Where Can You Turn if you
have Questions About Breastfeeding?
By Umm Zaynab
Breasfeeding questions have answers and breastfeeding
problems have solutions, almost none of which have to result in complete
termination of breastfeeding and very few of which should even result in partial
supplementation. Sadly, however, many mothers stop
breastfeeding or are forced to supplement simply because they (or their
healthcare providers) didn't know where to look for answers to their
questions. Here's a run-down of the places where you can look for answers
to your breastfeeding questions.
Books:
As La Leche League International is the world’s
best authority on breastfeeding, the La
Leche League Catalog is a good place to find
books and pamphlets that contain accurate breastfeeding information.
Purchasing books directly from La Leche League means that the profits
from the books are going to support the organization, however, even if you still
want to purchase your books from the local bookstore or check them out of your
local library, you can at least use the LLL Catalog as a source for good titles.
You may notice that several authors show up frequently in books published, distributed, or recommended by La Leche League. You can usually be sure that any books by the following authors will contain accurate breastfeeding information
In addition to books, La Leche League also offers a wide variety of small pamphlets on a variety of breastfeeding topics. Your local La Leche League Leader will usually have at least some of these pamphlets or they can be ordered through LLL directly.
Beware of breastfeeding materials that are formula-company sponsored! Although most of them do not contain outright false statements, they are typically full of half-truths, subtle degrading messages, and convenient omissions of information. If there is a pharmaceutical/formula company logo anywhere on the pamphlet you're reading (such as Nestle Carnation, Ross Pediatrics, or Abbott Labs) , it's best to seek another source of information to be absolutely sure you're getting accurate and complete information.
Websites:
There are many websites that deal with breastfeeding. Some deal with breastfeeding in general, others are more devoted to specific topcs. Please see our main breastfeeding page for additional links. The most famous and probably the best general breastfeeding sites include:
The La Leche League website includes an excellent FAQ which should be your first stop whenever you have a basic breastfeeding question. It also has a searchable index of articles from New Beginnings magazine and a search for local Leaders and Groups (see below).
Kelly's Attachment Parenting Page
Kellymom.com is another site with comprehensive breastfeeding information on every imaginable topic including "Why Nurse Past the First Year?" and handling criticism of your decision to breastfeed. It also has a number of excellent original articles by Dr. Jack Newman and Dr. Jack's breastfeeding handouts. There's also information on handling postpartum depression in a breastfeeding mother.
This website has a megalist of questions answered by lactation professionals, arranged in alphabetic order according to the first word of the question. It is kind of annoying since they usually start with "how...?" "why...?" or "my baby...?" and are not arranged topically, but the list covers a wide variety of topics. It also has lots of helpful goodies like a lactation consultant directory, breastfeeding myths articles by Dr. Jack Newman, breastfeeding and pumping video clips, message boards, and LOTS more.
This website includes FAQs on specific topics as well as many, many links to various general and specific breastfeeding sites. There are also stories of mothers who have breastfed successfully despite difficulties.
Although this is not a breastfeeding-specific site, you'll find accurate breastfeeding information here in the breastfeeding section.
Real Live people:
La Leche League International
La Leche League (LLL) is probably the most well-known organization in the world dedicated to free counseling and assistance for breastfeeding mothers. La Leche League is active in over 33 countries worldwide.
The information that follows is mainly for mothers in the USA and Canada. (In Francophone Canada La Leche League is called Allaitement.) If you live in Australia, the Australian Breastfeeding Association offers help similar to that of La Leche League and has been around almost as long.
Here's how La Leche League can help:
Please see our article "A Muslim Mother's Guide to La Leche League" for more information on La Leche League specifically for Muslim sisters.
Lactation Consultants
"Lactation Consultants" are increasingly available in hospitals and some are even contracted with pediatricians' offices. If you deliver your baby in a hospital, it is increasingly likely that you will be visited by a lactation consultant at least once or twice during your stay and some hospitals have programs where mothers can call or visit the lactation consultants for free for a specified period following the birth of their child.
