1. While you wait for your baby during pregnancy, build your ‘Tribe’ and after birth find your ‘Tribe’. A tribe of people amongst your care givers, family, friends and the online support groups who acknowledge and support your choice to breastfeed your baby are essential for your journey as a breastfeeding mother. 2. Plan and work towards a gentle and supported birth. Your experience of labor and birth can have a profound direct impact on the success of your breastfeeding. Choosing a midwife/birth doula and a healthcare provider who is supportive of your choice of gentle birth in an a birthing environment such as home or a hospital which is certified by UNICEF/WHO initiative Baby Friendly Hospital Initiative (BFHI) is an essential step towards avoiding most of the birth interventions —potential causes for breastfeeding problems including inability to latch, low milk supply, post-partum depression and sore nipples. 3. Never miss the Golden First Hour to feed your baby after birth. What’s crucial about the first hour of baby’s life at the breast is baby’s natural hard wired reflexes to latch and feed. Plenty of skin to skin close contact between you and your baby will allow for the body regulation of milk making and bonding hormones. Practice Kangaroo Mother Care (KMC) after birth until you leave the hospital even if you baby isn’t premature. You may well be bidding goodbye to the common experience of breast engorgement at all. KMC promotes natural cycles of feeding & sleeping. 4. Pain is never normal in breastfeeding. If you are experiencing pain seek professional help from your Board Certified Lactation Consultant (IBCLC). Breastfeeding should be enjoyable and pain is a sign of communication that something not going on. 5. Follow your instincts when you feel in your gut that something isn’t ok about breastfeeding your baby. Smooth Breastfeeding experience is an early health radar of a developing baby. 6. Often the milk supply issue isn’t the cause but just a symptom of the underlying factors that are not diagnosed well. If you are ever concerned consult your lactation consultant. 7. You will be thankful to know breastfeeding isn’t about being stuck at home only feeding but about experiencing the joy of being liberated from carrying loads of feeding supplies and finding your life with your baby. 8. Make the most of maternity leave if you are a working mother. Establishing a good rhythm of early weeks of breastfeeding can go a long way to continued feeding even when you return back to work. Published in FMC (First Moms Club) as "Today we have FMC Mommy Effath Yasmin giving us some useful tips on Lactation. She is an International Board Certified Lactation Consultant, a Certified Lactation Educator, an accredited Le Leche League Leader and a Biodynamic Craniosacral practitioner. She is the Director of Nourish & Nurture an outreach for Clinical Lactation Care to pregnant and nursing mothers and craniosacral biodynamic treatment." https://www.facebook.com/firstmomsclub/posts/1310234649059299:0
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Over 98% of women who sought desperate support for trauma resolution and challenging breastfeeding issues in my private lactation clinic are often whose journey of labor & birth has been fraught with challenging birthing experience. This includes medical interventions, surgery, lack of birth support and separation from baby. Birth is an intense experience both for baby, mother and the family. Yet it is a normal physiological process. When it is colored with fear, anxiety, pain and suffering this experience then becomes traumatic and makes it an overwhelming experience. Human rights in childbirth would have never been a subject to discuss if we as a society had honored the self autonomy of women to birth on her inner wisdom. To investigate and address this very daunting trauma through one of the most intimate and visceral experiences of a woman’s life – Birth India, in collaboration with Human Rights in Childbirth, held a conference recently in Mumbai. The Human Rights in Childbirth India Conference was a part of a global discussion to address the provision of respectful, culturally sensitive, human rights based maternity care. Birth India’s cause remains close to my heart in many ways. Some of my own experiences of birthing my daughter in a rather comfortable and supportive environment even though it was a high risk surgical birth made me question the whole paradigm of what is supportive birth. Educating and supporting women around birth thereby became the single most mission of my life. Birth India perhaps was my first exposure to connecting with the social voices outside of my world and perhaps my little window to hear and see other women’s voices. Being on the Board involves one to hold the vision and even though, many a time, when the vision blurred it stayed clear with new voices coming just when the vision faded over the past decade. I tremendously celebrate the selfless dedicated work of these women who made the small team with large hearts who made it work. The fact is, breastfeeding often slips through the cracks created in the biome of mother