New Beginings July 2010

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Infant Sleep,
Breastfeeding and Bed-Sharing
Choosing Breastfeeding
Nourishment of Love
The NEW Womanly Art of Breastfeeding:

Whats
New and Whats Not
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Celebrating Mothers and Babies Around the World TABLE OF CONTENTS
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[04]
[06]
Infant Sleep,
Breastfeeding and Bed-Sharing
The Womanly Art of Breastfeeding : Whats New and Whats Not
Mothers Stories
[12]
Devoted Dads
[15]
12 Worth the Struggle 13 Liams Weaning 14 Nourishment of Love
Kathleen Kendall-Tackett, Ph.D., IBCLC
[18]
LLL News
[24]
GlobaLLL: LLLI Peer Counselor Training in Malaysia LLL Austria Lllie-news LLL Ireland Kheema Kofte
llli.org | 2010
Breastfeeding in the News
[20]
Should Mothers Avoid Nighttime Breastfeeding to Decrease Their Risk of Depression? The Curious Lactivist: Breastfeeding Credited with Preventing War Related Deaths Sleeping with Your Baby A Parents Guide to Cosleeping
Your Letters:
[16]
Letters Page
Whats Cooking
[28]
Book review
[22]
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La mre, le bambin et lallaitement (Mothering Your Nursing Toddler)

by Norma Jane Bumgarner Journaliste et monitrice de la Ligue La Leche, lauteure remet dans un contexte densemble la relation mre-enfant et lexprience dallaiter un bb plus g ou un jeune enfant.
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Mothering Multiples: Breastfeeding and Caring for Twins or More

by Karen Kerkhoff Gromada Preparing for a multiple birth, valuable information on breastfeeding and caring for multiples.
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Breastfeeding Mothers Guide to Making More Milk

by Diana West, IBCLC, and Lisa Marasco, IBCLC Latest research on the causes of low milk supply and the way the body makes milk. How to determine causes for low milk supply and effective methods for increasing supply.
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Celebrating Mothers and Babies Around the World EDITORS LETTER
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Issue 1 | 2010 | Volume 2 | Number 2 2010, La Leche League International, Inc.

La Leche League believes women know best when it comes to mothering and offers accurate, sensible, reassuring information that leaves you to decide how to use it. The completely revised and updated 8th edition of The Womanly Art of Breastfeeding has been refocused and updated for todays mothers. The Womanly Art of Breastfeeding is the book no breastfeeding mom should be without! Help us reach our goal of putting this iconic book on the New York Times bestseller list by adding your pre-orders to those stacking up on our website.
Managing Editor | Barbara Higham Contributing Editors | Kathy Abbott, Johanna Horton, Barbara Mullins, Lesley Robinson Review Board | Barbara Emanuel, Gwen Gotsch, Carol Kolar, Kathleen Whitfield Art Director | Ronnelito Larracas Cover Photo | Inmagine.com Advertising Manager | ReNata Bauder web Development | Dave Davis, Shelly Stanley
Acceptance of paid advertisements does not advertised. LLLI does not require advertisers to carry product liability insurance.
Sharing Sleep
Worldwide and throughout history, mothers have found that breastfeeding has been made easier at night if they take their baby into bed and feed lying down. It is not at all unusual for both mother and baby to sleep better this way. While I was happy with the arrangement of sleeping with my babies, it was clear to me that it was seen as a problem by others because theyd ask, Is he sleeping through the night yet? Well, no he wasnt, but we were getting plenty of sleep and his nighttime feeds were not disturbing us. Reactions were mixed, but there was a common thread of disapproval. Some other mothers shared with me that they too slept with their babies. I usually got the impression that this was something they felt they should not be doing, or even that it was a failure on their part not to get their babies to sleep alone. Any fears I had were overridden by the convenience of the arrangement. I needed my rest and simply couldnt contemplate getting out of bed in the night to feed the baby! Theres something very special and relaxing about watching your child fall asleep next to youyour hormones play a part here and those instinctive feelings that this is something good. Research now points to the potential benefits derived from parents and infants sleeping in close proximity. In this issue of Breastfeeding Today, Helen Ball examines the issues of sharing sleep with a breastfed infant. We link to an article in which Kathleen Kendall-Tackett asks whether mothers should avoid nighttime breastfeeding to decrease their risk for postpartum depression. There is also a review of James McKennas Sleeping with Your Baby. I hope you enjoy these articles stories, letters and news in this second issue of Breastfeeding Today. Sweet dreams! Please share the link to Breastfeeding Today with other mothers and share YOuR stories, letters and photos with Breastfeeding Today.
constitute an LLLI endorsement of the product
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available to reputable outside groups. If you prefer La Leche League International fully supports LLLI Board of Directors, (2009, 2010)
the WHO (World Health Organization) International Code of Marketing of Breastmilk Substitutes.
Breastfeeding Today is published by La Leche League International Inc., PO Box 4079, Schaumburg, IL. 60168-4079 USA. Telephone 847-519-7730 (9 AM to 5 PM Central Time). Visit our Web site at llli.org. Canadian subscribers should contact LLL Canada at PO Box 700, Winchester, ON K0C 2K0, Canada, or go to www.lalecheleaguecanada.ca with any questions about subscriptions.
Barbara Higham
Barbara Higham | editorbt@llli.org
Barbara Higham is a La Leche League Leader and LLL magazine editor, who lives in the spa town of Ilkley, West Yorkshire in the north of england with Simon and their children, Felix (12), edgar (8) and Amelia (4).
Coming in issue 3:
Long-Term At-Breast Supplementing for the Breastfed Baby by Diana West, BA, IBCLC and Diane Wiessinger, MS, IBCLC
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The Womanly Art of Breastfeeding 04
The Womanly Art of Breastfeeding:

New 8th Edition
Diane Wiessinger, Diana West and Teresa Pitman
The very first Womanly Art of Breastfeeding was a thin notebook of mimeographed pages. The 8th edition is much thicker, of course, but we three authorsDiane Wiessinger, Diana West and Teresa Pitmanwent right back to that first version for inspiration and guidance. We were surprised (although we shouldnt have been!) to see how much of the information that helped mothers more than 40 years ago still held up today, with current research to support what their observations and hearts told them a half century ago. The Founders faith in mothers and babies came through on every page: they knew that breastfeeding worked and that it would provide a solid foundation for mothering.
Accepting the challenge of updating and modernizing the book that was so fundamental to our personal mothering journeys was both humbling and intimidating. The Womanly Art of Breastfeeding is a beloved icon to so many people around the world! But all three of us are deeply rooted in LLL philosophy, in our own lives and in our LLL and professional work. We drew from this to shape a book that we hoped would present the LLL philosophy clearly and compellingly to a new generation. This meant a more accessible, girlfriendto-girlfriend tone, with lots of humor and real-life anecdotes.
Our framework for this edition was an LLL meeting in a book. Of course, no two LLL meetings are ever the same, but certain themes, questions and issues tend to recur. We made a point of addressing those in the book. And todays mothers ask more detailed questions about a wider variety of topics than ever before. So youll find lots of new informationmore whys along with the howsas well as expanded sections on many familiar old topics. In every section, we hope LLL philosophy shines through. One of the biggest changes youll notice is that information has been organized in a new way. Just like the first meeting in our traditional Series Meetings, we begin the book with a chapter about how to prepare for breastfeeding during pregnancy, including how milk is made and the importance of nestingpreparing not the darling nursery but the babys real habitat of mothers body and a welcoming attitude. The next chapter is about the importance of building a support network of friends, family, health care professionals and other community resources.
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Whats New and Whats Not

Since medical interventions surrounding birth have become increasingly common and have caused increasing breastfeeding problems, the information in our chapter on how birth affects breastfeeding will help mothers know their options and make decisions. Youll meet em (everyday Mother) and her son Abe (Average Baby) and follow them through a normal birth. There are lots of tips for avoiding common interventions and for dealing with their effects if they occur. Mothers looking for quick answers for problems wont have to flip through the book. A chapter on tech support provides easy-to-find, tothe-point, evidence-based information to solve common breastfeeding challenges. The book is thoroughly referenced. Throughout the book weve added stories from mothers who share how they incorporate LLL philosophy into their own families, in a variety of circumstances. There are stories about motherbaby slumber parties; about wanting, from the age of two, to be able to nurse a real baby; about receiving a first flower from a chubby fist; about feeling linked to all mothers through all time; about the deliciousness of nursing and a story about a truly modern dilemmawhether or not to nurse an action figure named Captain Jack Sparrow. In fact, every time we got another whimsical or heart-touching story from a mother, we wondered again why we didnt just turn all the writing over to mothers.
Diane wiessinger, MS, IBCLC, has been a La Leche League Leader since 1985 and works as a Lactation Consultant in private practice, in Ithaca, New York. She is the author of many articles about breastfeeding, as well as being a popular speaker. Diane began her studies observing animal behavior over 30 years ago. See her collection of Common Sense Breastfeeding handouts http://www. normalfed.com. Diana west BA, IBCLC, is an LLL Leader and a co-author with Dr. Elliot Hirsch of Breastfeeding After Breast and Nipple Procedures, with Lisa Marasco of The Breastfeeding Mothers Guide to Making More Milk and author of the Clinicians Breastfeeding Triage Tool and Defining Your Own Success: Breastfeeding After Breast Reduction Surgery. She lives with her three sons and husband, Brad, in the picturesque mountains of western New Jersey. Teresa Pitman has been a La Leche League Leader in Canada for 30 years, and is the mother of four children and the grandmother of four. Shes the author or co-author of 12 published books, including two on breastfeeding (with Dr. Jack Newman). Her new grandson, Keagan, was born in November last year (at home, like two of his three older siblings). He is the fourth child for Teresas daughter-in-law Esmaralda, who is also an LLL Leader.
One of our new but very old additions relates to the sometimes-controversial question of getting the baby latched on. early editions didnt talk much about this issue. Position just meant a comfortable position for the mother. Latching was something the baby took care of. But over the years there have been more and more rules about how to position and latch the baby, and over the years birth interventions have made the babys role harder for him to manage. This edition focuses on a babys natural ability to find and latch onto the breastno rules, no one correct way to do it, with lots of help for supporting your babys instincts when hes having trouble and listening to your own instincts.
The next section of the book is a collection of ages and stages chaptersa sequential arrangement that makes it easier for mothers to zero in on the issues theyre dealing with at any given point. In each chapter, we present not only the answers to common questions that mothers might be having at a particular time, but we also describe the normal behaviors and needs of a breastfed baby at that age. The next section addresses the big questions: sleep, solids, working, pumping and challenging situations. each of these topics was addressed in the previous editions, but weve expanded the information greatly to include the newest research.
hroughout the book
weve added stories
from mothers who share how they incorporate La Leche League philosophy into their own families, in a variety of circumstances.
As you may have read in our article last month (Breastfeeding Today 2010 Issue 1; 6) about the process of how we developed this new edition, writing a new Womanly Art of Breastfeeding was an experience that touched us deeply and left us feeling more deeply bonded than ever to our breastfeeding sisterhood. We truly hope that youll feel the same way when you read it.
us in the JulyAug . azine! page 57 Pregna ncy Mag