An Intenational Board Certified Lactation Consultant (IBCLC) (or a Registered Lactation Consultant, aka RLC) is someone who has completed a certification program that includes a rigorous exam and thousands of hours of hands-on training and experience. An IBCLC is NOT to be confused with a self-styled "Lactation Consultant" who may have had little or no training at all. In some hospitals, "Lactation Consultant" or "LC" may refer to an IBCLC who is qualified to deal with the most complicated breastfeeding challenges, or it may simply be a nurse who took a one-day seminar in basic breastfeeding trivia. When in doubt, ask if you are dealing with an IBCLC or something else.
Almost all hospitals, midwives, and La Leche League Leaders can refer you to IBCLCs in your area. Breastfeeding.com also has an online lactation consultant search but remember that online searches are rarely comprehensive, and there may be one in your area even if one doesn't show up on the search.
When should you contact a lactation consultant? Ideally, La Leche League Leaders are your first choice when you have a breastfeeding question for two reasons: 1) La Leche League Leaders are free and 2) La Leche League Leaders can answer the usual, basic breastfeeding questions and help free up lactation consultants for more complicated problems. However, you will need to contact a lactation consultant anytime you need hands-on help, as the vast majority of La Leche League Leaders only do phone help and do not make home visits. You will also need to contact an IBCLC anytime you are dealing with complications of a premature or severely ill baby or a baby who is not latching on or breastfeeding at all.
Lactation consultants' fees vary, although they tend to charge office visit fees much like physicians do. Some will do phone helping for free much like La Leche League Leaders do.
Although many insurance plans say they do not cover the services of a lactation consultant, there are some who do. Many plans also have clauses in the policy stipulating that if there is a service you need that is not covered by the providers in the plan that you can follow a procedure to request that the insurance pay for that service. This may require having an in-network physician (such as your child's pediatrician) write a letter in support of the need for such services to be covered . This may be somewhat time-consuming and frustrating, but if you are financially challenged it is worth investigating. In some areas there are free clinics of lactation consultants that are open to anyone.
WIC (Women, Infants and Children)
In the United States, if you receive government assistance through the Women, Infants and Children program (WIC), you should know that local WIC offices often have breastfeeding counselors. Breastfeeding saves WIC money because it means they don't have to provide mothers with formula and because breastfed babies have lower medical costs because they are healthier. In some areas, WIC counselors have taken the La Leche League Breastfeeding Peer Counselor training program and are quite good, however WIC breastfeeding counselors are not immune from the ignorance of certain breastfeeding topics so be aware. WIC also sponsors a program called Fathers Supporting Breastfeeding to encourage African-American fathers to support the breastfeeding of their chidlren. WIC offices usually have referral information for your local La Leche League as well.
If you live outside the United States, many European countries include breastfeeding assistance in their government health programs as well. The same caveats apply. Some of the pamphlets we have read in government-sponsored breastfeeding programs from the UK for example, contain some incorrect information.
Other Muslim Mothers
It can be wonderful to get breastfeeding information and support from other sisters. Just keep in mind that other sisters may not always have the most accurate information about breastfeeding and when in doubt, it is best to compare another sister's advice with accurate breastfeeding materials. Please check our section on Muslim breastfeeding links in the main breastfeeding page.
What About Healthcare Providers, Anyway?
Unfortunately, not many healthcare providers (this includes nurses in the maternity floors of hospitals, pediatricians, OB/GYNs, and even many midwives) do not have the knowledge or experience necessary to help a mother with questions of breastfeeding management. As a result, many mothers are told by their healthcare providers to stop breastfeeding or to supplement breastfeeding with formula when such action is completely unnecessary, and are often advised about breastfeeding incorrectly. Certainly this is not true for all healthcare providers. There are some pediatricians, for example, who are knowledgeable about breastfeeding, however they are few and far between.
