Thursday, May 12, 2011

I wasn’t born this way.

One of the comments I often hear from folks—friends, clients and colleagues--is some variation of “you must have been raised this way”. “This way” refers to my affinity for holistic practices in my life. The truth is I have a completely mainstream background. I wasn’t born this way—I got here through experience, a lot of education--or more correctly re-education and personal evolution. 

I was raised like most kids in the 60s and 70s. I mostly grew up in a variety of Connecticut suburbs (we moved a lot) where I lived with my parents and my brother and sister and our various pets. My mother worked full time, but my father was home (okay—that’s different, but not insofar as this post is concerned). Because my mom worked, I made dinner every night from the age of ten. Dinner was the standard fare of meatloaf, pork chops, mac and cheese, chicken, steak, and potatos and a side vegetable, albeit made from scratch and yet to be infiltrated by Monsanto with GMO crops or laden with the factory-farmed chemicals of today. We went to McDonalds maybe twice a year as a “treat”, did not drink soda or eat much junk food of any kind (too expensive). But we ate margarine instead of butter, “processed cheese food” and instant milk (all because it was cheap). Still, overall we had far less processed or junk food than other kids even then, but only because it was what our parents could afford and what we were used to. But I cringe now when I think of all that margarine!

As an infant, I was apparently “colicky”, having been artificially-fed Carnation condensed milk and karo syrup. I had all the standard vaccines of the day. I also had common childhood viruses like chicken pox and measles. Our parents took us to doctors when we really sick and were sadly among the hoards of parents who bought into the lie that removing tonsils kept kids from getting sick. For the most part, though, I think we had far fewer medications than kids do today and maybe even fewer than a lot of other kids then. I know I got a certificate just about every year in school for perfect attendance.

But, other than cod liver oil, baking soda for hives, boric acid for eye infections and salt water for stomach aches, my parents were not exactly of any holistic mindset. My mother did buy “whole wheat” bread, if that counts. But, another cringe moment comes when I think of all that mercurochrome used for cuts and scrapes.

When I was seventeen, I watched a movie in high school English about slaughterhouses. I became a vegetarian that day. Granted, I had no idea what I was doing and didn’t do it well, but I was young and strong and healthy and did okay for awhile. I ate a lot of yogurt, peanut butter and mac & cheese. I did not stay healthy for long.

I was completely on my own from the age of 18 and married at 20. My college years were plagued by intense emotional stress, as my father was dying, my brother and sister were going through their own crises and I was unable to keep my focus on my education. During my early twenties, I began to really feel the strain and was hospitalized for severe dehydration and anemia. In hindsight I think that was the first time my adrenals were really spent.

Over the next few years I got progressively sicker. I had brain scans and ultrasounds and saw more than a dozen doctors. I had unbelievable migraines that sometimes lasted for days; I had more days with them than without them. I had intense pain during ovulation that escalated to the point where it was seriously debilitating for me. No one had any idea why I was so sick and in so much pain. I was medicated and medicated some more. I took more drugs during those 5 years of my life than in the rest of my life and my children’s lives combined.

A remarkable fact that most everyone I know finds shocking and that I cannot now imagine having made manifest was that I never planned to have children. From the time I was in my late teens, I was clear that I would never have children and when I married, my husband had accepted my decision. But, the Universe has interesting ways of turning us on us our heads and healing our emotional wounds in ways we may not expect. I think everyone has meaningful experiences like these, but we too often deny their importance in our lives, as we tend to be enculturated to separate the spiritual from the experiential. My life has held too much magic for me to do that and so I do not.

When I was 26, I was diagnosed with endometriosis. I did not seek a diagnosis for infertility as is so often the case, but rather because the pain I experienced monthly for almost three years had become so debilitating that I was taking very powerful narcotics just to get by, and each month they were becoming less and less effective. Finally, I had a diagnostic laparoscopy.

While I was in the recovery room at the hospital, I woke to a baby crying. To this day, I can still hear that baby’s cry. It disturbed me so badly that I asked the nurse over and over again what was wrong with him and why no one was attending to him. She repeatedly told me that he fine, but I did not believe her. My agitation about him would continue for days.

