Hit the Ground Running

I returned to Thailand the end of July and was immediately back to life away from apprenticeship and no sleep. Here's a summary of all that's been going on. Pictures and individual posts on each to come later (in my spare time HA!).

Apprenticeship: There will be a much bigger post about this later. 50 days in Bali and 40 births! After 2 years of apprenticeship there, a total of 100 births under my belt. So many life-changing experiences. I left with confidence!

World Breastfeeding Week: The first week of August saw me participating with breastfeeding events around Bangkok. One was a big media promo at a local hospital with lots of Thai celebrities that support breastfeeding. My family and I also attended a Thai breastfeeding flash mob at the biggest shopping mall. My children got their picture in one of the local papers.

Church: With 4 children in school, I can be more active in outreach ministries. The one in focus right now is at the Immigration Detention Center (IDC) aka PRISON for refugees and others. A group from our church goes to visit 1 hour a week with various detainees. Food is horrible, living conditions are deplorable. My visits were with Wesley, a wonderful man from Cameroon. We brought him and others fresh foods, laundry soap, shampoo, a Bible, and so much more. I was thrilled to be the one to tell Wesley that we were successful in getting him released and repatriated. 100s more (and many children there) are still waiting, with much more difficult situations with little hope of freedom in the near future.

Bangkok Birth & Beyond: I try to not be booked for more than one birth a month, but sometimes it's hard to say NO, especially when it's repeat clients! One in August, waiting for one in September. Two in October. One (many two) in November. I'm also already booked for 2 in April and one in May! Mix in a lot of private childbirth and breastfeeding visits, and I'm filling up my part-time hours quickly.

Foster Baby: I am doing foster care for a newborn that was born the end of August. Her mother first contacted me in May looking for options but heavily leaning towards abortion. I was able to counsel her and told her that I would support her however I could if she chose to give birth and arrange adoption. She gave birth to a beautiful 4.5 lb baby girl and was so happy to give her life. I caught her baby in the hospital! I am caring for the baby most days and nights. I have low breastmilk supply but can comfort nurse her while bottle feeding her donor breastmilk that amazing Thai women (that I've never met!) have gifted to us.

School for kids: Yay for four kids in school! Grace started 3rd grade and has an awesome artsy teacher that works with Grace's unique (dreamy) learning style. Isaiah started K5... pray for his teacher with 8 out of 12 in the class being very active little boys. The twins started K4 and are loving school. No tears for them!

Midwifery studies: With all of the above going on, I am barely able to focus on finishing this Masters of Midwifery Arts and Sciences with AAMI. The assignments I'm currently working on are geared towards sitting for the NARM exam next fall. I'm mentoring 3 other students, doing research, writing papers, creating protocols, and more.

CPM process: My apprenticeship is done, so all that I have left is compiling my protocols, informed consent document, and documents for practice. These papers plus finalized birth, newborn exam, etc. forms will all go with me to Bali in Christmas for signing and notarization with my preceptor.

Speaking of my preceptor... Robin Lim has been nominated for CNN Heroes 2011!!! Please go vote for her 10x a day from now until Dec. 7th. http://heroes.cnn.com/vote_en.aspx

Conference choices & Excitement

When registering for the Trust Birth Conference there were so many choices for the classes. I decided that even though some topics seemed more "fun" or maybe some speakers were on my "want to hear before I die" list, that the topics necessary to fill in my educational needs were more important.

Pre-conference is the 2 day skills lab. Most of these skills I already know but I feel I need a refresher and to see how other midwives do these. And there are a few skills I do still need.

I get to hear Dr. Jeanne Ohm (chiropractor and natural birth advocate) and Dr. Sarah Buckley on opening night.

And for the classes and why I chose them:

Track 1: Pamela Hines-Powell: Pre and Postnatal Depression
I had PPD. Others I know have had PPD. I feel that I can never know enough about PPD. And the midwife Pamela was the phone backup midwife for me with my twins homebirth.

Track 2: Jodilyn Owen: Newborn Assessment for Midwives
My newborn assessment is rusty. My preceptor doesn't teach it very well and I don't want to miss something on a newborn!

Track 3: Gail Hart: Postpartum Hemorrhage & Other Third Stage Difficulties
I have seen lots PPH in my time in Indonesia. Even there we did whole discussions on this. Again, can never know enough about PPH.

Track 4: Panel (Combest, Denny, Craig): Practical Skills for Midwives in a Third World Country
This is the class I'm most excited about. All of my midwifery training and work has been in 3rd world countries/environments.

