Archive | Breastfeeding Around the Globe

IBCLCs Volunteering at HIAM-Health in Timor Leste (East Timor )

Article by Sue Williamson IBCLC, Anne Scollon IBCLC, and  Maree Twomy,Dietician

Sue, Maree & Anne relaxing with their much needed ILCA Fans

This is the first-hand recollection of volunteering overseas in East Timor as shared by three Australians, two IBCLCs and a Dietician, after their month long experience at HIAM-Health. This facility provides a place for mothers and babies to come for a week after being in Dili Hospital, to learn about health and nutrition.  Timor Leste (East Timor) has a population of  1 million, with unfortunately an infant mortality rate  as high as 111 per 1000 births in some districts. Over 50% of children under 5 years are malnourished and hungry (MoH 2008) HIAM Health is an abbreviation of the East Timorese words Hamutuk Ita Ajuda Malu “Together we help each other”.

 “Almost home”…an email shared from Sue, Anne, and Maree.   Bon Dia Colleagues, Friends, and Family,

Our time at HIAM health Dili has been an amazing cultural, emotional, and educational experience for Anne, Maree and myself. The Timorese have endured incredible hardships and yet are simple, happy people, interested in learning, especially those in our class room.

Leaders breastfeeding their children

We have had 20 days of teaching breastfeeding and nutrition, also laughter, singing, and exercises.  Our endorphins are high. We sleep well. The 3 of us have bonded well and our skills complimented each others’ personalities. We could have never picked a better team.    We have taught women and men from 3 different communities; Aileu , Ermera district, and Atauro Island. They are valued leaders in their communities – non medical. They have shared with us their culture and stories and we will never forget.

Also the HIAM health workers were in our sessions most of the time.  They have heard the information 3 times over, so hopefully they can continue to teach the mothers in the centre. There are nurses amongst them plus those who are studying nutrition, a great benefit to the centre. They have been very impressive.  Jill (director at HIAM Health) has chosen well and they have great respect for her and Rosaria.  We had about 15 to 20 people at each session.   The Mothers and babies/ toddlers in residence, about 10 to 15 at a time, plus some siblings, usually stay for 21 days depending on the conditions. We have children with Tuberculous, heart disease with a weak suck etc.  All with malnutrition, they are put on a “plump-up” corn meal program. It takes about 2 months to make a difference in their body structure. There are 10 breastfeeding mothers in the center at the moment and we will be teaching and encouraging them over the next couple of days and spending time with the little one with a weak suck.

Around maternal health, the mothers eat very little in pregnancy so they can have small babies for easier labour.  Many still give birth at home and some still don’t give colostrum.  Instead they give sugar water. The mother and baby stay beside the fire in a smoky room for a number of days, postpartum. They usually breastfeed for beyond 2 years of age, and all sleep with their babies. Mothers believe when they are pregnant with their next child, that they should wean the first so he / she won’t be infected by the milk. With inverted nipples and delayed milk supply they stop breastfeeding. If their milk is not flowing well by day 2 they give up.

The two directors, Jill Hillary (Aussie) and Rosaria Martins da Cruz (Timorese) are amazing.  Jill works as the advisor and Rosaria as the up-front person.  Both had a vision for this place, meaning ‘together we can help each other’. You can read all about them on the HIAM Health web site.

There is a miracle tree here, called the MORINGA tree, and it is very high in protein, vitamins, and minerals.  Maree has been encouraging everyone to eat it 3 times a day for health and wellbeing. What a blessing as it grows all over Timor.   It’s like breast milk… free and readily available.

We visited Dr Dan Murphy’s clinic at Bairo Pite. So many medical problems and then a ward full of stunted young children,  oh so much to take in!  During our 2 hour round with him, we checked 5 new babies born overnight and witnessed a mother with Tuberculosis, who has been ill for many years, take her last breath! He sees 300 patients a day in his clinic!

Our rest and recreation at Atauro Island over night seemed like a ‘full week’ of rest. We stayed in an Eco hut and enjoyed meeting people who were bringing various skills to help Timor get back on their feet. It warmed our hearts to hear their stories. The clear sea water refreshed us to no end. We enjoyed being at the celebration for Tour de Timor, the extremely tough annual bike ride.  We even shook hands with the President, Prime Minister and his Aussie wife, Kirsty. Oh my, what a day! We also were invited to the US Embassy to have cocktails with Judith Fergin the Ambassador.  Always so much excitement going on here in Dili, we will never be the same. I think that will be enough for now, see you when we get home.”

Blessing Sue, Anne and Maree

Read about the History of Timor Leste (East Timor)

Sue:  aussiesjw@gmail.com

Anne:   scollona@optusnet.com.au

For more information about Sue, Anne, and Maree’s trip to East Timor, please see their article in the February E-Globe.

