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Jenn Foster No, you don’t understand, he is on for hours and hours at a time.  But his lips are flanged like a fish like I read in the books.”  She said – you know I think you really need to see our IBCLC that is here in the office.

Her Story.

Jenn Foster, IBCLC and master student in lactation is with us today. She is the mother of 4 children 13, 11 3 and 7 month old. She tandem nursed with her 4th pregnancy with her now 3 year old. Background History: I am born and raised in Central Florida. A household of divorced parents. I lived in 2 very different worlds. My father had a very religious household and my mother had a more diversified lifestyle. We had a wonderful childhood. I was never exposed to anyone breastfeeding. I have an older sister, a younger brother and 3 step sisters growing up. It was very much a juggle going between households. With my father, it was only skirts – no pants, no shorts, no movie, no TV or radio and church 3 times a week. With our mother things were much more liberal. Express yourself. Let’s experience all religions and cultures and lifestyles. They were two very, very different ends of the spectrum. We learned how to adapt to each household we were in at the time. It allowed me to be a more rounded individual growing up in this environment. Thinking back on it, I really feel very fortunate having the different perspectives in different households. You gain so much personally and that can carry into your professional life and your later family life as to what you want to implement with your own children. It provides a different perspective on life and culture and religion and everything in between. Jenn talked about babysitting when she was younger and she does not recall seeing any breastpumps or breastmilk. It was always preparing formula bottles and having a set schedule and going to bed in a certain time and a certain way.None of my friends had breastfed. No one in my family breastfeed, just a lot of bottle feeding. We chatted about being the first ones in our family who breastfed our babies. When Jenn had her first they did not know how to react to this fact that she lifted her shirt and fed her baby from her breast. They thought she needed to leave the area to feed her baby that way. Career Goals: When I was young – it reminds me of how my three year old is like now. I liked to sing and was very expressive. In high school, I became very interested in politics. I was involved in the debate team and Model United Nations and political organizations. My college major was originally political science and international relations. I was an intern for John Mica in Washington, DC. for a full summer. That was my vision. I wanted to be involved in politics and create change. First birth:  After the birth of my first son, everything just completely changed. I had a very long and very traumatic birth experience. I had no help with breastfeeding. The only thing that prompted me to breastfeed was that I had read that it was the best and I was determined to do it. It was very difficult with him at first. Once I realized that there were professionals out there who could help and make things better, and more successful, that was my passion and well this changed my path completely. Were you shocked at how much your focus changed as far as your career goals once you had a baby? I was not shocked. I became focused on how I could become that lactation professional and really help other mothers and babies have a more successful and positive experience. I think I refocused my original passion and redirecting my energy, my passion into the world of breastfeeding and birth. It certainly was a shock to my family. They were like: what in the world. We always imagined you being a politician in DC or a mayor. That passion is still there, just geared toward a different person. Jenn agrees that it is a shocking experience to become a mother. Your expectations are completely different than reality. I use to have this belly and I can control this belly because it is here. I could go to the restroom or the store and then you realize, I am on the baby’s schedule now. I can appreciate using the word shock. Breastfeeding experiences: Preparing to breastfeed- With my first, it was a pretty isolating experience being pregnant. It was not a welcome factor within the family or friends. I honesty just read a lot of books because I was in school full time. This was my only frame of reference. After he was born, I called the hotlines for help. After my second was born, I now had my previous breastfeeding experience to help guide me. I found out that WIC had breastfeeding support groups. I found it really helpful to be around other mothers who were having similar circumstances and having my questions answered I did not learn about La Leche League until my second was about 5 months. At that time, I had taken training to become a WIC peer breastfeeding counselor and I attended LLL conferences. Now I get to tell moms that there are so many options out there to learn about breastfeeding. I have learned that every breastfeeding experience is different. Having 4 kids now, I have learned that just because you breastfed one doesn’t mean that you know everything that you need to know for the next one. With the first, it was just reading books. With subsequent children, I had varying experiences and I learned to use the resources that were out there. WIC and breastfeeding support: WIC was my starting point in becoming an IBCLC and helping other mothers with breastfeeding support. I knew I wanted to have evidence-based knowledge because there are so many myths out there. When I was at WIC one day this person came up to me and said that she was a peer counselor and I noticed that you are breastfeeding your baby. I would like to know if you have any questions or if I can be of any assistance. Jenn thought that was kind of odd and asked her some more questions about exactly who she was. It is an odd thing to be in the WIC waiting room and have someone come up and ask you if you have any questions. This woman explained herself, saying that she was a WIC mom just like Jenn and to be a peer counselor you have to be a WIC mom and have to have breastfed my baby for at least 6 months or more and I am here to help you and answer any questions you have about your breastfeeding experience. Jenn started going through the peer counselor training when she was pregnant with her second son. It is called Loving Support – Breastfeeding Peer Counselor Training. It is 18 hours and the purpose is to help other WIC mothers have a good breastfeeding experience. This is where my heart really has always been. I served as WIC breastfeeding counselor coordinating and developing programs. The WIC program is fantastic in that there is a lot of education given by a nutritionist. The mom to mom support is so powerful. The research shows that this is a great addition to the WIC program. Moms can relate better to other moms who breastfeed, perhaps better then talking and relating to a physician. This reduces the fear of asking questions and they can be more open with each other. First breastfeeding experience: It was a long and difficult labor. Went in on a Thursday and he was not born until Saturday. I read that his lips should be flanged and everything looked right, but it did not feel right. The staff told me that everything looked fine. When we got home, he literally nursed all the time. I know that newborns do need to nurse frequently, but he was literally attached to the breast for 24/7. I could watch a whole movie and he was latched on the whole time. I was cracked and bleeding, not taking care of myself, not showering for days, exhausted and not eating myself. I did not have any help and I didn’t know any better and I didn’t know that something was not right. When I went to his first pediatric visit they asked me if I was bottlefeeding or breastfeeding? They told me he is down a lot from his birthweight and he is jaundiced. I was confused and said his latch is right and I called all these hotlines and they said newborns cluster feed and I thought that this was what he was doing. I asked them, well how long should he be breastfeeding? And I was told, well about 15 minutes or so….. and I just started balling. No, you don’t understand, he is on for hours and hours at a time. But his lips are flanged like a fish like I read in the books. She said: you know I think you need to see our IBCLC that is here in the office. That same day, thankfully, I went in for a full breastfeeding assessment, and we found out that the reason he was on for hours and hours is because his tongue was at the roof of his mouth. The analogy she used is that it is like drinking from a straw that is squished. Even though it looked right from the outside, there were signs that indicated that something was not right. The cracks and the bleeding and jaundice, the weight loss, the painful nipples. She really helped me turn that corner. She gave me a care plan to follow.

