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Friday, 18 January 2013

The problem with what Kochie said


If you live in Australia, you've probably seen the furore whizzing around social media in the past two days.

The Courier Mail, 16 January 2013 reports:
"A mother of three has been forced to leave a public pool in tears after staff insisted she stop breastfeeding her 11-month-old baby..."A staff member came up to me and told me I wasn't allowed to feed there, that I had to refrain from feeding out in the open,'' Ms Webster said."
Can you believe this is still happening? Right here in Australia, in 2013. For crying out loud!
"I said I was sure it was illegal to tell me to do that but she said it was a grey area...and had to insist I didn't feed there.''
"Grey area" my ... elbow. What that staff member did? Absolutely illegal in Australia.

Australian law states:
In Australian Federal Law breastfeeding is a right, not a privilege.
Under the federal Sex Discrimination Act 1984 it is illegal in Australia to discriminate against a person either directly or indirectly on the grounds of breastfeeding. Direct discrimination happens when a person treats someone less favourably than another person.
Yesterday morning, David 'Kochie' Koch, a presenter on Australia's leading breakfast television programme, Channel 7's Sunrise, had this to say following an interview with the mother in question:
Koch: "I think that's fair enough, to say, hey, can you be a bit discreeter, sorta go up on the grass or something like that..."
Co-presenter Samantha Armytage: "Really? ... I think if you want to breastfeed on the side of the pool you should be allowed."
Koch: "Well, no, not in high traffic areas, I know my daughters are really discreet and things like that, would go to a quieter area, that's a high traffic area on the side of the pool in the middle of summer on a hot day..."
Later that same program, Koch went on to say:
"Ladies I wonder whether she should have been more discreet. I totally agree with breastfeeding in public, but I think you've gotta be a bit classy about it, that feet on the edge of the pool, isn't discreet enough.... but I'm concerned for the safety if the baby wriggled and fell in the pool...I think there's a safety issue there... I think, theres, em, like, that's why you have mothers—or move back that's a high traffic area, I can understand how people were uncomfortable with it in such a high profile place."
Although he tried to backtrack and cover his words with a half-hearted attempt at safety concerns, clearly, his main point was that a breastfeeding woman should do so out of the public eye.

Social media is aflame with emotions and opinions from all sides of the fence. Overwhelmingly, most commenters are in support of breastfeeding mothers. But there are plenty that have taken Kochie's comments and run with them. And not in a good way for breastfeeding women the world over. There is always the negative minority, clinging to their almost clich├ęd ignorance in comment threads (for example here and here and here).

Here's the first problem with what Kochie said:

Stating that a woman needs to exercise discretion when breastfeeding confirms the misguided belief that breastfeeding is something that needs to be hidden.

Breastfeeding is breastfeeding. Nothing more, nothing less. Breastfeeding is simply a baby taking in nourishment and comfort from his or her mother.

However, to suggest a woman needs to be "discreet" about breastfeeding implies that breastfeeding is, somehow, a naturally exhibitionist act—it isn't. Breastfeeding only becomes explicit when someone else views it that way. And how does someone become offended by breastfeeding? By having an unnatural view of what breasts are actually for.

Despite what they'll tell you, those narrow-minded neanderthals who have a problem with the sight of a woman breastfeeding her baby don't have a problem with a bit of a flash of breast skin. Lets face it—breasts are everywhere.


The reason that those narrow-minded neanderthals get so uppity about the sight of a woman breastfeeding is because they believe the baby is committing an adult act. They cannot see breasts as anything other than sexual.

For far too long, there has remained a patriarchal assumption that a woman's body is, first and foremost, for the purposes of a man's sexual pleasure. Breasts are seen as sex objects before their primary mammalian function. So for a vocal few, the prospect of a baby sucking on a nipple causes all kinds of cognitive dissonance. 

In my opinion, the only time that breastfeeding stops being a naturally discreet act is when woman believe they should cover up—because then it's like a freaking neon sign pointing to something they are doing, that they are purposely covering up.

