 Hello and welcome to interview a production of the Government Information Service. I am Jolene Beset-Joseph. Now, over the last few weeks, we have been joined by representatives from the Ministry of Health who have been giving us some insight into the importance of breastfeeding. And I'm joined once again by a representative from the Ministry of Health in the form of Nurse Shirlene Duncan, who is actually a family nurse practitioner. Thank you for joining us today. Thank you for inviting me. Brilliant. I'm going to be touching on the subject of breastfeeding and support. Now, this is the first time I've actually even thought of breastfeeding and support as a subject. So tell me exactly what exactly is breastfeeding support? Yes, I think it's maybe a new term to several people, but it has been going on for a number of years, but they basically didn't know how to say what it was. So breastfeeding support, this involves a number of professionals, as well as the supportive persons in the woman's life, a woman who is breastfeeding, who provides encouragement to promote exclusive breastfeeding, as well as continuing to breastfeed throughout the breastfeeding journey. So those persons are there as a team to help her, to encourage her, to initiate breastfeeding, to encourage her to continue breastfeeding, and also to help her along the way with all the challenges that she may face. Okay. All right. So one of the notes you sent me is when you actually said what breastfeeding support could actually entail, there was a reference, individualized support, breastfeeding support. What do you mean by individualized, exactly? Okay. So every individual is different. So some may need more support than others, and some may need, you know, they just may need something brief, but others may need to, you need to go more in depth with them, or you may need to be there more often for them, and so on. So when we say individualized, it means that each individual is seen as a specific person with specific needs, and so you address that need based on the individual. Okay. Brilliant. All right. So what exactly would breastfeeding support actually stop? So generally, breastfeeding support starts when the woman is pregnant in the antenatal period. So during the antenatal period, she undergoes about maybe eight to twelve visits with either her midwife or her gynecologist. During this time, she is given information about how to care for her breast, the changes that happen in her breast while she is pregnant, what secretions she may see, she may see things like colostrum, which is the first stage of the development of breast milk. And so as she goes through the process, she is not surprised as to what is happening to her. So she gets that breastfeeding support even from the antenatal period, and this continues for at least about six months where the baby is supposed to only get breast milk during this period. Okay. All right. Now in your opinion, why do you see breastfeeding support as being so important? Okay. So breastfeeding is usually a new thing to most mothers, and even those who are breastfed, you still learn along the process, okay? Now in the first stages of giving birth, you go through a period where your hormones are out of place, or you feel overwhelmed, you have a new baby and so forth. And so most times, persons want to resort to the easiest way out is to give a bottle of formula. Right. However, this woman at this point, she is vulnerable, she is, her emotions are all over the place. So you need to strengthen and to improve on her self-confidence, so let her know that you can do this. Okay. All right? So also it helps her to reach her breastfeeding goals, meaning that in the first stage of giving birth, the postpartum period, the breast may not make enough, may not make all the milk that you expect it to make at the time. And so the woman needs to know that the first stage, there's the colostrum, it might not be too much, it might be scanty, but that's exactly what the baby needs and that's the right amount. And so it's a process where you continue to encourage them, let them know what's happening, to strengthen their confidence so that they can trust that they're doing a good job, or they will get there, and so it's more less to motivate them and to keep them going. Okay. Now we're mentioning a lot of positives about what can come from breastfeeding support, but in your experience, have you ever seen what could happen if a lady doesn't get that support that she needs at that time? Several times I've noticed when a woman does not get that support, what happens is that she has a breakdown, or she goes through postpartum depression, and anyone who receives support, no matter what stage they are in life, when you get support it kind of helps you to balance your emotions, to have a positive outlook on life, and so forth. And so those women who don't get that support, they give up. They may not even want to see the baby because they are stressed out, and they're blaming everybody for what's happening to them, and the first thing they resort to is to give formula, and we know that the best food for the baby in the first six months of life is breast milk. And so because of that, the woman needs the support so that she can initiate the breastfeeding, she can continue the breastfeeding, and so as she goes through this breastfeeding journey, she's supported every step of the way. Okay, all right. Now you mentioned certain people that might actually be able to aid the new mother with breastfeeding support. Can you go into more detail about what these different people might be able to do for the mother? Oh yes. So the breastfeeding support is provided by a team. When I say a team, I mean it's not just the midwife. It's the midwife, her partner, her family members, the physician in her