What I Wish I Knew Then

I missed the October breastfeeding carnival!! I think the deadline was just 1 week from the time the topic was announced. It was quite a busy week at work so I totally missed it. But given that the topic is very interesting AND there are a lot of realizations I continuously learn about breastfeeding, I still thought of making my own list (and hope to add to it as I go breastfeeding-wiser).

1. You can never over-prepare for breastfeeding
2. Just because a person is a pediatrician does not mean that they know everything about breastfeeding
3. There is such a creature as a breastfeeding-friendly pediatrician.
4. There are formula-friendly lactation consultants.
5. It DOES hurt at the start but it gets easier as time goes on.
6. Formula milk is not equal to and WILL NEVER be equal to breastmilk
7. Having a can of formula (or bottles of liquid formula) on the dresser gives you more temptation to mix or formula feed.
8. A breastpump is not an essential breastfeeding gear.
9. Other moms' breastfeeding experiences will vary from yours and it may not be helpful sometimes to compare.
10. There IS breastfeeding support in the Philippines -- you just need to look for it.

More Night Nursing

Naima is almost 2 but her nursing sessions are increasing in frequency! During the day, she doesn't drink milk -- just around 80ml. We've weaned her from the bottle so she takes her milk from her straw cup. She's also now able to sleep on her own for nap times with yaya sitting on the foot of her bed with a Tagalog pocketbook.
But during weekends, it has to be Mommy Jen who has to put her to sleep! And she nurses a lot when we're together. She still doesn't sleep through the night -- boo! Now that she's articulate, it's "milk, Milk, MILK!" in the middle of the night -- not only that, she also insists on having the "o-der side, mommy jen".
I'm really think it's time for night weaning (at least on my part). We've already set up her crib beside our main bed and put her there when she turns in for the night. But after the first waking she always manages to climb up back on our main bed.
Lately, she has also been having night terrors -- she wakes up crying and can't be calmed down by nursing. I've been planning to stop pumping at work when Naima hits 2 but I think the night nursings are still here to stay.
*sigh* i miss my bed and i miss a full night's sleep!

All about L.A.T.C.H.

LATCH is a non-profit organization composed of " group of trained peer counselors offering mother to mother support and services, to take the guesswork out of breastfeeding." It began in 2006 with its 1st batch of 8 peer counselors trained by The Medical City pediatricians.

LATCHers conduct monthly breastfeeding workshops at The Medical City and regularly contributes to a breastfeeding column in Baby Magazine. LATCHers are also invited to become resource persons in talks and workshops in various malls, magazine launches and other similar events.

Early this year, the LATCH co-founders decided to expand its membership and conducted a second peer counselor training in March 2009. With the addition of new members, LATCH now has a wider coverage and has participated in more events.

In the works is a revamp of the LATCH website to include instructional videos by Dr. Jack Newman. A third training session is also being scheduled for 2010. LATCH is also working to add more breastfeeding classes in other major hospitals in Metro Manila.

What makes LATCH unique is that it is composed of volunteer moms with a myriad of talents and skills, who band together to plan, organize and volunteer for various activities and events. Unlike other groups, we each have our own businesses and employments. We also conduct our own fund-raising activities to make things happen.

Currently, LATCHers are busy with relief missions for the Ondoy victims. LATCH will be ending the year with its last breastfeeding basics workshop at The Medical City on November 14, 2009. LATCH is currently a beneficiary of Blissful Babes’ Mother Tongue collection. So please head on over to Made for Mama and purchase for a cause!

Purchase for a Cause

Blissfulbabes, a company owned by L.A.T.C.H. President Buding Aquino-Dee is turning 10 years old in 2010. They are celebrating with a bang and recently launched a line of Graphic Novel-Tees. The collection is called "Mother Tongue" because the graphics used feature the word "mother" in various languages.

So why am I promoting this? Not only because Buding is our President but more importantly, she will donate 20% of the sales to L.A.T.C.H.!! Hooraaaay!! This is very important since our upcoming fund-raising activity - the calendar project was pushed back.

October was supposed to be our marketing month for the project but the organization decided to focus our energies and resources to our breastfeeding missions in various evacuation centers housing Ondoy victims. We are supposed to have another fund-raising project but I'm not sure if our holiday photo project will push through since all the members are busy preparing for the holidays themselves.

So, in the meantime, please help us raise funds for L.A.T.C.H. by buying shirts from Blissful Babes “Mother Tongue” Collection. There are styles to suit every personality and age range so there is an appropriate one for your mom of choice. Shirts come in 4 designs with 2 print styles:

Type

Swirl

*photos courtesy of Blissful Babes Design, Inc.

You can check out Made for Mama for more information and pictures about the collection. The collection can be purchased soon from Mama.Baby.Love.

