Keeping Up-To-Date

Keeping up to date is a big part of being an IBCLC – making sure practice is evidence-based.  This week I have been fortunate enough to experience some local and world-renowned speakers who I found inspiring. Kathleen Marinelli is a neonatologist and Director of her hospital’s Lactation Support Services.  Her dynamic talk was on a gut disorder in babies and breastfeeding’s role in protecting against and minimizing the risks of this illness.  She also gave a talk on her hospital’s treatment of ‘late, pre-term babies’.  Her approach is of careful observation while keeping the mother and baby together whenever possible and only intervening when absolutely necessary. Other speakers discussed the risks involved of offering babies ‘Just One Bottle’ and a update on current research happening in Perth. These topics have implications for me as an IBCLC – both in terms of my practice and awareness of what a mother may have experienced before I see them in a consultation.  It’s a pleasure to keep abreast of current topics with speakers like this. Image by Kookai...
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The Great Dummy Debate – A Personal Perspective From An IBCLC

All my children had dummies…. Was this a good thing?  The answer is both yes and no for me.  For my first child, having a dummy was the means to an end and also the beginning of a slippery slope to early weaning. When I brought my first beautiful newborn baby home from hospital, I was elated.  This lovely scene came crashing down around me when breastfeeding went very wrong.  My baby was drowsy and I was getting more and more frustrated that she wasn’t feeding.  Eventually after she became more alert, she REALLY wanted to feed.  By this stage breastfeeding was excruciating.  I dreaded attaching this beautiful little bubba to my breast to feed.  I started trying anything I could to delay feeding her and stretch the feeds out.  This inevitably led to using a dummy.  There were two things wrong with this. Firstly, she was crying because she wanted to feed and make up for the days that she had been drowsy.  She was showing me all the feeding cues and I just didn’t recognise them.  Also, my breasts were not getting the stimulation they needed to make the amount of milk my baby needed. Secondly, she was already attaching poorly and introducing a foreign teat which in no way stretches and functions like a breast was, in my opinion, contributing to her trouble. In the end I couldn’t face the toe-curling pain with each feed and chose to express my breastmilk and feed it to her with a bottle.  I was disappointed and sad that breastfeeding hadn’t worked out for me.  It wasn’t all about the dummy, but it certainly didn’t help. My second and third babies also had dummies.  This time around I was more informed and more determined to get things right.  So I chose to focus on establishing breastfeeding as a priority after I had the baby – electing to use other settling techniques and delaying the use of a dummy until about 6-8 weeks.  When I did use the dummy it was sparingly and when I knew that the baby’s tummy was full.  I tuned into my babies and looked for feeding cues, I also realised that I had a limited milk storage capacity and that my babies really NEEDED to feed frequently to thrive – which they did.  I used the dummy to help them to get to sleep, in the car...
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Sleep Routine Books

I often get asked which sleep/routine book I recommend for babies.  The answer is a difficult one – there are so many out there.  What I usually ask mothers of new babies is why they expect their baby to be in a routine?  I felt pressure from a whole range of people to ‘have my baby in a routine’.  As a first time mum, I thought this was something I really had to instil in my baby.  I thought that as ‘good parents’ we had to teach our baby to sleep through, feed at predictable times and have a nap when it was convenient for me. It wasn’t until later that I became more educated about breastfeeding.  This helped me realised how trying to get babies to ‘fit in’ to our expectations instead of tuning in to our baby’s needs can compromise some people’s ability to breastfeed.  Some breastfeeding issues do effect a baby’s ability to sleep or settle, and if you’re concerned that this is the case you can contact me to see if a consultation would be appropriate. Some of the side-effects of enforcing a routine on your baby can be detrimental to breastfeeding.  If your baby is crying because they are hungry and this cry is not heeded, at least two things happen.  The baby will not have his needs met and the mother’s breasts do not receive the stimulation they need to maintain her milk supply.  If this continues, a baby is at risk of poor weight gains and the mother is at risk of a diminishing supply.  Sometimes, like me, hindsight tells us we could have made better choices. Do I like any of these books?  Absolutely.  Any book which supports a mother to listen to and respond gently to her baby has a role to play.  Having a variety of tools in your ‘parenting toolbox’ can be a great benefit. If you’re looking for a book to help you with some parenting, sleeping and breastfeeding issues, I suggest you read whatever you like – take from it things that you think suit your parenting style, is gentle with it’s approach,  and supports feeding your baby when they are hungry – and discard the rest. As babies get older, they often find their own natural pattern of feeding and sleeping.  When we tune in to our babies, we are more likely to pick up on...
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Alcohol and Breastfeeding

