Last hurrah for Breastfeeding Month!

This is a really toxic week for me. Just flew in from Singapore Monday night from a family vacation with Naima, Stan, my parents and mother-in-law. It was fun but really hectic! I'm currently busy preparing for the 2-day breastfeeding awareness festival at my government institution. Thanks to my partner, C, everything looks good! The posters are up, speakers and exhibitors have been contacted. Venue reserved and lay-out prepared. C is very efficient! :) Hoping that employees' participation will be high and that the event will be well received.
After the 2-day festival, I will be flying from Manila to Davao (1.5 hours plane ride) on Friday night with Naima and yaya in tow for the Gifts of Breastfeeding Seminar.

The "Gifts of Breastfeeding" Mommy Meet and Skills Seminar is scheduled on August 29th, 2009, at the SM Event Center in celebration of World Breastfeeding Week, and is listed as one of the activities for WABA this year. SM is one of our major sponsors. It is Mommy Sense's biggest project to date, and promises to be Davao's biggest Breastfeeding event yet! It will kick off in the morning with a motorcade ( jump-off point SM carpark), and the sponsors' tables will be open from 10:30 to 5pm. The programme proper starts at 130pm with the opening rites, then the seminar about breastfeeding begins. There will be prizes and raffles from sponsors all throughout.

Last year, I was part of Mommy Sense's Portraits of Love, a photo exhibit of breastfeeding moms, which was displayed in various malls in Davao City. This year, I will be a speaker at the "Meet and Greet" seminar, focusing on breastfeeding and working. I've completed my presentation with materials from Arugaan, C, LATCH and internet research. Two other members of Mommy Sense will also have presentations.

Aside from the Davao event, the Medela Moms and The Breastfeeding Club are sponsoring a "Baby Shower" for pregnant moms:

Pregnant? Be pampered at The Breastfeeding Club's Breastfeeding Month Offering - their first ever Baby Shower! Games + Raffle Prizes + Generous Loot Bags + Breastfeeding Tips + Baby Shower Tips + Discounts from Sponsors = FUN, FUN, FUN!!!! Co-presented by Prolacta and Medela, this event is being sponsored by Mamaway, HandyDandy Diapers, and Scholastic Books. Register now and see you on August 29, from 10am-1pm at the Medela House (29 1st St., New Manila, QC). You may register via email or via sms (0917-5614366). Just tell us how many are going so we can include you in the headcount.

Finally, Mommy Academy is holding its 18th Pregnancy and Baby Series entitled "The Inside Story: Surprising Discoveries About The Coming of a New Baby" on 29 August 2009, 730am-12nn at the Dusit Thani, Makati City.

Listen to experts as they help you prepare for the final stretch of your pregnancy, shed light on common myths about caring for baby, and let you discover what valuable lessons we can learn from our children. Be the first 300 online registrants to receive a thank you bag. Likewise, kindly take note that a minimal fee will be charged during the event to cover the event materials.

To register, visit their website or call 8257454.

It's going to be a busy Saturday to close Breastfeeding Awareness Month!

Learnings from the Milk Code Forum

Two LATCHers presented during the Forum. Velvet discussed the superiority of breast milk over formula and how a baby learns rhythm through breastfeeding. She also mentioned that in the Muslim culture, when a mother has given 3 full feedings to another baby, that baby will be considered as her own child's milk-sibling. Judy also had a short presentation on the "superstars" of the formula milk industry - BPA, rocket chemicals, growth hormones, melamine - you will be amazed and scared to learn about the multitude of contaminants that go into formula milk. She also showed a powerpoint show on "The Story of Milk". A more detailed summary of Judy's presentation is available here.

It was enlightening to hear about the experiences of Carmen Solinap, who was a representative of the Women Trade Union. She worked with a textile company in Laguna and was able to establish a lactation room in the factory. Ms. Solinap shared that they did not seek the milk-expression times as a favor or additional benefit from management but rather, they were able to schedule the employees' breaks around their milk-expression time. The Laguna lactation program was quite successful such that it had become the "norm" among the female employees to breastfeed their babies even if their maternity leaves already ended. She is now working on the establishment of a similar program in factories in Bulacan.

The heart of the Forum - the Milk Code and Rooming-In Act - were discussed by Atty. Ipat Luna of Tanggol Kalikasan. Atty. Ipat emphasized the coverage of the Milk Code and the violations being committed by the milk companies. She had a collection of photographs evidencing these violations. She also emphasized the need to be vigilant in watching or policing these milk companies. Atty. Ipat recognized the difficulty in implementing the penal provision of the milk code on individuals but stressed that if the different breastfeeding groups worked together, it would be possible to penalize milk companies (through suspension/revocation of the licenses/permits) in view of their rampant violations. The main problem is the lack of violation reports to set-up the stage for penalizing the milk companies. If no formal report of the violation is filed and submitted with the Inter-Agency Committee set up by the Milk Code, then there will be no basis to hold these companies liable.

