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The BirthandBaby Monitor


In this Edition:

-       On Sale - Subscribe for the Latest Newsletter Sale Items

-       News - Family Resources moves to a larger store.

-       Questions-Lactation Consultants, Different types of Midwives

-       Article - The Benefits of "Extended" Breastfeeding


            On Sale


            News

Family Resources Moved to a Larger Store

Family Resources has moved to a new, larger store just southeast of the Alderwood Mall in Lynnwood, WA. This move will allow Family Resources to fill orders faster and hold more inventory.

 

            Questions

Q. What is a Lactation Consultant? After my baby was born the hospital's Lactation Specialist helped me, but to help with engorgement problems, my friend suggested I call a Lactation Consultant. Is there a difference? A.L. Shreveport, LA.

A. Thank you for your question. Letters behind a name does not always indicate expertise and experience. When seeking breastfeeding help you should interview your care provider to make sure their attitudes and commitment to breastfeeding are aligned with yours. You should recognize that breastfeeding is a specialty that requires special training and experience. Some naturopaths, chiropractors and others - even an occasional M.D. - may be able to help with breastfeeding. But most are not trained or experienced in helping moms breastfeed. There are basically four levels of specific breastfeeding help.

La Leche League  - an international breastfeeding organization "to help mothers worldwide to breastfeed through mother-to-mother support, encouragement, information and education, and to promote a better understanding of breastfeeding as an important element in the healthy development of the baby and the mother". Volunteer leaders offer free breastfeeding help and support through local meetings and telephone "hotline" help. They are not professionals but they can answer basic questions and direct more difficult situations to the proper professional. A few other advocacy groups offer similar help but LLL is by far the largest.

Lactation Specialist or Breastfeeding Consultant - there are no requirements to use these titles. It is a popular trend for hospitals and clinics to designate someone "Lactation Specialist".

Lactation Educator - this professional should be able to produce a certificate showing attendance at a class (usually 1 wk intensive course). The bulk of their information and training comes from their own experience and study.

Lactation Consultant - Professionals who have been certified by the International Board of Certified Lactation Consultants typically use the designation LC or IBCLC. To earn this designation they must have four years of college with at least 30 hrs of breastfeeding specific education within 3 years of their exam. They need at least 2,500 hours of breastfeeding consulting and must pass a difficult examination (offered throughout the world one day each year). In order to maintain their designation they must recertify every five years with 75 continuing education credits and every ten years by examination.

PJ Jacobsen, IBCLC


Q.
What are the different types of midwives?

A. Last time we talked about the difference between MD's and midwives. At that time I put all midwives together. This time I will talk about the different types of midwives. 

The most known midwife are nurse midwives. They are called CNM's or Certified Nurse Midwife. They are nurses first then go on to one year of midwifery training and take a test to become midwives. The advantage of a CNM is that they are standardized or certified nationally by the nurse midwife association called American College of Nurse Midwives (ACNM). Because of their training as nurses they can attend births in a hospital and they usually have support by medical doctors. CNM's will be able to offer family planning that other midwives cannot offer. They can prescribe birth control pills and insert IUD's. Some people feel more comfortable with a practitioner who is more book taught than hands on skills taught. These people would feel more at ease with a CNM. They have the medical training of four years of nursing then the one added year of midwifery. Because CNM's work in hospitals they have to follow the protocol of the hospitals. They are limited by what the hospital will allow and they also have the advantage of offering what the hospital has to offer, namely any medications that a woman feels she will need in labor. CNM's are a very needed part of the birthing community for women and their families that feel more comfortable in a hospital setting. They have so much to offer the women they serve. 

The next category is a Licensed Midwife. Some people refer to them as lay midwives, they are not, they are only non-nurse midwives. They are licensed by the state they live if there is a mechanism for licensor. They go through two to three years, depending on state requirement of midwifery training. This is similar to going to a trade school for your education. The training is only in midwifery with some "book" or classroom learning and more skills or hands on training by licensed midwives. They can have more birth experience than a CNM. 

Some states allow the licensed midwife to carry any emergency drugs including oxygen that is available in the hospital. Other states do not allow the midwife to carry the drugs. I know here in Washington state we are allowed by law to carry many emergency drugs and can give women drugs or just offer IV fluids for a laboring woman. We can also give any drug to a labor woman that we have a MD's orders to offer. 

The midwifery community wanted to have a national standard as the CNM's have available. The midwives put together an association that offers Certified Professional Midwife (CPM) This standard is not accepted in every state as the CNM certification is and these midwives are not allowed in hospitals, except Washington state. This is for states that do not have any licensing body for midwives who have done the training and are very skilled but can not be licensed because of the state they live. Many of these midwives have had years of working with a midwife and are now capable of attending births with great skill. "Granny" midwives would be put into this category. They did not have any training at a formal school like medical doctors but they knew the way of birth and they were the best choice for attendants at a birth. Most granny midwives were trained by a practicing midwife and she would not let her apprentice take on a birth until she felt the apprenticing midwife was ready to handle the birth. The granny midwife was very well taught, just not by man's way of birthing. These midwives are also needed in the birthing community for those women who know that birth is not a disease and does not need to be in the hospital. 