Oh-so-discreet!
The only way that breastfeeding will become as uncontroversial as it should be is by seeing it happening. Breastfeeding is not a big deal. A breastfeeding mother is not 'flopping' her boob out, or 'flashing', or trying to prove some kind of political point. She is simply feeding her child.

Here's the second problem with what Kochie said: 

A celebrity stating that a breastfeeding woman needs to be "discreet" enables the continued oppression-via-ignorance of breastfeeding women.

It doesn't matter how well-intentioned or benign Kochie's comments were in his own mind. Outwardly, what he said was critical of breastfeeding in public. His suggestions that a woman be "discreet" or "a bit classy" confirm the misguided viewpoint that breastfeeding should be hidden. So, for those with a problem seeing a breastfeeding dyad, it's a very slippery slope from Kochie's personal 'opinion' of: "I  totally agree with breastfeeding in public, BUT..." to this:

Or this:
Yes, because excreting bodily waste is totally the same as providing life-giving sustenance to a child.
I hope these people don't operate heavy machinery with that mindset.
You see my point? Kochie (and his supporters) can believe that what he said was mundane and respectful, but he's forgotten the reach of his opinion. As a prominent public figure, he has a responsibility for—and a very powerful ability to persuade—public opinion.

Implying that a woman needs to be respectful of others when breastfeeding her child is a little bit like victim blaming. The problem with someone's sensitivity to public breastfeeding does not lie with the breastfeeding mother — it lies with the person who finds it offensive. In those instances, that person has a right to exercise that thing that holds their head up, and look away. Or move. And then, get some therapy.

Breastfeeding rates in Australia are depressing enough without having prominent public figures, such as Kochie, adding to a mother's burden. Breastfeeding mothers face enough roadblocks without having to worry about what a few other narrow-minded neanderthals people might think.

Oh okay, Ryan, if you have to.
Support for breastfeeding must be unconditional. Caveating "support" with a "but" totally negates that support. Kochie, unless you acknowledge that you committed a rather large faux-pas, you will always be yet another roadblock in the true liberation of women.

To pump or not to pump? When is expressing really necessary?

This article was published in the Australian Breastfeeding Association's Essence Magazine, January 2012.

When you're expecting a new baby, it is easy to be overwhelmed by the abundance of baby products and information on the market. Almost every item is marketed as essential. It can be confusing to work out exactly what you are really going to need for your new baby.

I am often asked by expectant or new mothers about expressing milk for their baby ‘How do I express? What sort of pump do I need?’ Breast pumps and associated equipment are marketed alongside sippy cups and baby blankets — firmly entrenched it seems, within the ‘essentials’ category. The aim of all marketing is to create a sense of need in the consumer — even if the product is not really necessary(1).


So when is expressing breastmilk really necessary?

In some cases that answer is relatively simple; for example, if the mother will be away from her baby for any length of time and the baby will need to be fed her breastmilk by a caregiver during her absence — in instances such as returning to work or study. In other fairly common scenarios, a mother of a prematurely born infant may need to regularly express her breastmilk in order to establish her milk supply and supply her breastmilk for her baby to be fed in hospital. Some mothers find that a breast pump can help keep milk flowing to clear a blocked duct and pumps can be useful to help increase milk supply — but more often than not, the baby is perfectly equipped to manage those tasks.

So why are breast pumps so commonly available on the market? Does every breastfeeding mother need to purchase a pump and learn the art of expressing as part of her breastfeeding relationship? The answer is no! It is perfectly possible to breastfeed your baby throughout his childhood, right through to weaning, without ever even touching a breast pump.

It seems that a school of thought exists in our culture that expressing, or pumping, may be necessary to maintain a mother’s milk supply. This is usually advocated as part of a regimented breastfeeding schedule or routine. But if we look at how breastmilk is made and a mother’s milk supply is maintained, we can see that, provided the baby is given unrestricted access to the mother’s breast, expressing is not actually necessary.