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Some of the familiar information comes in new forms. A section at the back of the book is made up of tearoff sheetsthats right, we encourage you to rip pages out if you want to. (Photocopying is an option too.) These are handy references for tracking the babys diaper output, learning to hand-express, or gently letting grandparents know what kind of help and support you need.
Helen Ball 06
Infant Sleep, Breastfeeding

Professor Helen Ball, Parent-Infant Sleep Lab, Department of Anthropology, Durham University, UK
Good babies and sleep development
Is s/he a good baby? is a question commonly posed to new mothers and fathers in the early days of parenthood. Typically the enquirer wants to know whether the baby is contented and sleeps well. Those whose babies are good are congratulated. Those whose babies are troublesome receive sympathy and tips on how to improve their babys sleep habits. The management of infant sleep is one of the first areas of parenting in which new mothers and fathers are judged by others. It is not surprising then that infant sleep issues are a source of anxiety and frustration for many parents.
Babies sleep very differently from their parents: they dont sleep exclusively at night; they dont sleep all night; they fall asleep differently, have shorter sleep cycles and experience much more ReM.
Sleep is a developmental process, and our sleep patterns change throughout our lifetimes. Babies sleep patterns mature over the first several years of life, and the sleep architecture of newborns is very different than that of adults. Newborns sleep for 20 or so hours a day, but only for 23 hours at a time. During the first year overall sleep duration falls to around 15 hours, and the majority of sleep becomes consolidated during night time as circadian rhythms develop. Sleep is composed of two main states known as ReM (Rapid eye Movement) and non-ReM sleep. A normal sleep cycle progresses though phases of deep and less
at night; they dont sleep all night; they fall asleep differently, have shorter sleep cycles and experience much more REM.
abies sleep very differently from their parents: they dont sleep exclusively
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and Bed-Sharing
babys sleep time is made up of ReM, and when babies fall asleep they spend 20 or so minutes in ReM before dropping into non-ReM. During ReM sleep babies wake easily while non-ReM is often thought of as the floppy baby stage of sleep when they can be easily moved without waking. Both pediatric and popular knowledge about babies sleep maturation and regulation is based upon studies of formula-fed infants sleeping alone.
Settling is the term used to describe the phase when a baby begins to fall quickly into deep sleep, and to stay asleep for prolonged periods of time (typically from 12 am to 5am). Settling has been considered a desirable parenting goal for the past 50 years. In the late 1950s sleep researchers reported that 70% of the 160 babies they studied began settling by three months of age. The threemonth goal became enshrined in pediatric textbooks and has come to represent the age at which babies should be sleeping through the night in the minds of Anglo-American parents and health professionals. In the uK infant night waking is one of the most common reasons for parents consulting a health professional. However this milestone for sleeping through the night was established when breastfeeding rates were at their lowest, and solitary infant sleep was the norm.1 ReM. As the night progresses ReM sleep begins to take over, with most ReM occurring towards the morning. The adult pattern of 1520% of sleep time being comprised of ReM is not achieved until puberty. Babies brains grow rapidly throughout the first year of life. The process of forming neural connections happens during sleep, and so ReM sleep dominates newborn infant sleep cycles. From birth to three months 4050% of a
Photo: shutterstock.com
deep non-ReM sleep to ReM sleep (also called active sleep) and back again. In adults this cycle takes around 90 minutes; in newborns it is shorter, around 60 minutes. In nonReM sleep higher order brain functions (the thinking parts of our brain) shut down, while in ReM sleep the brain is actively processing information acquired during waking hours. Adults typically drop quickly into non-ReM sleep when we fall asleep, our initial sleep cycles comprising mostly deep sleep with little
Settling cannot be isolated from other aspects of infant development. It is now clear that not only do infants begin to settle at different ages, there are big differences in settling behavior between breastfed infants and those who are fed cows milk formula. Several research studies have now shown that breastfeeding is associated with a later onset of sleeping through the night, and with more frequent night waking, indicating that the established norms for infant sleep do not apply to infants who are breastfed. In fact, in societies where all babies are breastfed, settling is an unknown
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concept and infant night-waking is expected throughout the first year of life and beyond.
Breastfeeding and sleep
The tension between parents desires, that their babies sleep habits should match their own as early as possible, and the physiological characteristics of breastfed infants to wake and feed frequently throughout day and night, is known to be an impediment to breastfeeding in Western societies. Research studies exploring barriers to breastfeeding have reported that one issue mentioned by parents was their need for a satisfied baby that sleeps through the night and does not feed too frequently. Parents often seem unprepared to discover that breastfed infants need to feed frequently during the night, and sometimes interpret this as a failure of breastmilk to satisfy the baby leading to early weaning. Breastfed babies do wake and feed more frequently at night than those fed artificial formula, and this is the physiological norm for human infants. Newborns have tiny stomachs (the size of a cherry), and breastmilk is quickly digested. Night-feeding allows the baby to obtain sufficient nutrition (up to one third of daily calories). Babies generally double their birth weight by about six months of age, and their brains grow very rapidly, both of which require a large intake of calories. As breastmilk is high in sugar, it provides easily mobilized calories for brain growth, but it is digested in about 90 minutes. Babies therefore feel hungry again after two to three hours. When mothers commit to
breastfeeding, sleeping in close proximity to the baby is one way of making nighttime breastfeeding efficient and minimizing parental sleep disruption.
experienced breastfeeding mothers are aware that minimizing the disruption of nighttime breastfeeding is important in sustaining the breastfeeding relationship over many months. One way to accomplish this is for mother and baby to sleep together,
Mothers who discover the ease with which they can nurse at night when bed-sharing report that they continue breastfeeding for a much longer duration than they would have done otherwise. While around 50% of uK babies have slept with their parents at some point by the time they are three months old, over 70% of breastfed babies have done so, compared with a third of babies who are not breastfed.
There is no single simple message about bed-sharing that is appropriate for all families and all situations. Parents should consider the pros and cons for their own situation in order to make an informed choice.
close proximity to the baby is one way of making nighttime breastfeeding efficient and minimizing parental sleep disruption.
allowing the infant easy access to the mothers breasts, and causing minimal sleep disturbance for the mother when her baby needs to nurse. Numerous research studies in the past decade have shown a very strong and clear relationship between breastfeeding and bedsharing.1 The relationship is an obvious oneand many mothers report that they generally do not notice feeding their babies in the night. Observations of sleepsharing breastfeeding infants show that they nurse more frequently, and for longer periods than breastfeeding infants who do not sleep next to their mothers, but nonetheless routinely bed-sharing mothers obtain as much or more sleep as those who sleep apart from their breastfed babies.
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Concerns about bed-sharing
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The question of whether or not to bed-share concerns many parents. On the one hand it facilitates breastfeeding, which is good for both mothers and babys health. On the other hand parents are fearful of accidental smothering and Sudden Infant Death Syndrome (SIDS) when the baby is in their bed. The advice new parents receive about bed-sharing can appear contradictory. Advocates on both sides of the discussion have the interests of parents and babies at heart, but the apparently competing messages result in confusion and anxiety, which is not helped by media reports that present study results incorrectly or out of context.
Concerns regarding SIDS and/ or accidental death have led some authorities (for example, coroners and pathologists) to label parentbaby bed-sharing as a questionable practice that should be abandoned by parents and discouraged by health professionals. These recommendations acknowledge little or no value in mother infant sleep contact, and do not take the benefits of bedsharing into account. This view is reinforced by the results of large population-based studies that calculate the likelihood of SIDS or accidental infant deaths, based on the characteristics of babies who have died compared with matched controls. According to these types of study putting a baby down to sleep in the prone (tummy-down) position, placing a baby to sleep in a separate room, parental smoking, and infant head covering during sleep are all behaviors that increased the risk of unexpected infant death. As a consequence, advice on reducing the risk of SIDS in the uK and many other nations emphasizes the importance of placing babies on their backs to sleep, keeping babies in the parents room for the first six months, not smoking during pregnancy or in the vicinity of a baby, and avoiding loose bedding by employing the feet-to-foot position in a cot/crib. These are all relatively simple messages with little conflicting evidence.
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sharing that is appropriate for all families and all situations. Parents should consider the pros and cons for their own situation in order to make an informed choice.
None of the SIDS studies published so far provides data on the risk of SIDS for bed-sharing babies by feeding type. until more appropriate data are collected it is impossible to know whether breastfeedingrelated bed-sharing constitutes a risk to babies. However, it is unlikely that any potential risk would be of great magnitude given that breastfeeding generally reduces the risk of SIDS compared to formulafeeding according to several studies. One recent systematic review of all the published studies considering the evidence relating to harms and benefits of bed-sharing concluded that evidence on the benefits of bed-sharing to breastfeeding are clear, while the evidence regarding the risks is ambiguous.4
here is no single simple message about bed-
Avoiding dangerous situations
The picture is much more complicated in the case of bed-sharing; the estimates of the risk of SIDS for bed-sharing babies vary widely and depend on the circumstances under which bedsharing is practiced. They also depend on how each research study defined what bed-sharing entailed. Some studies include sofa-sharingand at least one included as bed-sharing deaths those that occurred after an infant had been returned to a cot/crib. These different definitions mean that we cannot simply accept at face value the authors (or medias) headline conclusions. Data on SIDS-risk for bed-sharing babies in england range from no increased risk for babies who sleep with non-smoking parents to a 12-fold
increase for infants sharing a sofa for sleep with a parent who smokes.2 The most recent study on bed-sharing and SIDS in the uK found that babies who died while sleeping with a parent were doing so in a hazardous environment, particularly on a sofa, or with a parent who had consumed alcohol or drugs.3 The authors of this paper note that simplistic advice to avoid bed-sharing may actually cause harm, commenting Parents of young infants need to feed them during the night, sometimes several times, and if we demonise the parents bed we may be in danger of the sofa being chosen. A better approach may be to warn parents of the specific circumstances that put infants at risk.3
The sleep behavior of breastfeeding bedsharing mothers and babies shows certain key characteristics. Dyads who regularly sleep together in order to breastfeed at night sleep in close proximity, face one another for most of the night, and have synchronized sleep cycles (with some evidence that mothers sleep cycles reduce from 90 to 60 minutes to match those of their infants). Breastfeeding mothers and babies have been studied sleeping in narrow hospital beds, full-size beds in sleep labs, and at home in beds ranging from single to king-size. under all circumstances mothers sleep on their side, facing, and curled up around their baby. Babies, positioned level with their mothers breasts, sleep in the space created between her arm (positioned above her babys head, on or under
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the mothers pillow) and her knees (drawn up under her babys feet). The consistency across several studies suggests that this very distinctive way of bed-sharing is an instinctive behavior on the part of a breastfeeding mother to protect her baby during sleep. When breastfeeding mothers sleep with their babies in this way they construct a space in which the baby can sleep constrained by
infant need to remember is that risks vary according to WHO is bed-sharing, WHERE and HOW they are doing it, and WHAT they have been doing before sleeping with their baby.
their mothers body and protected from potentially dangerous environmental factors such as duvets and pillows, or other bedpartners.4 The crucial thing that parents who are thinking of sleeping with their infant need to remember is that risks vary according to WHO is bed-sharing, WHeRe and HOW they are doing it, and WHAT they have been doing before sleeping with their baby. they did not adopt the protective sleep position with the same consistency, and they experienced less sleep synchrony. Fathers sleep behavior while bed-sharing was hugely variable. Some fathers were very in-tune with their infants and adopted similar bed-sharing styles to mothers while others turned away from the mother-baby dyad and slept oblivious to all nocturnal interactions. The hormonal feedback cycle experienced by breastfeeding mothers promotes close contact with, heightened responsiveness toward and bonding with infants in a way that is absent or diminished among mothers who do not breastfeed. The implication for bed-sharingthat breastfeeding mothers and babies sleep together in significantly different ways than
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he crucial thing that parents who are thinking of sleeping with their
families videoed sleeping at home, formula-fed infants were generally placed high in the bed, level with their parents faces, and positioned between or on top of their parents pillows. In contrast, breastfed babies were always positioned flat on the mattress, below pillow height. Mothers who did not breastfeed spent significantly less time facing their baby than did breastfeeding mother-baby pairs,
The most important issues to remember when sleeping with your breastfed baby are:
Never sleep with your baby on a sofa or armchair/recliner. Never sleep with your baby after drinking alcohol. Never sleep with your baby after consuming (legal or illegal) drugs or any medication (such as nighttime cold remedies) that affect your awareness during sleep. Be aware that bed-sharing with a parent who smokes (or a mother who smoked during pregnancy) increases the risk of SIDS. Think about your bed and bedding with infant safety in mind (avoid gaps, soft surfaces, keep babies away from pillows, do not swaddle or over-wrap a bed-sharing baby). Make sure bed-partners are aware the baby is in the bed, and do not allow small children to sleep next to a baby.
do non-breastfeeding mothers and babiessuggests that future casecontrol studies of bed-sharing must take feeding type into account. It is also important for breastfeeding mothers to be aware that the consumption of alcohol or drugs (including certain prescription and over-the-counter medications) can severely inhibit their normal responses and behavior when sleeping with their infants, and should always be avoided.
Where to find helpful information
Parents need information with which to make informed decisions, and should weigh any potential risks and benefits of bedsharing in light of their own individual circumstances (WHO, WHERE, HOW & WHAT). Useful sources of information include:
La Leche League GB Information Sheet Safe Sleep and the Breastfed Baby www. lllgbbooks.co.uk/shopping/ go_shopping/booklets_ and_information_sheets/ single_information_sheets/ safe_sleep_and_the_breastfed_ baby_information_sheet/ UNICEF Baby Friendly Initiative leaflet Sharing a Bed With Your Baby www.babyfriendly.org.uk/ pdfs/sharingbedleaflet.pdf National Childbirth Trust. Position Statement: Cosleeping and bed-sharing. www.nct.org.uk/pressoffice/position-statements/ transitionparenthood Royal College of Midwives. Bed-sharing and Co-sleeping: Position Statement No. 8. www. rcm.org.uk/professional/docs/ PS%208%20Bed%20sharing.doc American Academy of Breastfeeding Medicine Guideline on Co-sleeping and Breastfeeding www.bfmed. org/Resources/Download. aspx?filename=Protocol_6.pdf La Leche League International http://www.llli.org/NB/NBsleep. html
Bed-sharing babies of breastfeeding mothers appear, then, to avoid the presumed hazards of sleeping in adult beds (for example suffocation, overlaying, and entrapment) due to the presence and behavior of their mothers. But this may not be the case for babies who are not breastfed. When we have compared
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References 1. Ball, H. & Klingaman, K. Breastfeeding and Mother-infant sleep proximity: implications for infant care. Evolutionary Medicine and Health: New Perspectives Eds. Trevathan, W., Smith, E., McKenna, J. New York: OUP, 2008. 2. Blair, P., Fleming, P. et al. Babies sleeping with parents: case-control study of factors influencing the risk of the sudden infant death syndrome. British Medical Journal 1999; 319: 14571461. 3. Blair P., Sidebotham, P. et al. Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. British Medical Journal 2009; 339:b3666 doi: 10.1136/bmj.b3666. 4. Horsley T, Clifford, T. et al. Benefits and harms associated with the practice of bed sharing. Archives of Pedatric and Adolescent Medicine 2007; 161: 237245.
Helen Ball is Professor of Anthropology at Durham University, where she is Director of the Parent-Infant Sleep Lab and a Fellow of the Wolfson Research Institute. Together with her team of ten Postdoctoral and PhD students Helen has been conducting studies of parent-infant sleep in the lab, the community and in local hospitals for the past 15 years. She is a member of LLL Panel of Professional Advisors, the NCT Research Advisory Board and the Advisory Board of Attachment Parenting EU. More information about Helens research projects, publications, and upcoming presentations can be found at www.dur. ac.uk/sleep.lab
Nighttime Parenting: How to Get Your Baby and Child to Sleep
http://store.llli.org/public/product/92
Dr. William Sears urges parents to have confidence in their own intuition and be responsive to their babies and young children at night.
http://www.thefoodoflove.org/breastfeed-inyour-sleep.htm
Helen shared a link to this cartoon about nighttime breastfeeding:
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Worth the Struggle

