World Breastfeeding Week 2014: Parent Support Deserts in the USA

By Rita Brhel, Editor of Attached Family magazine, API’s Publications Coordinator

World Breastfeeding Week 2014What this year’s celebration of World Breastfeeding Week is really about—more than updating the status on breastfeeding acceptance or increasing understanding for mothers who are unable to breastfeed—is advocacy for parent support.

While the primary goal of Attachment Parenting International (API) is to raise awareness of the importance of a secure parent-child attachment, the organization’s overarching strategy is to provide research-backed information in an environment of respect, empathy and compassion in order to support parents in making decisions for their families and to create support environments in their communities. API extends beyond attachment education, also promoting the best practices in all aspects of parenting from pregnancy and childbirth to infant feeding and nurturing touch to sleep and discipline to personal balance and self-improvement through such innovative programs as API Support Groups, the API Reads book club and the Journal of Attachment Parenting, just to name a few.

API is a parent support organization made up of parents located around the world with a deep desire to support other parents.

In this spirit, API created the Parent Support Deserts project through which we mapped gaps in local parent support opportunities specific to Attachment Parenting (AP). The goals of this multi-layered project are to identify communities, regions and nations in need of conscious-minded parent support and to encourage collaboration among like-minded organizations to address these gaps.

As research pours in on the benefits of breast milk and breastfeeding, evidence continues to point toward AP practices, such as using fewer interventions during childbirth, avoiding early mother-baby separation, rooming-in at the hospital, breastfeeding on demand, interpreting pre-cry hunger signals, encouraging skin-to-skin contact, room sharing, discouraging cry-it-out sleep training, helping the father in supporting the mother, and others. As a result, the vast support network that many communities now have for breastfeeding mothers—from a breastfeeding-friendly medical community to lactation consultants and peer counselors to doulas and childbirth educators and parent educators trained in lactation support—tend to direct breastfeeding mothers toward Attachment Parenting.

Local parent support for breastfeeding has grown at an astonishing rate since La Leche League (LLL) International was founded in Illinois, USA, in 1956. LLL groups are located worldwide in nearly all developed nations as well as other less-developed countries. LLL has expanded its resources as cultures have evolved with technology and the changing roles for mothers, assisting mothers in providing breast milk to their infants whether through exclusive or partial breastfeeding or pumping as needed.

By contrast, there are few organized AP-minded support opportunities for mothers who are unable to or choose not to breastfeed or feed expressed breast milk. Formula-feeding parents are relatively on their own in terms of finding support that rightly points them in the direction of Attachment Parenting, as this choice or necessity to bottle-feed exclusively is seen less as part of the relationship context and more solely a nutritive option—though certainly we know, and research in sensitive responsiveness is finding, the behaviors surrounding bottle feeding are as much a part of the parent-child relationship as is breastfeeding. Unlike breastfeeding support, formula-feeding support is much less cohesive, with some information sources putting forth questionable science regarding formula versus breastfeeding benefits.

For this introductory look at the Parent Support Deserts project, we examined locations of parent support groups in terms of infant-feeding in the Attachment Parenting context. We focused on LLL for breastfeeding support and API for both breastfeeding and formula-feeding support. While this list is in flux, click here to see state reports of API’s Parent Support Deserts specific to Attachment Parenting infant-feeding support in the United States as spring 2014, as well as read more details about the Parent Support Deserts project. You can find this article in the latest issue of Attached Family magazine.

World Breastfeeding Week 2014: Sometimes Breastfeeding Requires a Bottle

By Rita Brhel, WIC Breastfeeding Peer Counselor, API Leader, API’s Publications Coordinator/Managing Editor

World Breastfeeding Week 2014Among the wonderful aspects of Attachment Parenting is that it is an approach to child rearing that every parent can take part in. Certainly, research supports some parenting techniques more than others. Breastfeeding, for example, is quoted in Attached at the Heart by Attachment Parenting International cofounders Lysa Parker and Barbara Nicholson as “the model of attachment,” and by reading an overview of the research, it certainly is.

But there is an alternative for parents who are unable to breastfeed. Not breastfeeding doesn’t exclude you from the benefits of Attachment Parenting, in particular feeding your baby with love and respect.

