A miserable, tongue-tied baby, courtesy of flickr.com
Kudos to the researchers at the University of Florida for drawing attention to a major “Booby Trap” in helping mothers achieve their personal breastfeeding goal, as published online in Pediatrics. Many in the breastfeeding community have known for a long time that an unusually short frenulum, the connective tissue under the tongue, is more common than people realize and can be easily and quickly snipped by credentialed professionals to allow the baby’s tongue to move properly and milk the breast. If left undiagnosed and untreated, this condition, commonly called “tongue-tie,” can in severe cases result in low weight gain with a great deal of frustration and suffering for the baby, and extreme nipple pain, mastitis and frustration and agony for the mother. Contrary to popular belief, not all doctors are permitted to perform this procedure, so it is important to find one that is (see bottom section).
“It is called a frenotomy, and it is far simpler than a circumcision, which we do fairly routinely . . . It literally takes longer to fill out the consent form for the procedure than to do the actual procedure itself.”
The tongue motions required to breastfeed are more complex than those required to drink from a bottle (hence the benefits to the baby’s jaw & speech development). Sullivan explains:
“If you take a bottle with an artificial nipple, there is not a lot a baby has to do to get milk.”
“To get milk out of the breast, they have to make a vacuum and if they cannot get their tongue to the roof of their mouth, they cannot do this. They also need to use their jaw and tongue to move the milk along through the milk ducts in the breast.
“If they just bite on the nipple (like a bottle), first, it hurts (the baby’s mother) a lot and second, it blocks off all those little tubes, which keeps the milk stuck in the breast.”
Isabella Knox, associate professor of pediatrics at the University of Washington says that 4 million babies are born each year, so 40,000 to 100,000 babies are affected by the condition.
“That’s a lot of babies,” Knox says. “I don’t think general pediatrics training gives us a lot of skills in supporting breastfeeding . . . we don’t really know how to help somebody and for some people it is not always a priority.”
According to Futurity.org, “Sullivan is part of an international organization focused on issues related to tongue ties. She and other members of the group’s screening committee are working to develop a screening tool that would help nurses quickly screen for a tongue tie while assessing the baby after birth.”
“There is not a lot of literature about frenotomy, and there are still a lot of doctors who say, ‘Is this really necessary?’” Sullivan says.
“Whether or not there is an epidemic or whether we ignored tongue ties and are looking for them now, this is something that is coming up more often in nurseries.”
Danielle Rigg, CLC & Co-Founder of Best for Babes, who experienced tongue-tie with her second child says that “doctors and health care professionals are not only unaware of ankyloglossia or tongue-tie, they often confuse “frenotomy,” which is a very simple, relatively painless and easy to perform procedure for newborns, with “frenectomy,” or “frenuloplasty” a more involved procedure used to free the frenulum in older children and adults who have shown signs of speech and mechanical pathology. Because of this confusion, it can be hard to find a doctor or health care professional who will perform it. The other problem, according to Jenny Thomas, MD, IBCLC is that contrary to popular belief, not all doctors (like herself) are allowed to perform the procedure, even if they recognize it and want to fix it. ”Most area hospitals, clinics and malpractice carriers consider this MORE than a minor office procedure and classify it validly as a surgical procedure, albeit a quick one. That means, for those places, you need surgical credentials (proving you’ve been mentored and have done enough procedures to not get sued). You then get surgical privileges in your institution and then subsequently need increased malpractice insurance,” explains Dr. Thomas. From what we understand from Dr. Thomas, some hospitals have an ENT (ear, nose & throat doctor) on staff who is educated about tongue-tie and performs all needed procedures, and paying increased premiums so all doctors can perform them isn’t necessary. (And then there is a whole debate about whether doctors are over-performing the procedure to make money.) However, from what we’re hearing from moms, there are plenty of hospitals that don’t have a credentialed doctor performing the procedure, and at those hospitals, moms are up a creek. To make it worse, some lactation consultants (even IBCLCs) are not experienced in recognizing the condition either, so it’s easily missed. (On the other hand, we’ve heard of lactation consultants who have, in a pinch, used a sterilized fingernail to slice the frenulum).
Purchased from Dreamstime.com
Danielle had to track down an oral surgeon, the only one in her area (at that time Montclair, New Jersey) who was willing to do it. “I went straight from the hospital, and although my daughter was less than two days old, she had already learned painful latching habits and I was already bleeding. The procedure took less than a minute, there was no blood, my daughter didn’t even cry,” says Danielle. ”When I tried to thank the surgeon, Dr. Richard Riva of Chatham, New Jersey, he said ”you go nurse that baby, tell me how it feels, and then thank me’. It immediately felt much better, though as a CLC I knew I would have to work with my daughter to help her re-learn a proper latch before all the pain would go away. When I expressed my gratitude to Dr. Riva, here were his words of wisdom:
”Every child deserves to have the pleasure of breastfeeding successfully, and every child deserves the pleasure of licking an ice-cream cone, both of which are aided by this procedure.”
We’d like to add, that every mom deserves to have a positive breastfeeding experience without the trauma of severe nipple pain caused by this condition and other undiagnosed but easily solved breastfeeding issues. Danielle should not have had to leap through the extra hoop of finding an oral surgeon outside of the hospital. Best for Babes hopes that the American Academy of Pediatrics will push for every hospital to have a credentialed doctor who can perform the procedure, education on diagnosis as a requirement in the core pediatrics curriculum in medical school, and that the nurses associations will do the same.While they’re at it, they should require doctors to complete at least a week-long training similar to what the Healthy Children Project offers to train certified lactation counselors, and/or work with the Academy of Breastfeeding Medicine to develop a curriculum. Luckily, pediatricians who are already Fellows of the Academy of Breastfeeding Medicine (look for FABM after their initials, similar to FAAP for Fellow of the American Academy of Pediatrics, and FACOG for Fellow of the American College of Obstetrics & Gynecology) are educated in all things breastfeeding. We’re sure our friend and supporter Dr. Ruth Lawrence, Chair of the American Academy of Pediatrics Breastfeeding Section, has been working on this for years.