to supplementary feeders. After suffering mastitis and broken skin I purchased a high-grade pump with the intention that not breastfeeding would allow my body to heal. I pumped exclusively for three straight weeks while my body sorted itself out. My husband would feed our daughter the expressed milk in the early hours of the morning while I cried, trying to pump more to keep up. Needless to say, it wasnt what I had expected. On top of this, all the confusion from hearing different advice was leaving me with a feeling of helplessness. it one feeding, one hour, then one day at a time. My daughter was nursing, and before long I started to heal. Thats when I found my first La Leche League Group and started gaining confidence in my ability to get through our problems. Two things that random strangers had told me gave me the willpower to survive our problems: If a woman is determined to give her milk to her baby, she will find a way and Yes, you may know what youve read, but you need to give your baby the time to learn as well. eight weeks, gels, creams, antibiotics, pads, machines, and countless teary nights later, we had established a nursing relationship. Together my daughter and I had found a way to breastfeed. Maybe its because we had been through so much together, or maybe its the way her eyes would roll in bliss as she nursed, but that time we spent together was the most cherished that I can remember. She weaned recently at 16 months and, although I cried for three straight days about it, yesterday my thoughts shifted. I came across a sample of formula that Id been given while pregnant, and realized that we never even opened it. From a woman and her baby who were facing big odds, we transformed into a team that nursed really well into toddlerhood. It is not with sadness but with great pride that I can say my daughter breastfed as long as she wanted and never consumed a single drop of formula. It wasnt easy, but when I look back and realize that it was the single biggest accomplishment I have ever achieved, doesnt that make it worth the struggle?
Photo courtesy of Natalie Dykstra
W
Photo courtesy of Natalie Dykstra
e took it one feeding, one hour, then one day at a time.