Probably the two most common situations in which mothers are often misadvised are:
When a mother has to take medication and is told by her healthcare provider that she must stop breastfeeding because the medication will harm her baby.
This is almost always untrue! Most healthcare providers are completely unaware of the numerous resources available for determining the safety of medications for use by breastfeeding mothers. These include:
The American Academy of Pediatrics maintains a list of medications and their use in breastfeeding mothers, including a long list of medications approved for breastfeeding mothers and contraindicated for breastfeeding mothers.
Dr. Thomas Hale is a "breastfeeding pharmacologist" who maintains a website, an online forum for physicians, and is the author of the biannual guide Medications and Mothers Milk which lists specific pharmacological details, including any applicable medical studies and chemical analyses regarding the use of most medications by breastfeeding mothers. New medications that come out after the publication of the book are listed on the website, which is constantly updated.
Most medications you are likely to be prescribed are in fact compatible with breastfeeding. In the event a medication is found to be problematic regarding breastfeeding there is often an alternative medication that can be tried or a dosing schedule that can be utilized that will not impact the nursing baby.
When the baby is not gaining "enough" weight, gaining "too much" weight, having problems with excessive gas, spitting up, fussiness, colic, exczema, green poop, infrequent poop, etc.
These are all issues in which breastfeeding itself is not to blame. Mainly they are instances in which the management of breastfeeding can be altered in order to change the situation. This includes changing the method or timing of feedings, the baby's latch-on and positioning at the breast, or possibly a change in the mother's diet. Often some these issues are completely unrelated to breastfeeding, but the provider tends to blame breastfeeding because they have misinformation or a prejudice about breastfeeding. Unfortuntely most health care providers are not trained in the diagnosis and management of these issues (breastfeeding management is NOT taught in medical school... yes, strange but true!!!) and they often recommend cessation of breastfeeding because they don't know what else to suggest.
Let me say something loud and clear-- despite the fact that there are some pediatricians who try to tell mothers so,
there is NO SUCH THING as a baby who is "allergic" to its mother's milk, PERIOD. There is also no such thing as a "lactose intolerant" baby.
Even galactosemia, a rare metabolic disorder in which a baby is born without the crucial enzyme necessary to break down lactose, the milk sugar, this disorder is so rare that there is some debate in the medical community as to whether or not it even exists. (Babies born with such a disease genuinely cannot be breastfed.) Many doctors commonly confuse "lactose intolerance" with "milk allergy" or "milk sensitivity". "Lactose intolerance" is an inability to break down lactose in cow's milk and typically does not develop until somewhere around age 4 or 5. "Milk allergy" or "milk sensitivity" in a breastfed baby is a sensitivity or allergy to the cow's milk proteins from the cow's milk products that a mother ingests which then pass into her milk. A dairy elimination diet on the part of the mother is the way to determine if this may be causing the baby's problems.
If you have a healthcare provider who tries to tell you that your milk is somehow not good for your baby or that your baby is "allergic" to your milk, they are wrong. Seek a second opinion. Mothers at La Leche League meetings or local midwives can often recommend to you a local healthcare provider who is supportive of breastfeeding. There is usually at least one in any given area.
If for some reason you are unable to change your healthcare provider and they are insisting that complete cessation of breastfeeding is necessary, contact a La Leche League Leader or an IBCLC for advice. Although LLLLs and IBCLCs are not healthcare professionals (except in the case of IBCLCs who are also doctors), they can provide you with information, often in the form of photocopied documents, from medical books and journals that you can take to your healthcare provider so that they can research and consider the issue further. Contrary to what Arab and Indo-Pakistani cultures seem to think these days, no doctor is perfect and no doctor knows everything there is to know about a particular subject and there should be no shame in encouraging a doctor to seek out sources of information in order to consider the possibility of continuing to breastfeed. A doctor who is truly concerned about you and your baby's well-being should never be hostile to the suggestion that they should do some more research on the issue before recommending a course of action as drastic as complete cessation of breastfeeding.
© 2004 Umm Zaynab