Make a Difference!
Become a Breastfeeding Advocate.
by Shannon Lilienthal, BA, IBCLC, RLC
When I was a social work intern in rural Oregon in the late 1990s, I was surprised to see some of the first-time mothers on my caseload experience challenges with breastfeeding. I assumed breastfeeding came naturally and the baby would just know what to do. The clinic where I interned employed an IBCLC – an International Board Certified Lactation Consultant. As I brought the moms and babies on my caseload in to see the Lactation Consultant for help, I learned about the issues some mothers face, like low milk supply or sore nipples due to poor latch. I soon discovered that getting help early with breastfeeding issues was essential.
Later, as a social worker in West Philadelphia, I again discovered that the new moms on my caseload needed help with breastfeeding, but unfortunately there was less support for them in their community. This experience ultimately led me down the path to becoming an IBCLC myself. While still working as a social worker, I paid to participate in an internship program at a hospital with a busy maternity floor. It took a few years for me to complete the required coursework and to accumulate the required 2.500 clinical hours working with moms and babies under the supervision of an experienced IBCLC. Then I spent several months intensely preparing for the comprehensive board exam.
Mothers often ask me how they can become an IBCLC. I refer them to the International Board of Lactation Examiners (http://www.iblce.org) to learn about the different pathways to certification. However, you should know that there are many other ways to help breastfeeding mothers and babies, and many in your local community.
Nursing Mothers' Counselors (NMC) is a volunteer organization that pairs mothers who have breastfed their babies with new moms who need breastfeeding support. The organization is affiliated with Pinnacle Health's Harrisburg Hospital. NMC’s mission is hope – that volunteer counselors can offer mothers the support they need for a truly wonderful experience in providing excellent nutritional benefits and love to a new breastfed generation.
NMC is in need of women who have breastfed a baby for at least 6 months, have a desire to help other breastfeeding moms, and can give about 5-6 hours a month to volunteer on the postpartum floor. Counselors will work with the hospital IBCLCs to support new mothers who choose to breastfeed their babies. To become a Nursing Mothers Counselor, you will be asked to complete a training module and shadow two of our existing counselors as they assist new mothers in the hospital. If you would like more information, please call the Learning Institute at (717) 221-6255 or go to http://www.nursingmotherscounselors.com/.
Another advocacy group in need of volunteers is La Leche League (LLL). LLL is an international, nonprofit, nonsectarian organization dedicated to providing education, information, support, and encouragement to women who want to breastfeed. La Leche League Leaders are experienced mothers who have breastfed their own babies and who have been trained and accredited by La Leche League International to help mothers and mothers-to-be with all aspects of breastfeeding. They are available by phone whenever you have breastfeeding questions or concerns. To find a local meeting, go to http://www.llli.org/Web/Pennsylvania.html
If your strengths lend themselves to advocacy and changing public policy, then consider becoming a member of The Pennsylvania Breastfeeding Coalition (PABC). This group has quarterly meetings in locations throughout the state – the summer meeting is in Harrisburg and the fall meeting is in State College. PABC receives funding to work on advocacy projects, such as helping employers develop lactation rooms for working moms to pump in and recognizing breastfeeding friendly businesses. To find out more, go to http://pabreastfeeding.org/
When I gave birth to my first son, I thought breastfeeding was going to be so easy. I was already an IBCLC and had worked with hundreds of mothers. However, Aidan had a posterior tongue-tie that made breastfeeding very painful until we got his frenulum clipped when he was 6 weeks old. In those early weeks, I was headed for postpartum depression as I struggled with the disappointment I felt because breastfeeding was not going as smoothly as I expected. Thankfully I was well connected to NMC and LLL, and both groups gave me encouragement and support to continue to bond with my baby until we solved our breastfeeding challenge. Consider becoming the support and advocate that can make the difference in the breastfeeding bond of a mother and baby. We need you!
What is Your Child's Behavior Trying to Tell You
by Venus Grella, Positive Discipline Instructor
Does your child throw peas across the kitchen, bite his/her siblings, or whine to no avail? No matter what display of undesirable behavior you deal with, there is always a need or want associated with it. Children naturally seek belonging and significance from their caretakers. When they lack the communication and social skills necessary to meet those two primary needs, misguided or ‘bad’ behavior is the result.
As the caring adult, our job is to identify the message behind the behavior. What is your child trying to tell you? Is she trying to keep your attention or get you to do extra things for her? If so, she is experiencing that feeling of belonging she desires when she is noticed by you or getting special attention and help from you. If you find yourself having to respond by coaxing her or doing things for her she could do for herself, her behavior often stops temporarily, but later it resumes or another annoying behavior takes its place. Does this sound familiar? Does this interaction leave you feeling annoyed, worried, or even guilty?
A helpful way to minimize demanding attention seeking behavior is to redirect the child by involving her in a useful task. Hand her the clothes to put in the laundry basket or let her throw away the envelopes from the opened mail. Useful is the key word. If she feels useful she will build self esteem. If she can’t help right at the moment, you might say, “I love you and will spend time with you later.” Give her a specific time and a specific activity. When you follow through, it will be to her delight every time. Having special, planned time, as little as ten minutes, can help reduce the need for undue attention, ultimately decreasing annoying, attention seeking behavior.
Another behavior we all deal with is power struggles. A child exhibiting this behavior has misguided power and always wants to be the boss. He feels like he belongs, only when he is the boss, in control, or proving no one can boss him, “You can’t make me.” You engage in the battle for power by wanting to be right and lecturing why you are right, or thinking “I will make you,” or “You can’t get away with this.” But in order to continue the battle, he intensifies his behavior. He is happy and feels he has won when you get upset or when you give in. This interaction leaves you feeling threatened, challenged, or maybe just defeated.