Finding a Breastfeeding-Friendly Pediatrician

Naima at 3 months at her pediatrician's office.

In one of my previous posts, I discussed how finding a breastfeeding-friendly pediatrician is crucial in establishing a successful breastfeeding relationship with your baby. Apparently, here in the Philippines, this is much easier said than done. Ask any pediatrician and they will tell you that "yes, i am a breastfeeding advocate". Probe much further and you'll find where your pediatrician's "true loyalties" lie.

I asked a pediatrician-friend why a lot of pediatricians claim to be pro-breastfeeding but end up undermining the breastfeeding relationship instead. She shared that most of the time, pediatricians do not truly understand what it means to be "breastfeeding-friendly". For them, by suggesting that breastfeeding is best, they believe that they are already pro-breastfeeding. However, at the first sign of trouble, they cave in and give formula instead -- thinking that it is for the best.

Indeed, this is very disturbing and I had such an experience with one of the pediatricians my daughter and I visited. This pediatrician was highly touted to be a naturalist and breastfeeding-friendly. When I visited her, she told me that I had to wean Naima when she turns 9 months since she needed to be independent. I really got turned off and went to another doctor. Just recently, I heard that she told another new mom to "take a break from breastfeeding" because the new mom was having so many issues/problems with it.

However, I still have a LOT of breastfeeding friends who go to her -- and these friends are extended nursers. I've asked them about their experiences and they tell me that this doctor does not say anything about their babies still breastfeeding even beyond one. In my opinion, going to this pediatrician won't be a problem if the mom has a solid breastfeeding background, with a strong personality (no to independent life force at 9 months) and does not have breastfeeding issues and problems. Otherwise, I think the mom is better off going to a "true" breastfeeding advocate.

There have been several articles and posts written about how to find a breastfeeding friendly pediatrician. Instead of re-writing the tips, I decided to compile all the links here for mothers to easily click on and refer to.

1. BabyCenter Philippines' tips written by L.A.T.C.H. President Buding Aquino-Dee are organized into steps moms can take and questions they should ask when interviewing a potential pediatrician.
2. Best for Babes has a comprehensive list on establishing your "A-Team"
3. Dr. Jack Newman also has a summary of things to watch out for to know that your pediatrician is NOT a breastfeeding advocate.
4. Parenting.Ivillage has also devised questions based on the "Ten Steps to Successful Breastfeeding" developed by the WHO and UNICEF in 1990.
5. You can also read this post by The Milk Mama where she described her experiences with a self-proclaimed breastfeeding friendly pediatrician who ended up threatening her nursing relationship with her son

Meanwhile, if you're a pediatrician or OB-Gyne wishing to establish a breastfeeding-friendly practice, you can check out the tips from Massachusetts Breastfeeding Coalition (pediatricians, OB-gynes) or download this list on how to establish a breastfeeding friendly practice from the Academy of Breastfeeding Medicine.

I'm not going to recommend any one pediatrician who is breastfeeding friendly. Choosing a doctor for your baby is very personal and no one can make this decision for you. I highly recommend that moms do their homework, start interviewing and choosing their pediatricians even while pregnant to ensure that the pediatrician they end up with will not be a hindrance to the establishment of a successful breastfeeding relationship with their baby.

WABA Certificate

Sharing the certificate that we received from WABA in recognition of our participation in World Breastfeeding Week through our breastfeeding awareness festival.

So what has happened since then? Well, management has instructed the Space Allocation Committee to look for another lactation room in second building. Procurement for a refrigerator with a lock has started and I was able to email a comparison chart of what should be inside a lactation room to our space allocation committee to help them in identifying a proper room and making purchase requisitions for items to be procured for the rooms.

C and I really need to start working on the Lactation Policy. However, things have really been crazy and with the holidays coming I think we will have to postpone the implementation of the policy for next year.

Toddler Moms and Relactation

Since I joined L.A.T.C.H., I have received several inquiries connected with relactation. The ages of their babies vary from 1 month to 16 months. For a mom to successfully relactate, a lot of dedication, special strategies and medication is usually necessary. Thus, I always refer cases like these to the International Board Certified Lactation Consultants (IBCLC) in the Philippines. There are currently just 5 with a couple more applicants trying to complete their certification.

However, I also give the moms some reading materials on relactation so they know what to expect before they contact the IBCLCs. Here are some of the materials I share:

1. Kellymom

2. La Leche League International

3. Idaho Public Health (PDF)

4. Dr. Jay Gordon

For moms with toddlers, however, I also advice them not to stress out about relactation anymore. As a toddler, it is more important for him/her to learn how to eat healthy foods and have a balanced diet. In fact, milk is gradually replaced by solids beyond the first year. In fact, some kids completely stop drinking milk by age 2 and get their calcium and other requirements from foods such as malunggay, orange juice, cheese and yogurt. In my previous post, I shared the thoughts of Dr. Francesca Tatad-To, on the importance of having a balanced and healthy diet instead of filling up toddlers with milk. Thus, the best advice I can share to moms with toddlers is to focus on their children's diet and making sure that they are fed with healthy nutritious food, rather than worrying and stressing themselves out with relactation.