Part 2

Continuation from Part 1 – Episode # 169

I worked very diligently to nurse him and pump afterwards and provide him that milk. Within 24 hours, he was a completely different baby and I was a completely different mom, a woman. I felt like okay, there’s an answer here. That was really that pivotal learning experience that catapulted me from going from one career to the other. She said that experience just completely changed me. It was a huge learning experience in so many ways. He was between 3 and 5 days old when I had that visit. It really helped to understand the importance about getting seen by a professional and getting seen soon. Some moms think when you call a phone number and they say a newborn cluster feeds that this is the answer. But without seeing you and your baby and having that hands on experience, something can be missed. I tell moms – If you think something is wrong don’t rely just on phone call or a book . See someone that is a professional for hands on assessment. We had an informative discussion about frequency of feedings: We discussed the subject of babies “feeding all the time.” Are they really feeding all the time? Are the feedings productive? Or is your baby sleeping most of the time? What is the latch and milk transfer like? Because new parents have not spent time breastfeeding, there perception of “feeding all the time”, might be a time period that is out of the ordinary and signals that something is wrong, OR it can be well within normal range and everything going well. There are many factors that go into a good assessment. Emphasizing that “in person” assistance is so important. Lori shared her little joke about the need to see “the baby and the boob” in order to provide a complete evaluation. Sleep deprivation: Jenn does acknowledge that sleep deprivation is a problem for most new mothers and she said this was certainly an issue for her with each baby. Some tips that she shares with new mothers about making this time period easier. 1. Limiting visitors can be very helpful. Family and friends get so excited about the baby. However, the parents and baby all need time to bond and to rest. Jenn tells us that she did not implement this until her 4th baby. 2. Jenn knows moms hear this all the time, and yet, not all pay attention to this tip. Sleep when your baby sleeps. The dishes can wait. If your baby is napping, just take some time for yourself and take a nap too. 3. We talked about the need to nicely tell helpers who drop off food, that you appreciate them bringing by a meal, but if they want to stay and visit, you need to nicely tell them that you need to sleep. Don’t feel the need to entertain them. 4. Don’t feel the need to respond to every phone call, text or email. Take the time for you and your baby. Jenn talks about how fast life is going with her new baby. She had an amazing quick waterbirth home with her 3rd and 4th baby. Her 8 month old is now is scooting around and trying to walk and she sees it all going so fast as she feels like he was just born. What is one thing that you would really like mothers to know: Breastfeeding is a learned art. It is just like swimming or driving a car or riding a bicycle, or learning to walk. It takes practice, time and patience. It may be natural, that is what breasts are made for. It is such a learned art and it is like a dance between mom and baby and it is unique to every mom and baby. If you feel like something is off, ask for help. Don’t suffer in silence. It is not like the movies. It is not always like you envision that baby is going to pop right on and sometimes this doesn’t always work so easily. If you could wrap your arms around your newly postpartum self and whisper something in your ear to help you with early postpartum, what would it be? You are stronger than you imagine. You are capable. You are doing the best that you can and that is all that you can do and you are providing the best you can for your child. This will pass. Jenn tells me that her early support with her first baby was not much. She can really empathize with single moms and those that don’t have that support. Whether this is purposeful or not purposeful on the part of friends and family. The mother’s perception is her reality. She remembers feeling so powerless. I am not sure I can do this. She use to say to herself I am not sure if I am doing this right. You are a lot strong than you think you are. You are doing a great job. The best is all you can ever do. It may seem overwhelming, but you are doing an amazing job. Funny breastfeeding experiences: The first time she went out in public. Her baby was screaming, he was a couple of weeks old. She did not know what else to do, so she finally just latched him on and she literally sprayed the bag boy in the store. Confessions of the breastfeeding mother: This was very secretive at the time. I have shared with some people at the time and with more people recently. This was a very humbling experience. There is a big gap between my second and third. I was remarried and we decided we wanted to add to the family. During that time frame, I was a breast