life, the nutritionist, the mental health practitioners. Persons who are always there for her to support her to encourage her, these people from part of the team. And each of these people play a pivotal role in encouraging her and keeping her on that breastfeeding journey. So as I mentioned earlier, the midwife and the physician will, at this point in the antenatal period, start off by telling her about the benefits of breastfeeding, how to care for her breasts, how to put the baby onto the breast in terms of latching onto the breast. The physician will do the same thing. Also you have persons like lactation specialists who also encourage her to breastfeed and tell her the components of breast milk and how it's going to benefit the baby, how to breastfeed, and so forth. The nutritionist is also on board to provide information about how breastfeeding is going to benefit the baby in terms of the nutritional value of breastfeeding and why is she not supposed to add any water to the diet at this point because breast milk, as we know, is about almost 90% purely water. And so because of that, the woman would have to get additional support throughout the process. So persons like the mental health practitioner would be responsible for guiding her through the process in terms of encouraging her so that she doesn't go into this postpartum depression that we speak about. And also several studies have proven that breastfeeding also protects a woman from having postpartum depression. So all of these persons on board, as well as her partner and her family members, will come on board, will also be there to assist in the chores, give her a chance to take a longer nap by feeding the baby, attending the visits with her as well, attending the antenatal visits, the postnatal visits, to be there as a support person for her. Also the father can decide to take paternity leave around that time so that he can be there for her during the time where she's most vulnerable, where her emotions are all over the place and she's losing on sleep and she's feeling tired and she's wondering, am I doing this right? Especially if this is a new mother and so all these people from part of the team to ensure that she gets the support that she needs to initiate breastfeeding and to continue breastfeeding, especially exclusive breastfeeding. Now you mentioned one person there that I didn't even I wasn't aware, I've had two children, I wasn't aware of a lactation specialist. That's the first time I've actually ever heard that, I'm sorry, but it is. Tell me more about a lactation specialist and what their role can be because you talked about telling them how to get the baby to latch onto the breast and such but in more detail, what does a lactation specialist actually do and where as a new mother could I find out or even garner information from this person? Unfortunately I don't think this position exists in the Ministry of Health. But this person, their role basically would entail assisting the mother in learning about breast development, what happens as the breast develops so that it can produce breast milk. They would tell her about the components of the breast milk, they would also assist her in attaching the baby onto the breast, different positions to tell her how to care for her breast as well. Be there to encourage her to let her know when she's doing well and they're also available, you can call them when you're having difficulty in getting the baby to latch onto the breast and they basically specialize in that area to deal with breastfeeding and allowing the baby to get that good food, as we say it, the breast milk that they need and also to help the mother to know that it's a journey. It will start rough when she gets there because at this point the woman starts with learning, then she starts to get it and then she eventually starts to thrive and so she's able to do it on her own and even sometimes it may be that she may think that she gets it and then she may go back into frustration because maybe today the baby didn't want to take the breast and she's depressed or he was taking the breast yesterday and today he's not taking it so the lactation specialist is also there that when she needs this person to guide her and support her will be there to do that. So touched on the partner and the family, what words of encouragement would you as a person in the profession actually give to family members and such like in regards to helping the new mother in regards to breastfeeding support? Very good question well as we know anything you do you cannot do it alone, especially a woman who has just given both she's vulnerable and she needs help and so anybody in her life it may not be her partner, it may be a family member, it may be a best friend, it may be a neighbor who can assist, I would encourage you to be there for this woman this is a time when she wants to know that she's supported, that she's getting the information that she needs so that she can continue to breastfeed and when you are there for her, so while she's getting the information from the midwife, the midwife is not at home with her, so she has her family members, her friends who are there to help her along the way so I'm encouraging anybody who knows somebody who has given both who wants to breastfeed to offer your help as this person, do you need any help, I'm there for you, whatever you need me to do I can come and hold a baby so that you can take a bath I can come and wash the dishes so that you can take a little longer nap during this time, so no matter how small you may think that the help is it is important, I too when giving birth to my son, I was very fortunate to have had my husband around and my mom around and so I got this opportunity to sleep a little longer during the day and I didn't have to worry about where my meal was