Advanced Biology

A little humour first :) 

Students in an advanced Biology class were taking their mid-term exam. The last question was, 'Name seven advantages of Mother's Milk,' worth 70 points or none at all. One student, in particular, was hard put to think of seven advantages. He wrote:

1.) It is perfect formula for the child.

2.) It provides immunity against numerous diseases.

3.) It is always the right temperature.

4.) It is inexpensive.

5.) It bonds the child to mother, and vice versa.

6.) It is always available as needed.

And then, the student was stuck. Finally,in desperation, just before the bell indicating the end of the test rang, he wrote...

7.) It comes in 2 attractive containers.

He got an A.




Now for those of you that would like to know what really is wonderful about breast milk read this link below - its amazing all the new things that are being found ...

 http://www.drjen4kids.com/soap%20box/notjustfood.htm#.TyvG1ZiQkTM

Looking back at 2011...

Happy New Year everyone

I'm looking back at the year and feel very happy about it  . This time last year I was starting back after maternity leave with my 5th baby . She is now 21 months old and  a very independent little lady. I suspect this may be her last few months of breastfeeding , I will find it very hard not to be a breastfeeding mother anymore .....  I really dont want to think about it !
Highlights of 2011 for me were : (not in any particular  order )

Purple Hearts Awards for Bravery in Breastfeeding .
   This year I decided to send out purple heart awards to mums who went that extra mile and hung in there despite awful hurdles . Some lasted weeks feeding , some months - thats not the point really, I am constantly astonished by their determination and courage.  You all know who you are ! 

• Getting lots of Dads to come along to the breastfeeding  prep class . It makes such a difference and they contribute so much to the great atmosphere .It also really helps that they know their stuff during the early days at home . 
• The huge success of the tongue tie and Breastfeeding Seminar in September . 
• Meeting Catherine Watson Genna and Diana West  . Two of my heros.  
• All my exam prep students passing their IBCLC exam in July. Not passing either -  we had some excellent high scores too.
• Having an excellent paediatrician Dr Justin Roche  in Clonmel  to refer babies  who were having problems breastfeeding because of tongue tie   . He is truly a wonderful doctor and his secretary and  coworkers  in Clonmel are the best !  I  am so grateful for this service. 
• Becoming the breastfeeding expert on  www.eumom.ie .  They are a lovely team . 
• Really feeling like things are changing here in Ireland . There are wonderful support groups now - something for everyone ....online or in person . We had a fantastic National Breastfeeding  Week in October - probably one of the best ever :)

 Finally , I also felt that the profile of the IBCLC is so well respected and more mothers than ever  know about us .  We make such  a difference to many mums and babies breastfeeding experience and  thats what makes it worth it . There are so many  amazing mothers and babies  out there. Thank you and Happy New Year ! .                                                                                  

Breastfeeding Pillows , Yes or No ?

Im frequently asked about breastfeeding cushions in my class . Are they a necessary purchase to ensure breastfeeding works ?
When I started in private practice 6 years ago , I loved them , back then   teaching breastfeeding and latching  was full of instructions and mothers needed to have 20 hands to get it all right. So-  cushions were quite handy to support the baby . Then, I started to notice that lots of mothers were breastfeeding just lying the baby on the cushion and not holding them close enough  .

Unfortunately thats a recipe for sore nipples . Most newborns will attach quite well but as they get a bit sleepy they slip back , they pull on the nipple and don't feed effectively .  Can you see in the above picture how the baby is pulling backwards on the breast ?

Another issue I see frequently is that if the mother has large breasts and uses a breastfeeding cushion sometimes the cushion is in the way . There is no room for the baby ! The cushion is so high up on her torso that the baby is above nipple height ........
Most cushions cost at least €50 , are only used for 2-3 weeks and then put away in a cupboard . Id be pretty fed up if Id spent that amount and only used the product for a couple of weeks.

 Although some people will get more use  from  cushions later on when their babies need support to sit upright .

Since I and most of my colleagues  have started to teach less about latching and more about self attachment or babyled attachment , cushions have really become redundant . When mothers lie back or recline slightly there is no need for cushions . If they have had a caesarian section  and are concerned about their wound a pillow or cushion from the couch will protect the tender area.

The only time I think a cushion is a great idea is for breastfeeding twins . There is an excellent cushion called the ez2nurse twincushion . Its very useful for latching one twin and having the other close by . Its also wider than standard cushions and most mums of twins find it great. They say that the first few weeks are spent on the couch breastfeeding - the cushion balances plates of food very well ! ( Im glad to see im not the only mother who would have to pick crumbs off the baby )

So some mothers love their cushion/pillow and swear by them ...Im not a huge fan and find most of the time we can improve a poor latch by removing the cushion and using a laidback approach . My verdict would be no - not at all necessary for breastfeeding and save your money, treat yourself to a nice breastfeeding bra  !