As my surgery was purely diagnostic, it was a simple out-patient procedure. After I spoke with the doctor, I was able to go home for the rest of the day. My conversation with that doctor was another gift that I would not understand for some time. He was, to say the least, cold and detached. He had not idea that I did not want children and offered little hope that I might ever be able to conceive without extensive medical intervention. I thought at the time that is was his demeanor that caused me such grief, but in hindsight, I know it was because something very primal and significant in my heart had been awakened that day. The contrast of his chill nature with the immediacy of the infant’s cry for help set in motion a complex series of events that to this day I cannot fully explain.

When I went home, I laid on my couch to read the issue of Vegetarian Times that had been in my mailbox. In it there was an article about homeopathy, a healing modality that I had never heard of. I have no idea why I did this, but I phoned the number for the National Center for Homeopathy that I found at the end of the article. I was given the names of four physicians in Connecticut who practiced homeopathy. I phoned the one closest to me geographically. Within minutes, I had made an appointment, with absolutely no idea as to what I might expect. The doctor had been very clear with me that he had never treated endometriosis, but also explained that from a homeopath’s perspective, this did not matter at all. Homeopathy restores the vital force and supports balance and healing. It does not treat a particular disease. I have no idea why I believed him, but I did.

From that moment on, I began to have exceptional experiences with healing that I began to refer to as “recognition”. It was as if I simply knew when something was right or not. There was no need for rationalizing or proving I was right. When it came to my own well-being, I just knew exactly what was right, something I had never really experienced before. It was like recognition, seamless and obvious.

Within a year of beginning homeopathic treatment and making nutritional changes (my first improvement was that I stopped eating all dairy), I was well and pregnant with my first child. Once you are awake, you are awake. You cannot put the knowing back away because it is inconvenient or challenging. "If you want to make your dreams come true, the first thing you have to do is wake up." J.M. Power

I was awake and no matter how I was born, this was who I was becoming. The amazing healing and support for wellness that my family has experienced using holistic practices has been a gift I would be delighted to see anyone embrace. So, when folks look at my life and think “well you can do that but I cannot” or “it’s easy for you, but not for me”, I know they are simply not ready. And that’s fine. The day I was ready, all the Universe lined up and one awareness after another flooded into my consciousness. It just seems to work that way.

Wednesday, May 11, 2011

What's in a name?

I thought a lot about the name for my blog. Granted, it was far less time than it has taken me to get around to actually creating a blog, but while it’s true that I often ruminate over minor decisions, this one felt pretty significant. I have been an IBCLC (International Board Certified Lactation Consultant) for fifteen years. I debated for almost a year before I made the decision to sit the exam and become board certified. I was already helping thousands of women breastfeed. I was a La Leche League Leader—completely committed to mother-to-mother support and coordinated a very successful inner city peer counseling program.  I was passionately opposed to the medicalization of mothering in all aspects of birth and parenting. I did not want to be a part of the problem and considered long and hard whether I could avoid that fate if I took the step to become a lactation professional.

In the end, I decided to become certified because, while working in hospital I saw how quickly the medicalization of birth was overtaking infant feeding. As birth has become more interventive, infant feeding has become more and more complicated for more and more mothers. And, there’s more than birth intervention in play. As the environment has become more toxic, as women struggle with infertility, hormone imbalances (such as hypothyroidism and PCOS), and as more and more women enter childbearing at a nutritional deficit, infant feeding has taken an even bigger hit.

We used to tell women that only a tiny percentage of women cannot produce enough milk for their babies, that breastfeeding doesn’t hurt so long as the baby is positioned correctly, that very few babies are bothered by foods their mothers consume, that tongue-tie is very rare, that breastfeeding takes a little practice and a lot of support, but that most women can succeed quite easily.

To be honest, that’s pretty much what I used to see as a La Leche League Leader. But, for the past 15 years, that has no longer been my experience. Cultural attitudes, poor science that has directed the focus away from breastfeeding and toward the product of lactation, intensive marketing by pharmaceutical companies of every manner of breastmilk substitute, the wildly and often repeated myths that fly through cyberspace and the ratcheting up of interventions in birth have changed the entire scenario. Breastfeeding in most of the Western world is not easy. Women need help. Really, really good help. So, I became an IBCLC.

Let me pause for a moment to explain something about that. IBCLC is an international certification, so it is identical throughout the world. That actually makes it pretty unique. An MD, an RN, a DO and many other health care providers cannot simply cross international borders and practice in their professions. Often, they require a different bit of training to come into line with the educational requirements in the new country. Since the IBCLC is conferred based upon the same guidelines everywhere, moving from one location to another does not require different evaluation or education. It might be true that a given country does not allow an IBCLC to practice without certain other guidelines being met, but that has nothing to do with the criteria met to become an IBCLC. So, when you hire an IBCLC, you are hiring someone whose prerequisites are to have met a certain set of educational criteria and spent thousands of hours working with breastfeeding mothers prior to passing an exam. For this reason, only an IBCLC should be referred to as a “lactation consultant“ (LC).

