Breastfeeding in Public

by: Charlene Carlos


When my eldest, Macie, was breastfeeding, I used to get so stressed whenever I went out with her. She never took the bottle and nursed directly all throughout her 17 months of breastfeeding. Anyway, I was so stressed because I didn’t know where or how to breastfeed in public. Back then, malls didn’t have breastfeeding rooms! I also REFUSED to breastfeed in the ladies C.R. I mean, adults don’t eat in C.R.s, so why should we feed our babies in them?! UGH, GROSS!

But then I got the hang of it eventually. With my second child, Matteo, I was much more confident. I learned the “friendly breastfeeding” places: A secluded booth or table in a restaurant, the couch at the back of the store in Baby & Co. Podium, changing room in Lacoste and Picture Company, Gymboree’s breastfeeding room, etc. I also learned that the stores that catered to babies and kids were very supportive and offered me a secluded spot inside even if I wasn’t there to purchase anything. You’ll be amazed how supportive people are!

I also dressed better. I used better nursing shirts that were both stylish yet functional. Other times, I used the Maya Wrap, so I can position Matteo to breastfeed while he was in it. So people, who did look at me, didn’t really know that I was breastfeeding!

I’m pregnant with my third child now. And I’m excited to breastfeed again. I can’t wait to try out the new breastfeeding room at Rustan’s. I hear it’s pretty nice. I know that the Mall of Asia and other SM malls have them as well.

Go ahead, breastfeed in public. It's not as difficult as you think.

Here I am Breastfeeding Matteo in Disneyland

Is Baby Getting ENOUGH?

   How will you know if your baby is getting enough milk?  He is probably getting enough to eat if he nurses every 2 or 3 hours.  Is he "filling out" and putting on weight?  Growing in length?  Active and alert?  A "yes" to these questions is an indication that your baby is thriving well.

   A quick, easy way to reassure yourself that your infant is getting enough milk is to check the number of wet diapers.  If he has 6-8 wet cloth diapers a day (3-4 disposable diapers) after his 1st week, you can be sure he is getting plenty of milk.  Frequent bowel movements are also a sign that baby is getting enough to eat.  For the 1st 6 weeks or so, a breastfed baby will usually have 2-5 bowel movements a day (on the 7th week onwards, baby may reduce bowel movements to upto once a week as he is able to absorb all the nutrients in breastmilk).

   From time to time, your doctor will weigh the baby as a way of measuring his physical progress.  Some babies never lose an ounce from the day they're born and put on weight with the greatest of ease.  Most babies, however, lose some weight during the 1st week but get back to birth weight by 2-3 weeks of age.  After that, a pound a month (453g), or 4-8ozs (113-226g) a week, is usually considered an acceptable gain, although some babies gain as much as a pound a week in the early months.  Family characteristics and the baby's individual makeup need to be considered.  Remember - healthy, happy babies come in all shapes and sizes.  Bothe the quite fat and the very slim baby can be normal and health.  Neither bigness nor smallness is a reason for concern as long as the baby's food is human milk and nurses according to his needs.  If you feed your baby in the way that is naturally intended for the human infant, his weight gain will be what is natural for your particular child.

   With regard to baby's size and appetite, a health professional observes, "Mothers who gave birth to large babies and mothers who gave birth to small babies have at least 1 thing in common:  They can expect to have their ability to totally breastfeed the baby questioned."

   Marian Thompson, one of La Leche League's co-Founders, remembers when 2 of her nieces had identical weights of 17 lbs - but one was 6 months and the other was 18 months.  Yet the doctor for each was satisfied that the baby was healthy.

   If you are having problems with your milk supply, or if your baby is not gaining weight at least 4ozs a week, see your pediatrician, call a lactation counselor or a La Leche League Leader in your community.

Excerpt from The Womanly Art of Breastfeeding (6th revised edition), La Leche League International, Schamburg, Illinois

10 Quick Breastfeeding Tips

If you're about to give birth, this is a guick info guide on breastfeeding...

