working and breastfeeding

Celebrating Mothers and Babies Around the World
TABLE OF CONTENTS
Today
[04]
&
g
n
i
k
r
o
W
!
g
n
i
d
e
e
f
Brea st
[08] Thank You
La Leche League
[10] Working and
Breastfeeding
[16] Interview
D-MER (Dysphoric Milk Ejection Reflex)
What is it?
[22] LLL News
GlobaLLL
[24] What’s Cooking
[20] The Curious Lactivist
US Mothers Get Time to Pump Defining “Reasonable”
Jiaozi (Chinese Dumpling)
Photo: © Punchstock.com
[08]
Mothers’ Stories
[26] Donors Making
a Difference
[12] Diary of a
Breastfeeding
Mother Returning to Work
[14] Supplementation
and Breast Refusal
Today
Celebrating Mothers and Babies Around the World
EDITOR’S LETTER
Today
Issue 4 | 2010 | Volume 4 | Number 4 © 2010,
La Leche League International, Inc.
Managing Editor | Barbara Higham
Contributing Editors | Kathy Abbott, Johanna
Horton, Barbara Mullins, Lesley Robinson
Review Board | Barbara Emanuel, Gwen Gotsch,
Carol Kolar, Kathleen Whitfield
Art Director | Ronnelito Larracas
Cover Photo | Punchstock.com
Advertising Manager | ReNata Bauder
Web Development | Dave Davis, Shelly Stanley
Acceptance of paid advertisements does not
constitute an LLLI endorsement of the product
advertised. LLLI does not require advertisers
to carry product liability insurance.
Mailing Lists: LLLI sometimes makes its mailing list of members
available to reputable outside groups. If you prefer
Breastfeeding Mothers
Who Return To Work
Returning to work after becoming a mother isn’t easy, no matter how the baby is
fed. In this issue Diana Cassar-Uhl IBCLC examines mothers’ and babies’ feelings
and needs as well as the logistics of separation when a breastfeeding mom goes
back to work. We hear from two mothers in France about how they coped with
the challenges of employment outside the home while continuing to breastfeed
their babies. Kathy Abbott, our “Curious Lactivist” considers the definition of
“reasonable” in the new US healthcare legislation signed earlier this year by
President Obama to enable mothers to pump their milk at work.
Breastfeeding Today interviews lactation counselor Alia Macrina Heise and Diane
Wiessinger, IBCLC, about D-MER (Dysphoric Milk Ejection Reflex) to learn more
about what this condition is and what help is available for mothers who are
suffering from it.
Wherever in the world you are reading this, Breastfeeding Today wants to hear
from you! Please send your letters, stories and photos to editorbt@llli.org. The
writer of the star letter in “Your Letters” receives a FREE copy of the new edition
of The Womanly Art of Breastfeeding.
not to receive these mailings, notify LLLI.
Read on for more mother-to-mother sharing!
La Leche League International fully supports
the WHO (World Health Organization) International
Code of Marketing of Breastmilk Substitutes.
LLLI Board of Directors, (2009, 2010)
Barbara
Barbara Higham | editorbt@llli.org
is a La Leche League Leader, managing editor of Breastfeeding Today and co-editor of LLLGB’s
Breastfeeding Matters. She lives in the spa town of Ilkley, West Yorkshire in the north of
England with Simon and their children, Felix (12), Edgar (8) and Amelia (5).
Breastfeeding Today is published by La Leche League
International Inc., 957 N. Plum Grove Road, Schaumburg, IL.
60173 USA. Telephone 847-519-7730
(9 AM to 5 PM Central Time). Visit our Web site at llli.org.
Canadian subscribers should contact LLL Canada at
PO Box 700, Winchester, ON K0C 2K0, Canada, or
go to www.lalecheleaguecanada.ca with any questions about
subscriptions.
Diana Cassar-Uhl
004
If You Leave Me Now
Working & Breastfeeding
(with a little help from music of the ‘70s and ‘80s!)
Nature has designed a perfect system; a mother’s body is fully equipped
to provide a safe place for a baby to grow and, after the baby is born,
mother’s body provides all of the nourishment and nurturing the baby
needs to thrive in the world. A mother’s well-being is as dependent upon
her baby’s presence as her baby’s survival is upon hers, and the dance of
give and take dictates a pace of life very different from what most mothers
were accustomed to before the baby arrived.
When undisturbed by competing demands and supported by people close
to the mother, nature’s system provides the ideal start to the mother-baby
dyad’s journey. However, mothers sometimes find themselves at the hands
of challenging situations that separate them from their babies, upsetting
the perfect balance the breastfeeding relationship so adeptly establishes.
Can mothers preserve this basic, primal link to their babies, even if life
demands that it be interrupted?
W hat I Did for Love
Why are you breastfeeding your baby? Is it because you know your
milk is the superior food for your baby, rich in nutrients your baby needs
for optimal growth and development? Do you breastfeed because doing
so protects your body from certain cancers and supports your recovery
from the work of pregnancy and birth? Does the closeness between you
and your baby delight you so much that you can’t imagine not doing it?
Perhaps all of these reasons motivated you to begin breastfeeding, even
when there might have been challenges. These same reasons can remind
you why you continue to breastfeed your baby and provide your milk for
him, even if your circumstances seem a bit complicated.
It is important to assess your emotional state about separating from your
baby. There are lots of reasons why you might have to leave; only you
can decide whether those are “good enough” reasons for your family’s
situation. Some mothers carry the health insurance for their family and
have to return to work when their babies are very young. Others may have
to return to school, or are in a career field that requires a certain number
of consecutive years in order to provide long-term security. Perhaps you
feel that the work you do is an important part of who you are. Whatever
your reasons, it is important that you are honest with yourself and
with those who are supporting you about your feelings when you are
considering separating from your baby.
You may feel that you are obligated to return to work because that’s what
you decided before the baby was born, then discover that the only person
holding you to that commitment is you, and there are other options. Your
workplace may be amenable to a gradual return, minimizing the separations
from your baby for as long as possible, or delaying your return to work
a few more months. Maybe you can work with your baby in tow, or find a
childcare solution that allows you to be close to your baby. Staying true to
your feelings will help you and those who care for you to think outside the
box and find the best way for you to stay connected to your baby. Trust
the feelings in your heart!
Photo: © veer.com
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Diana Cassar-Uhl
005
B
rea stf e ed i n g
or not, I don’t
think any mother
feels good when she
has to leave her baby.
T otal Eclipse of the Heart
Breastfeeding or not, I don’t think any
mother feels good when she has to leave her
baby. Knowing that your baby finds his comfort
in your arms is both rewarding and humbling.
It can be a devastating reality when a mother
understands how stressful it is for her baby when
they are separated for any length of time. This
stress occurs whether the baby is breastfed or
artificially fed. It is important to accept that
separations between mothers and their babies
are not ideal. Taking stock of your particular
situation and assessing whether you could do
something different can define your experience. A
mother who has no choice but to separate from
her baby can feel deep regret that her situation
was not different; there were circumstances
beyond her control that influenced her choice.
Being able to distinguish between guilt and regret
can help you to focus on what you CAN do to
preserve the ideal start that you and your baby
have enjoyed. The experience of regret allows us
to mourn the aspects of a situation that were not
ideal, while guilt can perhaps propel us to make
changes and revisit our priorities.
B reaking Up is Hard to Do
No matter how many people you’ve seen do
it before you, going back to work after having
a baby may be one of the most complicated
things you’ve ever done. On top of concern for
your baby’s well-being and how he will eat and
be comforted, you will worry about the logistics
of commuting, child care, pumping and storing
your milk, and whether you can even do your job
any more! Add your concerns to the exhaustion
that comes from caring for a baby around the
clock and you are likely to find yourself crying
under the ironing board in your locker room on
your first day back (oh wait, that was me!). Take
a deep breath, and tackle one concern at a time.
Remember that separating from your baby will
be hard on both of you, regardless of how he is
fed. Keep in mind that when you and your baby
are together, you can rest together and nurse
as much as he needs. When a baby nurses, he
is filling up two tanks: his tummy full of food,
and his “love tank,” his emotional side. Even if
he doesn’t seem hungry, your baby needs your
closeness and your attention when you are not
at work.