Breasts contain three types of tissue. Firstly, there is fatty tissue, which determines the size and shape of the breast. Secondly, there is glandular tissue. This is where breastmilk is produced and, unlike fatty tissue which varies enormously from one woman to the next, most women have roughly the same amount of glandular tissue. And lastly there is connective tissue, holding it all together.

During pregnancy, glandular tissue grows and develops, preparing to provide nourishment for the baby. Once the baby is born and the placenta is out, the body is given the message — make milk!

As the baby suckles at the breast, nerves within the mother’s nipple are stimulated, causing hormones to be released into the bloodstream. One of these hormones, prolactin, stimulates glandular tissue into milk production. Another hormone, oxytocin, causes rhythmic contractions of the milk ducts within the breasts which causes milk to be pushed or released out of the nipple. This is known as the let-down or milk ejection reflex. The more often the let-down reflex is stimulated by a baby’s suckling and the more milk that is removed, the more milk will be produced. This is known as supply and demand — milk ‘supply’ regulates to equal the ‘demand’ for milk.

Just like breastfeeding your baby, expressing breastmilk is a learned skill, and something that takes time and patience to master. Additionally, it can take quite some time and a lot of practice for a mother’s body to become conditioned to ‘let down’ milk for a breast pump, as a pump is not nearly as effective at milking the breast as a human baby!

As a result, it is quite common when learning to express, or only expressing very occasionally, that mums are unable to express a lot of milk — or even any milk at all. This can often cause a mother to feel unnecessarily anxious or worried about her milk supply. A mother may also often assume that the fault must lie with her, or her breasts, rather than what is more likely faulty or potentially even harmful (if used incorrectly) equipment(2). Given how differently a breast pump works at the breast when compared to a human baby and how the let-down reflex works within the mother’s body, the amount of milk that can be expressed is not at all an accurate indication of the amount of milk that a mother can actually produce for her baby.

Even in instances such as the mother returning to regular work or study, expressing may not always be necessary. Perhaps the baby is old enough to have solids and water while she is away and can ‘catch up’ on her breastfeeds at home or when they are together. Alternatively, a mum may find that hand expressing yields a sufficient amount of milk to provide for her baby during her absence so a pump may not be needed.

In instances where expressing with a breast pump may be necessary, there is a wide range of pumps available. For short term, occasional expressing, many mums find that a manual, hand-powered pump works well. For longer-term, regular or frequent expressing, such as instances of returning to work while the baby is young, an electric pump would be recommended.

Whatever the case, chatting to an ABA breastfeeding counsellor will help you work out firstly if there is a need for expressing during your breastfeeding relationship. Secondly, she can also help you decide what may be right for you and for your baby.

References:
(1), (2). Thorley V 2011, The dilemma of breastmilk feeding. Breastfeeding Review 19(1): 5–7

Wednesday, 9 January 2013

Breastfeeding boundaries: Why it's okay to say 'no' to your toddler

Image source
Learning to breastfeed a newborn can feel like the most difficult task in the world. 

When you're sleep deprived, exhausted and aching or traumatised by birth with sore nipples, a crying baby and a world that erects breastfeeding hurdles in front of you faster than we can say, 'where's the Lansinoh?', breastfeeding can seem like an insurmountable task. Our far-less-than-optimal breastfeeding rates are illustration to that.

But once you get past the newborn bit, when you've grasped an understanding of supply and demand, why your baby needs to breastfeed around the clock and everything clicks into place, suddenly, you're off and running. Huzzah! Breastfeeding is easy!

And then the baby grows into a toddler. You battle the cultural roadblocks to term breastfeeding; you notice the baby that once nursed while curled in your arms now sprawls bodily across the couch.

