Nursing on demand and parental authority
There is a lady who writes in an Israeli magazine, whose articles on parenting I always look forward to. She speaks a lot about parental authority, delegating responsibilities to children, resisting worldly influences and other subjects I find instructive. Her most recent article was no exception. She lamented the fact that so many parents are encouraged to choose the so-called “child-centered” lifestyle, becoming slaves to the child’s choice of friends, clothes, toys, extra-curricular activities, and… nursing on demand.
What to do while breastfeeding
Having a newborn means breastfeeding… a lot. Several hours a day (cumulatively), and during the night as well. I love this, because it allows me to sit back, relax, and take things slowly with the best excuse ever. Keep a snack and a bottle of water handy, because making milk for a baby means expenditure of both liquid and calories.
Breastfeeding doesn’t mean neglecting the other children. On the contrary, it’s a great time for uninterrupted conversation, word games and, of course, reading. We’re really getting through chapter after chapter in the last few days!
I have many favorites among children’s books, most of them classics – Winnie the Pooh, Alice in Wonderland, the Narnia books, and everything by Astrid Lindgren. Revisiting Pippi Longstocking is always a pleasure:
“But don’t you understand that you must go to school?”
Fenugreek: A WonderHerb
Fenugreek itself has some wonderful nutritional benefits, being rich in calcium and magnesium – and also some very special health properties. It has a beneficial effect on blood sugar regulation and is known as a milk-supply booster for nursing mothers. I had taken Fenugreek capsules in the past, when I reckoned I needed to build up my supply, and I reckon they helped a bit, but nothing very dramatic. However, after a Shabbat of enjoying homemade hilbe spread in very moderate amounts, I suddenly felt a very prominent increase in my milk supply, something I didn’t even think of or aim for (since my baby was almost one year old and I figured we have a pretty steady supply-demand thing going). I suppose this effect was due to pre-soaking the Fenugreek seeds for a couple of days, thus allowing the special plant components to activate.
I think that’s really worth noting, as capsules are so much more expensive – and, apparently, less effective – than the real thing. I’m not sure you can buy Fenugreek everywhere, though. In Israel, the seeds are available in health food stores, and the leaves can be found at certain markets in season.
Here is the recipe we used:
– salt and pepper to taste
A word of warning: hilbe has a dominant smell; some like it, some don’t mind, some wish they could do without it. The smell can later come out in your sweat, or even in your baby’s diaper. The Fenugreek capsules don’t smell when you take them, but the smell comes out with a vengeance later through all your pores.
Nourishing Traditions and breastfeeding
Disclaimer: this post focuses only on the section on infant feeding in “Nourishing Traditions”, which is just a small part of the book.
As I approached the section on infant feeding in Nourishing Traditions, I was looking forward to a detailed survey of breastfeeding practices in traditional cultures, including perhaps a comprehensive list of foods which are thought to be beneficial for nursing mothers, plus detailed suggestions of milk-boosting diets, meals, beverages etc.
I was disappointed. At the beginning of the chapter, the author says that the importance of breastfeeding your baby “cannot be overemphasized.” However, I felt that the rest of the chapter contradicts this statement by concentrating mostly on recipes for homemade baby formulas, and by providing some advice which is outright detrimental to successful breastfeeding.
Are homemade “natural” formulas better than commercial formulas? Perhaps. Let’s even assume so. But no formula will ever come close to breastfeeding, either in nutritional content or otherwise. Mother’s milk is the food God designed for babies; cow’s milk is the food God designed for calves. It’s as simple as that. Cows’ or goats’ milk protein is unlike the protein in mother’s milk and is less well suited to human infants. Yes, it is possible for a baby to grow up just fine on formula, but on all points – nutritious, emotional and immunological benefits, protection from exogenous diseases, convenience and price – the score of breastfeeding is way higher. Therefore, as I see it, it’s definitely worthwhile to do everything possible to ensure that the baby is breastfed.
The author flatly and unequivocally states that the optimal duration of breastfeeding is “six months to a year”. This essentially means that some babies should be completely weaned as early as six months of age – which is just plain wrong, both according to the current position of the WHO, which states that
“Exclusive breastfeeding is recommended up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond”
– and according to wisdom of most traditional cultures. As a matter of fact, I find it astonishing that a book which takes such an obvious stance of learning from traditions of various people around the world blatantly ignores the fact that in traditional cultures, breastfeeding normally continues well beyond one year and certainly beyond six months! In the Jewish tradition, the standard length of breastfeeding is two years.
The statement, “remember that babies should be chubby” (page 601) really grated on my nerves. Is there no room for diversity, no role for heredity to play in the baby’s body build? This expectation from two tall lean parents to produce a fat little butterball baby, makes mothers anxious about their milk supply when in fact they have plenty, and causes them to rush to supplement with formulas and artificially fatten up their babies.
