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Volume 49, Number 4, July 2013

Baby-led attachment Working and parenting A dad's perspective on breastfeeding Champion weightlifting and breastfeeding


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Dial in my needs.

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Your best start to breastfeeding

Welcome to July 2013

Dear Essence winning letter

page 9 features

Breast check — a dad’s perspective Erik Peacock......................................................................... 7 Juggling elite athletics and breastfeeding Julie McGuire......................................................................10 Baby-led attachment Linda Indrisie......................................................................12 Breastfeeding in Myanmar (Burma) Simone Braithwaite............................................................13 Mouth size v nipple size Lisa Scott and Louise Brown................................................23

regulars Dear Essence....................................................................... 8 Breastfeeding Information and Research........................16 Mother-to-mother: Working and parenting....................... 17 Talking point: Nipples: how big is too big?.....................22

Did you know that in the first 6 weeks you will feed your baby approximately 336 times? Frequent feeding can cause neck, back and shoulder stiffness. Milkbar’s unique shape takes the weight and stress out of feeding your baby by gently supporting baby’s head at the correct height.

Breastfeeding Friendly Workplaces..................................24 Mummy diaries..................................................................26 Looking back........................27 On the shelf..........................28

Media watch.........................32 Breastfeeding Helpline........33 Mum's health matters..........34 July 2013

COVER:

®

portable nursing pillow

Photo by Papillon Studio

fertilemind.com.au

The Australian Breastfeeding Association | Essence | 3

Available at Mothers Direct

milkbar

Association news..................30


www.breastfeeding.asn.au Founded as the Nursing Mothers’ Association in 1964 by Mary Paton AM Patron: Her Excellency Ms Quentin Bryce AC, Governor-General of Australia

Contacting an Australian Breastfeeding Association counsellor Volunteer Australian Breastfeeding Association counsellors can help you with breastfeeding information and also with general enquiries including information about local groups. Contact a local counsellor or our Breastfeeding Helpline:

Who are we? The Australian Breastfeeding Association is a voluntary organisation established in 1964 to encourage and support mothers who wish to breastfeed their babies and to promote skilled and loving mothering, while creating in the community an awareness of the importance of human milk. At present, there are over 13,600 members in around 250 Australian Breastfeeding Association groups nationwide and over 1140 trained volunteers. Since 1964, more than 225,000 Australians have become members of the Association.

Our vision Breastfeeding is recognised as important by all Australians and is culturally normal.

Our mission As Australia’s leading authority on breastfeeding, we support, educate and advocate for a breastfeeding inclusive society.

YOUR PRIVACY IS IMPORTANT TO US The Australian Breastfeeding Association collects names, addresses and payment information for the purpose of providing Association services. Your personal details will not be given to any other party unless legally required to do so. Our privacy policy can be viewed at www.breastfeeding.asn.au or obtained by calling 03 9885 0855 during business hours. Your personal details may be used for internal fundraising purposes. Should you prefer not to receive these requests, please contact us.

Email counselling is also available:

www.breastfeeding.asn.au then click on ‘Breastfeeding Helpline’ The Breastfeeding Helpline is supported by funding from the Australian Government.

Essence editorial team Essence editor (Articles and mailbox letters) Helen Jeffcoat 8 Normanby Street, Indooroopilly QLD 4068 E: essence@breastfeeding.asn.au Assistant editor Judy Gifford OAM Essence design team Design coordinator Debbie Court E: essencedesign@breastfeeding.asn.au Graphic designers Kim Lock Rachel Clark

Special thanks to our subeditors, writers, contributors and the Proofreading and Approval and Design Working Groups

© Copyright: Australian Breastfeeding Association ABN 64 005 081 523 ISSN 0156 0476 No article to be reprinted without the editor’s permission. Personal opinions expressed are not necessarily those of ABA. The distribution for each issue of Essence is 17,000. Products and services advertised in this magazine, with the exception of ABA products, are not necessarily endorsed by the Association. Printer: Printgraphics, Mount Waverley, VIC

Essence advertising Essence advertising c/o Australian Breastfeeding Association PO Box 4000, Glen Iris VIC 3146 T: (03) 9885 0855 F: (03) 9885 0866 E: marketing@breastfeeding.asn.au

Head Office

General enquiries Executive Officer 1818–1822 Malvern Rd, East Malvern VIC 3145 PO Box 4000, Glen Iris VIC 3146 T: (03) 9885 0855 F: (03) 9885 0866 E: info@breastfeeding.asn.au W: www.breastfeeding.asn.au Breastfeeding Friendly Workplace (BFW) E: bfwa@breastfeeding.asn.au

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Sales Mothers Direct Pty Ltd PO Box 4000, Glen Iris VIC 3146 T: (03) 9886 9399 F: (03) 9886 9033 Credit card orders: 1800 032 926 E: orders@mothersdirect.com.au W: www.mothersdirect.com.au To contact any of the Australian Breastfeeding Association Directors please refer to the Executive Officer. Receiving Essence Essence is a membership benefit of the Australian Breastfeeding Association. Membership costs $65 per year and includes a range of benefits, including six issue of Essence per year. To become a member, and find out about the other benefits, visit breastfeeding. asn.au/membership or call 03 9885 0855. July 2013


July 2013 A D V E R T I

from the editor

S E

What’s new...

M E N T

I love the range of articles in this issue. The interview with weightlifter Deb Acason is inspiring. A healthy lifestyle is within the reach of us all. Appreciating fresh food and an active lifestyle is a gift we can give to our children. I am looking forward to ordering the new ABA Rose. What’s in a name? Many years ago, my mother bought me a daylily that she had seen at a garden show with the unlikely name of ‘Helen Mary’ — my name. My mother died in 2009 and every time I look at the bed of Helen Mary daylilies I remember my mum’s love and care. I mentioned this story to my daughter but she didn’t think that her name ‘Olwen Ernestine’ would catch on as the rose name! The working and parenting letters in our ‘Mother to mother’ page come from the heart. Is there time for both in your life? I now work full-time and often at dinner my children ask me what I did at work today. I think back on the day and often I can only come up with an answer of ‘nothing much’. Funny, this is the answer they give when I ask them what they did at school today! Maybe it is because what happens at home is what matters the most. So these are my final words this month — ‘Make home matter’. This issue has the first of a small regular piece from the ABA Board — an excellent way of keeping all members up-to-date with ABA plans and policies. In 2009 the Board met in Brisbane and it was the first time I had had the opportunity to meet Debbie Court, recently retired ABA Director and leader of the Essence design team. I had just started with Essence on the ‘Media Watch’ page. Debbie filled me in on the history of Essence and we talked over ideas for future issues. It’s a pleasure to still be on the Essence team and working with Debbie Court and Judy Gifford — both long-standing contributors, proofreaders and designers. I was recently in traffic and noticed that the registration plate on the car in front was encircled with a clip-on border saying ‘Breastfeeding Helpline 1800 686 268’. What a great group project! For information on how to purchase this and other group projects see the ad on page 38.

Helen Jeffcoat Editor July 2013

The Australian Breastfeeding Association | Essence | 5


Name our

dear members

Dear members, Welcome to a brand new column. Behind the Australian Breastfeeding Association (ABA) you know through reading Essence, sits a complex business that delivers a wide range of services and programs, and relies on a large and dedicated group of volunteers. We want to use this column to let you know about what is happening on the business side of ABA. We want to let you know about the many other facets of ABA and maybe even inspire you to become involved, because we know that it is through our general membership that people often go on to become volunteers. We want to be transparent and available to our members. How to contact the Executive Officer and the Board is on page 4. Now is a very exciting time for ABA members, past and present, as work has begun in earnest on the plans for the Australian Breastfeeding Association’s 50th Birthday. As we approach this significant milestone, the Board and Executive Officer are working very closely together to ensure the longevity of ABA continues well past 2014 — indeed we would like to see the Association remain relevant and prosper to support breastfeeding mothers for another 50 years.

50th Birthday Rose In 2014 ABA is turning 50! To celebrate we are releasing a commemorative rose, a sister to our ‘Mother’s Love’ rose, and the new baby needs a name.

To name the 50th Birthday Rose, log into My ABA: breastfeeding.asn.au/myaba to submit your entry. Entries are open to ABA members only and open 14 June 2013 and close on 1 September 2013.

In seeing this happen, ABA is currently undergoing a major review process. In 2012, we revised our vision and mission statements (both can be found on page 4), resulting in two simple, clear messages that are relevant to Australian families. The Board has recently finalised a new strategic plan that will focus ABA’s work for the next 4 years, ensuring the organisation remains relevant to mothers who need information, help and support as they breastfeed their babies. We look forward to keeping you informed of ABA’s activities.

Rachel Fuller President

Sue McIvor Executive Officer

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nner The wi e a eiv will rec ative mor comme rose July 2013


Breast check — a dad’s perspective by Erik Peacock

These days there seems to be a serious amount of cleavage on display and for some reason 16-year-old girls now feel the need to share their mammaries with the world. I suspect that it’s not just me. Our society does seem obsessed with breasts. I was chatting about this with my wife recently and about our breastfeeding journey — two children, 2 years of breastfeeding each and counting. We see breasts in every imaginable context except one — nourishing and nurturing babies. It seems there is a social consensus that breasts are sexual, sexuality is for display, but sex has nothing to do with reproduction (yuck) and reproduction has nothing to do with breastfeeding (gross). It’s truly bizarre. So I decided to take a ‘breast check’ of casual observations of mammaries around town one lunch break. Outside the newsagent is a stand of gossip magazines with various neurotic looking models and actors sharing their private lives and private parts. Looking through the shop window there is a fitness magazine with the ubiquitous boob tube. The stunt bike shop opposite has a larger than life picture on the awning of a sultry model with boobs busting out of her leopard skin pattern bra (not sure what this has to do with stunt bikes). Strolling through the mall I pass several groups of mothers with strollers and their little tots. They are young mothers and the babies are sucking bottles or dummies. Just past them is a lingerie shop. All the skimpy frilly things that mostly fit teenagers are on display next to a life-size picture of a young woman sporting the goods. It is apparent from her figure that she has never had babies. No one is breastfeeding in the mall. It’s legal now (well done, ABA), but it might certainly be looked at strangely. On the way home I stop at the petrol station and pass the large porn stand on the way in to pay. Usually I make a point of not looking, but this time I stop to do a count. There are over a dozen magazines sporting women with improbably slim waists and July 2013

Breastfeeding is normal Photo courtesy of Vicky Leon

We see breasts in every imaginable context except one — nourishing and nurturing babies impossibly large bosoms whose nipples are barely concealed by very uncomfortable looking lycra straps. When I was a teenager this would have been a temptation. Maybe I’m getting old but now I wonder how these women would go with attachment in the first couple of weeks of establishing breastfeeding and whether those breasts will ever serve a socially useful purpose. I suspect in any case that silicone and Photoshop have a lot to answer for. It seems lingerie is fine. Porn is fine. Breastfeeding maybe not. After a breast-filled day it is pleasant to go home and see Jenny nurturing a healthy baby on a healthy pair of bosoms. Yes, we are mammals. I almost feel like printing a T-shirt saying ‘Mammal and Proud’ but it may be misunderstood. What a shame that breastfeeding is not normal and pervasive in public spaces. Most of us blokes got our idea of breasts from porn or the other side of the porn industry — fashion. How much better for boys and teenagers if our first encounter with breasts was seeing female relatives and friends suckling babies? I am sure we would all be healthier for it. Erik, his wife Jenny and their two children aged 1 and 4 live in Tasmania. He is a husband, dad, civil servant and part-time writer. The Australian Breastfeeding Association | Essence | 7


dear essence

essence@breastfeeding.asn.au

Thank you for all your letters, feedback (positive or negative) and photos ... we love receiving them all. As you can imagine, we can’t fit them all in. So, sorry in advance if your letter or photo doesn’t make it into print. You can be assured, though, we do enjoy reading them and being part of your lives. Please email your contributions of 300 words or less to essence@breastfeeding.asn.au and include permission to use your group name and state.

