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Interview with a Midwife: Breastfeeding

On Facebook and Twitter, at our Headquarters, and in our Chapters, we have been talking about World Breastfeeding Week.  The theme for this year’s WBW is Breastfeeding Support: Close to Mothers. From their website:

Even when mothers are able to get off to a good start, all too often in the weeks or months after delivery there is a sharp decline in breastfeeding rates, and practices, particularly exclusive breastfeeding…The key to best breastfeeding practices is continued day-to-day support for the breastfeeding mother within her home and community.

Img Source: Claremont Midwife

The theme for this week recognizes that many women depend on the support of medical personnel throughout their pregnancy. However, many women struggle through the changes in that support after delivery.  Unlike in generations past, many of today’s moms are not surrounded with mothers, grandmothers, sisters, and aunts who can offer calming advice, tension easing anecdotes, and tried-and-true tips for the days leading up to and following birth.  Without those natural and familial support system, many women turn to their OB providers (doctors, nurses, and midwives) for that support.

We here at Elizabeth Ministry have strong relationships with some phenomenal midwives.  The midwives we know — who provide support at home births, who run birthing center, and who are changing the standard of care in our local hospitals — go beyond pregnancy and delivery to provide consistency of support for today’s moms.

One such midwife, Stefanie Hernet, is a certified nurse midwife with Affinity Medical Group.  She serves patients in Oshkosh and Neenah, WI.   We sat down with Stefanie this week to talk with her about the benefits of breastfeeding, and how midwives support mothers throughout the struggles and joys of breastfeeding.

Interview breastfeeding

If you could sum up your philosophy of obstetrics and gynecological care in one sentence, what would it be?

I believe in personalized care for women that goes beyond labor and birth.

How do you advocate for breastfeeding with your patients?

Breastfeeding advocacy happens from the first contact I have with patients and can last well in to the baby’s first year.  In the beginning, thorough prenatal education is key.  I talk with my patients about their fears and concerns about breastfeeding, help them understand what to expect, and encourage them to take breastfeeding classes – preferably with their partner.  I talk with moms about the importance of immediate skin-to-skin contact (within 5 minutes of delivery) for mom and baby, and after delivery, I try to leave the baby there until he or she initiates breastfeeding.  This immediate contact has been shown to greatly increase the success rate of breastfeeding.  After delivery, I work closely with lactation consultants throughout our area to remedy difficulties early on in the breastfeeding process.  Of course, this means that I make sure my patients know that I am available to answer questions and offer advice throughout the postpartum period.

What do you say to women who are reluctant to breastfeed?

It depends on the reason for their reluctance.  Many women just do not know about the benefits that both mom and baby get from breastfeeding.  For example:

  • Breastfeeding soon after birth may reduce the risk of maternal blood loss and enhance maternal-infant bonding.
  • Breast milk contains antibodies that cannot be duplicated in commercially prepared formulas, and that have been shown to protect infants from certain infectious diseases.
  • Breastfeeding has been shown to decrease the risk of obesity, asthma, celiac disease, inflammatory bowel disease and types I and II Diabetes later in childhood.

Some women are worried that the baby won’t get enough from nursing alone, so I remind them that exclusive breastfeeding for the first six months provides their baby with all the nutrition they need for growth and development.

Some women don’t have support for breastfeeding at home.  I try to pair these women up with a lactation consultant and let them know of the many places in our area they can go for support.  I also encourage them to take a breastfeeding course with their partner so that they both have the best tools and information for success.

How long do you recommend that women breastfeed?

That is a very personal decision among a mom, her partner, and her child.  I always recommend exclusive breastfeeding for the first six months, and tell patients that ideally breastfeeding should continue at least throughout the first year of life.

It seems like many breastfeeding women we talk to are concerned about milk supply, especially in those first 2-3 months.  Should women be worried about their milk supply?

Most women worry unnecessarily about their milk supply.  In fact, most women make one-third more breast milk than their babies typically drink.  A woman’s milk supply can go up or down slightly for a variety of reasons like diet, stress, hydration, etc.  The size of a woman’s breast is not an indication of her milk supply.

In rare cases, there are women who do not make enough milk for their babies.  This is usually caused by a medical condition.  If you are taking your baby for regular weigh-ins, you will discover a genuine problem when the baby fails to gain weight.

What about those women who truly do not make enough milk, or women struggle with breastfeeding, or feel like they can’t – what do you tell them?

It’s important to remember that some women truly cannot breastfeed.  There are a variety of medical conditions (for either mother or baby) that can prevent breastfeeding.  For women who do not have supportive partners, breastfeeding may be a battle they do not have the energy to fight in those first few sleep-deprived months.

While I always encourage, support and promote breastfeeding, I also remind mothers who, for whatever reason, cannot or choose not to, that it is not a sign of failure.  For some women, breastfeeding is a joyful and peaceful experience.  For others, it can feel like a nightmare of worry and stress.  There are so many anxieties that go with having a newborn – breastfeeding does not need to add to that stress.  Your worth and value as a mother is not dependent upon how soon your baby has his/her first bottle!

What other breastfeeding support resources do you recommend?

There is no support that can compare to an experienced mom!  Find other women who breastfeed and get to know them.   Remember that your midwife and pediatrician are also there to help.  Do not be afraid to ask questions!  And by all means, please, please do not use Google (or WebMD) as your only source of information.  Talk with a real, experienced person about your concerns before you let yourself start worrying about a problem.

Other local resources:

La Leche Leagues
LLL’s mission is to help mothers worldwide to breastfeed through mother-to-mother support, encouragement, information, and education, and to promote a better understanding of breastfeeding as an important element in the healthy development of the baby and mother.
1-877-MOM-MILK or 1-877-666-6455
http://www.llli.org/webus.html   Search their website for a local gathering near you!

Other Breastfeeding Support Groups
La Leche League is not the only breastfeeding support group out there.  Many local communities have them as well.  For example, in NE WI there are:

  • Breastfeeding Support Network: 2050 W. 9th Ave., Oshkosh (920) 231-1611
  • Fox Valley Breastfeeding Coalition: (920) 832-2207

Breastfeeding Specialists
Your local hospital or birth center may have in house breastfeeding specialists who can help you.  In the NE Wisconsin area there are many breastfeeding specialists:

Women, Infants and Children (WIC)
A federal supplemental food and nutrition program for pregnant women, women who are breast-feeding, and infants and children up to age 5.

http://www.fns.usda.gov/wic  Find your state agency on their website or search for “[Your state] WIC”

Private Practice Lactation Consultants
Private Practice lactation consultants may work in an office and/or make home visits.  Find one through the International Lactation Consultant Association:  http://www.ilca.org/i4a/pages/index.cfm?pageid=3432

In the NE Wisconsin area there are many private practice lactation consultants:

  • Oshkosh (Private Practice) Lactation Consultant (920) 231-1611 (Medela breast pumps to rent)
  • New London Breastfeeding Specialist (920) 233-1280
  • Shawano Lactation Educator (715) 526-7184 (work) or (715) 526-5864 (home)
  • Waupaca Lactation Consultant (715) 258-1078 or Leave a message at (715) 258-1076

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