End of the World As We Know It
feel fine!)
I t’s(andTheI don’t
Ideally, you want to postpone your return to
work as long as is possible. The longer you
and your baby are able to get breastfeeding
established without interruption, the more likely
you will be to reach your breastfeeding goals as
circumstances change. Think creatively—even
one more month, or another year, with your baby
can make such a difference in how things go when
you do have to return to work, both in terms of
your baby’s well-being and your productivity.
Can you do your job from home? Bring your
baby with you? Infants tend to be very portable,
while crawling or toddling babies may do well with
a caregiver who can keep them busy and safe
while mother works nearby. Maybe you can work
out a mixed situation, which allows you some
time of working near your baby and a number
of hours each week of traditional separation.
Mothers whose jobs require travel can consider
having baby and caregiver travel with them, or
perhaps a family member or friend who lives near
the travel destination can provide a safe, caring
environment for the baby while mother attends
training or meetings. Realizing the value of the
breastfeeding relationship and the ease that
comes with keeping your baby close makes it
worthwhile in the long run.
F reak Out
Every baby is different. Some are easygoing
and will be comfortable with a sensitive caregiver
who attends to the baby in a manner similar to
mother; others will show their distress openly,
perhaps refusing to eat until mother returns.
Most babies will likely be somewhere in between
these extremes. Keep an open mind and try to
remember that your baby doesn’t understand
what is happening. He only knows that you are
gone, and he is confused.
My first baby, now seven years old, flatly refused
to eat or go to sleep for the night until I was with
her. I learned to adjust my work schedule and my
caregivers’ roles so that I could feed Anna when
she needed to eat and we could be together
when it was time for her to sleep, even if that
meant she was awake a little later and enjoying
a concert of patriotic music with the adults! As
she got older and was able to eat solid food,
she accepted those feedings from her daddy or
other caregivers, making my daytimes a bit more
flexible, but ensuring I stayed close at night. My
second baby, now five, also refused to eat in my
absence, but enjoyed an afternoon nursing/nap
close to me each day. He settled nicely for his
daddy in the evenings, which enabled me to catch
up on the work I postponed so we could have
our afternoon nap together. Just when I thought
I knew everything about balancing babies and
my job, my third baby, now two, came along.
She LOVED the wrap sling, and would be happily
worn in it by anyone! She was also happy to take
my milk from a bottle until she was about nine
months old, so long as I wore her in the sling or
held her close to me during all the hours I wasn’t
away from her. I was happy to oblige!
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Diana Cassar-Uhl
006
may expect your baby to behave
like an artificially-fed baby. Be
sure to help your caregiver learn
about human milk. How it is
quickly digested by your baby,
how it should be handled and
stored, and how valuable every
drop is are all important points
for discussion. See Information
Sheets Storing Human Milk LLLI
2008 http://store.llli.org/public/
profile/308 and Storing Your Milk
LLLGB 2009, Quickfind: 2807
http://www.lllgbbooks.co.uk/
product/269/storing_your_
milk_-_pad_of_50/default.aspx
P ump (“For My Love”)
Photo of Lesley Griffin and baby. Courtesy of Sacha Blackburne.
The thought of a crying baby
who is unable to be soothed
is one of the most stressful
for a mother facing a return to
work. A common question many
mothers ask is whether they need
to “force” their baby to take a
bottle so that the baby will eat
during the separation. Some
important considerations when
faced with this question include:
✤✤ How old is the baby?
Is he eating solid foods
yet?
✤✤ Can the baby drink
from a cup, spoon or
other vessel?
✤✤ How long will the
separations be? How
often?
✤✤ Is the caregiver able
to provide the emotional
support that the baby
needs?
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Choosing a compassionate
caregiver is vital to ensuring
your baby’s relative comfort
while you are away. Be sure to
let your baby’s caregiver know
how important breastfeeding
is to you, and involve her in
developing ways to keep the
breastfeeding relationship secure.
Being able to feed the baby
just as you leave and return to
a hungry baby, whom you can
nurse right away, can really help
shorten the separation for your
baby. Being able to visit your
baby at lunchtime or even more
often is also a viable option for
many mothers and can be very
effective. Encouraging your
caregiver to feed small amounts,
on demand, will also help your
baby feel more comfortable.
Many caregivers have never
worked with a breastfed baby and
llli.org
Well, okay, you’ll probably
never really LOVE the pump, not
the way you love that soft, sweetsmelling little baby, who fits so
perfectly in your arms and gazes
up at you with pure admiration,
but for many mothers who
separate from their babies the
pump is the way they will protect
their milk production and be able
to provide milk. Which pump will
you use? This question is best
answered by considering your
particular situation and what
your pumping needs will be—not
every mother needs an expensive,
double-electric breast pump. See
A Guide to Pumping Your Milk LLLI
2009 http://store.llli.org/public/
profile/381
Where will you pump? When?
There is now legislation that
protects mothers who are asking
these questions. Even under the
most ideal circumstances though,
some mothers find that they
cannot experience a let-down
for the pump. Many pump cases
have a spot for a photo of your
baby—the visual reminder of
why you are hooked up to that
motorized milking machine might
help your body release milk.
Stimulating your other senses
might help, too—smelling a
onesie your baby slept in last
night, humming a song your baby
likes to hear you sing, or holding
a soft receiving blanket while you
pump are all ways to encourage
an oxytocin release and bring on
a let-down. Conversely, for some
mothers thinking about anything
BUT their babies gives them
the most success—imagining a
spraying fire hydrant or simply
mentally escaping to a “happy
place” may be the best method.
Get Enough of Your
Milk, Mommy
C an’t
How will you know if you are
making enough milk? You watch
your milk as it drips and sprays,
and fret each minute that you’ll
never be able to keep up with
what your baby needs. This
worrying will not help! Don’t
watch the pump bottles. Use the
pumping time in your workday to
take a break and let your body
do what it needs to do. Have
your baby’s caregiver offer small
amounts in each bottle, so that
less milk is wasted during the
course of a day or week—every
ounce is precious.
If your baby is taking
considerably more than you’re
able to produce for the pump,
ensure that you are pumping
frequently enough. Consider
adding a few pumping sessions
even when you are at home, such
as just before bed, as soon as
you wake up and, on weekends,
after your baby feeds. It’s OK
if your baby just ate; your
Diana Cassar-Uhl
007
breasts are never really “empty” and the more
milk you are taking, the more your body will
make in response. Pump both sides and save
whatever you get. If your baby is older and
beginning to demonstrate readiness for solids,
consider supplementing what you produce with
wholesome starter foods instead of with artificial
baby milks. My own babies began taking solid
foods and, for the first few months, only got
solids when I wasn’t at home! I nursed them
when we were together and let them have four
or five meals of fruits, vegetables or cereals
each week when we couldn’t be together (which
allowed me almost completely to bypass the
stains of pureed carrots and green beans on
my white shirts). Talk to your pediatrician if
you have questions about your baby’s growth,
appetite and calorie needs, as well as what might
be the best ways to meet them if you feel your
milk production is not keeping up.
Always keep in mind that some breastmilk is
better than no breastmilk! Even if you cannot
pump every ounce that your baby will need
to thrive, what you are able to provide is so
precious, and can be sustained for as long as
you and your baby want to continue nursing,
well past the 12-month mark. You can nurse
exclusively when you are together, which will
satisfy your baby and help boost your milk
production. The benefits to being breastfed go
far beyond nutrition for a baby, and the bond
you will preserve by breastfeeding as much as
you can, when you can, will serve you well into
your baby’s childhood.
you’re together—perhaps all evening, all night
and all weekend. This doesn’t necessarily mean
he’s hungry; keep in mind that when your baby
nurses, he is filling up his emotional “love tank”
as well as his physical “tummy tank.”
You may feel that between working and nursing
your baby, there is simply no time left for
anything else. Now is a good time to remember
your motivation, both for breastfeeding your
baby and for going back to work. If your
situation still requires that you separate from
your baby, see if you can enlist some help
around the house. Easy meals, some assistance
with the laundry and cleaning, and the freedom
to rest and just be with your baby will help
you get through this phase, and it is only a
phase, one that will end soon enough. Putting
“people before things” will help you remember
that, in this season, the most important things
you can do are take care of your baby and
yourself. There will be time for the other things
as your baby gets older and his need of you,
while always present, becomes less intense.
