Informative Websites
Go Dairy Free
No Milk
Whole Foods Market

Blogs
The Spunky Coconut
Avoiding Milk Protein
The Milk Free Life
Ashley’s Dairy-free cooking

Books
Go Dairy Free
The Milk-Free Kitchen: Living Well Without Dairy Products
Levana Cooks Dairy-Free

I expected nursing to go somewhat easier this time. For the most part, it has. No cracked and bleeding nipples. No crying. I have had our share of rough nights, sore nipples, and poor latches, but I can’t complain. I don’t have intense pain like the first time. Now, beside the joy of providing nourishment to our son and the joy of just plain nursing him, in the fullness of the word “nurse,” I have found an adorable breastfeeding partner — our oldest child. Yes, the one that had the double short frenulum. He climbed up onto the couch, said, “nurse Elmo,” and that’s exactly what he did — nurse his baby! What a privilege we have as moms to NURSE our babies. It’s even better when our older children immitate us because they think it’s pretty special too.

• NURSE, NURSE, NURSE: The very best method for increasing supply is to nurse more often and until baby has completely emptied the breast. If you are certain that your baby is nursing effectively and has a good latch and suck, simply offer the breast more often; switching from approximately every 3 hours to approximately every 2 1/2 hours, for example. Unlimited access to the breast for baby would be the ideal situation. Additionally, always offer both breasts at each feeding. If you remove more milk, your body will produce more milk. Milk production is an almost purely a supply=demand=supply=demand situation and by extracting more milk, your body is triggered to make more milk.
• INCREASE INTAKE: You can try increasing the amount of milk that baby is taking in while at the breast through switch nursing and breast compression. To use switch nursing, watch baby closely as they eat. The moment they fall asleep, lose interest, or switch to “comfort” sucking, switch sides. A new let-down and fast ejection of the milk will renew their attention and increase the amount of milk they are taking in. Use both breasts at least twice during a nursing session to assure that baby is getting adequate hind milk. The additional fast sucking stimulation will trigger an increase. You can also use breast compression to boost the amount of milk being taken in. This involves stimulating a milk ejection by squeezing the breast after baby has stopped sucking on their own. Dr. Jack Newman, a leading expert on breastfeeding, has a “Protocol to Increase Breastmilk Intake in Babies” which is posted on KellyMom.
• UP YOUR PROTEIN: Milk production needs water, fat and protein. Making sure to keep your water intake up combined with our bodies FABULOUS ability take the fat from itself if its not readily available (yee-haw!), protein may be the thing that’s lacking. Grab a big spoonful of peanut butter or cottage cheese, fish, eggs, etc.
• TRY A GALACTAGOGUE: A galactagogue is a substance that increases milk supply. These should be tried only in combination with the other methods listed. Think and research before trying one. The average nursing mother shouldn’t need a galatagogue to maintain an effective supply. If you chose to use one, there are many out there: both ones that have a proven effect and other’s that are “old wives tales”. They effect production in different ways so you might need to try a few before you find one that works for you. KellyMom is a wonderful resource for dosage and side effect information. The two most common galactagogues are fenugreek, and oatmeal.

Ideally, you’ll never have a supply issue. But if you do, first NURSE, NURSE, NURSE and then try some of these other effective methods.

Psalm 8:2 (The Message)

Nursing infants gurgle choruses about you;

toddlers shout the songs that drown out enemy talk, and silence atheist babble.

Psalm 22:9-10 (NIV)

Yet you brought me out of the womb;

you made me trust in you even at my mother’s breast

Isaiah 49:15 (NIV)

Can a mother forget the baby at her breast and have no compassion on the child she has borne?

Though she may forget, I will not forget you!

1 Peter 2:1 (The Message)

So clean house! Make a clean sweep of malice and pretense, envy and hurtful talk. You’ve had a taste of God. Now, like infants at the breast, drink deep of God’s pure kindness. Then you’ll grow up mature and whole in God.

