Thursday, February 24, 2011

NEWS! Dou-la-la: Future IBCLC

Just got word yesterday that I've been accepted into Birthingway's brand-spanking-new lactation program, a 2 year degree that includes enough credits and clinical hours to be eligible to sit for the daunting IBCLE (the certifying exam for all IBCLCs).


I am so excited, and nervous, and a little worried about balancing it with my new life, but mostly? STOKED. I still plan on eventually pursuing midwifery, likely through the same school, but in order to meet my daughter's needs, I think that this will be better suited to our lives once she is older. I'm thinking that won't be for at least 5 years, bare minimum. Probably more like 10. And in the meantime, I'll be able to work in a field I'm equally passionate about - doing doula work along the way!

Wish me luck! And lots of financial aid . . .

Thursday, February 17, 2011

Nursing in Captivity: On Bethenny, Gorillas, and Why It Really Does Take a Village

Photo of lactation consultant in the wild?

Another day, another internet kerfuffle about nursing in public, semi-fondly abbreviated as NIP. Just this morning, a friend of mine was quite rudely told to relocate to the bathroom at a YMCA, despite living in a state where the law is very clear on supporting breastfeeding anywhere the mother already has the right to be.

I was asked to go to the bathroom or locker room to breastfeed, and not nicely. To clarify, there was NOTHING obscene about it either, because I had a blanket covering myself. I even asked the guy if I had a right to be there and if so, then I have the right to breastfeed my child there. To which he replied, "I don't care."
And many of you have no doubt heard about Bethenny Frankel and Rachael Ray dissing "public breastfeeding" (which is in itself a bit of a problematic term, just like 'extended' breastfeeding; both imply a deviation from the norm by virtue of the modifier) a few days ago. Best for Babes reported on the exchange and transcribed this:
Shea: “I’m expecting my second child and strongly thinking of breastfeeding. What are your rules for public breastfeeding, like where is it appropriate?”
Bethenny: “I think, unless you are Pamela Anderson, you shouldn’t be showing anyone your breasts besides your husband and your baby.”
Rachael Ray: “Exactly.”
Bethenny: “I really do. I think you should find a corner, or there is always a back room, I just think it makes other people uncomfortable. When you are a mother you think everyone is ‘in on’ what you’re ‘in on’, [. . .] but they’re not. Because I didn’t know anything about [breastfeeding] until I was pregnant and I was sensitive to the fact that it would have flipped me out. So I think, just keep it private. But definitely breastfeed and do things your own way, but in that one way, I would keep it a little bit private. Whipping out your boob at the dinner table is a good diet tip for everyone else.
So let me make sure I'm clear on this . . . it's okay to show your breasts in public as long as they are of Pamela Anderson quality, but if they're substandard, you should refrain from risking even exposing a tiny square inch of skin to use them for their primary biological purpose? Having a tough time wrapping my head around the logic. I certainly do think breasts can be appreciated aesthetically as part of the female form, but to render them shameful and even nauseating (thanks for the diet tip) in any other context is just ridiculous. As an aside, I wonder what Pamela Anderson herself thinks of this? She's known to have nursed both her boys.

But here's the greater point: I sometimes wonder if the reason this issue is so important is understood by those outside of our inner lactivist circles, which, let's face it, just like any other circles, can become a little echo-chamber-y. I worry specifically when clogging up my Facebook feed with the latest insult to nursing mothers, wondering if I'm annoying that random 8th grade friend I reconnected with. Is she in a similar camp? What was her experience like? Does she just think I'm a rabid, intolerant member of the Breastapo? Why is this all so important?

The issue of nursing in public is not just a matter of supporting the rights of individual mothers and their babies, though this is also vital. The issue of nursing in public is important because nursing in public is important. In itself, it is important. Why? Because to normalize breastfeeding, truly normalize it, we need to SEE IT. All of us. We need to see it as kids, we need to know that's where most babies get their milk, we need to grow up watching our mothers and others mothers and then our friends and sisters and neighbors.

It sounds overly simple. Certainly there is more to it than that, but it is a vital component of the societal change that needs to happen. How's this for timing? An interview with James Akre, author of The Problem with Breastfeeding, that came out last week says it all, and then some:

Q. Can you explain what you mean when you say that it’s not really mothers who breastfeed after all?

A. Essentially, what I’m saying is that it’s not just women who breastfeed, but entire cultures and societies that do – or variously don’t. In other words, cultures and societies as a whole are responsible for producing and sustaining the complex value system that results in more or less breastfeeding by the mothers and children in their midst.

I base this observation on a single universal constant across time and geography: With only the rarest of exceptions, all mothers love their children and want what is best for them. And translating this love into “best” feeding behavior is invariably a culturally determined value. Thus, our best hope of seeing more mothers and children breastfeeding longer lies in transforming the society in which they are born, reared, come of age, beget, birth and nurture.

We often talk about the role choice plays in our lives, which is understandable given how fond we are of describing our behavior in terms of rational decision-making. But where child-feeding mode is concerned – to breastfeed or not – do we “choose” whether to breastfeed based on carefully worked out criteria? In the main, I think not. We respond the way we have learned to respond, which is why I insist that if we want to change a society’s predominant artificial-feeding mode we need to change society in all its structural complexity and not just focus on one or two contributing factors in isolation.
I'm applauding everything here, but I especially appreciate his point in the last paragraph regarding choice. If you read this blog, you're likely a consumer of other social media as well, and of social media that addresses this topic, so you've seen it. You've been there. An article or incident involving nursing in public (or another breastfeeding issue) is brought up, and if enough people are involved, more often than not, the conversation slowly winds around into women talking about their choices, defending them, or explaining them, or talking about how they feel attacked for them. I think that while individual choice is ALWAYS part of the equation, and absolutely always needs to be respected, we sometimes lose sight of the greater context.