The contributor of the winning letter or image for each issue of Essence receives a $50 gift voucher from Mothers Direct — the Australian Breastfeeding Association’s retail subsidiary. Mothers Direct specialises in useful, quality products for breastfeeding and early parenting. Visit mothersdirect.com.au to see our range and find our store locations in Melbourne and Brisbane.

Anke’s son breastfeeding an hour after birth

Helene Collard and her son

Thank you ABA For me, breastfeeding was a ‘no-brainer’. It is how nature intended for babies to grow, be nurtured, comforted and protected. My son Akasha is now 9 months and although he loves his solid food, he still keenly enjoys his ‘milk’. Breastfeeding takes commitment, patience and perseverance from mother, baby and partner and I never once contemplated giving up. Thank you to the ABA counsellors for being there for me, keep up the good work. Helene Collard, Lismore Group NSW

Flashback to the 1970s, Anke’s mother breastfeeding her, with her sister and her doll sharing the bed.

Things have changed for the better

A reminder to be confident

My family lives overseas. When I told my mother I was home the same day after giving birth to my first child, she was really worried about how the breastfeeding would work out. In the Netherlands, you get a lot of support at home from your midwife. I told my mother that Thomas drank directly after birth, that I was an ABA member and could call the helpline 24/7. When my mother came over to Australia 6 weeks later, she told me about her experiences with breastfeeding when we were born in the late 1970s. Then, the art of breastfeeding had almost vanished in the Netherlands. Within two generations most knowledge was lost, so my mother couldn’t even get good advice from her own mother. My mother was very keen on breastfeeding and even now, more than 30 years later, she is really frustrated about the bad advice she got from lactation specialists. One piece of advice was to switch to 5 feeds per day as soon as the baby got to 4 kilos and to give the baby rusks and lemonade from 6 weeks. Luckily for Mum she moved to Cameroon in Africa soon after she had her second child and there she got better advice, because the knowledge was still among the women. Anyway, my mother found ABA’s book Breastfeeding ... naturally, very helpful, practical and down to earth and so did I. She returned to the Netherlands relieved that I was in good hands with the breastfeeding. Anke Snoek, Sydney NSW

Recently I was at a restaurant at Concord in Sydney. I wanted to sit outside and the waiter suggested a table right next to the footpath. I felt like this was too ‘out in the open’ as I planned to breastfeed and was self-conscious about people walking past (I’ve been a mum for 7 weeks now!). I asked to be moved to another table that was a little more hidden. I told him, as I was moving to that table, that I was going to breastfeed. Much to my surprise (and delight), the waiter looked at me, and said ‘Why? It’s the most natural thing a woman can do’. He was so right. What a reply! Bernadette Šmon, Sydney, NSW

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‘Sleeping through’ is the exception, not the norm Sleep, along with feeding, is one of the most discussed parenting topics. ‘Some babies will sleep through from 6 weeks’ (March Essence, p.19) talks about using a feeding schedule to teach babies to ‘sleep through’. It is wonderful when a family finds something that works for them and confidence is something that all parents deserve to feel. I would like to reassure mothers and fathers that it is perfectly okay to allow baby to fall asleep on the breast and to breastfeed according to baby’s need day and night. Breastmilk contains cholecystokinin (CCK), a hormone specifically designed to cause baby to July 2013


feel sated and sleepy. CCK is released in the mother and baby’s bodies during breastfeeding. The comfort and relaxation provided by sucking at the breast, along with a lovely cuddle from mum, all combine to form nature’s intended sleepinducing atmosphere for baby. Human mothers have always breastfed their babies to sleep and find that it is a wonderful way to show baby that sleep is a safe and loving space to go. As they grow older, babies will rely less and less on the breast to go to sleep until one day they are managing to drift off by themselves. A mother’s milk supply is maintained by frequent baby-led suckling, so many mothers find that feeding to a schedule provides inadequate breast stimulation to maintain milk supply. It is perfectly normal for a baby to wake multiple times a night and need parental assistance to re-settle. Night-waking is common and normal and parents can be reassured that their child will ‘sleep through’ in their own time. Kim Lock, Barossa Valley Group SA

Jasper is doing fine The story of the birth of my son Jasper was in March 2013 Essence. I wanted to give readers an update. Jasper is now 13 months old and healthy. He was exclusively breastfed to 6 months when I introduced solids. He is still breastfeeding once a day and I have just returned to work. We have been so successful. Huge thanks to ABA and to my husband for being the most supportive person. Caitlyn Rolfe, Brisbane QLD

my story

I live in remote central Australia. I haven’t attended a group meeting yet as I live 200 km from the nearest group and driving to town from out bush is not always the easiest thing to do with young Angus who likes to feed frequently. I thought that the drive to hospital when I was in labour would be my baby challenge. After making it successfully to town, it did not take long for me to discover that my challenge was going to be breastfeeding. After suffering Carolyn’s son Angus aged 2 months cracked nipples, breast engorgement, poor attachment, blocked ducts, the onset of mastitis and then to top it all off — a loss of milk supply — the support of my partner Steve Nankivell was fundamental in helping me through all this. He was there to listen, help me attach our son to my breast and to call ABA and speak with the counsellor when I was too upset with no milk, no sleep and a distraught 7-day-old all taking its toll on me. Together we have been able to establish a successful breastfeeding relationship. Without his support, my breastfeeding journey would have been far more difficult and I wonder if we would have made it through. For us, teamwork has been the key. Carolyn Keeghan M’bunghara, NT Volume 49, Number 1, March

by Caitlyn Rolfe

I thought I would share my breastfeeding experience with you: k I am a type 1 diabetic. k My baby was born at 35 weeks. k I expressed as much colostrum as I could before the birth so he could be fed in special care. k It all worked out in the end!

When my husband and I found out that we were expecting, we were filled with excitement — until we announced the pregnancy and people started telling us their horror stories. We started getting frightened, especially when a lot of the horror stories and discouragement were about breastfeeding. My husband was breastfed for 4 years but I had been bottle fed. His health is great and I get sick at a drop of a hat. I was determined to breastfeed for as long as I could. People kept asking: ‘Are you going to breastfeed or formula-feed?’ and when I responded that I was going to breastfeed they would usually reply, ‘Oh your nipples will never be the same. Why breastfeed when formula is good enough.’ This would be followed with stories of mastitis, engorgement and low supply. I have type 1 diabetes and my mum kept telling me I wouldn’t

drip. He was then quickly taken away to special care. Unfortunately I didn't get to breastfeed him immediately after the birth. I was heartbroken and worried that this might mean we wouldn’t be able to establish breastfeeding. I was so ill that I had to stay in the labour room until 8 am the next day. The nurses helped me express more colostrum to be fed to Jasper in special care. I was so frustrated and was in tears all night. When I finally got to special care late the next day, the nurses didn't encourage me to breastfeed. Jasper was making lip smacking sounds and I thought, if they won't help me, I'll figure this out myself. However, I wasn't sure if I was allowed to take him out of the humidicrib, so I didn't start. Later that day they put him in an open air crib and I asked the midwife if I could breastfeed. She wasn't encouraging but I just picked him up and put him on. Sadly no nurse was around to advise me. Jasper get

to know each

have any milk (as she too is a type 1 diabetic and hadn’t been able to develop a good supply after I was born). Not surprisingly, I was feeling quite discouraged about breastfeeding.

Expect an early delivery

At 28 weeks my breasts started leaking colostrum. I was ecstatic. This seemed to me to be a sign that I would have a great supply of milk. At 32 weeks, my blood pressure started increasing and I became very swollen. I was given some syringes and was advised to express some colostrum for my baby. The colostrum could then be fed to my baby if we were separated and I was unable to start breastfeeding immediately. Nobody explained how I was to do this so I went home and watched a YouTube video to learn. I was only getting 1 mL at a time and I was quite down about this, I didn't realise it is normal to produce only a small amount. At 33.5 weeks I was admitted to hospital with pre-eclampsia. My legs, hands and face were badly swollen and blood pressure was 170/100. I had severe headaches, protein in my urine and felt quite sick. I asked the nurse at the hospital

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July 2013

Support from my partner

Research into child care Severe foo d intolera nce Upper liptie explain ed Diabetes and breastfeedin g

Caitlyn and

In the beginning

winning letter

She got Jasper out of the cot and taught me how to feed and encouraged me to feel confident that I could manage. Things were going so well and the evening midwife was just as great and made sure I fed Jasper regularly. The following morning, Jasper was taken off the glucose drip. We then had to stay one more night in hospital as Jasper needed to have 6 hours of good glucose readings before he could come home. At first I thought they would send me home first but then my iron levels were found to be dangerously low and I had to be monitored in case I needed a blood transfusion. In spite of this, I was so happy as 7 pm that evening Jasper was discharged from special care and came in the general ward with me. I was still struggling a little with breastfeeding painwise but the next day we were discharged. Finally I was going home, after being in hospital for almost 3 weeks.

other

for more syringes to keep expressing. I was really happy when she said 1.5 mL was pretty good for someone who hasn't had a baby yet. All up, I collected five syringes full of colostrum. At 35 weeks gestation, in the middle of the night, the doctor thought my body had had enough and recommended a caesarean. I begged her to let me try for a natural delivery as I had a feeling I was already in early labour. When she checked my cervix, it was 2 cm dilated so they broke my waters to bring on labour. Ten hours later, I started pushing and after 2 hours Jasper was born at 2:30 pm on 23 January 2012. He was popped on my chest right away. Even though he was born 5 weeks early he weighed in at a whopping 3762 grams. This was due to my diabetes as babies of mothers with diabetes are usually born large for gestational age. Jasper did have some breathing problems and his blood glucose level was 1.0 (this is very low). So they whipped him off to the resuscitation table and worked on getting his oxygen levels up. He was on a CPAP (Continuous Positive Airway Pressure) machine for 50 minutes but after that he could breathe well and then was hooked up to a glucose March 2013

I think I must have got our attachment wrong as my nipples became a bit bruised and blistered. So the next midwife helped me to express until they felt better. The next day, Jasper changed rooms. I was so tired as I hadn't had any sleep because I was trying to express through the pain with no help. I walked up and told the midwife in his new room to start formula-feeding him, so he could come off the glucose drip. My doctor said I would be going home the next day and I didn't want to go home without my baby. This midwife said, ‘Why are you expressing when he clearly has a sucking reflex? I'm on a 12-hour shift and together we will get you breastfeeding before 7 pm tonight.’ March 2013

Back home

That first evening at home, it seemed like Jasper fed nonstop. I had a really bad night and my husband came out to find me bawling my eyes out and me begging him to let me formula-feed. He was supportive and said calmly that we would get formula as soon as the shops opened the next day. In the early hours of the morning, I rang the Breastfeeding Helpline and spoke to an ABA counsellor about the pain and my general confusion about breastfeeding. The counsellor gave me some great breastfeeding tips and assured me that my baby was behaving normally. So I kept feeding Jasper and suddenly the

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2013

my story

pain disappeared, so by the morning everything seemed a lot better. I changed my mind about formula and bought an electric breast pump so I could express easily if necessary. To this day, Jasper has not had formula nor has he had any expressed milk. I got through it and I don't think I would have without my husband and the ABA counsellor. I am so proud of myself for not giving up on breastfeeding. My son had a bumpy start in life health-wise and I wanted to ensure that I did all I could to help him. I think that breastfeeding helped me achieve this. I love sitting watching him feed. I feel it's the most beautiful and natural thing to do. I just want other new mums to know it’s not the end of the world if you can't have that special moment right after labour and that it needn’t affect your breastfeeding later. Thanks so much ABA. Caitlyn, David and Jasper Rolfe live in Brisbane

Mothers with diabetes and their babies Mothers with type 1 diabetes may have a delayed onset of lactation due to a lower level of prolactin, but they should not give up as their milk will still come in. Babies of mothers with diabetes may have problems with low blood sugar. Supplementation with formula can often be suggested. Some health professionals suggest that diabetic mothers express colostrum during the last weeks of pregnancy, freeze it, to have it available for their baby as a supplement during the first few days of life, if necessary.