Seminar Report - Tongue Tie and Breastfeeding

Well its 7 days since the seminar and Im just about recovered now ! My goodness it was alot of work but so worth it . I should start by saying that when I planned it I really didnt think Id have 110 attendees . That is the level of interest in this issue in Ireland . We had IBCLCs , Midwives, nurses, dieticans , SaLTs , GPs , paediatricians , Cuidiu breastfeeding Counsellors and La Leche League leaders . The wonderful thing about it was that we had IBCLCs from the UK travel over to hear Catherine Watson Genna . Some of these IBCLCs are dividing tongue ties on a daily basis . So we had a wealth of expertise in the room.
The day went off beautifully , all kept to time and there was lots of discussion .

Look at what I can do with my new improved tongue ! One of our Irish babies post frenotomy . 

So here's the things i learned....




Well guess what ? Tongue tie does effect breastfeeding sometimes . ( thats a joke :) ) 

• The main thing that seems to be important with tongue function and breastfeeding  is not extension but elevation.  If the babys tongue can elevate over half way up in the oral cavity when the mouth is open they may be ok.
• Sucking blisters on the lips particularly a sucking callous on the top lip are a sign that the baby is using their lips to stay attached (vacumn should be with the  jaw and tongue . )
• A pointed pronounced upper lip between lip and nose  ( philtrum )  is a sign of a narrow palate - narrow palates can go along with tongue tie. The tongue shapes the palate inutero , if the tongue doesnt touch the palate it becomes narrow .
• There are many different ways to spot a posterior tongue tie -  the Murphy Manouvre , looking at the palate , looking at the tongue itself and how it moves . 
• Sometimes babies are doing just fine but the mum is in alot of pain - this can be caused by the baby humping its tongue up at the back and compressing the nipple. 
• Ok BIG one coming : Irish Figures ....... yippee 
• 97% ( yes 97% ) of Dr Justin Roche's audit sample said there was a marked improvement in feeding within 48 hours of frenectomy  .  148 questionnaires posted , 83 returned (59%) .  
• Kings College Tongue Tie clinic has a very strict criteria for becoming "Frenulotomy Ready"  . They don't see babies under 3 weeks and they don't see babies that have not had intensive breastfeeding support to try everything else. 
• Kings College Tongue Tie Clinic  have a very strict policy of Post frenulotomy wound care , The wound site is massaged or disrupted for up to 14 days post procedure . They have a low reoccurance or scarring rate ( 4%).  This seems to be a contentious issue  among practitioners  but the IATP is in agreement that some amount of post frenotomy care /exercises are appropriate . 
• Cathy Watson Gennas talk on how to Help mothers and Babies with Tongue tie to Breastfeed was a gem . Highlight for me was the "breast dent " . Amazingly simple to do but so effective on getting that extra bit of breast tissue into the babies  mouth. 
• Finally - the last talk was the only one i got to sit and really listen to , Infant use of hands during Latch . Brilliant !  Essentially babies use their hands to find the breast and latch . Understanding this and telling mums what the babys behaviour means makes so much sense . This leads to much calmer mothers and lets babies do what they are best at - self attaching . I've been using this all week in my work and its just fantastic.

So , no plans for another seminar at the moment but  you never know ;)   First time  running a seminar is a steep learning curve but judging by  the evaluations , I did a fairly good job.   

Factors Associated With Duration of Breastfeeding in Ireland : Potential Areas for Improvement

An Irish "study" in our own international journal. This is great to see . But really theres nothing in it that we don't know. The recommendations are to increase postnatal support, to recognise that Dads play a role in breastfeeding duration , to promote the first feed after birth as breastmilk and also promote exclusive breastfeeding. Enough we've tried all that , it doesn't work .

 I think they should stop pouring money into breastfeeding promotion and just  help the mothers who want to breastfeed. No more posters please ! Actual antenatal education , proper postnatal support not just dependant on luck and being informed . Baby cafes ,  incentives to breastfeed such as meal vouchers. Lets keep the nearly 50%  of women we have wanting to breastfeed... actually happily feeding  at the moment they are  not making it anywhere near 6 weeks . Its just not fair to push breastfeeding at every antenatal visit then give no help afterwards .