and baby due to birth trauma. Not enough noise is made about this fact and must I say, not even enough amongst many birth workers themselves. Loss of early initiation of breastfeeding and then premature weaning of breastfeeding is the darkest reality of the impact of poor support in childbirth and rising number of C-section births. We may eventually be heading towards raising infant human rights to seed and feed if we continue to ignore the fundamental needs of a baby: #1: A chance for baby to trigger labour and birth #2: A chance to have an undisturbed skin to skin closeness with mom #3: A chance to not experience distress from separation from mom for routine procedures. #4: A chance to initiate breastfeeding right after birth #5 A chance to not experience birth trauma due to routine labor pain management and birth augmentation. #6: A chance to not taste infant formula unnecessarily. #7: A chance to experience joyful and comfortable breastfeeding. #8: A chance to optimal development and growth with direct breastfeeding. #9: A chance to normalise overall health, immunity and muscular-skeletal functions with direct breastfeeding. #10: A chance to life. Even though the Human Rights in Childbirth conference didn’t as much raise and debate the true impact of poor birth support resulting in horrific realities of distressed parents trying to feed their babies, the conference marvelously began the dialogue. It had to begin somewhere and the HRiC conference did just that. Frankly, I also think the debate about sub-standard care for breastfeeding mothers and the voices of struggling mothers who wish to breastfeed needs a whole platform or conference of its own! In order for that to happen first many need to understand the prerogative of women to birth respectfully which HRiC managed to create a noise about. What was thrilling for me to witness is how the glass of territories between the medical community, educators, policy makers and birth workers shattered during the conference. It was the birth of new direction of action. For the first time we heard Obstetrician/Gynaecology clinicians acknowledge the need to break away from deep seated mindset of “Good doctor, naive patient” model to “trusting doctor, empowered mother”. While it seems important that advocacy lobbyists engage and move the political will of the policy makers to listen up and include essential human rights of birthing women and secure legislation in public and private maternal health care system, it seems not so important in a democracy like India. The liberty to service is a fundamental right of every citizen anyways. Hospitals like Fernandez Hospital in Hyderabad, Sitaram Bhartia Institute of Science and Research in New Delhi and many other individual service providers including Lactation Consultants, Midwives, Doula, and Obstetricians have moved their personal will to better the system and services without a need to policy change. My summary of the take away from the conference that adds to my personal vision and commitment includes: #1 Push forward the agenda of respective care for bringing in Justice, Dignity and Respect in the medical maternal health system in India in policy changes as a fundamental right of a women. #2 Value the traditional birth companion model and integrate, create a system of holistic certified midwifery to counter the increasing maternal deaths & significantly reduce unnecessary c-sections in India. #3 Create mitigation and contingency plan for current poor scenario of abuse and trauma in childbirth until we build prevention systems by
This conference and the roll over effect of crack down on increase surgical births is a game changer in Indian scenario. I hope for a day when the message is assertive & clear through such selfless workers of birth that, just as, Birth is a primal instinct for a woman and is an experience beyond just survival, breastfeeding is a primal instinct for a baby and is certainly beyond just the survival and being just fed. Publshed in Birth India Website http://birthindia.org/2017/03/07/birthing-experience-and-breastfeeding-fundamental-human-rights/ Subroto Bagchi writes in his book "Go Kiss the World" - "There I learnt that there is no limit to how concerned you can be for another human being and what the limit of inclusion is you can create." This truly describes the limitless boundaries I see myself in and I have often held myself back to limit myself which I realize is a fraudulent 'archy' which the world around could term you insane for having boundless love and concern for co human being and almost find it impossible to exist. Well I detest such an 'archy' or a system and believe it indeed exists.
The Indian Academy of Pediatrics (IAP), the UNICEF, the World Health Organization (WHO) and the Breastfeeding Promotion Network of India (BPNI) recommends exclusive breastfeeding for the first 6 months of a baby’s life and continued breastfeeding for up to two years and beyond with adequate complementary foods as the GOLD Standard and most appropriate feeding strategy for infants and young children. This is stated in the Infant and Young Child Feeding guidelines (IYCF) of the IAP.