It was very timely that the UP law students formed a new campus organization - UP Volunteers for Children. They had their first activity in May 2009 which was directed towards understaning the Milk Code and its Revised Implementing Rules and Regulations. They also had exercises on identifying the coverage of the Milk Code, activities being regulated and reviewing advertising materials/packaging of milk companies. They were a very enthusiastic group of students - they reminded me of myself when I was a young "hungry" law student :D. I was very happy to see a group step up to handle the monitoring of the Milk Code. They have set-up a website and you can email them if to report violations of the Milk Code. This is also a great project for Ateneo Human Rights Center to look into, particularly since AHRC has a Children's Desk.

Finally, the last speaker was Alessandro Iellamo of Unicef. Alex again emphasized the importance of vigilance in making sure that the milk companies act with the bounds of the Milk Code and its RIRR. Unicef in the Philippines is very active in promoting breastfeeding and policing these milk companies.

I was really happy to have attend the Milk Code Forum. In my previous post, I thought that familiarity with Code was sufficient. But after attending the Forum, I realized breastfeeding educators/counselors/consultants must read, know and live the Milk Code and RIRR. Otherwise, they become unwitting accomplices or even principal violators themselves - which makes them even worse than milk companies as these educators/counselors can be major influences in how a new mother will choose to feed her baby.

Part 1

Trying to Read the Labels

Following my posts on formula milk, my officemates and I started talking about how effective milk companies' marketing efforts are in influencing consumers' buying choices. We remembered how the commercial for Nido was emphasizing how it had less sugar than other milks. My officemate then whipped out his own Nido powdered milk (which he used in his oatmeal). I was really appalled when I read the label!

Now, Nido has another endorser - Dyan Castillejo whose "tagline" is "It pays to check the label". So let us examine the label of Nido. Read the ingredients list -- do you see sugar? So where did Suzy Entrata's 70g of sugar go? Now I undestand why it is only Nestle which has a "boycott Nestle" group especially targetting that company. Honestly, when I see "recombined whole milk", I wouldn't think that sugar was part of it. But even if Suzy's commercial already blatantly states that Nido has sugar, this ingredient is still not listed in the label! So, it will never pay to check the label as long as manufacturers are not transparent or honest enough to actually list each ingredient of the products they are selling.

Setting up a Lactation Program At Work, Preparing for the Festival

August is a very hectic month and I'm in the midst of preparing for my office's breastfeeding awareness festival, a family vacation in Singapore and a talk on breastfeeding and working I will be giving in my hometown at the end of the month. Our breastfeeding awareness festival has finally been given the "official" stamp of approval by my institution's management! We started the preparations while we were securing management approval.

The Story of Milk

I was finally able to get and upload Judy's powerpoint presentation on the story of milk. Judy wrote the story line while the art and animation is by Sam Leon. Watch and share!

Story Of Milk

View more presentations from rwchick.

What I Learned From The Milk Code Forum

Last Saturday, I was happy to have attended the Milk Code Forum organized by Arugaan, in cooperation with UP WinLaw and UP Volunteers for Children. It was a packed day, with several speakers. The coordinator/facilitator was Nanay Ines of Arugaan and she had the entire room decorated with various breastfeeding posters.

The forum started with a brief welcome by Unicef's Elham Monsef. She focused on the theme of this year's World Breastfeeding Week and discussed how the promotion of formula during emergencies displaced the breastfeeding moms. She also emphasized that in times of calamities, formula donations should not be given directly to breastfeeding moms, but rather be coursed through the Department of Health who will then determine whether a certain mom really needs it or whether giving her this formula will just curtail her breastfeeding relationship. Elham stressed the need to strengthen the 3 pillars of breastfeeding - protect, support and promote; and rued the loss of the culture of breastfeeding in the Philippines.

The forum participants were also lucky to hear Dr. Anthony Calibo's discussion. Dr. Anthony Calibo is the Philippine Medical Tourism Manager of the Office of the Undersecretary for Special Concerns, Department of Health. Dr. Calibo is also a practicing pediatrician and is connected with St. Luke's Medical Center. He discussed his experience as a medical student (on how breastfeeding is superficially discussed) and as young resident, who was bombarded by marketing strategies of big milk companies, in hopes that he will be swayed to support them. Dr. Cabilo emphasized that breastfeeding information should be given even by the ob-gynes and believed that pediatricians have a role in prenatal care (e.g. if only to advise the mothers about breastfeeding and rooming-in). He wrote a research paper on the top things that ob-gynes discuss with their patients and sadly, breastfeeding is not included in the list. It is really a sickness of the medical practice - to rely on milk companies/big pharmaceutical companies to support medical conventions - and thus be susceptible to marketing gimmicks or strategies thrown back to the doctors.