cancer survivor. I had to have a lumpectomy and subsequently breast surgery. It is not something I shared with my family until after everything was done. I had nursed two children very successfully for over a year and the second one for 2 1/2 years. So I didn’t really think anything of it. I was a Lactation Consultant. I had breastfed successfully. But when our child was born, I couldn’t produce everything that she needed. I was in denial. I was embarrassed. I just kept trying and trying, but she wasn’t gaining what she needed. It took another Lactation Consultant to take my hand and tell me that you have to let your pride go and put your child first. Because of all your history, things have changed. And as a lactation consultant, you know this. But you are in Mommy mode. You are in denial, but your baby needs to be fed. So, I used about 20% screened donor milk and used a supplement nurser at the breast to provide that for our third child. It was not something that until now was really shared with anybody. I was extremely embarrassed at first. I felt very inadequate. But now I know that this is nothing to be embarrassed about. There are so many mothers out there and for anyone who is listening that has gone through that, it is nothing to be embarrassed about. Even providing 10% of your babies intake is amazing. Now I work on the Board of Directors at the organization where I got the donor milk. Now being a recipient of the donor milk and being in those shoes it has really helped me to be more empathetic to others. It has provided me an opportunity to give back to the community. It has given me a whole new perspective on life, on breastfeeding on being a lactation consultant and so many different things. I have learned that sharing this story can help mothers realize and understand that it does not have to be all or nothing. It is okay to just produce a little bit. It’s okay that you have gone through different experiences and it is nothing to be embarrassed about. My daughter was about 2 1/2 – 3 months old before I realized that she needed more milk. It really took that outside perspective from another Lactation Consultant to tell me that things needed to change and that is okay to do something different. It still chokes me up to think about it because no mother wants to hear that she can’t provide all that her baby needs. It was very humbling and very emotional for me, but it has really helped me to grow as a mother and a professional. We talked about what an emotional thing it is for mothers to learn that they are not making enough milk for their babies. We may know logically that there is no shame, but for the mother herself there is that leap that she needs to make from being in denial to accepting it to then saying okay, what do I need to do about it. This is a huge leap and a huge emotional roller coaster that Lori says she can only empathize with as she has never been there. Jenn explains what an SNS ( supplementer nursing system) It is basically a device that goes around the neck and housed a container like a little bottle, with tubes on the outside, that I taped to my areola, and it would exceed about 1/4 inch past her nipple, so when her baby would go to breast, she was not only stimulating my breast and the hormones within my body to produce milk, but she was also getting the donor milk through the tube from the bottle of the SNS. What was so great about it, is that I was still able to get that bonding from her, and she was able to get a full feeding. The breast stimulation helped to maintain my supply but also encourages my body to produce more milk as well. For moms who feel like they are not producing enough milk and think they need to go just to the bottle, the SNS is an option that will help keep your baby at the breast. This helps to avoid the bottle and you are able to regulate the flow. I was that mom who wanted to avoid the bottle. With the SNS, I was able to do this. You are also able to regulate the flow using the SNS. We often tell our moms to try and avoid using pacifiers and bottles until breastfeeding is well established. Working with an IBCLC is a good option to help guide you saves mom struggling with all the details about using the SNS, particularly to ensure that it is working correctly and that your baby can get milk when using this. Jenn talks about the decision to use human milk and how she decided where to get it. She discussed this with her husband and it was important to both that their daughter was only going to drink donor milk. They wanted it to be from a reliable source. Get pumped is the organization that they went to. The donors are screened and the donor milk is from individuals within their community who go through a rigorous screening progress. It was not coming from the Milk Bank because they prioritize their milk for sick babies. Donor milk is a great choice for parents who would rather not feed their baby formula. Jenn cautions people to ensure milk safety when using informal milk sharing. Contact info: 2 Facebook pages: jennfoster nurturing miracles Email: [email protected] Get Pumped in Central Florida

