Jo Gilpin has been an educated and licensed lactation consultant for 20 years and BabyGaga had the wonderful opportunity to pick her brain in an exclusive interview. While completely natural, breastfeeding can come with a number of issues. Lactation consultants dedicate their lives to making breastfeeding easier and more enjoyable for both mother and baby.
Jo has a new book called Brilliant Breastfeeding: A Sensible Guide that is highly knowledgeable, organic, and kind. The book uses the newest evidence and information to create a collection that is a necessity for both mom and dad. The range of chapters explain the science behind breastfeeding and goes into advice on how to be the most successful. Many nursing mothers know the struggles that breastfeeding can bring. Women are often surprised that something we're all "supposed" to know how to do can be so hard.
There is unexpected pain, possible latching issues, and fears of having low supply. Jo addresses all of these concerns and more in her book. Whether you're a first-time mom, or a been there, done that mom, you will learn something from Jo. She is a mother herself who too first struggled with breastfeeding but then overcame it to become an expert in the field. Keep reading to learn a lot about the breastfeeding process.
BabyGaga (BG): How long have you been a lactation consultant? What makes you passionate about your line of work?
Jo Gilpin (JG): I first became accredited in 1999, so that’s 20 years ago. Then, I was working as a community child health nurse in the public health system. Most of my work was with parents and their new babies, and I became acutely aware of the enormous impact that breastfeeding had on a mother’s wellbeing and the emotional drain on the family when there were unresolved breastfeeding issues. I myself struggled to breastfeed my first child, and I remember the anxiety it caused me. Once overcome, through more determination than good advice, I settled into a beautiful, long breastfeeding relationship.
This is what I want for all mothers, a strong mother/baby connection or bond that is easy, enjoyable, satisfying and lasting as long as mother and baby want – together with the huge bonus of health benefits. This is why I am passionate about my work, and this is why I have drawn together all aspects that relate to breastfeeding success in ‘Brilliant Breastfeeding: A Sensible Guide’. I aim to give parents the very best evidenced-based information and guidance to breastfeed their babies with confidence – for as long as they choose.
BG: ‘Brilliant Breastfeeding: A Sensible Guide’ covers many important topics to guide a mother to successful breastfeeding. Which is most important?
JG: Agreed, there are many important topics. Apart from generally gathering as much information about breastfeeding before baby’s birth to build knowledge base and therefore confidence, I think a vital topic is that of skin-to-skin contact as soon as possible after birth with no separation of mother and baby, unless absolutely necessary. This is important because it usually leads to the first breastfeed, often within the first hour. This can be achieved with different birth situations.
If given time, baby can initiate this first breastfeed by making his or her own way skin against your skin, up your body to attach to one or other breast and suckle for the first time. Baby is often alert and can use natural instincts (sight, smell, touch, etc) and newborn reflexes to do this gradual climb or crawl. When baby attaches and suckles in this way, important foundations for correct attachment and successful longer-term breastfeeding can be laid. Although it’s only a few drops of colostrum that baby receives, the suckling is an important stimulant for your body to start the breastmilk production. It is also a beautiful reward for parents after their baby’s birth.
BG: What is the biggest misconception new mothers have about breastfeeding? What are some fears women have?
JG: I think every woman will have their ideas and fears about breastfeeding from what they have heard from others, from what they have read or observed. Especially when it is their first baby. Many mothers will say that they had no real understanding of how time-consuming their baby is, how overwhelmed they feel with the 24-hour responsibility, and how intense and involved their emotions are. One breastfeed is soon followed by another. The understanding that baby has been feeding almost continually towards the end of your pregnancy when cozy in your womb and needs to do similarly when out with you. Breastmilk, because it is so perfect for baby’s system, is digested quickly – often within half an hour, and so frequent feeds that are needed in the early months makes sense. Observing baby’s early cues or signs for feeding gets easier as you get to know your baby better, and understanding that baby crying is often a late feeding sign, is helpful. It is always best to go by watching baby, not the time of the last feed, or ‘the clock’.
Along with that is often the fear that ‘there is not enough milk’. As a lactation consultant, I find that one of the greatest misconceptions when breastfeeding gets underway, is the supply/demand aspect of breastfeeding and milk production. Commonly it is not understood that the more baby feeds, as long as baby is attaching and suckling correctly, the more milk will be made. As I say in my book… ‘It’s a miracle really!’ Supply really does result from baby’s demand.
BG: How do you suggest women initially make breastfeeding easier for themselves and their baby?
JG: Breastfeeding will be easier for all if you have good up-to-date information on hand. Knowledge leads to empowerment and gives more confidence to be appropriately assertive to discuss your birth and feeding plans with your caregivers. ‘Brilliant Breastfeeding: A Sensible Guide’ covers much information that will make breastfeeding easy and enjoyable – initially and in the weeks, months and even years ahead.
BG: What are the biggest reasons breastfeeding fails and what can be done to prevent breastfeeding failure?
JG: From my experience, these are the main reasons that come clearly to mind:
- Unnecessary separation of mother and baby immediately after birth, baby being returned to mother, firmly wrapped. If baby is separated unnecessarily, perhaps weighed and wiped and bundled in wraps, the gap can be significant. The special time when baby was alert has probably passed; baby may be asleep and not show any interest in feeding.
- No skin-to-skin contact with mother, thus baby misses the window of opportunity to crawl to the mother’s breasts to initiate the first breastfeed. Again, this is such a critical time when baby is usually alert and able to use natural instincts and newborn reflexes.