Track 5: Gail Hart: The First Sixty Minutes of Life
What to do and not to do with newborns in the first 60 minutes when it comes to protocols, interventions, etc.

Track 6: Amanda Hofedetz: Toxins in Breast milk: A Global Perspective on the Effects of Diet and Lifestyle
One of my specialties for AAMI is on breastfeeding.

Track 7: Panel (Combest, Edmonds, Hart, Hartley, Zittle): Licensure—Planning to Practice With or Without
I have decided to work towards the CPM (see previous post) but still want to know more of the pros/cons and how to work with those.

Track 8: Jenny West: Water birth—Promoting Trust and Less Interference
I love waterbirths and see a lot of them. I also see a lot of them done wrong in the hospitals here.

Track 9: Karen Strange: Meconium: Facts, Implications, and Perspectives
I really wanted to take Karen's neo-natal resuscitation class but it's the same time as the skills labs. So, I'll settle for 2nd best and at least hear her on a different topic that is somewhat related.

I am so excited about this conference. Leaving in less than 48 hours. The weather in Bangkok this week is supposed to reach at least 100F. Weather in Los Angeles? Highs in the mid-60s. After 9 years in Bangkok and no winter, I'm gonna freeze my butt off and looking forward to it!

My newest article 3 of 3

I just had published my final of 3 series articles published in the BAMBI magazine. It's the main pregnancy and parenting magazine for expats in Bangkok. So exciting to open it up and see it in print! I have been getting a lot of thumbs up from all over the globe for these, so thank you readers!

Here it is:

Breastfeeding More than One: Tandem Nursing
By Erin Kannon

I have a problem and there is just no solution: I have three children wanting to breastfeed and I only have two breasts! How did I end up in this situation? I have 17 month old twin girls and a three year old little boy who all love to be breastfed. I never thought that I’d be breastfeeding a toddler at three years old or that I would ever have twins but here I am breastfeeding all three. My situation is a little extreme but many women out there are breastfeeding two or “tandem nursing” twins or a baby and a toddler.

Women choose to tandem feed their children for a variety of reasons. The main reason is that their breastfed toddler wanted to continue after the new sibling is born, especially if the toddler is still very young. As stated in a my previous article “Breastfeeding Your Toddler”, there are many benefits to breastfeeding a toddler and these benefits reach far into the second, third, fourth, or more year of life. A pregnancy and new baby are no reason to stop breastfeeding and cut short those benefits. Older children have to adjust to a new baby, and breastfeeding helps with the adjustment and continued bonding time that he craves. If your toddler stopped breastfeeding during your pregnancy due to a diminishing milk supply, it is possible for him to be breastfed again. You may have to re-teach him how to have a proper latch on your nipple.

Preparation for tandem nursing is important during pregnancy. Continue eating and drinking enough for breastfeeding through the pregnancy and even more after the birth. If your toddler is breastfeeding as much as the new baby, you may need 1000 extra calories a day, paying special attention to high quality foods. One risk for tandem feeding mothers is a lack of nutrition, especially if your children are spaced close together.

After the new baby is born, your breasts will make colostrum again, so make sure that the baby gets the majority of it. Expect to have some soreness and pay attention to correct latching from both children. You can choose to feed each child separately or together. If you decide to feed them separately, the child who needs the most volume for weight gain or the child who can handle a heavier flow of milk should be breastfed first. The toddler can also help with engorgement and reduce the risk of plugged milk ducts.

You body should have plenty of milk for tandem feeding. The “supply and demand” that works with one baby will work with two children as well. Pay attention to the number of wet or dirty diapers, frequent feedings, and normal weight gain for the baby as you would if only breastfeeding one. Your toddler will be receiving creamier milk than usual, may fatten up, and could even have newborn looking poops! The best part about this stage of milk is its high levels of immunities that your toddler will receive. If there seems to not be enough milk for two, the younger baby should take priority and make sure that your toddler is being given enough other foods to make up for his need in calories. If one child becomes sick, there is not much risk of cross-infection between children or the breasts, except in the case of thrush (yeast).

The logistics of breastfeeding two (or more) will work themselves out over time. There are advantages of breastfeeding only one at a time. Each child will have undivided attention, especially if there are jealousy issues, or you may find that the child not being fed will be jealous while waiting and you’ll end up feeding them together. If you find that you are feeling “over-touched,” feeding one will help. The biggest disadvantage to breastfeeding one at a time is TIME, as you will spend a larger portion of your day feeding if your children have to take turns. You will also have to figure out a way to keep the other child occupied during feeding times.