Part 2

Formula Milk for Toddlers

For older babies, even if extended breastfeeding is considered to be beneficial, the milk companies attempt to manipulate consumers that by giving their children formula milk, they are getting something better. If you notice, all of the formula milk ads are targeted towards toddlers and preschoolers. In the US, the American Academy of Pediatricians recommends whole cow's milk for children beyond one and not formula. However, in the Philippines, we have formula milk for almost everyone!
Dr. Francesca Tatad-To,* respected pediatrician-neonatologist AND breastfeeding advocate shares her thoughts on this matter. Please note that this post is for informational purposes only and this is no substitute for medical advice given after an actual examination by a board certified doctor of your particular case.

Formula is unnecessary in children who are older than 1. At this age, children are expected to have a full/complete diet which may or may not include full cream fresh milk.
Fresh milk is the standard dairy recommendation for children older than 1 who are no longer breastfed, and the American Academy of Pediatrics actually recommends low-fat milk for ALL children (Except malnourished ones) older than 2.

As infant formula was originally designed to be a breastmilk replacement/alternative, children who have weaned naturally and no longer require breastmilk should not require formula either.

In most countries, formula sold is really only for babies 1 and below. It is only in countries like ours where the commercial demand is strong that formula manufacturers take advantage and try to create an even bigger demand through marketing, etc.

The average toddler formula is higher in calories than full cream fresh milk and this is not a good thing. These extra calories are usually from sugar and fat, not from any added 'special nutrients'. In fact, toddler and preschool formula is often the culprit in young children who are obese and who have poor diets. The typical caloric requirement for a toddler is 1000-1200 kcal/day and the majority of this should be coming from solid food. The recommended limit for dairy/milk intake for children older than 1 is 16-24 oz or 2-3 cups a day only. This means that a toddler taking 3 cups of milk a day will already consume 40-50% of his calories in milk, leaving 50% for food. Giving your child toddler formula almost always ensures that he/she will get more fat, sugar and calories than he/she needs.

Also, it is common for children who exceed the recommended milk intake to develop iron-deficiency anemia. This is because cow milk protein causes a little bit of bleeding in the gut and larger amounts of milk translates to bigger blood loss. Many parents don't know this but this is a common concern of well-trained pediatricians and is found in all our medical textbooks.

There is a lot more information available in books and online. If you look at the recommended Food Pyramid for children, you will see that there is no recommendation for formula here either.

Indeed, a lot of research has shown that formula (actually milk for that matter) is unnecessary in children who are older than 1. In fact, even Dr. Sears believes that milk is not necessary and experts generally believe that milk is just an easy and convenient source of calcium, protein, fats, vitamin D (if fortified).
Hopefully, Filipino moms will realize that we do not really need to purchase those formula milk to make our children healthy or smart. To be honest, being "panatag" (secure) is just an excuse to be lazy and not attempt to teach or encourage your child to have a healthy diet. As Dr. Zeka pointed out, there is no recommendation for formula in the Food Pyramid.


Furthermore, just because Nido claims to have less sugar (70g) doesn't mean it is better than the other brands or than regular milk for that matter. The 70g sugar is still extra sugar that your child will do without if you choose to give him regular milk or other foods to provide whatever "nutrients" s/he is supposed to get from Nido.
Whether or not you decide to include milk in your family's diet is your choice. But again, really, FORMULA MILK IS NOT NECESSARY. It is really high time for Filipino consumers to be educated and bust those formula milk myths.

*Dr. A.M. Francesca Tatad-To specializes in pediatrics and newborn medicine. She also serves as medical consultant to L.A.T.C.H.
*The opinion that toddler formulas are unnecessary is also shared by this American doctor.

Part I of this Post is here.

So called nutrition for Toddlers

Do toddlers still need to be given formula milk?! (a.k.a Breastmilk v. Formula)

Recently, the issue of the hazards of cow's milk (including formula) cropped up in my peer counselor group and another local mother's group I'm part of. One of the moms was worried about the effects of formula milk (or hormonized cow's milk, as she calls it) that her daughter was taking. Her pediatrician had patients who were menstruating at 4 and 7 years old - and the pediatrician thought it was because of the milk they were taking (the mom required the child to take 8 glasses to make up for the low food intake). Meanwhile, another mom (who continued to breastfeeding her 18 month old baby - yay! :D) was worried that her toddler was not getting all the required vitamins and minerals - she had been bombarded with the commercials for formula milk (and we have plenty!! DHA? ARA? +7 IQ points?).