I am finding great delight in the fact that my
once high-need baby girl is now a big helper
in the kitchen! We made lasagna together the
other night and met each other’s needs to be
close, while also taking pride in being able to
do something good together, for our family.
Before Anna weaned, I could never imagine how
she and I might relate to each other without
breastfeeding, or that there would ever be a
time she would be able to function without
me! That day came, perhaps much too quickly,
but I am certain that the investments I made in
sustaining our breastfeeding relationship after
my return to work played a huge part in our
continuing closeness today.
A Balancing Act
LLLI Pamphlet addresses issues that many
employed mothers face while breastfeeding
http://store.llli.org/public/profile/83
Breastfeeding for
Working Mothers
In less than 20 minutes,
this program shows new
and expectant mothers how
to successfully continue
breastfeeding once they
return to work. Viewers will
learn how to plan during
pregnancy, prepare during
maternity leave, and how to
pump and store their milk
once they are back at work.
T he Mother and Child Reunion
You will undoubtedly discover very quickly
that being away from your baby is difficult,
both emotionally and physically. This is part
of that perfect system nature has given us for
nurturing our babies, and your success will be
magnified if you respect the difficulty and work
to minimize it in any way you can. Hurrying to
be with your baby (observing proper safety laws,
of course!) at the end of the day will bring you
the reward of a smiling, snuggly baby who can’t
wait to curl up with his mama for some nursing.
He might decide he is so happy to be with you,
he’ll want to nurse for hours and hours when
Photo of Lesley Griffin and baby. Courtesy of Sacha Blackburne.
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Mothers’ Stories
008
Thank You
La Leche League
Theresa Monfet, Northern New Jersey, USA
Young mom Theresa found the support she needed
through La Leche League …
I’ve just finished reading the premier issue of Breastfeeding Today... well to
be honest I’m in tears. See, I’m a young mother of 23, although I like to
call myself a “seasoned mommy” because I’ve just had my second child.
What a handful, a two-year-old and a three-month-old! I feel blessed,
however, to have my two beautiful daughters in my life.
I
truly can’t thank LLL
moms enough for the
continued support and love
you give to new moms.
As a young mom, there wasn’t much help out there
for me when I had my first daughter, or so I thought.
Young mothers today don’t know where to go with
their questions, or for advice, or just a womanly
opinion, besides perhaps their own mothers. So you’ll
understand how lost I felt when I brought my beautiful
daughter, Kays home from the hospital. My mother
had had three children and didn’t breastfeed any of
us. I had trouble breastfeeding and felt I had no one to
turn to apart from my physician, obstetric gynecologist
and the lactation consultant at the hospital, none of
who were able to help. I just couldn’t get a handle on
breastfeeding. I went into a big dip of postpartum
depression.
About three weeks after my daughter was born, having
given up on breastfeeding altogether, I started seeing
a therapist. I had had a cesarean section and been
told wrongly by some that my milk might not have
come in properly because of the trauma from such a
delivery. I took prescription meds to help me cope with
depression and to help deal with the infection that
occurred following my surgery.
Photo of Theresa Monfet and baby. Courtesy of Theresa Monfet
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Mothers’ Stories
009
However, that emptiness in my heart was at times unbearable. I had dreamed
for months of the perfect delivery, the perfect baby and that oh so perfect
bond I would have with my daughter when I began breastfeeding her for the
first time.
On a visit with my physician, he decided to take a quick breast exam since my
breasts had no longer been producing milk. He informed me that there was
in fact a small mass in my right breast. Right away I was sent for x-rays and
an ultrasound, but because the mass was right behind my areola it was hard
to diagnose. The only thing they could do was go in surgically to remove and
biopsy the mass, in the hope of finding out what it was. My grandmother
had been diagnosed with breast cancer in her early fifties so, of course, I was
worried.
A grueling nine and a half weeks after my surgery, the results were back—
luckily, no cancer. However, the mass that had been removed was a cyst
that had grown right behind my areola and nipple, which kept the milk from
flowing.
LLLI Annual Supporting
Membership | $25.00
Supporting membership includes:
•10% savings on items purchased in the LLLI online store With the upcoming arrival of my second daughter, I read all the books, found
other moms who could give me help and tips and a local lactation consultant
who was willing to come to my home once a day for the first week to help
me with breastfeeding, as well as finding my local La Leche League Group.
I’m now a happy exclusively breastfeeding mama, and intend to continue
breastfeeding at least until my youngest daughter, Olivia is 12 months old.
I truly can’t thank LLL moms enough for the continued support and love you
give to new moms. Without women like you, I might have missed out on this
wonderful experience. This bond with my daughter is one that no one can
ever take away from me.
•Breastfeeding Today, our global online publication breastfeeding research, articles, resources,
products and much more.
•Special offers and advanced notices for new products and materials.
Most importantly, your support will help
mothers and babies around the world!
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Mothers’ Stories
010
Working and
Breastfeeding
Sandra Esteban, Paris, France
I returned to work when my son was six
months old. I believe breastfeeding helped
me to cope with our separation.
Before going back to work, I had decided I was
going to breastfeed for six months. As the time
to return to work approached, I realized I didn’t
want to stop breastfeeding, so I thought I would
continue to breastfeed morning and night. A
week after I had made this decision, I learned
(though never really mastered) breastfeeding
using a sling. I planned to breastfeed my son
on the way to his nanny’s and on the way back.
I started reading two online forums and asking
questions of other mothers in the same situation
and found out that some pumped their milk.
Wow! I thought they were very brave and that I
could never do that! Some time later, however, I
ordered a pump and then, that harrowing day
arrived: I had to start taking my son to the nanny
or “nounou” so that he could get to know her. At
the start, I would drop him off and cry my eyes
out. When I collected him I would breastfeed
him as a way to reconnect (I don’t know if it was
more for me or for him).
Two weeks later I started back at work. Other
mothers were very gentle with me. It was the
kind of solidarity you get from moms who have
experienced for themselves that wobbly feeling,
having also been separated (prematurely, in my
opinion) from their own babies.
I had a super bag with a double breast pump
and proudly told my boss—a man whose wife
had breastfed—what it was for. He looked at
me puzzled and said, “You do what you want”
meaning “Too much information!” I started
pumping three times a day and slowly reduced it
to twice a day. I didn’t openly tell the world I was
pumping, but if anyone asked then I did explain
what was in the bag. I was very lucky, everyone
was supportive and no one ever bothered me
when I disappeared to pump—I’m not sure they
even realized that’s what I was doing.
T
he same way that
bottle-fed babies
sleep though the night
for 12 hours without
eating, my breastfed
son could have less milk
throughout the day and
then get all he needed
in the evening, night
and early morning.
Photo of Sandra Esteban & her baby. Courtesy of S Esteban
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Mothers’ Stories
011
Photo of Sandra Esteban & her baby. Courtesy of S Esteban
Having enough milk for my son’s
time with the nanny was the most
stressful part of pumping. By this
time, I didn’t want to give my son
artificial milk and my nanny had
never looked after a breastfed
baby. She herself had breastfed
her last baby for nine months,
but only because her baby had
been born prematurely. She
insisted on giving my son 180 ml
and then 240 ml bottles of milk.
It wasn’t malicious but it took
some negotiating and explaining
so that she didn’t think I was
starving my son. I explained that
my son breastfed at night so he
was getting all the milk he needed
then. The same way that bottlefed babies sleep though the night
for 12 hours without eating, my
breastfed son could have less
milk throughout the day and then
get all he needed in the evening,
night and early morning. As my
son began to eat solids, it became
easier for everyone.
I think cosleeping was an essential
in my breastfeeding journey. I
never felt tired (or, more honestly,
I always felt tired so I didn’t know
what it felt like not to be tired)
and I had this positive belief that
my breastfeeding hormones were
helping me through. Cosleeping
was important because my son
fed two or three times in the
night and I felt that I was getting
the physical contact I was missing
out on when I went to work. I
felt less guilty. Most of the time,
I drifted back to sleep. It is only
now that my son is over two that I
wake up if he feeds at night.