When I came to the final page, titled “Tips for Successful Breastfeeding”, I was dismayed to find much of the same counter-productive advice you often hear from doctors whose knowledge on breastfeeding comes close to zero. Yes, good nutrition and proper rest play an important role in maintaining adequate milk supply. But the author neglects to mention that the most important factor in boosting milk supply is nursing on demand, which usually means often. Again, where is the analysis of traditional practices such as attachment parenting, baby-wearing and co-sleeping, which all encourage frequent nursing?
It isn’t that I think everyone should go the attachment parenting way. Parents are perfectly within their right to offer pacifiers and insist that the baby should sleep in their own room from day one. But if we’re talking about optimizing the chances of successful breastfeeding, people should make their choices with open eyes.
How about this: “If you have any qualms or fears about not having enough milk, assemble the ingredients for homemade formula…” not “check if you really have cause for concern”; not “contact a lactation consultant and/or a La Leche League representative”, not “nurse more often.” Prepare to give formula!! According to the author, “having the supplies on hand can be enough to give you the peace of mind that allows your milk to keep flowing”. Well, you know what? This very strongly reminds me of the well-meaning doctors and nurses who tried to persuade us to keep a can of formula at home, “just in case”. Does having formula around help to keep the milk flowing? I’m sorry, but I’m not buying that.
Supplementing may be necessary sometimes, but it is just about one of the most critical steps towards diminishing milk supply.
And this: “Lack of adequate milk supply sometimes does occur, especially as baby grows and his appetite increases.” Yes, sometimes during a growth spurt it may seem as though the milk supply is inadequate. However, by nursing more often, eating well and resting, milk supply can usually be increased. Mother and baby are hormonally tuned in to one another. Infant suckling stimulates milk supply. Lack of adequate supply doesn’t just “occur” (it’s maddening that a serious author implies that a basic bodily function like lactation just stops or decreases out of the blue). It has reasons which can often be traced to things like abrupt night weaning, introduction of solids, spending time away from your baby, giving a pacifier, a new pregnancy, etc.
I’m not saying that mothers who couldn’t breastfeed, for whatever reason, should feel guilty. But I do think that authors should feel guilty if their advice might have undermined breastfeeding for thousands of women.
My final conclusion? Eat the apple and spit out the seeds. “Nourishing Traditions” is a fascinating book with lots of insightful material and valuable advice, and it is kept at a place of honor on my shelf and often referred to. However, on this matter of breastfeeding I quite plainly disagree with a lot of what the author has to say.
Weaning, attachment and separation
The following article was included in my e-booklet, Nurturing Hands.
I have yet to have the experience of weaning a baby off breastfeeding; the first time, my milk just dried up because of subsequent pregnancy, but as my child was 15 months old and used to a wide variety of foods, that was alright. The second time, I went on nursing over two years, and somehow, very gradually, without my knowing how it happened, one day my daughter was weaned. I admit I was very grateful for it happening this way. Weaning is a bittersweet experience for me, even after a long and satisfying nursing relationship. I can only imagine what it must be like to intentionally wean a child who cries and frets and demands to be comforted in the best way they have known since birth, and to deny this comfort which it is in my power to give.
I realize sometimes babies or toddlers must be weaned, for a variety of reasons (medical, psychological or practical). It can, hopefully, be done gradually in order to minimize the stress and discomfort. I do feel compelled to speak out, however (at the risk of sounding judgmental), against a practice I noticed among some mothers I know – that of abrupt weaning of an older baby or toddler who is deemed “too old” to nurse, by the simple method of the mother disappearing from home for a week or so.
First off, the modern society’s idea of weaning age does not correspond at all with Jewish tradition. In the Jewish tradition, it is a matter of course that a child is nursed at least until 2 years old, and breastfeeding is quite common and acceptable until even later. In practice, today most babies are weaned off the breast at less than 1 year old (only to be given a bottle of formula in exchange).
A neighbor of mine went for a week-long vacation abroad with her friends, leaving behind her son (then 10 months old) in the vague hope that maybe he will give up on breastfeeding by the time she is back. That hope proved futile. “I don’t know what to do with him,” she complained irritably a day after returning home, “he cried and nursed all night. I didn’t get any sleep!” I had to bite my tongue to keep from retorting. How could she be surprised?