During the Milk Code Forum I attended last Saturday, one of the presenters, Judy, had a terrific presentation on the story of milk. She emphasized that because of the great demand for milk, dairy farmers are doing everything to boost their cows' milk production - by adding hormones which for sure eventually ends up in the milk that we drink. Judy also shared that even if companies say that they've tested the milk for contaminants and did not find any, there are other contaminants not being tested or detected! There are about 60 or more chemicals/medicines injected into cows but only the presence of 6 (in the end-milk product) is being tested. And this is only for the regular milk! Formula milk undergoes more processing for it to be converted into milk "suitable" for babies. To mimic breast milk, milk companies then add synthetic DHA and ARA (from cultured algae, etc.) to the powdered milk. The formula milk is exposed to more contamination risks (BPA, melamine, salmonella, etc.) during the processing, canning and preparation process. No wonder our generation's hormones are totally whacked out - with menstruation even starting at age 4!!!
In my response to the breastfeeding toddler's mom, I shared how milk companies earn P42B from Filipino consumers which is why they spend P1B in marketing their products. I got those figures during the Milk Code Forum from Nanay Ines of Arugaan. Obviously, each milk company wants to get the biggest chunk of that P42B pie - which is why they are aggressively (and unethically) marketing their products.
With the passage of the Milk Code's revised rules and regulations, milk companies recognized that they can no longer actively market products targeted for babies below 1 year old, to preserve their "good image". The superiority of breast milk of formula has been settled and established. Detailed comparisons are available here and here. There is even a downloadable brochure of stacked blocks which show how far away formula milk is from breast milk, particularly in terms of nutritional content. So, they directed their attention to older babies.

To be continued... Part 2.

Unicef on WBW 2009 - Breastfeeding a crucial priority for child survival in emergencies

UNICEF joined the World Alliance for Breastfeeding Action in commemorating World Breastfeeding Week, 1-7 August 2009, through the release of this video which underscores the vital importance of breastfeeding during emergencies.

You can read UNICEF's press release here. Two things struck me most in that press release.

"Globally, only 38 percent of infants under the age of six months are exclusively breastfed".
The Philippines' 2008 National Demographic and Health Survey (NDHS) has just been recently publicly released and I am sad to read that the Philippine statistics are even lower than the global rates. Although the headline states that 50% of Filipina moms breastfeed, this number refers to babies at 1-2 months. According to our Secretary of Health Francisco Duque III, "the 50 percent breastfeeding rate in 2008 was down from 53 percent in 2003; the same study showed 34 percent of infants below six months are being exclusively breastfed." Actually, the 34% rate refers to babies at 2-3 months. I was able to obtain a copy of of the 2008 NDHS survey and the results are more dismal. At 4-5 months, only 22.6% are exclusively breastfeeding, despite the UNICEF's (and other experts') position that breastfeeding provides the best food for a baby’s first six months of life.

"More damaging is the common donor impulse to send infant formula or breast milk substitutes to disaster zones"
When I was single and not breastfeeding Naima, I was guilty of this same practice. Actually, even during the early months of breastfeeding Naima, I was likewise guilty of propagating the formula culture. I had cans and cans of formula leftover since I was already making enough milk for Naima. My mom's secretary had a baby two months older than Naima and was think of weaning at 6 months. I did encourage her to continue breastfeeding, but I guess my encouragement was not enough and what was even more damaging was that as I eventually sent her all my cans and bottles of formula.
In hindsight, I should have thrown out all those formula instead of giving them away. This is also the reason why I don't advice new moms to buy even just a small can of formula "for reserve" or for "just in case". With the Filipino trait of being frugal/thrifty, you will certainly be tempted to use the formula or give it away.

Do you always believe in the news?

Breastfeeding Benefits

About 2 weeks ago, I came across an article claiming that the breastfeeding benefits are greatly exaggerated. Specifically, the article states that Dr. Michael Kramer, a pediatrician who has advised UNICEF and WHO believes that breastfed babies are healthier because their mothers follow a healthier lifestyle and not because of the benefits they get from breastfeeding which are "oversold".

Then, about a week ago, Dr. Kramer talked to another newspaper and said that the press twisted his words! What he actually said was: "The existing evidence suggests that breastfeeding may protect against the risk of leukaemia, lymphoma, inflammatory bowel disease, type 1 diabetes, heart disease and blood pressure." He further stated that there was a need for "more and better studies to pursue these links." I have to agree that this certainly doesn't mean that the benefits are exaggerated! Sometimes, words need to be twisted to sensationalize the news. Maybe the writers recognized how The Atlantic article stirred up controversy and hoped to create a similar frenzy with this article.

Organic Food

Last week, my sister-in-law forwarded an article stating that organic food had no nutritional or health benefits over ordinary food. According to the study, "no evidence to support the selection of organically over conventionally produced foods on the basis of nutritional superiority." I shared this article with Judy one of my mom-friends who succinctly commented:

"Who are they trying to convince? 2 year olds? I don't like toxic chemicals in my food period! Since when did food laden with pesticides and other nasty stuff become equally healthy to food without them? In what planet does that make sense?"

Several articles have lambasted the study and Dr. Alan Dangour, the scientist behind the study, has been reported to be a current victim of a hate campaign.

I try to include organic food in our diet regularly but have difficulty in finding it readily available. For instance, my regular organic vegetable delivery guy, Shino, told me that his harvest for this month is insufficient because of the rains and he is unable to deliver. So back to the regular grocery for my vegetable purchases.

I tend to believe that nutrients will be the same whether you are buying an organic carrot or not à a carrot is a carrot. But, like Judy, I am more concerned with the chemicals that non-organic produce get into contact with. So hopefully, next month, we’ll be back to our organic veggie stocks again.