I stopped pumping when my son
was 14 months old. What a relief!
Suddenly, I could finish my work
without rushing everything and I
could even go for coffee with my
colleagues. I have to admit I felt
really proud of myself for having
pumped for all this time. By this
time, my son loved going to the
nanny and playing with the other
children when he was there. He
would cry when I took him home.
I was able to accept this and even
be happy that he had such fun
with his nanny. I never felt jealous
of her, as most people told me I
would. I think breastfeeding helps
you to stay attached and to know
that you are the only one who
can provide this special gift for
your child, however happy he is
without you. I wanted my son to
be attached to his nanny because
I think it is emotionally healthy for
him to be with someone he cares
about when I am not with him.
My son is now 26 months old and
still an avid breastfeeder. When I
get back from work, he wants to
play outside and breastfeeding
takes second place, but it still
makes him chuckle with joy. For
me, it is the perfect excuse to lie
down for a while to relax before
getting on with the cooking and
other chores.
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Mothers’ Stories
012
Diary of a
Breastfeeding
Mother
Returning to
Work
Amélie Benoit, Paris, France
I went back to work after a maternity leave
followed by parental leave, which allowed me
to spend the first six months of my daughter’s
life with her and to exclusively breastfeed.
For the first month following my return to
the workplace, the baby’s father will take
care of her in order to ensure a smooth
transition to the crèche soon after. We believe
in attachment parenting and breastfeeding
according to our baby’s needs.
I work in a managerial position: I have a highpressure job in a major group of companies.
Here is my story, recounted as it unfolded.
the day before my
return to work
S unday,
I find myself crying because I am sad
about leaving my baby and a little bit
anxious about perhaps having lost the
ability to do my job after all this time at
home. I have the impression that I am
going to mess up my child’s life somehow,
even if, in other respects, I have had
enough of staying home and changing
nappies. Consequently, I feel contradictory
emotions: stressed, cheerful and sad, all at
the same time.
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Photo of Christabel, Courtesy of Rugby Breastfeeding Café, UK.
M
onday, D-Day
I must say that it gives me pleasure to
do my make-up and dress myself nicely. I kiss
my family and leave them, peacefully sleeping.
It is very comforting to see my baby sleeping
peacefully in her father’s arms and to know
that he will take very good care of her the
whole day long. I managed to express milk
with my electric pump so I am not worried
that she will go hungry.
At work, my colleagues welcome me back very
warmly: motherhood wins people over, and
colleagues for whom I was insignificant find a
new interest in me. For me, it’s a sign of the
solidarity between mothers. My boss then
arrives at 10 am and greets me just as kindly.
All goes well until I tell her that from now on
I will be closing my door two or three times
a day in order to express my milk. She merely
replies with a slightly revolted smile, “Well,
good luck.”
My boss is a career woman who has herself
returned recently from maternity leave and
has stopped breastfeeding for that reason.
She comes in late and goes home late. She is
cold, but professional and polite.
I do not react but simply close my door and
express my milk. I take care to note down the
times when I pump, how long it takes and the
quantity obtained, just in case she may say
to me that I am wasting time. In fact, I am
pumping three times for ten minutes each
time (I have a double pumping kit). If I add the
time for rinsing the components, then I spend
15 minutes three times a day on pumping.
Since I do not take a coffee or smoking break
and I express at 10 am (when the others take
their coffee break), at 1 pm (during my lunch
break) and at 4 pm (when the others take a
second coffee break), I don’t feel concerned!
When pumping, I look at photos of my little
girl, which my husband sends me hourly, and
I listen to a light-hearted show on the radio.
This makes expressing more fun and helps me
Mothers’ Stories
013
unwind. Thinking of something other than work
really helps me express milk successfully.
Having arrived at 8 am, I go home without a
bad conscience at 5.30 pm in order to get
into the habit of leaving on time to collect my
daughter from the crèche.
T
hinking of something
other than work
really helps me express
milk successfully.
I put my milk in a cool bag and transfer it to
the fridge as soon as I get home. On my arrival
home, I see a huge smile on a tiny baby and
I am the happiest woman in the world! After
some cuddles and play, we go to bed. Our baby
wakes in the night to feed and undoubtedly
also to reconnect with me. I am delighted with
how well this first day has gone.
T
he rest of the week
Our baby is waking up more and more.
She now nurses two or three times a night.
Fortunately, cosleeping allows me to get back
to sleep quickly and not be too tired at work.
At work, I am getting into something of a
routine. I close my door, express my milk and
work without worrying about the looks from
my boss. My work is not suffering because of
these breaks and I even concentrate better
than I did before! The times when I close my
door allow me to step back from my work and
to pick up mistakes I have made, which makes
me feel much better.
Going home in the evening is harder: twice
in a row my boss arranges a meeting for me
at home time and I have to gather up all my
courage to say, “Sorry, but I have to go home.
We can have meetings early in the morning if
you want but in the evening I have to go home,
I have to pick up my child from the crèche.”
That does not go down well with her. She tells
me that she cannot come any earlier. I reply
that I have the same problem but in reverse and
that we can surely manage to arrange meetings
between 10 am in the morning and 5 pm in the
evening, which she accepts.
W eek Two
My baby is becoming less accepting of
my departure in the mornings. She cries. It
breaks my heart and I arrive at work shaking.
Is the game worth the candle? Yes, because
we need the money! My boss is not too keen
on my new set-up and reminds me that I used
to work late. I reply simply and calmly that I
can make arrangements in advance to stay late
occasionally but that the days of working up
until 9 pm on a regular basis are past. And,
furthermore, that it’s healthier for the whole
team this way.
M y Tips
✤✤ It is possible to breastfeed and
express milk even if you work in
a managerial position with a lot of
responsibility.
✤✤ Focus on the choices you have
made and seek the support of those
around you.
✤✤ Using a hands-free kit makes
things easier.
✤✤ In the beginning, photos and light
(radio) programmes help you to relax.
I have purchased a hands-free kit, which
enables me to continue working while
expressing my milk. I am able to tell my boss
that I am not taking any breaks during the day
even if the law allows me one hour a day to
express.
✤✤ An enclosed office is a huge
advantage (even if my colleague did
express her milk in the bathroom for
nine months).
I stay calm and organize my job according to
the priorities. The worst that could happen
would be to be fired, which is not likely since
everyone acknowledges that I am doing a
good job and more than fulfilling my side
of the contract. At worst, I know that I can
find another job. I know where my priorities
lie—with my family. Reminding myself of that
helps me to stop getting stressed out and to
produce milk: 300 to 400 ml a day.
I hope that this account of my experience will
help other working mothers to pluck up the
courage to express milk at work. Your initiative
will be received positively by your colleagues,
and even if your boss is not understanding in
the beginning, staying true to your course of
action while remaining calm and professional
will make him or her accept the new set-up.
After all, you have a baby now and it’s normal
for that to change how your life is organized!
✤✤ You need a small cool bag (they
cost very little at camping shops).
I no longer need a photo or the radio in order
to pump. I breastfeed mornings and evenings.
My colleagues congratulate me and encourage
me to continue since it is good for my baby,
particularly with all the epidemics around these
days.
I still enjoy my work as much and I am better at
it since I am less stressed out. It is not always
easy to express one’s milk but it is much easier
than I had ever thought, and being able to
breastfeed still is the ultimate reward, as my
baby loves it!
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Today
Mothers’ Stories
014
Supplementation and Breast Refusal
Megan Abbott, Rockford, IL, USA
Megan was surprised to find
breastfeeding wasn’t so easy second time
around …
When Paige was born, I figured nursing
would be a breeze. I had nursed her big
sister successfully for almost a year with no
complications. Paige and I had some trouble
in the hospital, but I figured we would get
the hang of it sooner or later. I was more
confident than I should have been and
didn’t bother to get help from the lactation
consultant.
After a few days at home with a very fussy
newborn, I realized that she hadn’t latched
on to the breast successfully in many hours.
Also, she hadn’t passed a stool in a few
days. In a panic, I started pumping in order
not to lose my supply. I called the lactation
consultant first thing the next morning.