After eight long weeks of gadgets, gizmos and breastfeeding books I looked at my daughter one day and realized that all of this was becoming more difficult. She was lying right there while I was desperately trying to get her my milk. Thats when I realized that all of the help had overcomplicated things and perhaps I needed to return to basics and focus on the simple things. I picked up my daughter and brought her to my breast. At first I brought her in and then whipped her away, scared of the painanyone who has had a baby damage her nipple will commiserate! With strength and love, I summoned the courage to bring her to me firmly and to hold her with confidence. As soon as I felt the slightest bit of pain, I took her off and started again. I needed to focus on the simple step of getting a good latch-on. We took
Natalie Dykstra, Ottawa, Ontario, Canada

While pregnant, I completed my Masters degree in biochemistry, which focused in part on the benefits of breastfeeding. Nursing was something that I assumed would come easily to me and my thesis had set me up to believe it was the key health benefit I could offer my daughter in her infancy. Boy was I passionate! It was so important to me that I told everyone who would listen; my husband even told my midwife in confidence that he hoped it went well or wed be in trouble.
I realized pretty quickly after my daughters birth that science only goes so far. We just couldnt make it work. Luckily I had midwives who were supportive of delaying supplementation and protected my right to wait. They gave me time. One of the many lactation consultants we saw said that I would never be able to nurse without a nipple shield because of my flat nipples, and another said that something between my baby and me just wasnt working. Needless to say, I ended up buying and trying just about everything on the market from nipple shields
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Mothers Stories 013
Jovina Adams, Panama City, FL, USA

Before I even became pregnant, I knew I was going to try my best to breastfeed. I did a lot of reading and research about it before Liam was born. I was prepared for the possible challenges and knew it would be a lot of work. Luckily, for us, it was pretty easy. I never experienced any real problems. My goal was to nurse Liam for 12 months.
Liams Weaning
Well, 12 months came and went and he was still nursing five or six times a day. I figured, why end a good thing? Then a couple of months later, Liam would nurse a little less and would even skip a few sessions. I knew our nursing days were coming to an end. Then one day, he went all night without nursing. Although I sometimes felt I could use a rest, in my heart I just wasnt ready for Liam to stop nursing. Amazingly Liam did just fine without nursing. I cried for four days. Since I wasnt emotionally prepared to wean him, I felt as though I was somehow less of a mom now I was no longer nursing my baby. I felt as though anyone could do my job now and that my baby had grown and no longer needed me. I felt as though I hadnt said my goodbye. After work on a Fridayhed stopped nursing on a Tuesdayhe nursed for one last time. I kissed his sweet little head and stroked his arms as we had our last nursing moments together. It was beautiful. Since that day, we have both moved on. All the special memories are in a special place in my heartnothing will ever replace them. I look forward to watching Liam grow. And I look forward to building new memories with him as well. I know that Liam will always need me and that no one will ever be to him what I am. That was something I wasnt so convinced of when I first weaned him. A million thanks to La Leche League for helping me. I cannot wait to have my second baby so I can do this all over again.
Photo: Jovina & Liam
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Mothers Stories 014
Nourishment of Love
Mara Jos Pinzn Guqueta, the Dominican Republic
I was so eager for the arrival of my baby, whose birth I can now say was a blessing. This new life experience has enabled me to discover facets of my own personality that I could never have imagined. The daily nourishment of this tiny person who would transform my life was now in my hands, or rather my breasts, which had until then been full of nothing but potential. Today my Pablo Augusto has been one hundred percent breastfed for six months and I never fail to be amazed: I make more milk every day. I never for a minute considered giving him formula. I am certain that my confidence is what enabled me to continue breastfeeding himthe mind is powerful. We live and enjoy the moment without worrying too much about tomorrows difficulties. Time passes too quickly for that. I look back and rememberbreastfeeding has taken commitment, dedication and sacrifice. Now I understand the divine perfection of it: a mother makes the quantity of milk that is required at each particular stage by her baby. The infinite and indescribable love for my baby gave me patience. I held him in my arms and to my breast as much as possible so I could produce the milk he needed. Pablo Augusto and I are developing a mutual understanding, and Nature, on the pretext of keeping him fed, keeps us together, getting to know each other, observing each other, loving each other.
Photo courtesy of Mara Jos
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Dedicated to my son, Pablo Augusto Yermenos Pinzn, my source of inspiration and satisfaction.
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Devoted Dads 015
George Hay, East Lothian, UK
When my wife was pregnant with our first child and announced that she was intending to breastfeed our baby I wasnt particularly surprised. In fact, I hadnt really given much thought to how the baby should be fed, but it seemed sensible. After all, thats what breasts are for, and you dont have to be a genius to work out that formula is a very poor substitute for mothers milk. How many adults would drink powdered milk if there were fresh milk in the fridge? Reconstituted milk on your cornflakes? No, I dont fancy it either. So why should babies have to? In the words of Johnny Guitar Watsons 70s funk classic, A Real Mother for Ya: Theyre making milk out of powder Theyve got the babies cryin Poor babies, they dont know what that stuff is! children we reverted to the more traditional arrangement: I went out to work while she stayed at home, even though that meant a significant loss of income. We now have five children and they have all been fully breastfed, and by that I mean exclusively on breastmilk until they showed an interest in solids (usually by grabbing food off our plates). We let them wean themselvesusually a short comfort feed at bedtime was last to go at about four years old. Some of you might think that is a long time to breastfeed a child, but thats how it used to be done, and still is in the so called Third World.
spent three years as a full-time dad, and going
out to work is ridiculously easy in comparison.

The songs not really about breastfeeding, or mothers. Its a general lament about the way society is heading, and the readiness to give babies second best is just one part of that. However, I live in a country where its now regarded as normal and desirable for mothers to go back to work as soon as possibleas if raising a child were not important and valuable work. Its much more difficult to sustain breastfeeding if your wife/partner is out at work, but it can be done. When our first son was born, I stayed at home with him and my wife worked full time. She expressed milk so that I wouldnt have to give him formula, and often I would take him to meet her at lunchtime for a proper feed. However, it was hard work for both of us, and for our subsequent
Given the obvious and welldocumented benefits of breastfeeding its difficult to see why it isnt more Photo courtesy of George Hay popular here. However, the decision on whether to breastfeed or not Here are the benefits and isnt made in isolationdads also disadvantages as I see them: have a say, and, in my experience, many appear surprisingly ready to accept formula. Why is Formulapoor substitute for breastmilk, dad has that? Well, I suspect that a lot of men think that to take turns at getting up in the middle of the theyll get their sex lives back more quickly if the night to prepare it, babys poo smells bad. baby is bottle-fed and packed off to another room as soon as possible. It makes sense for Breastmilkideal food for babies, no getting out breastfed babies to sleep in the same bed as of bed required, babys poo is inoffensive, your their motherthat way no one needs to get up partner has surprisingly large breasts. in the middle of the night. Thats great if you want a good nights sleep, but not if you want Surely this cant be a difficult choice for anyone hot sex (and, believe it or not, even breastfeeding who likes babies. Or breasts. mums enjoy some of that). However, I reckon the answer isnt to give our babies a second rate milk substituteits to offer our partners the help and support they need (but wont ask for, because they are women). Sulking in front of the TV with a bottle of beer isnt going to make us dads attractive to tired and harassed partners. Doing more around the house and helping out with childcare is. And doing a full-time job isnt an excuse for being a couch potato at home. I spent three years as a full-time dad, and going out to work is ridiculously easy in comparison.
llli.org | 2010
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Your Letters 016
Letters Page
Happy Birthday LLL
Recently LLL Tyne & Wear, uK celebrated its second birthday. A big party was held at a local community centre that was attended by lots of mothers, their babies, toddlers and partners. A fun time was had by all and there were lots of toys, a bouncy castle and lots of food, including some delicious cakes and, of course, lots of breastfeeding! Gillian Mabbitt, UK
LLL is SpeciaLLL
I enjoy being a La Leche League Leader because this really makes a difference to other women and their children. Being a volunteer means I can help anyone who calls me. There is no worry about whether the mothers have money or insurance. It is priceless to hear the words, Thats the first time shes ever latched on! Or, thats the first time it hasnt hurt! I think every woman should have access to breastfeeding support. LLL values the personal experience of mothers who have breastfed, and makes this a prerequisite for leadership, which is somewhat unique. As a registered nurse and lactation consultant, I know very well that personal experience is not a necessary element for providing competent medical or lactation help. But I appreciate that LLL goes beyond the technical aspect, and fills a different, more personal role as well. Gina Kruml, RN, BSN, Sierra Vista, AZ, USA
Photo: Allie van Gundys baby
star letter!
Biting Babies
One of the questions I hear most often from other mothers is Are you going to stop nursing when your baby gets teeth? I smile, shake my head, and reply, My son has eight teeth already. Often the response is Wow! Well the first time my kid bites me I am dzone. I try to inform them that, just like most things, biting (if it happens at all) will pass. But many of my friends cannot wrap their mind around that idea until they reach this particular point in their own nursing relationships. After my son bit me a few times, I realized eventually that I had been mistaking his cues and offering to nurse him when he actually just wanted to do something else instead. It was a mother on the forums at www.llli.org who suggested that this might be the reason he had bitten me.
Multi-tasking
As parents we often learn how to do several things at once. Here are a couple of photos to illustrate our multi-tasking skills. How many tasks can you accomplish at the same time? Wed love to hear from you! Send your letters and photos to editorbt@llli.org
Papa, Amandine & Gavin courtesy of Charlotte Yonge, Paris, France.
end your letters and photos to editorbt@llli.org
A p r ize for the star letter!

Ellyn Hutchinson nursing Sabina while redecorating her hallway courtesy of Newcastle calendar copies available from
Allie van Gundy, Rathdrum, Idaho, USA
Resources This informative article from the LLLI magazine for parents, New Beginnings Mar/April 1999, 3639, details reasons why a baby might bite as well as strategies to avoid biting.
The star letter for Issue 3, 2010, will receive the new 8th edition of The Womanly Art of Breastfeeding!
Mothers share their solutions to biting and latching difficulties in Toddler Tips New Beginnings Jul/ Aug 2001, 143145.
www.breastfeedinginnewcastle.blogspot.com
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Feature Article 018
Should Mothers Avoid Nighttime Breastfeeding to Decrease Their Risk of Depression?