Most mothers need immense encouragement and support to continue breastfeeding beyond the first 6 months of exclusive breastfeeding period either due to breastfeeding challenges, going back to work or societal pressure to wean especially from their ill-informed doctors. While the need for exclusive breastfeeding period of 6 months is well documented and supported by most said authorities and society, it is hard to find great support for mothers who chose to continue beyond the first year. Yet It may be surprising to you to know that despite lack of support, several mothers still nurse their children at three or five years of age in secrecy of their homes just to avoid disapproval. New research tells us that children who breastfeed for beyond infancy are gifted with high quality nutrition, a boost of immunity, faster recovery from illness, significant degree of prevention from incidence of hospitalization, a boost of self-autonomy, confidence, closeness, compassion towards fellow beings and less aggressive behavior and much more including lower incidence of emotional depression and aggression later in life. Also if you study primates’ behavior, you notice that many primates wean their young when their first permanent molars erupt. Isn’t it also interesting to note that the permanent molar erupts between 5 to 7 years of age along with maturing of the immune system? Further Dr. Katherine Dettwyler in her research review also notes that according to some anthropological studies it has been noted that weaning period for babies is approximately 6 times the gestation age which is around 4.5 - 5 years again. Again several studies reveal that in prolonged lactation, the fat energy contribution of breast milk to the infant diet might be significant since breastmilk is species specific and also growth specific as per growth of the baby. This is contrary to popular belief that breastmilk loses its nutrient content by the time baby starts to have solids. The other false understanding about prolonged breastfeeding are:
Weaning is an interactive process between you and your toddler/child. Your child continues to nurse for many reasons: for comfort, security, for a way to calm down and for reassurance besides nutrition. It is ‘home’ for your child in her ‘world’ of chaotic exploration. Breastfeeding creates a bond and relationship you and your child and you will be the best judge to know the needs of your child. It might help you to know baby can be completely trusted to wean herself as her needs slowly get fulfilled and is not a habit that needs to be broken. This is a milestone reached at their own internal pace like walking, talking and other milestones are different for each child. Mothers who are mindful of the needs of their child may consider any intervention such a use of potions or herbs to wean as breech of trust in the relationship between mother and child which was so carefully build from nursing since birth. Need for sucking is a biological need and is restorative for rapidly growing little children so much so they are many children who are restricted to nurse resort to thumb sucking, fingers, hair, blankets and pacifiers. Sucking is a tool for growing and is a healthy need of baby. According to Norma Jane Bumgarner in her book "Mothering your Nursing Toddler" says "..a baby is learning to trust and depend on other human beings, especially his mother and to suppose that nutrition is primary significance and that attachment is secondary will be a mistake." Consider accessing the LLL Pan-India library and reading wonderful books such as "Mothering Your Nursing Toddler", "How Weaning happens" "A Mother's Guide to Weaning' which can be helpful. Also working with your private International Board Certified Lactation Consultant (IBCLC) knowledgeable about natural weaning may have unique understanding to hears and acknowledges you and could help you in your individual journey of weaning. Contribited article for Mother & Baby print and Online Magazine published in August 2016 New mothers understandably find it really hard to trust easily in a process they cannot measure. Concerns about low milk supply is the number one reason mothers give for not being able to begin early breastfeeding after birth and also the number one reason to not continue breastfeeding for as long as the stated standard recommendation — breastfeeding for minimum of first two years of baby’s life.