We visited the LC when Paige was five days
old. She had lost almost two full pounds
from her birth weight. I felt terrible that my
child hadn’t been eating and I had been too
stubborn to notice. To make things worse,
my supply had plummeted. I could only pump
a few cubic centimeters at a time. We started
Photo of Megan’s family and Megan. Courtesy of Megan Abbott.
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a “non-latch protocol,” of pumping at least
eight times a day to get my supply back and
using the bottle to feed my baby. This also
included supplementing with formula but
having her try the breast at every feed. I’m
pretty sure this was the worst week of my life.
I
had so enjoyed nursing
my firstborn and was
looking forward to
sharing that same joy
with Paige.
The baby blues hit me hard, I was recovering
from a C-section, and my baby wouldn’t take
the breast. I felt like such a failure and spent
much of each day in tears. I didn’t know how
long I could go on like that and assumed
I would have to give up on breastfeeding
and switch to giving my baby only formula.
I hated that idea because I had so enjoyed
nursing my firstborn and was looking forward
to sharing that same joy with Paige.
After a few days of pumping, my supply
came back little by little. After less than a
week, we cut out formula all together. Before
two weeks had passed, I was making enough
milk to freeze some. Although I offered Paige
the breast at least once a day, she wasn’t
having it. I read some success stories online
that helped boost my morale when I was
feeling low. Then at three weeks, it happened.
She nursed! It was just on one side and I still
fed her a bottle after that but it was a step
in the right direction! Her fourth week, she
nursed once a day every day but only on that
same side. I was learning tricks to help her to
latch on and things to avoid that seemed to
cause us trouble. Then, when she was exactly
five weeks old, the light seemed to come on.
She latched on and breastfed on both sides
the whole day. I was so happy and so proud
of myself for sticking to it.
I feel that we succeeded in establishing
breastfeeding because of two very important
factors: an incredible support system and my
sheer determination to breastfeed.
P
lease send your stories
and photos for publication
in Breastfeeding Today to
editorbt@llli.org
Interview
016
D-MER What is it?
(Dysphoric Milk Ejection Reflex)
Alia Macrina Heise is a lactation
counselor who suffered some
intense negative emotions
while breastfeeding her third
baby. When her milk let
down she felt unpleasant and
uncomfortable. Breastfeeding
Today asked Alia and Diane
Wiessinger, IBCLC, some
questions to learn something
about these bad feelings and
the naming of the condition.
lia, can you tell us please
about the feelings you
Aexperienced
when nursing
your baby?
The best way to understand my
feelings during a D-MER is to
refer to what I wrote in 2007.
These are excerpts from my
first post on D-MER in a thread
titled “Only When Nursing”
in the Postpartum Depression
section of a natural parenting
forum:
Photo: © shutterstock.com
they occurred, how long they
lasted and so on. When I first
realized I was having these negative
emotional surges throughout the
day, I was very unsure of what could
be causing them or even where
to begin looking. At first I didn’t
connect them with breastfeeding,
because they happened before
let-down and they happened with
every let-down I had, including
spontaneous let-downs—of which
I had many. By the time I finally
found a particular thread on a
forum that helped me put two and
two together, my baby was almost
a month old. I began to track and
document them and posted this:
It’s a sickening feeling in the
pit of my stomach. There is a
strong aversion to food. I don’t
feel sad, but I feel “icky and
yucky.” It is a feeling I seem
to have associated with strong
feelings of worry and guilt
in the past, because when I
first started experiencing the
sensation I kept searching for
what I was feeling guilty or
worried about. It turns out that
there was nothing. It was just
that same sinking feeling in the
pit of my stomach that makes
me lose my appetite that I had
experienced in the past for
these other reasons.
The way I am feeling is
connected to feeding and milk.
The reason I didn’t realize it
before is because it is related
to LET-DOWN specifically. In
fact, now I can tell a let-down
I then began to analyze not just
what the emotions were, but when
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is coming because of how I
SUDDENLY feel. A let-down in
between feedings is much worse.
I can tell I am about to let-down
(about 60–90 seconds after the
emotions hit) because of how I
feel—it’s a horrid feeling lasting
about two minutes. This happens
several times during a feeding,
but those times are not nearly as
intense as the emotional feelings
I get in between feedings during
a spontaneous let-down. I think
this is because during feeding
I am at least feeling more
connected to my baby and the
nice feelings of nursing and so
the yucky emotional stuff is
easier to ignore.
I feel able to cope with it, as I
know now what it is and why. I
think also as time goes on (my
baby is four weeks now) it gets
less intense. I lost a lot of weight
quickly in the beginning because
food always sounded so horrible.
I am able to eat now … it just
sometimes doesn’t sound good
at the moment or after I eat, I
momentarily wish I hadn’t.
My biggest thought right now
is about NAMING this. If there
are so many of us and it seems
to be mostly unheard of, it
ought to have a name. Also as a
breastfeeding counselor I would
take comfort in knowing what
this issue IS.
you suffering from
depression?
W erepostnatal
I was not. When I was not in
the act of breastfeeding, and
even in-between let-downs, I
felt normal and fine. It was
an extremely emotional roller
coaster to go from a normal or
good mood to crashing down
into a D-MER “state” only to
bounce right back up again.
Interview
017
W
hat led you to investigate your
condition?
Since I had breastfed my previous two
children “normally” and this was the first
time experiencing the phenomenon of
D-MER, I knew this was something “not quite
right” and that there must be an explanation.
So after discovering that my awful feelings
were directly related to let-down, I went
looking for answers. Though I am not an
IBCLC, I am educated as a lactation counselor.
I was a CLC working for WIC and had been
in the arena of breastfeeding helpers for
four years. I had never heard of such a thing
happening to another breastfeeding mother,
but asked myself, “Why would I be the only
one?” But my first attempts at information
gathering, of delving into lactation texts,
came up empty. So I went to the next
obvious place—the Internet and lactation
professionals. I started doing archive searches
on Lactnet*, which helped lead me to Diane.
H
ow did you find other mothers who
were suffering similar feelings when
breastfeeding?
Now when you google words like “sadness
while nursing,” “depression with milk
ejection” or “anxiety before let-down” you
get answers. Three years ago you didn’t. I
went to the breastfeeding and postpartum
depression forums of a popular, natural
parenting forum and lurked. I wish I could
say I was brave enough to post the question
myself. But I had personal doubts. At that
point I had not been able to dig up any
information and I was starting to think that it
was all in my head or an oppressed memory
or some emotional quirk that would label me
a “failure as a mother.”
But the forums led the way. I finally found that
first thread—it had the words that made me
sit up and say out loud, “Aha! I’m NOT the
only one.” Once that was established it was a
matter of finding out how not alone I actually
was—the Internet to the rescue. Armored with
the knowledge that I was not a lone freak, and
that surely this was hormonally based, I started
posting and posting and posting. As a result
I found hundreds of women had experienced
D-MER in the past or were currently experiencing
it. And they had—with the exception of one or
two—all been lurking as I was, afraid to post,
afraid to be the first one to ask. (One or two
women had asked before me but their threads
had gotten buried and ignored in the end.) It
was about timing, numbers and persistence.
Persistence was something I wasn’t short on.
I started a blog after I had exhausted the
forums, and ultimately started www.d-mer.org
in order to get information and support out
to other mothers and to medical and lactation
professionals.
S
ince I had breastfed my
previous two children
“normally” and this was the
first time experiencing the
phenomenon of D-MER, I
knew this was something
“not quite right” and that
there must be an explanation.
W
hat did your investigations reveal?
We were able to confirm quickly that it was
a physiological reaction, not a psychological
one. Based on its behavior we were able to
deduce that it was a hormonal reaction. We
really needed to find out which hormones
were doing what. We consulted with oxytocin
specialists, prolactin experts, lactation
professionals who studied thyroid function,
and those in the field of endocrinology.
The word dopamine was finally brought
into the conversation. There’s just not much
information out there yet about dopamine in
regards to its role in lactation. We did find out
that for prolactin to be involved in lactation,
dopamine has to get involved, too. Once we
were able to start asking the right questions
about the right hormones to the right
people we made progress. Then we started
experimenting with the idea of dopamine:
looking at what increases dopamine, what
inhibits it and how these things affect
a mother’s D-MER. It sure seemed that
anything that caused an increase in dopamine
alleviated a mother’s D-MER.
led you to give a name to these
W hatfeelings?