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The Australian Breastfeeding Association | Essence | 17

The Australian Breastfeeding Association | Essence | 9


Juggling elite athletics and breastfeeding

— it can be done! Of course, as an athlete the support and encouragement from others is really important, particularly from family, close friends, and my coach and training partner. I met my husband the year before I competed in my second Olympics (in Beijing 2008); so juggling our engagement, the Olympic trials, the Olympic Games and then our wedding 2 months later had its challenging moments. However, he is a very supportive, patient and caring man, particularly when we lived 300 kilometres away from each other until we were married. The most challenging part of my career has been the way I train and compete after marriage and having my baby

'How our babies start has a huge effect on not only our families but also our society as a whole' Weightlifter Deborah Acason (née Lovely) is a dual Olympian, a Commonwealth Games Champion — having won a gold, three silver and a bronze medal across three Commonwealth Games campaigns — and is now a first-time mum. In this edition of Essence, she speaks about juggling her roles as an elite athlete and a breastfeeding mum to baby Eva.

What inspired you to become an athlete? I am the middle of five children. I have two older brothers and two younger sisters and was brought up believing that I was blessed by God with gifts and abilities and that the only thing that anyone (particularly my parents) wanted from me was to do my absolute best in everything I did. I was a very energetic and determined girl but had lots of encouragement from my parents. Along with this physical and mental toughness was good health. My mum

grew up in the country and we always had a fantastically healthy diet of fruit, vegies, lean meat and some dairy. We loved this food and now, as adults, we find we still eat the way we did growing up — healthy!

princess. I can’t be the athlete that can put themselves [sic] first anymore. As an elite athlete you have to do what’s best for yourself and your training but now my baby and hubby have to come first — priorities just change.

You also studied a double Law and Criminology degree, became a mum and continued to train at an elite level for the National, Oceania and Commonwealth championships, and London Olympic selection trial. I learnt very early in life to juggle lots of things well. My mum did this with five kids and helping lots of people at the same time, so I found I learnt her skills in time management. In high school, I split Year 11 and 12 into 3 years to help me train more and still study hard. I was responsible and self-motivated in getting all my training and study done and still making it to school when I needed to be there.

10 | Essence | The Australian Breastfeeding Association

Amity Neumann (right) interviews Deborah Acason as part of the Australian Health Bank initiative

July 2013


Photos by Sylvie Jackson of Papillon Studio Brisbane, papillonstudio.com.au

"Understanding the importance of excellent nutrition also made me realise how essential getting the best start through breastfeeding was for my daughter."

As a professional athlete, has your knowledge of healthy eating and exercise influenced your personal decision to breastfeed? I think because of my wonderful upbringing I knew how important breastfeeding was and I always had every intention of doing it. I was breastfed until well after [I was] 2 years old and Mum always told me how I was very rarely sick as a baby and a child. I always felt very loved, safe and secure as a child and I put much of it down to having the healthiest possible start in life with being breastfed. I remember the long cuddles with my mum during and after being fed by her and I really believe this had a lasting impression on me feeling loved as a baby and young child. In turn, I became very independent and outgoing, I think from knowing Mum was always there for me. Even though my next brother older than me was only 20 months older, because Mum breastfed me I still got that quality time with her. It also made her sit still and rest for a while. As an elite athlete, I completely understand from experience how important nutrition is for optimum sporting performance and health. Not getting the right nutrition not only affects sporting performance but also basic health and the ability for the body to recover both awake and asleep. Understanding the importance of excellent nutrition also made me realise how essential getting the best start through breastfeeding was for my daughter. Obviously my husband was wonderfully supportive of me breastfeeding my daughter and was very thankful that I did, even though I was training for the Olympics.

What advice do you have for young families in Australia? Do your best in everything that you do and achieve what you can. I know how important it was to have achieved what I did before I had my daughter because I love spending every second with her and my priorities have totally changed to put her above my work and my sport. How our babies start has a huge effect on not only our families but also our society as a whole. No one else will love and care for my daughter as much as me and my husband, so looking after her is my priority. July 2013

Australian Health Bank This interview has been reproduced with permission from the Australian Health Bank and edited for length and clarity by Lisa Scott. The Australian Health Bank is the website and project that ABA member and Brisbane academic Julie McGuire has been working on with the Queensland University of Technology and the QLD Health Department. The project received a Healthy QLD Award prize in 2012. It will be a generic health site for schools and will provide curriculum appropriate resources for health educators and teachers. The project aims to embed important health issues, such as breastfeeding, nutrition and exercise, into general subject areas. The website is just the beginning! The Australian Breastfeeding Association | Essence | 11


my story

by Linda Indrisie

Linda Indrisie is currently completing her Certificate IV in Breastfeeding Education (Counselling and Community), is a member of the South Eastern Suburbs Group, WA and treasurer of ABA WA Branch.

My first baby I had attachment problems with my first and it resulted in cracked, bleeding nipples. With my second, I was determined to get this baby-led attachment process right! Firstly, for the sake of my poor nipples and secondly, to see for myself how this birth bonding was supposed to work.

Baby-led attachment My second baby I went into labour naturally at 5 pm but by 10.30 pm my doctor was worried about foetal distress as my baby’s heart rate dropped dramatically with every contraction. They wheeled me in for an emergency caesarean but just as they were about to cut, one last check found me fully dilated and it was decided to try a vacuum extraction. I had an episiotomy and then with one push he was born at 11.40 pm. Straight away I asked that he be put on my chest, skin-to-skin. They wheeled us back to the room; I refused all the well meaning breastfeeding intervention from the midwives as I wanted us to try baby-led attachment. But little Jamie just lay on my chest and did nothing for about 2 hours. All I had in my mind was a vague worry that a ‘baby needs to be breastfed within an hour of birth’. I tried coaxing him; he would lick my nipple but not really suck. Eventually I guided his mouth to my nipple and this seemed to work. Over the next few days I tried to let Jamie find his own way to the breast but he didn’t seem to have read the same book! I felt like he was chewing my nipple. And as I had experienced nipple trauma before, there was no way I was going back to that! I was starting to feel like a failure as both a mum and a potential counsellor. What was I doing wrong for him not to get it, and what sort of counsellor would I be when explaining this process to mums if I couldn’t even do it myself? I don’t know why I thought these silly thoughts, but I did. I could only get him on the breast using a football hold — this seemed very odd. I rang my wonderful, fantastic group leader

Kerry Smith who said that there was no one ‘right’ way. So that’s how we fed for our remaining time in hospital. When I got home we tried letting Jamie find his way to the breast again, and it eventually happened — Jamie got it! Can’t remember exactly when, all those early days kind of blend in. And now he’s awesome at getting on the breast all by himself and we have been a demo mum and baby at Breastfeeding Education Classes. Jamie is now 4 months old; he sleeps with me at night and attaches himself to the breast during the night if he needs a feed — no more waking up for me to feed him ... YAY!

My suggestions Did I do anything wrong? I don’t think so. Try different holds, if one doesn’t work just try another. If a cradle hold doesn’t work, try the football. I would say to mums, try whatever you think might work for your baby. If it doesn’t work, move on, try something else. It doesn’t mean anything if your baby doesn’t attach right after birth. Maybe, like my baby, yours just needs a little time.

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Linda, her son and daughter today

Linda and her newborn son

Baby-led Attachment Babies have an instinct to seek out their mother’s breast and, if left to their own devices, are usually able to attach themselves and start to feed. ‘Baby-led attachment’ is a term used to describe this process. Your own instincts and your natural anxiety are probably telling you to bring your baby to your breast and put your nipple into his mouth for him. But if you can allow your baby to take charge, you’ll be amazed at what happens. Baby-led attachment offers your baby the most natural introduction to breastfeeding. This is what you might like to do with your newborn: • Sit comfortably • Your baby needs to be calm and alert • Have skin-to-skin contact with your baby • Hold your baby against your body • Let your baby follow his instincts • Support your baby • Allow your baby to attach to your breast. More information on this topic is available in Breastfeeding … naturally, ABA 2011 at page 51. A free copy of this book is sent to all new ABA members

July 2013


by Simone Braithwaite

my story

Breastfeeding in Myanmar (Burma)

‘This is Burma and it is unlike any land you know about.’ Rudyard Kipling (1898)

Being cut off from the world for so many decades, Myanmar is a country shrouded in secrecy and mystery. Images of military junta rule, a dubious human rights record and the imprisonment of activist Aung San Suu Kyi form our visions of this South-East Asian country. But what is it like to be a mother or a parent living, working and raising a family in this truly fascinating and unique country?

My professional interest in Myanmar was focused on breastfeeding and nourishment of babies under 2 years of age. Protecting, supporting and improving breastfeeding is one of the key strategies to improving malnutrition and subsequent child survival rates. For example, initiation of breastfeeding within 1 hour of birth has the potential to reduce neonatal deaths by 22%1, largely by reducing

Protecting, supporting and improving breastfeeding is one of the key strategies to improving malnutrition and subsequent child survival rates. My first visit to Myanmar in 2009 was to set up home with my husband and our 20 month old son. Working for an international non-government organisation, my role was to focus on nutrition for women and children with an aim to prevent and combat child malnutrition. I returned to Myanmar in 2012, to work with displaced women and children in a conflict zone in the country’s north-west.

July 2013

neonatal infections. Vital to my role, I needed to better understand the social, economic, political, religious, spiritual and cultural aspects that influence a mother’s breastfeeding journey. This was actually a very challenging task, particularly with the significant language and cultural barriers that I faced. Thankfully, I had the expertise and assistance of my multilingual colleagues who were so generous and patient as teachers.

Breastfeeding is the norm in Myanmar and having come from Australia, this was something I really had to get my head around. A typical woman’s breastfeeding journey really is very different and naturally I viewed it through my Australian (and often ABA) ‘filters’. For example, many women give birth at home and many without a midwife in attendance. But before images of warm water birthing tubs surrounded by loving supportive family form — the reality for most women is birthing on cold, hard, dirt floors, with assistance from a traditional birth attendant all too often resulting in unacceptable rates of maternal and neonatal infections and death. Those ‘lucky’ to be able to afford to birth in a hospital can face issues of poor hygiene, very low numbers of professionals with inadequate facilities, equipment and training. Early skin-toskin contact and breastfeeding initiation is more often interrupted by cultural beliefs to wrap the baby in blankets, and physical environments that make recovering from birth and keeping your baby close and snug near impossible. Hospital practices claim to be WHO Baby continued page 14 >

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my story

Breastfeeding in Myanmar (Burma) continued

Displaced persons camps in Myanmar

Friendly, but anecdotal stories from many mothers paint quite a different picture — one influenced by free formula samples and medical endorsements of artificial feeding. Colostrum is commonly believed to be ‘dirty’, plagued with ghosts or bad spirits so can be expressed and thrown away. Women frequently reported practices where newborns are denied breastfeeds until day 3 or 4, due to these strong traditional beliefs carried by family matriarchs. Fragile newborn gastrointestinal tracts are commonly challenged by traditional feeding of ground rice or herbal concoctions, and unsafe water supplies mean even tiny sips to drink can have disastrous consequences. Baby wearing is commonplace for many of Myanmar’s ethnic minorities, but not so much for the majority Bamar people. Co-sleeping is usual practice, and I got the impression that separate sleeping would simply be strange. Women, particularly the rural poor, work hard with the chores of daily living. Many rural women return to paid work within 2 weeks, often to undertake hard physical work in agriculture whilst more educated women commonly return to paid work by 3 months. Rarely are these workplaces ‘breastfeeding friendly’ and

taking lactation breaks is not common practice. Expressing breastmilk for your baby whilst at work is unusual. For many of the rural poor even basic hygiene necessities such as soap and clean water may not be available, making me question the value of recommending hand expression into a cup for a baby left with a family member. One afternoon, I witnessed firsthand how hard home work impacts on breastfeeding. I had organised a focus group discussion with a group of 25 displaced women. As we sat cross-legged in a circle discussing their breastfeeding experiences, I witnessed a constant stream

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of children entering the hut. By the end of the discussion, almost every woman in the room had been joined by an infant or child, who had come in for a breastfeed. The women had been telling me how hard things had been since the conflict and how busy they were with the tasks of daily living. I think the children were simply making the most of the opportunity of a sitting and stationary mother! In Myanmar, approximately 90% of mothers commence breastfeeding; with 85% still breastfeeding their baby at 12–15 months and 67% still breastfeeding at 20–23 months of age1! Despite these near optimal breastfeeding rates, the rates of

Displaced persons camps in Myanmar

July 2013


my story capita income increases and communities are more heavily influenced by the power of marketing. As Myanmar opens its doors to the world, sanctions are lifted and living conditions improve, it would be amazing to see exclusive breastfeeding rates improve whilst maintaining high continuation rates. I do not believe any other country has managed to maintain and improve breastfeeding rates as they become more ‘developed’ — but maybe, just maybe, in this case Rudyard Kipling will be right! References 1. Edmond K et al 2006, Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics 117: 380–386. 2. MICS 2003, Table 14, pp. 40–41. Taken from: childinfo.org/breastfeeding_iycf.php Simone Braithwaite is a Public Health Nutritionist and an ABA Community Educator with Sherwood Group, Queensland. She is mother to two boys — Miller (5 years) and Spencer (3 years who was made in Myanmar!) and partner to Jeff.