What can parents do
1. Get a second opinion. If you suspect your baby has tongue-tie while still in the hospital, ask if there is an ear nose or throat doctor (ENT) on staff who is trained in diagnosing tongue-tie and performing frenotomies. You may want to get the opinion of a highly recommended IBCLC (you made need to bring someone in from outside the hospital). Tongue-tie is not a black and white issue and some will see a problem where others have missed it. If you can’t get help from within the hospital, see an ENT in private practice, an oral surgeon, or a dentist. Read the stories here of moms who have navigated this booby trap.
Earth Mama Angel Baby is a proud sponsor of Best for Babes
2. Politely and diplomatically educate your pediatrician, and other health care professionals and encourage him/her to be part of the solution. Many doctors don’t know about breastfeeding issues because they weren’t trained, but when enrolled instead of attacked, can be powerful advocates for change.
3. Spread the word to moms. Share this page with any expecting or new mothers. If we can prevent even one mother and baby from suffering through this unnecessarily, we will be ecstatic!!
4. Be gentle to mothers who couldn’t breastfeed. There are a lot of mothers out there whose babies were not diagnosed with tongue-tie, suffered miserably, thought they couldn’t produce enough milk, and agonized over their baby’s lack of sufficient weight-gain, blaming themselves or their babies, and quit breastfeeding long before they intended to. We never judge a mother who quit breastfeeding as “not being committed” because we can not truly stand in her shoes, and most of the time she has been booby-trapped and didn’t know it.
“My son has a tongue tie we didn’t find out about it till he was 10, after years of speech classes at school. That plus nipple confusion caused us much stress trying to nurse and we gave up a lot sooner than we wanted to.”
We can’t help but wonder, how many children and adults have suffered from preventable speech problems because we live in a bottle-feeding culture? It should be added to the next study on potential cost savings. If more babies were diagnosed with tongue-tie properly, not only would moms who want to breastfeed have a better chance of succeeding, but some speech pathology in formula-fed babies could be prevented. It could save parents and children much worry, distress, poor performance in school, teasing from friends, etc. So not diagnosing and treating tongue-tie is a booby-trap for breastfeeding AND formula feeding parents!
Have you experienced this “Booby Trap”? Have you had any success with educating your doctor or health care professionals? Let’s hear it!
The Best for Babes Foundation is releasing a provocative new breastfeeding ad in a special Pregnancy & Wellness Report to be inserted in USA Today on June 25th in the greater metropolitan areas of Los Angeles, Chicago and New York. The Best for Babes Foundation was established in 2007 to fight the barriers to breastfeeding, and to give breastfeeding a makeover by using mainstream marketing and branding.
According to the ad, the real miracle isn’t the bra, but mothers, and their ability to make milk for their own and others’ babies. Best for Babes urges parents to get the right support to navigate the “Booby Traps“-the cultural and institutional barriers that keep mothers from making informed feeding decisions and carrying them out. “Most moms want to breastfeed, and don’t realize how they are being undermined by the very institutions that should be helping them. Whether they breastfeed for 2 weeks, 2 months, 2 years or not at all, they deserve to achieve their personal goals. We’re clearing through the information clutter-much of it misleading-and are showing them how to succeed and who they can trust, much like a personal trainer or nutritionist would for someone who wants to get fit,” says Best for Babes Co-Founder Bettina Forbes.
The ad, which is part of a series of arresting visuals, is the first of its kind that aims to raise awareness of the “WHO-Code“-the World Health Organization’s International Code of Marketing of Breastmilk Substitutes and direct parents to hospitals, doctors, employers and resources that are WHO-Code compliant. “Most parents don’t know that the WHO-Code was created to protect parent’s right to make an informed feeding decision at one of the most vulnerable and precious times of their lives-the birth of a child, explains Marsha Walker, RN, IBCLC and a leading expert on WHO-Code compliance. “The aggressive marketing of artificial human milk substitutes has been shown to undermine breastfeeding intention and success, and parents should be careful about where they turn for breastfeeding support.” The ad also acknowledges breastfeeding industry companies such as Evenflo, Numom Nutrition, 60 Second Parent, Pumpease, My Baby Experts, Earth Mama Angel Baby, My Milkies, and Be Nice that are WHO-Code compliant and support Best for Babes’ mission to beat the “Booby Traps” and change the cultural perception of breastfeeding.
Unlike government and state breastfeeding campaigns that have come under fire for using scare tactics, unappealing visuals, or making moms feel judged or guilty, the Best for Babes ad campaign is eye-catching, fun, and designed to cheer on, coach and celebrate moms. “We want moms to have an awesome, empowering breastfeeding experience, ” says Best for Babes Co-Founder Danielle Rigg. “All parents want what’s best for their babies. They deserve support and resources, and those who can’t breastfeed deserve access to the next best substitute: pasteurized, screened human milk from a registered donor milk bank.” The six-figure ad campaign was created pro-bono by Frank About Women, a leading marketing-to-women communications group. It has been positively received for bringing levity and a fresh approach to a persistent public health problem. Best for Babes aims to raise funds to continue the series on billboards and bus stations. The USA Today Pregnancy & Wellness Report, produced by Media Planet, will reach 2.2 million readers in Chicago, Los Angeles, and New York; will be distributed to ob/gyn offices and physicians through the American College of Obstetrics and Gynecology, will be carried in all Destination Maternity stores, distributed at March of Dimes events, will be circulated to 25,000 members of the United States Breastfeeding Committee and all member organizations, and all physician members of the Academy of Breastfeeding Medicine.
The Best for Babes Foundation, a non-profit 501c3, was established in 2007 to give breastfeeding a makeover by using mainstream marketing and branding to inspire, prepare and empower moms, and to raise awareness of and fight the barriers that keep moms from achieving their personal breastfeeding goals, despite their best intentions. The Best for Babes Web site offers breastfeeding inspiration, help for moms who don’t want to breastfeed, a ground-breaking checklist for expectant moms, important information about navigating the “booby traps,” as well as opportunities to become involved and donate.
We have had a vision for a long time of seeing the breastfeeding discussed in a meaningful way on Oprah. Not sensationalized, “ewww breastmilk cheese” or “kooky mother is still breastfeeding her 8-year old” topics as we have often seen in the media that only serve to make breastfeeding more fringe when we are trying to make it mainstream. Not “benefits of breastfeeding” that will just further polarize moms without addressing the real problem- the “Booby Traps“- the barriers that keep moms from achieving their personal breastfeeding goals.
