Today LCCE Tanya Strusberg interviews the author of "Born to Breastfeed: The First Six Weeks and Beyond," Rowena Gray, RM, RN, IBCLC. Rowena shares why she wrote this book and discusses some of the current challenges facing new parents, and how her book might just make the journey a bit easier. You can find the review by clicking here. - Sharon Muza, Community Manager, Science & Sensibility.

Tanya Strusberg: Tell our readers a little bit about you!

Rowena Gray: I am Mum to three little ladies, coordinate a local weekly playgroup and juggle my private practise as a Lactation Consultant around my busy family. One of my daughters tells her friends that "My Mummy breastfeeds lots of babies at work!". I constantly feel like I have a million balls in the air and sometimes drop a few but that's motherhood right?! In my spare time I enjoy baking bread - there is something very comforting about the smell of bread baking in the oven.

TS: You are a registered nurse, midwife AND an International Board Certified Lactation Consultant (IBCLC). What drew you to midwifery and then what inspired you to exclusively practice as a Lactation Consultant?

RG: I remember as a child knowing that when I grew up I wanted to work with newborn babies. That desire never changed and so I became a nurse as a stepping stone to midwifery. I was lucky enough to start my professional career working in a paediatric unit and continued to do so whilst later studying midwifery.

When I was a midwifery student, I remember being asked by the midwife in charge to "go and help that new mum to breastfeed". I had absolutely NO idea of what to do or what to say! I soon discovered that I had a keen interest in knowing more about breastfeeding and found myself attending breastfeeding conferences, hearing people from around the world sharing their knowledge with incredible passion. I seemed to have caught that passion! I had the great privilege of being mentored by some very knowledgeable and experienced LCs in my work place and I found myself wanting to focus as many of my working hours as possible on educating and supporting breastfeeding mums and bubs.

As I was growing my own young family and experiencing breastfeeding ups and downs for myself, I realised just how much support and information a new mother craves and wanted to share the knowledge that I have with as many mums as possible!

TS: In your professional experience, what do you believe are the biggest barriers to breastfeeding success for new mothers?

RG: The biggest impact on breastfeeding for new mums is the inundation of conflicting advice from health professionals, family, friends and, of course, social media. A new mother can find it really difficult to sift the good information from the bad and this destroys her confidence in her breastfeeding ability.

There's also an issue with the accessibility of breastfeeding support services - hospital services are overbooked with waiting periods of up to three weeks; free local clinics are not always available and private lactation consultants are not a financially viable option for everyone.

There is a fallacy that mothers should impose a routine, which leads to misinterpretation of normal newborn behaviour and ultimately, feeding problems, because the 'art' of reading baby cues is lost.

There seems to be a general acceptance that formula is a good alternative to breast milk however breast milk is unique to each individual mother and baby and its nutritional and immunological components cannot be replicated in formula.

Partner attitudes to breastfeeding can make or break a mother's confidence - a partner who is supportive and involved in the decision to breastfeed increases a mother's resilience to cope with breastfeeding challenges.

Return to work presents the challenges of expressing and storing milk at work and finding a carer who appreciates the importance of breastfeeding and knows how to handle expressed breast milk (EBM) can be daunting.

TS: You've written a book, Born to Breastfeed: The First Six Weeks and Beyond. What led you to want to write a book?

RG: As a breastfeeding mum AND a lactation consultant, I endured my own breastfeeding difficulties - difficult attachment, cracked and bleeding nipples, oversupply and mastitis. It was really hard work even with easy access to all the right information and advice. I realised that without being able to seek the advice of other lactation consultants I would have felt really overwhelmed and had a sudden deep understanding of why many mothers feel the only option for them is to stop breastfeeding.

My mother, Anne Hillis, has been writing books on infant nutrition for some years and one of her long-term passions has been to write a book for breastfeeding mums - something with up to date breastfeeding information and nutritional advice and support to help breastfeeding mums make easy and sensible food choices. She invited me to write a book with her and look what happened!

Every pregnant and breastfeeding mother deserves easy access to good, accurate and sensible breastfeeding information and advice. Not everyone can afford or has access to a lactation consultant and so 'Born to Breastfeed' is the next best thing - your own personal lactation consultant on your bookshelf!

TS: What makes Born to Breastfeed different from the other breastfeeding books out there?

RG: "Born to Breastfeed" is written from the baby's perspective. It encourages mum to watch her baby's cues (and her 'mummy gut') to know what to do next. It aims to normalise the unpredictable and sometimes confusing madness of the very early weeks as a breastfeeding pair and what to do if things do go a little pear shaped.

The book also offers advice on how labour and birth choices can affect the early days of getting breastfeeding started - this is not to sway mothers from their choices of pain relief but to simply offer the information of what they might expect in the early days after birth.

I have created charts to describe common baby behaviours at the breast, what that behaviour might mean, and what to do about it. Sometimes it's a simple as your baby is fussing because he doesn't want to feed right now. The books also offers guidance on when and where to seek further breastfeeding support

TS: Is the book specifically aimed at Australian women, or is it suitable for all nursing mothers?

