Best for Babes

Here is one of the biggest “booby-traps” that keeps nursing moms from meeting their personal breastfeeding goals and reaping the lifetime benefits of breastfeeding for themselves and their babies:

There is no unified national policy to protect breastfeeding mothers from being fired or discriminated against in the workplace. While 49 states, the District of Columbia, Puerto Rico and the Virgin Islands have enacted various laws protecting breastfeeding mothers, those laws are not uniform and most are not comprehensive.  

Rep. Carolyn Maloney and Senator Jeff Merkley have introduced the Breastfeeding Promotion Act of 2009 in Congress on June 11, 2009.  The Act (H.R.2819, S. 1244) includes five provisions:

1)  Amends the Civil Rights Act of 1964 to protect breastfeeding women from being fired or discriminated against in the workplace.

2) Provides tax incentives for businesses that establish private lactation areas in the workplace, or provide breastfeeding equipment or consultation services to their employees. 

3) Provides for a performance standard to ensure breast pumps are safe and effective.   Crappy pumps put an end to breastfeeding.

4) Allows breastfeeding equipment and consultation services to be tax deductible for families (amends Internal Revenue Code definition of “medical care”)  This is huge because lactation counseling services can be critical to helping moms and too often are not covered by health insurance.

5) Protects the privacy of breastfeeding mothers by ensuring they have break time and a private place to pump (for employers with 50 or more employees).   Consider that many employees are allowed smoking breaks but not pumping breaks, or have to pump in the bathroom or a broom closet!

Here’s an easy email tool from the United States Breastfeeding Committee that in 60 seconds allows you to enter your name and address including zip
code+4 and have the USBC send emails to the appropriate
representatives and senators asking them to co-sponsor the bill.
http://org2.democracyinaction.org/o/5162/t/6359/campaign.jsp?campaign_KEY=1697

In addition to Maloney and Merkley, 10 representatives and one senator are co-sponsoring the bill as of June 17, 2009: Reps. Capps, Olver, and Frank of Massachusetts, Reps. Roybal-Allard, Levin, and Meeks of New York, and Reps. Kaptur, Snyder, Schwartz, and Moran of Virginia, and Senator Gillibrand of New York  (the first breastfeeding congressperson in history).

On Martin Luther King Day, I wrote about how nursing moms are being discriminated against by cultural and institutional barriers.    If you think breastfeeding is not a big deal, or that because you succeeded with it that moms are “just not committed enough” (a phrase by the smug that just makes me really mad), then please read that post or the one I wrote for Mom’s Rising.   The reality is that moms are being urged (and sometimes not very nicely) to breastfeed at the same time that they are being set up to fail.   If you are tired of the lip service, here’s your chance to do something about it!!   Boy, wouldn’t it be nice if Hannah Rosin and The Atlantic had focused on publicizing the Breastfeeding Promotion Act instead of the Case Against Breastfeeding?

Thanks to Angela White of Breastfeeding 1-2-3 for motivating us bloggers to post about this momentous occasion!

One of the things we enjoy most is not reinventing the wheel.    When we founded Best for Babes, we knew that there is already tons of great information out there for moms . . . just not enough moms know about it!   As we’ve said a million times, moms know more about which stroller to buy than how to breastfeed.   So we’re here to help level the playing field and get some of that awesome info into your hands, babe!

Here’s a great example.   http://www.workandpump.com.    A website for moms who are going back to work, to answer all your questions.   Created by a really smart mom (she’s a scientist, and we’re totally impressed), Kirsten did all the work and research so you don’t have to.    She even created handouts for your employer that you can just print out, and goes over everything you need to know from how to build up a stash of milk to a packing checklist for work.  

Kirsten very kindly gave us her top “FAQs” — frequently asked questions — and answered them for us!   Here they are, and don’t forget to check out her website for detailed information.   

