
change when she has a baby, and it will take
time for you to return to your former fitness.
It’s important to take it slowly, make sure
you have the go-ahead from your health
care practitioner and give your body credit
where it’s due: it’s carried and birthed your
4. Step outside and breathe. Sometimes beautiful baby and you continue to nourish
none of these ideas will work for you. him with your body. You are amazing!
Maybe the weather is terrible, your
child is ill, your mobility is limited, or * Do take advice from an experienced
you have older relatives to care for. yoga teacher if you are considering
Maybe you just have a really busy practicing yoga with your baby. You may
life, juggling working, pumping and also find helpful books at your local library,
motherhood. If you do only one thing or information about a local parent and
to contribute to your overall well-being, child class.
make it this one: step outside, even for
just a few minutes, and breathe. Take
Lisa Hassan Scott is an LLL Leader, writer and
your morning coffee outside, stand
yoga teacher living in Wales, UK with her
outside your door, and notice what
husband and three children.
is happening around you. The moon,
the rising sun, birds going about their
business, the feeling of the wind or rain Further reading
on your cheek, the stillness of falling
snow—all of these are events we so Keep Fit http://viewer.zmags.com/publicatio
often overlook, but can bring us right n/5f3b8aed#/5f3b8aed/6
back to a sense of calm. Every day, try
to get outside and just notice.
Marathon Mother http://viewer.zmags.com/
publication/ed9fb378#/ed9fb378/14
One of the most important things to
recognize is that a baby’s needs change Triathlete Breastfeeding Mom http://
over time. He won’t be this needy forever, viewer.zmags.com/publication/a8e5de2a#/
and gradually you may find that you have a8e5de2a/12
more and more time to give to your own
wellness. When your baby is very young, Outdoors Baby and Family http://viewer.
it’s okay to focus on his needs and allow z m a g s . c o m / p u b l i c a t i o n / f 8 0 c f 6 6 f # /
yourself time to adjust to motherhood. In f80cf66f/20
llli.org
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2015
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JANUARY
•
To day
What’s Cooking ?
24
Katja Leccisi
Katja Leccisi
Raising
Healthy
Eaters
Lessons Learned from Breastfeeding
Katja Leccisi MS RDN, Mont-Tremblant, Quebec, Canada
To day
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2015
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llli.org
As parents, we try to do what’s right when feeding our
children. Unfortunately, that’s no easy task with so much
confusion about what that is exactly. Nutritional advice is
forever changing. Foods that were supposedly healthy one
month are apparently off the list the next. In my experience
as a dietitian and lactation consultant, I have seen many wellmeaning parents get so caught up in the do’s and don’ts of
what is good and what is bad, that the simple pleasure of
eating disappears. Mealtimes become stressful when parents
worry about all this and whether their child is eating enough
or too much, and what to do about it. The happy family meal
around the table seems a thing of the past.
My focus is on helping children develop a healthy relationship
with food and eating. The goal is for our children to become
adults who listen to their signals of hunger and satiety, who like
to discover and try new foods, and who take pleasure in eating.
How can we make this happen? Let’s look at what we learn from
breastfeeding that instils healthy eating habits in our children.
25
As children grow up, things may get more
confusing. How many of us have heard or
said, “Just eat two more bites,” “You can
have dessert when you finish that plate of
food,” or “You can’t be hungry, you only
just ate,” or “No second helpings!” Children
grow at different rates, and it is normal for
their hunger levels to vary enormously,
from week to week and even from day to
day. Remember that growth spurt at two
months, when you breastfed round the
clock to satisfy your baby? Well, that could
be happening in your preschooler too, not
to mention your teen.
Internationally renowned food author Ellyn
Satter says that parents are responsible
for what, when and where food is offered
(providing regular meals and snacks), while
children are responsible for how much and
whether they eat. Trust your child!
2. Try, try again.
1. Eat when hungry, stop when satisfied.
As a breastfeeding mom, you are giving
your child a great start. A baby is born
knowing when he is hungry and when he
has had enough to eat. You respect these
signals of hunger and satiety. Your baby can
eat when she’s hungry, and when she’s had
enough she will stop.
Can you imagine making your child keep
breastfeeding once he’s had enough? Or
purposely refusing to nurse even though
your baby is giving you all the signs that
he’s hungry again? So why do we feel we
can make a five-year-old eat more when she
says she’s full? Trust in your child, just as
you did when she was a baby. Respecting
signals of hunger and satiety is fundamental
in the development of healthy and normal
attitudes toward food and eating.
You didn’t give up the first time you had
difficulty breastfeeding, so don’t give up
the first time your child looks at a new
food and says no! A child may be exposed
to a new food as many as ten or twelve
times before he accepts it. Children will
eventually eat what their parents eat, so it
is important for you to sit down at the table
with them and eat what they are eating. In
my experience, it’s very easy for parents to
give up too quickly, or turn mealtime into
a battle or power struggle, when a child
refuses a food.
3. Keep mealtimes pleasant and eat
together.
Remember how well a breastfeeding
session went when you were calm and
unhurried, when you kept your cool even
though your baby was tired and cranky?