As far as this baby was concerned, his mother, who was always there to take care of him and nurse him, suddenly disappeared for a whole week – an eternity in a baby’s terms – snatching away his best source of comfort and nutrition. He had experienced the trauma of losing his mother, without any possible alleviation in the form of understanding she will be back eventually, because a 10-month-old is unable to grasp the concept of Mom going on vacation. To him, when Mom is gone, she is gone. There is no difference, as far as he is concerned, whether she is on vacation or dead. She is simply not there.
The same thing was done by several other women I know, always saying things like, “oh, he’ll be fine”, “I really need a break from it all”, “I need to wean her because she’s embarrassing me in public” and even “I need to wean because I want to get pregnant again”.
Now, I realize all babies go through the stage when they break out crying as soon as they lose sight of their mother (we’re just past that stage at this time, actually), and learn that she will come back eventually, whether in several minutes (if Mom goes to the bathroom) or several hours (if the baby is in some sort of day care). Now, if you know me, you know I’m all for home education or at least for keeping children at home well past the toddler years, and don’t think an enforced separation from Mom on a daily basis is good for the baby or toddler. Sometimes there really is no choice, however, and families adjust. A week-long separation, though, is really much too long for a baby, in my opinion. In their little minds, they are actually becoming accustomed to the idea of losing their mother forever. See quote from here:
“Infants may develop attachments to other members of the family or carers, who can take mother’s place for a while. But if mother does not return soon, some infants can become quite distressed, with crying and an increase of behaviors designed to bring the mother and infant together again. If the separation lasts for some days, the first state of crying and “protest” may be replaced by a mood of quiet unhappiness or despair. In the first two or three years of life an infant has no adult sense of time, and since explanations cannot be understood, the infant seems to despair of the mother’s return, in a kind of grief or mourning reaction.”
For this very reason, quite apart from breastfeeding, I personally would never voluntarily separate overnight from a child who does not yet have good verbal communication skills and a more-or-less consistent sense of time – in other words, a child under 3 or 4 years old. It is simply impossible to explain to a very young child that “Mommy will be back in a couple of days”, and without such understanding, the enforced separation is, as far as the child is concerned, nothing short of abandonment.
I realize that sometimes, such an abrupt separation is unavoidable (in the case of sudden hospitalization, etc). But I would not put a child through such trauma for the sake of a vacation, or in order to wean as quickly as possible (which, above all else, may result in plugged ducts and mastitis for the mother). It’s far better to make an attitude switch and vacation with the baby, and wean, if weaning is necessary indeed, slowly and gradually.
Just one final word: time passes so quickly. The baby who cries when his mother goes into the bathroom will sooner than you know turn into a 4-year-old who is quite happy at the adventure of staying with Grandma and Grandpa for a couple of days. There is no need to rush. Be with your baby; you will never regret it, and really, everything else can wait.
Common breastfeeding misconceptions
The more time goes by on this parenting journey of mine, the better I realize how important it is for every nursing mother and baby to have a pediatrician who is not just supportive of breastfeeding, but thoroughly educated about it – and unfortunately, they seem to be rare.
Back in university, I only had one course dedicated to infant nutrition, which emphasized the importance of breastfeeding but didn’t cover many important details such as supply and demand, possibility of poor latch, overactive letdown, distracted nursing, and many other common issues breastfeeding mothers often have to deal with. I know that in medical schools, more often than not even less is learned about this wonderful natural way of feeding babies.
Most pediatricians today tell mothers they should nurse their babies – if everything goes smoothly, if no problems arise, and if the baby is gaining weight strictly according to age-appropriate charts. From stories of fellow mothers, many pediatricians have only a vague concept that breasts make milk, and have all too many misconceptions, such as:
* It’s very common to have inadequate milk supply.
* A mother’s milk supply can dry up for no reason and it’s normal; it isn’t worth the trouble to check why this happens.
* Whatever a mother does or doesn’t do, it doesn’t affect her milk supply and therefore it’s pointless to try and improve it.
* Each baby needs to eat at such-and-such intervals, and weight gain should be such-and-such number each week.
* Weighing a baby before and after a feeding is a good way to assess how much food the baby gets throughout the day, because the amount of milk a baby gets per nursing session is the same every time.
I’m not saying pediatricians have no clue. They certainly have lots of knowledge, and their advice and opinion regarding a child’s health should be taken most seriously. But – and this is a serious but – don’t be overwhelmed by someone’s authority just because he is a doctor. Western medicine often has an impatient, quick-fix attitude, which is good for acute conditions, but many times displays little knowledge and much arrogance towards treatment of anything that has to do with chronic illnesses, allergies, and nutrition.
In certain areas, nurses tend to know more than doctors; or less. I had a nurse tell me that even if breastfeeding is going well, it’s recommended to supplement with formula starting from four months.
Many medical professionals have an attitude that can be described as well-meaning but misguided. Be careful and discerning.