It is good for any individual to feel powerful, including children. The power must be within limits as well as be respectful to self and others. One way to bring about desirable behavior or positive power is to ask the child for help. Don’t fight and don’t give in, but withdraw from the conflict by saying, “I know I can’t make you, but I would really appreciate your help.” You will be surprised how intriguing this is to a child, especially if he is used to the fight. You are teaching self-respect when you respect yourself this way. And let’s face it; you really cannot make someone do what they don’t want to do, not without hurt feelings or manipulation. It is better to walk away than to do and say things you will regret and have to apologize for later.
There are many great tools to avoid power struggles, such as letting routines be the boss and holding family meetings to set reasonable limits that are agreed upon. Decide ahead of time what you will do instead of waiting for the moment when you and your child are upset. It is respectful and fair to let the child know what you have decided. For example you might say, “When you yell at me, I will leave the room.” When you follow through with what you say it teaches him to listen to you and to respect you. This practice fosters trust, so when larger problems arise he will more readily bring them to you. Allowing a child to have an appropriate amount of power will decrease his demand for misguided power. For example a two year old can pick out which shirt and shorts he wants to wear, while a ten year old can decide what he will watch or play for his hour of screen time. Notice in the example that getting dressed is not up for discussion, but the child can decide what to wear. Likewise, the older child can decide what to do, but not how long the activity will last.
No one ever said parenting was easy, but it should be a joyful experience. Think of parenting as teaching. Every time a child misbehaves, it is an opportunity for you to teach him or her a valuable life skill. Children should not have to pay with punishment for their mistakes or for their inability to communicate their needs. Instead they should be encouraged and guided to learn to do better. When children feel better about themselves and feel capable to tackle life’s challenges, they will behave better too.
None of these suggested responses to behavior are magic or always successful, but they are far better than anger, hopelessness, or giving up out of frustration.
As a mother who has given birth twice in a hospital and once at home, a doula, a certified childbirth educator, and a labor and delivery nurse, I have seen and experienced first-hand, both as a consumer and as a provider, a very wide spectrum of birthing possibilities. I have read and studied countless books, journals, articles, blogs and websites in search of truth and scientific evidence to expand my knowledge and better my practice. What I have found, time and time again, is that birth is a normal, healthy life experience that is safest when left to its own natural process, for the vast majority of all healthy women.
There are many different opinions on the definition of “normal” within the context of pregnancy, labor, birth, and postpartum experiences. I agree with the simple concept that normal birth for humans is the same as for any animal in nature. This position holds strong that animals do best in birth when undisturbed in their own environment. Animals have been observed to stop their labor in its tracks when they felt threatened or scared. Proponents for homebirth agree. What animal would leave their nest to go have a baby? “Normal”, defined by the Merriam-Webster Dictionary as “occurring naturally”, supports the concept of birth as a regular and expected process of nature.
Another definition of normal precedes the aforementioned in the same Merriam-Webster source. Here, “normal” is defined as “a: according with, constituting, or not deviating from a norm, rule, or principle” and “b: conforming to a type, standard, or regular pattern”. The medicalized birthing community certainly enjoys this definition in the context of birth. The sensationalized media images of birth as an emergency that will end in devastating outcomes if the doctors aren’t there to save the mother and baby, also backs up this definition. In fact, it can be argued that the media creates normal for our culture. The “reality” birth television shows indeed standardize and write the rules for normal birthing as lying on one’s back, being strapped to monitors and IV’s, being numb with narcotic medications, having a dress code of sterile gowns, gloves and masks, legs in stirrups and a doctor dutifully sitting in the place of honor so they may “do” the delivery. In this sense, our country’s “norm” as defined by TV, looks very similar to what is really happening most of the time.
Another source of “normal”, in labor and delivery in hospitals, is defined by the Friedman Curve, where labor is subjectively timed and plotted on a graph. Physicians are trained to plot labor, regardless of a woman’s individual history, physical or emotional condition, etc., and are taught that if a woman’s labor is any slower than the curve allows, there is justification (and duty) to intervene with augmentation or a cesarean section. [It may be important to note here that Dr. Friedman’s curve was based on research done in the 1950’s when the majority of laboring women were heavily medicated with ‘twilight sleep’ anesthesia. Ironically, colleagues of Dr. Friedman report that he intended the curve to serve as a tool to prevent unnecessary interventions and cesareans. ]
At home, with a midwife in attendance, interventions with the birth process are minimal. In hospitals, interventions are immediate and profuse. Yet most women in our society birth in hospitals. Induction of labor and epidural rates are very high, both of which are associated with higher risks of delivering vaginally with a vacuum or forceps and delivering by c-section. Most women don’t imagine their upcoming birth as being complicated and ending with a c-section. But, cesarean births are rampant, at a national rate of almost 1 in 3 births and rising. Most women return home after their births with a healthy baby, but many feel an emotional loss because of their unexpected and sometimes traumatic mode of “normal” delivery.
Some birth trauma specialists have tried to redefine a good, normal birth not as one that was vaginal or cesarean, but one where the woman felt in control, empowered, and part of the decision making process regarding her birth.
Many organizations, (i.e. Lamaze International, The World Health Organization, Coalition for Improving Maternity Services, Doulas of North America etc.) promote normal (natural) birth with very specific and relatively easy evidence-based care practices to optimize outcomes for the mother and baby, regardless of the birth setting. Some of these practices include educating oneself by reading, joining a birth network or support group, and taking childbirth education classes. Having a confident, knowledgeable labor support team and a doula for continuous labor support has been shown to significantly reduce the likelihood of having c-section. Having an open, communicative relationship with your birth care providers is essential to making informed choices during your pregnancy and childbirth.
What is your normal?