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Working and Breastfeeding: An Interview With Nancy Mohrbacher

Copy of Journal of Human Lactation (2)

International Lactation Consultant Association® (ILCA®)  Medialert Team member Leigh Anne O’Connor recently interviewed Nancy Mohrbacher. Learn more about Nancy’s approach to supporting breastfeeding working families in Leigh Anne’s interview:

I first met Nancy Mohrbacher on a hot August day into 2001. We were both guests on the Montel Williams show. Nancy was the expert guest and I was the “real person” nursing mom guest. I was quite nervous. Nancy, though she said she was nervous, possessed a calm and confident air about her, not at all cocky.  She just knew her stuff.  

Over the years meeting her at various conferences I always learned something new. What has impressed me and what makes her different is that her information is consistently accessible while remaining up-to-date and relevant. Nancy never stops learning and she shares her wealth of knowledge for not only professionals but for breastfeeding families.

The information Nancy has made available about breastfeeding and working in her recent book, Working and Breastfeeding Made Simple, is critical to working families, as employment outside of the home can be a significant barrier to continued breastfeeding.

In her upcoming webinar for ILCA, Nancy will share practical strategies for the International Board Certified Lactation Consultant® (IBCLC®) and other breastfeeding supporters to help working mothers reach their breastfeeding goals. I had the great pleasure to interview Nancy Mohrbacher and here’s what she had to say:

What inspired you to write a book for working parents?

For two years I worked for a national corporate lactation program, where I spoke daily to mothers going back to work. During that time, I realized then that in the years since the last really good book on working and breastfeeding was published we have learned a lot. Even so, recent research found that two-thirds of U.S. mothers who intend to exclusively breastfeed for three months do not meet this goal. The time seemed right for an up-to-date resource that thoroughly addresses employed mothers’ questions and concerns.

What are the unique benefits of breastfeeding for working families?

Many employed mothers have told me what is most precious to them about breastfeeding is that it strengthens their emotional connection to their baby. We’ve also learned more in recent years about breastfeeding as a key women’s health issue. Breastfeeding helps to “reset” a mother’s metabolism after birth. Even decades later a lack of breastfeeding or early weaning increases mothers’ risk of many health problems, including Type-2 diabetes, breast and ovarian cancers, metabolic syndrome, and heart disease, the number one killer of women. Most people know that breastfeeding is important to baby’s health, but now more women are motivated by the importance of breastfeeding to their own health.

What is the biggest challenge for working mothers who are breastfeeding?

Life is complicated, and I think the biggest challenge for working mothers is to distinguish between what is important to achieving their breastfeeding targets and what can be ignored. During my years with the corporate lactation program, I discovered that many new mothers are over focused on the wrong things. Most mothers think, for example, that their milk supply hinges on how much fluid they drink and are drinking massive amounts of water. Research tells us that despite popular opinion this actually doesn’t have a significant effect on milk production. Mothers need to be clear on what does affect their supply so they can take control of their own experience. My goal for Working and Breastfeeding Made Simple is to simplify life for working mothers by clarifying what needs their attention and why. Hopefully, with this information, they can stop wasting their time on the unimportant and focus on those things that truly make a difference.

What is the most unusual strategy that a mother has used to balance breastfeeding and employment?

Breast storage capacity has a major effect on the number of milk removals needed per day to maintain long-term milk production. I’ve been amazed that some full-time working women with very large storage capacities can maintain their milk production without any milk expression during their workday. I’ve learned to never say never!

If you could only give one piece of advice to a working mother, what would it be?

My advice would be to take some time—ideally during pregnancy—to find her tribe. Having a good support network is priceless. During pregnancy, mothers can create this network themselves by talking to family and friends to find those who have had a positive breastfeeding experience. Then they can ask those women to mentor them as they get started. The idea of a career mentor is common. We need to encourage mothers to find breastfeeding mentors, too.

Another way, of course, is to take advantage of online and in-person mother-to-mother support from organizations like La Leche League International, which is almost everywhere, and national organizations like the Australian Breastfeeding Association, Breastfeeding USA, the National Childbirth Trust, etc. It is well worth it to take the time to find other women they can rely on for solid information and emotional support.

