What do cars & breastfeeding have to do with each other?

by Kristine Phillips Keller

breastmilk and pump

I learned the answer to this question the hard way with my oldest son. I was not much of a reader but breastfed because both of my sisters did the breastfeeding thing. If they could do it, so could I. However, in hindsight, I pretty much did everything wrong that I could have done. I wanted a nursery (I needed sleep, right?), I wanted pacifiers (he can’t just suck on me or I won’t get any sleep) and I wanted bottles (dads need to help too, right?). I thought, surely I can make all of this work. Boy was I wrong!

Not only did I go into it uneducated, I also have flat nipples. I honestly thought they were broken as they never became fully erect prior to years of nursing/pumping. I also have really naturally dry skin. Early on, I had damage but didn’t realize how bad it was until it was visible, right at Stage III damage (which means skin is literally gone). I was in such pain that I would cry when my boys would cry because I knew what was coming. I would fear nursing them because of the toe curling pain that it took to get them latched on. For the most part, after a minute or two it became bearable. Other times, the entire feeding was excruciatingly painful for me.

At six weeks with my first, I gave into pumping full time. I asked for help from family repeatedly to try and figure out what I was doing wrong and what I could do to correct the latch. No one seemed to be able to offer me the advice that I needed to make direct breastfeeding work and I just didn’t have it in me to bear that kind of pain any more. However, I still wanted to give them my milk…so I continued on with pumping & still continued to have cracked, bloody nipples until a good 10-11 months of pumping.

Around that same time, I was talking with my sister about all of the bloody milk that I was dumping because, even though I was no longer nursing, I still had pretty bad damage on both of my nipples. I just thought that’s how it was going to be for me. She then asked me if I was lubricating before I pumped. My response to her was, “Isn’t that what you do when you have sex?” She laughed & then said yes but that the pump shields were dry. Babies have moisture in their mouth for lubrication but there is no moisture on the pump shield prior to pumping.

I mean, would you ever expect to drive a car with NO lubrication and have things go well? ABSOLUTELY NOT! There must be lubrication to prevent friction… and to prevent damage. After all, isn’t that what our healthcare is supposed to be about these days, preventative care? Well, let me tell you…the difference was night and day. I went from having constantly damaged, bloody nipples to pain free/damage free nipples overnight. It was such a relief to know that there was something I could do to prevent this pain and discomfort.

I started working for WIC 2.5 years ago as a peer counselor and have since applied theory to moms that come to me with damaged or sore nipples. If you lubricate before you latch, you lessen the probability of damage happening from the initial suck (regardless of whether it’s baby or the pump). That lubrication gives both something to slide against instead of that reverse pressure working against dry skin.

I’ve asked numerous breastfeeding professionals and no one seemed to know of any literature that puts emphasis on “lubricating BEFORE nursing or BEFORE pumping”. The only reference that I’ve seen is to use breast milk on sore nipples AFTER nursing. If it works after, why not try it before?

Lubricant suggestions: (you may need to try a few different ones to decide which is most comfortable for you.)

  • Your breastmilk
  • Nipple cream/ointment (suggest vegan and edible, rather than animal based)
  • Coconut oil
  • Olive oil
  • Almond oil
  • Infant massage oil
  • Avoid synthetics such as traditional baby oil

 

Some moms have found that regularly lubricating their breasts and pump horns before pumping greatly reduces the amount of discomfort they experience which in turn helps them let down easier and respond better to the pump.  There’s no need for pumping to be a painful or uncomfortable experience, experiment with different lubricant options to find what works best for you.  I hope this simple tip helps you in your breastfeeding and pumping journey as it has helped me.  How about we pass along this little known tip and prevent the damage in the first place?

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What pumping tips do you have to share to help other moms?

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Kristine Thanks to her sister, Kristine breastfed/exclusively pumped for her two boys now 3.5 and 8 years old, she pretty much did everything wrong when it came to breastfeeding but managed to get the pumping thing right (after a while).  After experiencing discrimination she contacted WIC about becoming a breastfeeding peer counselor and begin training to become an IBCLC. She sits for the IBCLC exam this summer and looks forward to continuing to help mothers reach their breastfeeding goals.