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IBCLCs Around the World – Natalya Razakhatskaya

I was born in Belarus in 1978. While in school, I wanted to be a doctor just like my granny. Later, I entered the linguistic university and became an interpreter. After graduation, I started to work in a French IT company as a translator, but that job didn’t make me happy. I was eager to be useful to people, so when I got pregnant I decided to change my job. As a breastfeeding mother, I had many questions about breastfeeding and care of my first baby. I didn’t receive helpful assistance from my pediatrician. Luckily, I met the first Belarusian lactation consultant at that time, who explained the simplicity of breastfeeding.  Soon, I decided to become a breastfeeding counselor in order to help other mothers feel happy.

The am-am.info website was started in March 2008 as a personal blog, which my husband kindly gave to me as a present on Women’s Day. Gradually the blog was filled with articles about breastfeeding and natural parenting. At the same time, I began to meet with other breastfeeding mothers almost every week and the blog became a good place for communication. The blog became a unique community which, in addition to the forum, included a list of sites for women, Frequently Asked Questions (FAQ), and a photo-gallery and online consultations on various women’s topics. I made educational video clips about breastfeeding, and how to carry your baby in-arms and in a sling. After a few years of work on the blog, I managed to write and publish a book about breastfeeding, called “Breastfeeding: A Guide for Nursing Mothers”.

On average, about 5,000 people visit the am-am.info website every day. The most popular articles are about normal infant weight gain, infant stooling, low milk supply, and how to transition the baby from artificial feedings to full breastfeeding. Each day, I reply to about 10 e-mails, and about the same number of comments to articles, forum posts and telephone calls.  Also, the website supports live chat and Skype. Occasionally, I organize free educational webinars. I continue to meet with forum members in person at family centers around Minsk and organize local breastfeeding support events.

To encourage breastfeeding in public, we have created a special project: www.go.am-am.info. At this website, you can download stickers of the international breastfeeding symbol and distribute them to cafes and other public places which are friendly to breastfeeding mothers.

The project is funded from personal sources. I’ve received voluntary donations from other breastfeeding support group leaders and breastfeeding mothers from the forum who help answer questions of other visitors. I am really amazed to read feedback from many countries and know that my project can help breastfeeding mothers all over the world.

The purpose of the am-am.info project is to provide an informative resource about breastfeeding and natural parenting and to facilitate communication with other parents. I want to open a test center on this website, first for parents who are interested in breastfeeding, and then an educational platform for other breastfeeding specialists.

Natalya Razakhatskaya, IBCLC

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Mama Aroha means ‘mother love’ in Maori – New Zealand

Mama Aroha means ‘mother love’ in Maori. ‘Aroha’ can be interpreted as love, compassion, sympathise, and pity. It is this ‘aroha’ that drives most of us to do what we do. For the beautiful breastfeeding wahine (women) that we all work with, her ‘mother love’ that flows through her breastmilk not only provides nourishment, but also ‘aroha’ (love) for her baby

Imagine if every health worker provided every mother with consistent and accurate breastfeeding information.  Imagine then if that same mother received the same messages each time she came in contact with a different health worker.  Imagine if we provided this mother with all the necessary skills and knowledge she would need to continue to breastfeed her baby.  Imagine if she could then pass this knowledge and skills onto her friends and family.

It has been this vision that has inspired me, and given me the drive, to develop a new resource that makes breastfeeding simple, interesting and accurate for our 21st century mothers. These ‘talk cards’ were launched in August 2011 at the New Zealand Lactation Consultant Association Conference.

Almost two years ago while I was running a breastfeeding drop-in centre in the community,  I would often find myself scribbling diagrams on bits of paper while I was talking my way through the mother’s issues as this was the most effective way to get information across. Traditionally for Maori, we are an oracle culture who can often catch on quickly and easily when the information is explained verbally.  In fact studies have shown that only 10% of all adults retain information by reading it, while 70% learn through participation in a discussion. Yet, while I was working in the Maternity Unit as a midwife I found there was a lack of resources that suited this type of learning. We needed something that could be used while sitting with the mother ‘talking’ about breastfeeding.

Over the past two years I have continued to help breastfeeding mothers in the community, worked as a BFHI coordinator, set up a peer counselling programme, and became a Lactation Consultant (IBCLC). But my biggest qualification in life is being a mother of four young children. I am still breastfeeding my nine month old baby and find most of my inspiration while I am up feeding him in the early hours of the night.

What makes these ‘talk cards’ unique is that they have been developed at a grassroots level, they are New Zealand-owned and have been made with no other intention other than to help breastfeeding mothers of all cultures reclaim ownership of the knowledge and skills that are necessary to breastfeed a baby. The beautiful mothers and babies that are featured in the cards have been very much a part of the process. These cards have come from the women, this is what they want, and this is what works for them. I have seen with my own eyes how much impact they can have on a mother and her family.

