Optimizing Breastfeeding with Jack Newman, MD

Welcome to Mama Goddess. I'm your host, Alexandra J. Johnson. This podcast is all about rocking your goddess life, creating vibrant health and celebrating motherhood and family life. It's about living an authentically awesome life. Let's have.

Hello and welcome. I'm Alexander J. Johnson and Today's guest is Dr. Jack Newman. Dr. Newman is the leading researcher in the field of breastfeeding. He graduated from the University of Toronto Medical School and has worked as a physician in Central America, New Zealand and as a pediatrician in South Africa. He founded the first hospital based breastfeeding clinic in Canada in 1984. He is the author of Dr. Jack Newman's Guide to Breastfeeding, the Ultimate Breastfeeding Book of Answers, the Latch and Other Keys to Breastfeeding Success. And he is also the father of three children. Welcome, Dr. Newman.

Thank you very much. Pleased to be with you.

Yes, I'm very excited. As I was saying with you earlier, you're a pioneer for breastfeeding. So thank you for all the amazing work that you've done.

Well, thank you very much. I don't know, I think the mothers of the world are the pioneers, aren't they?

I think it's a combination. All right, I will say yes, the mothers. And then also we as not a mother yet, soon to be a mother in the next couple months, but appreciate your work and all of your research. So I'd love to start off with why you're so passionate about breastfeeding. Why is breastfeeding so important?

Well, it's actually very important. And I think that the question should be asked to other pediatricians and physicians, why aren't you passionate about breastfeeding? We know that breastfeeding is very important to the health of the child, to the health of the mother as well, something that's not very often emphasized. And on top of that, it's much more than nutrition. People sort of think nutrition and then they stop. But nutrition is not the only thing that breastfeeding is important for. It's the best nutrition for the young baby. That's true. But it's also something that gives the baby immunity. It gives the baby what are called growth factors, which help develop his immune system, help develop his gut, help develop, in fact, all the parts of the body, including the brain. And it's also in many ways, much more than the milk that you can get from the breast. It's also a relationship and a very important and intimate relationship between mothers and babies, and not only babies, but toddlers as well. So it's extremely important. So there's the health side, there's the nutritional side, there's the immunity side, there's the growth side, and then there's that relationship between mothers and children that's amazing.

So it seems like, why wouldn't people breastfeed? Do they not have the information? What do you find in your practice for women not actually breastfeeding?

Well, I work only in a clinic where mothers come because they want to continue breastfeeding. But we have a lot of information about why mothers don't breastfeed. First of all, for example, you're more likely to breastfeed if you are older, if you are in a stable relationship with the baby's father or another partner, if you're relatively affluent, and if you're well educated. And with those four factors, we know that a mother. The more they have of those, the more likely the mother is to breastfeed. But I think there's a lot more to it, too. And one of the reasons that mothers want to breastfeed but don't continue is, is because they're basically getting really lousy information about breastfeeding. You know, there are, you know, the hospital practices in the vast majority of hospitals in the United States and Canada and the rest of the world as well, really do not support breastfeeding. They say they do, but they often give very, very poor advice. Supplementation is almost routine in many hospitals. And then when the mother and baby finally leave the hospital, they also get very poor information from magazines, from television, from their doctors, unfortunately, and from also their families as well. And things are so bad, I think, with regard to breastfeeding, it's not surprising how many women have difficulties with breastfeeding, but how many mothers actually don't have difficulty with breastfeeding in spite of all that? And further. Oh, sorry, go ahead.

No, that's awesome. I love that. Okay.

And on top of that, you know, there's a whole, you know, industry of marketing of formula, which basically is doing a very good job of convincing mothers and doctors and families that, you know, formula 601, half a dozen of the other. Sorry, breastfeeding, formula 601, half a dozen of the other. They're basically the same. And in fact, they not only emphasize that, but they also emphasize breastfeeding hurts. They're a problem with breastfeeding. You know, babies get certain problems with breastfeeding, and it just goes on and on and on. And so people really come into the whole question of pregnancy and then breastfeeding thinking that it doesn't really matter whether you breastfeed or not. And it does matter. And the fact that some of us, you know, were never breastfed, never tasted our mother's milk, you know, we're okay. That doesn't count. There are lots of people who aren't okay and lots of children who do get quite sick when they're fed formula rather than the breast. And if you are okay because you weren't breast, in spite of the fact that you weren't breast fed, well, you've got good genes and you're lucky.

So what are some of the common problems that you see with the formula? I love that you're so passionate about this with the formula as well, because it just seems everybody's like, oh, it's not that big of a deal. I couldn't breastfeed and I tried for a week or something, and now I'm using formula. Not a big deal. So what are some kind of the side effects or the challenges with using formula?

Well, there are laws. I mean, children get sick when they're fed formula. There are 500 babies every year, more or less, that die from gut infections, gastroenteritis, under the age of a year. And this is almost always due to the fact that they're not breastfed. A study that came out in November of 2010 basically said that at least 1,000 deaths occur in the United States every year because babies aren't breastfed. And not just from gastroenteritis, but also from lung infections and that sort of of thing. So, you know, not breastfeeding can be deadly. We also know that babies who are not breastfed have a higher incidence of sudden infant death syndrome. And so that breastfeeding actually protects from sudden infant death syndrome. But, you know, like, most babies don't die, obviously, when they're on when they're fed formula. In fact, the vast majority don't. But they're more likely to get infections. They're more likely to have difficulties in later life. For example, they're more likely to get diabetes, type 1, which is what we call the childhood diabetes. But they're also more likely to get the older type of diabetes, what we call type 2. There are certain cancers that are more common in formula fed babies than in breastfed babies. This is just beginning the whole question of the obesity epidemic in the Western world. I mean, a large part of the prevention that we could use to decrease the rate of obesity that starts with breastfeeding. We have lots of studies now that breastfed babies are less likely to be overweight than if they were formula fed. And finally, well, not finally. There's lots of other things that have been looked at, but another very important thing is that breastfed babies tend to be brighter, do better in school, do better on cognitive tests than formula fed babies when they're older, cold enough to do the test. That is.

That's amazing. I love that, too. With the formula causing later problems in our life. You might think your baby's okay with it, but they have a pretty healthy body to start off, and then it just slowly can start deteriorating if you weren't breastfed.