1)     How can I tell my boss I’ll need pumping breaks when I come back?  First, the facts: when employers support breastfeeding moms, they save tons of money.  Yes, you’re taking breaks all day for about a year, but here’s what your boss gets: you and your baby cost less in health insurance – it costs insurers over $450/year in additional health care costs when a baby isn’t breastfed. You miss less work – because your baby is healthier. You are a better employee – because you feel supported by your boss, and are (statistically, anyway) less likely to quit. So – go into the conversation with these facts in mind. You don’t have to rattle them off, but just knowing that you help the company’s bottom line by breastfeeding can help you feel better about asking. Second, check state laws. To date, 24 states have legislation relating to breastfeeding moms in the workplace (check here for updates and to see what your state’s laws say: http://www.ncsl.org/IssuesResearch/Health/BreastfeedingLaws/tabid/14389/Default.aspx).  If you’re protected by the law, a copy of the legislation dropped in your boss’ box may be enough. But when it comes down to it, just ask for what you need. A private (non-bathroom) space and a few breaks each day. You can say you need to “express milk to feed the baby” if you don’t care to have your boss and the word “breast” in the same room. Tell your boss it’s a limited time benefit that’s being supported by more and more companies, including our own US government’s Offices of Health and Human Services (who are supporting the Business Case for Breastfeeding Project to encourage more businesses to accommodate their breastfeeding moms.)

2)     How much milk do I need to leave for my baby? It depends. An average baby between the ages of 1 and 6 months takes in about 25 ounces per day. But remember, “average” means some take more, some less, but one ounce per hour is a reasonable starting point. Factor in the time your baby is sleeping and not eating at night, and usually about 12-15 ounces is more than enough for a 9 hour separation. Let your baby help figure it out – the end of a feeding should be determined by the baby, not the amount of milk left in the bottle. And really, the daily amount doesn’t change in the first 6 months – it just seems like it because they sleep longer at night, so need to eat more when they’re awake.

3)     How can my childcare provider support my breastfeeding? Easy, don’t overfeed the kid! If your baby is fed too much while you’re gone, that’s more milk you have to pump or express. Give them this fabulous handout  from the Australian breastfeeding association – it explains how to pace (i.e. slow down) feedings, and has lots of breastfeeding-supportive information – written just for child care providers.

4)     What’s the best kind of bottle for a breastfeeding baby? Depends on the baby, there’s no one best choice. Go with the one that they’ll accept, but not drink too quickly from. The most important thing is to stick with the lowest flow nipples you can buy. Why? Because if feeding from the bottle is too easy, your baby may begin to prefer the bottle. He may also overeat while you’re away – meaning more pumping and less nursing time for you – not a good deal.  (Note:   Choose a bottle that is BPA-free)

5)     How often do I need to pump at work? Again, it depends. The average is every three hours. But some women can store a large amount of milk in their breasts and may be able to pump only twice a day and express all they need. Others can store smaller amounts, and need to pump more often. However, in both cases, these two things are true – when breasts are full of milk, they tell your body to stop making so much. And, when breasts are empty, they make milk much faster. So, frequently emptying them is the best way to make more.

Happy working and pumping!!

We would love your input here.   We have put up a new section on our website about how to be a “bosom buddy” and what to say and not to say to moms (see below), and would love more suggestions to flesh it out!  

How do I support a friend to breastfeed?

Here are some suggestions excerpted and expounded upon from our Fit Pregnancy:  Update on Facebook vs. Breastfeeding:

1)  Be gentle.   Come from a place of acceptance and compassion; most mothers are far more open to hearing your experience than they are interested in being lectured to or told what to do.   Your best bet is to share your experience in a non-judgemental, humble way.    Always put your friendship first.

2) Listen.   Ask your friend what she knows about or has heard about breastfeeding.    Help her think about any underlying feelings she may have, share yours.   Only if you listen to what is really going on with her will you know how to best support her, and be able to direct her to the appropriate resources.   Hammering her with the science will do no good if her mother disapproves of her interest in breastfeeding.

This does not work.

3)  If you see a mom nursing in public, give her a “thumbs up”!   We usually just say “Good for you!” or “Great job!” as we pass by.   Many new moms are very nervous about nursing in public and your encouragement gives them a confidence boost and sets a good example for others.

4) Ignore misbehavior.   Yes, there are some moms who go too far and are looking for attention, and the best thing you can do in those situations is ignore them.     Try to keep it all in perspective—flagrantly whipping your boobs out is still not as bad showing that you are not wearing underwear or something!  The more accepting our culture becomes of mothers who nurse discreetly, the sooner the need for militancy, extremism or baring all to make others uncomfortable will disappear.   Try to understand that militancy comes about from frustration at the overwhelming odds stacked against moms. 

More resources: 

A fabulous post on supporting moms to make decisions right for them:    Breastfeeding, Bottle-feeding, and Somewhere in Between:  Why the Guilt?

What if a breastfeeding mom makes me uncomfortable?  

