This month I attended the
annual conference of ELACTA (European Lactation Consultants Alliance) in
Copenhagen. I was delighted to see again my friends, Barb Glare (IBCLC, CEO of "Breastfeeding
Conferences," and HUG's "agent" in Australia) and Min-Sung Kwon
(a nurse from the Republic of Korea who is studying
to become an IBCLC in Australia).
Jim volunteered to go to the local bakery and
bring home dessert. He says he thought three lactation consultants would really
appreciate his choice of a couple of special chocolate mousse cakes--both tasty AND consistent with ELACTA's theme!
(Photo of Barb, Min and Jan getting into the spirit of ELACTA!) We joined 450 lactation
specialists from 48 countries at ELACTA. It was interesting to consider the experiences
and problems we share, as LCs, in our efforts to support breastfeeding families. The conference covered (among other issues)
important topics such as: the biochemistry of breast milk and oxytocin, the decrease
in breast cancer risk for women who breastfeed, the power of skin to skin
contact, co-sleeping research, breastfeeding support for infants with cleft palettes,
the process of beginning solids, the potential to heal from traumatic birth
experiences, and the critical role of fathers in the birthing and breastfeeding
experiences.
Min visited me at my ELACTA poster
presentation. The poster provided a chance to chat with colleagues about how
helping mothers understand developmental events that impact breastfeeding
(birth to one year) can extend breastfeeding duration. One participant
says, “I think mothers quit because they just don’t want to breastfeed.” But, I
think she may have it backwards. Mother don’t understand their baby--or have a
problem they can’t solve--so THEN they decide not to breastfeed. Mothers don’t
want to feel unsuccessful. They may find it easier to say they don’t want to
breastfeed rather than to say they couldn't figure out their baby or their
breastfeeding problem. “The Roadmap to Breastfeeding Success” offers information
BEFORE mothers give up! Timing is urgently important.
I
was surprised to hear very little this week about how to support breastfeeding
duration beyond the first few weeks. Though extending breastfeeding duration is
a critical public health issue in the USA (and in other parts of the world I have visited
this year), perhaps it is seen as not such a problem in Denmark. A 2013 report on Denmark revealed the following:
Mothers have 14 weeks' maternity leave, and fathers have two weeks of paternity
leave. THEN, between mother and father they can take another 32 weeks of leave.
(Adopting families are afforded the same benefits.) Four months after delivery,
64% of mothers are exclusively breastfeeding. However, this Scandinavian study
did show that only 46% of obese mothers in Denmark were exclusively
breastfeeding at 6 months.
Breastfeeding duration is not as impressive in
most of the other countries that were represented at the ELACTA conference. USA rates for
exclusive breastfeeding at six months run about 13%, and are approximately 39%,
on average, in developing countries.
As is no surprise, everyone sees information
through the lens of their own experiences. Am I wrong about
this, or does it seem that most LCs (or those who can afford to go to a
conference) are oriented to the hospital or to the first few weeks of the
breastfeeding experience?
Clearly, "extending breastfeeding
duration" cannot happen if mothers don't "get going" those first
few weeks. However, a woman’s belief
that her baby is not satisfied, whether there is evidence of insufficient milk
or not, causes many women to abandon breastfeeding. Consider
behaviors in babies at different ages that might indicate to a mother that her
baby is NOT satisfied: increased crying, hard to calm, difficulty with state
regulation, difficult to wake up to feed, frequent awakening at night, or
seemingly inattentive to her mother.
The reasons mothers do not continue to breastfeed
are multi-factoral. While
it is important for professionals to respond to the demographic, biological,
social, psychological and educational variables that impact breastfeeding, it
is also critical that professionals consider normal child behavior and
developmental issues between birth and one year which, if misunderstood, can
cause a mother to believe that her baby is not satisfied. Sharing this
information is my mission, and I look forward to more conversations with
lactation consultants who serve families, both inside and outside the first few
weeks of babies’ lives.