What’s the most important thing to know for IBCLCs who support working mothers?

When troubleshooting with an employed mother, my suggestion is to first focus on her number of milk removals (breastfeeds plus pumps) during her entire 24-hour day. Many IBCLCs ask only about a mother’s pumping patterns at work. What’s most important to long-term milk production, however, is the number of milk removals per day and how that compares to a woman’s Magic Number.

When I helped mothers through the corporate lactation program I had the luxury of time to talk as long as necessary to find out exactly what their issue was. I began to realize that due to common misconceptions many women were pumping often enough at work but were dropping feedings at home. I found that was the main source of many women’s milk-production challenges.

 

NancyMohrbacher-190x238Nancy began helping breastfeeding families in the Chicago area as a volunteer in 1982 and became board-certified as a lactation consultant in 1991. She founded and ran a large private lactation practice for 10 years. She also worked for a major breast-pump company and a national corporate lactation program. Nancy is author of Breastfeeding Answers Made Simple and co-authored with Kathleen Kendall-Tackett, the book for parents Breastfeeding Made Simple. Her 2013 tiny troubleshooting guide for mothers, Breastfeeding Solutions, is now available as the ground-breaking Breastfeeding Solutions app for Android and iPhones. Her new book, Working and Breastfeeding Made Simple, debuted in 2014. Nancy speaks at events around the world.

LAO headshot summer 2014Leigh Anne O’Connor is a IBCLC with a busy Private Practice in New York City. She is also a La Leche League Leader. She lives in Manhattan with her husband Rob and their three children. Leigh Anne blogs at www.mamamilkandme.com

 

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Freya’s Gold: Milk Donation After Loss

#ds37 - Mom and BabyIn today’s Lactation Matters, we’ll hear from Monique, who opted to donate milk after the loss of her daughter, Freya. Monique shared her story in honor of both daughters (Aviana and Freya) who passed away. For her, it is comforting to have their names out there and for their lives to be recognized in some way.

Clinical Lactation, the journal of the United States Lactation Consultant Association, has published an article entitled Lactation After Loss that you may find useful as you support bereaved families.

You may also find previous articles on how to become a milk donor and debunking common milk banking myths helpful as you educate others about milk donation options.

Monique’s story:

When I found out that I was pregnant in 2011, my husband, Justin, and I were both excited and scared because we had already been through a first trimester miscarriage and a loss at 23 weeks gestation when my cervix dilated and I went into early labor (Aviana only lived an hour and a half). Due to previous complications during pregnancy, we decided to work with a high-risk specialist to prevent preterm contractions and cervical dilation. During my pregnancy, I was on bed rest for over three months and was monitored very closely. In preparing for the possibility of preterm labor, I was working with a lactation specialist to learn how to pump milk for a preterm baby. At 33 weeks gestation, there was a cord accident and our second daughter Freya died in-utero. I never had the opportunity to breastfeed or pump milk for Freya.

Even though I had no baby to feed, I produced milk and decided that I wanted to pump. The lactation specialist that I worked with during my pregnancy was bewildered that I wanted to keep pumping my milk after Freya died. She seemed confused as to why a bereaved mother would want to keep pumping her milk . . .

My main support to keep pumping came from my husband and a dear friend, who is a naturopath and a midwife. Both of them encouraged me to pump my milk as long as I wanted to.

The pain of losing a baby is indescribable and for me, pumping milk helped create a structure for the days after my loss that were filled with grief. I pumped my milk multiple times a day for six weeks. I stored every drop of milk that I pumped in a freezer. I couldn’t imagine throwing away “Freya’s Gold” because there was so much love in that milk.

In my experience, there is a general discomfort with grief and loss in our culture. There is pressure to close the loop on suffering which is not realistic for bereaved mothers. Pumping milk is one way that bereaved mothers can manage the intense and ongoing grief of losing a baby.

I have always felt very lucky in love (I love you Justin), and even in the darkest days of my grief, I could feel this light and this love from Freya. I knew I wanted to do something meaningful in memory of our daughter. So I called the Mothers’ Milk Bank about donating my milk. For me, donating milk was a way to help other babies benefit from our daughter’s milk and it was a way to honor my body and my experience.