To get into position for breastfeeding both children together, it is easiest to correctly latch on the newborn first and then let the toddler figure out his position. You may need pillows or a footstool and maybe even an extra hand to get situated until you get comfortable doing it on your own. Double cradle, upright, or football holds work well. As the newborn grows, you can get more creative with positions. Side-lying with the older child draped over onto the top breast works well, as does lying on the back with a child in each arm.

When tandem feeding, your levels of oxytocin will be very high so feeling a little “foggy-brained” is normal. Make sure that you get enough rest as your body is working harder to produce extra milk. It is also normal to feel “over-touched” or to not like the sensation of breastfeeding the older child. Some mothers only let the toddler have one side or come up with “rules” for breastfeeding, such as only before naptime. Breastfeeding is an ever-evolving relationship between you and your children. Your children will bond together as they feed together and may even wean together as twins usually do. This is also a time where you can work with their communication and how they interact together.

Tandem feeding can be challenging. In today’s society we rarely if ever see or hear of other women breastfeeding more than one child at a time, let alone just one child past a year or so. There is very little “group wisdom” to be passed down. Tandem feeding is normal in many cultures, yet women often breastfeed in private because of peer pressure and are embarrassed to say that their toddler is still breastfed. Our bodies are designed to make milk and plenty of it. Surround yourself with supportive friends and family and know that you are giving your children a precious gift.

For further information:
Mothering Your Nursing Toddler by Norma Jane Bumgarner © 2000 (in the BAMBI library)
Adventures in Tandem Nursing by Hilary Flower © 2003 (also BAMBI library)
http://www.kellymom.com/ (general research-based information and forums)
http://www.mothering.com/ (articles and breastfeeding forums)

My newest article 2 of 3

I just had published my 2nd of 3 series articles published in the BAMBI magazine. It's the main pregnancy and parenting magazine for expats in Bangkok. So exciting to open it up and see it in print!

Here it is:

Breastfeeding During Pregnancy
By Erin Kannon

One day as I was breastfeeding my son, I realized he was not a baby anymore. I began thinking about babies, wanting more, and realized, “wait a minute, I missed my period this month, could I be pregnant?” The next morning, two pink lines on the pregnancy test stick revealed that I was definitely pregnant. During the next month, my nipples hurt some and I wondered if I should stop breastfeeding my son, who was definitely no longer the baby since there was a new baby on the way.

Welcome to breastfeeding during pregnancy. If you read my article “Breastfeeding Your Toddler” you know that there are many benefits of breastfeeding your child well past the first six months and on into his second, third, or fourth year of life. Breastfeeding is intended for years and not months, continues attachment with your child, and has unique nutritional and immunological benefits. A new baby does not need to end the breastfeeding relationship that you have with your older child. The dynamics of breastfeeding during pregnancy are a little different, and as an expecting mother, you will need to take care of yourself and your growing baby inside.

Breastfeeding during pregnancy will most likely require a little bit of determination and a whole lot more of extra food. This should not be a problem as most pregnant women love to eat! If you are still nursing a very small baby exclusively you will need about 300 extra calories for pregnancy and another 350 for breastfeeding. If your child is older you will need about 200 extra calories. If you find that you are not gaining enough weight, increase the amount of calories you consume, especially in protein. Protein builds breastmilk and protein builds your growing baby. If you are hungry or feel fatigued, eat more! Remember that you will need extra fluids as well.

When breastfeeding during pregnancy it is common to have some nipple discomfort. You may or may not have sore breasts and this can change during the months of pregnancy. You might also feel a little nauseated, restless or “creepy-crawly” during the feed. This is your chance to practice those breathing exercises for birth! Try to remember your motivation for wanting to breastfeed your toddler and make some breastfeeding “rules” for him if needed. Check that your child has a good latch to help with your comfort level. Fatigue is also common, especially if you are chasing a toddler all day. Take care of yourself and make sure that you are having restful nights and a nap during the day if possible. Try lying down to breastfeed your toddler and nap together.

Your milk will change during pregnancy. Many women notice a change in production, and about 70% of women will have a decrease of supply. Your toddler will most likely notice a reduced let-down reflex and a more salty taste. You can explain these changes to him and he may continue to want to breastfeed even if your supply drops or goes away. There are no known safe options, pharmaceutical or herbal, to help your supply during pregnancy. Some foods, such as oats may help. If your milk goes away, your child can still “dry nurse” if it is not too uncomfortable for you. Expect him to switch back and forth between breasts trying to find more milk! Your body begins producing colostrum by your 20th week of pregnancy and he may want to breastfeed for longer periods of time again.