From Fit Pregnancy:  Update on Facebook vs. Breastfeeding:

We understand because we used to be uncomfortable with it too! After all, breastfeeding in public has been taboo until recently. It might help to view it like other cultural changes: it took a while to get used to the bikini, or seeing people in their workout clothes. Americans are very flexible culturally–consider that Hummers used to be cool, now they are not, because we are more aware of environmental damage (it’s hip to go green and breastfeeding dovetails perfectly with the environmental movement, it’s the original organic!) We hope that with a little effort, soon breastfeeding will not only be tolerated as normal, but will be celebrated, admired and supported.

More resources:

From Elita, one of our favorite, hip & hilarious bloggers, at Blactating Blog:  How do I act around a breastfeeding mom?

What else can I do?

Join us to help bring about mainstream change.  Send this link to a friend, sign up for our blog,  donate so we can help educate more people on how best to support moms.   Part of the backlash against breastfeeding has come about because too many people are beating women over the head about breastfeeding but not using the same coaching skills and encouragement they would to support someone to exercise or quit smoking.   We have heard horror stories about how women were berated in the hospital, at home, in public and the workplace.   Please help us put an end to this abuse!    Best for Babes has a group and cause on Facebook, you can help spread the word and raise funds to educate more mothers about how to avoid the “booby traps” and help fight the barriers that are tripping them up.   Breastfeeding protects against dozens of diseases, yet most of these diseases have millions more supporters and dollars than any breastfeeding organization.   It’s time we all stood up for the “mother of all prevention,” right under our nose!     

We welcome more suggestions, posts, and comments for this section.   Please contact us!

The Wall Street Journal Online posted a good article, “Pumping Breast Milk on The Job Still Carries Costs.”  I think the “carrying costs” part is a little confusing, though.   The truth is that not helping moms to succeed at breastfeeding carries the greatest costs–for moms, babies, society and the environment.  Still, the article does a good job covering some of the challenges of going back to work in a culture that does not fully appreciate the benefits of breastfeeding.   “Despite the advantages for both mother and infant’s health and the potential for employers to reap fewer absences in the long run, expressing milk on the job remains a sensitive subject for many working women.”   

I’m not sure if it’s a sensitive subject as much as it is an uphill battle for far too many women.   It’s a shame that U.S. mothers are in a position where they have to choose between doing what’s best—best for their babies, best for their own health, best for employers, insurance companies, the environment and more—and what’s socially acceptable or convenient.    Pumping at work is not convenient in the U.S., unless you have a white-collar job at one of a few companies that really support moms.  Even then, our culture is such that many people are not comfortable with anyone pumping on the job, even if it is supported by company policy.  “Mothers working low-wage jobs and jobs with high turnover are especially vulnerable to quitting breastfeeding early.”

What I particularly liked is that the article mentioned the role of stress in inhibiting milk production.  The stress our culture puts mothers under by encouraging them to breastfeed but setting them up to fail can surely be blamed for the high numbers of women who think they can’t make enough milk, but probably could if they weren’t under stress—stress from in-laws, strangers, employers, hospitals, doctors and friends who mean well but undermine their confidence or badger them in various ways to give up breastfeeding.    

The article also touched on the recent statement from the Centers of Disease Control encouraging breastfeeding to help babies fight off possible infection  of the H1N1 (swine) flu.  

A bit misleading is the implication that progress is being made because 43% of moms are doing some breastfeeding at 6 months vs. the government’s goal of 50% set for 2010.   I know it’s important to acknowledge progress, but I can’t help but continuously be disappointed in the goal that was set at only 50%.   Consider that in Sweden, 79% of moms are still breastfeeding at 6 months.   More compelling is the fact that the American Academy of Pediatrics recommends exclusive breastfeeding for 6 months, and only 12% of all U.S. moms are making that goal.  

That is where the real cost to all of us lies.

The CDC issued guidelines for moms who are breastfeeding, or considering breastfeeding, and are concerned about the swine flu (H1N1 flu).   The swine flu is a particularly nasty strain of flu that is spreading from person-to-person just like the regular flu.   I might add that this information is helpful too, for any mom who is feeding formula but has access to screened, pasteurized donor milk from a human milk bank.  I thought these guidelines were excellent, and show just how critical breastfeeding is!

Here is a summary, beyond the already widespread urging to wash hands and not cough or sneeze on anybody, including your baby.   (If you are ill, or coughing and sneezing, you may want to see a doctor to be tested for the flu and consider wearing a mask.)