When I lost Aviana at 23 weeks, I suppressed lactation and never pumped my milk. When Freya died, I chose to continue expressing my milk and then donated it to the milk bank. I made these decisions based on what was best for me at the time. I feel strongly that it is important for lactation consultants to address lactation with bereaved mothers and give them the option to pump their milk so they can make an informed decision.

Special thanks to the Mother’s Milk Bank (a San Jose, California based non-profit milk bank serving 13 states in the U.S.) for working with Monique and sharing her story with Lactation Matters. To stay in touch with the Mother’s Milk Bank, please click here.

Photo credit: Indiana Mothers’ Milk Bank

What strategies and tools have you used when talking with bereaved mothers?

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The Power of Milk Donation at Milk Matters in Cape Town, South Africa

By Louise Goosen, RN, RM, IBCLC

Put a group of enthusiastic “Lactavists” in a room, give them a challenge and WOW, there is no holding back!

The story of Milk Matters Milk Bank in South Africa started 10 years ago at Mowbray Maternity Hospital in Cape Town where two of the  founding members were employed part time as lactation consultants. With the support of our colleagues, we collected 20 liters of milk only to discover, to our horror, that no one was interested in using our precious bootie … not surprising when the HIV rate in the country was over 25%.

Soon, our modern day hero, Dr Allan Horn, a neonatologist from Groote Schuur Hospital, heard about our precious milk. He was eager to use our pasteurised milk as he believed it could make a difference to the unacceptably high mortality and morbidity rates of the micro-premature babies in his unit. He was right and soon two other hospitals were requesting donor milk.

Those were small beginnings. We have since registered as a Public Benefit and Non Profit Organisation, improved our donor and milk screening techniques, developed posters, pamphlets and promo videos, sent regular articles to magazines and newspapers, developed a website, and established a presence on Facebook and Twitter. This has enabled us to dramatically increase the Milk Matters donor base. Subsequently, our processing rate has grown from one liter per week to almost six liters a day and it is still not enough. We supply donor milk to four large neonatal intensive care units on a daily basis and 24 other hospitals when the need arises.

Although we started “giving our milk away” at no charge, this had to change and we are now forced to charge a processing fee in an attempt to recover some of our costs. Our sustainability would not have been possible if it were not for the founder members who still offer their services voluntarily.

There is plenty still to be done. In a developing country where the exclusive breastfeeding rate at 6 months is a mere 8%, we could never rest on our laurels. The need to increase our breastfeeding rates as a nation is paramount. Donor breastmilk must never be viewed as a replacement for mother’s own milk, but it does fill the gap when ill health prevails or when mothers need the time to build up their own supply.

Encouraging all mothers to consider the impact of human milk is critical. Crippling, outdated information that “forbade” HIV+ mothers to breastfeed has changed and HIV+ mothers are now actively encouraged to breastfeed while they and their babies have access to antiretroviral (ARV) drug treatment. Twelve months ago, our National Department of Health called on each and every one of us to reinstitute breastfeeding as the norm in our communities. What’s more the Department is encouraging the establishment of donor milk banks throughout the country. Milk Matters has already helped in the setting up of 5 other milk banks and more are in the developmental stages. Our latest invite is from further afield, Malawi, a fellow African country to the north of us.

Milk Matters continues to reach out as the approximately 50 babies that we are feeding every day or 1,500 babies that we are feeding every month isn’t enough. Many more need access to their own mothers’ milk and that is where our true mission lies.

Please visit us on the web at www.milkmatters.org or on Twitter at www.twitter.com/milkmatters.

Louise Goosen’s full time career in breastfeeding started in 1986 when she also ran birth preparation classes for 7 years. She qualified as an IBCLC in 2003. She has been a member of the South African Breast Feeding Association for the last 30 years and been chairperson for over 10 years. Since its inception in 2002, she has been an active member of the South African Kangaroo Mothercare Foundation (KMC). After ten years at Mowbray Maternity Hospital as the resident IBCLC and BFHI co-coordinator, trainer and assessor, she has taken up the voluntary position as chairperson of the breastmilk bank, Milk Matters. She is also still involved with breastfeeding and KMC training for medical, physiotherapy, dietetic and nursing students.

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