Fair enough. And that's right. And many people don't take into consideration that this might be an effect of how I fed my baby. So, for example, I mean, lots of children get ear infections, know that ear infections are less common in breastfed babies. But people who say, oh, you know, my baby had a. Or my child had an ear infection last week, and blah, blah, blah, and they don't think, well, that's because he wasn't breastfed, or the fact that he may get diabetes later on, that's another possibility. So, you know, they just don't make the connection because people don't read about breastfeeding. They don't read the data. And the newspapers and the media tend to underemphasize this. They usually only emphasize problems with breastfeeding.

And then most people, if they're going to the hospital, too, the doctors there are saying formula is not a big deal, so they're trusting in their doctors, that their doctor is giving them the proper information for the health of their child. And that's not really the case.

Yeah. And the problem with that, of course, is that it's a not true. And the problem is that so many doctors have received absolutely no information or training about breastfeeding and how to prevent problems and how to fix problems once they've happened. In fact, I can tell you that in 1969, when I was a medical student, we got one hour of infant feeding in our course, and that one hour was. Here it is. The pediatrician stood up in front of the class and said, well, I'm going to tell you about infant feeding, first of all, about breastfeeding. It's the best because it always comes at the right temperature and comes in such cute containers. Now I'm going to tell you about formula. And that was it. Of course, that would be politically incorrect.

Today, but okay then. Yeah, yeah, totally.

That's right. And I mean, things have improved marginally, I would say, because I hear what the students and pediatric residents get at the University of Toronto in the hospital for sick children. And it's appalling. And they so do not understand breastfeeding, and they so do not understand how to prevent and help mothers if they have problems.

And what inspired you? Sorry, go ahead.

Well, you know, it started with my own family. You know, I was pretty clueless at the time as well. But when our first son was born, he just took to it. I mean, it wasn't easy at first because there were things that we didn't know. But basically he took to it and he did the right job and we muddled through and eventually it worked, and that was fine. And that was great. And, you know, and I could see how important it was to him and to his mother. And that was, you know, the beginning. And then I. When I finished my pediatrics, I went to work in South Africa and I saw that babies died all the time when they weren't breastfed. And it was such a, you know, such a disaster. And what. Everything you've heard about Nestle and all the formula companies, how they push formula on these poor women from poor countries and, you know, making them believe that this is, you know, great stuff. And it's what all the Western women do, the affluent women. And the problem, of course, is that the affluent women in South Africa and other parts of Africa often don't breastfeed. And, you know, their kids are happy and bouncing and that sort of thing, whereas the, you know, the babies, that's what they want. That's what the mothers want. Big, happy, fat babies, and that's what they get, except that they die often as well, from infections and so forth. So then when I came back to Canada, I decided, I'm going to make a difference here. I'm going to start a clinic and we're going to change things so that nobody can say that Canadian women don't breastfeed. They, in fact, they do in quite substantial numbers.

Wow, that's so great. I love that it was from your personal experience, too, and being willing to be a pioneer, like I said at the beginning, it's pretty inspiring for all of us. So I'm just curious, how does somebody. Do you have recommendations for somebody who is listening to this and maybe wanting to get pregnant or pregnant? And how can they prepare for breastfeeding? Is there any preparation that one can do before they have their child?

Yeah, it's really important that mothers understand how breastfeeding works, that they need to know that they've got to get past the formula company marketing and they have to trust themselves and Nature, that nature usually works. The problem is we mess up nature. So, you know, there's reading to be done, but they need to read the right stuff. And I think that any book that includes bottle feeding as a, you know, equal. An equal choice should be avoided. I think that anything like what to, you know, what to expect in the first year of life. Their whole breastfeeding stuff is terrible, absolutely terrible. They have no idea about breastfeeding. So I think that if they're going to read anything, then that's fine, but make sure you get the right books. We have a website that shows mothers a bunch of videos that help them understand how breastfeeding actually works. So, for example, a few of the videos show babies who are breastfeeding, well, who are actually getting milk from the breast. And this is as early as 10 hours after birth that show these videos. And there's texts that explain, you know, how to know this baby is getting milk or not. And the important thing is that once mothers know how to know a baby's getting milk, they also know when a baby's not getting milk. And therefore they can understand first of all, that 20 minutes on each side, which is still being told to all sorts of mothers, 20 minutes on each side or 15 minutes on each side or whatever number you want to pick, makes absolutely no sense. You know, a baby isn't necessarily getting milk just because the baby's on the breast and sucking. So this is some sort of thing they need to know. But I think, too, they should look at having as natural birth as possible. The more interventions that occur during labor and birth, the more difficult breastfeeding can become. So, for example, you know, it's almost routine now for mothers to get epidurals. And I won't talk about the epidurals, although I think they do interfere with babies getting ready for breastfeeding. But if a mother has an epidural, she always gets an intravenous. And the problem with the intravenous is that the mothers get lots of fluid when they have these intravenous, and so does the baby. And so the baby is born extra heavy, you know, because of all the extra fluid on board. And so they have rules in a lot of hospital that if the baby loses more than 10% of his birth weight, then the baby needs to be supplemented. And so because these babies pee out all this extra urine, all this extra fluid, they do lose the weight. And so they get bottles of formula. And this is absolutely the wrong thing to do. I mean, even if percent weight loss meant something Which I don't think it does. The thing to do is to help the mother with the breastfeeding, not to automatically give the baby formula. So, you know, that's just one aspect of how, you know, the intervention type of birth may interfere with breastfeeding, but there are lots more. So as natural a birth as possible. And that often means getting good support. Because when mothers get good support during the labor and birth, then they can, they can often do without medication, they can often do without epidurals. They just need that support, which helps them get through this, you know, not necessarily easy time after, you know, while the baby is being born. And then I think that if they can find a place to birth where people don't interfere automatically. And I'm a big supporter of home births for the right people and also a hospital that is considered baby friendly, that helps a lot. And so does a physician or pediatrician for the baby who actually knows something about breastfeeding. Not easy to find, believe me.

Right. That's so great. And then what about the skin to skin contact you were talking about? All these interventions that happen. Why is skin to skin so important for a newborn? And.