Cue all the seasoned PR folks to roll their eyes at the bajillions of people who have wanted to be on Oprah; naive do-gooders and entrepreneurs who see it as a magic bullet to convey their message or sell their product. PR folks know just how nightmarishly difficult it is to get on to Oprah, and that companies pay big bucks to make it happen. That’s okay, we know that too, and we are getting guidance on just how to bring it about, but to be realistic, it will probably take us a while.
Vote for Shari Criso's OWN Show on Oprah!
Which is why we were so excited to hear that one of our trusted experts, Shari Criso, RN, CNM, IBCLC has submitted an entry for “Your Own Show: Oprah’s Search for the Next TV Star.“ Some of you know Shari from #bfcafe on Twitter, where she has dispensed terrific tips and answered tricky breastfeeding questions. Some of you know her from her awesome full-breastfeeding-class-on-DVD and CD set, which we endorse because not enough parents are getting quality, WHO-Code compliant breastfeeding education. Some of you lucky ones have been her clients in her store or received private lactation counseling from her. We know Shari as all of these and more: she’s a powerful advocate for ALL parents, and is a key influencer (she is the new breastfeeding expert for Babies R US) who is helping us to give breastfeeding a makeover and raise awareness of and beat the “booby traps”.
Shari Criso has all the key ingredients to have a shot at winning the Oprah contest; a hot and important topic, a polished camera presence, a compelling message that can help moms, babies and the planet, and a loyal following. We are excited about the possibility of having a breastfeeding advocate take center stage on Oprah and raise the visibility of this issue in a meaningful way, so we are asking all of our friends and followers to please join us in voting for Shari! It only takes a few seconds . . . you can vote as often as you want and please leave a comment too so the producers of Oprah can see the impact she can have.
Last week CBSNews.com ran a wonderful video on the Challenges of Breastfeeding, and we issued a challenge to our readers to send 100 letters to CBSNews.com thanking them for “getting breastfeeding right.” (If you haven’t yet, please send an e-mail to CBSNews.com using this link telling them you loved the video and want to see more, especially on how to Beat the Booby Booby Traps! All moms deserve to achieve their personal goals without being undermined, whether they decide to breastfeed for 2 weeks, 2 months or 2 years, or not at all.)
We got a letter from CBSNews.com Health Senior Producer Mike Wuebben thanking us for our letters and our blog post, and Dr. Jen Ashton blogged about it and invites your feedback and ideas, proving that positive recognition is an effective, complementary strategy for advocacy work in changing our breastfeeding culture. Mike Wuebben also shared that his wife had breastfed all three of their children, including one under very difficult circumstances. We asked him to share his family’s story.
That my wife would breastfeed our second son, Willem, was a no-brainer. Leslie nursed our son Benjamin for his first 14 months and except for a rough couple early days, it came very naturally.
In the delivery room at 10 in the morning, just a few minutes after Will was born, Leslie put him to her breast, but this groggy little kid wouldn’t latch on. Oh well. The nurses said he was tired and this was normal. After a half an hour she tried again. No latch. With a beautiful calm focus, Leslie tried again and again. Twelve hours later the nurses came and took the baby away for the night.
Bright and early the next morning they were at it again with no success. Nurses, the midwives, the lactation consultant all gave tips but nothing would work. About this time they were noticing other odd things about my son — Will was “floppy,” low muscle tone, had a funny cry, didn’t blink when tapped on the forehead. By the next day the staff looks of concern had turned to pity. We were told before leaving for home, there was something “not normal” about my son.
Leslie was pumping and using the Haberman feeder- a special bottle for babies with feeding problems. He would eat but still couldn’t suck. We saw specialists, therapists, neurologists, chiropractors and no one knew why he was unresponsive. It was possible, we were told, he could “snap out of it.” Or he might not.
My wife never gave up trying to nurse him and for weeks she would put him to the breast before resorting to the feeder.
Around this time we discovered online a rare disorder that might fit Willem’s symptoms- low muscle tone, inability to blink, suck, move the muscles of his face. It’s called Moebius Syndrome. The article was titled “Kids Born without a Smile.” I had hoped for that “snap” moment when he would become a normal baby and here I was reading about my son’s future with a lifelong disability. Then I read further and saw a golden lining: most kids with Moebius have normal brain function and normal life expectancy.
Finally we knew something. He couldn’t suck because he couldn’t move the muscles of his face. He didn’t react because his muscles were weak and he couldn’t blink.
And then the miracles started to happen. One day, my wife went to nurse him and he sucked. She held his little lips together and he managed to get something. He could do it. As long as he could have something to latch onto deep in his mouth he could use his swallow response to pull the milk out. As those muscles grew stronger we started to see tiny twitches in his cheeks. The few muscles he had in his face were starting to work.
Willem continued to nurse well after his first birthday without the use of feeders and other aids. Though late, he continued to hit milestones. At 15 months he started to talk. At 30 months he walked. He learned to drink through a straw (no small feat for someone who can’t close his lips).
I was mostly a bystander to all this. I got to watch the incredible power of a mother’s love for her baby. Leslie was determined to give Willem the same early childhood experience that came so easy to his older brother and millions of other children. I hope her story inspires other mothers who face difficulties nursing.
Willem turns five this summer and he’ll start kindergarten in the fall. He still receives a full regimen of therapies to work on his muscle tone and speech, but he’s a happy, healthy, funny little boy. And I’ve discovered that the doctor at the hospital was right, my son is not normal, he’s extraordinary.
Any other moms or Lactation Consultants out there who have experience with helping babies with Moebius Syndrome breastfeed, we’d love to hear from you! Please share your tips, links and resources!
This CBS News video on the Challenges of Breastfeeding is wonderful in so many ways it is hard to know where to start. Especially on the heels of our disappointment with ABC News, and more dirt on their ties with industry, I think it is really important to give a huge shout out to CBS for getting breastfeeding right, and giving moms a huge boost in beating the “Booby Traps.” Below is what I like about the video; read to the end for the REAL punchline-I’m issuing a challenge!
Here’s what I loved about the video right off the bat:
The breastfeeding depictions in the opening help normalize breastfeeding in our squeamish culture.