Part 3

Continuation from Part 2 – Episode # 172

Jenn and Lori talk about tandem nursing

Do we agree on what tandem nursing is?

Tandem nursing could be perceived as nursing 2 infants at once and that could be nursing twins. The technical definition is nursing 2 different children of 2 different ages. However, we both agree, putting labels aside, that any mom who is nursing 2 children at once and feels she is tandem nursing, who are we to be so specific. Let’s support her with breastfeeding and allow her the space to call it whatever she pleases. If we are helping her, our focus is on what she is doing rather then labels and definitions.

Was tandem nursing something you had planned ahead of time? Something you were looking forward to? Or did it just work out that way?

Jenn said: This was something I had always looked forward to. She was quite surprised with the 4th pregnancy and once the shock wore off she realized: WOW. Maybe I can actually tandem nurse this time. She became so excited about this. It was not necessarily planned because she wanted her daughter to have her own nursing experience. My third was still nursing during the pregnancy, the belly got bigger and she liked to lay down and nurse to sleep. Jenn did laugh at the fun memories about the fact that things can get a little difficult when she got a princess toddler bed and getting situated and comfortable was quite challenging with an 8 month pregnant belly.

Jenn said that one of her favorite pictures is one that her husband took with the new baby when she tandem nursed for the first time. Her daughter is sharing her usual space at the breast that was once only hers. She was looking at her new baby brother and gazing at him and holding his hand and being so loving. It really helped Jenn to appreciate the positive benefits of both kids and the relationship they built while tandem nursing.

When you were pregnant, was there any nipple problems or pain or soreness when you were nursing?

Yes, there was discomfort. She was 2 years old and I was able to rationalize with her. I would tell her that there is a baby in the belly and you have to be gentle and mommies boobies are a bit sore and she would say – Okay, mommy. It was so important for me and for her and so I just kept going even though it was sore and uncomfortable.

Additional thoughts about soreness and supply –

1. One of the first things moms notice is that their supply has dropped during their pregnancy. If noone told them that this would happen, they are often quite shocked and some very saddened as they were not ready to wean their nursing baby. Some babies/toddlers are pretty tenacious and keep nursing anyway & others lose interest and wean.
2. Infertility – Some moms need to start fertility treatments even before their baby is 1 year old. What they don’t realize is that their supply is going to drop when they have kids so close. They soon realize that they will need to add supplemental milk to their babies daily diet if they are under a year old.
3. Uncomfortable – Some mothers just gloss over all of this because they want to continue nursing so bad that they don’t hold much weight on the nipple soreness or other challenges of nursing through a pregnancy. They just carry on and are happy doing so.