Well, it does a number of things. It does a number of things. First of all, the mother's hormones react to the touch of the baby and so does the baby's hormones react. And what do we see when a baby is allowed to be skin to skin immediately after birth is that babies will often over an hour or so, sometimes less, sometimes more, but over an hour or so will find the breast on their own and latch on all by themselves. And this is, you know, tremendous. This is beautiful to begin with. I mean, imagine that a baby can crawl from the mother's abdomen all the way to the breast and latch on by themselves and start to suckle. It sounds amazing, it sounds unreal, but in fact, every mammal in the wild has to do this. You know, if a moose doesn't latch on by himself, the moose dies. Right. So all mammals do this. You live relatively rural, so, you know, all you have to do is go to a farm, find a pig or a horse, and you'll see these pigs, these baby pigs, these baby horses, these colts, they'll find the breast all by themselves. And the problem is that we intervene so much. We separate mothers and babies. We wash all over the place. But the thing is that babies often find the breasts by smell. So if we wash the breasts like so many people tell mothers to do, then the baby can't find the breast as easily because there's no smell, it's been washed off. So there are all these interventions that really interfere with breastfeeding, but skin to skin contact does more. One of the big bugbears of breastfeeding and the pediatricians go silly in the head about this is low blood sugar. But we know from several studies that when a baby is skin to skin with the mother, the baby's blood sugar is maintained better than if he separated from her. So a lot of the worries about the baby's dropping his blood sugar, which is actually a bit of hysteria, doesn't come. And you know, the mother often will fall in love with the baby when the baby is skin to skin with her. It's interesting that there are studies that show that if the baby's put skin to skin with the mother, even mothers who had no intention of breastfeeding will breastfeed.

Wow, that's amazing. Because it's instinct, like it's in us to breastfeed and it's obviously in the baby.

In the baby and in the mother too.

Wow, that's amazing. And you have some great websites too. Just watching the baby kind of search for the boob. It's incredible. Wow, that's so amazing. So let's say somebody does I lean towards the home birth as well, and that's my intention as well. But somebody listening to this, who is going to have their baby in the hospital, what would you recommend them to do? Because they usually, like you said, they take the babies, they wash and they have to do the weight and the tests and all these things. Do you have any recommendations for a woman going into the hospital of what she should be aware of and what she can do to nurture this process?

Yeah, I think they should, first of all become well informed. And I think second of all, if they decide to have the baby in the hospital, that they should visit the hospital before the birth and make sure that, you know, I mean, there are good signs and bad signs. If there are formula company ads, you know, on the walls, then, you know, be careful. If they're, if they walk by a room and every bedside table has a bottle of formula on it. Yeah, be careful. And I think that mothers need to remember that this is their baby, it's not the hospital's baby. You know, they have the right to say no to a lot of things that are being pushed on mothers, including, you know, like just the other day, just the other day yesterday we had a baby who was given formula at 24 hours of age because that baby lost a pound from birth. To one day after birth. Now, that's absurd. There's no way a baby can lose that much weight in 24 hours. Either the scale was wrong in one place or they just wrote it down wrong. The fact of the matter is that babies don't lose a pound in 24 hours. It would be unheard of. But people don't think. They say, oh, we lost this much weight, we better give them formula. And what they need is to be able to help mothers properly. And there are not a lot of places where they. So I would recommend most mothers get, you know, good help, such as a doula to help them through the labor if they're in hospital, or. And. Or maybe even a good lactation consultant. Not always easy to find, you know, good doulas, good lactation consultants. Unfortunately, too many lactation consultants have bought into the 10% weight loss. Feed the baby every 3 hours, 20 minutes on each side. Nipple shields. Hate nipple shields. I think they're horrible. I think that they should be banned. They cause nothing but trouble. So there's a lot of things that are important, but I think that with a good lactation film, a good doula, you know, it's extra money, but it may be worth it in the long run.

So I have a question. I don't even know what a nipple shield is. What's a nipple shield?

Basically, it's a piece of plastic that fits over the mother's breast so that the baby can. The idea is that the baby can latch on better, but in fact, the baby who. You can just imagine, it's like a nipple on a bottle, more or less. Not quite as protuberant as the nipple shield, but, you know, they use this, like, they pass these around like, I don't know, like pills or candy for the mothers. You know, there are so many hospitals where the majority of mothers leave with a nipple shield. Why? Because the staff is not trained and they don't know what to do. And this is an easy answer, which is no answer at all as far as I'm concerned.

Right, okay. Got it. Thank you. I'm like, I don't even know.

We have an information sheet on the website on nipple shields, why they should not be used.

Well, then it would just seem to make sense. It seems like a bottle and kind of a plastic and manmade stuff around the boob would affect the baby not being able to smell and kind of feel very foreign to them.

Right, Exactly.

Interesting. So what about.

Pain?

This is a big thing that I hear women talking about pain during breastfeeding sore nipples and infections and things like that. I know it's a big topic and you have a lot of information on your website, but can you kind of address, how do we assess this pain?

Well, there shouldn't be pain. The answer to that is simple. There should not be pain. If there's pain, something is wrong, and, you know, the earlier we get on it, the easier it is to fix. So there are a number of issues that are causing pain, but the most important is that the baby's not taking the breath properly, the baby's not latching on properly, and helping the mother get a good latch with the baby is the way to prevent and to treat sore nipples. The problem is that we have people who really don't understand what this is all about. So for a long time in this area, and I don't know if it's true elsewhere as well, but we had mothers being told, oh, if it hurt, this is in hospital. If it hurts, then the latch is no good. And that's, you know, that's true usually. So take the baby off, latch them on again. Oh, hurts again. Take them off, latch him on again. Oh, still hurts. Well, just keep doing it until you get it right. And I hope that makes no sense to your listeners, because what's happening then is that the mother, instead of having one painful latch, may have 10 or 12 painful latches, 10 or 12 times more damage to the nipple. And of course, a frustrated baby and a frustrated mother as well. That's not how you fix the problem. There are ways of fixing the problem that don't involve taking the baby off and putting them on again, taking them off and putting them on again. And there are things to look for. I mean, even in our city where we push the notion of tongue ties very strongly, we've seen several babies this week who have got gross tongue ties. You know, like, do you know what that is? Yeah.

The tongue is attached to the bottom part of the mouth.