Dr. Jennifer Ashton is attractive, sympathetic and articulate. Her image can help give breastfeeding a makeover and make it mainstream. Move over, Dr. Nancy Snyderman! I love that Dr. Ashton shares that breastfeeding was challenging for her personally, and how she was much more successful with baby #2, just like most moms (but we hope that someday, baby #1 won’t get the short end of the breastfeeding stick any more, once the barriers are gone.)
Ashton notes that breastfeeding is important for the baby AND the mother! Yes! Too often the focus is just on the baby, but moms get huge health and emotional benefits from breastfeeding too, and they are worth it. Personally I have no problem with any mom who breastfeeds because it’s good for HER.
That delicious breastfeeding baby with all the hair! Rooting away, sucking on Rosenfeld’s practiced finger, I was practically cheering that little babe on.
Watching a master at work. Expert lactation consultant (IBCLC) Freda Rosenfeld is the kind of LC I wish all moms had PAID, INSURED access to instead of some of the imposters out there. What a great role model to expose the mainstream public to, when not enough mothers know about ILCA.org and how to find the right A-team to support them through birth & breastfeeding! Rosenfeld was wonderful on camera, and a joy to watch. I absolutely worship the true “Boob Whisperers” out there, and delight in how they handle babies and mothers with supreme knowledge, skill, intuition and love.
Lots of breastfeeding footage and even a little bit of nipple. In the right context (think Salma Hayek or Angelina Jolie on the cover of W magazine); I have total faith that the American public can embrace breastfeeding in full view.
Highlighting the uniqueness of every mom-baby breastfeeding experience. Moms need to know to have no expectations, but to have the mindset that breastfeeding is an adventure; and that as long as you are not being booby-trapped or have medical contraindications you will probably get the hang of it just like riding a bike. Helping moms understand that they need to get help right away if they are having difficulty.
There are some things that annoyed me like the heavy-handed focus on pumps and featuring a product made by a company that is not WHO Code Compliant, but I am not going to nitpick. Overall the story was fantastic.
However, I fear that this video clip will not spread like wildfire throughout the ‘net and blogosphere. Let’s face it, media coverage or blogs that stir up the mommy wars and send everyone into a tweeting, commenting, posting, judging frenzy generate a lot more hits and a lot more attention than an informative, positive, supportive view of breastfeeding. But how can we encourage huge media outlets like CBS to get awesome messages about breastfeeding under the nose (literally) of the mainstream public if we only focus on the negative? Just like in parenting, we need to provide MORE positive reinforcement. So I am issuing a challenge to you:
Please write CBS and tell them how much you appreciate the fantastic video and what a great service they provided for mothers and babies. Then come back and comment that you did it; then tweet it and facebook it! I bet we can get 100 people to send them a letter. If enough of us flood them with gratitude for this feature, maybe other media outlets will follow suit. Are you listening, ABC News?
Take it from me: we mothers find it very difficult to ask for help! When my son was born, I found myself entertaining guests even though I had a grueling delivery, suffered from undiagnosed post-partum depression and could barely walk (I’ll spare you the gory details of why). The fact that I could not articulate my needs or felt uncomfortable assigning specific tasks to my friends just worsened my already fragile state of mind. Being in my late 30s and having enjoyed a successful career, I was used to being in control of my life, so the more my house became unkempt, and the less I was able to accomplish, the more I spiraled into a dark place. Many moms today are living apart from their families and are extremely independent and self-sufficient, so bringing home baby and adjusting to the new realities as a family, including relying on others for help, can extra be challenging. Not preparing properly (expecting? see our ultimate checklist) or not knowing how to ask for help is a big “Booby Trap!”
But there is a better way. If you have read The Red Tent, or had the chance to live in or observe cultures that protect the mother-baby dyad, you will already know that taking care of the mother is the best way to take care of the baby. Julie Hamilton, Mrs. Nashville 2010, a mother of 3 including exclusively breastfed twins (read how she did it) and a blogger at memoirsofabreastfeeder.wordpress.com knows just how important it is to ask for help, and worked with us to create a tool that can go a long way in making sure that a mother of a new baby is being cared for. The best gift you can give any new mother is to nurture the nurterer! So yes, pick out that cute outfit for the new baby, but also make sure you sign up to deliver some TLC in the form of a meal, some grocery shopping, laundry folding or other errand. Many moms need more help with tasks; having a clean & organized house makes it easier to relax, turn off the brain, and sleep when the baby sleeps. Especially for breastfeeding moms, who need to master the learning curve of breastfeeding during the first few weeks, getting help can make or break her success. If you are an experienced mom, then you already know just how welcome your efforts are. If you are not a mom, then consider it part of the “what goes around comes around” cycle that will be paid back to you some day, in some form or another! If you are expecting your first, it is the best internship you could have to learn the ropes.
Here are the new tools Julie developed with us. Please let us know if you have suggestions to make them more useful to ALL moms who just had a baby. As a non-profit our goal we rely on volunteers and feedback so we can provide more free resources to moms!
BfB Help Sheet: A fill-in sheet to help new mothers or a mother of a new baby (baby #2, or #3, or #4 . . . ) enlist friends and family members to take care of errands and everyday household chores. There is space to add other things you need help with. Don’t be shy! The point is to ensure your success as a new mother so these first few weeks can be as enjoyable and rewarding as possible. If you are sunk in a pit of laundry, grocery shopping and cleaning up, you are no good to anyone. Here’s how to use it: Fill out one sheet for each friend. Record who is doing what accordingly on the master sheet, and give the help sheet to the person assigned to the task(s). If you have a home print/scan/copy machine, you can also make a copy of the help sheet to keep for yourself, if that makes it easier for you to keep track.
BfB Help Sheet-Master: This is a chart to help you keep track of who is doing what. It is to be filled out by the mom, her partner or a friend or family member who is helping the mom every week. Write the person’s name & phone number if necessary in the appropriate square, for example, “Amy S.: 212-999-9999″ in Dinner row, Tuesday column. If you have a really super organized friend who wants to coordinate this, even better! You may want to keep phone numbers of friends and relatives on a separate sheet that you can refer to, or that your partner, a relative or your best friend can use to contact anyone if there is a change in plans. Put it on the fridge, by the phone or by your bedside where you know you will see it.
