Tuesday, October 18, 2011

Breastfeeding, Take Two Q&A and Giveaway!

I am still amazed by how wonderful Stephanie Casemore has been through this.  It shows through the kindness in her book and through the emails sent.  I have never met an author that truly cares about this topic more than her.

Here is the Q&A between Stephanie and myself and after, there is a giveaway so you can win your own copy of her new book, Breastfeeding, Take Two!

1. In the book, you discussed many times how your nursing relationship with your son in ways made you more determined to nurse your next child. How did you personally prepare for your next experience?

A good deal of my personal preparations for my second breastfeeding experience came through the research and education I gained writing my first book, Exclusively Pumping Breast Milk.  When my son was born, I had no understanding of lactation and how milk supply was initiated or controlled. Exclusively pumping for a year, and the subsequent research for my book, filled in many of the gaps in my knowledge.

When I was pregnant with my daughter, I spent a lot of time reading about “normal” birth and really focused a lot of my preparation there. The birth experience has a great impact on breastfeeding initiation, and the more I read about normal birth, the more I knew that was what I needed. This, I think, also helped to overcome the loss of a “normal” birth the first time around. Books such as Ina May Gaskin’s Ina May’s Guide to Chidbirth helped to reframe my expectations and understand this continuum between birth and breastfeeding, as well as books by other authors such as Michel Odent and Jean Liedloff.

Emotionally, my preparations were a bit more challenging. Writing my first book certainly helped to work through some of the emotions from my first experience, and communicating with many women who were exclusively pumping and grieving their own breastfeeding losses helped me reframe my own experience. I also had a much stronger social support system around me and knew where to go for support. My husband was also able to take a few weeks off work which provided a great deal of support. When my son was born, my husband was in school and so I had been on my own a lot.

Once my daughter was born though, I was really quite unprepared for the resurfacing of emotions left over from the experience with my son. What I thought had been sorted out was clearly still at play.

2. What made you actually sit down and write this book?

That’s a really great question. The idea for the book started to form in 2009, shortly after my daughter weaned. I was likely a bit nostalgic for the breastfeeding relationship that had just ended and beginning to really consider what it meant to me as well as contrasting it to the breastfeeding relationship I had had with my son—or perhaps more accurately with my breast pump and his bottle. It was clear to me that the opportunity to nurse my daughter for three years had really played a pivotal role in healing the remaining hurt and sense of loss I felt over my son’s experience, as well as cementing in my mind the impact of breastfeeding on the mother-baby relationship.

Around that time I also began to recognize a recurring theme in the emails I would receive from mothers who were exclusively pumping and who were looking for information and support; so many women felt a keen sense of loss, an overwhelming sense of guilt, and a fear of what would happen the next time around. This, I realized, was the same experience I had gone through.

When I started searching for books already written on the topic, I realized there were none.

When I did an internet search though, I realized there were many women who were feeling this sense of anxiety about breastfeeding after a difficult experience and these women were posting on various discussion boards looking for information, support, and understanding. Toni Morrison, one of my favourite authors, said, “If there is a book that you really want to read, but it hasn’t been written yet, then you must write it.” And so, since the book I wanted to read hadn’t yet been written, the idea began to incubate and grow.

I wasn’t sure that what I had to say on the subject was something of value. But finally through communication with a couple women in the lactation community—women I greatly respected for their knowledge and dedication to breastfeeding and their support of mothers—I was encouraged to write the book and decided that I did have something to say. My daughter started kindergarten in the fall of 2010 and it was at that point I started writing in earnest.

3. As you were writing this book, did you wonder if it would be any help to another mother wanting a successful nursing relationship the next time?

Of course! I knew the ideas and information I was pulling together were meaningful to me. All of the research I undertook, and my own experience with my children, kept leading me to the importance of the biological element of breastfeeding, but also highlighting the divide within society that made breastfeeding so challenging. I felt this pull of influences in my own life and experiences, but there is never any way to know if anyone else will see things in the same way. Ultimately, I kept returning to the reminder that teachers often give students: if you are wondering about something, chances are others are too, so go ahead and ask the question or start
the discussion. I’m starting the discussion.

4. Your son was born very early, at 31 weeks, and you exclusively pumped for a year. Are there any words of wisdom you can give women that have very premature babies and have the same worries that you did about feeding?

Being the mom of a preemie is hard. Not only do you have the worry of your baby’s health and development, but often there are complications with your own health that led to the premature delivery of your baby. Logistics of hospital visits and work can be challenging. Having to pump with great frequency amid all the other busyness of the day can seem like a monumental task. And often the people around you are completely focused on your baby and forget about the trauma that you have just gone through.