As your pregnant belly grows, your toddler will run out of room on your lap during breastfeeding. Expect to find yourself using new positions and your toddler experimenting with “nursing gymnastics”. Some breastfeeding positions that you can try while navigating over your bump are the cradle-hold (modified), football hold, toddler standing, seated side by side, back-lying, side-lying, or any which way!

At some point during your pregnancy, you may consider weaning your toddler. Many toddlers choose to wean due to the change in taste or supply. Some wean gradually and others abruptly. An older child is more likely to want to wean, though once the new baby has arrived, he may show interest in breastfeeding again. Weaning is common during pregnancy as your hormones change. Studies have shown that of those breastfeeding and pregnant, 57% weaned. Your decision to wean or not will come down to how you are feeling (body wisdom), cultural preferences, if you want to tandem feed, and what feels the most natural to you. Your needs are just as important as your child’s needs.

Is breastfeeding during pregnancy safe for your unborn baby? Research shows that breastfeeding does not cause premature labor or dilating contractions. The hormone oxytocin that is produced from nipple stimulation does not have an effect during pregnancy due to interaction with other hormones and oxytocin receptors in the uterus. If your healthcare provider tells you to wean because you are pregnant, ask for the reasons why. As long as you have no major health concerns, you are gaining enough weight, and you feel well, there is no reason to stop breastfeeding. One advantage of breastfeeding a toddler is that if you do have a premature baby, you already have a milk supply going. Breastfeeding during pregnancy does not affect the milk supply after the birth.

I continued to breastfeed my son during the first three months of my third pregnancy. I then learned that I was carrying twins and was told that I should immediately wean him. An abrupt weaning would have been devastating for us both, but I knew that weight gain would be of utmost importance for a twin pregnancy. I slowly weaned him as my supply diminished and by my 6th month, he had weaned though he never stopped asking to breastfeed and would occasionally dry-nurse. I was relieved and so happy that he remembered how to latch on correctly after the twins were born. This helped him during those first few months of craziness with new babies and gave us some very special sharing time.


For further information:
Mothering Your Nursing Toddler by Norma Jane Bumgarner © 2000 (in the BAMBI library)
Adventures in Tandem Nursing by Hilary Flower © 2003 (in the BAMBI library)
http://www.kellymom.com/ (general research-based information and forums)
http://www.mothering.com/ (articles and breastfeeding forums)

My newest article 1 of 3

I just had published my 1st of 3 series articles published in the BAMBI magazine. So exciting to open up the magazine and see it in print!

Here it is:

Breastfeeding Your Toddler
By Erin Kannon

When I started on my breastfeeding journey over five years ago, I did not know a single woman who had breastfed her baby for more than a year. I was not aware that nursing a toddler was an option! As I read more about breastfeeding and had such success nursing my firstborn, I did not want to force my daughter to wean and learned that many women breastfeed past one year. During my research I was surprised to find that the World Health Organization (WHO) recommended breastfeeding for at least two years.

Breastfeeding a toddler can be a satisfying experience. Your breastmilk offers optimum nutrition because it contains everything your baby needs that he is not getting from solid foods, especially when he reaches the finicky or picky eating stages. Breastmilk will also promote better health past infancy as your body passes on antibodies as it did in the early months. You can expect fewer ear infections, more resistance against infection, fewer allergies, better dental health, a stronger immune system (from bloodstream to respiratory system to intestinal tract), and fewer skin problems such as eczema. If your child does become ill, breastmilk aids in hydration and is easily digested.

When breastfeeding a toddler, there are a few things that you need to keep in mind. Breastfed babies and toddlers tend to grow slower and do not “measure up” on growth charts. Remember that these growth charts are based on formula fed babies or toddlers that are weaned and drinking cow milk. Iron-rich foods are needed after one year as iron absorption is reduced after the addition of solids. Cavities are rare from breastfeeding at night but remember that you still need to practice normal dental hygiene with your toddler.

The toddler years are a time of emotional development for your toddler. Breastfeeding during this phase aids in attachment to the mother while feeling safe to explore and gain independence. You can also calm a child easier when he becomes hurt, is teething (natural analgesic), or needs to take a nap or go to bed.

Breastfeeding during the toddler years goes through phases. During the second year (13 to 24 months, the toddler is still more like a “baby” and will continue to breastfeed frequently. Many toddlers at this stage go through a “nursing strike”. Assume that your child is not ready to wean and look for other areas of discomfort such as a stuffy nose, sore mouth, or broken tooth. Also use this phase to teach a nursing code word, such as “Milkies” or “NumNums” or as it is in my house, “Mama Milk”. Expect your toddler to want to experiment with a variety of breastfeeding positions and want to use his hands all over the place, including your hair, belly button, ear, your other nipple, or his lunch. Consider using a “nursing necklace”, toy, or stuffed animal to help redirect those hands.

