Barcelona Breastfeeding Advice
1. What post-birth services do you offer women in Catalunya?
I offer breastfeeding help - to new mums, experienced mums, working mums, weaning mums, general info etc. I suggest solutions to any breastfeeding issue.
2. Do you feel there is adequate support for mothers here in Catalunya post birth in terms of caring fr the baby and breastfeeding?
In some hospitals there are nurses or workers that do help out with the inicial latching once you have the baby in your arms and explain the concept of feeding on demand, but its not very common unfortunately, and its mostly in the public hospitals. In the private hospitals they tend to give a handout telling mums not to feed on demand, to wait 3 hours between each feed and only allow the baby to feed for 15 minutes on each breast. And they will reprimand a mother feeding her baby for longer or if they need to take the baby away to weigh it, often preasuring mothers to 'top up' new borns with formula, or worse still just feed them a bottle here and there while they take them to check on them, without the mother even being aware of it. This can be the best way to ensure breastfeeding isn't successful.
3. You are certified by the FEDCAT Catalan Federation of Breastfeeding? What is FEDCAT and what are its aims?
FEDCAT is the Catalan Breastfeeding Federation, they promote breastfeeding and serve as a networking tool for support groups to have a meeting point to keep up with new research and share resources. They also run courses to train consultants every 2 years, to create breastfeeding consultants.
4. What are the benefits of breastfeeding your baby?
Many direct health benefits for the baby and for the mother and also emotionally fusing the mother and baby and getting them maximum contact to ensure the baby never feels defenceless. The immune system of the child is dependent on the breast milk for development. And the mother's uterus is helped to shrink back to normal by breastfeeding also, not to mention the help to loose the extra weight we gain from pregnancy more for our health than operation bikini...
5. What advice would you give a pregnant woman in how to prepare for breastfeeding her newborn? Is there any literature they can read or advice they can seek?
It's a good idea, like with child birth, to get informed. Going into anything with at least an idea of what we are in for is a good plan I think. Go to the mothers groups near you or that you feel comfortable with before you baby's born, so you see and hear what its like from new mums and hear advice for the basic potential common problems. The prenatal info sessions run by midwives at the CAP or hospital can be good, depending on who does them. Talking to experienced mums particularly the ones that have recently breastfed or are still is also good to do. And of course the internet has plenty to read if you want really search high and low.
6. Many women are concerned about the practice here of taking the baby away from the mother immediately after birth. How important is it that a mother attempts to breastfeed her child straight after the birth?
Very very very important that they dont take your baby away and wash and perfume and god-knows what else!!! For many reasons the baby needs to be close to their mother and smell and feel her as well as to feed straight away if they want/need to.
7. What are the main problems women suffer in the first few days after birth?
The most common is the poor latch, which causes sore nipples due to chafing of the lips and tongue around the nipple (if they latch on properly they shouldn't even be rubbing on the nipple). The chafing can cause dryness and which causes the skin to crack, which can split open up and bleed. Its really very painful if it gets this far and it becomes a vicious cycle of trying to heal something that is being regularly irritated and not allowed to heal properly. But there are plenty more things that can and do go wrong, especially in the first 6 weeks. Bear in mind that we have healing bodyparts, sleep deprivation and extreme exaustion which often mean emotions run very high and you feel so alone with everything new-baby-new-mama that sometime we are not thinking straight to seek out the help we need.
8.For mothers who have low milk production, what would you advise? Is this eventually self-regulating? Are there any herbal remedies? Or should a mother introduce a milk supplement?
The initiation of milk secretion happens due to the drop in progesterone when the placenta is delivered. Milk secretion in the first few days is an endocrine process, not "demand and supply." Another opportunity to empower and boost confidence in new mothers. It's unusual that mom has "no milk" since early secretion occur without the help of the baby suckling. My midwife had a herbal remedy for increasing milk supply. But I find that just have the baby and mama as close as possible and as rested and relaxed as possible can do wonders for regulating milk production. None of this having to entertain guests and family members...especially the first couple of weeks.
9. Until what age ideally would you recommend a baby be breastfed
The WHO recommend at least 1 year is ideal 2 is even better and the first 6 months exclusively breastfed. I tend to agree with this, but I also realise that there are many considerations and circumstances in women's lives that mean this is not possible and I have been helping new mums combine work and life around breastfeeding as much as they can or desire to.
10. There is a huge amount of pressure on mothers to breastfeed for up to 6 months, and many feel very guilty if they do not manage to do so, what advice would you give to mums in this situation?
I don't think adding more preasure to new mums is ever a good idea - and we are all just trying to do the best we can for our babies. Women have to make peace with their limits and their circumstances, its such an intimate thing and we can only do what we can. I just help women believe in and follow their instinct - babies are resilient creatures!