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It doesn’t have to be all or nothing

by Kari Swanson
This post made possible in part by the generous support of Beco Baby Carrier.

full term breastfeeding

My daughter was placed on my chest immediately after my obstetrician finished stitching up my c-section incision. She latched onto my breast and started breastfeeding right there in the operating room. Last month we celebrated her third birthday. She knows that babies have mama milk. She also knows that big girls have mama milk until they are ready to stop having mama milk. I expect that sometime between now and the time she is around 5 years old she will gradually wean.

Some might consider the fact that my daughter is 3 and still receiving breastmilk to be extreme, but anthropological evidence indicates that this is biologically normal for a young hominid primate. That being said, it is probably no surprise that I consider myself to be a lactivist. I believe that human breastmilk is the biologically normal food source for human infants and I volunteer as an admin on The Leaky B@@b in order to support other breastfeeding mothers and to help normalize breastfeeding in a culture that has largely lost sight of the real reason women have breasts.

What may come as a surprise to some is that my daughter and my son before her received formula in addition to breastmilk. Why? Because I work full time outside of my home and I am among the unlucky few who truly do not respond well to breast pumps. For whatever reason my body just does not give up the gold for a machine despite my supply being more than adequate. After a time, despite numerous tips and tricks, pumping whenever and wherever I could, I ceased to be able to pump enough milk to entirely meet my babies’ nutritional needs while they were separated from me while I worked.

With my daughter I was fortunate to be able to spend 3 months home with her after she was born, and to spend 3 months thereafter working half time. I pumped at home before returning to work and I pumped before work, during work, after work, and on non-workdays once I returned to work. I had a small stash of milk in the deep freezer when I returned to work, but it was quickly depleted. When I first returned to work and pumped I easily had enough milk by the end of the day to send to the daycare without dipping into my frozen milk stash.

I determined how much milk my daughter needed in her daycare bottles using an iPhone app called “Breast Milk Calculator.” The app uses the baby’s weight, age and number of feedings in the previous 24 hours to suggest how much milk he or she needs per feeding. Using the app I determined exactly how many ounces she needed per bottle. The number of feedings was based on the number of hours she was away from me and how frequently she would normally nurse.

But, just as it had when my son was a baby, my pumping output dwindled over time. Eventually I was pumping less than an ounce per side per pumping session. I used up my entire frozen milk stash. Despite my best efforts at around 6 months I was no longer able to pump enough to send only breastmilk in my daughter’s daycare bottles. So, I sent as much breastmilk as I could and to make sure she had sufficient nutrition I sent formula too.

When my daughter was a newborn she, like her brother, needed supplementation. They both had jaundice and they both lost more than the usual amount of weight after birth. Although her condition was better than her brother’s had been (he was a very sleepy 37 weeker with more severe jaundice), my daughter was also a slow gainer. So, the IBCLC we saw recommended supplementation while I built up my own supply. When my son was a newborn he received formula supplementation, but my daughter received donor breastmilk, or as we referred to it “Auntie milk”—because our milk donor was my sister who was still breastfeeding her toddler son at the time my daughter was born.

By the time my daughter was in daycare full time and my pumping supply could not keep up with my daughter’s demands my sister’s son had weaned. I considered donor breastmilk, but decided against it. My strong, healthy baby did fine on formula, and I felt that the relatively limited supply of donor milk in my area should be available to babies for whom formula was not an option, babies whose mothers could not breastfeed them at all or whose health really warranted the exclusive use of donor milk. So, we chose formula instead.

I already knew exactly what formula I would choose for my daughter if I reached this point, because I had read quite a bit of research about formula before I had my son. I looked up numerous scholarly research articles and reviews of the literature about formula on PubMed. At that point I knew I wanted to breastfeed, but I had been given the somewhat unhelpful advice that my desire to breastfeed and to go back to work full time were “setting [myself] up for failure”. So, in case that was true I did all of that research about formula and based my decision on what I had read. (Bear in mind that my son was born in 2004 and donor milk was not as prevalent, except from milk banks by prescription and at a rather high price.) Despite many assertions otherwise, infant formula is an acceptable, nutritionally adequate alternative to breastmilk and is a much better choice than the milk of any other mammal or milk made from plants.

Eventually both of my babies received only formula in their daycare bottles. Both times the amount I was able to pump became miniscule compared to the amount they needed and the stress and frustration of pumping so little became too much for me, so I stopped. They both did fine on the formula they received part of the time, so I felt comfortable giving them as much as they needed while they were separated from me. My daughter had breastmilk exclusively, either at the breast or in bottles, for more than 6 months. They were around the same age when they started receiving formula alone in their daycare bottles: 7-8 months. Despite this both of my babies continued to breastfeed whenever they were with me. They never experienced nipple confusion, expressed a preference for the bottle, or had nursing strikes. They both stopped receiving formula when they no longer needed bottles at daycare.