We’re also compiling a list of helpful information and best resources on the ‘net on this topic. Any suggestions? Let us know, and we’ll add it to this list! All we ask is that the information be mom-friendly: non-judgmental, evidence-based, positive and encouraging, and not undermining of breastfeeding moms.
It’s been a crazy few days. My Best for Babes co-founder Danielle and I were scheduled to fly out to Ohio on Tuesday morning to meet with a key player in the breastfeeding world. Monday afternoon we noticed the weather report calling for a major snowstorm to hit the area and spread to the East Coast, where I live. Should we go or should we call it off? Every hair on my head said it was a mistake, that we should reschedule. Various things started to go awry as if to prove that it was not meant to be; Danielle didn’t feel well, my printer kept fritzing as I was putting together our press packets, my daughter got a bad scrape under her eye while sledding with a friend . . . you know how it is. I texted Danielle that I thought we should postpone. An hour later I spoke to her husband who said she had gone to bed and was set to leave for the airport at 4:30 a.m. So I worked until 2:30 a.m. and got up at 4:30 to leave for the airport myself.
We got to Ohio, and then I got a message that my flight back to Newark that evening had been canceled. We went to our meeting, met some folks who are truly passionate about helping moms and babies breastfeed successfully and had a great time all around. But what to do about my flight? Danielle’s flight had not been canceled because she was flying into Atlanta on a larger jet. I was booked on a flight for early Wednesday morning, but what if that flight too, would be canceled? The likelihood was high because all the planes to the East Coast were smaller and more vulnerable to the weather. My husband had already taken Tuesday off from work for me to stay with the kids, and now had to take Wednesday off too because school was canceled due to the storm, but I knew I had to be back before he left for a business trip Thursday morning. I decided to drive.
Really, I should have my head examined. On two hours sleep, pumped up with excitement from a great meeting and more ideas on how to “beat the booby traps” so that more moms can achieve their personal breastfeeding goals, I headed east on I-70 on Tuesday afternoon. The streets were icy and snow was coming straight at me but I kept up a good pace until I hit a wall of exhaustion at midnight. I had driven eight hours to Harrisburg, PA. I pulled off, declined the seedy motels, and settled into a Howard Johnson, feeling a twinge of nostalgia from my youth.
When I woke up the streets looked really bad. The snow had really come down hard, and there was not a crumb to be had at HoJo’s “Country Oven,” which was missing its employees due to the weather. I cleaned 4 inches of snow off my rental car (with my bare hands, having not thought of gloves in the scramble to get to the airport the day before) and pulled out, figuring that at least the highways would be clear.
I saw a few of these. Not fun. Image courtesy of racheltingley.com
I have never driven in worse conditions in my life. I thought the highway would be clear, but spent the next 8 hours (which should have been 3) crawling along single file on two grayish tracks in the snow. The visibility was low, I sat hunched over, peering out my snow-encrusted windshield, sandwiched between two trucks, gripping the steering wheel so tight I now have blisters on my fingers. I saw quite a few cars in various ditches, and a few slammed into the divider rail with a crushed bumper. At one point in the Pennsylvania mountains, the road was so bad that a couple of jacknifed trucks were just stopped on the highway; traffic slowed to 5 miles an hour as we wove our way around them. Anybody who was on the road was either a fool or was driving some precious cargo.
So, what about me? What precious cargo was I driving in my bright blue Dodge Journey (aptly named for my trip from hell) from Alamo? What on earth would persuade Danielle and I to fly right into the eye of the storm against our better judgment, and then have to practically dig our way out? If I could have hunkered down in a hotel and waited for the storm to clear and the flights to stabilize I would have; but I simply could not let my husband miss his trip when he has done so much for me and for Best for Babes. Was it sheer insanity?
I got a whole lot of help and a whole lot of love from some amazing women after a horrible birth experience and a rocky start to breastfeeding (you can still see traces of the black eye and burst blood vessels I had from pushing for 3.5 hours).
Nope, it was love. As I drove back, high on adrenaline, I was thinking about only two things: how badly I wanted to get back to my family and go sledding with my kids, and how much I want to help mothers and babies. These two loves are linked: never in a million years would I have ended up in this gig if it had not been for the awful time I had trying to breastfeed my son. My experience coincided with the stories of dozens of women that Danielle had been helping as a lactation counselor, and is what prompted us to found Best for Babes. We simply could not bear to see more women decide to nurse, only to have their hopes dashed by one booby trap after another. According to our contact at the CDC, 86% of expecting mothers say they want to breastfeed, yet only 74% even try once after giving birth, and the number of women breastfeeding exclusively as recommended drops precipitously during the first days and weeks, long before many mothers go back to work. Something is very, very wrong. If breastfeeding was really meant to be as hard as it is today the human race would have died out-hence our conviction that moms are not only not getting the proper support, but are actually being prevented from succeeding. A lot of moms are not as lucky as I was to be able to get excellent help and have women in my family who had breastfed and encouraged me.
Home at last thanks to my rental from Alamo. No 4-wheel drive but trusty nonetheless. The icing on the cake? After driving 16 hours in horrendous conditions without incident, I got stuck pulling into my driveway. Patrick had to shovel me out.
I still don’t know exactly what possessed me to basically endanger my life and make that crazy trip, but since I was listening to 80s tunes I’ll go ahead and be corny and say it was the “wings of love” (it’s okay, you can roll your eyes). Love for my kids and my awesome husband, but also the love I have for transforming the breastfeeding movement into a true cause that cheers on, coaches and celebrates ALL moms, regardless of whether they breastfeed for 2 weeks, 2 months, 2 years or not at all; love for my best friend and business partner Danielle who keeps going despite ongoing health problems stemming from her bout with breast cancer; love for all the moms and babies I meet. I do it because I know it can be done; we CAN create a culture where breastfeeding in public or pumping at work is not just barely tolerated but embraced and seen as the awesome power that it is, and where moms who can not or decide not to breastfeed are respected and cheered on and have access to the best substitute, screened, pasteurized donor milk from a registered donor milk bank.
