Breast Feeding encouragement.

By the three-month mark, only 75 per cent are nursing and the numbers continue to decline. By six months, only 58 per cent are breast-feeding. As natural as breast-feeding is, it can be fraught with difficulties: cracked nipples from a poorly latched baby, yeast infections, mastitis, poor milk supply, not to mention sleepy babies who would rather snooze than eat.


Orlee Muroff was delighted to receive an unusual baby shower gift - a visit from a lactation expert. The nervous first-time mom had already lined up a night nurse for the first two weeks after her baby's birth because she wanted to start things off on the right foot, especially breast-feeding. "I was not breast-fed as a baby, so my mother couldn't help me there," says Muroff, a 33-year-old health food buyer for a grocery store chain. "I'm nervous. I could negotiate a million-dollar contract but I don't know baby." A holistic nutritionist by training, Muroff knows the benefits of breast-feeding. She's happy that Jesse, born Oct. 26, is feeding well and gaining weight. Educated and determined, Muroff exemplifies the new generation of mothers who have embraced breast-feeding with a vengeance and are willing to pay whatever it takes to get the help they need. Lactation experts who cost $100 per visit or more, doulas who charge $600 and up to accompany a mother at birth and advise her after, and baby nurses who collect as much as $2,000 for two weeks of night care, are all part of the cottage industry that has sprung up to meet their demands. More than 90 per cent of all mothers nursed their babies in hospital, according to Toronto public health, citing 2003 statistics, but the numbers begin to drop as soon as they get home. By the three-month mark, only 75 per cent are nursing and the numbers continue to decline. By six months, only 58 per cent are breast-feeding. As natural as breast-feeding is, it can be fraught with difficulties: cracked nipples from a poorly latched baby, yeast infections, mastitis, poor milk supply, not to mention sleepy babies who would rather snooze than eat. Bottle-fed themselves, new mothers find they can't turn to the generation before for assistance. "It's a skill and that skill was lost in our parents' generation," says Nora Dixon, a nurse who hired lactation consultant Edith Kernerman when she had difficulties feeding baby Taylor, born Sept. 11. She repeatedly bundled up the newborn and drove her to the hospital to visit a breast-feeding clinic, but called in the expert when she realized it was just too impractical to shuttle the newborn back and forth. Kernerman, who was recommended by the family's doctor, has visited the family so frequently that "she is definitely Aunt Edith by now," laughs husband Rob, 28, an IT salesman. "I think it is the hardest work I have ever done," Dixon says of the non-stop pumping and her attempts to breast-feed. So, why are all these new mothers hanging in there? "I just feel it is the most natural food and worth trying," says Dixon, adding that hiring experts is "expensive and for a lot of people it would not be possible. That's unfortunate." Meanwhile, a recent discussion at her east-end Toronto mother's group revealed that most had called in lactation consultants, she says. Kernerman, a former sculptor who was certified by the International Board of Lactation Consultant Examiners three years ago, says lactation consultants began appearing on the scene in the late '80s as the numbers of women who wanted to breast-feed their babies began to increase, a direct result of widespread public health campaigns that advocate "breast is best." "Finally breast-feeding is coming back in favour," says Kernerman, whose visits often last more than an hour and a half while she watches a mother feed her baby and offers suggestions about ways to hold an infant. The main problem is establishing a good "latch," or the proper position of the baby's mouth on the mother's nipple so it can compress the milk ducts and get enough to eat. If the latch is wrong, mothers can experience painful cracks and bleeding nipples, explains Kernerman, who gently takes babies off breasts to reposition them while asking the mothers, "Do you feel any pain?" There should not be pain, says Kernerman, adding many moms don't know about the arsenal of weapons out there to help them in the battle to breast-feed. There are herbs and medications to improve milk supply, ointments for pain, antibiotics for infections, not to mention ways to supplement feeding with expresssed breast milk. Lactation consultant Anne-Marie Desjardins, a nurse, says many new moms seem to forget whatever they learned in the hospital when they get home and their milk comes in. The day after birth, babies are sleepy and mom is only producing colostrum, a weak milk easily digested by babies. By day three or four, however, baby has "woken up" and mom's breasts are swollen with milk. "The best way to learn is in their home, where they are in charge," Desjardins says. "I can see where they sit, their whole body, and how the father is, what kind of supports she has. And, once we have successfully taught feeding, I teach the mothers how to do this lying down." Being able to rest in bed while feeding a baby is a tremendous benefit to a new mother, says Desjardins, the mother of two daughters aged 9 and 12. If a family has a web camera with their computer, she sometimes watches a feeding from her home office, using technology to aid the primal urge. "Just because breast-feeding is natural does not mean it is easy," she says. Ask the mothers who struggle. Vanessa Rae is successfully breast-feeding 8-month-old Nicola Bertwistle today but it was a hard at first. Her breasts were so sore, a nurse at the hospital exclaimed, "I can't believe you still want to do this." But she did. "I work for the provincial government. You take a year off and you approach it (the baby) like a job." All of the women she knows are breast-feeding while their own mothers are making comments like, "Oh, just give the baby a bottle," says Rae, who ended up hiring Desjardins. Real-estate agent Amy Polson, 30, breast-fed all three of her children ages 4, 2 and 10 months, but at first it didn't start well. "I'd sit in pain, with my shoulders up around my ear lobes. I felt such guilt. It was supposed to be natural." An experienced doula helped her get a better latch and things settled down nicely. Hiring a doula, "made sure I had support," says Polson. Her doula, Lisa Caron, jumped in the car and came over even in the middle of the night. Caron often helps new mothers breast-feed and sees it as part of her role, which she describes as being like a mother or an aunt. "Fifty years ago, our mothers came over to take care of us" when women gave birth. Silvia Presenza, 38, hired a baby nurse for the birth of her daughter Bianca Presenza-Long in July 2003. It is estimated there are roughly 150 newborn specialists, both nurses and personal support workers, in the GTA. She lucked into an "amazing night nurse" and she kept her on for a number of weeks for a total cost of $6,000. "It is the best money I ever spent," says the corporate communications manager, who is married to a lawyer. Presenza's mother died when she was a teen and she knew she would have to hire assistance for those early days home from the hospital. "The minute she walked in the door to take the baby, I knew I could relax." The nurse taught Presenza and her husband all the business of taking care of a new baby, including how to bathe the newborn. In the middle of the night when it was time to feed, the nurse brought the baby to Presenza in her bed. The nurse helped to get the baby to latch properly after a few missteps. "Having her made me realize I am doing it right. She gave good advice to me and built my confidence." Danielle Chandler, 37, prepared for motherhood with the same zeal that she studied for her law exams. She read books, hired a doula for support during childbirth and committed herself to a natural childbirth and breast-feeding. There were no drugs when Olivia was born and she was breast-fed. Chandler says the successful older mother sees the baby experience as another challenge to conquer. "We are reading (baby books) and we are not winging it." Chandler relied on her network of plugged-in mommas to find a doula. She interviewed seven people before hiring one for $900. "I felt I wanted to have as much support as I could." When it's time to call in an expert, the husbands are often the ones making the call or paying the bill. Teacher Tanya Wharton was struggling to nurse Thomas after his birth in November 2004 and experiencing sharp pain. She used contacts from her prenatal class to find out about a lactation consultant but balked at the $100 price. "My husband just wrote out the cheque," says Wharton. "My husband was so supportive. He told me, `Formula is not the solution. Do you want to be cleaning bottles all the time? We'll get it right.'" And they did. Thomas was breast-fed for nine months.

Lactation nation Nov. 25, 2005. 01:00 AM


Increase breast milk production.