Yeah. Yeah. Not necessarily can't move, but it's that little piece of skin under the tongue. And we can fix in two seconds, we can fix that just by a simple snip with the scissors. And the mother will say, oh, my gosh, that's so different. That's so much better. And yet in the hospitals, they often don't even look for it. Right.

Well, I knew somebody who had that, and the doctor just kind of was like, oh, you should just do formula. You're probably not going to be able to breastfeed. And I saw the video on your Website, too. It's like literally a two second procedure.

Exactly. It takes no time at all and it can make a huge difference. This is the exact sort of thing that disappoints me so much about so many doctors is they'd rather have the baby at risk for all sorts of illnesses rather than do a tongue tie release, which is so easy. And this doctor obviously felt that formula feeding breastfeeding makes no difference at all. Well, he's absolutely wrong. And if I were that mother and I went on formula and that child got diabetes, I would. She's in California.

No, Illinois.

Okay. Well, they don't sue as much in Illinois anyhow.

That's funny. Yeah. So you were not supposed to be having sore nipples at all?

No, no. If it's painful, then something's wrong. Now, you know, many mothers will say, you know, it's a bit tender in the first few days. Okay, I can accept that. But if the mother has so much pain that she's hesitant to put the baby on the breast, there's definitely something wrong. And it can be fixed in two seconds, often just by fixing the latch, sometimes doing a tongue tie release, sometimes, sometimes a little more difficult, but if you get on it quickly, it can be fixed. And when mothers are told, oh, it's normal to have sore nipples, which is frequently, told them they should not trust that person's advice.

That's so great. I love that. I rarely hear this. Our midwife has said this to us, but I'm like, I've never heard that. I've always heard mothers say, oh, it's so hard, it's so painful. And everyone has all these creams and all these challenges. So I love that you're saying that we just need to have the proper latch and get some help, that it doesn't need to be painful.

By the time we see the mothers at our clinic, often two, three, six weeks after the birth, we do use ointments to help them heal up the nipples. But if they had gotten help right at the beginning, they probably wouldn't have needed it.

So then that's the. Like candida and thrush and all these bacterial infections is just like consistently breastfeeding improperly.

Yes, that sets the mothers up. Now, once they have damage to the nipples, they can get infections with candida or with bacteria. But that sets the initial problem, which is the way the baby takes the breast. That sets the mothers up. If they never had pain at all, then it would be unlikely that they would get these candidal or bacterial infections.

So what about do you have tips for the best way to have a proper latch?

Yeah, but it's complicated to explain over the phone. And this is where I would suggest to the mothers that they go to our website and there are two video clips there called 28 Hour Old Baby or something like that. And one of them shows a lactation consultant helping the mother get the baby latched on. And that's the way we teach it. Now this, in that particular video, it didn't, you know, it wasn't perfect, but it was pretty good. And I think that maybe that would be the best way to try to describe. I frequently describe at conferences how we put the babies onto the breast or we help the mother put the baby onto the breast. But then, you know, I'm showing and even there it's kind of difficult to try to show how to do it. It's not that complicated, but it's difficult to show over the phone.

Yeah, yeah. And your videos are awesome. So yes, anyone that's listening, check out, Tell me your website again.

It's www of course, www.breastfeedinginc.ca is for Canada, so it's just Breastfeeding Inc.

Great. So checking out the 28 Hour Baby video, right.

And you know the baby who's drinking well, the 10 hour old baby who is also drinking well on the breast. If the baby drinks well, then there's no need to get all excited, no need to check his blood sugar, no need to, you know, anything like that. The baby's drinking, the baby's drinking, things will be fine and there's no need to worry about.

Right. So what about, you said the 10 hour baby, is there like a time frame that a baby starts to breastfeed after birth?

Yes, he should start to breastfeed as soon as possible after birth. And again, if the baby is allowed to crawl up to the breast, then he may breastfeed within the first hour. Now not all babies do that, especially if there have been a lot of interventions during the labor and birth. But some do. And you know, if they don't crawl towards the breast, they can be helped to the breast. But certainly the baby should be, should have the breast available within the first hour, you know, as soon as possible after the birth. I have photos too of babies who are at the breast while the obstetrician is sewing them up after a cesarean section. There's actually no reason why that can't be except that, oh, we don't do that. Well, we don't do. That is not a good enough excuse.

Right. That's so great. So being willing to challenge what. What we can do.

Oh, yes. Oh, yes. There's lots that can be done. And unfortunately, too many mothers, you know, fall for it. You've got to have a epidural. You've got to, you know, here's a secret. You know why everybody has to have an epidural? No.

Tell.

Because the anesthetist is in the hospital and there's no point in him being in the hospital if he can't make money.

Right. So that's why they come in and check on the woman every hour or more and say, do you need an epidural? Do you need an epidural?

Yeah, that probably has a lot to do with it. Not everybody needs it, Right. I'm not saying nobody needs it, but not everybody needs it. By any. I mean, if you have a baby in our three major birthing hospitals in Toronto, their epidural rates are in there. If you exclude. If you exclude those that are born, those babies who are born with midwives rather than doctors or obstetricians, the epidural rate is probably about 95% or more. Really? Yep. It may not be that high. I don't know where you're going to have your baby, but, like, in a rural hospital, it's likely to be much less. But big city hospital, like in Los Angeles or San Francisco, the only people that don't have it are those with midwives or who are just crunchy granola, right?

Yeah, I lean towards a little bit crunchy granola. I'm planning a home birth.

There's nothing wrong with it. I think that is just a question of attitude towards words. I don't need the pain on one side and on the other side. This is an experience that I'm not going to have very often in my life, and I want to live it.

Right. I feel like it's also. There's so many protective things of, like, a mother can't do this during pregnancy, and you shouldn't take this drug or this medication or whatever. And then all of a sudden that gets thrown out the window at the birth and we're like, okay, we're going to inject you with all these drugs and it's going to go to you and the baby. Okay, good thing I didn't have those for nine months, but now I'm going to infuse their bloodstream with them. Just seems bizarre to me.

Right. But then once the mother is breastfeeding this baby, then again, you can't take any medication. While you're breastfeeding, which is absolutely not true. The vast, vast majority of drugs that mothers may require, you know, during the months and years after the baby's birth while they're breastfeeding, they are not contraindicated during breastfeeding. Mothers should continue to breastfeed when they're taking these medications. Of course, there's a lot of doctors that prescribe medications for everything, often when it's not necessary, but even then, the mothers shouldn't stop breastfeeding.