So, yes I am a lactivist. I believe breastmilk is the biologically normal food for human infants. But, breastfeeding doesn’t have to be all or nothing.

 

You can read more from Kari over on her site and enjoy her thoughtful, thorough writing and beautiful photography.

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Did you respond well to breast pumps?  Have you had to supplement?  If so, what did you use?  Were you able to supplement and still reach your breastfeeding goals?

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An overview to making an educated choice about formula

Star and I worked together on this post as a result of seeing a need to answer some questions and provide information on infant formula.  I believe that breastfeeding advocates and educators often provide only “formula is bad” kind of information that isn’t helpful for the parent that seriously needs to consider formula options for their child.  This article is intended to be a resource for those that will be using formula and would like information as they go about making their decision and for those that want to offer genuinely supportive support to all families, regardless of the feeding method employed.  There will be further information on formula available soon but for now, we hope this is helpful for those that need it.  It is my hope that breastfeeding advocates and educators will be able to provide quality information on formula when necessary and do so in a supportive manner.  Let’s truly support families and be a safe source of information on infant nutrition, free of judgment and profit-making agendas.  If you are a breastfeeding mom that needs to supplement with formula or switch entirely over to formula, be sure to consult not only with your child’s doctor but also an IBCLC in making your formula choice.  ~Jessica 

What are the questions and why do we need to look at them

Babies and breastmilk go together perfectly.  Breastmilk is the optimal, normal standard of infant nutrition, and I love the fact that I am in a profession where I can help mothers to achieve their goals where breastfeeding is concerned.  While I am a hugely passionate breastfeeding advocate I am not anti-formula.  Something that seems to confuse some people but it boils down to respecting the fact that we all make choices in feeding our babies, and sometimes formulas are a part of that choice.  Formula feeding moms love their babies just as much as breastfeeding moms do and want their babies to grow and thrive.  During some hiccups in my own breastfeeding relationships, I used commercial infant formulas as a supplement and I am thoroughly unashamed of that fact.  However, formula can be such a dirty word in infant feeding communities, and there’s a lot of confusion over it.  What kinds are there?  Which formulas are better than others?  Should I use commercially made formulas or make my own?  And how do we mix them?

 

The different types of formula

First of all, let’s address the varieties of formula.  There are three major types that are available: cow’s milk based formulas, soy formulas, and protein hydrolysate formulas.  Cow’s milk is the least expensive and most common.  They are nutritionally appropriate for most babies and engineered to be as close as possible to breastmilk recognizing they can not completely replicate all that is breastmilk.  However, some babies may not do well on these.  Some common reasons for not using cow’s milk formulas are allergies to the protein in the cow’s milk or the family’s desire to avoid animal products for their babies.

The next variety of formula is soy.  Soy formulas are not recommended for preemies.  They do not contain animal proteins, so they are useful in some medical situations or if a baby has issues with those proteins.  They can also be used by families who adhere to a lifestyle that avoids animal products.  A review by the AAP in 2008 found very few medical reasons to utilize soy formula.  There are also concerns that soy could interfere with the thyroid, immune system, or the reproductive system.  Those concerns have not yet been proven to be warranted, although the AAP did advocate for further testing.  Bottom line?  Unless your baby needs soy formula or you have some family reason that you are choosing to avoid animal products, it is probably not necessary.

The last of the three major commercial varieties is the protein hydrolysate formula.  These are also called hypoallergenic formulas.  Really, these will generally be ordered by a doctor to combat an issue like allergies to both the soy and the cow’s milk formulas.  Most people aren’t buying these over the counter because they’re just such an amazing choice.  They’re typically very expensive and needed only in specific cases.

 

Standards and regulations

Formula is held to certain standards of nutrition by the FDA.  (Note: this is different than being approved or regulated by the FDA.  However, there are standards of nutrition that must be met or the FDA will take action.)  Therefore, there is typically not significant difference between generic and name brand formulas of the same type.  There are pretty negligible differences between organic and nonorganic formulas, too.  Basically, with organic formulas, there is a certain standard for the production of the ingredients in the formulas.  Organic formulas have not been proven to be better for babies.  They are sometimes sweetened with organic cane sugar, which can make them taste sweeter.  This might be a problem – babies could develop a taste for sweeter foods or overeat due to the taste – but these are theories that have not been proven with peer reviewed research.