Suddenly, you find yourself dealing with breastfeeding annoyances not encountered before. A two-year-old that insists on carrying out a dental exam whilst breastfeeding, fingers worming insistently into your mouth. Pinching, squeezing, scratching at your neck, throat, other breast. An eighteen-month-old who simply won't breastfeed without tweaking, twisting or pulling the other nipple. A three-year-old who wants to stand up and breastfeed, or roll around on the couch and breastfeed in a kind of unstoppable breastfeeding gymnastics. A toddler whose voracious appetite to nurse rivals that of any eager newborn, constantly demanding a 'boobie' every time Mama looks even sideways at a chair.

And when you try and gently put a stop to any of it, or even dare saying 'not right now' to the umpteenth breast request that morning, you're met with deafening, rage-filled tantrums.

Enough! You find yourself screaming inwardly. Just get off me!

Without a doubt, the most common complaint from a mother breastfeeding a toddler are those above. Pinching, wriggling, constant, constant boobing, and just not taking 'no' for an answer.

But the minute we bemoan our boobalicious toddler, all we tend to hear is 'why don't you just wean him'? Or, 'you wanted to breastfeed—now you'll never stop him.' (The kind of well-intentioned but completely misguided advice that you file alongside advice to bottle-feed or sleep-train when you were exhausted with the newborn.)

So you put up with it. And put up with it. Until one day, you never want to see that child ever again and you decide that breastfeeding is the single most horrendous thing you've ever done in your entire life. We worry that everything they warned us about as an infant has come true—did attending to our infant's every need really spoil this child?

While it's important to lovingly, promptly attend to all of an infant's needs (especially for breastfeeding or cuddles) to teach them that the world is a safe, loving place and that they are worthy of love and affection, a toddler needs to learn a new kind of compassionate worldly lesson: boundaries.

How can it be so hard to find a middle ground, where boundaries are respected, but breastfeeding can continue?

Firstly, let me begin by saying it's completely normal for a toddler to want to breastfeed all the time. Just as it's normal for a newborn, a toddler is going through immense physical and neurological growth. Toddlers are inherently driven to move, to explore, to experience and conquer new sensory and motor challenges, and breastfeeding provides comfort, normalcy, hugs, and nutrients to get through it. While their understanding of the world morphs and changes at a rapid rate around them, Mama's breast stays the same – warm, loving, comforting, relaxing. Who wouldn't want that to return to every five minutes?  (Conversely, it's also normal for a toddler to suddenly seem uninterested in breastfeeding for enormous chunks of the day, or even days at a time. Relax—this is normal, too, and will pass. But that's a topic for another blog post.)

But while it's important to respond promptly and gently to your newborn or infant's cues to breastfeed, it is equally important to respond to your toddler's cues with a new kind of gentle parenting – boundaries. As parenting author Pinky McKay says:
"Now is the time to guide and protect your toddler with a new kind of parenting that includes setting appropriate limits: just as absolute freedom is confusing... too many rules can make little ones feel so trapped that their only option is rebellion." (1)
Toddlers are driven to seek out boundaries, and to test what happens when they are pushed. Testing limits is the only way to ascertain what and where social limits are. How do they find these limits? By testing them. Humans are social animals, and our young are driven to fit with the herd—just as we are. They need to know how to behave, what is acceptable, and what isn't. So while we need to gently, firmly show them our boundaries, we also need to remember that flexibility and empathy are important, and remember that excessive rules, restrictions or punishments are unnecessary.

Moreover, toddlers are inherent narcissists. Empathy doesn't develop until somewhere around their fourth year, so they simply cannot understand why they cannot have everything they want, and right now. So whilst it is unrealistic to expect a toddler to comply unquestioningly with your request to stop tweaking your goddamn nipple, it is additionally unfair (on both of you!) to simply put up with it when you hate it so much you want to throw them across the room.

Welcome to the world of parenting a toddler, where the loving, firm assertion of boundaries is one of the most common things you will do all day. Over and over again. And often, to the ear-splitting tune of shrieks of rage.

It's okay to say no. It's important to say no. But do it gently, and with compassion.