• Breastfeed to protect your baby.  Nursing moms make antibodies to viruses and pass these along to their babies while nursing, or through expressed milk.   Antibodies help fight infection, so the best thing all mothers can do is continue breastfeeding.  “Flu can be very serious in young babies. Babies who are not breastfed get sick from infections like the flu more often and more severely than babies who are breastfed.”
  

  Not how we got the swine flu, but a cute picture!

• Don’t stop breastfeeding if you think you have come into contact with the flu.   “Because mothers make antibodies to fight diseases they come in contact with, their milk is custom-made to fight the diseases their babies are exposed to as well. This is really important in young babies when their immune system is still developing. Breastfeeding also helps the baby to develop his own ability to fight off diseases.”
• Breastfeed even if you are sick with the swine flu, or any other flu.  “Breastfeed early and often. Limit formula feeds as much as possible. This will help protect your baby from infection.  If you are too sick to breastfeed, pump and have someone give the expressed milk to your baby.”
• If your baby is sick, breastfeed!   “One of the best things you can do for your sick baby is keep breastfeeding.  Babies who are sick need more fluids, and breast milk is better than water, juice or Pedialyte®.   Breastmilk is easier to digest (some babies who have a stomach virus will throw up Pedialyte®, but not breastmilk) and is custom-made for your baby, meaning that the water content of your breastmilk adjusts to what your baby needs.   Also, did you know that your breasts can detect a one degree drop in temperature in your baby and warm up to act as an incubator?
• “If your baby is too sick to breastfeed, he or she can drink your milk from a cup, bottle, syringe, or eye-dropper.” Using these types of feeding methods will ensure that your baby goes back to the breast easily.   Using a nipple and a bottle may cause your baby to change his/her “latch” which can make breastfeeding difficult and/or painful.
• “If no expressed milk is available, you can give your baby milk donated by other mothers to a HMBANA-certified milk bank.”
• Continue breastfeeding even if you are taking medicine for the flu.   If your doctor is unsure about whether you can continue breastfeeding, or says you should stop, refer them to the CDC guidelines or the  CDC H1N1 website often for the most recent updates. 

In her first interview since giving birth to twin girls Charlie and Dolly four months ago, Rebecca Romijn reveals to Extra that her secret to losing weight is breastfeeding.   She’s pretty candid that with nursing twins, she hasn’t “been able to work out that much . . . It’s impossible to get back into a regular schedule.”    She goes on to admit that she is not back in shape, but what’s great is that she doesn’t seem to care. 

It’s also so awesome that Ms. Romijn is breastfeeding twins, especially at 4 months.  The best thing a mom who is expecting a duo can do is meet with a lactation consultant and get prepared.  For some tips on how to succeed with twins, see our contribution to the Celebrity Baby Blog story on Angelina Jolie, and for a good laugh, read Double Trouble by Suzanne Schlosberg.   Guaranteed you will have a new appreciation for Ms. Romijn and all moms who have tried–and/or succeeded–with nursing twins!

We’re thrilled that Ms. Romijn is so open about the fact that she is breastfeeding, because celebrities can really help lessen the cultural squeamishness around nursing.   I was one of those people who was uncomfortable seeing a mother nursing, most likely because it was so rare.   When celebrities share that they are nursing it helps desensitize us.   It can even be a clever way to sway your mother or mother-in-law who would feel more comfortable if you didn’t breastfeed.   If the subject comes up (again), try casually mentioning that Gwyneth Paltrow, Kelly Ripa and ____________ (insert the name of her favorite celebrity that you happen to know breastfed here) and perhaps she’ll change her perspective a little bit!    For the latest updates on breastfeeding celebrities, check out the breastfeeding page at Celebrity-Babies.com.

Have you ever “name-dropped” a breastfeeding celeb?

CBS News did a wonderful segment that shows just how critical human milk is to premature infants.  Kudos to CBS for raising awareness of this important issue.  The video and accompanying article explain that only “45% of premature babies are going home on breastmilk, as compared to 74% of full-term babies”, marvel at the unknown powers of human milk, and emphasize the increased risk of deadly necrotizing enterocolitis in babies that are not breastfed.   At the UC Medical Center in San Diego, rates of necrotizing enterocolitis dropped from 5.8% to less than 1% after preemies started routinely receiving human milk. 

First, let me argue with the statistic a little bit.   While 74% of babies initiate breastfeeding in the hospital, it is not true that 74% go home on breastmilk. In fact, because hospitals have been shown to perform poorly on breastfeeding support, at some hospitals, only half that number is still breastfeeding at all at discharge, and the percentage that is exclusively breastfeeding is much lower.   So, along with great media coverage of hospitals that are moving in the right direction,  we need more media coverage of the hospital practices that are still sabotaging breastfeeding. 