Milk Code Forum

As early as 1986, the Philippines already enacted a law regulating the advertisement of breastmilk substitutes, called the Milk Code. Almost a decade later, implementing rules and regulations (RIRR) were revised and redrafted by the responsible agency - the Department of Health and became subject of a controversial case between the Pharmaceutical and Health Care Association of the Philippines (PHAP) and the Department of Health and others. The case reached all the way to the Philippine Supreme Court who promulgated a decision in 9 October 2007.
The resulting Supreme Court decision did not result in a complete victory for either party. The Supreme Court struck down certain provisions of the RIRR particularly those which absolutely prohibit the advertising/promotion/sponsorships of infant formula, breastmilk substitutes and other related products. However, the Court agreed with the Department of Health that these advertisements/promotions needed prior regulation.
Regulation is being handled by the Inter-Agency Committee established by the Milk Code, whose Secretariat is with BFAD (809-4390, loc. 1051-1052). Responsible individuals include Ms. Merle Ramos, Flor de Moralejos and Atty. Christine de Guzman.
This topic is a thorny and controversial one but I believe that as breastfeeding advocates/counselors, we should at least read and be familiar with the law and its implementing rules and regulations. I, myself, want to know more about the Milk Code and whether the implementing rules/regulations have really taken effect – which was why I was happy to learn about the upcoming Milk Code Forum organized by Arugaan, UP Women in Law and UP Volunteers for Children, to be held at the UP College of Law on August 8, 2009.
The forum will focus on breastfeeding issues, the Milk Code Story, the Supreme Court decision and monitoring under the Milk Code as well as do’s and don’ts. With our upcoming Breastfeeding Awareness Festival, I really do want to know what we should watch out for that may be considered to be violative of the Milk Code. This promises to be a very enlightening event and I definitely will be there. For interested attendees, contact Nanay Ines of Arugaan.

Tips for Consistent and Long-term Breastfeeding Success

Welcome to the Carnival of Breastfeeding for August.For this month's carnival, the theme is La Leche League's World Breastfeeding Week theme: Prepared for Life. I checked LLL USA's website to obtain more information on what specifically the theme wishes to address. Focus of the theme is "solid breastfeeding information" to ensure successful breastfeeding at ANY TIME (including catastrophic and personal emergencies). Please check out the other contributing bloggers linked at the bottom of this post. :)

Being in the earthquake belt and typhoon path, the Philippines regularly experiences these natural calamities. In 2009 alone, a range of 7-34 earthquakes has been recorded every month, in various locations in the Philippines and in varying intensities. In the past 59 years, there has been an average of 19-20 tropical cyclones which has visited the Philippine Area of Responsibility. As of July 2009, the Philippines has been visited by 9 tropical storms. Evacuation centers are regularly set up to respond to the destruction wrought by these typhoons. Considering that only 34% of Filipino babies below 6 months are breastfed (2008 National Health and Demographic Survey), solid breastfeeding information should not only be established but be widely disseminated, particularly to the C-D-E classes.

I had previously written an article which was supposed to be published for a local magazine. However, due to space constraints, they had to scrap my main article and focus instead on the breastfeeding resources and support groups directory that I had also prepared. I have decided instead to submit the article to this month's carnival -- focusing on tips to ensure consistent and long-term breastfeeding success, which would enable Pinay moms to continue breastfeeding in the face of calamities.

==========================================
Breast is best. This mantra is heard over and over again by pregnant and new moms - and most, if not all of them WANT to breastfeed. However, most moms are ill-prepared for the challenges that breastfeeding may bring. Instead of preparing for breastfeeding and new life with the baby, most moms are more concerned with getting ready for the actual birth - packing a hospital bag, preparing a birth plan and researching which hospital to give birth at. Moms tend to forget that giving birth is just one day but the baby's very existence changes your life forever – and one of these major changes that moms need to prepare for is breastfeeding.

Pregnant moms are usually bombarded with horror stories about breastfeeding. Along with these stories comes the pressure to give your baby the liquid gold. Often, even before moms give birth, they already prime themselves that they will fail at breastfeeding based on their own moms’ or friends’ experience. Thus, preparation is crucial and is a key to a successful breastfeeding relationship with your baby.

Find and join a group

One of the best ways to prepare for breastfeeding is to join a breastfeeding support group. Good support is essential for successful breastfeeding and this support can be given not only by your family, but by knowledgeable counselors and consultants as well. There are several breastfeeding support groups in the Philippines focused on different advocacies.

A unique group is L.A.T.C.H. (Lactation, Attachment, Training, Counseling, Help), a hospital-based group of trained peer counselors who conduct breastfeeding workshops, breastfeeding support and hospital/home visits, among others. This group is based in The Medical City, Pasig City and holds monthly classes for pregnant couples in preparation for breastfeeding. Class topics include Breastfeeding Benefits, What to Expect in the First Week, Positioning and Latching, Back to Work and Busting Breastfeeding Myths.

