When I first started working in my capacity as a Lactation Consultant (15 years ago), and up until the last 3 to 4 years, the majority of problems that I saw were very simply fixed by positioning. ie. back then that's what the midwives and child health nurses were pretty lousy at. Since then things have changed! The problems I'm seeing now are much more complex, suggesting that the basics are being addressed much better. (By most, not all X;{) BUT, there's still not one conference I've come away from in all those years that I haven't learnt something new. Our breastfeeding knowledge is still in its infancy.
Breastfeeding has been very much the ugly step-sister of birthing - every other aspect was researched and examined closely and has been for many years, probably because of the high medical involvement in it. Breastfeeding was ignored so badly that during the 50's and 60's the breastfeeding rates were so low that a whole generation of mothers/sisters/aunties/grandmas AND midwives knowledge of breastfeeding was lost. This has been a very difficult situation to come back from.
Research into breastfeeding is very recent. There are still huge gaps in our knowledge. Trying to disseminate what knowledge we do have is laborious, particularly when so many people (general population and health care population) dismiss it as just a 50:50 choice for how a mother feels like she might want to feed. Infant formula carries VERY significant risks of ill health and sub-optimal development for ALL babies who are fed it. We can't bury our heads in the sand and say this isn't true - it is!! It's the best alternative we have when breastmilk is not available, but that doesn't deny the facts.
Breastfeeding is normal. Major breastfeeding difficulties in a majority of mothers is NOT normal. Let's support and encourage our researchers, and make sure we update ourselves at least every year so that we are always giving mothers the best knowledge available at the time.
Denise
At 11:32 AM 19/05/2005 +1000, you wrote:
As a consumer I don't know if I should butt into this conversation, but I will anyway. I breastfeed my daughter for 2.5 years (and weaned her before either of us was completely ready for fertility reasons). The first 8 weeks of breastfeeding was utter hell, the next 8 was not great either but definitely better, over the two years I experienced grazes, cracks (polite term for gaping wounds), vaso spasm (which I still get now in my luteal phase but not as badly), blocked ducts, engorgement, 7 or 8 rounds of mastitis, cellulitis, over supply, under supply, and that is what I can remember. I wought help from midwives, IBCLS, GPs and called the ABA. I have to say that I have very little faith in the advice most people are getting when there are real problems with breasfeeding.
It seems to me that midwives and IBCLCs all dish out the same not very useful advice "If it hurts the latch is wrong, fix the latch and it won't hurt". How anyone thinks that damaged nipples that hurt non stop 24 hours a day will stop hurting because a baby starts sucking on them is beyond me. Poor attachment will increase the damage and good attachment will in time allow it to heal but good attachment WILL NOT stop damaged nipples from hurting and if this is what you tell women they won't believe anything else you say has credibility either.
And when nipple/breast pain problems go beyond attachment or vasospasm there is virtually no advice available at all. In the end, of the various breastfeeding advisors that I saw my own GP (who is also and IBCLC) was the only one prepared to say to me "her mouth is small small, your breast is large, your areolas are huge and fat, your nipples are small and flat and extremely fiborous. You are doing all you can attachment wise and I can see that it still hurts and I can tell you that it will probably keep hurting for a while. You just have to wait until your nipples slowly and painfully stretch and her mouth gets bigger as she grows. If you persist it will get better around 8 weeks". It got better at eight weeks and three days. This advice was so much more helpful than the "You just need to attach her right.... oh look at that it's perfect... oh why are you crying in pain?... have you tried the football hold?.... and here is some lahnsino" that I got from everyone else.
I paid a lot of attention to the breastfeeding women around me when I was breastfeeding and not many had the sort of problems I did, I heard only one story worse than mine and a only a few equally as bad but neither did I hear of many at the other end of the spectrum. I only ever met one woman who put her newborn first child straight to the breast and had never a single breastfeeding problem. In between were the women with minor problems through to those with truly dreadful stories and very few of them seemed to be getting great advice. My dear friend had her second child two weeks ago and the visiting midwife (from the RPA) tried to tell her to stop demand feeding, that she was feeding way to much, should feed only every 3-4 hours and that she must sleep more or she was in danger of hurting herself and hurting her baby (she is an experienced breastfeeder with great family support and knew this advice was laugable). In the end my friend agreed with everything she said just t!
o get her out the door and make sure she never came back. So now she is trying to figure out on her own how to deal with a sever over supply problem and a late developing attachment problem.... Given she has over 2 years breastfeeding experience I know that she will sort it out but she should not have to do it on her own.
I am sure that most australian women give up due to poor through to appalling advice from health professionals, possibly combined with lack of support from their families/partners not due to a physical inability to feed.
sorry for rambling, my fertility treatment has gone seriously wrong in the last fortnight so my hormones are whacked and interfering with my concentration but I really wanted to say something...
cheers
Jo
Denise Fisher
Health e-Learning
http://www.health-e-learning.com
[EMAIL PROTECTED]
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