Kathleen Kendall-Tackett, Ph.D., IBCLC
Breastfeeding mothers are less tired and get more sleep than their formula- or mixed-feeding counterparts. And this lowers their risk for depression
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Feature Article 019

using supplementation as a coping strategy for minimizing sleep loss can actually be detrimental because of its impact on prolactin hormone production and secretion. Maintenance of breastfeeding, as well as deep restorative sleep stages, may be greatly compromised for new mothers who cope with infant feedings by supplementing in an effort to get more sleep time. Doan, T., Gardiner, A., Gay, C. L., & Lee, K. A. Breastfeeding increases sleep duration of new parents. Journal of Perinatal & Neonatal Nursing 2007; 21(3), 200206. See a video on Kathleen Kendall-Tacketts Depression in New MothersCauses, consequences, and treatment alternatives 2nd edition: Routledge, 2009 here:
suPPOrting membershiP
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Advising women to avoid nighttime breastfeeding to lessen their risk of depression is not medically sound. In fact, if women follow this advice, it may actually increase their risk of depression. Read the full article here: http://www.uppitysciencechick.com/nighttime_ breastfeeding.pdf
http://www.onetruemedia.com/shared?p=a4e5a c867db516ca92c0d8&skin_id=601 My enthusiasm for the comprehensive content and easy-to-read style of Depression in New Mothers leads me to recommend this book as an important resource for everyone working with pregnant and postpartum women as well as the family members affected by this condition. Marian Tompson, Co-founder, La Leche League International. Depression in New Mothers is available at http://store.llli. org/internal/ product/189
- Breastfeeding Today, our new global online publication with breastfeeding research, articles, resources and products.
magaz ine NEWOnline | 2010
Kathleen Kendall-Tackett, Ph.D., IBCLC is a health psychologist, board-certified lactation consultant and La Leche League Leader. She is clinical associate professor of pediatrics at Texas Tech University School of Medicine in Amarillo, Texas. For more information, visit her Web sites: www.UppityScienceChick.com and www. BreastfeedingMadeSimple.com
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Breastfeeding in the News 020
The Curious Lactivist
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Photo is courtesy of Sacha Blackburne
Breastfeeding in the News 021
Kathy Abbott, IBCLC, Boston, USA
Breastfeeding Credited with Preventing War Related Deaths

Make love, not war was the chant shouted by those in the peace movement in the 1960s, but maybe the slogan should have been Make mothers milk, not war. Long before any of us had heard about global warming, societys biggest worry was the amount of damage being caused by wars. The good news is those cries for peace did not go unheeded. In a remarkable report by the School for International Studies*, it appears that the number of deaths during times of war has been reduced significantly in the last few decades. even more surprisingly, the worldwide effort to encourage women to breastfeed was seen to be one of the reasons for declining wartime mortality rates. The first half of the 20th century, marred by two full-scale world wars, the explosion of two nuclear bombs, and a series of cold wars scattered across the globe took a horrendous toll both on those countries immediately involved and on the men and women who participated. But during wartime its not just soldiers who suffer. The collateral damage created by armed conflict takes a heavy toll on a countrys infrastructure. Limited access to food, clean water and health care has consequences far beyond the battlefield. The innocent bystander suffers as well and, not surprisingly, it is the youngest who suffer most. Not long ago 50% of the deaths during wartime occurred to those under five years old.
is far less damage to the existing infrastructure in other more peaceful parts of the country. According to The Shrinking Costs of War, a Human Security Report, The data indicate that in the new millennium the average conflict killed 90 percent fewer people each year than did the average conflict in the 1950s.
But it is not just the change in the way wars are fought these days that has made the difference. Today much more humanitarian aid is being offered from other nations during times of conflict. We now spend three times more on help for refugees than we did at the end of the cold war years. Furthermore decades of efforts from the united Nations and participating organizations to improve health conditions in developing nations during peace times has led to astounding improvements in health in many areas of the world. Back in 1974 fewer than 5% of children worldwide had been vaccinated against the six most preventable childhood diseases, diseases that children are particularly vulnerable to during times of war: diphtheria, measles, pertussis, polio, tetanus and tuberculosis. By 2006 that figure had risen to 75%. According to the Human Security Report, By some estimates, immunization alone has saved up to one million lives a year on average over the past two decades.
pneumonia. Babies less than six months old who are not exclusively breastfed have a seven-fold increased chance of dying of diarrhea. Likewise the increased risk of dying of pneumonia is five fold. The bottom line is that children suffer the biggest impact during times of war. And children who are healthy and well nourished before a war begins have the greatest chance of survival.
hildren who are
healthy and well
nourished before a war chance of survival
Despite all our tremendous medical advances the rate of those dying from war-related injuries has not shrunk in comparison to the number of lives saved through the prevention of common war-related diseases and conditions. Bullets and minefields continue to be deadly. But malnutrition and diarrhea, measles and pneumonia need not be the killers they once were. One of the greatest lessons we have learned in the last century is that it is still easier to prevent disease than it is to cure it. It is far easier (and less costly) to avoid death by providing the basicsclean water, healthy food and access to minimum health care, than it is to save a life through new technology. Breastfeeding continues to be one of the most advanced non-technological tools in our medical survival kit. Breastfeeding is still the simplest and most effective way to protect our babies in times of peace and war, in times of poverty and economic success, in times of calamity and in times of tranquility. And, who knows, maybe one day it will even be recognized as playing a part in reducing global warming as well! * Human Security Report Project at the School for International Studies. The Shrinking Costs of War. Human Security Report 2009, Part II, 2010: Simon Fraser university.
begins have the greatest
Todays wars are different. Battle lines are no longer drawn between nations; superpowers no longer go head to head with each other as they once did. Instead most conflicts are confined within one nations borders. Today the battles are more localized. usually the struggle is between a government and poorly armed rebels who are not equipped with long-range military capacity. There
The report went on to credit specifically efforts to increase breastfeeding rates with the decrease of children dying during times of conflict. Due to efforts by the uN and uNICeFs Revolution in Child Survival initiative, which began in 1982, breastfeeding rates have increased worldwide. In sub-Saharan Africa exclusive breastfeeding rates have doubled. Breastmilk (the best vaccine of all!) provides protection against two major killers of infants during wartime: diarrhea and acute respiratory infections (ARIs) such as
Kathy Abbott as The Curious Lactivist likes to reflect on the ways that breastfeeding is presented in the news media. As a private Lactation Consultant and LLL Leader she is constantly learning from the women she works with and as the mother of a smart, vivacious, totally awesome 13-year-old daughter she is renewed in her faith that the next generation will most certainly get it right! www.TheCuriousLactivist.Wordpress.com
http://www.humansecurityreport.info/index. php?option=com_content&task=view&id=205 &Itemid=91
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Book Review 022
Sleeping with Your Baby

A Parents Guide to Cosleeping Whether you do it occasionally or every night, do it safely
by James J McKenna, PhD Review by Gwyneth Little, East Lothian, UK
Despite an annoyingly long and unwieldy title and subtitle on the cover (see above), James McKennas book on cosleeping is a wonderfully easy, mother-sized read. Very short, at just over 100 pages, it can be picked up at any odd moment as it is divided into sections, each only a few pages long.
The author prefaces his book with a note on Why I Care So Much About This Subject, the contents of which reassure us, right from the start, that this is a book written not by some remote self-proclaimed expert, but by a person who, while having impeccable scientific and research credentials, also actually walks the walk by having coslept with his own children. I like the analogy he draws in his preface between cosleeping and eating: although it is known that people can and do die while eating (through choking), no one would dream of recommending that we therefore stop the normal, common and instinctive practice of eating. Instead, we minimize the risks involved. Cosleeping requires a similar commonsense approach, and that is what we find in this book.
Photo courtesy of Sacha Blackburne: Kim with her baby Kayden
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Book Review 023

The book proper starts by explaining what cosleeping isa reference to the many different ways babies sleep in close emotional and physical contact with their parents, usually within arms reach. It is therefore not necessarily synonymous with bed-sharing, although this particular form of cosleeping is discussed at length in the book. necessarily always stick to the same arrangement, since cosleeping is a practice that evolves over time, and there are endless variations on the theme. This message is slightly undermined by the fact that on one page there is an illustration entitled The Proper Way to Cosleep, with very specific instructions about the bedding to be used and a sketch of a family of three asleep on a mattress in the very centre of an otherwise fairly bare room. However, to his credit, McKenna does explain precisely why this is the ideal arrangement, but not the only one, and gives a very welcome rundown of the risks associated with other arrangements and ways of minimizing them. By the way, the number one risk of bedsharing is not suffocation, but entrapment of the baby, for example between the bed and a wall, between the bed and another object or piece of furniture or in a headboard or footboard. an interest in monitoring the safety of one or both twins. It is not clear to me why such an arrangement (two adults, each willing to take responsibility for one child) could not also work for two siblings of different ages.
McKenna then goes on to explore the historical, cultural, anthropologic and scientific aspects of cosleeping, and presents lists of the benefits of this practice for both baby and mother, as well as specifically for the management of breastfeeding. He explains the phases of sleep and the role of sleep in brain development, enthusing about how much happens during sleep and bedsharing, and pointing out how much babies therefore miss out on if they are deprived of this experience. At one point he puts forward the intriguing hypothesis that, since the average length of time between breastfeeds for a bed-sharing mother and baby is about an hour and a half, or equivalent to the length of the human sleep cycle, the nutritional needs of cosleeping and breastfeeding infants might actually be what dictated the average length of the adult sleep cycle in the first place.
However, these minor quibbles apart, this is a very useful book if you are considering cosleeping and want to separate the myths from the facts, or if you are already happily cosleeping but would like to learn how to respond to curious, or even downright critical, friends, family and health professionals. On the whole, this book, like LLL, concentrates on giving information, not advice (though McKenna does both recommend and advise on several occasions!), and speaks to parents as people who are very capable of making their own decisions.
On the subject of SIDS, and the popular perception of a link with cosleeping, he roundly condemns the lazy scaremongering of the press and of what he refers to as medical parenting science, and usefully gives a breakdown of the many independent risk factors for SIDS that need to be considered when reading sensationalist reports on deaths caused by bedsharing. The press, he points out, makes no distinction between the act of cosleeping and the conditions in which it occurs. In fact, as he reminds us, putting a baby to sleep in a separate room on its own actually doubles the risk of SIDS. For babies who do have to sleep or even take short naps on their own, he suggests using a baby monitor in reverse, to pipe sounds and noises from the active part of the house into the room where the baby is sleeping. In a practical how to section, McKenna stresses that there is no correct or one-size-fitsall method of cosleeping. Nor will any family
cKenna explores the historical, cultural, anthropologic and scientific aspects of cosleeping and lists the benefits for baby and mother, as well as for the management of breastfeeding.
McKennas official website (at the Mother-Baby Behavioural Sleep Laboratory of the university of Notre Dame, Indiana, uSA) can be checked out at www.nd.edu/~jmckenn1/lab/
One thing I found a little confusing is that McKenna categorically advises against bedsharing (though, please note, only against bed-sharing, not other forms of cosleeping, such as room-sharing) if there are other children who can or are likely to climb into your bed (a situation that is going to apply to very many of us, and certainly applied to my own family over a period of many years), later specifying in more detail not to bed-share if older siblings who do not understand the risks of suffocation are sleeping in the same bed with infants less than one year old. However, when discussing twins, although he generally recommends not bed-sharing, he does not rule it out altogether, provided that there are two responsible adults present, who are both active participants with
Available from the llli store http://store.llli.org/ public/product/246
llli.org | 2010
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LLL News 024