coming from and so I have personal experience with this type of support and I cannot over emphasize how this helped me along the way, even as a nurse teaching persons about breastfeeding and when it was my turn now, I started to feel the feelings of aware of the patient's experience and so because I had that support, I was able to go through the journey and to breastfeed my son exclusively for six months and beyond then I'm still breastfeeding That's brilliant and to be honest, I'm glad you said that because what I find that a lot of people don't even realize at times when they're not the person going through it is that when you are experiencing this new thing and you don't get the support it's even harder for you to even make them melt because you're so stressed you know, so it's a fantastic thing if you have that support because stress also impedes the production of breast milk and so some mothers will tell you, my breasts aren't making enough milk and then you ask them, are you stressed out? When you're breastfeeding, are you relaxed? Because you need to be in a comfortable chair your feet need to be up, you need to have those good hormones going through your body and anytime you are stressed out, you have hormones that will counteract the good hormones and so prolactin will be diminished and so because of that, the production of breast milk will be limited and so the baby will not get enough and the baby will continue to be fussy and you're now frustrated and the cycle continues and so the support is important so that the woman can feel that you know I can do this thing and the body will respond naturally and the milk will just let down Brilliant, we're just going to take a little break now and when we come back we'll carry on with our conversation about breastfeeding and support, we'll be right back We are working parents and we breastfed both babies exclusively My first six years, my boy used to take all the good things Mother's breast milk is naturally the best milk for baby love yourself and love your baby Breastfeeding saves me money and it's free Every moment I breastfeed strengthens the bond between me and my baby I breastfed twin boys and lost all my baby fats And we have breast milk power I am Pastor Alvin and I support breastfeeding For more information, call the Nutrition Unit of the Ministry of Health and Wellness at 468-5359 Welcome back, welcome back to the interview, I'm here today with Nurse Duncan and we are talking about breastfeeding support Before we went to the break, again we were talking about the way that family members can help out with breastfeeding support However, the last interview I know I did with another nurse, we were talking about the work situation How would you say that the work situation could offer support to breastfeeding mothers? First of all, most women fall off the bandwagon because they have to return to work before the six months that is recommended Before she goes to work, I would recommend that the woman would speak with her supervisor or her manager to let her know that I'm a breastfeeding mom and when I come back to work I want to continue breastfeeding my baby So I would appreciate it if you would give me maybe some time in the day if I could go and express my breast milk Or maybe they can bring the baby in at a point in time during the work experience And so it's a partnership So most women fall off the bandwagon because they don't feel like they will get that form of support at work That person would think that she needs too many breaks and she's taking too many breaks and so And because of that, that also affects how she thinks about breastfeeding and that will also diminish her production So most women when they go back to work, their production usually diminishes But we want them to refocus and reframe their thinking and let them know that If you have a good communication relationship with your supervisor, your workplace manager This person can come on board as a supportive person by giving you the time to breastfeed as well as the time to express Also making a room available for you because I know right now maybe most workplaces do not have this breastfeeding room Or if there is any back room or room that is conducive that can be that she can get a comfortable chair She can get a sink to wash her hands afterwards And if there is a fridge at work, make a fridge available to her to store that breastmilk until she's ready to live All of this is a way that the workplace can support the woman in continuing to breastfeed And so we as the infant and young child feeding committee, these are one of the areas that we want to tackle To meet with the managers of businesses to sensitize them about the benefits of breastfeeding And they might say, okay, this woman may have to take so much time from work because she's breastfeeding But studies have shown that breastfeeding mothers, the fact that they feel supported, there's less absenteeism And so they come to work and then they do their work and then they just take a few minutes to go express their milk But if they figure, you know what, I don't get a chance to express, they'll call in sick and say, you know what, I can't come to work today And so the support is almost like it fosters increasing production because this person feels comfortable to be at work And they will do their work to the best of their ability and still get to meet the needs of the baby by meeting their breastfeeding goals That's so important, yeah, brilliant Okay, also can you just give me, especially if you're like new mothers, young mothers who have never been through the experience before Now if they want certain information and certain support or even certain guidance in regards to breastfeeding Just go down the different people that they can contact, we kind of touched on it before For