1.  All women have milk.

   There is less than 1% of womenwho may have low or no milk supply because they are gravely ill, had complications with breast surgery or took very strong medications.

2.  Mommies have milk from birth.

   Colostrum is produced for the 1st few days followed by transitional milk then mature milk.  Squeezing and pumping will not draw the colostrum out but only direct suckling.

3.  Babies (and mommies) need to learn how to breastfeed.

   It is natural for babies to suckle but breastfeeding is new to both mommy & baby so they need patience to learn and master it.

4.  Colostrum is more medicinal than nutritive.

   Babies are not hungry during the 1st few days but need to breastfeed to get the colostrum which will protect them from illnesses during the early months.  It is also a good time for baby to practice and master breastfeeding.  Water & formula only makes the baby lose the drive to suckle effectively.

5.  Position & latch are key to success.  

   Tummy to tummy position.  Baby should get nipple & areola (as much breast possible), cheeks well rounded, whole jaw moving and gulping action seen.

6.  No pumping for the 1st six weeks.

   Breastfeeding works on supply & demand.  It takes 6 weeks for a mom's body to fully master demand of baby.  Pumping before that time will cause false demand and may lead to over or under supply.

7.  Breastfeeding may be uncomfortable at the start.  

   The breasts have never been subjected to this kind of suckling and may become sore at the start.  If position and latch are correct, be patient.  Skin on the breast will adjust and be more flexible in a few days.

8.  Breastfeed exclusively for the 1st 6 months. 

   NO FORMULA, WATER (breastmilk is 70% water) nor VITAMINS (breastmilk has complete antibodies).  This will protect your baby from all childhood diseases upto 12 years old.

9.  Wash hands but do not wash / wipe breasts.

   The breasts have a natural moisturizer secreted by the Montgomery glands to keep it hydrated and clean.  Cleaning with water before feeding takes off that moisture and leads to dryness and skin breakage.  Furthermore, breastmilk has anti-bacterial properties that keeps area clean and sterile each feeding session.

10.  Breastfeed babies upto 2 years old.

   Breastfeeding upto 2 years old reduces the risks of getting family diseases.  Aside from increased IQ & EQ, this is definitely the best for your child.

My dream to be an IBCLC

International Board Certified Lactation Consultant - this is my breastfeeding profession dream...

The pathway for non doctors is very stringent and I have been preparing for almost 2 years now.  My mentor, Dra. Grace Agrasada, who is the 1st IBCLC in the Philippines, a US Certified Lactation Counselor and the Country Coordinator for the IBLCE (International Board for Lactation Consultancy Examinations), has been stressing how important it is to be thoroughly prepared for this career.  The 2500 supervised clinical hours alone is a difficult feat.  If I were to do it everyday for 4 hours for 6 days a week, that would be about 18  months.  But my mentor nor other IBCLCs don't have 4 hours to spare me for this long that's why it's taking a while.  I also have to take some pre medicine courses like anatomy, biology, etc...  And invest in about at least 2 expensive resource books  costing about 5T each.  

Of course I can always just claim my 2500 hours, have somebody share with me the subjects I need to study and photocopy the books.  But as Dra. Grace said, this is not the way to become a good IBCLC.  I may be one in word but in practice, will not be respected.  So, I take the long path.

She targets that I can take the board exam by July 2009.  I will now have to devote full attention to breastfeeding and studying.  But the rewards are far greater than the wait.