Right. So is there like a. You know, this might be controversial, but I'm super curious about your thoughts on this. Is there, like, cases where women are just truly biologically unable to breastfeed?

Yes, yes. In the sense that they're unable to produce all the milk the baby needs, there's no reason they can't breastfeed. Of course they can breastfeed. Even if they're only producing, I don't know, say, 15% of the baby's requirements. Why shouldn't they breastfeed? Of course they should breastfeed. And that's why I emphasize so frequently that the importance of breastfeeding as opposed to breast milk. And that's why when we run into mothers who are having difficulty with milk supply, usually it's because they got terrible advice or they got lots of interventions during labor and birth. But yes, there are women who really cannot produce all the milk the baby needs. Okay, fine. We get the mothers to supplement the baby with a tube that runs along the breast and that comes from a bottle. And often it's. Sometimes it's donated breast milk, and the mother supplements the baby at the breast, and so she's still breastfeeding even if the baby's getting milk other than hers. And so again, breastfeeding is so much more than just milk. It's not just about the nutritional value of milk. It's also the act of breastfeeding. And we don't tell people who are infertile, for example, not to have sex anymore just because they can't make babies. Why should we tell a mother who doesn't produce enough milk that she shouldn't breastfeed? It's not worth it. Of course it's worth it.

That's so great. So if a woman's listening to this and just can't do it all, all the time that it's cool to supplement and just still consistently do it.

That's right. It's true. For example, that doctor that told the mother with the baby's tongue tie just formula feed the attitude out there is so often. Well, some breast milk is actually worse than none at all.

That's what they say.

Well, that's what he said in effect, isn't he?

Right? Yeah, yeah, true.

And that happens very frequently. Oh, you're not producing enough milk. Just don't bother it. Just give the baby a bottle of formula. We hear that all the time. As if breastfeeding doesn't count for anything. It counts for a lot of the act of breastfeeding. But, you know, the act of breastfeeding is also very threatening to a lot of people. You know, it's like having sex with babies or children. Even worse if the child is three, as on that Time magazine. That child wasn't three. He was probably four. Look the size of him.

Anyhow, it was a very provocative picture, too.

Yeah, yeah, yeah, it was meant to be provocative.

Who breastfeeds like that?

Nobody. But the. You know, what's interesting is that the story itself had nothing to do with breastfeeding toddlers. It had absolutely nothing to do with it. I mean, they mentioned breastfeeding a little.

Bit, but it was all about William Sears, attachment parenting.

That's right. That's right. Exactly.

That's really funny. So then is there a reason for the milk supply? Like too much, too little? Some women just overproduce, some women underproduce. Or is there, like a nutritional factor that plays into that as well?

No, I don't think so. Not in North America. I mean, most people are not starving in North America, but even in countries like, you know, like every so often we get reports, you know, about famine in Africa. And, you know, they show. They show mothers who are skinny, skinny, but, you know, often their babies are doing okay breastfeeding, and the milk may be decreased in quantity, but often it's still enough for the babies to do. Well. This actually brings up another issue, is that in cases of famine, you know, do gooders who don't understand the importance of breastfeeding often will collect, you know, formula for, you know, to send to, say, Ethiopia so that the babies can get formula and not starve. Well, you know, I've always recommended, when I worked in Africa is don't give the formula to the baby. Give the formula to the mothers, and then they'll produce more milk. But, you know, like, this idea that we can help babies by sending formula to starving people is absolutely horrendous. It establishes formula as important. And, you know, in cultures that are still cultures of breastfeeding, and, you know, here we are again saying here this is great stuff. This is not going to save those babies. Those babies will die anyway because there's just, you know, where are they? They're in places where there's no good water. They're going to die. They're already starving. They're going to die of starvation and then gastroenteritis anyhow. Give the milk to the mothers. I guess that's a bit of a tangent there. Right?

Yeah, but that's. I like that too. And it's also important for a woman to make sure that she's nourished. Right. So she's feeding her baby properly.

That's right. So, in fact, you know, like, the problem in North America and a lot of the Western countries is not under nutrition of the mother, but actually over nutrition of the mother or poor nutrition. We can call it malnutrition. Even if they're overweight? If they're overweight and they're eating chips and Coca Cola all the time, I.

Would call that malnutrition, definitely. So what about weight gain for the baby? Is there a recommended. Because I know this is a big. Like you said, if they started putting the baby on formula because they lost a pound or whatever, but is there a certain amount that your baby should be gaining? Or you just think, go ahead. No, I was just going to say. Or is it just like, as long as you're breastfeeding, your baby's feeding, then it's perfect? What's the thought around weight?

Well, the whole issue of weight has become like. I mean, we're obsessive about weight, we're obsessive about numbers. And I think that what we really need to do is stand back a little bit and say these numbers that tell us how much baby should gain every week or every month or. Or whatever. I mean, these are just guidelines. They're not, you know, God's word. These are guidelines. And they're telling us what the growth curves. What are they about? Well, the growth curves are saying to us, you know, if a baby's following his growth curve, then, you know, things are probably all right. It's a sign probably of good health. It's not a guarantee, but it's a sign probably of good health. Just like, you know, a baby who's alert, a baby who is breathes normally. You know, these are just signs of good health, as is the growth curve. And it tells us that he's gaining appropriately. And when babies don't gain appropriately, then we have to ask the question, why? And it's not just, oh, your baby didn't gain enough, you got to give him formula. That's not at all it. I mean, babies cannot gain weight. Well, because there's something wrong with them because they've got a heart disease or they've got an infection in the urine or something like that. And so giving the baby formula isn't going to fix his heart disease. It isn't going to fix his infection. In fact, it actually makes the infection worse because the baby's getting breast milk diluted by formula now. So the immune factors are diluted. So what these growth curves and what these guidelines for how much babies should gain are basically saying, okay, this baby is on his growth curve. We can be pretty sure, given everything else, that this baby is falling off his growth curve. He needs more attention. What's going on here? And that's what they're all about. They're not about, oh, well, just give him formula. And unfortunately, that's the way too many doctors think. Even worse is that many doctors, I wouldn't say majority by any means, but there are many doctors who think that anything under the 50th percentile is underweight. But that's not how the growth curves work. The growth curves are saying, like, if your baby's on the 25th percentile, it means your baby is lighter than 75% of other babies. That doesn't mean he's abnormal. Somebody's got to be there. I mean, not everybody's exactly the same. Right?