 Its no wonder women are angry about it , Im angry that when i had my first baby 14 years ago that i was coerced into giving formula as his first feed . There was nothing wrong with him , he just needed some time to recover after a long birth and instrumental delivery . I see this happening all the time , I also see mums not knowing about the 2nd night .Where babies sometimes  like to wake up and feed all night long ?  This is basic breastfeeding information . Yet, lots of mothers don't know about it.
Labour lasts one day , two at the most , breastfeeding lasts an awful lot longer yet most first time parents spend a whole day at an antenatal class where less than 1 hour is given to breastfeeding. Sometimes a portion of that time is given to the advantages of breastfeeding , that ship has sailed long ago ...... these parents need tips , information , videos , practical demonstrations all backed up with written information with lots of graphics .
 Most women see very clearly on their second breastfeeding experience where things went wrong on their first . They know about getting help fast if things are not right , they know that if they are sore its not supposed to last the whole feed and should improve as the days go by .
Its all about education first , then skilled help, then support to keep going. Thats not so hard is it ?

Tales from the trenches – Nursing Strikes , Breast refusal ...

Well , this tale is from my own trench .  In all my years breastfeeding I had never experienced  a strike. And boy, do I not want to ever see one again . We have had a very easy year my youngest daughter and I – after a rough start with  a posterior tongue tie , once that was divided and she sorted out her sucking – we never looked back .   So   about this time last week my little lassie of 13 months old ,  started to refuse to feed . She just kept turning her head away , no interest. She was perfectly happy , she just didn’t want to feed . So the first day I didn’t get too bothered , the second day,  I was  getting a little more concerned , I kept trying her but no go .

Now, I started looking for reasons – of course the mammy guilt crept  in ! I had been really busy at work and  had not spent as much time with her as usual . Had been out a couple of evenings and not put her to bed.  She had slept through a number of nights thus not feeding during the night .  She had  a slight runny nose but had never refused before even when streaming with a cold.  I had started taking multivitamins and fish oils – maybe there was a taste to my milk she didn’t like ? 

That night I ran into her when she woke thinking if I caught her when she was sleepy she might latch . Nope . Nada , don’t go there Mum.  She even put her hand over her mouth . She was really calm , no crying , just not going to feed.

I lay awake thinking  , this is the end , cue major panic . Devastation . Im  not ready for this and neither is she ( even if she doesn’t know it !) . My husband mopped up the tears.

I got up on Saturday  and pulled out the books – actually, I pulled out the Womanly Art of Breastfeeding . It was like a hug . They said – get support . So I rang the wonderful Mairead of LLL .  Even us IBCLCs know when we need support. Mairead said she would ring me back .  I decided to just try to see if she’d latch and guess what? On she went  and took a couple of sucks . The relief was amazing (both physical and mental !)  Over the day she had fairly short feeds but she was back on and that was all that mattered.  On Sunday she was even better – back to her old self, coming off the boob laughing .  My husband calls it her “fix “.  She can be howling about some injustice, quick feed and  she pops up laughing.

We are back to normal feeding now ,  I’m a little shaken by it all , quite surprised that I was so emotional.   I guess I was just rolling along and though we had at least another year to go.  I am so grateful to Mairead for her support and the long chat on Saturday. Obviously, she has great powers because once I made the call, it all started to fix itself !

And guess what , Monday morning I spotted a nice little molar peeping through at the back of her mouth ……  if there’s a next time I promise to be calmer .  All is well ,  Life is good . 

For more info on nursing strikes - http://www.kellymom.com/bf/concerns/baby/back-to-breast.html

So what if this advertising campaign ran in Ireland ?

I was reading the post below from phd in parenting and found myself thinking ...what if the food safety authority here in Ireland  ran an ad like this ? What if they told parents that the claims that a certain formula will make your baby laugh all day are baloney? That the addition of DHA to infant formula is absolutely useless and the origin of the additives is fairly yuch?  That the additive in infant formula  to settle babies who are colicky/reflux  is potato starch ...
Why is it all glossed over and made look pretty ? Because thats what sells ..
And then i got to thinking , well is breastfeeding presented in a glossy ,angelic ,  never a problem and if there is its your own fault for not doing it right.   If you cant do it perfectly, there's something wrong with you as a woman ? Yes, sometimes it is and that doesn't help anyone .
I often say that if you are looking for someone to support you in the early days of breastfeeding , a mum who has had some teething (pardon the pun) problems might be  a better  choice than one who never had an issue. Learning a new skill generally isn't very pretty , so mums in white nightdresses with perfect babies ( no spots or blemishes!) would make me think that its a little unreal, only for the perfect beautiful people .... Most new mums are anxious , nervous , going feed to feed, one day at a time , don't  understand that just because the latch doesn't go right first, second or third time - doesn't mean that both of you wont be breastfeeding easily in a couple of weeks .
Everything thats worth it , takes time.
http://www.phdinparenting.com/2011/03/04/do-advertisers-just-think-parents-are-this-stupid-or-are-they