Donating Breast Milk

Breast milk donations are very important not only during times of calamities (such as Ondoy) but also during ordinary days to help sick babies whose moms are unable to breastfeed. Aside from PGH, PCMC in Quezon City also has a pasteurizer and is likewise requesting for breastmilk from nursing mommies with extra milk.

Mission Accomplished!

*This is an edited version of Velvet’s account.

Six nursing moms went on a breastfeeding mission to ULTRA (a sports arena) in Pasig City yesterday. Pasig City was one of the hardest hit in the typhoon Ondoy flood. Earlier that day, I went to UP-PGH-NICU's milk bank to drop off some of Naima's extra milk and pick-up the pasteurized milk that we were going to use for cup-feeding.

Dr. Zeka had informed me that ABS-CBN was going to be there to cover the pasteurization process. Since I was donating milk, they decided to do an ambush interview! (note the bad hair day!) I agreed to the interview hoping that more moms would donate milk to the existing milk banks. The need for breast milk exists not only during calamities such as Ondoy but also during regular days, to serve the requirements of premature and sickly babies whose mothers cannot fully provide breast milk. If you’re a nursing mom, click here to find out where you can donate your milk.

At the ULTRA Pasig, there were 2 areas (big gym and the covered court that housed the evacuees. We first went to the biggest gym, where there were about 120++ moms and babies including 1 mom who gave birth in the a public school (where they were formerly housed) with her 3 day old baby. Velvet tried to shower her with more gifts compared to the other moms because she was so touched by the baby and mom tandem. The new mom was still experiencing birthing pains and was crying from the pains. However, she was nursing her baby which was a happy sight.

We were very happy to observe that the moms there were mostly breastfeeding. One mom, who was mixed feeding, used to give her baby 5 bottles of formula per day. However, with the lack of clean water, she is trying her best to relactate and is now down to 2 bottles of formula per day.

We brought about 15 liters of pasteurized breast milk from the PGH milk bank but only 1.3L were thawed and used. Velvet was only able to cup feed a few kids. Initially, we were supposed to leave the extra milk for the public health workers to distribute. Since there was a blackout, we had to return the unused frozen milk to avoid wastage and allow other babies to benefit from it.

Since there was no electricity, it was a good thing that it was showering a bit outside to temper the heat. We could only imagine how hot it gets inside the arena at high noon! There was also no megaphone available so we had to shout out our message to the participants.

It was a team effort and as Velvet noted, there was great teamwork! There were 6 moms with an audience of more than 120. Happily, we survived. Judy had the bright idea of conducting a game of "Truths and Myths". With the assistance of Mec, they were able to encourage the audience to participate and ask their questions about breastfeeding. The moms were so happy to receive clothes and toys for their kids.

After the breastfeeding talk, we gave some goodies to the moms. To have more order and prevent the moms with their babies from getting too tired from lining up, Velvet requested that the team distribute soap, napkins, clothes to each and every mom who sat down patiently.

There was a group who wanted to give Bonamil and Nestogen to the evacuees. Eagle-eyed Atty. Booey alerted the group to this activity and she pointed it out to the Department of Health representatives. Dr. Del Rosario of DOH Pasig and Ms. Myrna of DOH-National immediately approached them and asked them NOT to distribute formula as what they were doing is against the law. It was very sad since the donors were doctors! However, they started distributing their goods when we left so I’m unsure if they still proceeded to distribute formula milk.

Two LATCHers, Jenny Medina and Mec Arevalo previously participated in the UP-PGH Breastfeeding Mission but for all the others (except for Velvet), it was our first time to be involved in such an activity. The Pasig BF Mission was a little difficult with its glitches but I believe that we survived it and completed the activity with flying colors!

Breastfeeding Mission

Tomorrow, LATCHers will be going on a breastfeeding mission at Ultra, where 500 familes (about 2,000 individuals) are housed. These families are evacuees who were formerly housed in public schools. But they have been transferred to Ultra to allow the students to resume classes.

According to Dr. Zeka (who coordinated with UNICEF/WHO/DOH on behalf of LATCH), what is being sought is several visits to the evacuation center to give support to the local government units (who previously had established breastfeeding support systems) whose services were disrupted by Ondoy. Despite the Milk Code, donations of formula milk are still being requested and continue to pour in. In fact, last Saturday, when I was at the Ateneo covered courts volunteering for the repacking, I saw a mountain of repackaged formula milk - various brands.