I also do it because of the synergistic contagious energy that flies around when I meet people who care about making the world a better place. Every day I “meet” another mother who has gone above and beyond to help another mother, or a nurse that has gone the extra mile to help a new mom see an excellent lactation consultant. There is a lot of love out there, love and protection for moms and babies. I hope nobody else was nuts enough to drive in a blizzard, but I will bet that there are some incredible stories of the lengths friends and strangers have gone to help another mother navigate “the booby traps” and get the hang of breastfeeding her babe.
What have you done for love? In the spirit of upcoming Valentine’s Day, tell us your story of helping one or more moms breastfeed, or how you are changing the culture and “beating the booby traps“. We can’t wait to hear it!
Bear with me while I make an analogy between breastfeeding and fishing, and tell me if you think I’ve gone off the deep end.
There is an old saying: “Give a man a fish, you feed him for a day; teach a man a fish, you feed him for a lifetime.”
It would be easy to apply that to breastfeeding: “Give a newborn artificial baby milk, you feed him for a day; teach the baby’s mother to breastfeed, you feed, nurture and improve the health of both for a lifetime, so that mothers, babies, healthcare, employers, society and the planet benefit.”
Upon visiting this fishmarket in Catania, Sicily, I learned that aggressive industrial & commercial fishing threatens the livelihood of local, small-scale fishermen. It also destroys the breeding ground of the bluefin tuna, diminishes biodiversity and threatens the health of our planet.
But here’s the rub. What if it is not easy to teach a man to fish? What if men have had the best intentions of fishing, only to go to the lake, and find that the fish have been depleted by aggressive practices, or the waters polluted, or signs and fences put up threatening anyone who tries to fish? What if men were being told that fishing is great for them, and healthy too, but every day they are handed a bag of fast food which just seems so much easier than getting prepared for fishing, and putting in the time and effort to secure a good catch of fresh fish? What if the teachers who are supposed to teach men to fish are being bought out to promote fast food, too, because while fishing has huge long-term advantages, it takes just a little more work, a little more support? What if the few fishermen who succeeded in fishing, are heckled and jeered at? How many fishermen then, do you think, will really survive this process?
So that leaves the question. What do we do? Do we continue to try to teach the man to fish, one man at a time, and leave him to fend for himself against the forces that threaten the fishing industry? Do we continue to send mothers to support groups, or to get expert lactation counseling (if they can afford it), and stand by wringing our hands as they are being failed by the lack of a breastfeeding infrastructure, and are being undermined by barriers? Do we continue to tell them the benefits of fishing breastfeeding, and heap pressure on them while allowing them to be threatened and suffer botched and negative breastfeeding experiences? Do we wait for them to tell each other their horror stories-stories that did not need to be, most of which could have either been prevented or easily solved by preparation and early, proper lactation management-and discourage each other? Do we stand by as more mothers are robbed of an exquisitely intimate and precious experience with their babies that is as instinctive as kissing the ones we love?
There is another way, the way of social entrepreneurship. Ashoka Founder Bill Drayton, once famously said that “social entrepreneurs are not content just to give a fish or teach how to fish. They will not rest until they have revolutionized the fishing industry.”
Social entrepreneurs are “change agents,” creating “large-scale change through pattern-breaking ideas,” “addressing the root causes” of social problems, possessing “the ambition to create systemic change by introducing a new idea and persuading others to adopt it,” and changing “the social systems that create and maintain” problems. These types of transformative changes can be national or global. They can also often be highly localized—but no less powerful—in their impact. Most often, social entrepreneurs who create transformative changes combine innovative practices, deep and targeted knowledge of their social issue area, applied and cutting-edge research, and political savvy to reach their goals. For all entrepreneurs, whether in the business or social realm, innovation is not a one-time event—but continues over time.-Skoll Foundation
And that is precisely what the breastfeeding movement needs, and what Best for Babes aims to deliver: the passion, drive, creativity and innovation needed to revolutionize the breastfeeding movement and make it the Mother of All Causes. For this reason, we are going to be nominated for the prestigious Ashoka fellowship by a titan in the foundation world who believes that we fit the criteria of a social entrepreneur. It is a ridiculous long shot (past nominees have gone on to win the Nobel prize, haha) and we’ll just be honored to be nominated. Heck, we’ll just be excited to finish the draft application we started last year.
We need your help. These days, it takes a village to protect the mother so she can feed her baby; and we are building that village one volunteer, one advocate, one influencer, one donation at a time. It is your involvement, and your commitment to us, that will determine whether we succeed or fail. It is our collective collaboration that will determine whether we can bring together not only the 2% of women who made it to one year of breastfeeding exclusively (the “choir” most of us are preaching to) but the 72% of women-some three million every year-that try to breastfeed, and the billions more that wanted to breastfeed but were set up to fail. Moreover, let’s bring in those who are affected by a society that doesn’t support breastfeeding; the spouses, the employers, the health care system, the schools . . . and take to the streets, like those marching under the other pink ribbon, and race for the cure literally under our nose. Trust us, if we can get everyone past the destructive trio of pressure, judgment and guilt, and unite all who have been affected by “the booby traps,” our numbers will be greater than any other cause to date. It’s time to harness that formidable energy.
Will you join us? This year we have accomplished much to set this ball into motion-our innovative celebrity interviews and our groundbreaking ad campaign are gaining steam (80 blogs are now carrying it!). We are getting our message and our CREDO out into the media (through incredible coverage in SHAPE and Fit Pregnancy magazines among others), and we are the first non-profit to change the conversation by shifting the pressure OFF moms and on to the barriers that keep them from achieving their personal goals. Despite being “outsiders” to the medical/scientific world, we’ve won over the breastfeeding movement leadership (see left, we made the front page of an AAP newsletter!)- we brought down the house at the Academy of Breastfeeding Medicine, and we’re slated for the Healthy Children Conference and the United States Breastfeeding Committee Conference in January-trust us, our message will shake up the status quo. We have jumped headfirst into social media, becoming one of the fastest growing breastfeeding causes on Facebook and one of the only breastfeeding non-profits that is blogging and is active on Twitter. We have dazzled more potential corporate allies than we’ve been able to follow up with, and there is tremendous untapped opportunity here to follow in the footsteps of the great cause-related marketing campaigns.