It would also be great if the media could shed some light on why the March of Dimes’ March for Babies, whose mission is to improve the health of babies by preventing birth defects, premature births, and infant mortality, is being sponsored by Mead Johnson Nutritionals, makers of Enfamil, a brand of infant formula.   Doesn’t this seem like a horrible conflict of interest?  What message does that send?

And don’t tell me that March of Dimes is not aware.   Promom.org organized a letter-writing campaign back in 2005.    If CBS News or 60 minutes could do a little story on that, then I’d be really impressed!

“Double Trouble”

By Suzanne Schlosberg  

Suzanne Schlosberg is the co-author of The Essential Breastfeeding Log, The Active Woman’s Pregnancy Log and author of The Essential Fertility Log.

Editor’s note:  The following is excerpted from Unbuttoned: Women Open Up About the Pleasures, Pains, and Politics of Breastfeeding, edited by Dana Sullivan and Maureen Connolly, copyright 2009, used by permission from The Harvard Common Press.   I have 5 copies of the book to give away.   To win a copy, leave a comment describing why you would be interested in reading this book. 

I used to think that the most boring person alive was Steve Forbes, the former Republican presidential candidate who droned on for a decade about replacing the federal income tax with a 17% flat tax on personal and corporate earnings.

But I was wrong. It’s not Steve Forbes. It’s me. Because all I talk about these days is breastfeeding.

Consider: Last week at the supermarket I ran into an elderly couple from the neighborhood. Though we ostensibly had plenty to chat about – their trip to Florida, our town’s new Thai restaurant - somehow, within seconds, I turned the conversation to my milk supply. Marlene managed to feign interest, but poor Nathan was reduced to reading the nutrition labels on the ground beef.

Worse: Last weekend at a bat-mitzvah party, the president of our synagogue’s board of directors marched over, grabbed my hand and said, “Could you stop talking about breastfeeding for five minutes and come dance?”

But what’s there not to talk about? Feeding my four-month-old twin boys is the driving force of my existence. In my every waking moment, I’m never more than 2 1/2 hours from the next nursing or pumping session, which means if I’m not nursing or pumping, then I’m thinking about the next time I have to nurse or pump and calculating how to squeeze the rest of my life into that window. My breastfeeding schedule dictates everything, even down to where I get my snow tires installed. (Every year it’s been Costco, where I brave the long lines in exchange for the low cost. But this year I paid double at a local garage because the wait at Costco was longer than my breasts could withstand.)

The other day a friend startled me with this question: “What do you like most about motherhood?” She might as well have asked, “What do you like most about Slovenia?” The thing is, I don’t really think of myself as a mother. I think of myself as a breastfeeder.

It’s true that I’m the one who delivered my twins - one vaginally and the other via c-section, which, technically, makes me not only a mother but also a war hero. And yet I feel I’ve done so little mothering. I would venture to say that my husband, who bathes the boys before bed and massages them with lotion while I work in my office, does the bulk of the mothering. Even when I’m singing “The Wheels on the Bus” to the boys on the morning shift, my mind is wandering: How much will I be able to accomplish before the next feeding?

A friend suggested that my preoccupation with breastfeeding is biologically driven – that new mothers are programmed to be so single-minded because otherwise their babies would starve. It’s a good point. I’m acutely aware that a few wrong moves – a couple of mistimed dermatologist appointments or a six-hour wait at the Costco – and my milk supply will dry up like Lake Anguli Nur in China.

Before the boys were born I wouldn’t have pegged myself as the type to blather on about nursing. After all, when I was pregnant, I rarely talked about my pregnancy. What was there to say? I was fat. I had heartburn. My ankles were swollen. None of this struck me as newsworthy. Pregnancy was easy to dismiss as a conversation topic because, other than monthly doctor’s visits and a trip to the jeweler to get my wedding ring sawed off, it required nothing of me. I was pregnant the same way I was left-handed: I just was. But breastfeeding is different, not only because it demands so much of my attention but also because my milk supply has been so hard-earned.

Toby and Ian were born a month early, weighing about 5 pounds each, with less body fat than Nicole Richie pre-rehab and even less interest in sucking. When presented with my nipples, they were at a complete loss, as if someone had offered them fly-fishing rods. They’d fall asleep or cry or just flail about, but rarely would they suck. Without sufficient stimulation, I was producing no milk. The hospital outfitted me with an industrial-grade breast pump that looked like it could extract breast milk from my deceased grandmothers, and I dutifully cranked it every three hours, 24 hours a day. But still, no milk.