- Latch difficulties and sore nipples. Sore nipples can make feeding baby excruciating unpleasant, and it is understandable that if it goes on unresolved, the breastfeeding journey will be disappointingly short.
- Baby being unnecessarily given formula via bottle in the days after birth. Unfortunately, this can happen in the early days after in hospital situations where staff may think it is necessary. Usually, it is not, as baby only needs minimal amounts of mother’s colostrum, or first milk, in the first few days.
- A belief that there is not enough milk for baby. This often relates to a lack of confidence and naturally an overwhelming need to ensure baby has ‘enough’
BG: You recommend that the whole family read Brilliant Breastfeeding: A Sensible Guide, not just the expecting mother. Why is that?
JG: The reality is that breastfeeding is not always easy, especially in the early weeks and months. A new mother or a second, third or fourth time mother can feel vulnerable and overwhelmed with hormonal changes as her body readjusts to the non-pregnant state. Tiredness and perhaps a lack of confidence can play a large part. With knowledgable support and enthusiasm from those around her, it all becomes so much easier and enjoyable. If other close supporters have read the book, they will be ‘on the same page’. There will be less confusion and more appropriate encouragement. This updated sensible information may be quite different from what the older generation understood or experienced about breastfeeding babies – they will find it interesting and fascinating. The mother’s partner’s understanding and knowledge of breastfeeding are particularly valuable when supporting mother and baby.
BG: How can partners and families be supportive of a breastfeeding mother?
JG: When partners and family members appreciate that adjusting to breastfeeding and a new baby although exciting and wonderful, can also be emotionally and physically tiring, it is helpful to the mother’s feelings of wellbeing if those around her are ‘on her side’, and looking out for ways to make life in general run smoothly. It’s great if partners and families see breastfeeding as a team effort, understanding that all benefit from breastfeeding success – baby, mother, family and community.
BG: How long do I personally think mothers should breastfeed for? How does breastfeeding change from the first few months to the first year?
JG: I personally think mothers should breastfeed for as long as they and their baby want to. For as long as it ‘feels right’. It is such an individual, decision between mother, her partner, her baby and her particular situation. Finally, it is no one's decision except for mothers.
When considering how long should mothers breastfeed – although it is their choice alone, I do think considering the World Health Organisation and UNICEF’s very sound, and evidenced-based recommendations can be used as useful guidelines for goal setting. They strongly suggest that for babies’ best overall development, to ‘exclusively breastfeed baby for the first six months, introducing solids around that time, with continued breastfeeding for up to two years of age and beyond.’
I do love to see an older baby breastfeeding because I think, yes … that mother and baby have really ‘got it’! They may have had challenges, but if so, they were overcome and they are both enjoying that precious relationship. And, importantly they will have many life-long health benefits. Additionally, I think that that mother may well encourage other mothers to breastfeed, just by her example alone. She will also possibly be a great resource for her children when they get to their child-bearing years.
BG: What are some common issues that breastfeeding mothers run into and how can they be solved?
JG: Please note, that although there are some common breastfeeding issues in the early weeks and months, there are also many mothers who breeze through without a hitch. These are often ones who have a good knowledge base about how breastfeeding works, have had skin-to-skin contact with their baby after the birth and breastfed within the first hour. Those that have had previous breastfeeding experiences, even if they have had initial challenges, may well find subsequent birth and breastfeeding experiences satisfying and successful.
The most common breastfeeding issues are in the early days and weeks that I see most are:
- Difficulty latching, sore nipples and uncomfortable feeding.
- Low milk supply
- Baby’s low weight gain
- Mother’s lack of confidence
BG: What are your thoughts on formula feeding?
JG: Formula as a breastmilk substitute has its place when other feeding options are unavailable, or when a mother has checked information and has decided that it suits her situation best. I always hope that a mother’s choice to formula feed has been an informed one, based on sound information. Sometimes I feel that women are coerced into using formula by the very clever marketing tactics of wealthy formula companies, who subtly promote formula as being as good as breast milk. We know it’s not.
There are definite times when breastfeeding, notwithstanding all effort, simply does not work. Mothers can feel a real depth of grief that can impact on parenting, possibly contributing to postnatal depression. I have the utmost respect for these mothers and feel their disappointment. Babies do very well on formula when it is made and used correctly. It is a sensible alternative. Sometimes it is essential for adequate growth, and we are fortunate to have such a backup. I do consider that a critical factor in baby’s growth and development is that babies are loved and nurtured in a safe environment.
BG: What do you tell the women who struggle to breastfeed but just can’t make it happen? How long do you suggest women try to breastfeed before giving up?
JG: This is an important question, but one that is hard to answer because every mother/baby situation is different. I think one of the vital aspects is to really listen to what the mother is saying – she may well want or need to ‘de-brief’ about her breastfeeding struggles. They may be of utmost importance to her. By listening, understanding and empathising, she will feel better about any decisions she makes. I would let her know that I would support and respect any decision she makes.
I would acknowledge the effort, emotional and physical she has put into breastfeeding, and let her know that every bit of breastmilk her baby has had, has been useful; that it has helped her baby’s immune system to be strong and healthy. Also, I would remind her that baby’s do very well regardless of the way they are fed, as long as they are consistently loved and nurtured.
As far as ‘how long’ do I suggest women try to breastfeed before giving up? I believe a mother will know in her heart when ‘enough is enough’. And it is her decision. It is my job as a lactation consultant to respect this and perhaps discuss ways to wean that has the least impact on her and her baby.
Thank you so much, Jo! All of your answers were so helpful and insightful. Brilliant Breastfeeding: A Sensible Guide is available to buy now. It is full of great information for any breastfeeding mom or family.