As a professional, I have often cringed at the "advice" women receive from online support groups. In the roles we have as doulas, educators, lactation helpers, etc., we strive to offer information versus advice -- our personal experience has little bearing or value on the help we give. 

This differs from groups where women convene for friendly, been-there/done-that stories of real-life. The information we offer as professionals is often an analysis of a woman's issue -- we are pointing the spotlight on one specific thing and how to improve a situation. Conversely, in a support group with peers, there is often a larger-scale picture presented. The ability to synthesize an issue -- to take all the pieces and plug them into life --  helps a woman see how things may actually work for her specific experience. The value of hearing what others have found helpful, ways they have creatively addressed solutions, and feeling the true, honest support from one who has been in that situation, is what makes these support groups not only effective, but also needed!

The next time you roll your eyes at a response, feeling you are an Avenger of Accurate Information whilst type, type, typing up a clarifying three-paragraphs of scientific rebuttal, remember: Women take both parts -- the evidence-based information, AND the emotionally engaging anecdotes of others -- to make their choices. Both sides offer insight and confidence when making difficult decisions, ultimately leaving a women stronger and more prepared for her future. 

I used to weigh myself weekly at the midwifery office in Chico, CA where I worked. I could pinpoint reasons I might weigh less or more. For example: fully dressed and Danskoed, I would weigh almost 5 pounds more -- my Danskos alone were about a pound! Despite what I could manipulate on my own, including drinking a ton of water, or peeing a ton of water, there was one other way my weight could change. This office had two scales. One was digital, and that's where I saw the precision of ounces. The other scale was the old, slide-over-the-doo-hickeys one -- you know, the tap-tap-tap-balance kind? The two scales rarely matched exactly, leaving a discrepancy of two-ish ounces lost somewhere in the hallway between bathrooms. 

This sweet little one was born at 35 weeks, 6 days, weighing 5 pounds, 13 ounces. His mom is a doula in Bakersfield, CA -- and a friend. Late preterm babies aren't new to her, but solely breastfeeding is. She has been so proud to nurse him, and even prouder to pump for him. He had to stay under the bili lights for jaundice treatment, and since his official discharge, he has been monitored by his doctor through repeat visits for weight and lab checks. 

From a Friday to a Monday, he gained 2.4 ounces, checked on the same scale. Great news for a baby at 7 days, who in there somewhere had lost 9% of his birthweight, right? (Mom also had 3 bags of IV fluids during labor.)

On Wednesday, he had only gained .5 of an ounce, and Mom was devastated. "Was it the same scale?" I asked. She replied: "Same office, different scale." I was surprised they didn't want to verify his weight with the other scale, and this mom didn't think to ask in her postpartum haze as her roller coaster dropped down...very fast.

The doctor asked, "Are you able to pump?" Mom responded with a hearty yes, she had almost 50 ounces in her freezer by now. The doctor then looked at her chart and said "Hmmm, let me go get you some formula. Give him an ounce to an ounce and a half after every feeding." The doctor sent this mother away with a bag filled with formula. 

We had more time, the mom and I, to troubleshoot. The first thing we looked at was his output, and he was having 7-8 wet diapers, and 7-8 poop blow-outs in 24 hours -- his stool had been yellow since day 4. Even with jaundice at play, I shared the ABM Protocol for Jaundice, which states "Breastfeeding infants should not be supplemented with water, glucose water, or formula," and that supplements offered, if needed, should be "expressed breastmilk, banked human milk, or formula (in that order of preference)..." I suggested she read that document and arm herself with what the AAP's own breastfeeding specialists have agreed is best practice, so she could ask, why is her baby different than the norm? Why is the doctor suggesting formula versus breastmilk?

All along, I encouraged this mama meet with an IBCLC, and I wondered why her pediatrician wasn't suggesting the same? Mom was making arrangements to do just that. Mom was so worried, the evening of the "weight loss," she offered the baby a bit of formula -- and he threw it up. Reaffirmed by this response, she supplemented him with an ounce of her own breastmilk after each feed.

At the next 24 hour weigh-in, back on the same scale that showed the original gain of 2.4 ounces, guess who was up three ounces in weight? As the nurse brought Mom and Baby to the exam room, they passed by the other scale. Mom asked if they could weigh him there? The nurse agreed. Suddenly he was 2 ounces less in weight! Mom came unglued and her Mama Bear claws started to emerge. The nurse showed a doctor, and the doctor tried to explain it away...this Mama was not having it! She demanded a new doctor! The new doctor apologized profusely as Mom told her everything they had experienced, including being sent home with formula and no further breastmilk or breastfeeding information/clarification. This new doctor was understanding and agreed things weren't handled well. 

So there you have it -- 2 ounces to me could be the difference between taking my keys out of my pocket or not. But for a new baby, pre-term and being watched closely (not closely enough?), 2 ounces is huge! The importance of sticking with the same scale cannot be underestimated when looking for true accuracy. It was one of the first questions I asked this mom, and it proved to be the point of contention. I am so proud of her -- she is pushing upstream against society, her doctor's suggestion of formula, and even her own doubts and past history, to listen to her gut and provide the best to her baby.

​Way to go, Mama!

You may not even know it, but you and your baby have been working hard, preparing for the next step in your relationship after pregnancy and birth -- breastfeeding. Just as you provided everything your baby needed to grow on the inside, you are sequenced to continue this job once baby is on the outside. Currently I am working toward increasing my formal lactation knowledge to better serve the Bakersfield and Visalia areas. To add to my current 6500 direct breastfeeding counseling hours, I am completing 90 hours of specific lactation education (required to become eligible to sit for the exam to become an IBCLC). I came across these quotes while studying, and I was struck by the timing of these events! 

While we are designed to nurse our babies, that doesn't mean it will happen easily. If you are experiencing breastfeeding issues, reach out for some help! There are many places to look, starting with the hospital where your baby may have been born, WIC offices, local public health options, private practice IBCLCs, and group support gatherings, such as La Leche League and Breastfeeding USA. Often you can call any of these resources for some phone help or questions answered. If you need more support, hopefully the person on the other end of the phone can further direct you to the best resources for your situation. 

Just because we are mammals and breastfeeding seems like it should be "natural," that doesn't mean we won't need some good information and ideas from others who are in positions to help. Don't be afraid to get some guidance -- you are your baby are in this together!

For more resources, view this past post.