Since L.A.T.C.H. is run by breastfeeding moms who are still breastfeeding or recently weaned their own babies, the counselors can better relate to the concerns of the new moms. Mec Arevalo, breastfeeding mom of 20-month old Yakee, attended two L.A.T.C.H. breastfeeding lectures and shares that “breastfeeding success had a face in the L.A.T.C.H. moms, so when they [nurses] gave her Yakee at the hospital, she was really prepared for the journey.” More information about L.A.T.C.H. is available on their website: www.theperfectlatch.com

Research and read, read, read

Breastfeeding relationships never start or are often cut short by the wrong information. Well-meaning relatives and friends share outdated (and false) information on why breastfeeding will not work or why moms are better off with formula milk. Joy, mom of 9-month old Brian, shares that her mom told her that she didn't have enough milk and it wasn't good to put then newborn Brian to the breast every time he started crying. Her mom also told her that since she wasn't eating well, Brian won't be getting any nutrition from her. She eventually stopped breastfeeding Brian when he was about 3 months old. Since Joy didn’t know any better, she just listened and followed what her mom told her about breastfeeding.

There is a multitude of breastfeeding information available in books and the Internet. Even while pregnant, moms can start reading up on breastfeeding and begin busting those breastfeeding myths. However, obtaining accurate and up-to-date information is equally important.

A top resource visited by moms and lactation consultants alike is Kellymom (www.kellymom.com). This site is run by Kelly Bonyata (a summa cum laude graduate of mathematics and physics) who is also an international board certified lactation consultant. Her website is a plethora of breastfeeding information, compiling relevant and authoritative references. Meanwhile, if you’re a visual mom (who prefers watching movies over reading books), check out the website of Dr. Jack Newman’s Newman Breastfeeding Clinic and Institute (http://www.nbcionline.org), which compiles various instructional videos on how to obtain the proper latch; cup feeding, good drinking, using lactation aids, and tongue tie. Dr. Newman is a pediatrician who founded the first hospital based breastfeeding clinic in Canada in 1984 and has been a consultant for UNICEF for the Baby Friendly Hospital Initiative.

For instructional books, make sure you choose books which are truly directed toward breastfeeding mothers. A lot of books which have chapters on breastfeeding actually give the wrong information. Some good books to choose from include: La Leche League’s The Womanly Art of Breastfeeding, Kathleen Huggins’ The Nursing Mother’s Companion, Martha Sear’s The Breastfeeding Book and Dr. Jack Newman’s The Ultimate Breastfeeding Book of Answers. There are a lot of other materials such as baby books, articles, booklets, pamphlets or brochures which also talk about breastfeeding. Note that materials which are sponsored by a formula company or bottle manufacturing company might give vague, inaccurate info about breastfeeding. So be an “informed reader” and check the source or author before considering these materials.

Talk to your doctors

Medical providers play an important role in the breastfeeding relationship. You can start by looking for an ob-gyne who supports breastfeeding. In this fast- paced world, more and more women are scheduling their births through caesarian operation. In preparing for your baby’s birth, talk to your ob-gyne, tell her that you would like to breastfeed and request that she/the doctors resort to caesarian operation only when all options for normal delivery have been exhausted. It is certainly more challenging to position and latch a baby born through a caesarian operation as compared to one born through natural delivery. Aside from finding the proper position, the nursing mom has to deal with her caesarian operation wound.

However, it is not impossible to breastfeed even if you underwent caesarian operation as long as the mom is willing and works with her doctor. Charyl Haw-Martin, who underwent caesarian deliveries for Liam (breastfed until 13 months) and Simone (2 months and currently breastfeeding), shares that she was able to successfully breastfeed both her babies despite her caesarian deliveries because she had commitment, determination and knowledge. She stayed focused, never thinking of quitting or giving in to the convenience of formula milk because she knew that the nourishment her children will get from mother's milk is the best gift she could give them.

Finding a breastfeeding friendly pediatrician is likewise very crucial, especially in the first few days of your baby’s life. These days are tough for a new mom – who has to deal not only with changes in her body but also with a new person who entirely relies on her and for whom she has to be responsible for. A pediatrician who pays lip service to breastfeeding and does not really believe in its benefits may eventually become a hindrance to the breastfeeding relationship by recommending that formula is necessary for the newborn baby to thrive since the mother’s milk has not come or is not enough. Hence, it is important to be prepared and not leave the choice of pediatrician at the last minute. Even while pregnant, moms-to-be can already start looking for pediatricians who are supportive of their desire to breastfeed by asking for referrals from friends or by talking or interviewing the pediatricians themselves.

Organize your life and utilize your resources

Talking to your family and friends about your plans to breastfeed your baby will also contribute to your breastfeeding success. Your own mom, mother-in-law or husband could unintentionally prevent you from continuing on with breastfeeding by making unhelpful remarks. One good advice I learned and share with nursing moms’ husbands or relatives is that if they don’t have anything supportive to say, then don’t say anything at all. If your husband or other relatives tell you that they want to participate in taking care of the baby, ask them to help in other activities like changing diapers, burping the baby, or singing and playing with the baby.