My advice would be to be kind to yourself. Recognize the experience can be very stressful and that you need to care for yourself. Ask for help. Don’t try to do it all. Do kangaroo care with your baby and spend as much time as you can with your baby. Remember that you are your baby’s mother. In the NICU it can seem like you are secondary and if it’s your first baby, it can be a daunting task to jump in and become a mother when your baby is so small and everyone around you seems to know what they are doing. But you were your baby’s home for the months leading up to their birth, and you are still the best, most comfortable home they know. You also have the right to speak up, demand options, ask for clarification, request to actually see the
neonatologist, and generally be given a say in your baby’s care.

With regards to feeding specifically, ensure you get excellent information about initiating your milk supply with a pump and be as committed to pumping as possible to prevent difficulties down the road—but recognize that we all have limits. Understand why you are pumping so frequently, and realize that it isn’t going to last forever. Use a hospital grade breast pump, at least in the early weeks. Realize that staff in the NICU are not often breastfeeding specialists. Ask to see a lactation consultant early on. Be patient when you begin nursing your baby and allow your baby to set the schedule. I highly recommend the work of Dr. Suzanne Colson (biological nurturing) and Dr. Christina Smillie (baby-led latching) as methods to approach breastfeeding. While it is exhausting pumping every two hours around the clock in the early days, it will help to ensure you establish a strong milk supply, and a strong milk supply will ensure that you have options down the road.

5. In the book you talk about how throughout your life you never truly saw breastfeeding. Most children now are still at that disadvantage. Are they any ways mothers can show their children and help them understand that nursing is a completely normal activity, especially if the women themselves have had trouble nursing subsequent children?

This is such a challenging area. Formula and baby bottles are so ingrained in our society that most little girls grow up knowing and understanding the use of a bottle, yet not having a true understanding of the biological purpose of breasts! In my own experience, I do a few things. The first is that I try not to miss out on an opportunity to talk about breastfeeding and “normal” infant feeding with both of my children. I always throw away the baby bottle that comes with dolls and will often say to my daughter that the doll doesn’t need that because a baby has their mommy’s milk. My daughter likes Dora and I’m always annoyed with the story when Dora becomes a big sister because Dora immediately helps to feed her new brother and sister by bottle. I will usually question my kids as to why the mother wouldn’t nurse her new babies. Formula advertising on television is another thing I usually make a comment about—although that is usually an angry rant!

These may seem like small things, but they are meaningful. And it is important to emphasize with all children the idea of breastfeeding as “normal”, regardless of whether they were breastfed, or whether they saw their siblings breastfeeding. My daughter who was breastfed will just as readily grab for a bottle for a doll as will any of her friends who may not have been breastfed. This is a social issue, not a personal issue, and the power of the media is overwhelming to our children.

Generally, I think it is important to have open communication and not shy away from talking about breastfeeding with our children. If we want our society to see it as normal, we need to treat it as normal with our children. Also encouraging other forms of nurturing—holding, babywearing, responsiveness, co-sleeping—in our children can help them understand breastfeeding as one method of many for nurturing our babies.

If breastfeeding challenges arise again with another child, talk about it with your older child. Explain the situation. Explain that because of difficulties you have to feed formula and that it’s good that we have formula for times like these, but that many mommies breastfeed their babies. Young children understand more than we think they will.

How can we show breastfeeding to our children? I think the best way is to be a supporter of other women who are breastfeeding. Encourage and support mothers who you know and even say a word of encouragement to a woman you might see in public nursing her child. Speak to your government representatives about rights for breastfeeding mothers. Encourage and support businesses that make it easy for moms to breastfeed without relegating them to a closet in the back; and likewise, let businesses that treat breastfeeding mothers as second-class citizens know that they need to change their ways. In order to give our children the opportunity to see breastfeeding as normal, we have to support breastfeeding as normal in our society. They will never see it if it’s not there! One thing I would like to see in every school is a meaningful unit
in health class on mothering and breastfeeding, for teen girls and well as boys. Our children will never see breastfeeding until we demand change in our society.

We need to do a better job of talking about breastfeeding in our society. Too often it becomes a formula vs. breastfeeding debate, but this isn’t useful. It’s not an either/or discussion. If children grow up with the knowledge that babies nurse at their mothers’ breast and that formula should be a life-saving intervention when needed, then breastfeeding will be seen as normal.

A number of year ago when I started to look around my own world and consider how I talked about breastfeeding, I realized that I too saw it as an option and spoke about it as a choice, not as the biologically normal way to feed a baby. And while I am by no means a prude, I saw breasts not as a nurturing aspect of a woman, but as the sexualized object my society suggests they are every day in film, on television, in magazine, and in fashion. This is a belief that I have had to question and examine, and ultimately change, since having my own children. Changing your own perspective, and then simply talking with your kids when the opportunity presents itself, will help change our children’s view of breastfeeding.