Quite simply, I, along with the other women I
was working with, got tired of calling it “it.”
We realized that there are other conditions
(such as Sheehan’s syndrome) with a much
lower prevalence than the condition I was
experiencing that have been named and
included in every professional lactation text.
There was no reason not to name it and
many reasons to do so. The word “dysphoria”
is a medical term and means an unpleasant
or uncomfortable mood, such as sadness
(depressed mood), restlessness, anxiety, or
irritability. Etymologically, it is the opposite of
euphoria. This described it perfectly. Because
the condition was directly related to the milk
ejection reflex, or let-down, we chose the
term dysphoric milk ejection ejecton reflex
(D-MER). D-MER is part of every MER to some
degree (usually less intense as the feeding
goes on, although not always).
LLL Leader and International Board Certified
Lactation Consultant Diane Wiessinger, MS,
is interested in learning more about this
phenomenon, too.
what do you think is happening
to these mothers who are experiencing
Dsuchiane,
negative feelings when letting down
their milk?
Well, it’s been an interesting, twisty-turny
path! When Alia first emailed me, I did
what every other person she’d approached
did. I said that it sounded like some sort of
postpartum depression and suggested she
look for help along those lines. I basically
“blew her off.” It must have made her grind
her teeth in frustration! A couple months
later she called me, and this time I really,
truly listened (those LLL Leader skills!).
From what she described, it was pretty clearly
physiological, and not psychological, not some
sort of past trauma coming to the surface.
It was too … mechanical. This triggers it,
that doesn’t. This makes it worse, that makes
it better. She took some pseudoephedrine
for a cold at one point—she didn’t realize
that pseudoephedrine can wreak havoc with
a milk supply—and happily, or maybe
significantly, it didn’t. Within hours, her
D-MER had disappeared altogether, and she
called to ask, “What happened?!” It came
back as the pseudoephedrine wore off.
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Interview
018
We brainstormed with others who
were willing to hear us out without
labeling it “depression.” We drew
up a chart of what made it better
and what made it worse, and looked
at how those drugs or activities
affected the hormones that we
thought might be involved. Binging
on chocolate ice cream helped!
High stress made it worse. Alia kept
records of the relative intensity
of each episode—something that
wasn’t that easy to do, because in
the midst of an episode she literally
couldn’t multiply two times three!
It was a really intense time for her,
trying things, keeping track, getting
her hopes up, having it not work
out.
Her D-MER was so clearly tied to
her milk releasing that at first we
figured oxytocin had to be involved.
We learned about other hormones
like vasopressin and dopamine,
and we looked at familiar ones like
prolactin. When we looked at how
quickly it came and went, and what
made it better and worse, by far
the best fit was dopamine. When
we looked back at times when
she’d felt something very similar
but wasn’t lactating, dopamine fit.
When she tried a prescription drug
that increases dopamine levels, her
D-MER got better.
like getting more exercise and
more sleep to a herbal remedy
to prescriptions that you can
talk over with a physician.
I s the condition curable?
We haven’t found anything
that stops it so that it never
comes back, except time. Most
women find that it gradually
gets better over time and
eventually just goes away.
Unfortunately, the worse it is
early on, the longer it seems to
go on. For some, it doesn’t go
away completely until weaning.
Happily, almost everyone Alia
talked with found that what
helped as much as anything—
and was usually enough in
itself—was knowing they
weren’t crazy, they weren’t
alone and it wasn’t going to
hurt them or their baby.
W hatsay?do the researchers
Researchers? What
researchers?! You’re talking
to them. One D-MER mother
and one LLL Leader/IBCLC.
We’ve written a paper about
Alia’s experiences and what
our guesses are that we hope
to publish in a breastfeeding
journal and that we hope will
attract others with much better
backgrounds than ours. We just
don’t have the solid knowledge
or understanding to do more
than hand this off to others.
hat help is available for
mothers suffering from
W
D-Mer?
At the moment, we think
that anything that increases
dopamine levels without
causing them to crash later
(which caffeine seemed to do)
would help. Some things are
clearly non-starters. You can’t
live on chocolate ice cream or
pseudoephedrine, and smoking
is obviously out. Alia has listed
a lot of other choices on her
Web site, from simple things
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Here’s what we think may happen,
and what we couldn’t confirm
through reading: when a milk
release is triggered, the oxytocin
level shoots up and, separately but
in response to the same milk release
trigger, dopamine makes an abrupt
but brief drop. Since dopamine
is a “gatekeeper” that blocks the
•
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release of the milk-making hormone
prolactin, we know dopamine has
to drop to allow prolactin to rise.
But we couldn’t find anything to
say when that drop occurs or how
abrupt or brief it is. Who knows—
maybe it isn’t in the literature yet
and D-MER mothers will be the
ones to provide the answer!
W here do you go from here?
We really hope that this catches
the eye of people who are
already doing research on
dopamine. Since dopamine
changes happen within
the brain, they can’t really
be measured in humans;
researchers tend to study
something like rats. But
here’s a group of humans
who can feel a particular
change instantly, any time
a milk release is triggered,
and describe it in detail
afterwards. Some researchers
have said that dopamine is
like a keyboard that can be
“played” to achieve anything
from desire to disgust. Well,
D-MER mothers can tell them
exactly where they are on the
keyboard. I was fascinated that
some of the mothers who wrote
to Alia described feelings of
“homesickness.” Now, that’s a
very, very specific emotion that
sounds to me like the knife
edge between pleasure and
pain—a painful recollection of
something pleasant. How cool
that information would be for
the right researcher!
Among the people we talked to
were menopausal women who felt
dysphoria with hot flashes and
a woman who felt Restless Leg
Syndrome with hot flashes. RLS
is treated with dopamine. What
does all this have to say about the
hormones of hot flashes? One man
even said that, as far back as he
can remember, he’s occasionally
felt dysphoria in the midst of
anticipating something pleasurable.
If he’s thinking about a trip,
suddenly he can think only about
losing the tickets. It sounds a whole
lot like D-MER. So I think this could
go in a lot of directions. I think
things similar to D-MER are out
there, and it’s just never occurred
to those who experience it that it
could have any significance.
mothers
H owsharecantheirD-MERexperiences?
In addition to www.D-MER.org
there’s a D-MER Facebook page
that is active with posts and
discussions. It’s important that
mothers with D-MER continually
feel that they are not alone.
Alia loves to hear from women
with D-MER and is active on the
Facebook page and regularly posts
encouragement and answers to
questions.
* A major online resource for the
professional and lay breastfeeding
support community.
The Curious Lactivist
020
US Mothers
Get Time to
Pump
Defining
“Reasonable“
Kathy Abbott, IBCLC
Recently a new mom who was on
her first day back at work put out
a desperate plea to her Facebook
friends. Like most breastfeeding
mothers she had brought along
a double electric pump in good
working condition. Her employer
however had been caught off guard
by her request for “pumping breaks.”
Extra breaks were out of the
question. “If” she needed to pump
(like she had a choice) she could do
it during her 15-minute morning
break or her half-hour lunch break.
Not only that, she had to “use the
bathroom,” which to her horror
she discovered had no electrical
outlets. With her breasts ready to
burst she put out an immediate
SOS to her online friends, “Does
anyone know how to hand express?”
Unfortunately, what neither the
desperate mom nor the heartless
employer knew at the time was
that, thanks to the new healthcare
package recently passed by
Congress, as of March 23, 2010,
all businesses in the US with 50
or more employees are required
to provide breastfeeding mothers
both a “reasonable” amount of
break time to express their milk
and a place “other than a bathroom”
which is “shielded from view and free
from intrusion from coworkers and the
public.” As any pumping mom can
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Photo Lily & Margo Photo Courtesy of Sacha Blackburne.
tell you, a guarantee of privacy is
an absolute necessity in order to
get a good let-down. Imagine men
being asked to collect their semen:
how many would be able to do it
knowing someone could barge in on
them at any time?!
Best of all, the new law is
designed to cover everyone.