In my many years of experience of supporting mothers, interesting, I began to notice that milk supply issues are much easier to address than most other breastfeeding related issues. That seems to open up a whole different discussion and perspective. Many mothers may find that quite surprising and often get interested to know why and how. Most if not all new mothers, family and friends around often think low supply is the cause for breastfeeding not going well. This has a potential to make mothers feel inadequate and in secured. On the other hand, the mother-to-mother support forums and group tend to think milk supply issues are a myth and perceived by mothers. The reality truly lies in between. A clear understanding of four most important components of breastfeeding can help us understand to know how to differentiate true milk supply issue and symptomatic low milk supply: How the lactating breasts work? Mothers feel empowered when they understand how breast work to nourish their babies. They begin to trust in the process more and begin to appreciate the amazing process of exclusively supporting their newborn’s life even more. The third and the most significant development of breast happens during pregnancy apart from during embryonic stage or during puberty. The many hormones of pregnancy which include progesterone, prolactin, estrogen among others work synergistically causing significant changes to occur in the breast such as development of lobes and lobules, nipple tissue, the areola, and the Montgomery glands during pregnancy preparing the body for breastfeeding a baby. It is interesting to know that a mother’s breasts begin to make milk as early as second trimester of the pregnancy as against what is often believed to be 2 or 3 days after birth. This is often called as “Milk Coming in” in almost all cultures of the world. What this “milk coming in” really is-is only an expected increase in milk making rather than just the beginning of milk production after the placenta is expelled after birth causing a plunge in the hormone progesterone and increase in prolactin levels. Therefore the low milk supply during the early days after birth is often a perceived one or delayed milk production is often an aftermath of a poor management of labour, birth and mother’s bonding with the baby soon after birth. Post birth, knowing that more milk is constantly being produced in the alveoli (milk making sac) will give a mother the confidence she needs to put her baby to the breast, even when it feels empty to her. Infact the empty breasts is what is needed to stimulate more milk production. Birth practices affect on milk supply: It is extremely important to understand that even though labor and birth may most often take only few hours, how the birth experience is has a direct and profound effect on how the breastfeeding gets established. Research has now established that birth drugs and procedures not only affect the baby’s ability to suck, swallow, and breathe which hinders in early stimulation of breast immediately after birth but these drugs and procedures also interferes with the natural augmentation of mothers’ hormones essential for normal lactation along with rendering the mother incapable of caring for her baby due to pain, sedation and separation. The lack of early and frequent breastfeeding results in low milk production rather than low milk supply causing a breastfeeding failure. It then helps to know that protecting the mother’s birth experience and being instinctive can go a long way to set the stage for a smooth beginning of breastfeeding. For more understanding refer to the Dec 2012 issue of Mother’s World.
Mother-related low milk supply issues Mothers often take on personal responsibility thinking that low milk supply is somehow a sign of their inadequacy. Most reasons are due to lack of early and frequent stimulation of breast. Being proactive and better management of birth and postpartum can address most.
Baby-related low milk supply issues The most significant piece of the puzzle of low milk supply syndrome is the infant ability to suck effectively and efficiently. The various concerns related to a baby are often undiagnosed, unacknowledged or remain unaddressed.
The basic simple mechanism of milk making process is breast stimulation. Ensuring to address primary infant sucking issues for better latch and better effective suckling of milk will protect and improve dramatically the more fragile milk supply issue during the post partum during the establishment of lactation by expert assessment and clinical lactation management from an International Board certified Lactation Consultant (IBCLC). Most other secondary low milk supply issues can be addressed either by timely counseling and basic lactation support by certified lactation Educators (CLE) or La Leche League Leaders (LLLL). March 27, 2012 at 11:01am Most children are being put in classes – chess class, swimming class, guitar class, ballet class and many more.. I ask my daughter who is 4 years now, “Would you like to learn how to skate?, “I already know it mamma!” comes the instance reply. “Would you like to try to learn stretching since you really like it with the help of a teacher? “But I am already learning.” Would you like