Filipino moms are lucky to be able to get help from a yaya or nanny. If resources permit, hire a yaya a month before you give birth and start teaching her how to help you in taking care of your baby. Do not try to do everything! During the time that she had to exclusively pump breastmilk, Claire (mom of 18-month old Clarisse who is still nursing) trained her yaya how to assemble her breastpump, wash her breastpump horns and store her breastmilk. This allowed her to spend more time with her daughter instead of worrying about setting-up and cleaning the breastpump.

Your own circle of friends is also a great place to find breastfeeding information and support. More and more moms are breastfeeding their babies and by asking them to talk about their experiences will help you learn from their mistakes and avoid repeating them. Find a friend who is a successful breastfeeding mom and who would be willing to respond to your texts, answer your calls and emails whenever you have questions or problems. This friend will be a good source of comfort and support especially during the early days of your breastfeeding journey.

Moms need to realize that breastfeeding is not as daunting as it appears. Preparation is the key to breastfeeding success and this should start even during your pregnancy, way before the baby is born. The best way to overcome your difficulties is to get help early on. Breastfeeding IS a mind game. Psyche yourself to overcome the challenges and be prepared.

Having strong and solid emotional support is also crucial. Remember that you don’t have to go through this alone. No sugar-coating - it is not always easy and if you’re having difficulties know that you’re not the only one. Be proactive - be ready to ask for help and utilize your resources. It is just a matter of asking and looking for the right help, which is readily available. You’ll soon realize that your fears were unfounded and you’ll be on your way to a fruitful breastfeeding experience.

Check out the posts of the other contributing bloggers:

HoboMama's Prepared for Life: Breastfeeding in local and global crises
Zen Mommy's How Breastfeeding has shaped my toddler's view of breasts
Pure Mother's Marketing Away "Real Milk"
Cave Mother's Three Moments That Made Me Thankful I Breastfeed
Motherwear Blog's The World Breastfeeding Week Carnival of Breastfeeding - Prepared for Life
Blacktating's August Carnival of Breastfeeding: Prepared for Life
Breastfeeding 123's Breastfeeding as a Lifesaver in Emergencies

Fusion Parenting's Breastfeeding - Prepared for LIFE!

Breastfeeding Slum Book

In late June, Cher asked me to answer some questions which she will be using to write an article for a local parenting magazine, to be released in August. She asked me to answer a certain portion of her survey. I wonder what the other questions were. This definitely was more challenging than answering a slum book ☺ I enjoyed answering the questions as it gave me a chance to immortalize my thoughts and hopefully, share them with Naima when she’s older.

IV. Breastfeeding and Daily Lives
1. What advice can you give moms regarding handling the day to day activities of work and running a household and breastfeeding?
Working full-time, breastfeeding and running a household are no easy tasks. Organization and preparation will allow any busy mom to balance the hectic daily activities. I work M-F from 8am-5 or 6pm. I've trained my helpers to prepare and pack my pump horns every morning. It also helps that get Stan involved and share in taking care of Naima. Hey, we live in the 21st century - no room for chauvinists here. Every Friday night, my cook and I discuss and prepare the menu for the week so we can do the grocery shopping over the weekend. Honestly, good help (and yaya) is essential to ensure that my household runs efficiently and Naima is being taken care of when I'm at the office. I also keep tabs by calling about 3x a day from the office (during my pumping times) to check on Naima.

2. How can breastfeeding be applicable to the fast paced modern life?
Breastfeeding IS a boon especially to busy moms. Since we co-sleep, it allows me to sleep better since I don't have to get up at night to fix her a bottle of milk. During the day, whenever Naima breastfeeds, it allows me to pause and take a breath - relax and enjoy the moment. Breastfeeding is our quiet and cuddle time together.

3. How can moms who exclusively breastfeed handle the following situations:
a. going to the mall - Postpone going to the mall till when baby is bigger. Your baby will be small/young only for a short time. Also, you can but a lot of the stuff online ;) If you really must go to the mall, bring the baby - use a sling to keep her close to you. Practice breastfeeding at home in front of a mirror to help you become more confident about nursing in public, if necessary. If you don't like nursing in public, visit a mall with nursing stations (there are a lot!!) and know the location of these stations.
b. going out of town for more than a week - Bring baby if possible. When Naima was 3 months old, we went to Cebu. When she was 5 months old, we went to Davao. When she was 9 months old, we went to Hong Kong. She has been everywhere :) If you can't bring the baby, start stocking up milk by pumping after baby feeds or if you're working, pump during weekends also. Bring your pump, milk bags and a cooler bag. I prefer bringing milk bags because they are less bulky than storage bottles. Pump as often as the baby nurses - wake up at night if you have too. A friend went to Hong Kong/Macau for 10 days and left her 11 month old baby. She pumped and dumped her milk (since she didn't have access to a refrigerator/freezer). When she went home, they simply resumed nursing without issue.
c. when one goes back to work - Check out your office's policies regarding break times. Talk to your boss and explain your circumstances - usually, they are willing to consider your requests - you just have to ask. Scope out places where you can pump (if you don't have a private room or a lactation room). Express milk at regular intervals. Set up your pumping station. I put my pump in one of my drawers and it's plugged and set-up. I just bring home the horns and leave the tubes (zipped inside a pouch). Some moms bring extra horns so they don't have to be bothered with washing after every pump. If you only have 1 set, you can rinse your horns, run it under hot water, store in a plastic container/ziploc and keep it in the fridge in between your pumping sessions.