Homemade formulas are touted by many people and websites, but they are not something that I would ever recommend to a client or anyone else, for that matter.  There absolutely are risks associated with feeding an infant commercial formula, but there are even more risks to non-commercial formula.  No health body that I’m aware of recommends homemade formulas.  With commercial formula, you are getting something that is built to have the most optimal nutrition possible when breastmilk is not an option.  With homemade formula, there are a plethora of risks, running from nutritional imbalances to severe infections from pathogens in the ingredients.  In the days before commercialized formula, babies had to be supplemented with other things to keep away conditions like scurvy and there were deaths due to babies ingesting contaminated products.  Do it yourself is awesome for cleaning products or baby food or many other things.  It’s not good for your baby, though.  This is particularly true in a young baby with an immature gut, or digestive tract where the risk of illness from contaminated formula is even higher.  This post takes a thorough look at goat’s milk and homemade formula as alternatives for infant nutrition if you’d like more information.

 

Preparation and safe handling

Preparation of commercialized formula can be a problem, too. We often think that women in developing countries where there is unsafe water or not enough money to purchase the correct quantity of formulas are the ones at risk of incorrect preparation.  Of course, that does happen.  But we also see preparation issues in developed countries, too.  We may not hear about them as often but they certainly occur.

The only kind of formula that is sterile and can pretty much be put in a bottle, heated, and be good to go is ready to feed liquid formula.  Some health organizations recommend that babies under 3 months be fed only ready to feed for this reason.  However, most people use powdered infant formula.  Powdered infant formula is not sterile.  If you have a baby with immune system issues, or an ill baby, it is preferable to use ready to feed.  Using powdered formula in the right way can really help to make it safer.  You want to prepare formula on a clean surface, with freshly washed hands, and put it in clean, sterile equipment.  The World Health Organization recommends that you use water that has been boiled and then allowed to cool for no more than 30 minutes.  You should mix this water with the powdered formula (the EXACT AMOUNT called for on the can.  There are generally scoops with the formulas, and you should use the correct amount of level scoops) and then cool it to a suitable temperature by running the feeding implement (bottle, cup, whatever) under cool/cold water or placing it in cool or cold water.  It should be fed to the baby right away and leftovers should be discarded.  For more information, see the WHO guidelines for the safe preparation, storage, and handling of powdered infant formula.

 

Social issues and real support

Now that we’ve talked about types and preparation – and if I didn’t cover something that you have a burning desire to know about, please, comment or message myself or Jessica and I will find it out for you – let me step on a soapbox for a minute.  We know that breastmilk is optimal nutrition and that formula is recommended by the World Health Organization as the 4th best option for infant nutrition (following milk from the mother’s breast, expressed milk from the mother, and donated milk from another lactating woman).  But we simply cannot go on acting like formula is a poisonous, horrible thing that only uneducated, mean parents feed to their poor defenseless babies.  Some of the horrible comments that I have seen about formula and formula feeding mothers lately are ridiculous.  Would it be awesome if all babies everywhere could get breastmilk, either from their mothers or from donated milk?  Sure.  Is that likely to happen in the not too distant future?  No.  (Look here and here for information on being a donor or if you need donated milk for your baby.)  If we can meet moms where they are and provide the information they are seeking without judgment, we can be a trusted source for education and support and moms won’t have to turn to the formula companies as their primary origin of information.

I am the first person to step up and say that formula should be better regulated, that marketing should be reined in, that we deserve the best possible product for the smallest and most defenseless of our citizens.  But those are issues with the formula companies or manufacturing, not issues with mothers who can’t or won’t breastfeed.  Every mother I have ever met has a wide variety of factors and reasons that came into play when she chose how to feed her baby.  Discounting those things or casting blame or shame on her for them quite frankly sucks.   A real advocate supports women in general and knows that not everyone will make the same choice as her.

 

 
 Star Rodriguiz, IBCLC, is a breastfeeding peer counselor for a WIC in the Midwest and has just started her private practice as an IBCLC (her Facebook page is here, go “like” for great support).  She also sits on the  breastfeeding task force in her town, is helping her  community’s Early Head Start redefine  their breastfeeding support, and is the  driving force behind a local breastfeeding campaign.  In  the remainder of her free  time, she chases around her nursling and preschooler.
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Bottle Feeding Breastfed Babies

 

by Tanya Lieberman, IBCLC, with Amy Peterson, IBCLC

We’re very pleased to share an interview about bottles and breastfed babies today. We asked Amy Peterson, IBCLC, co-author of Balancing Breast and Bottle: Reaching your Breastfeeding Goals, to answer our questions.