6. While pregnant, even if they don't have any children, how can a woman know what kind of support she will need after birth so she can find it?

Support is important and there are different types of support everyone needs. Most importantly every woman needs support that is in line with her goals and support people who will respect her goals. There are a few types of support that I think every woman needs, regardless whether this is your first baby or not.

You need to have your doctor on board—or at least know ahead of time that they will not be the source of support you need. Every woman should evaluate her doctor in terms of breastfeeding knowledge and support. Dr. Jack Newman has a great handout on how to know if your doctor is breastfeeding friendly. It is important to realize that not all doctors are breastfeeding friendly, just like not all people are breastfeeding friendly.

You need the support of your nuclear family. Ensure your partner and older children are aware of your intentions to breastfeed, what that will mean in terms of your time and schedule, and how they can help you. Fathers play a large role in breastfeeding success and can be great supporters through difficulties.

You need the support of your extended family and friends. Have an honest discussion with your family and friends. Let them know how important it is to have their support after your baby is born, but also let them know how important breastfeeding is to you and your baby. Ask them not to intervene or offer advice that is not supportive of that goal. Making it clear ahead of time may help to ease any hurt feelings after the baby is born if you need to stand up for yourself or ask someone to stop offering advice.

You need logistical support. Gather a list of friends and family you can call on to help with life: cleaning, shopping, childcare, cooking. While maybe you won’t need this kind of help, you’ll appreciate having it prearranged if you do. It’s unfortunately that in our society we isolate new mothers and too often new moms are expected to pick up where they left off almost immediately once their babies are born. Focus on your baby for those first few weeks at home and either let the house take care of itself, or allow your family and friends to help out. Giving the services of a housekeeper or a post-partum doula as a shower gift to a new mom would be a great thing for a group of friends or family to offer.

Finally, you definitely need to prepare for specific breastfeeding support. Before the birth of your baby gather as much information about breastfeeding support in your community. Create a list of names, phone numbers, and the services offered—and then call them! I really encourage women to make contact before the birth of their children. Go to a breastfeeding support group and arrange to meet with a lactation consultant. You’ll be more confident and comfortable to call after the birth of your baby if you’ve already forged a relationship. And don’t wait to ask for help. It’s never too early, and much easier to correct problems if they are caught early.

7. How can someone distinguish between the guilt of feeling like a failure and changing their level of satisfaction with their nursing relationship so the feeling of failure disappears?

Guilt is felt because you have done something you know you shouldn’t have, or you have not done something you know you should have. When it comes to breastfeeding, many women say they feel guilty because they should have breastfed but didn’t, or they weaned early and shouldn’t have. Moving past these feelings of guilt requires you to honestly investigate what you did do in the situation.

There are very, very few women that I have met who did not do everything possible to breastfeed. Some women in fact, go above and beyond what anyone who ever expect. Consider what you did do to make breastfeeding work. Consider the information you were given and support you had access to. If you did what you could and tried to access both information and support, then there is no reason to feel guilty. You may feel regret. You may experience grief. You have not failed if you did everything you could to make it work. Only you can determine what “everything” is.

Recognizing your efforts to breastfeed, and also identifying the areas that hindered your breastfeeding relationship, will help you to move beyond feelings of guilt and failure and help you to understand the strength you exhibited in a difficult situation, recognize the areas where you were failed by society, and help you to grow from your experience.

I think a more valid conversation is one of satisfaction as opposed to failure or guilt. Regardless of how long you breastfed, you were a breastfeeding mother if you put your baby to breast after they were born. However, if, for example, you had planned to breastfeed for a year and ended up weaning after only three weeks due to pain or your baby’s poor weight gain, you’re breastfeeding experience will likely not have been a satisfying one.

Satisfaction and feelings of failure are two separate issues. I don’t know if you will ever be able to feel satisfied with an experience that was less than what you had wanted, but you can move past feelings of failure. There is no magic cut off mark that makes you a breastfeeding success or failure. There is no governing body that establishes criteria that conclusively determines your success or failure breastfeeding. Your experience is your experience. Learning from it and making peace with it will allow you to move forward and grow from it. If you don’t have another opportunity to breastfeed, then your experience will inform your choices in other areas of your life, or you will have the opportunity to support women around you who are beginning a
breastfeeding relationship. Moving forward from your experience in a positive way and making use of your experience is the best thing you can do to become satisfied with it.


Now is your chance to win a copy of Stephanie's book!  The entries are below, the contest will run from today until the 1st of November, open to those in the US and Canada, and good luck!


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