To help the boys along, the nurses hooked us up with a remedial nursing system, training wheels for the lactationally challenged. Clipped to each of my bra straps were small, formula-filled bottles with tiny hoses dangling from them. I’d tape the hoses to my breasts, then insert the ends into the corner of the boys’ mouths as they “nursed.” The idea was that the babies would think they were breastfeeding when, in fact, they were sucking formula through a straw. My boys did not seem to appreciate the leg up and would expend huge amounts of energy shrieking and yanking the tubes off my breasts.

All of this was monumentally distressing. I couldn’t help but feel that I was failing Toby and Ian. (I’ll admit that at a low point, I tried to get them to shoulder some of the blame and blurted out, “You people have only one job – to suck – and you can’t even do that?” I later apologized.)

After four days in the hospital our problem moved home, along with all my anxieties. The situation remained so frustrating and so utterly ridiculous that my breastfeeding, or lack of it, was unquestionably my biggest headline when my friends asked how I was doing. And they seemed rapt as I described our strategies to keep the boys from falling asleep on the job, like tugging at their ears, tickling their feet and promising to buy them video games when they grew up, the kinds with Uzis, suicidal terrorists and mutilated female corpses.

We abandoned the hose system – you can’t use training wheels forever – and, gradually, the boys did start to catch on, though not enough to earn any Boy Scout badges. Toby would lick instead of suck. “It’s a nipple,” I’d plead, “not an ice-cream cone.” Ian would spit out my nipple 15 or 20 times per feeding, as if he were being force-fed Brussels sprouts.

I’m certain I’d have thrown in the towel if not for the encouragement of a friend with twins who’d persevered through ten weeks of the same problems, plus a breast infection and cracked and bleeding nipples. I felt like a demoralized marathon runner who’s on the verge of dropping out of the race – until someone with an artificial leg hobbles by. Quitting was not an option.

Plus, mercifully, there was Charlotte. Charlotte was our baby nurse, generously underwritten by my parents for our first two weeks of parenthood and imported from Los Angeles, where they live, because there was no such person as a baby nurse in my town. (I live in do-it-yourselferville, and though I’d like to maintain the delusion that I could have done it myself, I’m skeptical, and utterly grateful I didn’t have to find out.)

I adored Charlotte, mostly because she was even less domestic than me. Charlotte was incapable of loading a dishwasher – she’d arrange five dishes and suddenly the dishwasher was full - and her scrambled eggs were both burnt and runny, if that’s even possible. This was a woman who had raised three children. There was hope for me, after all.

Charlotte was intimately involved in our fledgling breastfeeding operation. Every three hours, she’d bring the boys to me in bed, then stand by my side and knead my breasts, imploring them to produce more milk and cheering on the boys as they thrashed around in the vicinity of my nipples. After my 10 minutes of quasi-nursing, Charlotte would bottlefeed one baby with a mixture of formula and breastmilk while my husband would bottlefeed the other, and I would pump. We made for a great threesome. I was sad to see Charlotte go.

Charlotte’s replacement, Sally, a grandmother of eight, billed herself as a doula – available “to do whatever a mother needs,” according to her resume - but seemed to have a single goal: to do as little as possible. Upon arrival, at 11 p.m., she’d yawn and whine, “Ooooh, I’m soooo tired.” (She was tired? One morning I applied mascara under my eyes instead of concealer, accidentally achieving the linebacker look.) Once, at 4 a.m. Sally carried the boys into my bedroom and announced, “OK, they’re ready to eat!” when, in fact, the boys were nearly comatose. Clearly, she was trying to unload them so she could go home.

Sally made no attempt to conceal her disapproval of our breastfeed/bottlefeed/pump triumvirate. She inspected my nipples, pronounced them “marvelous,” and insisted that if only I took vitamin B12 complex, my breasts would flow like the Fountain of Trevi. (I did take vitamin B12 complex, plus various herbs and teas, and none of it made a difference.) Sally lasted three days.

After six weeks of audacious effort, my milk was finally flowing. The boys were nursing like champs, and I could handle the whole operation solo. Breastfeeding became such a non-event that I could manage it while reading a magazine, a feat that, early on, seemed as improbable as my learning to juggle while riding a unicycle.