Lori talks about her experience of her second baby, her son Jesse who self weaned during her third pregnancy. This was quite a shock for Lori because she was not prepared for this at all, never having learned that the supply drops and/or literally changes flavor while pregnant and that either of these were likely a reason for his to quit nursing.

Were you concerned about having enough milk and nourishment?

Jenn was on the other side of the spectrum because of her past situation with having a lower supply with her third. She was more hopeful that if more milk was removed, if the breasts were stimulated more, that she would be able to produce more. However, we did make a rule that baby brother was able to nurse first and she was second. There were times he would nurse on one side and she would nurse on the other side. It is all about supply and demand. We talked about there coming a time when you can talk to your kids about nursing and discipline – taking turns, waiting for a nursing session.

The Joys of Tandem Nursing – What did Jenn love about tandem nursing?

Breastfeeding is one of her favorite parts of parenting for Jenn. She cherishes that bond and closeness so much. It really brings such a sense of comfort and peace to the infant and to the child as well. It was so heartwarming to see how much love they felt and the interaction between the two of them. I am at a loss for words on how to accurately describe it in the way that I want to. Jenn really enjoyed seeing the relationship between her nurslings grow. Her toddler was a lot more loving and compassionate and understanding than she initially thought she would be. She was a very loving and considerate sister. She wanted to share what she thought was good, with her brother. It has been a little while since she weaned. This has been the most touching experience that I have had, as a mother.

Words of Wisdom to Moms about tandem nursing – Jenn’s thoughts on other’s negative opinions –

I can empathize with her. As much as I loved the tandem nursing. There was a lot of family opposition to it and a lot of snide remarks made to her and behind my back. After she finished nursing, some family members would say to her: “your a big girl. You don’t need to be nursing anymore. I would emphasize to the mothers to Education yourself on the benefits of breastfeeding and extended breastfeeding. Be strong in your decision. Of course, this is easier said than done and taking what others say with a grain of salt is not easy. Being strong and knowing that you made this decision and if there is a father or partner involved, you made this decision as a family. You are the mother. You are the parent.

Maybe they are intended not to be negative but as a mother we see it as negative and not supportive. Smile and say: thank you for your concern, but I am very happy to continue to provide all these antibodies and nutrients because it is so important at this age. If you need a hug, get a hug from someone who understands you and is supportive of your choices. Jenn has learned that being confrontational towards others who are being negative, is not going to solve anything.

We both agree on this –

A good way to respond is by giving a smile, nod and say thank you for your concern however this is going to be my plan.

Practice a one liner. Keep saying the same response, rather than engaging in conversation because this creates further conversation about a subject you are not interested in talking to them about. So, just keep repeating your original response.

Lori talks about this issue as being ( dealing with other people’s strong opinions) just one of the many parenting decisions that you are going to have to make. You are not going to want to explain to someone else or give others decide on what regular foods you are going to feed them or on how to discipline your child.

You don’t owe them anything. This behavior typically starts during your pregnancy with others having opinions about what you eat, what you wear, what tests you should have. You will find many members of the peanut gallery, ready and willing to share their opinions with you – even though you never asked.

Lori J. Isenstadt, IBCLC

Lori j Isenstadt, IBCLCLori Jill Isenstadt, IBCLC is a huge breastfeeding supporter.  She has spent much  of her adult life working in the maternal health field. Once she became turned on to birth and became a childbirth educator, there was no stopping her love of working with families during their childbearing years.  Lori became a Birth doula and a Postpartum doula and soon became a lactation consultant.  She has been helping moms and babies with breastfeeding for over 25 years.  Lori founded her private practice, All About Breastfeeding where she meets with moms one on one to help solve their breastfeeding challenges.  She is an international speaker, book author and the host of the  popular itunes podcast, All About Breastfeeding, the place where the girls hang out.  You can reach Lori by email at: [email protected] or contact her via her website:  allaboutbreastfeeding.biz/contact

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