like certain topics and certain things they're going through, who would it be the different individuals for those certain things Like for instance, health and nutrition, who would they really see about that? Who are the different people that will take on different roles? Okay, so in the community in this sector as well as primary healthcare, there are a number of specialists that we have So you have, first of all you have the midwife, this is the first person that this person may end up meeting In terms of when she's pregnant to give her the kind of information that she would need in terms of breast development during this period How to care for the breast, the type of bras that she needs to wear to support the breast Also how is milk produced in the breast, the first stage is of milk production And so at this stage, the midwife or her gynecologist would provide that information at this stage Now throughout the antenatal stage, she's also referred to several specialists along the way So you have the nutritionist and every health region has a nutritionist And so this antenatal client is referred to the nutritionist, nutritionist would also encourage her to eat properly Eat the right amount of foods, the right type of foods, get all the nutrients that she needs Because these nutrients is what is going to be translated into the breast milk So that the baby can get the right amount of nutrients And so when we say breast milk is a complete balanced diet We mean that the nutrition that the woman has during antenatal would also be continued when she gives birth Which is what translates into the breast milk so that the baby can get the nutrients that the baby needs Also the woman is also referred to the mental health practitioner or mental health social worker Who also does an assessment of her mental faculties to see whether she's coping with this pregnancy Whether she's at risk of getting postpartum depression And any time a woman gets depression, you know the emotions affect the production of breast milk And so several specialists are involved in the care of that woman So that even before she gives birth the support starts from that stage Okay, brilliant Now also something that I never really thought of myself before So I don't know if you'll be able to go into it for me a little bit There's certain factors that could actually affect women in regards that would warrant them needing support Now one of the things that I noticed that was actually down on some information I was reading Is that embarrassment, how would you say that would actually factor in? Okay, so embarrassment there would come in the form where some people don't believe that women are supposed to breastfeed in public Ah, okay, yeah So because of that a woman may need to go out And she may know that, you know, I need to feed my baby But because she knows how it's going to be looked upon She may end up carrying it for a bottle of formula And so that breaks the cycle of the exclusive breastfeeding And so it depends on the society that the woman, you know, lives in Some societies look down on women who feed in public Or some may encourage it by saying, you know what, the baby is hungry, feed the baby, there's nothing wrong with that And also some women are embarrassed about their breasts, how their breasts look So to put out your breasts where persons can maybe see part of your breasts and so forth They may not want to do that So all of that embarrassment can play on her mind and that affects whether she continues to breastfeed Or it also affects her production, the breast milk production Okay, something that you said that just made me think of something Because how hard would you say it is I mean people know that women have children every day And they have to feed their children and it's breastfeeding that's the initial thing So how hard do you think it is to try and make people understand the importance Now I'm not talking about the mothers themselves, but just the lay person Because for some reason as you say that there always seems to be some kind of stigma behind When people have to think about mothers have to just do the natural thing and feed their children And I'm so happy that you said it's a natural thing Yes Because when your breast gets full, you feel it So it's not to say like it's something bad happening to you, it's something natural So in order for it to get that relaxation from your breast or that release You have to feed the baby and it may mean that it may have to happen on a bus It may mean that it may have to happen at a bus stop Or maybe in a store Because when the baby needs milk they need milk no matter where you are And so the public needs to understand that breastfeeding is a natural process And you know how much money that saves the country when women breastfeed? So it's a benefit to not just the mother, it's a benefit to the country, to the society Because breast milk is natural, there's no pollution when you breastfeed Exactly And we talk about going green and all of these things And so we don't realize that some of the practices that God has already designed for It's natural and I don't know how many people accept it Or the percentage of persons who reject it or have stigma towards it But I would encourage somebody who is looking at breastfeeding as something that is a hindrance To look at something that is beneficial to the society, to the mother, to the family Everybody around benefits from breastfeeding Because the teachers in the long run will benefit from breastfeeding Because they have brighter students The IQ of children, children who breastfeed are higher than those who take formula And so we cannot over emphasize how important breastfeeding is Especially exclusive breastfeeding Brilliant Can we now discuss some breastfeeding support groups? Because I know you have