Even with lactation counselling, she mentions, it is easy to claim to be a breastfeeding counselor (some people even claim that they are consultants when in fact there are only 5 IBCLCs in the country now), but what is important is the certifying body that gives credibility to the profession, which justifies the professional charges. As she said yesterday during the beginning of the 2nd lactation counselling management course, this eventually will be regulated as well, that is the moms' protection against false or lacking information.

by Abbie Yabot

breastfriends@yahoogroups.com

Breastfeeding is best for babies upto 2 years old... and beyond!  This is relatively a long and ever challenging time for moms (& dads) as compared to current statistics (80% of moms stop breastfeeding on their 2nd month).  The minimum requirement of WHO is 6 months, to complete baby's antibodies for childhood diseases immuniy.  So there still is that 4 months questionable.  Why do mommies stop?  Mostly when they need to go back to work...or maybe baby got nipple confusion and preferred the bottle...or wrong advice from a professional...  mostly though,  this is because they just need to be able to ask their questions and get practical answer.

Join the forum on breastfeeding.  Log on to

 http://www.groups.yahoo.com/groups/breastfriends. 

Click on join this group and you can start posting within 24 hours.  

Let's help each other have a successful breastfeeding relationship... for the love of breastfeeding!

The Aggressive Non-Nurser

I have never seen anything like it... a tiny 5lb. newborn, 5 days old, never tried a bottle, refuses to breastfeed from his mother.  Whenever mother puts her breast to her baby, her son screams, pushes the breast away and does not stop crying.  But there was no problem at all with cup feeding.

Consultations normally last for 2 hours, if case a bit tricky, upto 3 hours tops.  But this was a total exception - 7 hours!  Mother had flat nipples which made it even harder to latch the baby on.  But the real problem is that the baby (after researching and reviewing my lactation management notes) was an aggressive non-nurser.

Consultation started with teaching the mommy how to do the nipple roll to make her nipples protrude.  I also taught her alternative ways like ice, inverted syringe, the pump, etc.  But even with the slightly protruded nipples, baby refused to feed (last feeding was 2 hours ago and baby was definitely hungry).  It takes an hour of coaxing, coaching, soothing music, infant massage & more crying to decide he needed to get some milk inside.  I asked mom to express a little then feed the baby from the breast, dropping milk on top of breast to trickle down to baby's mouth.  This usually works but not with this one.  He screamed to the top of his lungs and kicked and pushed the breast.  For this session, we had to give him milk through a cup then when he was asleep,  answered more questions of the mom and gave her more tips.

When baby woke up after about 1-1/2 hours, we changed diapers and clothes, to make sure he is comfortable, dimmed the lights a bit, put on a Mozart cd and attempted to breastfeed even before he asked for it.  At first he was trying, 1...2...3 suckles then pushes the breast away.  Try again....and again and again, until the baby is crying so frantically, mommy cries in the process as well.  "Why is he rejecting me?  Doesn't he love me?"  I believe this is clearly becoming a case of "baby blues".   I tried to calm mother first and tell her that although I have never seen anything like this yet, I have read about it and in time and patience, baby can breastfeed.  I also told her I will not leave her side until I have latched her baby.   But for this feeding, we gave baby a cup again so mommy can recover from her emotions.

After another 2 hours (and boy was it getting late, around 10pm), I realized I had to change the breastfeeding goal for the day and do a follow up.  I asked her to try using the nipple shield just while the baby is learning how to latch so as to lessen the problems that we needed to address.  Coax the baby to take the breast first.  It was another 30 minutes of trying to latch on the nipple shield and pushing and kicking of her baby boy, before I finally saw 1 (suckling) ...2...3....4...5... stop.  Then 1...2...3...4...5......8....9...10... stop.  Then again 1...2.....6.....11.....20... and on.  He stayed on the breast for a good 10 minutes, with very visible gulping and swallowing.  Then breastfed on other breast for another 8 minutes.  Baby fell asleep after.

I advised mom to use the nipple shield for another 3 days and saw her again on the 4th day.  This time, baby was suckling very effectively already at the nipple shield.  The next challenge is to take it out (direct breastfeeding still is best to stimulate supply).  Luckily, it didn't take 7 hours to do so.  Baby was more cooperative and was doing direct breastfeeding after 4 hours.  

Baby is now  1y4m and still breastfeeding, rarely gets sick and is advanced with his milestone developments.   Mommy said if I hadn't come to help or given up, her baby would be formula feeding by now and she would always feel like a failure.  