Breastfeeding Necklace

T U Bar Kar Tu and her daughter

exclusive breastfeeding are low, reportedly 15% in 20092. The breastfeeding ‘challenges’ I described earlier easily translate into poor exclusive breastfeeding rates but are somehow are incongruent with such high breastfeeding continuation rates. On one hand are the positive benefits of strong social, cultural and spiritual norms and the ‘non intervention’ approach that comes with societies

so with some urgency. I witnessed an increasingly formula-feeding culture in the wealthy urban population and an increasing barrage of advertising and marketing of infant formula. Fat, healthy babies are pictured alongside beautiful families and bottles of infant formula on billboards, magazines, professional journals, newspapers and on television. Rural women frequently told me stories of aspiring to be able to give their babies

Breastfeeding is the norm in Myanmar that are more traditional and is often lauded by breastfeeding professionals in developed countries today. On the other hand, is the negative impact of poverty, food insecurity, traditional practices, inadequate education and provision of inadequate universal antenatal and maternity services. Myanmar has not adopted the International Code of Marketing of Breastmilk Substitutes and needs to do July 2013

formula. One breastfeeding woman told me how she and her husband would save for a tin of formula, which she would then give to her baby until it ran out and they had saved enough money to buy another. When I asked her why, she told of her desire to have a fat and healthy baby! Interestingly, she continued to breastfeed the whole time she gave these formula feeds. Changes in feeding culture are commonly seen as a country develops, per

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breastfeeding information and research

Summarised by Elizabeth McGuire BSc IBCLC In terms of evolutionary biology, breastfeeding can be regarded as a maternal investment in a child. Breastfeeding improves the child’s chance of survival, and hence in the long term, his or her chance of reproduction, so it improves the mother’s chance of passing on genes. While a mother is exclusively breastfeeding, she is unlikely to get pregnant, so it limits her chances of having another child. You could say that while breastfeeding continues she is putting all her eggs in one basket! According to evolutionary parental investment theory, (the Trivers-Willard hypothesis) parents will invest more in children that have a good chance of continuing the genetic line. In societies where males compete for female partners and a successful male may have multiple wives, the theory predicts that well-nourished mothers will preferentially invest in sons, and women in poor condition will preferentially invest in daughters. This makes sense because a well-nourished son has a chance to marry several women and have many children, while a well-nourished daughter will still only have a few children. On the other hand, a poorly nourished woman’s son may miss out on having any children, but a daughter is likely to have at least a few. The theory also predicts that mothers should invest less in children who do not thrive, since their chances of survival are low. A recent study has tested the theory by looking at how breastfeeding is practised in a traditional society.

Fujita M, Roth E, Lo YJ, Hurst C, Vollner J, Kendall A 2012, In poor families, mothers’ milk is richer for daughters than sons: a test of the Trivers-Willard hypothesis in agropastoral settlements in Northern Kenya. American Journal of Physical Anthropology 149: 52–59 This study followed the Ariaal people of Northern Kenya. The Ariaal men have multiple wives and men own all assets and make important decisions concerning things like marriage, divorce and contraception. Ariaal women have an average of six children over the span of their reproductive lives. In a study of 241 women, the authors looked at breastfeeding frequency to see whether a behavioural mechanism fitted the Trivers-Willard hypothesis of parental investment and measured breastmilk fat content to assess whether a biological mechanism might support the theory. The frequency of breastfeeding was measured by asking the women how many times they had breastfed over the previous 24 hours. Milk samples were collected in the morning from ‘whichever breast was not nursed overnight’. Avoiding night feeds from one breast and sampling that milk in the morning removes one variable in breastmilk fat content: the fullness of the breast. The study did not report whether one-sided feeding through the night was normal for these women, or whether they had 16 | Essence | The Australian Breastfeeding Association

been asked to feed in that way for the study, and there was no discussion of whether all women fulfilled this requirement. On average, the women reported feeding around 10 times per 24 hours. Women of lower socioeconomic status fed more frequently than women of higher status, but there was no difference between the frequencies of feeding male or female infants. The average measured milk fat content was 23 grams per litre. This is low, probably because the samples in this study were collected from full breasts. The average breastmilk fat content over 24 hours would be higher. The results supported the parental investment theory. ‘Economically sufficient’ women produced milk with higher fat content for sons than for daughters, while poor women produced milk with a higher fat content for their daughters than their sons. This study does not support the idea that mothers’ behavioural choices preferentially invest in children who improve the mother’s chance of passing on genes, but does provide some evidence that biological factors may have that result. July 2013

Photo courtesy of Rachel Richter

Breastfeeding as a parental investment


by Georgina Scambler

mother to mother

Working and parenting There is nothing as grounding, as validating or as precious, as when my child latches onto my breast after a long day and looks into my eyes, drawing nourishment from my body.

Helen Shearing’s daughter Emma

There might not be many of us back at work full-time 2 weeks after giving birth like Yahoo CEO Marissa Mayer, but figuring out the right time to return to work is a conundrum that most modern mothers (and fathers) share. This topic is very timely for me as I have just finished my university degree and am now re-entering the workforce after 4 years at home with my kids. Now it’s not only salary and job satisfaction to consider, but proximity to and cost of child care, flexible hours, and how pressure at work could influence my parenting and vice versa. I have enjoyed learning from our readers on how they are juggling motherhood and a range of careers. Georgina Scambler

Making it work in a mining town As a professional in the mining industry, our house came with my job, so keeping a roof over our heads meant returning to work after maternity leave. My managers were fantastic. We met several times before I returned to work and they kept me involved in changes on site during my maternity leave, so it was easy to slot back in. We worked out a progressive return to work plan that enabled all of us to adjust to the changes, combining some work from home and some site work and progressing to full on-site time after 3 weeks. On-site, I expressed 3 to 4 times per day in an office. Everyone on-site was supportive, with one (male) manager, on seeing me take my expressing equipment July 2013

to the kitchen to wash, commenting that I was doing very important work and encouraging me to keep it up. When I changed jobs, my new site was equally supportive and I was able to continue expressing breaks as needed. Day care was the hardest issue I faced. Day care centres could not cope with my hours of work. Family day care was great with flexible hours, but the carers didn’t know how to deal with expressed breastmilk. I gave each day carer a copy of ABA’s booklet Breastfeeding: expressing and storing breastmilk and spent time discussing it with them. For many weeks, I cried in the car each day after leaving my baby in care. Supportive carers showed me photos of what she was doing each day,

so I knew she was happy, and that helped. By talking and planning with managers and day carers beforehand, my return to work was fantastic. I was able to continue breastfeeding my daughter until she was ready to finish when she was nearly 3 years old. Allison Hutton, QLD Correspondence Group QLD

Both parents take a turn at home My decision to return to work was a no-brainer — my husband hated his job, while I quite liked mine, so we agreed that when our first son was 3 months old, I would return to work full-time, and he continued page 18 >

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mother to mother would stay home with the baby. Although it was difficult to leave my son at such a young age, I believed that my husband had just as much right to spend that precious bonding time with him and as long as the expressing and bottle-feeding worked out, I was happy with our plan. I started expressing and storing milk after our baby was a month old, so by the time I returned to work I had a freezer full of expressed breastmilk ready for use. A few weeks in and it seemed to be going well, though I was alarmed at how quickly my hungry boy was chugging through the freezer stock and worried I wouldn’t be able to keep up with demand. Then fate played its hand — my husband was called up to join the police. A lifelong aspiration, he had applied for this a few months before our son was born, but we’d heard it could take over a year. My employers were amazingly supportive and accommodating, setting me up to be able to work from home and allowing me flexibility on my one day a week in the office. I think because I had been loyal to them by returning so soon, they were (and still are) happy to retain me as an employee in whatever capacity I could manage. I am now on my second period of parental leave and will be happy to return to work again, knowing that I’ve juggled it once, I can do it again! Sulli Foster, Kalamunda Group WA

Breastfeeding is precious after hard days at work At 32, with two doctorates, a professional career, a fabulous husband and two beautiful sons, it may seem like I ‘have it all’. As the daughter of an NMAA counsellor, I was determined to breastfeed my babies and managed to do it, returning to work part-time at 6 months, establishing a lactation room to express at work, and breastfeeding my first son until I was pregnant (at 16 months). I am currently feeding my second (at 18 months). So, do I have it all? It didn’t feel like it when I conducted meetings through the pain of engorgement, or when I got mastitis after an overnight work trip. It didn’t feel like it when I missed my son’s first steps at day care, or when dinner was sometimes melted cheese on toast. But there is nothing as grounding, as validating or as precious, as when my son latches onto my breast after a long

continued

Zoe breastfeeding in her PhD academic robes

day and looks into my eyes, drawing nourishment from my body. With a lifestyle that stretches the term ‘work-life balance’ and leaves little time for me, continuing to breastfeed is something I did not compromise on — and I would not change a thing. Zoe Spiers, Camden-Wollondilly Group NSW

Shift work poses extra challenges I was lucky to have 18 months off after the birth of my son before returning to work. Overall it was easier than expected, but the lead up to it was full of stress and worry. Aneirin was still breastfeeding many times a day, both day and night, and only eating a small amount of food. I’m an ambulance dispatcher. My shifts are 12 hours long and include days and nights, so I was worried about how we would both cope. I debated whether to night wean or restrict feeds but in the end went with the flow, fed on demand when with him and he went without when I was at work. Thankfully I had some fantastic support. My partner Andy had much easier nights with him than I did, when the boobs weren’t on offer he was fine without them.