11. How do you feel about mothers mixing formula and breastfeeding during the first 6 months?
I don't recommend it and I offer solutions involving pumping and storing milk. But I don't judge women for the decisions they make, I just offer them alternative solutions if they want to try them.
12. At what age would you recommend a mother introducing solids?
At six months at the earliest and only if the baby is sitting up on their own. Also the introduction of solids is really a confusing thing, as most of us imagine a baby is going to eat a bowl of cereals or whatever on the first go, but in reality they are just tasting things and getting used to chewing for weeks before they actually eat bowls of food. I am more inclined to recommend baby-lead weaning, it's essentially what they did in my grandmother's generation of waiting til the baby shows interest in the solids, and just offering good options about 5 times a day around feeds.
13. What percentage of Catalan mothers breastfeed their babies and on average until what age?
I don't know the statistics really, but I see many mothers breastfeeding until at least 6 months and often longer, depends on work generally. There is a very strong culture here of both parents working fulltime - mother only taking 4 months off and then going straight back fulltime, this makes breastfeeding a serious challenge if they want to continue.
14. Do these percentages correspond with your experience of the international community here?
I find that generally foreigners (like myself) extend the 'time off' work to be with the baby for longer - usually about a year, even if it means living on less for a while. Again its a cultural choice and of course financial.
15. Is it acceptable in Catalunya to breastfeed in public and are there any breastfeeding areas set aside for mothers in public places/shopping centres etc?
I find it's really acceptable to breastfeed in public here, but only until around 1 - after that I see people squirm a little. There are places to go and feeding in a private space in shopping centers and usually in most places you can feed comfortable as long as you aren't shy of course. The only complaints I have personally had are from young American men.
16. What is the primary reason for women discontinuing breastfeeding?
In the early stages: unsolved small problems that snowball into big ones, then 'someone' giving them missinformation that just makes the situation worse and that just makes it too hard, in the mother's perception and so stopping seems easier than continuing. Beyond 4/6 months: Work/financial or cultural stigma maybe. Missinformation here too can be a huge factor, I remember my daughter's doctor told me at her 6 month visit that there was no point in breastfeeding now, there was no nutrients in the milk anymore?! Go figure.
17. Since maternity leave here is only 4 months, how would a mother continue to feed her child need she go back to full-time employment? Does she have any specific employment rights?
There is a way of legally extending maternity leave by 1 month I think, on the grounds of wanting to breastfeed - but it seems to change all the time, and is reliant on the company you work for being agreeable to it.
Women can pump their milk to have enough for the baby to feed during the following day, it sounds more complicated than it can be. Alternatively they can combine feed - by breastfeeding mornings, evenings and nights then bottle feeding during the day. There are options and possible solutions out there.
18. Is a mother entitled to unpaid maternity leave should she not choose to go back to work after the 4 month period?
No - its like the unemployment benefit here, once the time is up, its up!
19. For a mother going back to work after 4 months, do you have any advice on weaning the baby?
I recommend combined feeding, which is technically partially weaning - so its gradual for both baby and mother as stopping cold can be a bit of a shock to both.
20. For mothers who have breasfed for longer i.e. more than 2 years what is the best way to wean their child?
It can be a challenge but it depends on many things. Usually I do an overall assessment and start suggesting the things I think will work first and go down the list of options/tricks until there is success. By this stage they are old enough to understand things so explaining things generally works well. I know how tricky it can be as I did it with my daughter at around 2 years of age and am about to be in the same boat with my son who is nearly 2, but every child and family is unique so its important to consider as many elements of their lives as possible.
21. Do you have any particular success story you would like to share with our readers?
I can honestly say I love seeing mothers find the right solution for their specific breastfeeding hickups, as long as they come out of it all with a positive experience and the outcome they wanted, I feel good about what I do. I have a particular soft spot for single mothers and mothers with twins - as we all do who have struggles with just one baby and lived how hard it can be sometimes, so when I see mothers with twins or doing it on their own, I am so impressed when they persevere with breastfeeding as they all say the same, it eventually gets really easy and makes life so much easier.
22. How would our readers contact you for help or support with breastfeeding?
My mobile is 626 122 047, I am mostly able to answer it, but I have 2 kids, 1 is a toddler, so just keep trying. I have also started a drop-in group at the Lou's store MUJER in born every 2nd and 4th tues of the month at 11am - 2pm aprox. Anyone is welcome with any type of breastfeeding problem or doubt....initiating, weening, combining, getting general info, etc.
And most importantly there is no judgement, just support in the decisions you make!
(May 2011)