For those of you who combine bottles with breastfeeding – whether you’re pumping at work, supplementing, or use a bottle for occasional separations – bottle and nipple selection can be confusing. For those of you whose babies refuse bottles, it can be very frustrating!

We hope that the information she shares below is helpful. Amy offers more information on bottlefeeding breastfed babies on her website.

Many bottles are advertised as “easing the transition from breast to bottle” and back again. What do you think of these claims? Are they independently verified?

These claims are very misleading. Just as every mother’s breast has a unique shape and flow, every baby has a unique suck/swallow cycle. What works well for one baby might be terrible for another. Parents need to observe their own baby sucking on a bottle nipple and analyze if the latch and swallow look similar to that on the breast. In our book, we use a tool called the SIMPLE Method that guides parents step-by-step on how to choose a bottle nipple for their own baby’s unique latch.

We are not aware if such advertising claims have been verified. However, we do know that this type of marketing is in violation of the International Code of Breastmilk Substitutes. This international health policy document, adopted by many countries excluding the U.S., is designed to protect families from underhanded marketing ploys such as words or pictures idealizing artificial feeding. Comparing a bottle to breastfeeding—even if it contains breastmilk—is idealizing that brand.

In our professional experience of helping babies combine breast and bottle-feeding, we have found that the nipples which claim to be best for breastfed babies are often the worst choice. The bottle nipples that are best for breastfed babies have a gradual transition from tip to base.

You and your co-author tested 37 bottles. What were the features you were comparing, and what did you learn about the range of bottles that you’d most want parents of breastfed babies to know?

We tested two different aspects of bottle nipples. First, we measured dripping by looking at the number of drips and the size of each drip. Then we hooked up bottles to a hospital grade breast pump to determine how fast bottles flow. After performing these tests, we compared the results to see if bottle dripping and flow rate were related.

The results were surprising. First of all, about half of the nipples, regardless of a non-“no drip” label stopped dripping within five seconds of tipping them upside-down. That was important for us because many bottle companies claim their nipples are “no drip,” implying that bottles that don’t drip are a better choice. To rule out the importance of dripping, we did further testing.

Second, we measured the size of the drip for those bottles that did drip. The most important thing we found was dripping does not equal a higher amount of liquid. Bottles that appeared to drip a lot often had less volume. Frequently it is assumed that a fast dripping bottle has a large amount in the drip. We discovered that a bottle may drip frequently, but with a low output. So, it is impossible to judge the size of the drip with the naked eye. Stated another way, the number of drips doesn’t mean more liquid is coming out.

As for flow, the term “slow” is not standard. To determine flow, we hooked up bottles to a hospital grade breast pump and measured the amount of liquid collected after 20 cycles. We found there was a wide range of “slow.” For example, the fastest nipple was eleven times faster than the slowest nipple. Following testing, we ranked nipples from slowest to fastest in Appendix C of Balancing Breast and Bottle. This is important because if a nipple flows too quickly, a baby’s suck will become disorganized. Likewise, a nipple might be too slow for some babies. A parent needs to watch their baby’s response to bottle-feeding rather than relying on package labeling. If a parent thinks the bottle is flowing too fast, try a different nipple in the package, and/or try a different brand.

The most fascinating results came from comparing the data of these two tests (drip and flow). Dripping is different than flow; they are not related. Most breastfeeding books suggest turning a bottle over to see how fast it drips in an effort to select a bottle with a slow flow. This suggestion is not accurate. We tested a nipple that dripped an average of 56 times when tipped over, but had a slow flow. Then, we looked at a no-drip nipple and much to our surprise, found it flowed 10.6 times faster. Big difference! Dripping is not related to flow.

Parents are often advised to begin breastfed babies on “slow flow nipples,” but even nipples advertised as “slow flow” can seem very fast. Are there any that are as slow as you think is appropriate?

As mentioned earlier, the term “slow” is not standardized. Nonetheless, it is important to begin with a slow nipple. If a nipple flows too quickly, a baby’s suck will become disorganized. For breastfeeding babies, it is best to choose a flow that mimics mom’s flow. For this reason, it is hard to say one or two brands are “best” since flow varies from mother to mother. Likewise, a nipple might be too slow for some babies. This is why we ranked the bottles and listed them in our book.