There are midwives who feel that because pregnancy is not a disease a midwife need not be medically trained. Birth and pregnancy is a normal part of a woman's life cycle and there is no need to view it as a medical emergency. They will not be legally able to use emergency drugs. Most of these women know of herbs that can be use in an emergency and may actually feel more comfortable using herbs over man made drugs. There are also some people who feel that the government should not be involved in birth and see no need to license midwives or have the birth recorded by the state. This would be my classification of a lay midwife, or a woman who has no "formal" training and has a friend who wants her to be present at her birth. Some people would put "granny" midwives into this category. I would not, a lay midwife is one that is not licensed or certified by any governing body and may or may not have any skills taught to her from others practicing in the field of midwifery. 

I want to say something about the "granny" midwife. She is a woman who was trained by someone in the field of midwifery who has years of experience and skills taught to her by a woman who has had years of experience. They know normal birth far better than medical doctors.  They should be considered the experts in birth not the medical community that claims that right. 
Happy and satisfying birthing!
Charlene Jenkins, LM


            Article

The Benefits of “Extended” Breastfeeding
 

And although it is not the norm in most industrial cultures, UNICEF and the World Health Organization both advise breast-feeding to "two Years and beyond." Indeed, a child's immune response does not reach its full strength until age five or so.


How Breast Milk Protects Newborns
Jack Newman, M.D.
Scientific American, December 1995

This article should be titled "The Benefits of Normal Breastfeeding". The cruel cultural hoax of artificial baby milk has so distorted our anthropological and biological imperatives, that breastfeeding beyond a few weeks is considered an oddity and labeled "extended" as though it were some form of perversion. In the U.S. prior to the introduction of artificial baby milks in the 1920's - and in much of the world today - it is absolutely normal for babies to be breastfed for two to five years. Indeed, the World Health Organization (WHO) advises breastfeeding to "two years of age or beyond." Last May WHO accepted a resolution recommending infants be exclusively breast-fed for 6 months. The resolution, put forward by Brazil, was passed after many national delegates and several charities and organizations spoke strongly about the health benefits of breast-feeding. The news agency, Agencia Estado, reported that Nestle, a maker of infant formula that has been the target of action by breast-feeding groups, has accepted the resolution without question. The resolution urges member states of the World Health Organization to "support exclusive breastfeeding for 6 months as a global public health recommendation...and to provide safe and appropriate complementary foods, with continued breastfeeding for up to 2 years or beyond." Dr. Audrey Naylor, President of Wellstart International, said: "This is a key moment, and not just for the developing world. The scientific evidence continues to confirm the importance and value of exclusive breast-feeding, and this will help our efforts to achieve optimal maternal and infant health everywhere."

Yes, mom also benefits from normal breastfeeding. Last January the American Journal of Epidemiology presented a study indicating that women who breastfed for at least 73 months over the course of their lives had a much lower risk of breast cancer. "The longer duration of lactation - whether it is based on breastfeeding of a first child or breastfeeding over a lifetime - leads to a significantly reduced risk of breast cancer," Dr. Tongzhang Zheng, from Yale University School of Medicine in New Haven, Connecticut, said. The report stated that "women who breastfeed for at least 2 years cut their risk of developing breast cancer by nearly half compared with women who breastfeed for less than 6 months".

We maintain that a baby should be breastfed for as long as it has the biological or psychological need.

Some parents mistakenly make breastfeeding a control issue. Most parents recognize a need to control certain aspects of a child's behavior. A child needs boundaries and needs to know what they are. The concept of child-led weaning is sometime seen as an abandonment of parental control. As an adult the mother or father consider himself or herself most qualified to make a decision about weaning. Child-led weaning is recognition of the elegance and beauty of God's creation. Every little person is different. It is not as much giving babies what they want as it is giving them what they instinctively or spiritually know they need. They know when they are done, and no, they wont be breastfeeding when they are 19.

Be prepared to receive helpful advice about the harmful effects of normal breastfeeding from friends, relatives, or total strangers. Be confident that they are ignorant of scientific conclusion and spiritual confirmation. Many are trying to resolve their own intrinsic remorse for formula use by advocating their mistake. Reassure them that you are on the cutting edge of scientific research (you really are!). When considering advice, remember that you are the parent. You know your child and are connected to your child in a way no other person can be. Follow your heart.

Family Resources (BirthandBaby) offers the information in this newsletter for general educational and informational purposes only. This information is not intended as a substitute for advice, treatment, or recommendations from health care professionals. It is important to follow the advice of your health care professional regarding your individual medical and health care needs. Please consult with your Lactation Consultant or other health care professional before using any product or practice discussed within this Web site. The information contained in this web site is educational only and should not be construed as offering medical advice.  Family Resources is not engaged in rendering medical advice or services.

Copyright 2001, Family Resources.  All rights reserved.