Breastfeeding through the “terrible twos” (24 to 36 months) can help to head off tantrums. Tantrums are usually a result of a situation that feels tense for a toddler who cannot yet communicate his needs. Breastfeeding can diffuse the situation and also help you calm down as well! Frequent breastfeeding at this age can come from stress, over-stimulation, or boredom. At this phase expect your toddler to discuss breastfeeding with you. He is old enough to understand any breastfeeding rules you may have such as waiting until naptime or after dinner.

Some women continue to breastfeed their toddlers when they reach three years old. A nursing strike at this age could be weaning. Many women find it easier to breastfeed at this age compared to the two year old stage. Expect to have more conversations during breastfeeding. Last week I was breastfeeding my son (he’s three) and he stopped to tell me “I fight dragons!!!” and went right back to eating! This is usually the age when toddlers will discuss breastfeeding and think about when they want to stop. You are definitely not nursing a baby anymore. If your child is breastfeeding at the age of four and beyond, he is still enjoying the time he spends with you and continues to receive the benefits of breastmilk. Breastfeeding will become a memory for your child.

You also benefit from breastfeeding for more than a year. You will have stronger bones and a lower risk of breast and other cancers. Breastfeeding can also suppress menstruation which helps with natural child-spacing. Note: You can NOT rely on breastfeeding your toddler for contraception! It is important for you to have good nutrition. Focusing on protein, calcium, iron and zinc will help you to continue producing a quantity of milk. One side affect of nursing a toddler is also a side affect when nursing infants: lower estrogen levels resulting in vaginal dryness. This may also decrease your interest in sex when the decreased hormones are combined with fatigue and sense of “constantly being touched” or “touched-out”.

A common breastfeeding difficulty that continues into the toddler years is nipple discomfort. It is still possible to get mastitis or thrush (yeast) so continue regular hygiene but no soap on the nipples. If you are pregnant again, expect to feel some tenderness. Discomfort can also come from the toddler teething. Work with your child’s latch and make sure that he knows how to let go of your nipple without grazing it with his teeth. “Gymnastics nursing,” when your child decides to breastfeed in any sort of creative position, can also lend to some discomfort as well.

Depending on your culture and where you live, you may or may not have to deal with criticisms of breastfeeding a baby past one year. Pressures from family, partner, or strangers can make you feel like weaning for not doing what everyone else does. Remember that breastfeeding your toddler is a mutual choice for both you and your child. You can choose to breastfeed in public or in private. Older toddlers can be delayed or use a “code” word for nursing. Any doubts can be overcome when you see that your child is happy, learning, and growing. This is chance for you to educate others about the benefits of extended breastfeeding and the recommendations by the WHO to breastfeed for longer.

At some point during your breastfeeding relationship with your child you will consider weaning. If you become pregnant you may or may not want to wean, but it is possible to continue breastfeeding during pregnancy. As your milk changes, your child might not like the taste and decide to wean on his own. If you feel that you need to wean, you can choose to do so gradually. Abrupt weaning is usually not easy for the child and can cause engorgement for you.

When do most children wean? Consider that our ancient ancestors breastfed for at least two to three years. Large mammals wean when their birth weight is quadrupled. For humans, this is two to three years old. Large primates wean when they reach 6 times the length of gestation, about 4.5 human years. Ultimately, it is up to you and your child. Child-led weaning tends to be the best for your child as he can determine when he no longer needs to be breastfed, emotionally or physically.

I never thought I would be breastfeeding a toddler. It has been one of the most fulfilling and satisfying experiences of my parenting years. Yes, there have been times that I felt like quitting, but I know that his health and bond with me are more important. You do not have to breastfeed your child forever. Take it one day at a time and enjoy every minute of it.

For further information:
Mothering Your Nursing Toddler by Norma Jane Bumgarner © 2000 (in the BAMBI library)
http://www.kellymom.com/ (general research-based information and forums)
http://www.mothering.com/ (articles and breastfeeding forums)
http://www.drjacknewman.com/Breastfeeding-help.asp (breastfeeding articles)

Becoming a Lactation Counselor

I decided that since I already had so many roles (pun intended) on my plate that another couldn't hurt.

I first got interested in birth work after the difficult time I had breastfeeding my first baby. I realized that there was no one available to come at my call to help me. There is only one fully trained lacation consultant (LC) in the whole country, Meena. (I didn't know about her at the time). She is so busy working at the only baby-friendly hospital and doing lactation work with other hospitals while also helping to enforce the WHO standards of forumla marketing.