It is also important to remember that flow is only one aspect of choosing a bottle. If the baby’s mouth placement is wrong, regardless of the flow, baby will bring bad habits to the breast and still be in danger of early weaning.

For parents who are struggling to get their breastfed babies to take bottles, and who are exploring different bottles, what should they be looking for?

Moms need to consider the nipple shape and their baby’s mouth placement on the nipple. Ideally, the nipple chosen will gradually flare from the nipple length to the nipple base. This shape allows the tip of the nipple to reach far back into the baby’s mouth as the breast does, and then helps the baby to feed with the mouth open. Quite often a “narrow neck” nipple has a shape that reaches far into the baby’s mouth and allows for gradual widening of the baby’s lips.

A shape that often does not work well is a wide neck nipple where the nipple length meets the nipple base at a right angle. This nipple shape promotes what we call “straw” sucking, where the baby’s mouth closes around the length of the nipple and doesn’t open for the base. When babies “straw” suck on a bottle nipple, we often see gaps in the corners of the baby’s mouth which leads to leaking milk, gulping air, etc. This is quite different than breastfeeding.

One bottle feeding method is called “paced feeding.” Can you describe it and explain why it might be helpful to a breastfed baby? What are some signs that a baby is becoming overwhelmed while bottle feeding?

Paced feeding refers to helping a baby eat more slowly from the bottle. Pacing became popular in 2002, before flow had been studied. The idea behind pacing is that by helping the baby rest briefly during bottle-feeding, moms can more closely mimic how the baby naturally feeds at the breast. When a baby breastfeeds, the mother has several let-downs during the feeding. Between let-downs, the baby’s sucking slows and baby can rest briefly. If a baby is feeding from a fast flow “slow flow” nipple, the suck/swallow will be disorganized. Pacing helps the baby have rest periods while bottle feeding that naturally occur at the breast. Now that we know flow can be controlled by choosing an appropriate nipple, we have another technique in our bag of tricks to help babies be more coordinated when feeding from a bottle.

It is important to note that most babies can pace themselves once they master bottle-feeding with the right nipple. How do you pace? First, listen for swallowing while the baby is breastfeeding, noting when the baby naturally pauses and rests. Then apply the same rhythm to bottle-feeding. Also of importance is positioning. With bottle-feeding, support the baby in a more upright position because the flow of some bottles increases when the baby is laying back to feed (another element we tested).

Do all breastfed babies require pacing? No, in fact, imposing pacing can disrupt the natural feeding rhythm of a baby and cause harm when over used. Babies who are “good” feeders, meaning they have a normal, rhythmic suck/burst cycle, do not need pacing. It has been our experience that once a baby has mastered bottle feeding, it is no longer necessary for the parent to impose pacing.

Some signs of a poor bottle-feed include gulping, catch-up breaths, fast feeds, leaking milk from the sides of the mouth or down the chin, baby who has a furrowed brow looking very concerned, and a baby who pulls away from the bottle. For these babies, nipple shape and flow need to be double checked, and this becomes a good time to use pacing. Pacing also is an excellent technique for NICU and other high risk babies that are having feeding difficulties.

Lastly, we would like every caregiver who uses a bottle to know that dripping bottles given before a baby begins sucking usually cause the baby to pull back or flat out refuse the bottle. Caregivers need to be sure the nipple is not dripping when the bottle is offered to the baby. Allow the bottle to stop dripping or keep the milk tipped down in the bottom of the bottle. This topic is further explored on our website.

 

 

 Tanya Lieberman is a lactation consultant (IBCLC) who has helped nursing moms  in hospital and pediatric settings.  She writes and produces podcasts for several  breastfeeding websites, including  Motherwear,  Motherlove Herbal Company, and  the Best for Babes Foundation.  Tanya recently authored Spanish for Breastfeeding Support, a guide to help lactation consultants support Spanish-  speaking moms.  Prior to becoming a lactation consultant she was senior  education policy staff to the California legislature and Governor, and served as a  UN civilian peacekeeper.  Tanya is passionate about supporting nursing moms, and especially to eliminating the barriers so many moms face in meeting their breastfeeding goals. She lives in Massachusetts with her husband, her 8 year old son and her 1 year old daughter.

 

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