those, right? Yes So breastfeeding support groups, this involves women who are on the same stage of their breastfeeding journey They meet in an informal setting And they discuss what they've been going through throughout their breastfeeding journey Those who have problems with breastfeeding would share with others what they do To increase their production Those who want to know more about what to do when your breast is engorged They learn about that during that experience Also in these groups, you sometimes specially visit the groups And then they also give them information, new information and share with them how to And the benefits of breastfeeding And so it's an informal setting where women with similar characteristics At the same stage of breastfeeding, they meet and they discuss everything related to breastfeeding The type of bra you wear, what happens when your breast is not making enough milk And so it's just where they get a chance to vent Just to relax and then to just talk about what's happening with their bodies during that period And I'm so happy to hear that though there are groups like that Because for some reason, when you're a new mother and it's not so much you're isolated But you're getting to know your child and such You're kind of away from people and such So when things start going wrong, you start thinking there's something wrong with me Am I doing it wrong? And it's so good to hear that everybody else is going really going for the same thing I'm going to That is such a positive thing when you're able to share that It is because there are persons who have gone before you as well So some women may also revolt to women who probably have breastfed before as well And so that's also part of their support team to tell them When my breast was engaged, this is what I did And it helped And so they know that they are not alone in this Okay, cool Now are there other ways that women can actually get breastfeeding support as well? Well, breastfeeding support can come in the form of You watch an online video about what breastfeeding is Because we're now in the technological world Everything is online, everything is available at your fingertips And so you have persons who create blogs, persons who create Facebook pages To talk about breastfeeding and their journey Or some countries have talked about having things like a helpline A 24 hour helpline So in the middle of the night, you get up and you have a problem with breastfeeding And you can just take the phone and call And say, you know what, what should I do? And so we have not reached there yet I'm hoping that we can get there, right? But things like having a lactation specialist on board We don't have that yet And so we're looking forward to having those kinds of specialists on board And so on And we're also looking forward to having our breastfeeding friendly hospitals And so we are now in the process of starting the training for that So that we can get our hospitals certified So that when a baby is born Everybody knows that the only food that a baby is supposed to get is breast milk Okay? And so all of this is part of the activities that can initiate A woman help a woman initiate breastfeeding And continue breastfeeding and so provide the support that she needs Okay Well, Ms. Tonka, this has been a fantastic conversation that we've had today But it's no time to wrap up But before I go, I will just again, because I mean I've asked you two before But what were some words of encouragement that you would give out to the nation In regards to breastfeeding support And just helping young women along the way Okay, I would like to let the public know That breastfeeding is a public health issue It affects every single part of the economy as well as every single person And the benefits of breastfeeding outweighs any other disadvantage that you even think of Maybe the woman might be thinking of, okay, my breast is going to get very large And it's going to fall But think of the benefits that your child is going to get in the long run Think of the benefits that the country is going to experience So we would have a decline in diabetes Because more women do practice in exclusive breastfeeding And so that saves the country in spending money on medication for diabetes Okay, we have less pollution, less cans of formula around the place In the garbage bins and in the drains and all of these areas Also, the benefits for the woman as well It saves us so much money So that money that she's going to spend on buying formula She can use that to buy baby clothes for the baby Or maybe take the baby to the next appointment And so the funds for the family can be redirected to more important aspects As opposed to spending money on food for that baby which breast milk is free So I want to encourage them to let them know that breastfeeding reduces the burden on society In several ways And so if you see a woman who is pregnant or you know a woman who's pregnant And who's ready to give birth, encourage her to breastfeed Sentitize her to the benefits of breastfeeding And let her know that she's going to save so much money Things are difficult You know, no matter what pay grade that you are in Things are difficult for everybody And so if you can save money for the entire six months of life To save yourself from buying formula or buying juices and all of these things that the baby doesn't need I would encourage you and also encourage the public To encourage their friends and family to breastfeed Because it's the best food for the baby at that stage Well, thank you so much for joining us today As I said, it was been a wonderful conversation Thank you so much for having me, I really enjoyed it Well, thank you for tuning in and being a part of the interview today However, it's time for me, Jolyne B. Setjoseph, to say goodbye Take care