Meena really encouraged me to consider going into lactation work as there was a great need for it and I had come to love working with breastfeeding women while working as a doula and childbirth educator. I enjoyed my training with Childbirth Int'l and was so excited to hear they were about to begin a certified lactation counselor course in October. I enrolled quickly to get an "early bird" discount on top of a graduate discount. I knew that my doula/CBE training was good for breastfeeding education and wanted something way more in depth. While the training will not be as in depth as a LC that is IBCLE trained, this is a close second I believe. This will focus some on education and a lot more on solving breastfeeding problems.

I began the course two weeks ago and I am so impressed. Right now I'm working through anatomy and physiology of breastfeeding. The breastfeeding COUNSELOR part is fascinating, and just by browsing what I will be studying, I know that the counseling skills will be a huge asset to my midwifery and doula services. A lot of what I do with women now is counseling. Sometimes it's just listening to birth stories. Other times it's helping to build a birth plan, explain information to a worried father, debunk baby-sleep myths, and more. What I also already like about the course is that all of the books I need to read and about 75% of the assignments can also be used for my midwifery education so I'm not having to do double the work!

Of course I can't know everything about every topic, though I wish I did. I now have a growing list of people that I can refer to when I know it's a situation that I can't handle. Breastfeeding problems that I can't solve go to Meena. If it's someone in need of major psychological help, depression, marital, etc problems, I have a Christian counseling group that I can refer to. (They're actually the parents of two of my former students!) The BAMBI group here also has support groups for everything from PPD to breast cancer to SIDS.

One of the requirements for certification is to support a minimum of eight women for a minimum of 3 hours each. Since enrolling, I got my first phonecall needing help with breastfeeding just this week. The baby was born 5 weeks early and I had JUST read the section on breastfeeding preemies which was so helpful! Breastfeeding counseling is going to be great for my family because it will be hours that I can schedule more easily than births that just happen when they happen. Will I earn money from this? Not very much, but I just love the satisfaction of helping a mother work through her breastfeeding problems or to establish breastfeeding with a newborn.

So how did I work through my problems of breastfeeding my firstborn? Well I suffered horribly for seven weeks. I suspected it was a latch problem as I heard "clicking" when she nursed. The nurse at the hospital had said she was doing fine before we were discharged. At the 4 week checkup, our pediatrician (supposedly trained in lactation) said, "oh she's just a noisy eater." Never mind that the baby was puking up her whole entire meal three times a day, my nipples were raw, and every second of nursing hurt. I went to a BAMBI meeting (similar to La Leche League) and that day, a woman from Canada was visiting. She just happend to be a LLL leader and said that maybe she could help. She took the time that no one else had bothered to do for me. She watched me breastfeed for over an hour, checked the positioning, the baby's mouth, and the latch. What I could not see over my engorged breasts was a baby that was sucking in her bottom lip! After correcting the latch and training the baby to open her mouth to latch and keep the lip down, breastfeeding was painless within 24 hours. No more puking because she wasn't swallowing in so much air.

I don't know the name of the woman who helped me, but she forever changed my views on breastfeeding. I learned that babies need to learn how to breastfeed as much as the mother does. I learned that women need the support immediately and not weeks later, as that's when most women give up. I was ready to quit a week later if breastfeeding was still not working. 6 to 8 weeks had been my goal anyway at the time. Wow so much has changed in my breastfeeding goals! My daughter was breastfed to 19 months. My son was breastfed to 19 months, weaned during the rest of my twin pregnancy, and unweaned shortly after their birth. He is still breastfed at over 3 years old. My twins are 15 months old and have never had a drop of formula or even a bottle! Nursing them has been a huge challenge and reward.

Scholarship!!!!

I know this blog has been quiet, but I've been working! Every 3 months AAMI (my midwifery school) does a drawing and one of the prizes is 1/2 off tuition scholarship. To be a part of the drawing, you're given about 20 questions over a 3 month period. These questions have to be well researched with citations given. Not easy. I could only do about 7 of them. BUT, I won a scholarship! So, I called Carla, the head of the school and we talked for about half an hour. She totally thinks I can do the whole program from here and was also so excited to have a Christian missionary enrolling. She said she'd do anything she could to help me out with finding books and such.

So, I enrolled! And the neat thing is that I can postpone my start date for up to a year. I decided that August 1st would be a good starting time because a) I have time to get my house ready and study area set up b) twins will be over a year old and more routined with afternoon naps, c) regular school will be starting soon after that d) I'll have had the summer to collect textbooks. I'm so so excited!!!

