“I think everybody needs to get some kind of lactation education before they give birth,” said Farah Antoine-Mayberry, owner of Epiphany Birth Services, llc. We were chatting about the importance of making as much information as widely available as possible for first-time moms, or even moms who have had difficult breastfeeding journeys in the past. Farah believes (and I agree) that our culture doesn’t provide nearly enough opportunities for discussion and education when it comes to breastfeeding.
Farah is one of the many great Oklahoma professionals who devotes her time to providing a support system to new moms and soon-to-be moms, and she was gracious enough to share some of her insights with me this week.
“The more I’m around moms and babies, the more I want to be around moms and babies,” she says. “There are so many different types of support new parents deserve. For me, it’s an honor to be able to serve parents during the peri-natal season of life.”
Epiphany Birth Services, llc provides a LOT of those types of support, but I’ll get to that shortly… we’re talking about breastfeeding here!
Farah is not only a certified lactation counselor, she’s also been a pediatric occupational therapist. She’s been an OT for more than 16 years. As an occupational therapist, her job is to help both parents and babies learn to perform activities of daily living (ADLs with as much independence and safety as possible. For babies, those daily activities include being able to tolerate and participate in typical newborn activities such as sleep, hygiene tasks, and feeding. So between her lactation counseling, her experience in NICU, and her experience as an occupational therapist, Farah is in a great position to provide new parents some of the guidance they need on their breastfeeding journeys.
What Does a Lactation Counselor Do?
A lactation counselor (not to be confused with an Internationally Board Certified Lactation Consultant, which is another great resource often available in hospitals), helps moms work to meet their breastfeeding goals. A counselor is able to assess how feeding is going, and offer different types of advice or input for how to overcome challenges. Although some of the interventions Farah is able to provide as an occupational therapist may be outside the scope of a typical lactation counselor, any certified lactation counselor can make referrals if they feel the baby is restricted in some way, and guide parents to other healthcare professionals who may be able to help diagnose issues if necessary.
A lactation counselor is there to help parents understand what normal and abnormal look like when it comes to breastfeeding, to help moms establish and maintain milk supply, guide moms who are going back to work, and help them figure out what that looks like for them.
“Most people aren’t taught what goes into milk production,” Farah says. “The truth is that you already have milk in your milk production already begins mid-pregnancy, so even if you choose not to breastfeed for a variety of reasons, you still want to understand what’s going on in your body and how to meet your goals.”
“Natural” means different things to different people in the context of breastfeeding, she explained. When it comes to breastfeeding, “natural” doesn’t imply that things are going to be easy, particularly when there’s so little understanding about breastfeeding in the culture.
“A lot of times when you ask a mom if she is planning to breastfeed, she says, ‘I’m going to try’ which means there’s already doubt there,” says Farah. “At the very least every pregnant couple giving birth for the first time, or who has had a difficult breastfeeding journey in the past, will benefit greatly from getting some kind of prenatal education or prenatal counseling.
“That way, when they leave their birth space, they can more readily identify when something is actually wrong.”
For example, Farah tells me, moms sometimes think there’s something wrong if the baby wants to eat frequently, but in reality, it’s normal for a baby to nurse ten times a day. If you don’t know that, it can cause a lot of stress and anxiety, and make your breastfeeding journey harder than it needs to be.
Getting feedback from a lactation counselor is definitely helpful, but hearing experiences from another mom is golden.Farah Antoine-Mayberry
So What DOES Happen With Milk Production?
When you’re about 20 weeks pregnant, your placenta contains a hormone (progesterone) that helps produce the first milk, called colostrum.
When you deliver your baby and placenta, it takes a few days for your body to go from producing colostrum to transitional milk, which is then followed by more mature milk.
According to Farah, the common expression people use to talk about this process of milk transitioning is “my milk hasn’t come in yet” which can be pretty misleading.
In reality, your milk is there but people sometimes expect engorgement to be the cue that the milk is present. In reality, engorged breasts normally indicate that the breasts haven’t been emptied as frequently as they need to be. Your breasts should actually not feel dramatically different as you transition from colostrum to mature milk. In the meantime, it’s important to put the baby to breast whenever he or she shows cues. Don’t wait until the breasts are engorged to nurse.
Top Three Challenges for Breastfeeding Moms
There are a lot of topics to cover with pregnant moms, whether they choose to breastfeed or not, but according to Farah, these are the top three:
- Understanding the importance and benefits of skin to skin — Skin to skin is important for multiple reasons in the context of breastfeeding. For one, it helps you see exactly how the baby is positioned. If the baby’s heavily swaddled, you can’t see the direction his little knees are pointed in, and so on. Since proper positioning is crucial to breastfeeding, going the skin-to-skin route is beneficial. It also helps with milk supply, due to breast stimulation.
- Knowing how to position baby properly — This isn’t always intuitive, but it is important. When adults eat, Farah reminds me, we keep a basically neutral alignment. We don’t swaddle our feet or turn our head to the side. It’s important for baby to likewise be positioned in the way that’s most natural and conducive to breastfeeding.
- Knowing what a good latch looks like — A suboptimal latch can result in trauma to the nipples, and cause the baby to not get all the milk they need, because they weren’t able to empty the breast. If baby is having difficulty gaining weight, or mom has chapped or cracked nipples, the first step is to make sure the baby has a functional latch. A functional latch means the nipple should be deep in the baby’s mouth. The roof of the mouth is divided into a hard palate in the front and a soft palate in the back. The nipple should be deep enough in the baby’s mouth to be below the soft palate.
If moms are having trouble getting and sustaining that great latch, Farah says she would look first at the baby’s positioning and the mom’s posture and comfort level, and second at the baby’s mouth to make sure that’s not where the difficulty is.
“That’s a lot to learn for the first time after the baby’s born,” Farah said. “That’s why prenatal education is so beneficial.”
Getting Breastfeeding Support
The help moms need is really not just about breastfeeding, Farah explained. It’s about emotional and social support. “It’s a huge responsibility. As moms we put a lot of pressure on ourselves to provide the best for our baby, and we sometimes beat ourselves up if we don’t meet our goals or expectations , particularly when it comes to breastfeeding .”
Farah said one of the first questions she asks moms is what their breastfeeding goals are. If mom’s goal is to breastfeed for 6 months, that impacts the approach a lactation counselor or other support person might take. Then, if she’s having a rough patch, Farah can help her tailor her plan to meet her goals.
She said she always includes community resources in her discussions with new parents, including support groups. Farah facilitates one herself, but there are also other groups available in different counties around Oklahoma.
These are usually informal groups where moms come with their babies and toddlers, and they provide support to each other.
“During support groups I may ask the new moms how things are going, if there’s something challenging going on, and if it’s appropriate I might work with them one on one. A lot of times I ask other moms who have overcome breastfeeding challenges to share their experience with the group” she said. “Getting feedback from a lactation counselor is definitely helpful, but hearing experiences from another mom is golden. That trust is there… that other mom is doing life just as you are, and there’s a lot of comfort that can be gained from that.”
Many moms end up physically and emotionally isolated from other women for a long time after giving birth, so being around other moms doing the same thing can be incredibly therapeutic, she said.
Epiphany birth services, llc also offers doula services, infant massage, and birth assistant services (I said I’d get to this part shortly, and here we are at the end!) so if you’re expecting, make sure to check Farah out at epiphanybirthservices.com.