Unfortunately for me, I have asthma, seasonal allergies, and severe food allergies. While I can “rough it” by eliminating my allergy medication in certain seasons (even though it is technically safe), I cannot chose to ignore anaphylactic shock after eating something cross-contaminated with peanuts. I have to take a Benadryl (or in worse cases, my Epi-Pen). Without it, I will eventually be hospitalized or dead. Now, I should say this. When pregnant especially, I am extremely careful about what I eat. Epinephrine crosses the placenta and may lead to a decrease in uterine blood flow, not to mention that congenital defects are associated with first trimester exposure. (source) Obviously, using my Epi-Pen is not desirable.

If you’re like me, you want to know what is absolutely fine, what is safe if you really need it, and what you have to stay away from no matter what. Well, here you go…The following are resources put forth by health professionals. Just be sure to access the correct list — what may be okay in nursing may not be true for pregnancy.

* The Safe Fetus website is database of worldwide medications (generic & trade) that provides information on the drugs’ indications, fetal risk, breastfeeding risk, and risk during pregnancy, according to the FDA.
SafeFetus

* The American Academy of Pediatrics maintains a list of drugs that are transferred into breastmilk.
AAP list

* FAQs on medication use during pregnancy and breastfeeding from Centers for Disease Control and Prevention
CDC FAQs

* Dr. Sears’ answers on taking medication while breastfeeding
Dr. Sears

* Drug and breastmilk interaction chart from Babycenter
Babycenter chart

* La Leche Leagure article titled “Medications and Breastfeeding”
LLLI article 1

* La Leche League article titled “Maternal Medications and Breastfeeding”
LLLI article 2

The basic philosophy of La Leche League is summarized in the following statements:

• Mothering through breastfeeding is the most natural and effective way of understanding and satisfying the needs of the baby.
• Mother and baby need to be together early and often to establish a satisfying relationship and an adequate milk supply.
• In the early years the baby has an intense need to be with his mother which is as basic as his need for food.
• Breast milk is the superior infant food.
• For the healthy, full-term baby, breast milk is the only food necessary until the baby shows signs of needing solids, about the middle of the first year after birth.
• Ideally the breastfeeding relationship will continue until the baby outgrows the need.
• Alert and active participation by the mother in childbirth is a help in getting breastfeeding off to a good start.
• Breastfeeding is enhanced and the nursing couple sustained by the loving support, help, and companionship of the baby’s father. A father’s unique relationship with his baby is an important element in the child’s development from early infancy.
• Good nutrition means eating a well-balanced and varied diet of foods in as close to their natural state as possible.
• From infancy on, children need loving guidance which reflects acceptance of their capabilities and sensitivity to their feelings.

La Leche League leaders are mothers, just like us. They are well trained, having gone through training, required readings and mentoring by an established leader to earn their accreditation. They provide support in a number of ways. First, they run monthly meetings where nursing mothers gather, ask questions, and can see each other nurse in a safe, supportive environment. I have found wonderful camaraderie at these meetings and often, all a new mom needs is to see another mother nursing to gain the confidence she needs to continue in her journey.  Children are always welcome at meetings. Sometimes moms choose to come to only one meeting; sometimes moms choose to attend meetings throughout her entire pregnancy and nursing relationship. Either way is perfectly fine and acceptable. If you’d like to attend a meeting, know that you are welcome whether it is for one meeting or for many years. You can find your local meetings by clicking here and choosing your country from the grey bar just below the logo.

Leaders also provide breastfeeding support even if you don’t desire to ever attend a meeting. Leader’s phone numbers are listed and they welcome phone calls with breastfeeding questions and for those seeking support. Additionally, the La Leche League website offers a chat-style support and forums for asking questions. All questions will be answered by a La Leche League Leader.

I have found La Leche League to be a wonderful source of information and support in my breastfeeding season of my life.

Babywise is the popular name for the book On Becoming Babywise, which is a parenting regime authored by Gary Ezzo that teaches parents to “guide their baby’s day rather than be guided or enslaved to the infant’s unknown needs.” The book was self-published in 1993, as the secular counterpart to Ezzo’s religious materials for infants, Preparation for Parenting. Babywise was picked up by Multnomah Publishing in the mid-1990s, but then dropped in 2001, after publishers investigated medical issues related to the book and character concerns about Ezzo. Babywise is the first parenting guide that the American Academy of Pediatrics has publicly recommended against.