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He still breastfed on the nights I was home but had no problems when I wasn’t. My mum looks after him during my day shifts. I was able to start with one short shift a week for a few weeks and now I job share. My manager was understanding and arranged space for me to express once a shift. There’s no way I could do the work I do and parent without support. Going back to work is hard with a young child, but I love my job, the money helps, and I enjoy having a couple of shifts not being Mum each week. Vicki Thomas, Swan-Mundaring Group WA

Something has to give I have four children aged between 1 and 6 and have just returned to work part-time. We don’t plan to have any more children so this time returning has been very bittersweet. I’ve found it more and more difficult to leave them at home. Work is ‘me’ time. It’s the one thing I enjoy doing that I do for myself. I’m a better parent, more patient with the children and when I get home, I focus more on their individual needs. My workplace is quite supportive of my need for flexible working arrangements and in the past, I’ve July 2013


by Georgina Scambler

been able to take time to express milk up to twice a day for several months. I have also been able to collect my children from school, drop them home with the babysitter and then return to work. I dislike the term ‘having it all’. To me it means being able to spend time and support my children the way I want to but at the same time having a fulfilling and dedicated career. These two things are mutually exclusive — something had to give and it was my career. I admire women who are dedicated to their careers and have chosen to have no children just as I

admire women who stay home and raise their children. I feel stuck between those two worlds — forced to combine them as best as I can. Ilinka, Burley-Griffin Group ACT/SNSW

Overcoming ‘mummy guilt’ Returning to work early was inevitable for me for financial reasons and I was also on a contract. I returned to work full time as a high school teacher when my daughter, Emma, was 11 weeks old. I had planned to express at work, so I had already sussed out a private room with a power point.

mother to mother in November 2013 Co-sleeping

My experience of returning to work has mostly been positive, although there is some mummy guilt, and some people have not been very accepting of me working full-time and my husband being the stay-at-home parent. My husband has been absolutely amazing as he has completely immersed himself into the role, takes care of most of the housework and supports me. I enjoy my job and find it very rewarding which has made the days go quicker. I am proud to be still breastfeeding. I put this down to Emma having an easy temperament. However, it has not been all smooth sailing. There have been days when I have expressed next to nothing and weeks when supply has been low and I almost considered giving her formula as well. There are also days I find it hard to fit in time to express but it is just something I have to do and I manage somehow. Even after a hectic day I have to put it aside as Emma is my priority and when I feed her for the last time each night she gives me a smile as if to say: ‘Thanks Mum’, which makes it all worthwhile. Helen Shearing, St George QLD

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mother to mother

July 2013

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readers' photos

Nichola Spooner (breastfeeding counsellor from Rockhampton-Capricorn Coast Group, QLD), and her daughter, breastfeeding anywhere anytime!

Gemma and Lucy Potter

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July 2013


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July 2013

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first time, every time

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talking point

by Jody Kolkka

Nipples:

how big is too big? Breasts, like people, come in many unique shapes and sizes. As do nipples … and babies. Combine large nipples and a baby with a very small mouth or gape and things can get tricky. But surely over time, our bodies would have evolved to eliminate such an obvious mismatch between mother and dependent infant? Not so, as we found out from the letters we received on this topic. Having large nipples can make for a painful and frustrating breastfeeding experience. It can also make no difference at all. But fortunately it’s a problem that many overcome and go on to enjoy a long and beautiful breastfeeding relationship with their baby. Jody Kolkka, Gold Coast Central Group QLD

Great attachment, painful feeds Breastfeeding my babies was absolutely excruciating for the first few weeks. Once I got home and my baby started feeding more strongly, the first few minutes of each feed were complete agony. Tears would run down my face. I would tense up so as not to crush my tiny little baby. I could not stop myself crying out, making feeding in social situations impossible. But I had no damage to my nipples and the baby was attaching perfectly according to the lactation consultants we saw. The problem — I have large nipples and my baby’s mouth simply wasn’t big enough. There was absolutely nothing I could do. I tried nipple shields but they didn’t fit well and my baby didn’t like them. The only solution was to ‘grin and bear it’ until the baby got bigger. The pain has a disastrous effect on supply. Expressing can be almost as painful as my nipples only just fit in the pump. I wanted to let people know about this as a potential reason for painful feeding, because everyone tells you that if it hurts, the baby is not attaching correctly, which is frustrating. But for some people breastfeeding really does hurt, not much can be done about it, but it does get better. After a few weeks the baby gets bigger, the pain recedes and breastfeeding becomes the simple and beautiful experience that all mothers hope

Michelle Baird feeding daughter Scarlett (pain free) at a local café.

for. It was undoubtedly worth bearing with the pain for a few weeks, but the first time I was on the very cusp of giving up. Second time I knew what to expect, and had a much larger baby, but even then I still struggled for several weeks and contemplated quitting. I hope sharing my story might help anyone grappling with the same issue. Katie Mackenzie, Wynnum Group QLD

Support makes the difference Having my third child, I thought the least of my worries was going to be breastfeeding. I had managed to breastfeed my first for 2 years and my second for 3. It had been a while (my youngest was now 9) but I wasn’t prepared for trouble. From the moment she was born, my baby girl couldn’t or wouldn’t open her mouth enough to attach to my large nipples. Trying to attach her was time consuming and very painful. I ended up expressing for 48 hours to try to heal my badly injured nipples. Once I returned her to the breast, things improved slightly but not enough. I was in agony at every feed. One evening, in tears of pain and frustration, unable to get the baby to attach, I once again returned to expressing. It was such a horrible time of out of control emotions, pain, fatigue and fear. I was grieving the

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possibility that I would miss out on the beautiful breastfeeding relationship that I had with my other children but I stuck it out and I got the help I needed. I got the greatest support from my awesome husband who was at my side at every feed doing anything and everything to help. I learned that I needed to shape the breast and keep it shaped for the duration of the feed. I also had to support the baby’s head to prevent her slipping during the feed. I learned to be quick and hold her closer to make the most of her fleeting and tiny mouth openings and I waited for her to grow bigger — a sure fix to the problem. I’m so grateful to say that I made it through. By the time she was 3 weeks, she was permanently back to the breast. Michelle Baird, Townsville QLD

Large nipples, tiny mouth I hadn’t given my nipples any consideration when thinking about breastfeeding. A nipple is just like any other nipple, right? I thought my big breasts might be a bit of an issue but not the pink bits on the end! So my firstborn arrived and I’m trying to establish breastfeeding when the midwife casually says, ‘Well, you’ve got large flat nipples and he’s got a tiny mouth’, combined with a weak suck and gape due to what was later diagnosed as a torticollis (twisted July 2013


Commentaries: byMouth sizetalking v nipplepoint size Jody Kolkka Lisa Scott, Rockhampton-Capricorn Coast Group QLD

neck). So to cut a long story short, my son never actually latched on but I exclusively expressed for 6 months, which entailed getting the largest breast pump shields which were still slightly too small for one of my nipples! My second child arrived with me much better informed and prepared (largely due to ABA; thanks so much for your resources and support) but we still had issues due to my large anatomy. Poor attachment early on led to swelling of the areola and I had to start expressing again and try a nipple shield. The largest nipple shields were too small! With the support of a lactation consultant we persevered through a few weeks of expressing and battling with the shields until my daughter was big enough to attempt a good latch. Fortunately she started with a bigger mouth than my son and we had success. So here we are 11 months on and she is still breastfeeding and every time is like the first time she fed without a shield, it is such a joy! Bec Schwerdfeger, Somerville-Balnarring Group VIC

Size doesn’t matter I have huge nipples and always thought I would struggle to breastfeed. Fortunately, after four children I can say I never had a problem (thank goodness!). I suppose it’s like women with really small breasts that worry they won’t have enough milk, but then have oodles of it. Size doesn’t always matter, ladies! Julie Peters, Riverton WA A link to the ‘reverse pressure softening’ technique can be found on the Australian Breastfeeding Association website in an article titled Engorgement. It is also discussed in detail in the Australian Breastfeeding Association booklet Breastfeeding: breast and nipple care, available from Mothers Direct. If you are using a Medela or Ameda pump to express your breastmilk, ABA’s retail subsidiary Mothers Direct has a range of flange sizes available so that you get the best fit. mothersdirect.com.au/catalogue/ breast-pump-accessories Staff at the Melbourne and Brisbane shops will be happy to talk to you about the best product for your needs mothersdirect.com.au/contactus

July 2013

Do big nipples really mean big problems?

Pregnancy, childbirth and breastfeeding can do some unexpected things to our bodies: strange cravings, shifts in body shape, leaky bits, bigger breasts and sometimes bigger nipples. If your nipples were on the larger side to begin with, then this last change could be a bit disconcerting. Having large nipples and trying to fit them into a small baby mouth can sometimes feel like trying to squish a large parcel into a small letterbox. In those exhilarating, draining, joyous and sleep-deprived first days and weeks with a new baby it’s easy to feel overwhelmed by seemingly insurmountable obstacles. In addition, large nipples can seem a lot bigger than they really are. If you’re feeling like it’s all a big problem, here are a few suggestions to help you keep calm and keep it in perspective. Good attachment is the key to any good breastfeeding relationship. Regardless of your nipple size, ensuring your baby is attached correctly will help you avoid problems. Babies breastfeed, they don’t nipple feed, so always ensure your baby has a good mouthful of areola when feeding. Sometimes big nipples, engorged breasts or a combination of both can make it difficult for a newborn to get that much-needed mouthful of areola. If so, then a technique known as ‘reverse pressure softening’ may help your baby get a good attachment. It’s best to lie on your back when doing this. Immediately before a feed, apply pressure on your areola close to your nipple and hold it for about 1 to 3 minutes. This technique usually triggers your let-down reflex too, which can quickly help to soothe a hungry baby. If, however, you are expressing breastmilk until your baby’s mouth grows big enough to accommodate your nipple, then take the time to select a pump that’s right for you. Using a breast pump flange that is too small can make expressing painful and potentially damage your nipple — and you really don’t want to add to your woes. In the fog of sleepless nights and breastfeeding challenges, remember that your breasts are designed to produce food for your baby and most problems, even large ones, can be solved with a little time and patience. A breastfeeding counsellor can help too, so seek advice if you’re finding things tough. Chances are, with a little perspective, those problems won’t seem so large after all!

Louise Brown BSc BDSc IBCLC, Dentist and Group Leader Ipswich Group QLD

Mouth size

No dentist could say any two mouths they see are the same, for many reasons. There are little, big and in-between! One could hypothesise, therefore, that the same applies to babies’ mouths. Genetics obviously plays a part in this and probably not much thought is given to it unless mum’s nipples seem to be mismatched, size-wise. Thankfully, though, babies do breastfeed and not nipple-feed and their little mouths do seem to grow pretty quickly. Breastfeeding also encourages optimal development of the mouth and may even prevent or minimise orthodontic anomalies occurring as the child grows.

talking point in November 2013 Childhood obesity Childhood obesity is a hot topic in mainstream and social media. There’s a myriad of ideas on why we have increasing numbers of overweight children in Australia, the complex causes and how and who should fix it. How does this important health issue and subsequent coverage affect you and your family, or the way you raise and feed your children? We’d like to hear your opinions on the subject of childhood obesity. Please send your letters (300 words or less) by 1 August 2013 to: Talking point, c/- Jody Kolkka, 18 Lorikeet Lane, Burleigh Waters, 4220 QLD or email: talkingpoint@breastfeeding.asn.au

The Australian Breastfeeding Association | Essence | 23


The University Sector The higher education sector has an almost 70% female workforce, one of the highest female participation rates of any industry in Australia. The Universities Australia strategy for 2011–2014 states that all universities have a commitment to fully utilising the skills and capabilities of all members of their workforce and to continue to address the challenges facing women who enter and contribute to higher education. One way some Australian Universities are meeting this commitment is by gaining Breastfeeding Friendly Workplace Accreditation (BFWA). The Breastfeeding Friendly Workplace (BFW) Program is proud of the Universities that currently hold, or are working towards, BFWA. There are six universities across Australia accredited and five working towards accreditation. However, with 39 universities across Australia there is still a long way to go.

The BFW accredited universities are: • Flinders University • La Trobe University • NSW Macquarie University • University of NSW • The University of Queensland • University of South Australia

The two most recently accredited universities, University of NSW (UNSW) and Macquarie University (NSW) sought accreditation to help them meet their obligations under the Sex Discrimination Act (1984).

University of New South Wales For many years, the UNSW has hosted BFW ‘Return to Work Seminars’ for their employees who were pregnant and employees on maternity leave. Positive feedback from participants such as ‘Really glad that this type of workshop is offered’; ‘Keep doing this’; ‘Really good information, I feel much more informed and confident’ confirmed the positive impact this had for the women. The next logical step was to seek accreditation. Penny Pitcairn, from UNSW Workplace Diversity noted: ‘UNSW currently provides best practice maternity leave and flexible working arrangements for our female employees. With very high return to work rates for staff who have taken maternity leave it is important that the workplace can support our female staff to combine breastfeeding and work’. Pitcairn goes on to say that whilst female staff at UNSW may be expressing breastmilk behind closed doors, the organisation and managers are increasing the awareness of the importance of breastfeeding and how easy it is to support their colleagues to combine breastfeeding and working at UNSW.