RG: Breastfeeding breasts function in the same way all around the world - in the same way that babies are generally born in the same manner around the world!

The advice and guidance given in "Born to Breastfeed"is considered to be the most up to date (at the time of print) and effective ways to support long term breastfeeding in all mothers, anywhere, in any situation.

TS: As a childbirth educator, covering breastfeeding is an essential part of our teaching curriculum. Our primary focus is to give women and their partners the essential information they need to maximise their chances of getting breastfeeding off to a good start. What advice would you give to childbirth educators in terms of the most important content to cover?

RG: This is a difficult question to answer - there is so much I wish for every mother to confidently know!

I believe it's important that every mother has the confidence that her baby and her body know how to do this. Babies instinctively know how to breastfeed - it's what they're designed to do. We know that uninterrupted skin to skin time between mother and baby for at least the first hour after birth and baby finding the breast to feed within the first hour after birth are crucial for early breastfeeding success and long term breastfeeding with confidence.

The next most important thing I believe is skin to skin contact between mother and baby in the early weeks of breastfeeding. Skin to skin cuddles not only stimulate a mother's breastfeeding hormones to produce more milk but when you're that close to your little one you can easily pick up on your baby's subtle feeding and tired cues and this is what brings confidence in your parenting efforts.

Correct attachment allows baby to access all the milk s/he needs from the breast. Babies need to take a large mouthful of breast, not just the nipple, in order to attach well. Breastfeeding should be comfortable for mum but it is quite normal for it to be uncomfortable for the first few weeks. Nipples should not be cracked or bleeding or excruciatingly painful - these are signs that things are not quite right.

Seek support early. Don't feel you should struggle through any difficulties on your own. Visit breastfeeding counsellors and other breastfeeding mums at your local meet ups. Ask for help from your hospital midwives and lactation consultants, your child health nurse or a lactation consultant in private practise.

TS: In recent years, there has been an explosion on the market of so-called toddler formulas. Clearly it's a way for the formula companies to get around the WHO Code which bans the promotion of breastmilk substitutes. What are your thoughts on 'toddler formula'?

RG: I don't understand why any toddler should require 'toddler formula'? Many toddlers are continuing to breastfeed at 12 months and then to at least 2 years as well as eating healthy family foods plus drinks of water and cow's milk in a cup . It is important that most of toddler's nutrition comes from food rather than milk drinks. Nutritionally, toddler drinks are not required and there is a danger of toddlers over consuming toddler drinks if mum thinks her toddler is not eating properly - toddler drinks are very filling so they eat even more poorly.

TS: Birth professionals often have to deal with a backlash against the so-called "natural birth movement". As a lactation consultant, do you find that you deal with an equivalent in breastfeeding, with some women pushing the "anti-lactivist" agenda? If so, how do you respond to this?

RG: Every mother's breastfeeding journey is personal. And whilst it is almost every mother's desire to breastfeed it unfortunately does not come easily or at all for some mothers. There are many reasons for this of which one is choice. The "breast is best" slogan is responsible for many mothers' guilt in being made to feel second rate by needing to or choosing to feed their baby with formula.

I believe that good breastfeeding information is every mother's right but I also support every mother in making an informed decision to choose the feeding option that is right for her and her baby.

TS: With breastfeeding rates so low in industrialised countries, how can childbirth, parenting and breastfeeding professionals best send the message that breastfeeding is the optimal nutrition for our babies?

RG: I think we are already doing a pretty good job at getting this message out. What we're failing dismally in is providing mothers with the adequate and ongoing support needed in order to breastfeed long term. Our national statistics show it clearly - 97% of mothers commence breastfeeding and yet within 2 months only 50% of our mums and bubs are continuing to exclusively breastfeed. With the right advice and support almost all breastfeeding difficulties can be overcome.

I think we're also doing mothers a great disservice in not being brutally honest about the potential long term negative impact on health as a result of readily accessible formula. In Brazil their support of mothers to breastfeed is so strong that families require a prescription from a lactation consultant after a thorough review in order to access infant formula. Now I'm not at all suggesting that we go to this extreme but it certainly highlights the difference in level of support to breastfeeding mothers between the third world and the first world.

Have you read this book? Would you recommend it to new parents yourself? Would you like to win a free copy of Born to Breastfeed? Leave a comment on the book review published this past Tuesday or today's interview post by December 1, 2016, and you will be entered into a drawing for the book from amongst all who comment.

About Tanya Strusberg

Tanya Strusberg is a Lamaze Certified Childbirth Educator (LCCE) and founder of birthwell birthright, an independent childbirth education practice based in Melbourne, Australia. In 2015, Tanya was inducted as an FACCE (Fellow of the Academy of Certified Childbirth Educators) in recognition of her significant contribution to childbirth education. Through her internationally-accredited Lamaze Educator Training program, she is very excited to be training a new generation of Australian Lamaze educators. Last, but absolutely not least, she is also the mother of two beautiful children, her son Liev and daughter Amalia.

Published: November 24, 2016

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