As a Malaysian who has made Paraguay her home for the past 16 years, this has been a very humbling experience for me. Being with these wonderful women, who are full of energy, eager to learn and share experiences with a vision for Malaysia, made me think of our LLL Founders. More than 53 years ago, they saw a need and took a simple action to support and share up-todate information to help mothers breastfeeding. Such action is far-reaching.
GlobaLLL
A look at what is happening in LLL around the world
LLLI Peer Counselor Training in Malaysia
La Leche Liga sterreich (LLL Austria)
New York Times Best Seller

WatCh Our Pre-Orders staCk uP!
PreOrde rs
Pushpa Panadam, LLL Leader Paraguay, LLLPCPA training specialist
When a group of IBCLCs got together in Malaysia they asked themselves how they could increase the countrys breastfeeding rates. To do this, they felt that they needed trained peer counselors to run mother-to-mother support groups. They looked at various peer counselor curricula and were interested in the La Leche League program. Nor Kamariah of susuibu.com emailed me and I put her in touch with Kathy Baker, the Training Administrator for the LLL Peer Counselor Program (PCP). Soon the three of us had discussed the benefits of face-to-face training. The proposal they made to uNICeF Malaysia was accepted and led to a six-day training course of the LLL Peer Counselor Program Administrator (PCPA) and LLL PCP. LLL Austrias conference this year takes place in edthof in eben (Salzburg) from May 21st to 23rd 2010. Once again on offer there will be many interesting talks and workshops on breastfeeding and the work of breastfeeding supporters. The conference program will be available on the home page , where it will also be possible, for the first time, to register for the conference online.
3800
LLL Ireland
NIneteen women, many of whom were still nursing their children, participated actively, discovering interesting ways to reach women and families in the art of breastfeeding support. Their plan is to train peer counselors in different regions of the country.
At the Annual Conference on March, 17, Mike Brady of Baby Milk Action gave a talk on Whats your milk worth? For the text and PowerPoint presentation visit http://info.babymilkaction.org/ news/campaignblog070310
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In February LLLI launched lllie-news bringing Leaders updates and information via email from the LLLI office.
end notification of your countrys LLL news, events and resources to editorbt@llli.org
When mothers become grandmothers...

