Hi All,
About venting and LAM, I too, have had to justify what I teach re:
breastfeeding. Mostly this is becasue I teach Breastfeeding and not a
version of artificial feeding with baby at the breast, sometimes or when
its convenient...or belatedly. I have noticed (mainly from HCPs and
community agency workers - but sometimes from people who are regarded as
*pro bf*) an attitude that presumes bottle use. Although, when babies
are simply breastfed - without artficifial nipples involved in their
lives women benefit from lactational ammenorrhea.
When I first started the WIC bf education I did not mention this
wonderful side effect. Then I had ( a few) women calling me and asking
with a worried tone about their *problem* of not having their cycles
return, as *expected*.
Unfortunately, some called their OB and were told to wean! That they
would be at risk for osteopoprosis if they continued bfing for more than
three months. (That seems to be this particular MDs tolerance for BF -
and any excuse will do).
So I use the Population Council booket as the outline for that part of
the WIC education. Dr. Wendolyn Slusser has presented on this topic in
the past and does a great job. She is a pediatrician and breastfed too.
Some one on this list recently wrote about the qualifications of the
perfect LC. I think breastfeeding _without_ difficulties would be a
better thing to emulate.
Back to LAM:
here are a few if the qualifiers listed in the booklet:
1) no artificial nipple use - from birth.
2) baby nourished at breastf only - no H20, ABM etc.
3) baby breastfed at least 8 times per 24 hours (um, usually more)
4) cumulative sucking time at the breast >60 minutes per 24 hours
5) no break through bleeding (re:mom) past day 56 postpartum
6) no two feeds spaced further that 6 hours apart (and that would be
only occasionally).
Breaking these *rules* decreases the chance for women to benefit from
LAM. I then remind women that usually when someone is found anemic that
someone is a woman, or a kid but that's a different story. Experiencing
LAM allows them to get on track, that nature probably designed the
system this way, as a benefit. I also let them know that I have five
children, that I ecologically breastfed each and personally experienced
this. Often there is someone in the class with prior bf experience that
can say *I did that too!*
If ecological bf is what delivers the attributes of bfing to infants, to
mothers, to society (re: less health care cost - greater human kindness
etc.) then teaching THAT seems appropriate. I am really tired of the
emphasis of bf being 1) overcoming bf problem stories
2) assumptions that everybody uses bots
3) your favorite pet peeve
Breastfeeding is normal infant feeding. If it isn't then I *must* be a
very coordinated (not!), well eduacted (gee, if I had a degree I
wouldn't be reading this **& Chemistry book), highly motivated person
(maybe) to have done so little work to optimally nourish my kids.
My outline for this LAM info is at the office. Anyone notice anything I
missed.
After I started this in my classes we had a little inservice offered to
our whole WIC staff from the local birth control people. I am careful to
tell the women present that they may ovulate before the first period and
could possible become pregnant. I also let them know that I have several
friends who as long term breastfeeders did not have periods between
children. BY the way Dr. Slusser also mentioned in her talk that if a
woman were to bf this way - ecologically, that is - she would probably
have five children throughout her child bearing years. (wow, I do)
Paula Bermingham, IBCLC
WIC BF coordinator
Lake County, CA
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