Lets say you sit down to breastfeed your toddler:
  1. He goes to grapple with your other breast. Gently, you move his hand away, and say 'Hands off. I don't like that.'. 
  2. He goes for the breast again, more insistently. Gently, firmly, you take his hand away and say 'No. I don't like that.' 
  3. Perhaps he gets cross. Perhaps he fusses, or screams, or gets angry. 
  4. It is perfectly okay to sit with him through any outburst, to verbalise his feelings, but remain firm that the other breast is out of bounds. 
  5. He might scream and rage and tantrum for a few minutes, or maybe longer. Maybe a lot longer. Remember, he's learning to deal with overwhelming feelings, and strong emotions need an outlet. That's what you're there for—a safe space to let out his feelings. Even if you're the cause of those feelings! 
  6. Perhaps this happens many times a day (and night) for many days (and nights) until your toddler eventually gets the message: Mummy doesn't like me tweaking her other nipple. But he will get the message, eventually. I promise!
Or, lets say your toddler asks you for a breastfeed that you're just not in the mood to give. Here's the big difference between breastfeeding a newborn and breastfeeding a toddler—while a newborn simply cannot wait for mama's breast, a toddler can—despite the fact they'll act like they can't!
  1. Try and say 'yes'—but make it when you're ready. Perhaps, 'yes, when I've finished what I'm doing.' Or 'yes, before lunch.' Or 'yes, before bed tonight.'
  2. Repeat points 2 - 6 above.
Providing a safe, compassionate outlet for your toddlers big emotions, and providing comfort and security, teaches him the skills to manage and handle those big emotions as he grows. Just as you comforted your baby when he cried—now you comfort your toddler.

But this is so often easier said than done. Why is it so hard to say no?

Because more often than not, healthy boundaries were not modelled to us. What wasn't modelled to us as children (and what often isn't modelled to us as adults), can be darn hard to model to our own children.

I was raised by a classic martyr. My mother would give, and give, and give, and then snap and take away everything—and blame me for the fallout. Rather than saying 'no' when she'd had enough, she'd fear my big emotions and keep saying 'yes' until she just couldn't take it anymore. Then, it became my fault for pushing her too far. Of course, a child needs to understand that they've pushed someone too far, but we need to be careful with blame, or inducing shame. All I remember is being called 'naughty' or 'bad-tempered' or 'ruining everything' rather than hearing her say that she was uncomfortable with what I was doing.

Open, honest communication, owning our feelings, teaches children how to do so themselves. It shows them how to respect our own feelings enough to respect others, too.

It happens in adult relationships, too. We put up with things unnecessarily, we skirt around the real issues and we're passive aggressive instead of being open and honest.

When my first child was born, her needs absolutely floored me. I was so confronted by her constant need for me. But rather than feeling capable of taking brief moments of time to myself, my options seemed to be to become a slave to it, or disconnect altogether. Or worse.

This is why our personal boundaries are so important. They mark where our limits begin. And when our boundaries are pushed, or disrespected, we feel angry and resentful. So it's important for our health, for our relationships, to respect our boundaries – before we become so resentful and used-up that we snap altogether, and deny our toddlers their very real need for breastmilk and breast-comfort.

There really is no quick-fix 'way' to guide a toddler to respect our boundaries. It's inevitable that if we say 'not right now' to a breastfeed if we're not feeling like it, they might (or very likely will) have a tantrum. But try not to be discouraged by that. Try and see it as a learning opportunity—a parenting opportunity.

And remember to take some time for yourself, too. A tantrum over a breastfeed can feel incredibly confronting for a mother. Make sure your own cup is full—you need, and deserve, loving support from your partner, family, and friends. Make sure someone tells you what an awesome thing you are doing.

In fact, allow me to tell you—this thing you're doing? Awesome. You're doing a beautiful thing.


References:
(1) McKay, Pinky. 2008. Toddler Tactics. Pg. 59. Penguin Books.