Karin Banner and her son Gil at a UNSW return to work seminar

Macquarie University Macquarie University’s Equity & Diversity Unit saw the university’s support for staff returning to work from parental leave, as well as students who are breastfeeding, as the main drivers for seeking accreditation. BFWA was also a public demonstration of the university’s commitment to equity and diversity. To meet accreditation standards the university upgraded four existing parenting/first aid rooms and implemented new Breastfeeding on Campus Guidelines for staff. Macquarie University employee Maria, could not be happier, ‘I was apprehensive having to return to work so early but have now successfully managed to breastfeed until 6 months and still going strong. If it were not for the expressing room, it wouldn’t have been possible. The rooms were always immaculately clean and the Australian Breastfeeding Association magazines kept me entertained while expressing. I welcome Macquarie’s move toward supporting nursing working mothers upon return to work’.

24 | Essence | The Australian Breastfeeding Association

Svetlana Martynovich, Equity & Diversity Officer, in the Macquarie University expressing room

July 2013


The University of Queensland The University of Queensland (UQ) was the first university in Australia to be named a Breastfeeding Friendly Workplace in August 2004. UQ is committed to embedding equity and diversity in its role as an employer and education provider. Accreditation is only one aspect of a complex range of programs the university has initiated to create an inclusive environment for its staff, students and the rest of the UQ community. Gaining accreditation proves that UQ employees will be supported if they return to work while they are still breastfeeding. UQ also recognises the value of the annual re-accreditation process as it enables the university to assess its performance in providing a breastfeeding-friendly workplace and ensures it can provide up-to-date guidance on room availability and also on UQ’s policies, guidelines and other resources for carers.

University of Queensland Breastfeeding Room

Becoming a Breastfeeding Friendly Workplace Universities typically have a large female workforce, but BFW Accreditation is for any industry and any size organisation. The accreditation process is adapted to suit each organisation, their individual structure and practices. The annual re-accreditation ensures that the needs of breastfeeding employees are kept on the agenda, that information is supplied to employees, and managers are kept up-to-date. The BFW Program offers three different information sessions for employees: 1 Return to Work Information for Breastfeeding Women 2 Return to Work Webinar for Breastfeeding Women 3 Managers and the Breastfeeding Employee Seminar.

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July 2013

BFWonlineSeminarAdvertVpp.indd 1

25/03/13 1:30 PM The Australian Breastfeeding Association | Essence | 25


mummy diaries

by Janet Murphy

Have baby, will travel So, you’ve got your new baby home and you are wondering if you will ever leave the house again? Well, apart from the sheer necessity of having to go out to buy food, attend appointments and see your friends, going out with your baby is good for your health, and that of your baby. The good news is that going out with your breastfed baby is also very easy! Breastmilk is the ultimate in convenience food — readily available, the right temperature and specially designed for your baby! In my early mothering days we spent many hours out and about — Thomas spent more time out in his pram (I was yet to discover the joys of baby-wearing) than he did anywhere else. Instead of being isolated at home, I much preferred to go out and take Tom for a walk down the street. We would visit Daddy at his work, go shopping and run errands. As we made our way up the street we had our favourite shops to visit where the shop keepers knew Thomas. One older lady I remember would say that my gorgeous baby was much too pretty to be a boy!

We would stop to breastfeed whenever we needed to — in a shop, at the park or café. No one ever challenged me about breastfeeding in public. These outings had many benefits for Tom and me — it got me out of the house and enabled me to make connections in my community. I got some exercise and taught Tom about being a social being (something that has stayed with him for his 17 years so far). I have always found exercise good for physical and mental health. Even on the coldest days, all rugged up in our coats, gloves, beanies and a blanket for Tom, we would enjoy a brisk walk, if only around the block. Often we would go farther though, meeting Daddy for lunch or, as Tom got older, going to the park for a run. When Jack was born, 19 months after Tom, my sisters purchased a toddler seat for our pram and so off the three of us would go! Once Tom turned 2, he would ride his bike when we went out. With the birth of Angus I discovered baby-wearing and used a ring sling to start with. By this time Tom and Jack were both accomplished walkers and

we would walk where we needed to go. The portability of my breastfed baby was a great advantage with two active preschoolers to care for as well! As our family grew to six children I have continued to breastfeed whenever and wherever necessary. In church, at weddings, funerals, in airports, on planes, on buses, at numerous football games, on bushwalks, at the Battle of Britain Memorial Service at the Australian War Memorial, ANZAC Day Services, in fact, anywhere at all! Breastfeeding is the biological norm for infant feeding and it is illegal for anyone to discriminate against a mother or child for breastfeeding wherever they are. It may take time for you to develop your confidence in breastfeeding and then to breastfeed outside your home, but I can promise you it will be worth it for you and your baby. If you wish to discuss any issue related to breastfeeding in public, or otherwise, please call the Breastfeeding Helpline on 1800 686 268 to speak to a qualified Breastfeeding Counsellor.

Breastfed babies are very portable Photo courtesy of Susan D'Arcy

26 | Essence | The Australian Breastfeeding Association

July 2013


by Judy Gifford

1979

looking back

Judy Gifford OAM, honorary member and breastfeeding counsellor, Erina Group NSW and founding member of Wagga Wagga Group NSW, looks back at the evolution of our Association (formerly the Nursing Mothers’ Association of Australia) as revealed in our member magazines. lookingback@breastfeeding.asn.au

This is a special year for me as it was the year I was elected to the national Board of Directors, where I served for 9 years. I am proud of the many achievements of that period.

Highlights of 1979 include: • The former Research Department changed its name to the NMAA Information Service and appealed for help to research topics, write articles and update files. Many people offered and following Newsletters included information written by these volunteers to explain aspects of breastfeeding. • This was the International Year of the Child and we were reminded that the key right of any child is to be breastfed. NMAA’s contribution was to launch an event we still celebrate in May — National Mothering Week. The theme for the week was Breastfeeding: Nature’s way of caring. The week had three aims — to promote the importance of breastfeeding; to encourage mothers to breastfeed by offering support; and thirdly to educate parents about breastfeeding and its part in developing warm and happy family relationships. • A mother was ‘evicted’ from a large Melbourne chain store for breastfeeding — nothing seems to change, does it? Soon after, the company made a public apology to the mother and stated its policy that ‘breastfed babies are welcome in any of their 15 stores where there is a public eating facility’. • From Singapore came a story that was making front-page news. NMAA had sent a Lacto-aid (a breastfeeding supplementer) to assist a mother to build her supply for her baby who was allergic to cows’ milk. Forty local mothers rallied to supply their milk for this baby. • There were lovely stories about mothers breastfeeding their premature babies with lots of support from the hospitals, many of which had our booklet Breastfeeding Your Premature Baby. Babies seemed to stay in hospital a lot longer then than they do these days. July 2013

• A Victorian member Helen Steadman won four gold medals at the Australian Veterans’ Athletics Championships in the 30–35 age group, while still breastfeeding an 18-month-old. Helen started training soon after his birth and was now running faster than she did as a teenager. • Work was beginning on the booklet, Working and breastfeeding that was first printed in 1982. It was very controversial at the time for mothers, especially those breastfeeding, to be in the paid workforce. • NMAA’s amazing growth continued. Members were joining at the rate of 150 a week and the number who had ever belonged to NMAA reached 40,000 in July. • It was a big challenge to train enough women as breastfeeding counsellors to help support these members. In 12 months, 280 women had qualified. • NMAA’s 15th birthday was celebrated by a dinner dance in Sydney with honoured guests Professor Derek LlewellynJones and Founder Mary Paton. At a celebration dinner in Melbourne, over 100 members shared memories of how NMAA had grown: the hard work to raise funds to buy the first duplicator; the difficulties sending out the first printed material; the emphasis on public relations where ‘every post had to be a winner’; the importance of word-ofmouth to gain new members. • A small group led by Leigh Wigglesworth launched NMAA’s songbook Merrily Merrily, after 3 years of hard work. • NMAA’s first film, Breastfeeding: What a beautiful thing to do was produced by the Rosanna Group VIC. The husband of one of the counsellors was a filmmaker and many hours were spent developing this unique film.

Judy Gifford, 1979

• There was the usual range of personal stories. One that took my eye was from a woman who worked on a cattle property. In part, she said: I often think how lucky cows really are. They calve much better if left alone. Any disturbance causes an increase in adrenaline, which inhibits labour. They are not parted from their calves immediately after birth. Any farmer knows the problems of calf rejection, which would result. No one would dream of giving the calf glucose or boiled water. The value of colostrum is widely recognised. The calf is able to feed when it wants with no worries about how long and how often. The words of Frances Fiddian, incoming president in March 1979, still resonate today: NMAA is now reaping the benefits of dedicated members. Known throughout Australia and overseas, we are respected as an organisation that supports mothers in the art of skilled and loving mothering. You, the members, are our best public relations contacts. Many mothers first hear about NMAA through personal contact. The warm mother-to-mother support we provide is our greatest strength at all levels.

The Australian Breastfeeding Association | Essence | 27


on the shelf

The Sensible Sleep Solution: a guide to sleep in your baby’s first year by Sarah Blunden and Angie Willcocks Wakefield Press 2012 ISBN 1862549478 RRP $25.50

months of life, night feeds are important in terms of the baby’s nutrition and to maintain the mother’s breastmilk supply. The authors admit that many parents may wish to look at trying to reduce night feeds sometime after their baby is 6 months old. They suggest that while there is no magic answer to achieve this they do offer tips that may be helpful such as reducing the time spent feeding by 2–5 minutes each night or offering a short cuddle instead of a breastfeed. They don’t say how successful these suggestions are likely to be. The title The Sensible Sleep Solution is slightly misleading in suggesting that there is one ‘sensible sleep solution’. What the book provides is detailed information about infant sleep cycles and habits during the first 12 months and advice on realistic expectations as to how long a baby might sleep and how often a baby might need to be fed at different stages during the first 12 months. The breakdown into different age groups is useful as it acknowledges that younger babies who are exclusively breastfed need to feed more frequently than older babies who are taking in solids. It acknowledges that breastmilk is more easily digested but doesn’t suggest using formula to encourage baby to sleep longer. A good read but don’t worry too much if your baby still wakes up at night — a lot do and that’s normal too! Reviewed by Caroline Munchenberg

ABA’s retail subsidiary Mothers Direct has a good range of sleep and settling books mothersdirect.com.au/catalogue/ sleep-settling All sales help provide information and support to mothers who want to breastfeed or express breastmilk for their babies.

STYLISH NURSING WEAR FOR BREASTFEEDING MUMS

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The Sensible Sleep Solution is written by two Australian psychologists — Sarah Blunden and Angie Willcocks. They wrote the book to meet the need for a sensible, middle-ofthe road approach to establishing healthy sleep habits in the first year of life. It is intended to support and give confidence to parents who don’t want leave their baby to cry in distress or to end up with the baby in the parental bed against their wishes. The authors acknowledge that parents of young babies may not be getting much sleep themselves and acknowledge that lack of sleep in parents may lead to depression, anxiety and stress. While Blunden and Willcocks do suggest having routines and rituals around sleep and include sample possible daily routines, these are very different from the strict feeding and sleeping schedules promoted by some sections of the market which often have the consequence of interrupting the establishment and maintenance of successful breastfeeding.