And, of course, you are always with your
baby when you are breastfeeding! Can you
imagine its having been a good feed if you
were telling your baby to hurry up, latch on
and get done? And it would be impossible
to feed your baby if he were not cuddled
close to you. Let’s bring these concepts
forward in time. How can you expect
your toddler to eat those peas if you are
disappointed that he won’t? Or your teen
to finish her meatloaf if others are arguing
at the table? Mealtimes should be a time to
put hot topics aside and stick to something
pleasant. With young children, talk about
the food you are eating, where it comes
from or grows, how it tastes, feels, smells.
With all ages, it is a perfect time to catch up
on each other’s day, to stay involved with
that active teenager you hardly see around
the house any more.
Mealtime should be a positive time,
one that brings love, attention and
energy. From young childhood onward,
socialization is learned at the table, in
the company of others. Relationships that
develop while eating with others build a
sense of community and belonging. Eat
together whenever possible. Research
repeatedly shows that children, and
teens who eat meals with their families
Children have little control over many on a regular basis fare better socially,
things in their lives but what they eat is one academically, and nutritionally. Sitting in
of them. Let them explore, keep offering front of the television, or wolfing down
new foods, show them that you enjoy them, something while standing at the counter
and eventually they will join you. In the just cannot compare to conversation and
meantime, teach them to politely say, “No togetherness around the table.
thank you” to something they don’t care
for, which is much more acceptable than 4. Remember that eating is a joyful and
“Yuck!” and give them the option of quietly sensual experience.
spitting the food out into a napkin if they
don’t want to swallow it. Try serving at least No one knows this more than your
one food that you know they like at each breastfeeding baby! She gazes up at you,
meal, so they have a fall back option. Be or softly closes her eyes as she suckles,
creative, and have fun with food. Let them she holds on to you or gently kneads your
help you shop for it, prepare it, and serve it skin, her toes curl, and she is delighted.
in attractive ways—they will be more likely Moving ahead, as a toddler, she explores
to try something if they were involved with by rubbing food in her hair, squishing it
getting it to the table.
through her fingers, and by seeing what
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2015
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JANUARY
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To day
26
happens when she smells it, licks it, and
bites it. Why does the pleasure have to
go away as our children age? Ellyn Satter
says, “When the joy goes out of eating,
nutrition suffers.” Eating is not just about
filling up our stomach, or even about
getting the right amounts and kinds of
nutrients. Eating is about taking good care
of ourselves and our children. It’s about
pleasure, socialization, identity. Think about
the difference between “eat and run” and
“dine and savor.”
As a breastfeeding mom,
you are giving your child
a great start. A baby is
born knowing when he is
hungry and when he has
had enough to eat. You
respect these signals of
hunger and satiety. Your
5. Eat whole, fresh and varied food.
baby can eat when she’s
A mother’s milk is a complete food for her
We know it contains everything he
hungry, and when she’s baby.
needs to grow and thrive. It has a variety of
depending on what mom eats, and its
had enough she will stop. tastes
nutrient composition varies over the course
of each feed, over the day, over the months
As your child grows, help her to keep hold and years. What a wonderful, whole, fresh
of the joy of eating. Encourage her to eat and varied diet, an excellent model on
slowly, sitting at the table, taking in the which to base your child’s diet as he grows.
whole experience—how the food looks, What is it in human milk that makes it so
smells, tastes. Certainly there will be days healthy? Scientists keep on discovering
when you all have to speed through the new and important components, the
meal to make an appointment on time, interaction of which are impossible to
or you may even have to eat in the car. replicate in manufactured products (see
But, we all need to slow down sometime. The “Science of Mother’s Milk” http://www.
Remember how wonderful it felt to finally sit llli.org/nb/nbiss3-09p28.html).
still and breastfeed your baby, with nothing
but the present moment on your mind? It Teach your child to see food as FOOD, not
won’t take any longer, but if you change some package on the shelf. Good nutrition
your attitude about the preparation of the means eating a well-balanced and varied
meal, setting the table, even the cleanup, diet of foods in as close to their natural
you may find that it becomes another time state as possible. Offer him a colorful,
to savor with your family.
varied, interesting range of foods, and
you won’t need to worry so much about
whether he is getting too much of this or
not enough of that.
To day
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2015
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llli.org
6. Every baby is unique and you know
your baby best.
Perhaps your first child nursed around
the clock for months, while your second
slept for long stretches after a few weeks.
One needed to be burped every feed or
she spat up, the other was a voracious
feeder and never lost a drop. As a mother,
you learned and adapted your parenting
to best meet YOUR baby’s needs. There
are no absolute rules that suit all babies.
The same goes for feeding your child
as she grows. He may need a lot of
encouragement to try a new food, or she
will happily devour anything put in front of
her. Mothers, trust in yourselves and your
children. If you follow the principles you’ve
learned from breastfeeding, then you
won’t need to worry so much that what
you are doing is right.
Katja Leccisi is a registered dietitian/nutritionist
in the USA and Canada, a former International
Board Certified Lactation Consultant, and a La
Leche League Leader with over 20 years of
experience working in public health centers,
daycares, schools, and the community. She is
a mother and stepmother of three children.
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