In the latest ‘Essence’ magazine (published by the ABA), an article discusses some recent research which estimates the number of Australian women who drink alcohol while pregnant, breastfeeding or pregnant and breastfeeding. Quoting the research, Essence says that 29% of those who were pregnant, 43% of those who were breastfeeding and 36% of those who were both pregnant and breastfeeding drank alcohol.  The article goes on to point out some risks involved with drinking alcohol when pregnant or breastfeeding and those mothers who are more likely to drink alcohol. Am I surprised by the findings?  Not at all.  When doing consultations, part of my initial history involves talking about how much alcohol the mother is consuming.  The reason I ask about alcohol is two-fold. Firstly, there are risks involved in drinking alcohol in pregnancy and during breastfeeding, and the mother needs to be able to make an informed decision about alcohol consumption.  Being informed can help the mother to make choices that minimise the risks to her baby. Secondly, some mothers find that drinking alcohol inhibits their let-down.  This can be a real challenge if you are already struggling with low-supply or have a baby who needs some encouraging to go to the breast. The ABA article went on to discuss a brochure it has produced called ‘Alcohol and breastfeeding: a guide for mothers’, in which it gives some guidelines about timing of drinks and levels of alcohol in breastmilk.   Original research – Prevalence and predictors of alcohol use in pregnancy and breastfeeding among Australian women  Maloney E, HutchinsonD, Burns L, Mattick RP, Black E 2011, Birth 38:1 Article discussed in LRC section Essence Magazine, March 2012, 48:2...
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Breastfeeding In Public?

When you’re expecting your first baby you often have some really firm ideas about what you are and are not going to do with your baby.  You may not be sure how you feel about some things.  Feeding your baby in public is one of those topics that can polarise people.  So, let’s look at the facts. Babies are born with small tummies and exclusively breastfed babies digest their perfect food efficiently, so it moves through their gut quite quickly.  This all adds up to small babies needing to be fed fairly frequently.  Older babies can also go through periods where they need to feed more frequently than usual.  These situations, in themselves, are not an issue until you find yourself out in public with a baby who is showing all the signs of needing a feed.  What do you do? The answer to this is as individual as each mother/baby pair.  Some people feel very comfortable attending to their baby’s breastfeeding requirements when ever and where ever the baby needs.  So, for these people, it’s a simple matter of finding a comfortable position for themselves and their baby and getting on with it.  Remember, you are allowed to feed your baby anywhere!  There are very few exceptions to this rule. Other people are more concerned about feeding in public.  They may feel exposed or vulnerable feeding their baby in a public place.  For these people a quite corner of a café, a feeding room at a shop or in the passenger seat of the car can be a safe private place for them to meet their baby’s needs.  Some people choose to attach their baby and cover them with a wrap or baby-feeding cape.  This works for some people, and not for others – particularly as the baby gets older and wants to see what is happening around them.  Some mothers find that newer styles of breastfeeding-friendly clothing make them feel less exposed when they do need to feed in public, or that by sitting in front of a mirror and feeding their baby, they may be able to tell that actually, not a lot of skin or breast is visible when a baby is attached. Or, like a lot of people, you may find you are a mixture of both.  You may feel comfortable feeding in public in certain situations and in front of certain people, and with other...
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What is an IBCLC & When Do I Need One?

An IBCLC (International Board Certified Lactation Consultant) is a person who has worked with breastfeeding mothers and babies for an extended time, accrued significant professional development hours and has sat and passed an international level exam set by the International Board of Lactation Consultant Examiners (IBLCE).  IBCLC’s are specialists in their field and are a reference point for any breastfeeding issue. Many IBCLC’s come from a mother-to-mother breastfeeding counsellor or midwifery background.  Some are registered nurses from a hospital setting, others have been allied health professionals.   All lactation consultants who have IBCLC after their name, however, have attained the highest standard in the specialty of breastfeeding – regardless of their background. The role of an IBCLC is usually in one of two areas.  There are often IBCLC’s employed by maternity hospitals to support mothers who birth in that hospital during the post-natal period.  Others go into private practice and support mothers during pregnancy and after the birth of their baby. Research supports the fact that mothers (& their partners) who receive breastfeeding education before their baby is born are more likely to have better breastfeeding outcomes.  IBCLC’s have an indepth knowledge of issues which may effect breastfeeding and can provide an individual assessment before a baby arrives. IBCLC’s are a wealth of knowledge after your baby is born and can help with all breastfeeding related issues.  Whether a baby is having trouble attaching, breastfeeding is painful or there is concern about milk supply – if it’s breastfeeding related, an IBCLC will be able to help. If you’re returning to work, an IBCLC can help you to plan for the transition.  Both mother and baby will need to adjust to the changes, and input from an IBCLC can help make the transition as smooth as possible. Some IBCLC’s provide professional inservice sessions and conference lectures.  Some are authors of fantastic books or run online breastfeeding education sites. So, IBCLC’s are highly qualified health professionals that have a wide-ranging role in supporting breastfeeding mother/baby dyads in a variety of...
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