Each of my three children has taken a bottle as part of their full-time feeding strategy. Not every mother can breastfeed or breastfeed exclusively. There are plenty of breastfeeding advocates who will tell you otherwise, but as with just about everything in this life, there are exceptions to the mantra, “If you just tried harder … ”

My oldest child was born 10 weeks early. Babies born this early don’t generally yet have the ability to time their suck-swallow-breathe reflexes and must be fed by tube. Eventually they transition from the nasogastric tube to a bottle, as it’s much easier for some babies to get milk out of a bottle than the breast. My daughter required the easiest-flow nipples—and even then, we were enlarging the nipple hole with a safety pin. I pumped my breast milk, and every ounce had to be fortified with special nutrition to help her grow and medication for her many medical conditions. She never breastfed. She was bottle-nursed with expressed milk for six months and then with formula until she was a year old.

My second born was taken by Cesarean section two weeks early. I was anemic prior to the surgery and then hemorrhaged on the table. My doctor was concerned about a recent outbreak of hepatitis and persuaded me to not get a blood transfusion, even though I lost enough blood that it took six months of taking iron pills to get my blood iron level back to the normal range. I was so anemic that I would fall asleep part way through lunch and wake up two hours later to finish the plate, only to take another nap immediately afterward. I just plain didn’t have enough energy to keep up with the demands of breastfeeding exclusively. So my second daughter was supplemented with one to two bottles of formula a day. I was able to mostly breastfeed, with some formula, for nine months, and then bottle-nursed with all formula until her first birthday.

With my third baby, I was determined to breastfeed. I spent four years learning all I could about how to have a healthy pregnancy, natural childbirth and successful breastfeeding experience. And I was very healthy going into the birth, had a wonderful natural VBAC (vaginal birth after Cesarean) with no complications and started off my first exclusive-breastfeeding relationship.

Well, he is my first baby to receive only breastmilk, but he was not exclusively breastfed. Three weeks after my son was born, I developed mastitis and a breast abscess in the inverted nipple on my left side, and the subsequent procedure and antibiotics caused a yeast infection. As it turned out, I am allergic or resistant to every breastfeeding-safe antifungal available, medical or natural. In order to protect the right breast that remained yeast free, I only breastfed from the right breast, while exclusively pumping the left side and giving that milk to my baby through the bottle. This meant that I was pumping six times a day for the first six months in addition to breastfeeding, gradually reducing the number of times I pumped as I introduced solids. I did this pumping and breastfeeding routine for one year, before allowing the left breast to dry up. My son is now 2 years old, and I continue to breastfeed from the one side.

I would not choose bottle feeding if I had the option. I love breastfeeding. Bottle nursing is not the same as breastfeeding; it will not satisfy a mother’s desire to nurse her baby. But bottle nursing does give a mother an alternative to model the beginnings of attachment, which is designed in breastfeeding. Just as with breastfeeding, bottle nursing is done on demand, in response to the baby’s cues. Touch is supremely important, particularly skin-on-skin contact, as is eye contact and verbal communication. Looking into my life, a person would not see any difference in how I am raising my babies compared to another breastfeeding family, apart from the bottles. I cosleep, hold my babies all the time, respond quickly to their murmurs, don’t believe in any sort of crying-it-out and gently self-wean.

There are challenges to bottle nursing. Bottles, nipples and pump parts have to be washed after every use, and because of yeast issues, I had an additional careful sterilization process. The breast pump had to be remembered for every trip outside the house that might coincide with the pumping schedule, even if it was a trip to the grocery store. If you’re not pumping, you have to find an alternative, such as formula, which is expensive and comes with its own set of challenges, from increased allergy risk to ear infections.

Another challenge I frequently encountered, especially before my babies developed a strong preference for me demonstrated by separation anxiety, was that relatives would assume that since I wasn’t breastfeeding, that I didn’t care that they held the baby all day long and bottle-fed her, when in fact I did care very much. When I voiced my concern, that it’s important for my bonding—or in most cases, when I would simply go to the person and take my baby back—I would receive all sorts of teasing about spoiling my baby or even downright scolding about my selfishness.

It seems that, at least for me, people assume that breastfeeding is only for nutritional sake and that if you’re feeding by bottle, then suddenly mom’s job is reduced to changing dirty diapers. It shows that there is still a need for education about the importance of a secure parent-child attachment and that a mother is indeed much more than a source of milk.

You can read more in the double "Voices of Breastfeeding" issue of Attached Family magazine, in which we take a look at the cultural explosion of breastfeeding advocacy as well as the challenges still to overcome in supporting new parents with infant feeding. The magazine is free to API members--and membership in API is free! Visit to access your free issue or join API.
You can read more in the double “Voices of Breastfeeding” issue of Attached Family magazine, in which we take a look at the cultural explosion of breastfeeding advocacy as well as the challenges still to overcome in supporting new parents with infant feeding. The magazine is free to API members–and membership in API is free! Visit to access your free issue or join API.
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