Basics of Breastfeeding Lactation consultants help babies benefit from nurturing, nourishment

April 06, 1993|By Linell Smith | Linell Smith,Staff Writer

In the exhilarating and often hazy moments after giving birth, many women find that suckling a newborn is more complicated than those Madonna and Child paintings would imply. Most new mothers and their babies need a little help with the basics of breastfeeding.

It's a service Marla Newmark is happy to provide. As director of the lactation center at Greater Baltimore Medical Center -- the hospital with highest delivery rate in the Baltimore area -- and as a mother who has breastfed her 11 living children, Mrs. Newmark brings lots of knowledge to the subject. She and another lactation consultant are available to help roughly 4,500 new mothers and babies with breastfeeding each year and to take their calls after they leave the hospital.

Almost three-quarters of the new mothers at GBMC show an interest in learning how to breastfeed while they are in the hospital, Mrs. Newmark says.

"Breastfeeding can be a lot of hard work at the beginning. Most babies have to be taught how to nurse -- and mothers too. Breastfeeding is a commitment, but so is having a child."

The American Academy of Pediatrics, which has advocated breastfeeding since the organization was founded in 1930, recommended specifically last year that babies be breastfed for the first six to 12 months of their lives. (The organization says iron-fortified formula is the only acceptable alternative.)

Breastfeeding trends in the United States have changed dramatically during the past 40 years: In 1955, 22 percent of new mothers breastfed their babie; 1979 saw a high of 60 percent of new mothers breastfeeding in the hospital.

During the 1980s, however, breastfeeding declined. In 1989, about 52 percent of new mothers learned how to breastfeed, according to studies by Ross Laboratories, makers of infant formula.

Lactation consultants have recently seen another rise in breastfeeding, which they attribute, in part, to the appearance of certified breastfeeding specialists offering new mothers information and instruction at hospitals.

Mostly female, many lactation consultants have worked as nurses; most have breastfed their own babies. Since 1985, the field has offered specialty certification in preventing, identifying and solving breastfeeding problems. To qualify for the examination, lactation consultants usually have either a bachelor's degree and 2,500 hours of clinical experience with nursing mothers and babies, or a two-year degree and 4,000 hours of experience.

During the past few years, lactation education programs have started at Johns Hopkins, University, Union Memorial, Franklin Square, Francis Scott Key, Mercy and Maryland General hospitals.

When Bernadine Geary started working with new mothers at University Hospital a little more than a year ago, less than 10 percent of the women showed interest in breastfeeding. Now 25 percent of the women with normal deliveries learn how to breastfeed. Ms. Geary attributes the increase directly to mother education.

At Johns Hopkins Hospital, more teen-age mothers and economically disadvantaged women have begun nursing, says lactation specialist Judy Vogelhut.

"I couldn't tell you how long they'll continue, I'm just delighted that they try. Any of the milk those babies get and any of that intense bonding is better than none at all.

"My definition of breastfeeding is: however much milk you provided for your baby for however long. It could be a week for one mother and a month for another and a year for a third, but all those babies were breastfed. I think to consider any length of time as an indicator is wrong because any breastfeeding is good for the child."

Specialists say part of women's reluctance to try breastfeeding comes from certain misconceptions. They say:

Breastfeeding does not hurt if the baby is correctly positioned.

Breastfeeding will not make breasts sag; pregnancy is responsible for any changes.

Breastfeeding will give the baby enough nourishment, "even though the breast doesn't come with ounce marks" says Ms. Vogelhut.

The biggest barrier to breastfeeding, however, is the lack of cultural support. Not only have many workplaces been slow to acknowledge the need for breastfeeding mothers to pump milk at work, but many people consider public breastfeeding to be indecent exposure: Florida recently became the first state to guarantee a woman's right to breastfeed her child in public.

"There has been a lot of harassment of breastfeeding women," says childbirth educator Carl Jones, author of "Breastfeeding Your Baby: A Guide for the Contemporary Family." "Public facilities have discouraged women from breastfeeding. To me, that's harassment to expect a woman to feed her infant in the place where other people defecate and urinate."

Marla Newmark recalls the time she was standing behind a new mother in an endless line at the supermarket checkout counter. When the infant began to whimper, the woman unobtrusively put her baby to her breast and it suckled contentedly.

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