The authors are very clear that their ‘creating opportunities to self-soothe’ routines do not involve ‘controlled crying’; not only because controlled crying is distressing for the baby but also because the theory behind controlled crying (reward and learning theory) simply doesn’t make sense for human babies. Babies in the first months of life are too young to genuinely learn how to get to sleep and remember how, so in all likelihood it will be necessary to teach them to sleep again at a later stage. The authors stress the importance of the baby developing the self-soothing skills throughout their first year and show you how to help your baby learn these skills through ‘creating opportunities to self-soothe’ at each age. They offer an 11-step routine, outlining various settling techniques which help parents to calm baby and set up a peaceful, relaxed environment for sleep. The authors discuss sleep associations in some detail; dummies, thumb sucking, feeding to sleep, wrapping (swaddling), rocking, and music but they do suggest avoiding reliance on sleep associations that require a parent’s input — rocking or breastfeeding to sleep. The message is to avoid reliance on any one technique rather than necessarily having to avoid a particular technique completely. This approach will not suit all parents, particularly those practising a strong commitment to attachment parenting practices like co-sleeping, breastfeeding to sleep and baby-wearing. Other baby sleep books on the market, like those by William Sears, Pinky McKay or Elizabeth Pantley may better suit these families. The authors do have a positive attitude toward breastfeeding. The book acknowledges that while a baby is exclusively breastfed, during the first 6

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July 2013


on the shelf A

French Parents Don’t Give In 100 parenting tips from Paris By Pamela Druckerman Random House, 2013 ISBN 9780857521637 RRP $16.79 Some years ago I had my two daughters in inner city long day care. The homeward bound journey was most tiresome. A rush along inner city streets with a pram and a clinging toddler, a sprint through a crowded railway station concourse, a packed train ride and then an uphill walk home. I put it about that sharing this commute

July 2013

was precious mother and daughter time but really it was hell. I kept the peace by offering snacks every few metres. A French parent wouldn’t do that. Rules 27 and 28: ‘There’s just one snack a day’ and ‘Don’t solve a crisis with a cookie’. All that commuting with littlies was some time ago but I fear I am still falling at the food hurdle. Dinnertime finds our family serving a different menu for two of our children. They are normal healthy children and there are no medical or food intolerance requirements. Just fussy eaters and weak parents. Rule 26: ‘There are no children’s foods.’ My four teenage children groaned upon seeing me engrossed in a parent advice book. Rule 64: ‘Give children meaningful chores’ fell on deaf ears. Caca boudin! That translates as ‘poop sausage’ from Rule 65: ‘Everyone needs a swear word.’ I think I’ll be hearing that a lot … These 100 rules all seem so sensible, so easy and so adult. Are all the rules negative? Possibly, but let’s finish on Rule 96: ‘You’re not disciplining — you’re educating.’

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The Australian Breastfeeding Association | Essence | 29


association news Long time ABA members meet up

L–R: Judy Gifford OAM, Sue Cox AM IBCLC, both ABA honorary members, and Joy Heads OAM IBCLC and a former NMAA counsellor have been friends for more than 30 years because of their long involvement with the Nursing Mothers’ Association of Australia, now the Australian Breastfeeding Association. They met up in February at the annual convention of the Order of Australia Association. This photo was taken at a reception attended by 430 guests in the grounds of Yarralumla, the residence of the Governor General of Australia, Her Excellency Ms Quentin Bryce AC, who is the ABA Patron. The trio met her and were able to mention their connection with ABA.

Kingaroy Group QLD expands

Group Leader Priscilla Gash reports that since May 2012 the Kingaroy Group has been meeting weekly with wonderful results. The group has grown, with attendance reaching up to 18 mums some weeks! The Group has a Facebook page and attributes a lot of their success to the constant publicity that this brings. Lots of pregnant mums are coming along and subscribing before their babies are born. The group often meets at Priscilla’s mother’s home — Debbie Livingstone — who is a former ABA counsellor and a great help with setting up for the meeting and welcoming members into her home every Wednesday. The group would like to thank her for all her support and help.

Send Association News to: The editor, c/- 8 Normanby St, Indooroopilly QLD 4068 or essence@breastfeeding.asn.au

30 | Essence | The Australian Breastfeeding Association

Debbie Court honoured

Debbie Court, Essence Design Team Coordinator, has stepped down from the ABA Board in March after 9 years and 4 months of service (7 as honorary secretary). ABA and the Essence team would like to thank Debbie for all her hard work and commitment during her years on the Board. Her dedication, good sense and hard work have contributed enormously to ABA. Debbie will remain with the Essence Team where her design skills contribute greatly to a first rate magazine reaching us all six times a year.

Australian Breastfeeding Association Calendar 2013 14 June ‘Name our rose’ competition opens 1–7 August 2013 World Breastfeeding Week 1 September ‘Name our rose’ competition closes 26–27 October 2013 ABA Baby's Day Out 22 November 2013 2013 Annual General Meeting, 7 pm at the Treacy Centre, 126 The Avenue, Parkville, VIC 2014 February Book launch of the History of ABA in Melbourne Thursday, 13 February 2014 NMAA/ABA’s 50th birthday 1–3 August 2014 ABA National Conference Melbourne, ‘Liquid Gold’, celebrating ABA’s 50th anniversary. Advertising Disclaimer The Australian Breastfeeding Association (ABA) does not endorse all products that are advertised but aims to provide current information on products designed to support the breastfeeding mother, without discrimination or bias, to our wide variety of members. For further information on advertising guidelines email: marketing@breastfeeding.asn.au

July 2013


Queensland Branch hosts Virginia Thorley book launch

Above L–R: Lesley McBurney, Glenda Grove, Bev Kerr, Virginia Thorley, Helen Marsden, Linda Mabbutt, Judy Williams, Essence Editor Helen Jeffcoat, Judith John, Desley Hubner, QLD Branch President Elizabeth Oei Left: Virginia Thorley with her latest book

On 13 April the Brisbane Branch hosted a morning tea to celebrate the publication of The 10th Step and beyond: mother support for breastfeeding by Virginia Thorley. The Nursing Mothers’ Association of Australia first published Virginia’s ‘Successful Breastfeeding’ in 1977 and it was an all-out bestseller. Over the next 36 years Virginia, as a counsellor, lactation consultant, author and academic has contributed enormously to research into lactation and to helping mothers breastfeed. Many at the morning tea related touching stories of how Virginia had helped their groups in North Queensland and them personally to breastfeed their babies. There was a hotly contested competition at the tea as to who owned the most tattered copy of Successful Breastfeeding. It was a pleasure to see Desley Hubner behind the sales table and Lesley McBurney with the camera recording this event for ABA history.

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media watch

by Michelle McCarthy

HHMayim Bialik’s nursling

Mayim has announced that her little nursling Fred, aged 4, self-weaned this past Thanksgiving (2012). Bialik makes light of the criticism she faced nursing a toddler and balancing work by pointing out he won’t be breastfeeding as he walks down the wedding aisle or when he graduates high school. She lovingly and sincerely talks about Fred’s last breastfeed. ‘That day, he was distracted by his older brother shouting something, laughing, playing in the next room. His big blue eyes with the impossibly long tapered lashes darted around and settled on the next room, the source of the voice, his beloved older brother who himself had nursed for 2 years. The world beyond my breast was calling, and he hopped off of my lap and ran to the world waiting for him.’ (‘Mayim Bialik’s 4-year-old son is officially weaned’, http:// www.kveller.com/mayim-bialik/mayim-bialiks-4-year-old-son-isofficially-weaned/ 6 Feb 2013).

HHMarketing breaches put babies at risk

Photo courtesy Jen Shipston

are less likely to suffer from infections and disease. However, these benefits are still not outweighing the challenges of breastfeeding for the majority of mother-baby dyads. The data revealed that 92.3% of children aged 0–3 had received some breastmilk and in 2011–2012, 73.9% of children less than 4 months of age were still receiving breastmilk. The figure drops at 6–9 months to around half of babies still receiving some breastmilk (50.2%), and drops further to 29.7% of 9–12 month olds receiving some breastmilk. The second part of the report distinguishes between exclusive breastfeeding and breastfeeding. Exclusive breastfeeding means the child receives only breastmilk (including expressed milk) and no other fluids or food (with the exception of vitamins, minerals and medicines where necessary). The survey found that 57.8% of babies aged 2 months were exclusively breastfed while 38.6% of babies aged 4 months or more had been exclusively breastfed to at least 4 months of age. Exclusive breastfeeding to 6 months of age occurred in only 17.6% of children. With regard to the introduction of solids, the Australian Health Survey has found 22.6% were first introduced to solids by 4 months and 62.4% between 4 and 6 months. (4364.0.55.002: Australian Health Survey: Health Service Usage and Health Related Actions, 2011–12: Breastfeeding, Australian Bureau of Statistics abs. gov.au/ausstats/abs@.nsf/Lookup/6664B939E49FD9C1CA257B39000F 2E4B?opendocument 26 Mar 2013

New research exposes a list of global brands involved in questionable marketing practices around infant formula. The report by the Save the Children aid agency names: Nestlé, Danone, Mead Johnson, Abbott, Enfamil and Friso as promoting infant formula in ways that put babies and small children at risk in developing countries. The report estimates that 830,000 babies could be saved each year if they received colostrum within the first hour after birth. ‘When babies receive colostrum — the mother’s first milk — within an hour of birth, it kick-starts the child’s immune system, making them three times more likely to survive. Babies in developing countries breastfed for 6 months are up to 15 times less likely to die from diseases such as pneumonia and diarrhoea’, the report said. The inappropriate marketing of infant formula in conjunction with low education rates and a shortage of health workers in developing countries is to blame for the low breastfeeding rates. The report highlights the continued breaches of the World Health Organization International Code of Marketing of Breast Milk Substitutes citing, ‘one in five Pakistani health workers surveyed for the report said they received branded gifts from representatives of breastmilk substitute companies. In China, a quarter of mothers surveyed had received gifts from representatives of baby milk substitute companies or health workers and 40% had been given formula samples, often in hospital. [And] one recently terminated program run by a subsidiary of Danone in Indonesia under which midwives and other health workers were given cash gifts and free flights to Mecca in return for selling infant formula.’ (‘Newborns at risk from milk formula’, The Sydney Morning Herald National http://www.smh.com.au/national/health/newborns-at-riskfrom-milk-formula-20130217-2ela0.html 18 Feb 2013).

HHBreastfeeding in public

HHBenchmarks out of reach

(‘Mailbox’, Courier Mail QWeekend, 2–3 March 2013).

The Australian Health Survey undertaken from 2011–2013 has published its first media release pertaining to breastfeeding, making it clear that the recommendations for the duration of exclusive breastfeeding and the time at which solids are introduced are still not being met. The National Health and Medical Research Council (NHMRC) dietary guidelines recommend exclusive breastfeeding of infants until 6 months of age, with combined solid food and breastfeeding until 12 months of age, the report said. The release identifies specific benefits of breastfeeding for mothers, who are likely to recover more quickly from childbirth, and for babies, who 32 | Essence | The Australian Breastfeeding Association

The Courier Mail’s QWeekend magazine recently included a feature on 26-year-old Liana Webster, a mother who was asked to stop breastfeeding at a Bribie Island public swimming pool. An influx of letters to the editor followed, comments from which are included here: My message to the prudish, narrow-minded, immature and mean-spirited is ‘look the other way’. I breastfed three of my children but to see, as I have, a young mother flopping a breast out of a singlet to feed her baby in the middle of our local bakery I feel is not appropriate. A public swimming pool is for swimming; it is not for the consumption of food in any form. Perhaps it is the envy that spurs such criticism and contempt towards public breastfeeding.

Ed note: We would like to reassure our readers despite unfortunate incidents like this that you have the right to breastfeed in public and it is against the law to be asked not to do so or to move. For more information: breastfeeding.asn.au/bf-info/breastfeeding-and-law/legalright

Thank you to all contributors. Send your articles to: mediawatch@breastfeeding.asn.au or by mail to ABA Media Watch c/- Michelle McCarthy, 17 Wallangarra Road, Stanthorpe QLD 4308 July 2013


Behind the scenes at the ABA Breastfeeding Helpline By Jo Davey, Frankston Group VIC

It seems like my 2 year old is starting her training to volunteer on the ABA Breastfeeding Helpline. The other week I was doing the dishes and could hear my daughter Grace saying ‘boobie, baby and mummy’. After a few more exclamations, I looked around the doorway to see her sitting on the couch with my ABA booklets on cleft palates and expressing and storage that I had referred to when volunteering on the Breastfeeding Helpline the night before. Grace was pointing to the pictures of the ‘boobie, babies and mummies' in the latest Essence. Thanks ABA for normalising breastfeeding for my daughter!