It has been a long process with no sponsorship or funding and there have been many times that I have wanted to give up. There has never been any project planning, just inspiration! So I had to finish what I had started. However, it is the vision to help mothers understand breastfeeding that has kept me going, kept me motived. I often ask myself, “Has this been worth it?” When a mother looks at the cards and has a ‘light bulb’ moment, when I hear her passing on what she has learned to her family, when I see her feel empowered by this knowledge…I can say, “Yes, it has all been worth it.”

“I’m a busy mum of four young children which has given me my biggest qualification in life! “ Written by Amy Wray, BM, IBCLC, PCPA

Lactation Matters co-editor, Decalie Brown, adds …..This was Amy’s very first conference she had presented at, as her family championed her in the background. A loud call to her from the back stalls of the room was her baby being minded by her sister. Amy responded with a  nod as she calmly picked her baby.  There was a scurry towards the stage to produce a chair, where she sat and calmly breastfed her baby , completing her presentation to the ‘oh’ of the audience.   It was a truly magical moment, Amy!

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The Essence of Nelson Babies Growing: Part Two

If you missed the first installment of this article, please see The Essence of Nelson Babies Growing: Part One.

A planting area is born:
We approached the local city council for an area that would be appropriate. We also hoped it would be an area of significance in the region so that families would feel more compelled to plant there. We were delighted when they came back to us with the suggestion of the Centre of NZ where they have a conservation planting programme in progress and are looking for groups to contribute to the planting. This indeed was a significant area for Nelsonians!

The Centre of NZ is the geographical centre of New Zealand. It was deemed so by some surveyor in the UK when the early maps of New Zealand were being developed. Every year when I hike to the top of the hill I picture this surveyor as someone with a sense of humour. Of course the centre of NZ was never going to be on the flat fields all around the hill!

Hiking to the Centre of NZ

Since 2008, once a year, the local NZ College of Midwives, local iwi, and Nelson City Council, host a planting session in our newly formed whenua area. Representative of this are two large totara trees, which were planted at the start of the area and will stand over the area… and a third ‘Lyndell’ totara.

When we first started looking into providing a planting area, we did expect to come up against some obstruction, especially around burial of ‘body parts’.  Strangely enough placenta weren’t considered body parts. Or perhaps we can just be thankful to our maori forbearers who paved the way for us!  Checking health regulations, the only restriction was avoiding planting near waterways…easily done on a hill!

The fact that it is a re-vegetation planting area gave us clear guidelines and very little to discuss around ‘rules’ for the area. So we agreed to the council’s following conditions:

  • The area will be available over a number of seasons until the entire area is planted out. It will then be closed to further planting.
  • The site will only be available for this purpose once a year for the NZCOM event. Casual placenta burying or planting at other times of the year is not permitted.
  • Planting programme: this site is part of the council’s wider re-vegetation programme. There is no particular ownership or expectation about the future of the plant that is planted upon an individual’s placenta.
  • Participants also need to acknowledge there is no assurance that any individual plant will grow or be maintained to maturity given the usual rates of mortality from restoration projects and, as with any maturing forest, that a number of these plants will be replaced by other species as the restorations process continues. To this end we have selected an appropriate planting time to best ensure survival of the plants.
  • Council needs to ensure that appropriate native plants are planted from seeds/cuttings that have been collected from the correct areas (eco-sourced). To best achieve this, only NCC supplied plants can be used for the plantings.
  • As this site is a natural restoration area, no markings of any plant locations are permitted.

During the first year of planting, we had no idea how many families would take up the opportunity of this planting area. In this region there are around 1000 births per year. So it was a pleasant surprise to come over the brow of the hill and see the families who had made the trek.

First year of planting

The land is blessed ….

A song and a prayer…..

And the planting begins…..

In 2010, the Nelson Soroptmist club provided a hand crafted seat for rest and reflection alongside the whenua planting area.  Maia Hegglun, local carver, builder and father, designed the seat from a cultural perspective, to compliment the Whenua Planting Project. The seat is designed as a sculpture telling the story of the seen and unseen aspects of two different cultures coming together and as a functional enduring seat to be used by families (whanau) and the public.

The area has not been without some interesting discussion. It has led some Maori to express some unease about the area. We left the idea with local iwi for some months for them to have a final say and we would have respected any unease they had, but this wasn’t to be the case.  Some Pakeha (European), especially of the mature generation, have also expressed an unease, (or more a queasiness!) about walking past an area where placenta are buried. We hope in time their queasiness will settle.  The dogs that walk with them seem relaxed and we haven’t had a single plant lost to dogs digging them up. The plants from the past three years are flourishing!