V. Breastfeeding Etiquette
1. How can moms breastfeed in public? (Should moms ask people around her if it’s okay to breastfeed so as not to offend others?
Practice at home first - practice in front of the mirror. Practice in front of your husband, helpers, siblings, parents. It's not necessary for moms to ask permission to breastfeed. People don't ask permission when they shove a bottle into their babies’ face - so why should you? :P Since Naima has become aware of her surroundings, I've stopped covering up everytime she nurses. I also invested in good breastfeeding bras and nursing tops. These purchases allow me to breastfeed in public with ease. I've also noticed that it is only I who gets conscious and people don't usually look or mind me.

2. How can moms breastfeed in the office? (Is it okay to excuse yourself in a meeting in order to breastfeed? How do moms ask permission properly? Is it okay to bring your exclusively breastfed child to work?)
On bringing your breastfed child to work, it depends on your employer. Some employers have daycare where you can leave your baby, visit and breastfeed her during your break times. Other offices (like mine) have a “no-children policy”, so I have no choice but to leave her at home and express milk at the office. If I know that I have a meeting on a particular day, I schedule my pumping time so that I get to pump before and after the meeting. Again, it is important to talk to your boss about your concerns. If the meeting runs long, I will ask to take a break if there is an opportunity. I won't tell everyone that I'm going to pump, although I will inform my boss that I may take a break to pump. I think of it similar to excusing yourself to go to the bathroom :)

3. What are the challenges of a working breastfeeding mom?
Early on, it was to make sure that I had a good supply - ensure that I am able to leave enough milk for Naima when I'm at work. When my supply runs low, I pump over the weekend or at night before I sleep. This is also not the time to be lazy - I never miss a pump, even if the intervals between pumps are short. Also, instead of engaging in idle chit-chat with officemates, I try to work efficiently to maximize my office time and give me more time for my pumping breaks.

VII. Breastfeeding: Personal Anecdotes
1. What has been the most memorable, funniest, unforgettable experience you have had with regard to breastfeeding?
Most memorable for me is the peace that I experience every time Naima latches on - and the awe, wonder and satisfaction I feel when I think about how she gets all her sustenance (at least for the 1st 6 months) from me.

Reasons why today is not a good day

1. Naima has a stomach bug.
Yesterday was a pretty exciting day because we found a play school for Naima which looked promising. It was not too far from home plus one of Stan's friends was a teacher. Naima went for the first of her 3 trial class days yesterday. She had fun and all was well - or so I thought. Late afternoon, Naima's yaya called me. She had been vomiting several times since she woke up from her afternoon nap. She didn't have problems eating but 30minutes to an hour later she throws up. The vomiting until this morning so Stan and I decided to have bring her to her pediatrician.
Naima's 2 regular pediatricians were out of the country so I had to look for someone to check her. We had a health card for Naima through my company so I initially wanted to use that in making the pediatrician's appointment. But it will take about 45 minutes to wait for the health card referral, plus more waiting time at the doctor. With Naima vomiting almost every 2 hours, I decided to take her to the ER instead.
I was happy that the ER accepted Naima's health card. Her health card also covered the urinalysis and fecalysis that were done for Naima. The ER doctors didn't find anything wrong as she was not listless, had no fever, ear infection, sore throat and her lab results were all normal. They gave her domperidone and hydrite to be administered every time she throws up. This is the first time that Naima got a stomach bug and Stan and I are really worried :-c.

2. Aunt Flo is back.
After almost 29 months, my period is back! Yes, I didn't have any period since I got pregnant with Naima - and I enjoyed it! Now it's back and came on the day when Naima is sick!

3. Tita Cory has passed on.
Corazon C. Aquino, the first Philippine woman president passed away at 3am today. She was a symbol of democracy in the Philippines, is admired and serves as an inspiration for many Filipinos. She had been battling colon cancer since last year. I was still in grade school when she became president and remember wearing yellow and making the "L" sign to symbolize support for her party "Laban". During these past few weeks, several healing masses had been organized for her. At least, she is now at peace with her husband, Ninoy Aquino, recognized as a modern-day Philippine hero.

4. A typhoon is entering the country and it's been raining really hard.
To make matters worse, it has not stopped raining since dawn today. The weather matches the sadness of this day. Three typhoons are predicted to hit the Philippines this August. Hopefully, these will be mild not super typhoons and will not result in huge damage to the country. Although this year's WABA theme is breastfeeding as a vital emergency response, I do not want to apply this in my own real life.