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Go GLOBAL with the LLLI International bag! made from 100% recycled materials. Reusable for groceries, to tote personal items, and to show your support for breastfeeding mothers and babies around the world! (Measures 13x13x5.) by Thomas W. Hale, PhD New 14th edition, provides on-the-spot information on the impact of currently used medications on breastfeeding mothers and infants.
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Stillen: einfach nur stillen (Breastfeeding Pure and Simple)
by Gwen Gotsch Vermittelt Ihnen genaue Informationen und vor allem die Begeisterung, die Sie brauchen, um Ihr Baby am Anfang und in den vielen kommenden Monaten zu stillen. http://store.llli.org/public/profile/350
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find themmothers may in which it for bacteria the affected Breastfeeding be focal points may drop from s, of situations production of the symptom selves in a variety for them to pump their tive process. Milk during the worst breastfeeding seems necessary the need to use a breast breast for a few days to continue find t for the baby which type is milk. If you from turning it is importan want to know the infection will not With practice, but pump, you may help prevent to your needs. work, but dif- from that side to affected breast best suited milk from the of pump will of into an abscess. The almost any type may make one type g the duct. ferent situations to another. You may also harm the baby. the the material obstructin preferable manual or and disperse pump ded whereby familiar with way to reduce in nipple. has been recommen or want to become as this can be useful toward the are resistant A different approach front of the lump the masin when the bacteria are not hand-expression . Information on manual mother massages close to the nipple, repositionin front of frequently recurs antibiotic, when antibiotics , many situations be found in LLL publicaMastitis most the prescribed directly is prescribed on to Begin by massaging you are massaging ing the incorrect antibiotic expression can the way through most comm back until Art of Breastfeednot sensitive enough, when an the affected side, or when to help clear to sage farther of the continued long Breast Milk (such as milk tions, The Womanly nursing on This is thought in straight alignment be One for weaning Expression of the blockage. La a when the mother stops not been addressed sensitivity that may not Know if Your and Manual attention, because rs give the mastitis has , or by contacting a culture and How Do You is Low? convoluted ductworkducts require prompt d is reasons mothe initial cause of recurs, make sure that breast inflamMarmet Technique in your area. what organism had planne that leads to Leader the nipple. Plugged Milk Supply stasis). If mastitis milk to discover exactly Many organisms are r than they cascade of events Leche League a . it. on the soone after they can start test milk supply of ineffective most common is done what antibiotic will eliminate infection. like fussing repeated use describes the mation and breast nipples. rn about and the Baby behaviors involved and conceGet help antibiotics and The following is used sore or damaged USA often, or feeding 60173 Board use breast pumps IL is resistant to common the risk of an abscess. the causeof Schaumburg an International one type nursing, feeding reasons mothers culture that of time, HE increases Troubleshoot Leader, is 957 North Plum Grove Road that might make medications long periods Living in a in or Leche League 460 800-LALEC other expert , aureus (MRSA) considerations hing, it can for short or from a La fax 847.969.0 t (IBCLC), over another. resistant Staph hospital-acquired 730 ring breasts or less 847.519.7 Lactation Consultan baby is positioned everyt by methicillin for of pump preferable Certified toa break in the such as softer Mastitis caused prevalent. Increased risk sure that your measu skin milk to trust seen in mothers is to make or changes indicate a low Once breastfeeding for mothers the peribecoming more and difficult to treat situation, kicks or may not of breast infection. antibiotics in suckling correctly. production bea difficult the of leakage, may who Other cannot often just part latched, and MRSA, a virulentdelivery, administration of four days, milk and mothers your chances factory is safe for when they behaviors are the-night pumping. within two to time on, the emollient that be soothing with in supply. These ding. Whereas occurs, it increases a than formula the breast pumping a cesarean mothers with multiple gestation, t infection with the middle-ofcan forgo use of suitable often n. Outpatien This can is inside it into high gear. From that e how much milk to the normal course of breastfeeare full and middle-of-the-night about four period, partum find that they Consider the babies feed more wish to milk maintain that as HPA Lanolin. d in vitro fertilizatio Breast mothers need to their all-day supply until they are Tip 6: Breastfed baby to ingest, such cracked nipple. Youbehow much have experience see also may l weeks the breasts more common. When your breastsdetermin baby takes out. to it will a to Come to in the early milk your also is becoming healing ofsuited to your baby, medicated ointment the baby. to protect related to additiona fed babies. MRSA order Is Unable and speed is perfectly by how much applying a likegoing a into breast hard, this is your milk ilk substitutes over m. human milk When Baby sometimes likelihood of that sincetalk to your doctor about as extra milk d full milk than non-breastm be readyor the to eat months postpartu in, mothers make puts your baby in charge of Keep in mind will feed Well breasts as well the had an establishe hospitalrapidly and completely breastfedto decrease of supply and s begin to set nipple baby the law As the fluids in the once they have digested more formulas. Your or Cant Breast to come to breast or cant drain the damaged Prevention ned That doubt infection . Remember your baby needs. return the rentalThe packmore milk or soy-based of defense. situa- Some mothers find that the can what counterpart cows milk supply! best line well-intentio supply. Such weeks, they the baby nurses, his bottle-fed and beyond infection. baby is unable settle into milk soreness and double pump. lPrevention is the mothers milk serious illness, a supply for about two Sometimes a again between feedings sooner than work herethe more often severe nippleoften receive and your breasts a retail electric recommend for is at needs, Occasiona Use. enough to maintain periods of time link fluid is lost demand that that may even some experts to baby. between hospitalization your babys . If you baby is allowed at each pump and purchase should not say For breasts well main- going for long for your the prematurity, other conditions best grade abilitywell drained body will produce Duethe nipple by Staph aureus, soap and water and the are n that matches designed for Avoid poor advice a pump full-term, healthy your . productio When a ven though with but tions can include such as cleft palate, and your of were not really healas he needs, or feed areas of the breast aging for such on worse and his mothers of baby is getting cannot do so, if your the nipple and as long double pumps unable to come to breast away sure that all will feel softere promote wound need for milk ed. is one more on the situati physical condition supply for a baby who careful washing the breasts diapers to check of a medicated ointment to pumps are very However, these baby is A babysswitch Make to to nurse as often make can eventuin them, and a milk that try to right quantity by massagis usually establish Tip 7: Count pump. These are taining a milk supply when must establish application to an infection in find that if they n is nursing all the about this type of it feeding the rade breast that remain hard enough to eat. new), so they there are ways h a good supply of milk times a day. If the baby there is plenty of milk increase in frequency to drop in ajust when breast law progressio baby hospital-g produce Other mothers to starts es an to satisfy areas of theof the over $1,000 them. choice is a thinking ing and prevent that herhave enough milk Fortunately, with your doctor in well at breast. rade pump, their milk supply the hospital-grade eat 8-12 enoug e to purchase finds herself Address any examples purchase (usually the way! Sometim doesnt Talk most perfect Most babies using of an increase ) and two the milk over mother ally affect the breast. are making expensive to mothers choose Sometimes a means that she (five job due to prematur from a hospital-g they need to go back to of natures an indication is , ing while nursing nding how though some ducts. Massage and wonders if this wet cloth infection. to six disposables know if you diapers baby and of feeding is after birth) and time, and does time, used increase is unable to do the usually rented, demand. Understa care of plugged the another condition of breast their milk supply. the third day milk for a larger tiny week or two, to take need for mommy supply and so much and regulated makes it easier commonlyIf he has six to eight per day (beginning can be sure he is getting plenty ofand informationto help n, illness, or and maintain him. produce enough has been your babys but Quickly begin The best way movements if you have a pump to rebuild your breasts milk For more ways Understanding birth, separatio the breasts to breast pump to five bowel anything but your milk, you movements less frequently, is established behind the blockage 10 tips m weeks. Even supply problem. llli.org d. The ability of For removed from in any manner 30 ounces output will sound of an electricsupply their milk.and/or milk supply. Here are not reflect a not being given older baby may have bowel International. be reproduced the early postpartuable to express about milk must be babys diaper milk factory not Some mothers dislike the An (letting down) pumps ample sheet may not a be is set during League it, if neede m. If you are nourishment. al plentiful. and the by other means or else the and your baby find to tell is to look at yourfirst 6-8 weeks, most you want to maintain time releasing This informationpermission from La Leche to manual an or l premature baby, hours by two weeks postpartu want to contact that they have a hard using two one-handed they should be supply works without written and gain. In the using manual may down. If you League Internationa 24 feedings. how milk mothers, and weight However, when you.it August 2009, La Leche to help well, is very two weeks, you (900 ml) every problems begin to shut this situation and taking into good wet diapers your baby for s for increasing some of these much milk by a better choice. at least 5-7 nurse need to wake between that can cause producing that lactation consultant for suggestion milk produc- pedal pump may be No. 10221 baby who cant than three hours two hours Tip 8: You may to yourselves in how may times a day your baby babies have stools larger than a US quarter making every optimum or supply for a sleeps more every things attention to to to establish Mothers pumps to maintain the best way an LLL Leader to have fewer your baby regularly feedings at least at least 3-4 pay very close that she per- often. pumping up The best way consideration of a newborn. If you find that need to be awakened for established. If the baby begins If to finding get older, they other, Nurse the breast, may important that the mother eachTip 1: and early and is key your milk supply. the nursing frequency he may cm). As they the time supply and getting within an ensure milk production. effectively at supply is well 24 hours. You as possible to in feedings, (2.5 From nurses milk. will help to nurses a abundant milk nurse their babies until your milk be a corresponding drop movements. tion is to mimicleast eight to 10 times every choose to pump suction stroke as similar strokes per minute. or if the baby who to establishing during the day intervals each 24 hours to six there will may at feeding increase your farther apart supply but larger bowel This is the key to a good start. Mothers at frequent, unrestricted 8-12 times in until four a hours, or you baby is not should pump take one form 50 to 55 suction nurse less frequently, be spaced farther and at each feeding, the milk often off to nurse milk comes who nurse on to every three time breastfeeding the day and supply. If your gain around reverse: the less birth and nursings continue for a shorter period of their mothers choose to pump and a half hours during a good milk goal for the ted from Baby continue milk supply than mothers from the start also works in or half hour after a good the babies should two breast, a good less vigorously law of supply and demand (Timing is counted week. every two to session.) months of age, are more The Mother is Separa Travel likely to establish directly at the day is at least grams) per there will be. stretch at night. will diminish. of the next pumping a When l, or restricted feeding schedule. the less milk (150-210 you pump per longer, five-hour Supply Works to the start for the and therefore more 5-7 ounces the baby nurses, amount of milk 0mls). to Work, Schoo pumping session a higher prolactin level five hours or down gradually the more more often.How Milk time Due (750-90 of one slows separation of at the same build a milk babies to nurse the baby nurses, health care stimulate pump their Weight gain 25 to 30 ounces both breasts spurts cause will 2: The age you may pregnancy, the breasts then the Most mothers who experience to travel) Tip need tomore pumps Most mothers year. Your babys baby. if they pump 6 months of Tip 9: Growth and effective due g to gain one breast and During will be. milk. rest of the first feeding your 3 months and the nurse more often several days is continuin milk there breast larger milk supply , rather than pumping y. Frequent nursing her baby Any retail double for this sityour baby to supply to meetin preparation for is always making time through 3 weeks, 6 weeks, (perhaps even tell you if he milk milk almost continuousl the amount of milk factory Usually around nursing more often. Allowing they aid this process, their milk supply. very good provider can saves significant a single baby or will Your milk factory (double pumping) cause for concern. will increase your The the placenta for milk to protect For Occasional Use are breast produces avail-body to produce more milk the breast and drained often, pumping also pumps or if there is mothers notice your babydays around these times breasts are babies, extra state Hormones from other. Double 10 to 15 minutes tal-grade rental the that can baby nurses, the the key to establishing up and appropriately suckling signal When your that do not for two or three day. Pumping more often the carrying multiple milk builds some non-hospi rade pumps, rule of supply and demand is is usually sufficient. needs. So the course of the milk faster. If milk factory. There are also and for mothers make his needs. fee than hospital-g mother should make supply. you have multiples make more a while, they an even bigger estab- uation. make. This simple milk a for a cheaper 20 minutes if comes nurse for many often or for important in wants able, usually hormones create pumping. Again,maintaining an abundant the placenta that newborns session is very isnt removed decides he every 24 this type of hours, or at is born and and If your baby Tip 10: Remember hunger. the-night pumping a full supply (30 ounces mothers be used for every one to two Once the baby than for business A middle-ofmilk more slowly. Once some usually nurse reasons other factory opens milk supply. For more information about two weeks, Tip 3: Newborns.org in a 24 hour period. because he lishing a full on out, the milk provide a be nursing often established for body www.lllitimes in any mannerl. For more informati helping the mother to help least ten to 12 Your baby may of security from the close be reproduced hours) has been he but also way of not only sheet may not La Leche League Internationa llli.org likes the feeling nursing, because in any manner nursing is natures nutrition for her newborn, these special informational ed This comes with Enjoy This frequent permission from nal. or because l contact that of comfort and not be reproduc established. without written Internationa his suckling need, the League Internatio wonderful source supply to become quickly onal sheet may La Leche League needs to satisfy of your heartbeat and comfort milk This informati permission from La Leche May 2009, your baby. of the mothers he finds the sound touch a great source and bond with nal No. 10220 any further your without written nursing sessions League Internatio gentleness of his new world. If you have your La Leche to 2010, La Leche look at your baby. as he adjusts sure to contact February comes concerns, be look at the clock, g specialist. , the milk that the questions or Tip 4: Dont No. 10245 or other breastfeedin to get the hindmilk
USA progress engorgement, IL 60173 can fever) stress, chronic Road Schaumburg or without E wound healing, Plum Grove masses (with that 60 800.LALECH 957 North and breast of the breast 30 fax 847.969.04 breast pain, 847.519.77 may mastitis. Areas
Ca re Pla n for
It is usuallyof the breast. breast. This inflammation section of the Mastitis is an up milk in a Delayed nipple caused by backed infection if not treated. persistentto an
risk of e plugged ducts increase the or that experienc and start an infecremain undrained to take hold
Mastitis
USA rg IL 60173 Road Schaumbu ECHE Plum Grove 957 North .0460 800-LAL fax 847.969 847.519 .7730
Increasing
Establishing
ply Your Milk Sup
Your Milk
than your breasts to eat more up at the moment, have stored draining nursing and n he will keep until milk productio your breasts If meet his needs. speeds up to more than he you are making milk he leaves wants, the leftover to make your breast inside signals until your supply less and less he needs. How matches what ultimately is your baby feeds often but by not by his age determined the capacity your milk storage e in your milk size of the warehous whose mothers babies factory. The take of milk may the can store lots less often, while larger feedings with less storage babies of mothers meals and may space get smaller often. feed more
Encourage enough to nurse long and high in calories. on each Your baby needs a feeding as it is creamy least 10 to 15 minutes of at or start to flow, toward the end nurse from both breasts to let down, have to baby, if willing, the milk two or three minutes enough hindmilk usually had suckled both side. It may take beginning. Babies who have If your baby the at the breast. the baby nursed especially in and may fall asleep feeding with the breast take one breast at the next only relaxed bodies feeding, start like late preterm infants, are nursing frequently breasts at the small infants, just fine if they from last. (Often few days, and they do first a feeding the enough.)
League Leader
Tip 5: Be sure
your baby is of milk baby for signs Can you see removal. Watch tissue? depends on milklarge mouthful of breast a Are babys temples Milk production lower gum? you your baby have breast and their swallowing your milk? Do removal. Does These between your baby babys tongue swallows? Can you hear baby comes off the breast? from removing milk drained after moving as baby your baby is latch or breast has been assessing weather indicator of improper feel like your be helpful in be an questions may or cracked nipples may the breast. Sore breast. the positioning at
January 2010, No. 10238 La Leche League International
. suckling effectively
** Breastfed newborns their birth should regain days to two weight by 10 A baby who weeks of age. well should is not gaining a doctor. be checked by
in any manner not be reproduced International. League al sheet may This informationpermission from La Leche without written
For more information
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Survivor Moms
Mickey Sperlich, MA, CPM and Julia Seng, PhD, CNM Learn how sexual abuse affects women during pregnancy and childbirth and what you can do to help. Read excerpts from 81 womens stories of birthing, mothering and healing after childhood sexual abuse. The book also includes some complete narratives, suggestions for working together during maternity care and beyond, resources and information from current research. Suitable for both caregivers and pregnant survivors, Survivor Moms will help anyone whose life has been touched by sexual abuse. Motherbaby Press, Paper, 246 pages $34.95 + S&H
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Brought to Earth by Birth
Harriette Hartigan
This stunning collection of black and white photographs by one of the worlds master birth photographers celebrates giving birth and being born. Here is creation, lived by each of us. Through the poetry of photographs and the weaving of words, experience what birth means to you. Motherbaby Press, Paper, 96 pages $25.95 + S&H
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Whats Cooking 028
Kheema Kofte
Good nutrition means eating a well-balanced and varied diet of foods in as close to their natural state as possible.
Effath Yasmin, Mumbai, India
Indias rich diversity of culture, languages and religions is also depicted in the countrys diversity of cuisine. There is no single standard or homogenous Indian cuisine, which varies according to the local produce, livestock, cultural influence and religious beliefs. Among many different cuisines, such as Bengali, Goan, Gujarati, Kashmiri, Marathi, Punjabi, Rajasthani and South Indian food is Mughlai cuisine, which comes from the kitchens of the ancient Moghul emperors. Mughlai cuisine is known for its richness and the exotic use of spices, dried fruit and nuts. This cuisine is from the north of India. Kheema Kofte are quick to prepare and can be stored in the freezer for over a month before frying. If you intend to store them, do so after step 3. Highly nutritious, being rich in protein, fat, calcium, iron and B vitamins, these Kofte are a hot favorite for toddlers and young children. INGReDIeNTS: 250 g minced boneless lamb 100 g split roasted Bengal gram* 2 medium sized onions 1 green chili 1 dry red chili 1 green cardamom *garbanzo beans, chick peas 1 Inch cinnamon stick 2 cloves 1 medium sized tomato 8 garlic pods 1 Inch ginger 1 bunch of coriander leaves salt to taste
DIReCTIONS: Step 1: Grind all ingredients together coarsely in a mixer or a food processor. Step 2: Make small round balls of the ground meat with spices. Step 3: Boil 1 large glass of water in a wok and slip in the minced meat balls. Boil until the water has all gone. Step 4: Deep or shallow fry the Kofte until golden brown. Step 5: Serve hot with chutney as a starter or with rice.
GIvE the GI FT of
neW 8th editiOn
The Womanly Art of Breastfeeding!
Help a new mother and baby get the best start together by giving the gift of The Womanly Art of Breastfeeding today and be a part of LLLI history!
Effath Yasmin is mother to Zaara and an LLL Leader in Mumbai, India. In the virtual Group La Leche League Pan-India, for mothers all around India, she helps keep Group members in touch by regular emails. Any mother can join by clicking on the following link. http://groups.to/lllpanindia
Whats Cooking is edited by LLL Leader Lesley Robinson. She lives in Ottawa, Canada with husband, Mark. Her three grown children have own the nest.
CliCk here tO learn mOre!
lease send stories and photos to editorbt@llli.org