Families who have planted their whenua in the area use the walk as regular family time to check on the progress of ‘their’ plant.  They describe the area as ‘special’ and ‘peaceful’.

Indeed a special place to sit and reflect …Nelson babies growing the area, with flourishing plants representing how life moves on and along…

Suzi Hume, Anounska Myer, and Andrea Vincent

Andrea Vincent, Case-loading Midwife, Nelson, NZ via Seo Companies

Toitu he kianga; whatungarongaro he tangata
People are transient things but the land endures

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The Essence of Nelson Babies Growing: Part One

Planting the placenta

Over the past three years our annual ‘planting’ has caused reactions a plenty!  Families clambering up to New Zealand’s geographical Centre is not an unusual sight. Planting in a conservation area also is not unusual, however the ‘fertiliser’ used perhaps is somewhat different.

For New Zealand birthing families to be asked “Do you want to keep your placenta (whenua)?” following the birth of their child, is quite routine.  For those not of these shores we are greeted with a mixture of reactions.  Were it not for our indigenous Maori culture demanding respect of the whenua (placenta), such a question might not be so routine, but still viewed as slightly alternative.

Background:
In Maori culture whenu is the word for land and also the placenta (afterbirth).
All life is seen as being born from the womb of Paptuanuku, under the sea.
The lands that appear above the water are placentas from her womb.

Tangata whenua = people of the land. These people are those who have authority in a particular place. This is based on the deep relationship with that place, through their births and their ancestor’s birth.
As tangata whenua express themselves in that place, they gain the authority and confidence to project themselves into the world.

Child with ipu whenua

Burying a whenua (placenta): Traditionally whenua and pito (umbilical cord) of newborn babies are buried in a significant place, in a specially prepared receptacle. This reinforces the relationship between the newborn child and the land of his/her birth.

Ipu whenua: the receptacle used to house the whenua (placenta) on its journey to its special resting place. Usually clay, it remains unfired to the land (also whenua), so too will the clay of the ipu break down and return to the land. The ipu is lined with absorbent materials such as moss, fern or hair to soak up any blood.

Traditionally Maori bury the whenua in a place of significance to the whanau (family) or ancestors.

It was in the 1930’s when medicine deemed birth to be far too dangerous to occur at home or private nursing homes that, within a 10 year period, all births occurred in one central hospital. The ‘ownership’ of the placenta (whenua), seemed to also be assumed to be that of ‘the hospital’! It took a further 30-40 years for Maori to freely be able to leave the hospital with their whenua (placenta) without an argument with hospital authorities ensuing. It is only in the past 20 years that the change to asking all birthing parents if they wish to keep their placenta has become ‘routine’.

Planting the whenua

The addition of planting a tree on top of the whenua (placenta) is relatively new, but is very popular with Maori and many non-Maori families.

As mentioned in a recent article by Kaumatua Pita Pou:
“It’s no surprise given the kiwi obsession with quite literally putting down roots. That dates back to before the earliest days of European settlement. Maori were known to plant cabbage trees to mark hunting tracks, while the puriri tree, with its sometimes gnarling branches, was used as a burial ‘cradle’. Bodies would be place inside the tree and left to decompose, with the bones later removed and placed in caves or ditches.
The purpose is for the tree to embrace the bodies …so the flesh returns to the earth”. (Ref. The Marlborough Express 1/1/2009 – History’s plantation threatened.)

Increasingly, European families, having experienced the life changing event of childbirth and parenting, also appreciate the significance of ‘honouring the whenua’. Many realise what an amazing organ it is that has sustained the life of their child over those formative months.

Lyndell's husband, Boaz, and Midwifery colleagues

One of our local midwives, Lyndell Rown-Gabay, also held a ‘passion and respect’ for whenua – whenua the land and whenua the placenta. She was unable to bring herself to dispose of the whenua (placenta) in any other way but to bury them. So if parents didn’t want to do so themselves she would take them home, or under the cover of darkness, bury them in some more public place! The Centre of NZ, a local public walkway was one such place. Lyndell also had a flourishing garden!  In 2007, Lyndell died unexpectedly, at aged 40 years old.

Over the years, those of us who work as community  midwives, came to realise many families stored their placenta  in the freezer sometimes for many years. We would return for subsequent pregnancies for the family to joke – ‘oh great now we will have to make room in the freezer for another placenta’.

While many Maori families bury their whenua in a traditional area of their ancestors and iwi land, many don’t. Many young families, are more on the move these days and don’t put down roots in a particular property or are renting that property and don’t feel it is a significant place to them to go so far as planting their child’s whenua.

With this in mind and wanting to honour Lyndell and the work she did, it prompted us to establish a planting area in Nelson for everyone to use if they felt it was the appropriate place for them.

The Essence of Nelson Babies Growing: Part Two will be featured on November 17, 2011.

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