Truthfully we’ve bitten off more than we can chew, and that is the curse of being passionately obsessed with social change: we can see so clearly what needs to happen to help moms and raise breastfeeding rates that we tend to ignore our very human limitations of time and funding. But that’s okay. As much as we’d like to be the type that does one thing and one thing well, instead of the type that sets a bazillion things in motion, we know that it is more important right now to act as a catalyst to put a little rocket fuel under this cause and elevate it to the stature that it deserves. There is much, much work to be done, but we know you will stand with us, shoulder to shoulder!
Under the influence of the holiday spirit, (and late nights of deranged cookie-baking) I re-wrote the 12 Days of Christmas to reflect the Best for Babes vision of what it would take to really help moms. I’ve explained below why each of these gifts would rebuild our shattered breastfeeding infrastructure, and contribute to a world where all mothers who want to breastfeed could meet their personal breastfeeding goals without pressure, judgment or guilt. Moms, babies, our society and the planet would benefit.
Before you continue reading, click on the image to the right, and go ahead and sing it! It’s more fun when you actually do it. It may take a bit of nimbleness, but I tried it out on my kids and husband, so can vouch that it is sing-able.
(As Dr. Seuss might put it, you can sing it to your hospital, doctor, employer and store, sing it at the mall, they’ll ask for more! Sing it far and sing it loud, sing it to the squeamish crowd. Sing it at your breastfeeding meeting, sing it as a friendly greeting. Sing it to help moms succeed, and fulfill every breastfeeding need!”)
How 12 Gifts Would Rebuild Our Shattered Breastfeeding Infrastructure
A mother wanting to breastfeed: 74% of mothers want to breastfeed and are trying to breastfeed, but only 40% are achieving their personal goals, and only 12% are making it to the American Academy of Pediatric’s minimum recommendation of six months exclusive breastfeeding. Even worse, most moms are not even getting through the first few days or weeks of exclusive breastfeeding, and it is not their fault. Moms are being pressured to breastfeed but set up to fail by insidious “booby traps”-cultural and institutional barriers. It is as bad as telling someone to run a race and handing them flip-flops. For more about awful mixed messages we are giving moms, see this excellent article by babygooroo.com.
Two doula/midwives:Having a labor doula or midwife can lower the risk of a c-section, reduce labor time, perception of pain, and generally provide superior birth outcomes, which lead to better breastfeeding initiation. Many ob/gyns and hospitals welcome the participation of a labor doula as it makes their job easier, think of it as an experienced coach who can help you way more than your husband/partner, who in all likelihood, has never delivered a baby.
Three support groups:La Leche League is the largest and best known mother-to-mother support group provider; there are also support groups springing up through IBCLCs, Maternity and breastfeeding boutiques, and hospitals. Shop around, not all support groups are created equal and word of mouth will lead you to the best ones. Support groups that are judgmental or do not provide accurate, scientifically-proven information are a hidden “booby trap.”
Four (FABM) MDs: FABM stands for a Fellow of the Academy of Breastfeeding Medicine, and means that this physician has demonstrated advanced knowledge and skills in breastfeeding and lactation management (read between the lines: this doctor is not just giving “breast is best” lip service while handing out formula samples and undermining moms). Similar to FAAP (Fellow of the American Academy of Pediatrics) it follows the physician’s credentials, e.g. Caroline Chantry, MD, FABM. We dream of a day when not just Ob/Gyns and pediatricians are FABMs, but allergy, diabetes, heart disease and other specialities that are impacted by increased breastfeeding rates. When an expecting mother sees her allergist, he/she should be encouraging her to breastfeed, and discussing it in a supportive, evidence-based framework! For more on choosing a breastfeeding-friendly physician, click here.
Five Baby-Friendly Hospitals: This is a biggie, which is why it goes in the “5 golden rings line.” Only 3% of the 3,000 maternity and birth centers in the U.S. are designated “Baby-Friendly” under the Baby-Friendly Hospital Initiative. The Centers for Disease Control found that 70% of hospitals perform poorly on breastfeeding support; no wonder moms are not making it through the first few days! If all maternity & birth centers followed the ten steps to Baby-Friendly, such as rooming-in, latching the baby in the first hour, avoiding pacifiers and bottles, providing donated, screened, pasteurized human milk from a milk bank if supplementation is needed, and not handing out gift bags filled with formula samples (shown to reduce breastfeeding duration), we’d see a meteoric rise in breastfeeding rates (and population health improvement, and employee morale, and reduction in carbon emissions, etc.-we could go on and on). Moms are being “booby-trapped” by the hospitals they trust, and it has got to stop. Let’s move the nurse-ins to the hospital lobbies, and start writing respectful, but firm letters to hospital CEOs and copying them to the media.
Six great IBCLCs: An IBCLC is an International Board Certified Lactation Consultant. To find the best ones, click here, and be aware that like in every other field, there are some quacks. If your “lactation specialist” in the hospital is judgmental, grabs your boob, hands out nipple shields like candy, or otherwises raises your finely-tuned mom’s instinct antennae, call your La Leche League group, friendly doula/midwife, or local breastfeeding boutique for the name of a good one that can visit you in the hospital. We urge you to complain to the CEO of your hospital if you have a negative experience, and write a letter of commendation if you were helped. Copy it to your local newspaper.
Seven partners protecting: The role of your partner or spouse in protecting the breastfeeding relationship when a mother is at her most fragile and vulnerable is invaluable. Forget sending him or her to labor classes (get a doula instead); make sure your husband or partner is educated about the hospital booby traps and is ready to bare their teeth to all the insidious attempts to derail your breastfeeding efforts. This is where he/she can really be your hero.
Eight friends a-helping: Not only should your friends cheer you on for your decision to breastfeed, they should line themselves up to cook, clean, babysit your toddler, grocery shop and run errands for you. Your job is to rest and to get the hang of breastfeeding, you are an athelete in training with a single focus. Entertaining guests is for later!