Your local Starbucks might only
have 30 workers but when you
include everyone at corporate
headquarters (who’ve had a
lactation room for years!) plus all
their other employees, it’s easy to
see that they won’t be eligible for
exemption any time soon. Even
having fewer than 50 employees
doesn’t guarantee exemption.
An employer has to prove that
compliance would cause “undue
hardship” to be determined by “the
difficulty or expense of compliance for
a specific employer in comparison to
the size, financial resources, nature,
and structure of the employer’s
business.” In other words, rather
than making mothers beg for break
time it is now up to the employer to
plead their case for exemption.
To me the question of what
constitutes a “reasonable” amount
of break time is an interesting
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one. What is “reasonable” for one
mother may not work for another.
For starters not all women work in
an office. (One mom who worked in
a party supply store told me that
her milk let down every time a baby
entered the store and how she had
to stop and pump immediately!)
Women who can’t afford a double
electric pump will need more time
to collect their milk. One also has
to consider commuting time. The
longer a mother is separated from
her baby the more milk she will
need to supply each day. Although
the law covers babies up to a year
old the number of breaks needed
will vary according to the baby’s
age: the younger the baby the
more frequently a mother needs
to express. As one colleague put
it, the need for pumping breaks
varies so much from individual to
individual that the time needed
shouldn’t really be quantified at
all; instead it should be treated the
same as bathroom breaks. Unless
you are working on an assembly
line you should be allowed to take
care of your bodily needs as they
arise. In other words, when you
have to go, you have to go. No one
should have to “hold it” especially
when the “it” in this case is the very
sustenance that makes our babies
thrive!
For more information about
the Department of Labor’s
interpretation of the new law see
Fact Sheet #73: Break Time for
Nursing Mothers under the FLSA
http://www.dol.gov/whd/regs/
compliance/whdfs73.htm
Kathy Abbott as “The Curious
Lactivist” likes to reflect on
the ways that breastfeeding is
presented in the news media. As
a private Lactation Consultant
and LLL Leader she is constantly
learning from the women she works
with and as the mother of a smart,
vivacious, totally awesome 13-yearold daughter she is renewed in her
faith that the next generation will
most certainly get it right!
thecuriouslactivist.wordpress.com
Your Letters
021
Letters Page
STAR LETTER
S omething Worth Remembering
When I was 17 years old I got a tattoo of the
dove of peace. It reminds me of how idealistic
I was and how I wanted to change the world. I
turned 40 recently and wanted something that
would always remind me of this time: I am nursing
my baby daughter and also nursed my son. What
could be more important than motherhood and
breastfeeding? To me they go hand in hand.
The inspiration for my new tattoo came partly
from the image of the nursing mother on the
LLLI Web site. The three stars represent the
birthstones of our children (one of our babies
died before birth).
The power of breastfeeding has made all the
difference in our lives. I had a very difficult
time establishing a good milk supply and was
discouraged many times. My husband was my
biggest advocate, inspiring and supporting me.
He would clean my pump and cheer me on, lifting
my spirits when I just wanted to give up. I didn’t
and happily it all worked out. Having support in
a society that says “Just give her a bottle” was
crucial to my success. The joy breastfeeding has
brought to me and our children is indescribable.
Several people have asked me about the tattoo
and it gives me the opportunity to tell my story
of perseverance.
Thanks to La Leche League for all you do.
Kate Dirr, Nederland, Colorado, USA
W
omanly Art
I am breastfeeding my first baby and have
read The Womanly Art of Breastfeeding for the
first time in its new 8th edition. How infatuated
I am with my baby and breastfeeding! My son
is a natural (but every baby truly is). I just need
to say how much I praise this book. I wish I had
known it was around earlier. What a wonderful
book!
Ashley McKinnon Corby, USA
P romotional Posters
The National Health Service in the UK has
produced a set of posters with photos of mums
in Sunderland to promote breastfeeding amongst
young mothers. Here is one of them.
Amanda Dunbar, Tyne and Wear, UK
S
end your letters and photos
to editorbt@llli.org
A
prize foerr th! e
star lett
The star letter for Issue 4,
2010, will receive the new 8th
edition of The Womanly Art of
Breastfeeding!
Y outh For Breastfeeding
http://www.youtube.com/watch?v=pTi5QcrhXg
2010 llli combined
federal campaign
llli.org | 2010
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Today
LLL News
022
GlobaLLL
LLL Bermuda
and asking representatives from
the Department of Health and the
hospital to say a few words about
the importance of breastfeeding.
The opening night would give us an
opportunity to reaffirm a collective
commitment to promoting healthy
families in our community.
We were pleased and surprised
that by our closing deadline for
submissions last month, over 225
photos had been sent in for the
exhibit! Who knew so many families
would participate or how much
support there would be for women
choosing to nurse their babies?
Photo of Kristen Loving (left) and son, Aeziah, Shantae Burrows (right), and daughter Azae, with
Minister Roban (Photo Courtesy of Department of Communication and Information)
Report by Lena Ostroff
La Leche League of Bermuda,
a small Group on a tiny island,
recently partnered with our
Island’s Ministry of Health and
the maternity ward at our local
hospital (King Edward VII Memorial
Hospital) on a special project
to promote breastfeeding in our
community.
Bermuda’s first-ever Breastfed
Baby Photo Exhibit was launched
in October 2009 to educate the
public about the many health
benefits of giving babies the best
start in life and to encourage
more mothers to choose
breastfeeding. Breastfeeding rates
in our community are particularly
low—less than 1% of our mothers
follow World Health Organization
guidelines which recommend babies
be exclusively breastfed for six
months.
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2010
The project called on families to
submit photos of babies who were
being breastfed for an exhibit to
be displayed at a local art gallery
in our capital city during World
Breastfeeding Month in August
2010.
While we had worked with the
hospital in previous years to
celebrate World Breastfeeding
Week, this was our first
collaboration with the Department
of Health. We knew having their
endorsement would give us both
credibility and visibility and prove
critical to the long-term success
of breastfeeding promotion in our
community.
This project was not meant to be a
contest, but an exhibit to promote
the normalcy of breastfeeding and
to educate the public. Additionally,
we intended to include display
panels containing information
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llli.org
and facts about breastfeeding,
along with quotes from mothers
expressing why they chose to nurse
and how it had benefited their
babies.
When we launched the project
last year, we were hoping that at
least 20 or 30 photos would be
submitted. We rented a small room
at the gallery and figured we could
still run the event even if we only
received 25 photos.
We felt confident the exhibit would
be well attended—who doesn’t
want to visit an art gallery to view
photos of adorable babies they
might know? We knew friends and
family members would come out to
see their baby’s photo on display.
Our plans included inviting the
Minister of Health, the Hon. Walter
Roban, to officially open the event
Our biggest challenge was
narrowing down the submissions to
a number we could afford to frame
and squeeze into the tiny room
we had rented for the exhibit. In
the end, we chose over 85 photos
of gorgeous, happy and healthy
babies who were breastfed.
Months of planning and hundreds
of hours went into making this
event a success. We invited mothers
who had attended our meetings
or called us for assistance. And, of
course, each family who submitted
a photo planned to bring along
relatives and friends to see the
display.
Minister Roban officially opened
the Breastfed Baby Photo Exhibit at
the Bermuda Society of Arts gallery
to a huge audience of mothers,
fathers, aunties, grannies, children,
babies and family friends.
LLL News
023
A look at what is happening
in LLL around the world
During his opening remarks, the Minister said
our event drew attention to what is possible
when we do what is right for our children.
“These babies represent the promise of the
future. These photos show what happens when
we do what comes naturally, in more ways than
one.”
Hyacinth Emmanuel, a registered nurse from
the hospital’s maternity ward, commented
on how breastfeeding also benefits mothers.
“Not only does breastfeeding protect babies,
it reduces risk factors for three of the most
serious diseases that affect women—female
cancers, heart disease and osteoporosis.”
And our own LLL Leader, Melony Kendell,
confirmed that with the proper support,
information and encouragement women can
breastfeed successfully.
We were amazed, thrilled and overwhelmed
by the attendance and great success of the
evening. Several hundred people turned
out and feedback has been positive and
encouraging.
