Of Breasts and Milk



This week I intercepted my relaxing semester break and spent two days at work.  Both days were busy and kept me on my toes from the time I set my feet in the unit until I left.  Yet, I would not have wanted it any other way. 

My profession, practiced during these days—I am an IBCLC, an International Board Certified Lactation Consultant, and have been working per diem in the Family Birth Center of a busy local hospital for more than 8 years.    

My work—I am doing lactation rounds, in which I visit with every breastfeeding mom and family (95% of our clients), listen, listen some more, and even a little bit more, answer questions, educate on what to expect—and what not—in these very first days after birth, assist and—if needed—teach the new mom (and family) how to breastfeed the newborn, and help to find and implement solutions should problems arise.

Breastfeeding is the most natural thing in the world, right?  So why a specific profession?  Why a license that requires more than 1000 practice and theory hours, topped by a challenging, day-long exam? 

Well, it turns out, that breastfeeding is more of a learned art than intrinsic knowledge, coded for in our DNA.  In cultures where breastfeeding is, and has been an inherent part of life and child rearing, an IBCLC is rarely needed.  Us here…hmmm…we are of a different kind—the kind that all too often is rather intimidated by this naturally learned process.

Yesterday, the comment of an 18-hours-old father, as I was handing his wife a Nursing Journal, sums it up better than I ever could.  Overjoyed he reached for the booklet and said: “Oooh!  Is this a manual?!”  I felt like giving him a big old hug!  No, my dear friend, they don’t come with a manual!

The time following the birth of a child is unique and very special for every new family.  Emotions underlie their own erratic rules, and tears of joy, worries and frustration may rapidly alternate with sheer bliss and heartfelt laughter.  It is my utmost pleasure to stand back, and humbly watch it all unfold.  Having been there myself four times, I am pleased to watch different parenting styles evolve.  Sometimes well-meant intentions shatter early on when the new parents notice that their 8-pounds bundle of joy is more a bundle of pure energy and temperament.  Parenting is a learned art as well!

Working with families during such a sensitive and vulnerable time, on such a physically close and intimate level, leads inevitably to quite interesting situations.  Empathy and professionalism, I find, are key in getting out of any weird situation I may find myself in at work.  Sometimes that’s easier said than done…

Such as the day I was helping a new mom years ago.  Her baby was a few days old already, her mature milk was coming in and for various reasons this process had left her terribly—and I mean TERRIBLY—engorged.  If you have never seen engorged breasts—let alone terribly engorged ones, my friend—start by imagining two good-sized cantaloupes sitting snug, right where days before a B or C cup bra was perfectly sufficient.  While it may be visually impressive, they HURT!  BADLY!  Engorgement rarely gets this bad, but gone that far it is no fun at all.  I spent a very long time with this mom—hot compresses, massage, attempts to latch the baby, attempts to pump,…  Any effort to empty her painfully, ready-to-burst breasts failed because she was hurting so badly.  Massage was all that was left, and while she was pressing her hands against her face in an effort to find some abatement, I was able to gently hand express milk which soon gave her some relief.  Her previously tensed up facial expressions lightened up, and to my surprise she suddenly started to giggle.  She looked at me and said with a big grin: “Wow!  This is almost like in a good porn video.” 

Eeeeeeeeeeeewwww!!!  Wrong connection!  Absolutely wrong!  I was completely perplexed for a moment and must have stared at her my most appalled stare.  I was blown away and wondered how on earth this could have been her first thought after finally being relieved of the pain.  Lucky me, the friendly voice in my head quickly reminded me—“you better use your finest skills—empathy and professionalism!”  Yes!, I thought, ready to set some boundaries.  I smiled back at the mom and said something to the extent of: “One could think that, but we both know that this is not the case.”  Then I went on and taught her how to hand express herself…   Ha!

So, if breastfeeding can leave you terribly engorged and making terrible comments, which may leave your IBCLC terribly shocked—why bother with it at all?  The quick answer is—because it is a human infant’s natural source of food.  If human moms would give birth to calves or soy beans, formula would probably be the first choice.  While there doubtlessly are medical indications for babies to be fed formula, its unquestioned use in the early days and weeks can be especially detrimental to the breastfeeding relationship. 

              

On the other hand, breastfeeding has unique far-reaching benefits for baby, mom, the family and the community.  Here are just a few, as stated by the AAP (American Academy of Pediatrics).  A decreased incidence in infectious diseases, such as diarrhea, respiratory tract infection, urinary tract infections, and otitis media alone are worth every ounce of breastmilk given.  If you have ever lost nights of sleep while taking care of a little one with said conditions, you’ll understand…  Breastfeeding also leads to a decreased incident of Diabetes Mellitus type 1 & 2, certain childhood cancers, asthma, overweight and obesity.  As Signifying Nothing states in his latest blog post, 38.5% of girls born in 2000 will develop diabetes.  32.8% of boys born in 2000 will meet the same fate.  Similarly alarming rates are reported for cancer, asthma and obesity—a decrease of these numbers is worth every sip fresh from the tap!

There are plenty of rewards for breastfeeding moms as well.  How about earlier return to pre-pregnancy weight?  Breastmilk production burns about 500kcal extra per day, just like this!  Directly after birth, nursing decreases blood loss, because the hormones involved in breastfeeding cause the uterus to contract and reach pre-pregnancy size faster.  In the long run there is a decreased risk for breast and ovarian cancer and possibly osteoporosis.  I would take these benefits at any time.  Who wouldn’t?

My work as an IBCLC enables me to support young families in the early decision making process and its subsequent successful implementation.  This can influence their baby’s and their own health for decades to come.  It is my pleasure and passion to be their advocate and be part of improving individual and public health—one family at a time.