Nine celebs a-nursing: Celebrities are hugely influential in our celeb-obsessed culture, and can have a positive influence on the many women who have few or no breastfeeding role models. After Angelina Jolie’s breastfeeding cover on W magazine, many women wrote that if she could nurse twins, they felt empowered to do it too. We also need more celebrities to talk about more benefits of breastfeeding than just losing weight, and share their intimate breastfeeding stories in our context of helping moms (see our interviews with Kelly Rutherford and Gabrielle Reece). We need celebrities to nurse in public to show solidarity with moms who face huge social disapproval for nursing discreetly, or are outright discriminated against. We need celebrities to lobby for the Breastfeeding Promotion Act, and increased funding for breastfeeding infrastructure . . . in short, breastfeeding needs a Bono, Fox, Gere or Gore. Salma, Angelina, Gwyneth, Sigourney: we need your help!
Ten nursing nooks: Boy are we tired of hearing about moms who are thrown out of stores, restaurants and even airplanes for breastfeeding. It’s really getting old. And just for the record, most moms prefer to be discreet, but some babies yank those blankets right off. Wouldn’t it be great if every mall, every shopping plaza, and every airport had a cozy nursing lounge (i.e. NOT the bathroom)? And every store and restaurant had a quick and easy supportive breastfeeding policy? We’re working on it, and have an exciting platform, but we need your help to raise the funds to make it a reality. We’d love it if big breastfeeding-friendly retailers like Nordstrom would sponsor it; and it would help the image and PR of Target, Applebees, Victoria’s Secret and Starbucks if they would jump on board too. Did we mention that 74% of moms try to breastfeed? That’s at least 3 million moms per year, and billions that have ever breastfed!
Eleven strangers cheering: Best for Babes is working to change the breastfeeding culture in the United States so that the public not only accepts breastfeeding, but thinks it’s cool, hip and fabulous. This takes giving breastfeeding a makeover and branding and “marketing it to be as mainstream as motherhood itself”. This does not mean the overbearing lecture to moms on all the benefits of breastfeeding, it means setting a positive example and attracting women to breastfeeding so they are psyched and pumped up to breastfeed, much like working out or making any other lifestyle change! Face it, we all need a little motivation (benefits are great, but a cute workout suit can help too) to get to the gym, and breastfeeding is no different: some helpful information, some stellar breastfeeding products that make it more fun and a little easier can go a long way. Most of all, it takes a culture that adopts the Best for Babes credo of cheering on, coaching and celebrating ALL moms to make informed breastfeeding decisions, and achieve their personal breastfeeding goals whether it is one week one month or one year or not at all. We need to gently lower the defensiveness of women who didn’t breastfeed or couldn’t breastfeed by ending the horrible cycle of pressure, judgment and guilt. Like seatbelts and sunscreen, our mothers didn’t know better. Many of our peers were “booby-trapped” by the barriers, and feel awful about it, and are blaming themselves not realizing they were set up to fail. Some moms truly can’t breastfeed-how do you argue with a double mastectomy, or medication contraindicated by breastfeeding, or having tried everything to no avail? If 95% of women are capable of breastfeeding successfully, there are still 5% that are not, no matter how many IBCLCs they see. Another reason we need more milk banks! Most importantly, ALL moms deserve compassion and respect. With a little TLC for all, we’ll find the “breast vs. bottle” debate and the mommy and boob wars will lose steam and that even the moms who decided not to breastfeed or couldn’t breastfeed because of barriers will start cheering moms on. Case in point: My co-founder’s mother, who didn’t breastfeed her daughter, is one of our staunchest supporters. My special request, please read these two articles if you are a breastfeeding advocate (hint: become a mom advocate first): “Shame and the Mom: A Boob Story” by herbadmother.com, and “When Boobs Collide” by Hisboyscanswim.com.
Twelve supportive employers: This is last on the list because the reality is that most new moms are not making it past the first few days and weeks of exclusive breastfeeding, long before their maternity leave ends and they go back to work. (Oh yeah, and we have some of the worst maternity leave policies of any industrialized nation, so let’s assume that not all mothers even get maternity leave, unlike most European countries with high breastfeeding rates that provide a year or more. Some companies provide 3 months but that is not enough.) But the specter of having to fight for the right and the breaks to pump on the job, be sneered at and harassed, and have no place to pump besides the bathroom or a dirty closet with an outlet, can discourage many working moms from trying to breastfeed in the first place. And the ironic kicker? Breastfeeding benefits a company’s bottom line; less sick days used, lower employee turnover, higher morale, lower benefits expenses, better attraction of qualified employees, the list goes on. Go figure.
Reality TV star and former Playboy model Kendra Wilkinson is successfully breastfeeding, despite her initial fears. (You may remember that US magazine reported that both Kendra Wilkinson and Kourtney Kardashian were concerned they would not be able to nurse their babies because of breast implants received at a young age.) While the full story in the December 17 issue of OK! magazine does not mention breastfeeding (and states that husband Hank gave baby the first feed), we’ve been told by a spokesperson that Ms. Wilkinson started breastfeeding on the second day and is very happy to be nursing her baby.
Ms. Wilkinson got quite a bit of publicity for sharing about her fears. We wrote about it, offered some breastfeeding advice and a shopping list, and extended our cheers to Wilkinson, Kourtney Kardashian and US magazine for helping to change the public perception of breastfeeding and making it more mainstream. Soon after, we noticed an increase in the number of articles talking about implants and breastfeeding, which is wonderful! More surgeons who are performing breast augmentation and reduction surgeries need to know about procedures that preserve the milk ducts, and it should be standard protocol to discuss those options with patients in their childbearing years. More mothers who are planning to breastfeed deserve access to evidence-based information about breastfeeding with implants so they can prepare and plan accordingly.
Congratulations to Ms. Wilkinson for overcoming one of the earliest “booby-traps”-fear of breastfeeding due to misinformation. On behalf of all the moms and babies we serve, we thank her for raising awareness of this important health issue. Celebrities who share their personal breastfeeding stories, like Kelly Rutherford and Gabrielle Reece, help us cheer on, coach and celebrate moms to achieve their personal breastfeeding goals without pressure, judgment and guilt, and to get evidence-based and inspiring information into the hands of more moms. This is an exciting and wonderful time in a new mother’s life and we want all mothers who decide to breastfeed to have a positive breastfeeding experience!
Bestforbabes.org is the best thing to happen to breastfeeding since the invention of the breastpump! I LOVE the guilt/pressure free way you present everything. --Laura Rimbey, Oregon
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