So when it comes to nursing in public, when we advocate for it, it's not about trying to force our own standards of modesty onto other individuals for the sake of winning an argument or feeling like a superior mother. It has everything to do with normalizing breastfeeding, helping to return it to its status as the societal as well as the biological norm.

Now, all my pontificating might very well feel like an awful lot of pressure for those individual mothers, and let's be realistic, for all my talk of the collective, we still experience our lives as individuals. A young mother who's just learning to breastfeed and doesn't feel comfortable breastfeeding in public (perhaps the word "yet" can be applied, perhaps not) shouldn't feel guilty for wanting to nurse in more privacy, whether that means using a nursing cover or going to a more secluded spot. But the more common it becomes, the less likely it is she will feel uncomfortable in the first place, and moreover, the more likely it is that she will be able to troubleshoot some basic breastfeeding difficulties should she encounter them. We NEED to see breastfeeding.

Sometimes the sentiment is expressed: "But if breastfeeding is so natural and normal, shouldn't it come naturally?" Some things that are natural and normal also require a degree of learning, most importantly, modeling. Consider the case of the gorilla who had difficulty nursing her first baby.

I first learned of this story when doing my postpartum doula workshop with DONA, but it's also cited in "So That's What They're For". In a nutshell, a gorilla raised in captivity got pregnant without ever being around other mother gorillas and their young. When her baby was born, she just plain didn't know what to do - would hold the baby close to her breast but facing the wrong way, and so forth. The zookeepers eventually had to intervene and artificially feed the baby.

When she became pregnant again, someone had an anthropologically intriguing idea. The zoo contacted the local chapter of La Leche League and had some members start going to the zoo with their babies, feeding them in front of the gestating gorilla so she could see how fellow primates did it. And when her baby was born, she ultimately was able to nurse. Even when she stumbled a bit at first, the LLL taught her by example, and she prevailed. It wasn't by convincing her with studies on the benefits of gorilla milk. It wasn't through guilt or judgement. It was just by example.

If we are ever able to restore breastfeeding as the norm, what of the mothers who, as we often repeat but sometimes are not heard, truly cannot breastfeed? I know it's a sensitive matter, and feel strongly about two points on that: First, if breastfeeding is the norm, then obtaining donor milk or a wet nurse would not be prohibitively difficult or expensive, at least not more so than formula feeding. And second, whether using donor milk or formula (because as rare as galactosemia is, it does exist), it would be understood that if a mother was not nursing, she had a good reason for it, and that mother would be treated with respect and compassion.

O fanciful utopia, I know. But let's keep reaching for it. Continuing with the uncanny timing, another article came out last week, a characteristically great piece from the Academy of Breastfeeding Medicine. Most of the content focuses on workplace support specifically, rather than public nursing, but the title could just as well apply here, too: It takes a society to breastfeed a child.
Only when breastfeeding is normal, when society allows space for this normal behaviour, when children are part of our society and when breastfeeding is part of our society, it is possible for the majority of women to fulfil their own breastfeeding goals.
Protecting nursing in public is not merely about preventing the violation of individual rights, it's about transforming society altogether. Somehow, we need get to a place where we stop treating breastfeeding like it is a special bonus rather than the ho-hum ordinary thing that it is, as Akre puts it; where we can drop the double-edged language of "benefits" and "best" feeding. And for the reasons I've discussed here, nursing openly is a part of that path. When we can finally drop the "public" and the "extended" from references to mothers feeding their children whenever they need, for as long as they need, and just call it breastfeeding, period, we may have finally made it.

Friday, February 11, 2011

Weekend Movie: Delayed Cord Clamping

Haven't featured a weekend movie in a while, but this is really worth watching. From the always thought-provoking Dr. Nicholas Fogelson of Academic OB/GYN: a great presentation on delayed (a.k.a. non-premature) cord clamping.

Here's part one; click through to YouTube for the subsequent parts (totaling 50 minutes - again, so worthwhile).

At least watch as far as the orangutan baby being born.

Tuesday, February 8, 2011

Dou-la-la arrives in Shangri-La: It's OUR vagina!

Oh, hai! Did I not mention that I'd be heading into some pockets of radio silence as I embarked upon a massive move across the country to start life anew as a single mom with my soon-to-be three year old? It must have slipped my mind. Well, belatedly, it's true, though the biggest chores (packing, storing, and driving thousands of miles with the blizzardy cold weather nipping at our heels all the way) are completed. I'll still be settling in for a while.

But here I am, the promised land, Eden, Valhalla, Nirvana. Where else for a birth nerd but PORTLAND, OREGON? The home of Birthingway College of Midwifery. Land of a thousand doulas. Where being TOPLESS at any time, in any place is protected by law, so nursing in public? The very definition of moot. Where every neighborhood has its own farmer's market and home birth midwifery practice. Where cloth diapers are so commonplace that some of the natural parenting stores (note the plural) sell them secondhand. Where the school choices are so bountiful they just plain make my head spin. Where the most glorious bookstore in the country features gluten-free offerings in their cafe. (Okay, that last one's not so on-topic, but you get the idea. The restaurants, the arts, the open space, the natural beauty and mild climate, I could go on and on until you want to throttle me with your envy.)

Where I am thrilled to be raising my daughter.

The country is getting a nice taste of the extreme quirkiness that is Portland through Portlandia, and that "Dream of the 90's" video promo from the show is getting a lot of play. Hilarious and true, but the following song really sums up the feeling of Portland for me.

It's not MY vagina, it's OUR vagina.

That's the mighty Storm Large, not me, but it's how I FEEL, man. Video filmed in and with residents of Portland, including the openly gay mayor in the nightclub scenes (he's the prominently featured, dapper, handsome fellow).