On a different topic, I'm writing 3 articles for the pregnancy/parenting magazine that is a part of BAMBI (Babies & Mothers of Bangkok Int'l). It's a 3-part series: Breastfeeding Toddlers, Breastfeeding during Pregnancy, Tandem Breastfeeding. I've really enjoyed doing the research since it's relevant to me as well. I'm not only nursing 6mo old twins... I'm also still nursing my over 2-yr old as well. It's got it's own set of challenges! I'll post the articles as they are done. Also I still need to post the adventure of my friend having an unassisted birth at my house.

Having twins is busy busy, but I am so thankful to live in a country where I can hire someone to help me, which also gives me a little bit of free time to study and do what I love!

CBE class birth outcomes

All of the mamas in my first childbirth ed classes have had their babies. We had a fabulous class reunion where everyone shared their birth stories, showed off their babies, and discussed what it was like being new parents.

First birth: They were using a gov't hospital and the doctor had been talking about C-sections from day one. Guess what she got? First he tried the "your pelvis is too small" excuse. Then the "you're too fat for vaginal birth" excuse. Then the "you have PIH (pregnancy induced hypertension" excuse. Well, they fell for the PIH one. Her blood pressure was slightly elevated but in the safe range. AND the doctor recommended c-section when inducing would have been the safer, evidence-based alternative. The baby was born on its due date by C-section. The hospital kept the baby for "observation" for 2 days and breast-feeding was a nightmare. As I said in my classes, you get what you sign up for. If you know your doctor has a high C-section or intervention rate, you're playing the odds that you'll get the same. They are happy overall. Breastfeeding lasted less than 6 weeks after she went back to work =(

Second birth: Mama was at a great natural-birth hospital, totally set on natural birth. Went 8 days overdue. Decided she wanted the baby out "because it's more days I can spend with him before I go back to work." So she traded 1 or 2 more days inside for an unnecessary C-section. What happened? EXACTLY as the "mock scenario" we played out in class. She asks for her water to be broken. Never mind she'd been slowly in labor the last couple days. We had discussed the risks of the water being broken. But that's what happened, and the result? A posterior baby. The early "prodromal" labor that happens for a few days is usually the uterus rotating the baby into a better birthing position. So the baby is posterior, she has major back labor, not dilated enough to get in the birth tub, so asks for... an epidural. The epidural eventually wears out, so it gets topped off. A typical side affect happens to her... too low blood pressure. So they give her a drug to keep it up. The result? The baby's heart rate goes way up. So all of a sudden... ding ding ding. Emergency, must get out baby NOW. Aaaarrrggghhh. See the cascade of interventions here? Well, at least breastfeeding is going fabulous for them.

Third birth: Aaahh, finally a vaginal birth. I was supposed to doula for them, but she went into labor 3 weeks before her due date, didn't have my contact info with them (since they'd gone in for an appointment and they realized she was in labor), and so I missed a birth =( She was in labor, but the doctor wanted to using EFM (electric fetal monitoring) to see what was going on. It was showing the baby's heart rate reacting slowly to contractions. Her doctor said, you need a C-section now. She said, "no way." The doctor said, your baby is going to die then. She says, "no, I do not consent to a C-section." They waited a little while and she prayed and prayed and had more EFM done. Which showed the heart rate doing better, so the doctor said, yes you can "try" for a vaginal birth, but you have to have EFM during your whole labor. What that means is you are stuck on the bed during all of labor and can really do nothing for pain management. My hero stuck to her plans. Yes, her water was broken, yes, she was stuck on her bed, but 4 hours later and NO PAIN DRUGS, birthed a beautiful 5 lb 5oz baby!! She said she wanted me there so bad, but I told her when visiting her at the hospital... "What did you need me for? You did just fine." Breastfeeding went really well, until she went back to work 8 weeks later.

I have advertisements out for a new series starting up, but no responses yet. In a way, I'm hoping no one wants classes right now as I'm too tired, but I really love the teaching and want more of it!

Police Arrest 150 More Christians

Thought some of you might find this interesting. Christians are continuously persecuted in Eritrea (NE Africa).

Compass Direct News reports that in a large-scale roundup the past week, Eritrean authorities have detained 150 Christians from at least five of the country’s outlawed churches. Starting Wednesday (October 25), security officers in the town of Mendefera began going from house to house, arresting local Christians from a list they compiled of known members of Pentecostal churches and the Orthodox renewal movement. During the first day’s raids, a total of 38 men and 17 women were incarcerated at the military fort in Mendefera, 30 miles south of Asmara. Local sources confirmed to Compass that police authorities were subjecting the detained Christians to beatings and other physical mistreatment. According to eyewitnesses, at least 10 nursing mothers were among the new prisoners, all of them forced to leave their infants behind.

