Wednesday, March 14, 2007

Self diagnosing your breastfeeding problem

Living here in Japan without much support in our own language, and with so much information freely available on the internet, self-diagnosing your own breastfeeding problems seems easy and economical.

The trouble is that there is a lot of dubious information out there, and it can be hard to sift through it all to get to the good stuff when you have a crying or hungry baby on your knee, and you need a few more hours sleep yourself.

Getting qualified expert help may be crucial to the success of your breastfeeding relationship, so I encourage you to make contact with a real live person if you can, rather than to rely on articles from the internet alone. Years of experience helping real live mothers and babies with their specific breastfeeding situations counts for a lot when it comes to helping you and your baby. Having someone listen to exactly what is happening in your life with baby can help zoom in on the real problem, and following up with some well-referenced internet reading can be a good way of confirming your options.

La Leche League's network of trained volunteer Leaders all over the world helps mothers by phone or email, and discussion meetings are held in many different countries. Here in Japan we have English speaking Leaders in Tokyo, Sendai and Wakkanai, and occasionally there are Leaders on the US military bases. See here for contact details.

There are more international Board certified Lactation Consultants (with the intials IBCLC after their name) around the world now than ever before, and this past year alone, Japan has almost doubled the number of IBCLCs, to 270. As the qualification becomes more and more recognised as the gold standard in breastfeeding management and care, then we will hopefully see more and more staff in hospitals and clinics getting certified. It is a rapidly growing profession and it is very exciting to see improvements in the level of skill and care provided. For IBCLCs in Japan go here or here.

In the meantime, I continue to hear stories every week of parents who were given wrong advice or misinformation and the breastfeeding relationship has suffered as a result, maybe even ended prematurely. Parents are understandably disappointed (sometimes angry) when they hear that there may have been other options.

One example that comes to mind is the common advice by doctors in Japan to wean for 3 days while taking antibiotics. This is usually just wrong. There are many antibiotics which are perfectly safe to take while breastfeeding, and anyway, weaning is not something that can be done "cold turkey" for 3 days...then you would end up being very engorged and possibly even with mastitis from milk stasis, and a severely depleted supply when breastfeeding resumes. Telling the mother to wean for 3 days can have devastating consequences . And what about the baby? What will the baby drink for those 3 days? We know formula changes the way your baby's body works, and why would you do that unnecessarily for antibiotics? A tiny little bit of antibiotics in the milk has far less impact on your baby's health than 3 days of formula. Dr Thomas Hale has written an excellent book called Medications and Mother's Milk to which your doctor can refer to ascertain the safety of medications while nursing.

Another example is when a mother who is concerned about low milk supply is told by her doctor to "pump her milk to see how much she has". A mother expressing her breast, by hand or machine, is nothing like a baby drinking breastmilk directly! For a mother already worrying, being able to express only a few drops just confirms her fears, and is not productive to the ongoing breastfeeding relationship. Expressing milk does not give an accurate picture of the available milk. It would be more constructive for the doctor to educate the mother about ways of knowing her baby is getting enough. (We can judge if baby is getting enough milk by checking the urine and stool output, and by ensuring baby is breastfeeding frequently enough, not by measuring the mother's ability to efficiently express her milk, which is a learned skill in itself.)

It is incredible how much is misunderstood about fully breastfed babies and the way women's breasts work. Perhaps it is because the doctors and nurses have so little experience with successfully breastfed babies that they don't really have the faith or the belief that it is possible to fully nurture a child with breastmilk alone. Or perhaps it is just a general reflection of our society that doesn't value breastfeeding and the special relationship between a mother and baby. But if any of us can read articles on the internet and be informed about current breastfeeding topics and developments, you would hope that a health professional working with mothers and babies would also be keeping up-to-date too.

If you are breastfeeding and you are worried about anything in relation to your baby, as well as your doctor, get in touch with LLL or an IBCLC, and go over your concerns with them. Use them as a sounding board, for an instinct check. Sometimes what looks at first glance like a possible medical problem may just require a minor breastfeeding "tweak". Sometimes your baby may be doing something like refusing solid foods, or suddenly waking more at night or being very gassy. Check in with your LLL Leader or local IBCLC about these, as sometimes even if it doesn't look breastfeeding-related it might be! And sometimes, just talking to an experienced mother can help you decide if you should get a qualified opinion on things.

There is no substitute for your human resources who specialise in breastfeeding...we will do everything we can to support you and get you heading in the right direction, to reach your own breastfeeding goals. Providing you with the best information, the most up-to-date and reliable resources is what we do. Yes, this is a shameless plug...we LOVE what we do!!