L a L e c h e L e a g u e Tu r k e y
Announces the launch of LLL Turkey http://
www.llli.org/russian/groups/turkey.html
La Leche League
Great Britain
The gallery tells us many people have stopped
by to view the lovely photos on display.
Local TV, radio and newspapers covered the
event, which generated great publicity and
helped us convey our key message—mothers
are encouraged to follow WHO guidelines and
breastfeeding gives babies the best start in
life.
http://www.lllflorida.com/web/brochures/
BB%20photo%20exhbit%20brochure.pdf
L L L Fr a n c e
LLL France 2011 calendar: http://www.
lllfrance.org/Boutique/vmchk/Calendrierscartes-etc/Calendrier-LLL-France-2011.html
LLLI Logo Pins
LLLI (metal) logo lapel pin with military clutch
backing. Size is .75” and comes in a 1 1/8”
square clear acrylic gift box.
LLLGB has some lovely gift ideas for new
mothers http://www.lllgbbooks.co.uk/shop/2/
Gift_Ideas/default.aspx
See the Blossom Box http://www.lllgbbooks.
co.uk/product/365/blossom_box/default.aspx
t
Great Gif
aders,
e
L
L
L
L
r
fo
orters
p
p
u
S
,
s
r
e
b
Mem
!
and Friends
llli.org | 2010
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Issue 4
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Today
What’s Cooking
024
Jiaozi
S kin/wrapper for hot water dough
(Chinese Dumpling)
Hot water dough should be made with half hot water and
half cold water. Two cups of flour require half a cup of cold
water and half a cup of hot water.
First add the boiling water to the flour, then add the cold
water. Knead into a dough. Divide into little balls and roll
into circles. This makes a chewier wrapper suitable for
steaming or frying.
Dipping Sauce
The three main seasonings for dipping sauce are soy sauce,
vinegar and sesame oil. Prepare in a 2:2:1 ratio. Add hot
chili paste, chili oil or peeled garlic cloves if desired.
Here are two of my favorite dumpling recipes
E gg and Spinach Dumplings
Ingredients
1 portion of cold water dough (about 2 cups flour)
6 eggs
2/3 lb spinach
1/3 lb ground pork
Seasonings
1. t salt, 1 T cornstarch water
2. 1 t salt & white pepper as needed, 4 T sesame oil
Method
Divide dough into small balls, roll each ball into a circle.
Beat eggs, add seasoning 1, beat well, heat 3 T oil in a wok,
scramble the eggs, remove and chop finely.
Photo: © shutterstock.com
Emy Machida, China, Shanghai
Good nutrition means eating
a well-balanced and varied
diet of foods in as close
to their natural state as
possible.
The Jiaozi is a common Chinese
dumpling, made usually from
minced meat and finely chopped
vegetables wrapped in a thin
and elastic piece of dough skin.
Filling mixtures vary depending on
personal tastes and region.
Today
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Issue 4
•
Jiaozi are usually boiled or steamed
and traditionally eaten on Chinese
New Year’s Eve, the fifth day of
Chinese New Year and on special
family reunions. Extended family
members gather together to
make dumplings so it’s a great
opportunity to involve children.
The dish is eaten as a farewell to
family members or friends. In North
China, dumplings are eaten with a
dipping sauce made of vinegar and
chili oil or paste, and sometimes
with some soy sauce added in.
Stuffing
Rinse spinach, blanch in boiling water with a little salt added until soft,
remove, rinse under cold water, squeeze out excess water, chop finely.
Mince pork even more finely.
Combine egg, spinach and pork, add seasoning 2, mix well.
Place a little stuffing in the center of each dough circle, fold over, press
edges tightly to seal, cook in boiling water until floating on surface, remove,
drain and serve.
Tips
Dried small shrimp, soaked, can be added to scrambled egg,.
Adding a little cornstarch water to egg will make eggs puffy and soft. Use a
spatula to crush egg while stirring instead of chopping with knife.
2010
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llli.org
What’s Cooking
025
S
hrimp with Chive Dumplings
Ground pork adds thickness to stuffing and helps
hold it together. Add 1/2 egg white to shrimp if
not using pork.
Ingredients
1 portion of dough (about 2 cups flour)
2/3 lb shelled shrimp
1/3 lb yellow chives
1/3 lb ground pork
Seasonings
1 T cooking wine
1 t salt & white pepper as needed
2 T scallion and ginger juice
2 T sesame oil
“What’s Cooking” is edited by LLL Leader Lesley
Robinson. She lives in Ottawa, Canada with
husband, Mark. Her three grown children have
flown the nest.
P
lease send recipes and photos to
editorbt@llli.org
The LLLI Website offers
extensive breastfeeding
Method
Divide dough into small balls, roll each ball into
a circle.
Stuffing
Rinse shrimp, dry and dice.
Dice chives and mix shrimp and chives well with ground pork.
Add all seasonings.
Place a little stuffing in the center of each dough circle, fold over to make semi circle, press edges with hands to seal.
Bring water to boil. Cook dumplings in water
until they float on the surface, add cold
water twice, remove, drain and serve.
Tips
For the freshest shrimp, purchase in the shell.
Any kind of crunchy shrimp is suitable for this
dish.
and parenting information.
n Looking for an LLL Leader in
your city? Search the database for
information on how to contact a
local Leader or find LLL meetings
and other events.
n Need quick answers to
breastfeeding questions?
n Read the extensive Frequently
Asked Questions section.
n Want to connect online with
other breastfeeding moms? Browse
the Mother-to-Mother forums.
n Interested in the latest
breastfeeding and parenting
products? Shop at the
online store, store.llli.org
for books that have been
carefully evaluated
by nursing moms
like you.
n Missed out on issues of
Breastfeeding Today? Find articles
from back issues.
llli.org | 2010
•
Issue 4
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Today
Donors Making a Difference
026
Support from generous LLLI donors enabled us this
year to produce and distribute valuable breastfeeding
resources to pregnant and nursing mothers, La Leche
League Leaders, and to health professionals.
LLLI Educational
and Outreach Projects
We Accomplished
The Womanly Art
of Breastfeeding cornerstone book
with Your Support
Breastfeeding Today
Translations
LLLI in partnership with La Leche League Leaders
A new international online publication with
of LLLI
information about the work LLLI is doing around
Completely revised and updated, the 8th edition
the world in support of breastfeeding, current
of The Womanly Art of Breastfeeding was released
breastfeeding research, new breastfeeding
in July 2010 and became not only one of the best
materials and products, and other articles of
selling books but also the first breastfeeding book
interest geared toward a broad audience.
to become a National Best Seller! Complimentary
simultaneously translated key LLLI information
sheets (snapshots of pertinent breastfeeding issues)
into ten different languages including: Chinese
(Traditional and Mandarin/Simplified); Spanish;
Hindi; Arabic; Hebrew; Polish; German; Bulgarian;
and Portuguese.
copies were sent to places providing support to
pregnant and nursing mothers such as baby-friendly
hospitals, women’s shelters, and libraries.
“As a mom to be, I know this will be
an invaluable resource. I loved the
writing style, the frank and direct
advice given plus the thorough
resource section… I feel connected
already to a strong community
of women who have chosen to
breastfeed because of this book
and organization.”
From an expectant mother who shared her comments
Today
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Issue 4
•
2010
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llli.org
“This is fantastic,
very well presented,
warm and full of
valuable content.”
Yanet Olivares, Santo Domingo,
Dominican Republic
“When I was overwhelmed by low
milk supply in the late afternoon
hours, LLLI information sheets were
a bright hope for my tired baby
and me. When I was anxious about
returning to work, LLLI information
sheets showed me how to pump and
store breast milk for my baby.”
Cristina Wen, Beijing, China
Donors Making a Difference
027
You can help ensure
that mothers get the support
they need with your donation
today. Between now and
December 31, 2010, long-time
LLLI donors and LLLI Board have
agreed to match your donation
dollar-for-dollar, up to $50,000.
Your gift will enable LLLI to continue helping mothers
to breastfeed through mother-to-mother support,
encouragement, information and education for
families around the world.
Double your gift today and
help mothers and babies
get the best start together!
Donate Now
llli.org | 2010
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Issue 4
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Today