For breastfeeding information, suggestions, empathy and reassurance call 1800 mum 2 mum, that’s 1800 686 268, to be connected to a breastfeeding counsellor. The Breastfeeding Helpline is supported by funding from the Australian Government under the Support Breastfeeding Mums initiative. Initial funding for the set up and trial of the Breastfeeding Helpline was provided by NSW Health.

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Grace Davey reads up!

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mum’s health matters Photo by Veronica Webster

Sleep — who needs it? Sleep, or more precisely, lack of it, can become an all-consuming concern when you have a baby or little one. Quality of sleep can directly affect the quality of a mum’s waking life, including her mental sharpness, productivity, emotional balance, creativity and physical vitality. Most adults need 7½ to 9 hours sleep a night to function at their best, which with a baby in the house can be very hard to achieve.

Why you feel so bad — the stages of sleep There are two main types of sleep — REM and non-REM. REM stands for Rapid Eye Movement and is sometimes also called ‘active sleep’ because it is when you are in an active dreaming state. Non-REM sleep is sometimes called ‘quiet sleep’. There are three stages of non-REM or quiet sleep — transition, light sleep and deep sleep. Transition — your eyes will be moving slowly under your eyelids, your muscle activity slows down and you are easily awakened. Light sleep — your eye movement stops, your heart rate slows and your body temperature decreases. Deep sleep — in this deepest stage of sleep, your brain waves are very slow. You will be difficult to awaken. Deep sleep is a time when the body repairs itself and replenishes energy.

sleep in each cycle though. For instance, most deep sleep occurs in the first half of the night and REM sleep becomes longer later in the night.

Babies sleep differently to adults The sleep cycles for babies are quite different to those of adults. A sleep cycle for the average baby is 30–50 minutes. Like adults, babies tend to wake briefly between sleep cycles. Adults spend about 50% of their total sleep time in light sleep, 20% in active sleep and 30% in the remaining stages, including deep sleep. This is very different to infants — at birth babies spend half their time in active sleep and by 3 years of age still spend a third of their time in active sleep. This means that biologically infants are programmed to sleep more lightly and have more awakenings than adults.

Tips for coping with sleep deprivation About 70–90 minutes after falling asleep you enter REM or active sleep where dreaming occurs. Just as deep sleep renews the body, REM sleep renews the mind. During REM sleep, your brain consolidates and processes the information you’ve learned during the day, forms neural connections that strengthen memory and replenishes its supply of neurotransmitters. Together, the stages of REM and non-REM sleep form a complete sleep cycle and for the typical adult that lasts about 90 minutes. It’s normal for adults to wake briefly between sleep cycles. You don’t spend the same amount of time in each stage of

Get your head down as soon as the little ones are asleep in the evening. As most deep sleep occurs in the first half of the night you might find it easier to cope with night waking later on. Go back to bed for an extra hour in the morning. Many babies will drift off again in the morning once they have had a feed. Use this time for an extra snooze (if you don’t have a toddler to get up to or the school run to do!). Nap during the day. A nap in the afternoon cannot be rated highly enough. Even if you can’t do it every day, try at least a couple of times a week to sleep when your little one sleeps during the day. Catch up on sleep on days when you have an extra pair of hands around. You and your partner might like to tag-team sleepins on the weekend. Or a friend or relative might take your baby out for a walk for a couple of hours so you can nap. If you can’t sleep, at least rest. Don’t stand if you can sit, don’t sit if you can lie down. Breastfeeding lying down once or twice during the day can allow you to rest too. Be kind to yourself. No-one can operate at 100% when they are sleep-deprived; cut back on non-essential tasks and try and take it easy as much as you can.

Fascinating facts Adult dolphins are able to go without sleep for a month at a time. This is very handy; as dolphin babies do not sleep at all in the first month of life!

Photo courtesy of Erika van den Dries

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Herbivores sleep less each day than carnivores. This is because they need more time awake to gather and consume food.

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inspirations

marketing@breastfeeding.asn.au

Inspirations is our column for innovative, useful ideas, products and services for mothers and babies. If it has inspired us, you’ll find it here! Genius meets style for winter Keep your baby bump warm during pregnancy. And once bub is born snuggle up together in this clever, new style maternity jacket. With an ingenious zip-in front panel, this cosy down-filled jacket easily accommodates your growing bump while you’re pregnant. Once baby is born simply turn the panel upside down and it acts as a head and neck support for your baby while wearing them in your carrier! mamaway.com.au

Elegant and versatile feeding top Look and feel fabulous this winter with the elegant and versatile Goddess bamboo drape top. The vertical front nursing access is concealed by a gorgeous drape that cascades from the scooped neckline and sweeps down to one side of the body. Available in dusky grey, olive (pictured), tigerlilly and black. milkandlove.com.au

Swaddle your baby in the healthy hip position Already well-known for its baby carriers which support baby in an ergonomic position, Ergobaby has applied this principle to its new Swaddler. It’s the only swaddler to feature a patent-pending Healthy Hip Positioner, which helps keep baby’s hips in the physician-recommended, ergonomically correct ‘frog-leg’ position. The design also features a unique ‘removable leg pouch’ for quick and easy nappy changes. babesinarms.com.au

Get all the right breastfeeding information Find out all the information you need with the Australian Breastfeeding Association (ABA) booklets! ABA publishes over 20 different titles on topics from breast and nipple care, increasing your supply and returning to work to more specialised topics like breastfeeding your baby with Down syndrome, a cleft palate or premature babies. Suitable for both parents and health professionals, booklets are just $5–$7 each from Mothers Direct. mothersdirect.com.au

submission guidelines All about submitting articles and photos to Essence… We are always looking for interesting articles, group news and letters to include in future issues of Essence — breastfeeding, pregnancy, birth, parenting, child health and family relationships, just to name a few! All submitted material will require proofreading and approval before inclusion in Essence. Our letter sections have always been very popular amongst our readers too. Due to limited space, we cannot promise that everything we receive will be used and letters may need to be edited heavily (the shorter the letter, the less editing required). So to help with this please limit your letters to 300 words or less. We try to use as many different letters as possible, so in advance, apologies if your letter does not make it into Essence. Please understand that letters cannot be replied to on an individual basis. If your photo is precious, please send a copy, or email/post a separate jpeg file (high quality please!). Photos or graphics pasted in a word document or email are not suitable. Photos that are clear, colourful and do not exceed 2MB are ideal. Digital photos need to be 200–300 dpi. If you are unsure about how to save or send a file, please email or phone Debbie Court (see inside cover). Looking forward to your interesting stories and beautiful photos! Helen Jeffcoat Essence Editor

November 2013 issue submissions are due: 1 August 2013 Letters, emails and photos to be sent to the topic subeditor (details follow each topic in this issue). All other submissions to be sent to: Helen Jeffcoat 8 Normanby Street, Indooroopilly, QLD, 4068 Email: essence@breastfeeding.asn.au Keep up to date with Association news, our products and associated services by logging on to:

www.breastfeeding.asn.au

Breastfeeding, parenting and special situation information series

36 | Essence | The Australian Breastfeeding Association

All members have their own individual login and password for the members-only section of our website — where you can access back issues of Essence and other great member-only resources. Instructions on how to obtain your individual login and password can be found at the members-only site: my.breastfeeding.asn.au/user/login or by contacting Head Office on 03 9885 0855, info@breastfeeding.asn.au.

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products and services

marketing@breastfeeding.asn.au

Natural Parenting Melbourne Playgroups gentle parenting for a sustainable world

playgroups in and around Melbourne

www.naturalparentingmelbourne.com.au Unsettled baby? Do you suspect it might be caused by some foods in your diet? Help is at hand. Joy Anderson is an experienced lactation consultant (IBCLC) and accredited practising dietitian (APD), who focuses on food intolerance and food allergy in breastfed babies. Skype, phone and email consultations available

Specialist Dietetics and Lactation Services sdals@bigpond.com

dieteticsandlactation.com.au

BORN TO BREASTFEED:

A Global Public Health Imperative •

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your group project catalogue today!

Many Australian Breastfeeding Association groups produce quality items for sale. Choose from a range of DVDs, posters, stationery, clothing, jewellery and parenting aids that support and promote breastfeeding. Support our local groups by purchasing from the group project catalogue available for download from our website. breastfeeding.asn.au/shop/groupprojects

International Lactation Consultant Association 2013 Conference & Annual Meeting

ILCA 2013

25-28 July, 2013

Download

Melbourne Convention & Exhibition Centre

An ILCA Conference offers something for everyone – novice to expert! Clinical Issues

Puzzlers, case studies, high risk infants and mothers, and postpartum care

IBCLC Practice

Ethics, counselling, private practice, cultural support, public health, milk banking, and teaching

Workshops

Research, counselling, small-group clinical skills, and more

38 | Essence | The Australian Breastfeeding Association

•

Melbourne, Australia

Featured Speakers: Nils Bergman, MBChB, MPH, MD Liz Brooks, JD, IBCLC, FILCA Howard Chilton, MBBS, MRCP (UK), DCH Patricia Martens, PhD, IBCLC, FILCA Professor Louise Newman, AM Professor Lisa Jackson Pulver, AM Linda J. Smith, MPH, IBCLC, FACCE, FILCA Howard L. Sobel, MD, MPH

Registration Is Now Open! www.ilca.org/2013ilca

Email: info@ilca.org • Phone: + 1 919 861 5577 Tollfree in US and Canada: + 1 888 ILCA IS U (452 2478)

www.ilca.org

July 2013


Celebrate World Breastfeeding Week with 20% off Cake Lingerie and Hotmilk nursing bras (1 to 7 August) Need your maternity bras professionally fitted? Fitters from Hotmilk and Cake Lingerie will be here to help! Visit our Melbourne or Brisbane store on Friday 02/08 or Saturday 03/08 For Melbourne call: (03) 9805 5501 For Brisbane call: (07) 3847 5187 Bookings are essential.

The retail subsidiary of the Australian Breastfeeding Association (ABA), is your one stop shop for breastfeeding, expressing and early parenting products. Our wide range and trained staff mean you are shopping with the experts who truly care.

www.mothersdirect.com.au Melbourne Store 1818-1822 Malvern Rd, East Malvern 3145 Open Mon-Fri 9am-5pm, Sat 11am-3pm Ph 03 9805 5501

Brisbane Store 2A/26 Eva St, Coorparoo 4151 Open Mon-Fri 9am-5pm, Sat 10am-3.30pm Ph 07 3847 5187

*Conditions apply, see website for details.

Phone Free call 1800 032 926 (Mon-Fri 9am-5pm EST) Email orders@mothersdirect.com.au Fax 03 9886 9033


Helping you take the next step Your little one is growing up! The Australian Breastfeeding Association (ABA) can help make these next steps into parenthood easier. Continue your ABA membership and you can:

Stay informed

Continue to receive Essence magazine and regular eNewsletters so you can get the most up-to-date information on both breastfeeding and many aspects of parenting your toddler or older child.

Save money

Easily save your continued investment in ABA membership plus hundreds of dollars more with members-only My Savings. My Savings provides discounts from 5–75% on your everyday and special occasion shopping. My Savings allows you to easily save back your membership investment. As well, you will continue to save 10% on purchases from our retailer, Mothers Direct.

Stay connected

The mysteries of toddlerhood and beyond are now unfolding for you. The friendship and support from your ABA group and our friendly, volunteer counsellors can help you with tackling these new stages of parenting.

Help others

ABA is funded primarily by membership. Renewing your membership allows us to continue to provide our services to all those in the community.

Renew your membership now easily and quickly www.breastfeeding.asn.au/membership 03 9885 0855


Essence - July 2013  

Baby-led attachment Working and parenting A dad's perspective on breastfeeding Champion weightlifting and breastfeeding

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