But even though the big headlines have vanished, my obsession has remained. Where previously I was consumed with my shortcomings, now I’m completely caught up in the complexities of this whole process. Take, for instance, how I’ve mastered breastfeeding two babies at the same time.

Tandem nursing is not something you do at Starbucks. I see women breastfeeding while chatting with friends and sipping a latte and marvel at how discreetly it can be done. Tandem nursing is more like a piece of performance art involving a bed, numerous props and, inevitably, exposed breasts. There’s no stylish shawl that can shield the public from the spectacle of two four-month-olds sucking down their lunch. You’d have to erect a four-person tent.

These days I nurse my boys on a twin bed in their room. I place one Boppy on each end of the bed, then plant one baby on each Boppy while I buckle myself into a giant, U-shaped foam pillow that my friend Sarah has dubbed the “life raft,” all the while asking my wailing boys to forgive me for the delay. I place another foam pillow between my back and the wall, then hoist each baby atop the life raft and shove one Boppy under each side of it, to make the surface flat so that the babies don’t roll off.

Like I said, not something you do at Starbucks.

Once they get going, I never fail to be impressed with their competence and to note that they’ve each developed their own signature style. Ian sucks rhythmically, with his eyes closed and long lashes fluttering, and appears to be concentrating hard, as if he’s doing calculus in his little, lopsided head. Toby operates entirely on instinct. He sucks erratically, with his plump little fists planted on his temples, as if to say, “Oy vey, the brisket is undercooked.”

Sometimes, when he’s really hungry, he’ll …

Oh, dear. I did it again. I’m being boring.

When I think about how my life has come to this, I tend to start counting up all the hours I’m now devoting to breastfeeding. Some babies take five minutes to suck down a meal, but perhaps making up for all those weeks of trying, Toby and Ian prefer to linger at the table. (Lactation consultants call babies like mine “gourmet eaters.”) Sometimes, I’m nursing for 40 minutes, not counting the set-up time. Multiply that by four, then add in two half-hour pumping sessions (to produce enough milk for the boys’ daily bottle, given to them by our babysitter while I work). Then multiply it all by seven, and I’m spending upwards of 25 hours a week simply feeding my children.

Maybe breastfeeding is all I talk about because, some days, it’s practically all I do.

I know, I know. Breastfeeding is supposed to be a special time of intimacy and bonding. Well, when I calculate that I’ve probably spent as much time breastfeeding in the past four months as some women spend in a year, I have to wonder: How much more bonding do the three of us really need?

I’m already itching to quit, or at least scale back. I’d like to retrieve some of that time so I can do things that make me feel more like a mother than a breastfeeder. I want to sing “The Wheels on the Bus” without looking at the clock, and I want to know my children better when they’re not eating. I’d like for their dad to take over some of the feedings so that, sometimes, I can be the one to pick out their sleepers and toys at Target. And let’s deal with reality: I’d like more time so I can earn the money to pay for those sleepers and toys. If I just had a few extra hours, then I think I could put an end to this compulsive need to discuss my milk supply and stop being the most boring person alive.

I know that day will come soon enough, but right now, it seems a lifetime away. And so I talk, and I continue to test my friends’ patience. When I apologized to one friend last week for prattling on about my noisy breast pump, she cheerily told me I wasn’t a bother at all.

“You think you’re boring now?” she said. “Wait until all you talk about is potty training.”

BfB Notes:    Kudos to Suzanne!   For tips on breastfeeding twins, check out Kellymom, and see our post about Angelina Jolie.

By now you may have seen (and commented on) various responses to “The Case Against Breastfeeding” by Hannah Rosin in the April 2009 issue of Atlantic Monthly.  

You can read Best for Babes’ response on the Moms Rising website, and for a very good scientific rebuttal of Rosin’s article, read the blog by Tanya Lieberman, IBCLC.  Andi Silverman makes some good points, as do the Editors of a new book, “Unbuttoned,” that is coming out in April, and I’ve heard that several prominent M.D.s are working on responses as well.

Here is the American Academy of Pediatrics’ response:    

Letter to the Editor of The Atlantic (Submitted via email)

In the article, “The Case Against Breast-Feeding” by Hanna Rosin, the author skims the literature and has omitted many recent statements including the 2005 statement of the American Academy of Pediatrics which supports the value of breastfeeding for most infants. This policy references every statement with
scientific evidence from over 200 articles which meet scientific standards for accuracy and rigor. The statement was meticulously reviewed by the Section on Breastfeeding, the Committee on Nutrition and numerous other committees and approved by the Board of Directors of the Academy. Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries, a study released by the Agency for Healthcare Research and Quality (the AHRQ Report) strongly supports the evidence of benefits demonstrated in the breastfeeding research. The evidence for the value of breastfeeding is scientific, it is strong, and it is
continually being reaffirmed by new research work.