o T day
Issue 1
2010
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his first joke. I remember the lowsthe nipple pain; feeling overwhelmed by Olivers needs. But the hundreds of normal days, the thousands of warm, enjoyable but unmemorable feeds, fade into a blur. Attending LLL meetings and hearing about other mothers breastfeeding and parenting experiences have been brilliant. Over the past two and a half years I have gained so much from the mothers I have met through LLL. Theyve suggested tips for specific situations, changed some of my attitudes completely, and given me true empathy. Their experiences have helped me to recognize the truth in the phrase this too shall pass. This has really helped me to enjoy the good bits and cope with the rocky periods. I would like to say a particularly warm thank you to my local Leaders Ruth, Suzanne, and Barbara for their listening ears, helpful information, and, of course, their friendship.
Joanne Whistler
West Yorkshire Great Britain Adapted from a story in LLLGBs Breastfeeding Matters
Sisters Diane and Jamie and their babies
A Gift from My Sister
about it, just the basics, and thought that my baby and I would figure it out if it were meant to be. I didnt talk to my husband about it much or have him read anything about it either. I remember him being very shocked when late in the pregnancy I announced that I would be exclusively feeding the baby; we would not be using bottles if all went well. I remember he was not too happy about it. Looking back now, both of us should have read a lot more and given a lot more thought to the subject. My sister and I were not breastfed. Our mom says it just was not something you did then. So, we had never really been around any breastfeeding mothers. We were never taught about it in school, and no one ever talked to us about it. I believe that my
lackadaisical attitude toward breastfeeding during my pregnancy came from a lack of knowledge; knowledge (thank goodness) that my sister learned from a book and passed on to me. When my daughter was born, I had some complications, and it took seven days for my milk to come inseven long days in which my husband and I were vigorously reading about breastfeeding. Our LLL Leader, Jeanette, was awesome, providing us with much needed support and encouragement. She even came to visit me at my house because I was too ill to leave. And, of course, I called my sister. At that point I was determined to breastfeed. Seeing what a positive experience it was for my sister made me all the more eager to nurse my own child. I am so glad that I did. My 11-month-old daughter, Madison,
The Nursing Pads Women LOVE! joined a La Leche League Group in her Soothingly Soft Merino Wool absorbs moisture, area and established a wonderful breastkeeping skin feeding relationship with her daughter, dry. Benecial with vasospasms & many common breastfeeding problems. Only 2 Erin. pairs needed byWhen women. Natural lanolin month most I became pregnant a content provides antibacterial properties washabout after Erin was born, I asked Jaime only occasionally with lanolin-replenishing soap. breastfeeding. She told me several positives about it Imported by Danish Woolen Delight and told me to look up with wool of my local Contact us for FREE brochurethe number sample! LLL Group. She didnt push information Call toll-free 1-877-878-6089, fax (802) 878-6091on me. In her quiet way, she just info@DanishWool.com www.DanishWool.com recommended I read about it and decide for myself. I Also Importing Organic Wool Clothing late in my attended one LLL meeting pregnancy. I didnt read a whole lot v2.1 - Aug 11 2008 APPROVED Aug 12 2008
LANACare Organiclearn a lot by reading. So been one to Wool Nursingwhen shea was about breastfeeding. and Pads pregnant, Jaime read She learned lot
My younger sister, Jaime, has always
I am pleased to recommend Arms Reach as a wonderful nighttime attachment tool.

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Dr. Wm. P. Sears,
Converts to free-standing bassinet or changing table

For information on the benefits of co-sleeping please go to www.armsreach.com
Inc. ARM'S REACH, CO-SLEEPER, Mother & Child Logo and all other trademarks are stringently protected.All rights reserved. Patents pending.
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New Beginings July 2010

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I s s u e 2 | J u LY | 2 010

The NEW Womanly Art of Breastfeeding:

New and Whats Not

to access breastfeeding resources and information

Celebrating Mothers and Babies Around the World TABLE OF CONTENTS

The Womanly Art of Breastfeeding : Whats New and Whats Not

12 Worth the Struggle 13 Liams Weaning 14 Nourishment of Love

Kathleen Kendall-Tackett, Ph.D., IBCLC

Breastfeeding in the News

The Womanly Art of Breastfeeding

NEw 8th Edition

Pre-order now and help make this

book a New York Times best seller!

La mre, le bambin et lallaitement (Mothering Your Nursing Toddler)

Mothering Multiples: Breastfeeding and Caring for Twins or More

Breastfeeding Mothers Guide to Making More Milk

Celebrating Mothers and Babies Around the World EDITORS LETTER

The Womanly Art of Breastfeeding

constitute an LLLI endorsement of the product

The Womanly Art of Breastfeeding 04

The Womanly Art of Breastfeeding:

The Womanly Art of Breastfeeding 05

Whats New and Whats Not

hroughout the book

weve added stories

us in the JulyAug . azine! page 57 Pregna ncy Mag

Fea tu redt Is#e1 su of

The Womanly Art of Breastfeeding

Infant Sleep, Breastfeeding

Breastfeeding and sleep

Concerns about bed-sharing

here is no single simple message about bed-

Avoiding dangerous situations

Helen Ball 010

Where to find helpful information

Helen Ball 011

Nighttime Parenting: How to Get Your Baby and Child to Sleep

Helen shared a link to this cartoon about nighttime breastfeeding:

Mothers Stories 012

Worth the Struggle

Photo courtesy of Natalie Dykstra

e took it one feeding, one hour, then one day at a time.

Natalie Dykstra, Ottawa, Ontario, Canada

Mothers Stories 013

Jovina Adams, Panama City, FL, USA

Photo: Jovina & Liam

Mothers Stories 014

Photo courtesy of Mara Jos

Devoted Dads 015

spent three years as a full-time dad, and going

out to work is ridiculously easy in comparison.

Your Letters 016

Photo: Allie van Gundys baby

end your letters and photos to editorbt@llli.org

A p r ize for the star letter!

Allie van Gundy, Rathdrum, Idaho, USA

Feature Article 018

Should Mothers Avoid Nighttime Breastfeeding to Decrease Their Risk of Depression?

Feature Article 019

|05 Prem ier issue

gue La Lec he Lea ul! The Bea utif

Breastfeeding Older Children

*Unless specifically solicited by LLLI, photos

send digital file(s) to: photos@llli.org