I thought Isaiah would NEVER...

... exclusively breastfeed for a year! But we did it!

Isaiah turned 1 years old yesterday!!! My how the time has flown.

For the entire year, his only source of nourishment was breastmilk. That is a huge feat to accomplish in society today. "But he's 6mo old and NEEDS solids." Nope. Look at those chunky thighs. "But he's 9mo old and is ANEMIC." Nope. Did that blood test just to prove the pediatrician wrong. "But he won't like solids because he missed that developmental window." Nope. Look at him chow down on that cucumber today.

Why is there such a rush to add solids, when breastmilk alone gives all of the nutrients and calories a baby needs for at least the 1st year of life? I have 2 theories. The first: there is no education and support for new mothers. The second: awful, money-hungry, infant formula poisoning companies, such as Mead Johnson and Nestle to name a couple.

So what can we nursing moms do? Nurse in public and show breastfeeding as something normal and natural and easy to do. Kindly educate those pregnant mothers we see. Destroy all copies of Babywise (and similar schedule feeding books) that we can find. Petition formula companies to put a label (similar to cigarettes) that says formula feeding can be hazardous to babies health. Teach a breastfeeding class.

I think at this time last year I thought that I would NEVER feel as strongly about breastfeeding as I do now. Thank you to my little son for all of the wonderful hours we've spent together.

AND a lactation specialist too?

Should I pursue this too? There is only one certified lactation counselor in all of Thailand and she mainly helps moms at the hospital where she works. Not good! I'm filling in as best as I can, with no formal training, unless you can count having read 3 breastfeeding books as formal!

My most recent experience. We have many missionaries visit our church from surrounding countries. Whenever I see a pregnant mama, I pretty much know she's flown into Bangkok to have her baby because China, Vietnam, Cambodia, and Laos don't have good medical care. So they come here for high-tech, highly-unnatural childbirth instead! But at least they won't be sterilized (like in China) or exposed to AIDS (like in Vietnam and China) or have complications that can't be treated (like in Cambodia).

4 weeks ago, I met C and M, missionaries from a local communist country. She was 37 weeks pregnant, due with their first. They were using Bumrungrad hospital, the "best" hospital in Bangkok. It has an 80% C-section rate!!!!! Your odds are not good for a natural delivery there. Most labor and delivery nurses there have NEVER seen an unmedicated vaginal delivery. So we all talked a little bit, and later, I gave her my contact info saying I could help with labor assistance, childbirth ed (which they hadn't done), and breastfeeding basics.

I saw her at 40weeks (on her due date!) and she still had not dropped, which is really strange for a first baby. Felt her tummy and could tell it wasn't quite right. I didn't tell her that, but I knew that either the baby was too big to drop (not very likely) or that she had a malposition. They called me Thursday morning to say that she'd had a C-section. Her water had broken, no contractions after 6 hours, and the baby had not dropped. I think if she'd waited for contractions (up to 24 hr) and given her baby time, the baby should have rotated and corrected itself.

Bigger baby too. 4.4kg (9lb 12oz). But not too big. The nurses and pediatrician said the baby was too big and that formula supplementation was needed. Crazy!!! They wouldn't bring her the baby to breastfeed or would sneak bottles and then the baby wouldn't want to nurse. How did they teach her to nurse? Showed her a video!! So in desparation and having NO ONE else to ask for help, they called me. After 1.5 hours, the baby nursed 2 times, having some trouble latching, but it was better than before. I taught them the basics of breastfeeding, gave moral support, and one order. Keep the baby in the room at all times and NO MORE BOTTLES.

I am so happy to announce that the baby is now 100% breastfed! I apologized to them at the time that I couldn't help them as much as they needed since I'm not really trained in it. Just some experience. I felt so inadequate. I learned some basics with my doula/CBE training but I was still overwhelmed. Guess I'll either get that with midwifery training or try to get some training somewhere else. Unfortunately, I'd have to work with another lactation specialist, but none of those are willing or here! Hmm, one more thing to add to my studies!

Thank you CNN

Today I was watching CNN International and they had an excerpt about the Kareni villages on the Burmese/Thai borders. Right on TV, they were interviewing a woman as she was breastfeeding! Wow, they didn't edit it out... not that she showing a lot of skin, but you know how boobaphobic the news can be. =)