Right.

There's a lot of misunderstanding about what growth curves mean.

So how do we know if our baby's getting enough milk?

Okay, well, the first thing is to know that the baby is drinking milk. And that's why we use those videos, because it's hard to explain. So if a mother goes to our website and she finds those videos and it shows this pause in the chin that says, I just got a mouthful of milk, that is a very good way for a baby to know. For a mother to know that the baby is drinking, well, you know, lots of those mouthfuls. Baby comes off the breast, the baby's content, the baby is. Then, you know, the baby's putting out lots of urine, the baby's having lots of poops. Fine, great. That's fine. But the most important thing is to know that the baby is actually drinking milk at the breast. And once the mothers know that, then they can sort of cut through all the stuff, stupid things that are being told to mothers all over the world about breastfeeding. It's simple. It's simple. It's not complicated at All. And for example, if the mothers go to that first video that says really good drinking, well, what will we see? We'll see a baby who is generally content. A baby who not every baby is content all the time.

Right, Right.

Generally content. A baby who is undoubtedly gaining weight really well, A baby who's putting out lots of urine, a baby who's pooping lots. All those things are corroborations. Is that a word? Corroborations of the fact that the baby is drinking lots of milk. But the most important thing is how is the baby drinking at the breast? And once mothers know that, then they know also, as I said earlier, they know when the baby's not drinking milk. And if the baby is not drinking milk, I don't care what the scale says or if the baby is drinking milk really, really well, but the scale shows that he's not gained so. Well, maybe we should question the scale. Not the babe breastfeeding or not the baby's getting enough milk. Now, of course, it is possible that a baby is drinking tons of milk but not gaining weight. Well, because say, for example, he has cystic fibrosis. That's possible because he's not absorbing the milk. Or he's got a heart problem, which is making his heart work really hard and so he needs extra calories, or he gets tired at the breast because, you know, it's work when he's got a heart problem. So again, babies may be getting milk, and I think the doctors need to learn how to know the baby's getting milk from the breast so they can say, wait a second, this baby's drinking lots of milk. How come he's not gaining weight? Well, rather than just look at the scale and say, oh, you're not gaining weight. Well, just give him formula. But that's what they do.

So how often should a baby breastfeed?

Whenever he needs to. You know, I would guess that people have seen photos or videos of babies in the arms of their mothers. Their the mothers who are Indians in the Amazon jungle. Big fat babies who are gaining weight beautifully. And what else do you remark about these mothers? They don't have watches. They have no idea when the last time the baby fed was. And that's why it always worked. When you hear people say to a mother, you should feed the baby every two hours, but don't feed them any more than, sorry, you should feed them at least every three hours, but don't feed them more than every two hours because then your milk, blah, blah, blah, it's all blah, blah, blah, you don't know what they're talking about.

Well, that's like really popular though, right?

Of course.

Putting your baby on a schedule and then like if your baby's crying and hungry and like, sorry, you can't eat for another hour, that just seems like cruel.

A very good friend of mine, her daughter did exactly that. She tells me the story of, you know, with her first child, now she's on her third child, she's doing it differently, but for their first child, my friend would say to, you know, to her daughters, it's your baby's crying, why don't you feed him? She says, well, it's 10 to the hour. He's supposed to feed at 3 o'. Clock. That's ridiculous. And it's unbelievable how intelligent people can swallow that stuff. It's just nonsense. You feed the baby when the baby needs to feed and the baby will tell you when he's ready to eat, especially if he's close to the mother, if the baby is even. They don't have to be skin to skin only in the first hour. They can be skin to skin a lot of the time. This is a great time to be skin to skin because. So bloody hot. And the baby, when he starts to wake up and starts to get hungry, he'll sort of move his lips and he'll try to find the breast and he'll say, I'm ready, Mom, put me to the breast. And if the mother says no, then, you know, as time goes on, the, the baby will start to get more upset and scream. And once the baby's screaming, they don't feed that well and it causes nothing but problems. And anybody, you know, you have this big problem still, I don't know if it's, if it's still as popular as it was. But this baby wise nonsense that says that in the Bible, they fed the baby by the clock. Oh, right. Yeah, right by the sundial. But what if it was raining? You know.

That'S crazy. I haven't heard that. But that's crazy.

It is crazy. It is crazy. And yet when it comes out of a doctor's mouth or a nurse's mouth. Oh, well, that's okay. No, when somebody, even a physician. Why do I say even a physician when most of them haven't got a clue about breastfeeding. I'm sorry docs out there, but it's true. They learn nothing about it. But if it comes out of the mouth of a doctor or pediatrician, then it must be true. Well, it's not true. And you know, I mean, babies don't fit into our lifestyle. They haven't learned that yet. They haven't read the book that people need, you know, to have their life organized. No, sorry. No, they don't. When you decide to become a parent, you've blown it. Your regular life is over. Forget it. But enjoy it, because it can be enjoyable if you take the right attitude.

Well, I think that's a great point, too, because I think a lot of people in our culture want to kind of, rather than adjusting to the baby and listening to the baby's needs, they want to put the baby in their sleep schedule and like, organizing the child around their life rather than actually having to change their life. So I think that's a big topic and challenging for parents. Right?

Yep. Yep. Got the house, got the two cars, got the dog and got the baby. We're set.

Right.

Sorry.

We only have one car. But. But that's really funny. Yeah. Interesting on the feeding. I'm happy to hear you say that, too, because I've heard. I mean, it seems so common that everyone is putting their babies on schedules. Their babies like screaming.

Yeah, we love numbers in our society. You know, it gives us some sort of feeling of stability, you know, okay, the baby should feed every three hours, but it makes no sense. What's the point of having the baby cry for 20 minutes when he should have been, you know, when he could have been fed two and a half hours instead of every three hours, but he's crying for 20 minutes until the mother says, okay, now it's okay. What kind of sense does that make? There is even some evidence that when babies cry hard and long that there's brain damage that occurs. Probably minimal, but it does, apparently. And so maybe we should think some more about these things. Right.