to join the dance class?”, “I am already learning it at school mamma.” Many parents ask me, how much play can be allowed in a day. After all we cannot let her get by play, play and more play? When will learning happen if she plays all day? Sometimes like all parents I wonder is play really a waste of time? Why is it that young children instinctively want to always play. No one needs to teach them how to play! For me it turns out that life lessons as a parent is all about trusting and my ability to continue trusting myself and my child. I trusted her when she wanted to nurse any time of day and night no matter even if it may have seemed a zillion times all day and night. I trusted when she showed me signs that she was ready for family food. I trusted when she was done and dints push her for just one more bite. I trusted when she wanted more food many days when I felt it might be more than what I considered it was enough. I trusted when she was ready for school. I trusted when she wanted to play in the pool in cold water, I trusted when she refused to enter the pool on other days even if it seemed she is all fine with no cold or fever. I trust her now when she says I don’t want to go to a class.. For me, child rearing seems to be a test of my ability to trust. After all I din’t have to make her walk or talk. Family seemed concerned when she hadn’t walked past her 18 months. She hadnt spoken much until past her 2 years. Just yesterday my close friend who met me after years said, "your daughter can really talk eh!!". This with her non stop talking for 3 hours I had guests at home. No wonder we hadnt exchanged more than just a few sentences about our lives! Interestingly, language is the most difficult thing to learn, no one ever needs to really teach them that. So maybe I can continue to trust. When she was just 15 months she spent every morning and evening for hours on end pouring water from one glass to another messing up the floor every time she bathed and every she ate her breakfast and lunch, I knew she was learning how to measure, how to coordinate how to use her judgement. At 3 she knew how to use normal adult scissors with no supervision at all. Children are born explorers and if allowed their curiosity allows them to master their skills in accordance to their internal timetable. They will learn exactly what they need to learn when they are ready for it. Just a few days ago I wondered how is it that music maestros always have music savvy children? how is it that artists have art savy children? how is it that a athletic parent has a physically aware child and so on and so forth. The answer seems to speak out loud, exposure as a part of everyday living is the best form of teaching. I highlight “as a part of everyday living” because that’s when play becomes magical teaching process for children. The exposure has to happen in the background of playing and normal living. This is so true for any form of learning, be it physical, emotional or communication skills. I remember 25 years ago, while playing in our garden, I looked over the back yard wall into our neighbours garden and noticed the usual shabby looking servant boy busy playing with some coconut shells and stones. Of course he never went to school, but voila as he played he created the most astonishing water falls out of those two halves of the coconut shells and a small piece of pipe! I was awestruck even back then. No school lessons ever taught me how to actually make that kind of creation even with fully equipped laboratories in our school thru my schooling. When I sat down to help my daughter with project on homes, my observation of that young servant boy came in handy. I am hoping my lil explorer has picked up on this experience. That is what I call learning science in reality. Now when my daughter wants to know how water came up when the crow puts the pebbles in the pot while reading her stories, I tell her why don’t you try it yourself? She played throwing stones in the buckets for days and bingo she learned her physics law of buoyancy. When she says I want to cook something for you mamma, I tell her what would you like to cook, She says "I don’t know yet mamma but I just have an idea." Without any further questions I let her mix all the ingredients that comes to her mind. One day its atta with eggs and another day it was atta, jiggery and cut fruits. She asked to fry it up and guess what she had made the yummiest fruits fritters I had even tasted!! Did I even notice she had learned the law of measurement? and cooking too in the bargain. My daughter is not very fond of physical games. But interestingly when she is allowed to pick up a book in the book store, she had been lately picking up story books of Mahabharata or a book where characters physically fight with each other. She is trying to assimilate reality, alleviate her fears. This is her way of work with herself. She is learning her social skills and perhaps even some form of combat when the boys in her class show a punch to her. When emotions are running high and energies low, I use my skills of communication of problem solving with my daughter (essential part of my parenting communication workshop – check NnN Gentle Parenting group on Facebook - http://www.facebook.com/groups/358729090820372/). I knew she is emulating when she announced just last night, “In school its difficult to problem solve mamma because no one listens to each other.” !! I realised that learning the phenomenon was far more important than just naming the learning itself. As I write this, I once again let my trust be in the process of life to allow me to let life happen as a play. As a parent I am only a net of support, security and gentle guidance for my child not a director of her learning process. Life becomes a burden when work feels like no play and isn’t it true that those who PLAY LIFE are the ones with a better share of joy and happiness? Rajeshwari Shalabh Suradhaniwar This made me speechless!! I always had the confidence that i would prove to be a great mom and a good parent. But now that my daughter is almost 10 months old,there have been several times when my patience has been tested-as a wife,as a mom and as a Daughter in law. I remember crying the whole nights for the sudden imbalance and sudden change in my married life after baby. It took me 3 months to bond with my baby and now she is an inseparable part of me. Your article has given me a new point of view to my parenting skills. Trust your and your baby's instincts and it leads to a healthy parent-child relationship! Thank u so much :) your summary of experience will be helpful to all parents here. Love to Zaara,she's a wonderful child :-* March 27, 2012 at 2:13pm · Unlike · 2 Deepa Malhotra thnks yasmin:) i so needed it with my 20 month and 5 month old boys....it is so difficult to practice patience and trust.... March 27, 2012 at 11:49pm · Like Nupur Gulati Nice read.. Thanks March 28, 2012 at 11:21am · Like Effath Yasmin Rajeshwari, thank you for your kind words. Parenting children is definitively the most challenging test of ones abilities. As you trot through life as a parent allow yourself to make mistakes and learn from it and being kind to yourself. There is great power in being vulnerable so share your experiences with your child. and yes so far the single biggest lesson I have learned in my journey of parenting is the ability to trust my child and myself. March 29, 2012 at 9:52am · Like Effath Yasmin Nupur Gulati thank you Deepa Malhotra, I am glad we can support each other in this journey called parenting. It helps if you can pick a few communication skills to deal with it. March 29, 2012 at 9:54am · Like Aparna Kabiraj reading this , i now feel guilty (for the umpteenth time) when my daughter would need to be nursed and i would get so utterly irrritated . I have to say this - that a first time mom needs to be told that ''Trust your baby when she wants to nurse any time of day and night no matter even if it may have seemed a zillion times all day and night''. I had a friend who did tell me - . but that your job now Aparna !!??!! It was outright awakening . Its a well written piece Effath... i find a lot of encouragement when I read such aritcles - I think playing in any form is good - till the learning is allowed in freedom. sometimes having a teacher is too much of a conditioning, dont u think ?? March 29, 2012 at 12:55pm · Unlike · 1 Effath Yasmin Aparna Kabiraj, I totally agree with you a teacher is a person who allows you explore and gently guides you to a discovery of knowledge.. Here again I would lead my daughter to a person who can help learn a skill if she begins to show interest...again trusting her teachable moments. Like once she asked me "who is God mamma? and believe me she could sustain full 1 hour discussion on the subject of God.. and although admittedly I was uncomfortable with the nature of her inquiry (we were never allowed as children to question the existence of God), I let my anxiety channel into acknowledgement of her need to know and must I say I was delighted with her 4 year old brains level of insight.. March 29, 2012 at 6:05pm · Like Effath Yasmin Marianna France, thank you..I agree these are important lessons as parents. March 29, 2012 at 6:07pm · Like Mirabelle Dcunha As aways,..you rock Yasmin! April 3, 2012 at 11:41am · Unlike · 1 Swetha Purushothaman Effath Yasmin mind blowing page !! luv ur parenting stride ! April 16, 2012 at 1:32pm · Unlike · 1 Dolly Bose So true, loved it :) April 23, 2013 at 8:01am · Unlike · 1 Mithira Risham Amazing article Effath Yasmin..In my 6 months experience of ebf twins there are many a times when i just lost the battle with myself..when questioned my ability to nurse..times when one of my boys just wants to nurse all day and the other is happy with his usual feeds/ nursing on my demand bcoz he would never demand to nurse..constant comparison as you'd rarely see twins with behavioral similarity..If a baby is cranky for reasons unknown ppl would say my milk is not enough..If baby unusually playful I'm relaxing too much n not taking enuf care of the playful one since he's innocent..The never ending parenting advice none of them inspiring to the mom..but babies know it all..they will set their own traits..when to nurse when to sleep n when to play..even whom to play with..I'm taking inspiration from you and will learn to trust my babies from now on.. August 11, 2016 at 1:28pm · Like |
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