This is what makes me continue what I do.  Giving  the babies the best that they can have and providing the moms their confidence!  

by Abbie Yabot

Succesful Relactation

Bev Tan, who flew all the way from Bicol to know more about relactation, is now exclusively breastfeeding her now 7 month daughter, Be-An.  It took her about 7 weeks to relactate after consultations with certified breastfeeding counselor & La Leche League Leader, Abbie Yabot, who visited her 4 consecutive times while she was in Manila and did at least once a week phone consultations.  

Giving birth in Bicol with not much breastfeeding support,  Bev wanted to really breastfeed her baby but didn't know exactly how and when and how long, etc.  She was refused breastfeeding during the 1st 3 days as was advised to rest by her doctors.  In the meanwhile,  Be-An was being given formula.  She was even asked to stimulate by pumping (which is not advised before the 6th week) but this frustrated her as she was only able to pump maximum of 1oz even by her 2nd month.  

Deciding to want to give the best for her daughter despite the lack of support, she researched about breastfeeding and came upon Abbie Yabot's number.  At this time, Be-An was approaching 3 months and was 80% formula fed. 

The assessment during the initial visit was almost predictable:  nipple confusion, refusal of the breast, inability to latch properly.  Be-An suckling was tested (tongue movement had to be detected or trained) then was trained to take milk through a cup.  In the meantime, Bev was asked to pump for 15mins per breast every 2 hours during the day and 3 hours during the night.

During the 2nd visit, suckling and latch had improved but clearly, milk supply was still low.  At this time, Abbie suggested Bev to see an IBCLC (lactation doctor) to be given medicines to increase supply (not the regular malunggay capsules).  Abbie also made a nutrition guide for Bev to increase fluids (but not to overdo), avoid contracting foods (caffeine, too sweet, too salty, fast foods), include fruits and vegetables in her 3 main meals, etc.

The visit with Dr. Pat Kho went well.  She was also explained the proper use of her improvised SNS (Supplemental Nursing System) which Bev made herself, this is how dedicated and resourceful she is.  She bought the medicines and went back home for the lactation massage that Abbie also suggested to her (you know how important relaxation is to the breastfeeding mom).

Right before they flew to Bicol, Abbie visited her one last time to thoroughly explain her breastfeeding plan, gradually lessening formula and increasing breastfeeding more.  Weekly phone follow-ups were necessary to ensure that Be-An does not lose out on her nutritional needs.

Bev religously followed the plan and to her amazement, didn't notice she wasn't buying nor mixing formula anymore after a little more than 6 weeks... she did it!  Credit goes to both Abbie & Bev for their dedication and hard work.

Launching the Breastfeeding Club on April 20, 2008

Inviting pregnant and nursing moms (& dads too!) to join "The Breastfeeding Club", which gives the mom access to 3 breastfeeding classes (Beginning Breastfeeding, Sustaining Breastfeeding, Toddler Nursing & Weaning / Special Cases), discounts to various items and services, access to breastfeeding and parenting events and an online support system.  

With Gymboree as our learning partner, the launch will be held on April 20, 2008, Sunday, 3-5pm, Gymboree Shangrila Edsa Mall 4/L simultaneously with a "Sustaining Breastfeeding" class.  All attendees will be given free membership to the club plus giveaways and raffle prizes during the event.

The class will be facilitated by one of the only two Philippine Certified Lactation Counselors trained in UP PGH, Abigail Yabot, who also is a La Leche League Leader and took training courses in Chicago during the La Leche League Conforence in August 2007.   She has 4 children: Ira (14, breastfed till 6 months), Tristan (12, breastfed till 6 months), JM (breastfed till 44months and was breastfeeding while mommy was pregnant with...), Kyle (19months, still breastfeeding.

An exciting calendar of events await all members to reward their efforts to give only the best to their children....

For the love of breastfeeding!