So yes, there is a lot to be concerned about. Let’s start with the author. Gary Ezzo has no medical background. He has no professional training in child development, medicine, or breastfeeding support. Ezzo, Growing Families International (of whom he is the executive director) and his publisher have attributed to him three different academic degrees that he does not have. Ezzo even stated in writing that he had an associate’s degree in business from Mohawk Community College in Utica, New York, even specifying a major and a grade-point average. He never graduated from that school, officials say (source).

Questions about Ezzo’s qualifications are relevant for two reasons. First, his lack of integrity should be a huge concern for the Christian community. 1 Timothy 4:16 says, “Watch your life and doctrine closely. Persevere in them, because if you do, you will save both yourself and your hearers.” Proverbs 10:9 says, “He who walks in integrity walks securely, but he who perverts his ways will be found out.” David said in 1 Chronicles 29:17, “I know, my God, that you test the heart and are pleased with integrity.” And Proverbs 11:3 says, “The integrity of the upright will guide them, but the falseness of the treacherous will destroy them.” As Christians, we must be committed to integrity!

Second, Ezzo’s infant feeding advice is inconsistent with standard medical recommendations. Both Babywise and Preparation for Parenting tell parents that not following his principles is a potential health concern and that the American Academy of Pediatrics (AAP) supports Ezzo’s recommended number of feeding times. On the contrary, the AAP does not support scheduled feedings and has issued an AAP Media Alert about the poor weight gain and dehydration that may result. The AAP stated that Ezzo’s program “outlines an infant feeding schedule inconsistent with AAP recommendations.”

What about the co-author Dr. Bucknam, you might ask. Well, Babywise is the secularized version of Ezzo’s Christian Preparation for Parenting material (now retitled Along the Infant Way). This was in its third edition before the first edition of Babywise was published and the medical content is the same. So, it seems as though Dr. Bucknam was simply added to give credibility to the program.

In addition to a lack of credentials, John MacArthur’s Grace Community Church, where the programs got their start, affirms in a public statement that the Ezzos’ teachings demonstrate “a lack of clarity on certain fundamental doctrinal issues,” “confusion between biblical standards and matters of personal preference,” and “insufficient attention to the child’s need for regeneration,” as well as a “tendency to isolationism.” Numerous Christian groups have expressed concern over Babywise and the Ezzos in particular because they consistently exhibited a pattern of cultic behavior, including Scripture twisting, authoritarianism, isolationism, and physical and emotional endangerment (source).

Aside from a lack of credentials and integrity, Ezzo’s materials are dangerous for babies. The following is from an AAP News article in 1998:

“Expectant parents often fear the changes a new baby will bring, especially sleepless nights. What new parent wouldn’t want a how-to book that promises their baby will be sleeping through the night by three to eight weeks? One such book, On Becoming Babywise, has raised concern among pediatricians because it outlines an infant feeding program that has been associated with failure to thrive (FTT), poor milk supply failure, and involuntary early weaning. A Forsyth Medical Hospital Review Committee, in Winston-Salem N.C., has listed 11 areas in which the program is inadequately supported by conventional medical practice. The Child Abuse Prevention Council of Orange County, Calif., stated its concern after physicians called them with reports of dehydration, slow growth and development, and FTT associated with the program. And on Feb. 8, AAP District IV passed a resolution asking the Academy to investigate “Babywise,” determine the extent of its effects on infant health and alert its members, other organizations and parents of its findings.”

There are so many resources out there on Babywise and the Ezzos. A few are included as links within the text and here are a few more:

Christianity Today article

Christian Research Institute article

Evaluating Ezzo Programs – extremely helpful site with tons of info including theological concerns of Babywise, statements by organizations such as AAP and Focus on the Family, as well as alternatives to Babywise; great resource!

Blog of former Ezzo Contact Mom

New Challenges Facing Gary Ezzo…

In conclusion, I found the summarizing thoughts made by the Christian Research Institute perfectly stated, “parents and church leaders…need to be aware of the risks associated with a teaching environment where Scripture is used out of context, questioning is actively discouraged, rules and schedules become part of one’s ‘testimony,’ even other Christians are considered ‘humanistic,’ division results, and the leaders do not seem to be receptive to constructive criticism.” Beware parents!