LATCH will be bringing some pasteurized breastmilk from PGH-NICU milk bank to provide temporary relief to mothers/infants where the mother is too ill to breastfeed, or the baby is fully dependent on formula. However, the ultimate goal is the return to exclusive breastfeeding of as many mothers as possible, and to protect those who are already breastfeeding so that they continue to breastfeed exclusively for the first 6 months and then continue to breastfeed with the addition of complementary food.

LATCH also hopes to be able to keep track of data (illness and death in formula-fed vs breastfed babies) which can be submitted to other organizations/institutions/countries as evidence that breastfeeding in a disaster situation is possible and much more beneficial than formula feeding.

We hope to be able to provide a mother's class in Filipino to expectant mothers. I've prepared some materials on the benefits of breastfeeding in Filipino as well as pictures of positioning. I was hoping to be able to translate some of the myths and barriers to breastfeeding but there's not enough time to be ready for tomorrow's activity. We also seek to assess breastfeeding moms (positioning, latch), support moms who are mix-feeding and encourage them to get back to exclusive breastfeeding. Meanwhile, milk from PGH-NICU will be cup-fed to babies.

Velvet of Arugaan was hoping to conduct a cooking demo to encourage moms to use indigenous foods in complementary feeding. However, given the limited preparation time, this may be postponed for the next visit.

More updates after the activity...

Friday's Synchronized Breastfeeding

Last Friday, October 2, mothers from my government institution joined the world by participating in the Synchronized Breastfeeding event. We didn't have much time to prepare for the event because of the recent typhooon. Luckily, we were very well-supported by management. In fact, it was C's boss who suggested that we participate in the event by organizing a session at our workplace.
After sending an email announcement to all employees, we were able to gather only 4 moms to participate. There were several other moms who wanted to join. But because of the incoming storm Pepeng, they decided to keep their babies safe at home.
It was a very short and simple ceremony. I had a short talk and shared the call for breastmilk for the infant victims of Ondoy as well as the importance of discouraging formula donations. Then, it was 10am and we proceeded with a one-minute synchronized breastfeeding while a prayer for breastfeeding moms was read.
Previously, the Philippines participated in a mass synchronized breastfeeding event. However, this year, because of Ondoy, the event was smaller-scaled yet I think it was more meaningful. The main organizers, Nona and Dra. Elvira, gathered a group of volunteer wet nurses and suckled infant victims at an evacuation center in San Juan.
Also on the same day, another group headed by Dr. Silvestre plus several L.A.T.C.H. volunteers headed out to Cainta, Rizal and brought the collected donor's milk. One of the volunteer moms, Mec, blogged about her experience here.
Secretary Duque has emphasized the need to continue breastfeeding or to encourage moms who are mixed feeding to go back to exclusive breastfeeding. Several other milk banks have intensified efforts to collect donor milk.
Meanwhile, L.A.T.C.H. is in the midst of coordinating and scheduling more visits to evacuation centers this week in response to Alex's call. Everyone was really happy that Pepeng (Parma) avoided Metro Manila (although it hit Cagayan really hard) and hope that we continue to have fair weather this week to facilitate the continuation of relief operations.

Counselors needed at Evacuation Centers

This is a call for help for breastfeeding counselors' assistance in evacuation centers. Alex is a consultant for UNICEF/WHO in the Philippines. He has been working in evacuation centers - focusing on how to safely feed the infant victims of Ondoy. Alex shared that breastfeeding mothers are not given any support in the evacuation centers while there have been intensified efforts in requesting for donations of formula milk, bottles and teats.

Alex is working with the Philippines' Department of Health and looking for trained breastfeeding support groups who are willing to donate some time to provide breastfeeding counselling in key evacuation centers in Manila - particularly Marikina and Pasig. Those with community support groups are also requested to assist. Alex is willing to meet with the groups to discuss logistics and further management programs to be established in these evacuation centers.

The Department of Health has also renewed calls for breastmilk donations. Happily, Dr. Yolanda Oliveres, director of the National Center for Disease Control and Prevention discourages formula milk donations - "to make sure that breastfeeding will not be undermined especially at this time of emergency." Dr. Olivares also emphasized on the importance of breastfeeding especially during shortages, to boost the babies' resistance to diseases.

I have forwarded Alex's call for help to my own breastfeeding support group - L.A.T.C.H. Hopefully, we will be able to organize a visit to one of the evacuation centers. Alex has emphasized that time is of the essence. There is another incoming super typhoon "Pepeng" (international name: Parma) expected to land in the Philippines at 8am tomorrow morning. *sigh* still hoping that this typhoon will lose its strength as it enters the Philippines or maybe change paths to avoid the Philippines totally. We need a break!!