Well, it's also interesting, too, because with the breastfeeding, if you let your baby cry, baby's totally out of whack, and then you have to calm the baby down before the baby's even going to be able to eat. Right, Right.

Because angry babies may refuse to latch on.

So it just makes sense. Everything makes sense.

Unfortunately, it does.

What about babies who I've heard babies resisting the breast. What are your thoughts on that?

Yeah, Well, I can tell you that when I worked in Africa, I never heard of such a thing. And I think that a lot of it has to do with, first of all, again, the fluids that the mothers get during labor and birth. What does that mean? There's this whole question of getting extra fluid on board. But, you know, A lot of mothers after the birth are swollen. Their whole bodies are swollen, Right. I don't know if you visited a friend who just had gave birth, who had an IV and the whole bit. And, you know, they've retained fluid and their ankles are swollen and their fingers are swollen, and not surprisingly, their nipples and areolas are swollen, too. So it makes it difficult for the baby to latch on. And so that's often the beginning of a downward slope where, oh, your baby's not latching on. We better give them a bottle or we better use a nipple shield to help latch on. And, you know, because he hasn't fed yet. He's only. He's already three hours old. He hasn't fed yet. I mean, that's ridiculous, too, that the babies have to feed. I mean, you know, if you ask a midwife who. Ask your midwife, who I presume helps mothers get with their home births. Some babies, you know, will feed very frequently in the first 24, 48 hours. Some babies may not feed at all for the first 12 or 15 to 18 hours. And they're fine. If they're full term and they're otherwise healthy, they're not going to run into problems. But they've made up this worry that a baby who doesn't feed is going to have low blood sugar and therefore have brain damage and stuff like that. And that's nonsense. There's absolutely no evidence for that. And, you know, like, everybody's afraid. Everybody's afraid. The doctors are afraid, oh, the baby's going to get low blood sugar or the baby is going to get dehydrated or this sort of thing. And, you know, that starts a whole cascade of interventions that often makes things worse. But, you know, I mean, we see these mothers whose babies are not latching on, and we can often help those babies latch on. I would say in the vast majority of cases, and if the mother is producing a lot of milk, which they often are, it's almost a guarantee that we'll get those babies on.

Fascinating. And then for how long should a baby. You were saying that the 20 minutes. You know, people say babies breastfeed for 20 minutes. Is there a time frame of like, how long and when do you switch breasts? And how does that all work?

Okay, so if you know how to know the baby's actually drinking milk from the breast, then when the baby's no longer drinking milk from the breast, you switch sides. Sometimes the baby will come off by himself, but not always. So if the baby's sitting on the breast and just nibbling rather than actually drinking. Then take him off, switch the other side. Don't look at the watch, don't look at the clock. When he's not drinking anymore, he's not drinking it. And you know, it's quite possible if the mother has a lot of milk, that the baby will come off the breast and won't want the other side, Although the baby should be offered it. And if he doesn't want it, that's okay.

Cool. So you might have one breast, and then you might have. You should always kind of offer the.

Other breast for the other breast. And if the baby has been drinking really well at the breast and he doesn't want the other side, that's fine. That's not a worry. But mothers tend to have more milk in the morning than they have in the evening. So what may be possible in the morning may not be possible in the evening. So the baby will feed one breast in the morning, but come the evening, he may want both breasts. And mother should not follow rules when they're breastfeeding.

Right. And it sounds like a lot of it is coming back to. Which I think is so important for us as women to come back to our intuition and our instincts around our body and trusting ourselves and trusting that we know what's best for our baby, too.

Right, Exactly. But, you know, many people have lost that intuition. They've been listening to experts too often.

Totally.

That's why, by the way, I say I'm not the expert. It's the mother that's the expert. She still has to learn to remember her instincts.

Right? Yeah. I think that's what I always kind of joke. Our culture doesn't support a woman in many ways to become a mother. I don't know any of this. I didn't see all of this. So I have to go into education in order to then trust my instincts. Because otherwise it's just kind of like I have no idea.

Have you ever seen a baby breastfeed before?

I have, but not a lot. I mean, not a lot.

That's right. That's right. Whereas where I worked in Africa, everybody breastfed.

Yeah. And a home birth. I've never even actually seen a birth. I've only seen the movies. I've only heard stories. And I started watching all these movies, and I was like, oh, that's what births supposed to look like.

You've seen the movies, you've got the books, and you have the T shirt.

What does the T shirt say?

Oh, I don't know. I just made that Up.

That's pretty awesome, though. No, but I should get the T shirt. But it's like going back to school, which seems like you said in Africa, it's just natural and normal for them. They've been around it, they've seen it. But we as women in our culture haven't.

That's right. That's quite right.

So what about breast pumps? What are your thoughts on the breast pumps and bottles?

No, no, no. You see, you have a big problem in the United States. And I think that everybody, every woman in the United States should be lobbying government for decent maternity leave. You know, six weeks really sucks. That's terrible. And all these people who are going off and all these politicians who talk endlessly about family values. I haven't heard anybody say we should extend the maternity leave. You know that in Canada, women get one year maternity le. Really? Yep. And that means they never have to worry about bottles, they never have to worry about pumping, they never have to worry about formula. They just breastfeed, they add solids, and then, you know, when the baby's a year old, then they go back to work. But we're not even the best. I mean, you know, Sweden, Norway, it's 18 months, which, by the way, six months has to be taken by the father. You know, why?

Why? To support the mother.

Because it all has to do with a woman going to interview for a job. The. What do they call them? The, you know, the person. What do you call them? The guy that gives the interviews who hires these people anyhow? You know, he's looking at this woman who say, maybe he's just been married for a year. And he's saying, I'm not going to hire her because she's going to get pregnant soon. I have to give her 18, you know, a year of maternity leave. But then, because they say, you know, because the father has to take six months of that 18 months, he can't really do that. He says, this guy gets a. Has a baby, you know, in the next year or so, I'm going to have to give him six months. So, you know, it doesn't matter whether it's a man or a woman. It's supposed to protect the mother's ability to get a job.

Wow, that's fascinating.

So.

So a man gets six months and a woman gets a year, and we get six weeks in, right?