The American Academy of Pediatrics encourages women to make an informed decision about feeding their infants based on scientifically established information from credible resources.

David T. Tayloe, Jr., MD, FAAP
President
American Academy of Pediatrics

As we mentioned in the blog on MomsRising, the AAP has no financial incentive to promote breastfeeding, the only motives that I can see here are to adhere to their mission and moral obligation, and retain the respect of the international medical, scientific and public health communities.   So I was thrilled when I heard that they wrote a letter to the Atlantic Monthly, and I am posting it so you can link to it easily as you respond to the different articles.   Go, AAP!

We also wish Rosin had seriously regarded this sentence from the AAP Policy Statement on Breastfeeding and the Use of Human Milk:

“Before advising against breastfeeding or recommending premature weaning, weigh the
benefits of breastfeeding against the risks of not receiving human milk.”

Let me just reiterate that Best for Babes believes no woman should be judged for her decision on how to feed her baby, and she deserves to have the best, evidence-based information to make and carry out that decision, free of undermining influences.

Here is an awesome new tool that can go a long way, babe, to helping mothers succeed at breastfeeding:  The Essential Breastfeeding Log by Sarah Bowen Shea and Suzanne Schlosberg, available today wherever books are sold.   It’s a perfect shower gift, especially as a motivator for brand new moms who are unsure about breastfeeding but willing to give it a try. 

I had a common experience after the birth of my first baby:   Everything I thought I knew about frequency of feedings or number of wet diapers to look for went out the window.   I am sure there was a chart somewhere in the mound of badly xeroxed and boring sheets they gave me at the hospital, but it got lost in the shuffle.   Brand new moms are like budding fitness devotees—smart and stylish tools and accessories can boost your self-confidence and skill-set and improve the odds that you will stick with it for the long term.  Getting through the initial learning curve of breastfeeding can be challenging, just like starting to work out, and this snazzy little book can help you make sense of the process and appreciate your and baby’s progress.  Both authors breastfed their babies, including exclusively nursing twins (!) for over one year, so they have walked the talk.

While I’ve seen a number of logs created to track feedings, diaper changes and the like, this is the first feeding log devoted to the mother who wants to breastfeed.   The log pages are extremely well designed, and I think they represent a significant advance over other logs on the market.  You will find a page for each day of the first six months, with a place to track feedings, diapers, sleep habits, and notes; even a gentle nudge for moms to get back to exercising to boost those endorphins!   Scattered throughout the book are “breastfeeding factoids” which will not only amaze and inspire you but subtly dazzle and educate your babysitter, your friends and your mother-in-law, as you leave the log out to be filled in by others on your way to the gym or a well-deserved date night.  These breastfeeding facts are so intriguing that it is worth buying the book just to pore over them at your leisure, and are what sets this book apart from other logs;  you are not just noting the facts but getting inspired and empowered along the way.  This handy log also serves to help break down one of the hidden obstacles to breastfeeding—what Best for Babes calls the “booby traps”, the cultural and institutional barriers to success.   In our bottle-friendly and measurement-obsessed culture, many moms and many pediatricians are ill-at-ease with breastfeeding’s natural intuitiveness.   “How will I know how the baby is getting enough?”  is a common refrain.   This log is a valuable tool to track visible signs that the baby is truly getting enough (and remember, babies are hard-wired to breastfeed) and provide comfort and reassurance to those who are not yet proficient in working with breastfeeding moms and babies!   

We strongly encourage you to read the full intro, and not just skip to the log pages.  The intro is well-written and will help boost your knowledge and motivation to succeed.    We’re adding a couple of tips here, based on our experience in the breastfeeding biz:  1) amazingly, exclusively breastfeeding moms actually report feeling more well-rested and get an average of 45 minutes more sleep per night; 2) rely on word-of-mouth or your breastfeeding network to find a good breastfeeding class and lactation counselor—hospitals with poor breastfeeding success rates are not the best place to turn for help; 3) you may not need to supplement, but if you do, push for donated, screened, pasteurized breastmilk through a milk bank (it is significantly superior to artificial substitutes, as per the World Health Organization).

Best for Babes is pleased to recommend the Essential Breastfeeding Log for it’s ability to inspire, prepare and empower new moms to breastfeed successfully.