Oh, I've just come back from Eastern Europe, where I was doing some conferences in Slovakia, in Hungary. I don't know about other places, but in those two countries, women get three years Maternity leave in the Czech Republic, where I just spoke recently, they get four years maternity leave.

Oh, my gosh. And everything is covered. Yeah, everything is covered. Wow. So why do you think this is so important? Because I think this is such a huge topic, as you're saying, in our culture for families and creating healthy families. Why do you think it's so important for parents to be with their child and breastfeed in the first couple years?

Well, think about the mother's situation of having to leave her baby at six weeks after the birth, of having, you know, I mean, aside from the often very, very traumatic effect on the mother of, you know, putting her baby in daycare or even, you know, even if it's her own mother that's taking care of the baby or the father's mother, it's still very traumatic for this for most mothers to leave their babies and go back to their outside jobs. And then, you know, it often, if they want to continue breastfeeding, it often means, you know, pumping and, and storing milk and babies getting bottles and often becoming difficult to breastfeed because they're getting these bottles. And so I am sure that this very inadequate, indecent maternity leave results in lots of babies who don't breastfeed for as long as they should and therefore don't get, or they get formula much earlier than they would have had the mother been able to stay home. And it's a real problem this early weaning and rejection of the breast, which the mother often interprets as, you know, he's rejecting me. But it's not that the fact the baby's getting bottles at the daycare and, you know, even in Canada, we have problems with that because daycares, daycare workers often don't have a clue that a baby of a year doesn't need to drink from a bottle. They just don't know that. I mean, of course he doesn't have to drink from a bottle. A baby of a year can drink from an open cup. They can have milk mixed with their solids. They don't need bottles. But they don't know that. They don't get taught anything like that. I mean, breastfeeding doesn't exist in our society. Even though in Toronto, I don't know, 96% of women in 2009 stated that they initiated breastfeeding. But then it's probably the same in much of California, you know, well, over 90% of women initiate breastfeeding. But as far as daycare centers, as far as, you know, the world, nobody knows that breastfeeding exists. And that's where, of course, we run into the problem of people being thrown out of malls or, you know, thrown out of swimming pools because they're breastfeeding their babies. You know, that's the funniest of all is the swimming pools, you know, where women are running around in the skimpiest of bathing suits, and that's okay, but the mother exposes the nipple so that she can latch her baby on, and out you go there. Or we'll call the police.

Oh, my gosh, we have some work to do.

Yeah, we do.

So what is the recommended age, as you're saying, some of these people get four years of maternity leave. What's the recommended age for people to breastfeed till, like, there's the Time magazine, you know, and all that?

So, yeah, I mean, there's a simple answer. I mean, the American Academy of Pediatrics, the Canadian Pediatric Society, and most pediatric societies around the world basically have the same approach. Exclusive breastfeeding to about six months, and then the American Academy and then to continue breastfeeding to two years and beyond. So, you know, there's no upper limit there. The American Academy said it a bit differently. They say exclusive breastfeeding to six months and then for the mother to continue to at least a year, and then for as long as the mother and baby desire. Why they would change it to that, I don't know. It doesn't make any sense to me. But, you know, it would have been nice if everybody had been in sync. I mean, it doesn't mean that, you know, you quit at one year, which, by the way, in 2005 when the statement came out saying to at least a year, and then for as long as the mother and baby desire, people interpret that as just two a year. And that's not what it meant at all.

Yes, I hear that people saying a year. Like, a year is kind of ideal.

Another magic number. Which is too bad, actually, because if you've ever seen a mother and child who are, I don't know, where the child is, say, 20 months old. I mean, they love to breastfeed. And for the mother and the child, it's like a very, very beautiful experience most of the time. Not always, but, you know, it's like everything. I mean, children can be demanding. Just because they're your child doesn't mean that there are times when you want. You don't. You know, you say, oh, my God, you know, he wants to go to the park again. Oh, my God, he wants to go to the zoo. He Wants ice cream again. He wants to breastfeed again.

Yeah.

I mean, that's. That's the way it is sometimes, but most of the time when the baby is. When the toddler is breastfeeding, it's a very beautiful experience for the mother and baby. I think it bugs the hell out of other people sometimes because, again, in our society, breasts are seen as sexual only. And therefore, if you're feeding, especially a boy who say 2 years old, oh, my God, people say things like, if he's old enough to ask for it, it's too old. That sort of thing. Nonsense. It's a beautiful experience. People always breastfed from the beginning of human time on Earth. They always breastfed into the third and fourth year of life.

Right? Yeah. You're just saying this information needs to get out there so people don't think it's so weird so we can shift culture for the health of our children. Right?

That's right. That's why when a mother says, well, I want to give bottles so when I go out, I can leave them with the ball. And I'd say, well, no. Strike a blow for mothers, breastfeeding mothers and babies, take them outside, breastfeed them in public. In fact, in the United States, every state has a law that says that a mother can breastfeed, is legally allowed to breastfeed everywhere. The mother is legally allowed to be, in other words, in shopping malls, too. And so the mothers are protected, but that doesn't stop people from throwing them out or calling the guards. So we can change. The more people see mothers breastfeed, the more mothers will breastfeed. And in public. And it's not as usual. The Europeans find us a bit strange. Not counting the French, who are weird, too. Oh, yeah. I mean, I know of a number of people. I don't know if you. You know this, but for women to go topless on beaches in France is like, you know, it's run of the mill, but breastfeed a baby on the beach and, you know, like, you'll get dirty looks. And the French aren't afraid to give dirty comments either. And it's very, very strange. But most of the rest of Europe, you know, these seem to be breastfeeding on the street anywhere. They don't care.

Right? Yeah. That's so great. And I love that you said that, too. For all of us to just go out there and do it and be seen and start to make the changes so that other mothers can do it and feel empowered and confident about it. Fantastic. Well, this was amazing. So much information. I so appreciate all of your wisdom and all of your research and your passion. So thank you so much for sharing.

Well, thank you. It's a pleasure to spoken with you.

Definitely. And then everyone please check out Dr. Newman@breastfeedinginc.ca and check out all of the videos. And they're amazing. And yes, thank you. Thank you. You do have a great day.

You too.

We hope you enjoyed this episode of Mama Goddess. Sending you lots of love and blessings. If you'd like to connect more, go to mamagoddess.com until next time, keep rocking it and have an awesome day.