There is a lot of confusion around this topic, though and for the most part mothers are caught up ion the confusion without even knowing it. Sometimes, in their lack of understanding of the highly specialized education required to be a competent lactation consultant, health care providers have thought to expand their own knowledge base so as to be more helpful to their clients. Usually, such education is very limited and cannot be relied upon to support more than the simplest breastfeeding problems. In other cases, once it becomes clear to various administrators that having some kind of lactation specialist on their staff might be beneficial to their marketing strategies, many hospitals, clinics and physicians offices pay for staff members to receive breastfeeding training which typically consists of a weekend or week long program.

The problem is you don’t know what you don’t know. If a nurse or doula, for example, has taken a week-long course in breastfeeding, she knows an awful lot more than she did before. She can help a lot more moms than she could before. On the other hand, if she has no idea how complex a problem might become, she can easily have a false sense of her own skills, and have a poor sense of when she might need to refer elsewhere. To be honest, I think it also becomes awkward to promote yourself or your staff member as the “breastfeeding expert” or “breastfeeding specialist”, only to find yourself having to explain why your expertise is not sufficient. In the end, too few women receive the level of skill they need from their “lactation consultant”.

And, consider this. If you have had a hospital birth, chances today are pretty good you saw someone in your hospital who identified herself as being a “breastfeeding specialist” of some kind. She may have called herself a lactation consultant. Whether that person is an IBCLC, you may never know. Usually, you would never know to ask. I have had hundreds of moms tell me they “saw the LC in the hospital” and when I find out the person’s name, I discover that the person is not an LC at all. Alas, we as humans can be a little quirky about being “taken”. Often, in our embarrassment, we are angry at the person who told us, rather than the person who misled us.

But, this is what happens when you see someone who does not have adequate skills to assist you. Since you believe you saw an LC, you are not inclined to see another. After all, aren’t we all the same? It is especially challenging to consider that you may well have to pay out of pocket to see the credentialed LC, when the person you can see at your doctor’s office or hospital is free. It can be very difficult to imagine that there is such a significant difference that the fee is warranted.

You don’t know what you don’t know can apply just as easily to IBCLCs. For example, if you work in the hospital or clinic setting and have limited access to long-term feedback from mothers, you may well suggest strategies that are outdated or ineffective, but since you have no way of knowing this, you continue giving the same advice. Certainly, this is not always the case, but my advice is this: just as you would not assume every practitioner in any other field has the same experience and expertise, do not assume it of LCs either. And just as you would get a second opinion if someone could not help you if you had an injury, a toothache, a strange rattling noise under the hood of your car or a broken pipe in your house, please consider that your breastfeeding relationship deserves at least that much effort. While I agree that it should not have to be this complicated, and it should not be your problem, the reality is that this is how it is right now and the best you can do is learn to navigate the myriad of initials and help others do the same.

Basically, if a breastfeeding specialist has any initials other than IBCLC, her role is likely to be that of educator and support person, not clinician. The skills are very beneficial when you are hiring a birth or post-partum doula or midwife, when you are a choosing a physican’s office, when offered assistance at a WIC office or clinic. It means that the practitioner has enough interest in the relevance of breastfeeding to her role that she has chosen to spend time and money to be a better resource to her clients. But, part of the value of that additional education is her ability to establish pretty quickly when you might need more skilled intervention and to refer accordingly.

On my blog I could have used the term lactation consultant, but I decided I needed to be really clear that the initials IBCLC stand for something that I think parents have a right and a need to understand. My hope is that you will come to think of LC as synonymous with IBCLC and understand the differences as I have described above. 

Here’s the last piece. The “holistic” piece of my blog name. I personally practice in a way that has been informed as much by the path of my own life as by any education I have pursued. I have been living and raising my children holistically for 25 years and have incorporated all that I have learned in those years into my practice. For me, this is where the passion, the joy and the intellectual fulfillment enters my work. There is nothing more rewarding to me than to help a momma who has a breastfeeding problem such as mastitis, thrush, pain, or a poorly growing baby avoid the common interventions that typically only address symptoms and can wreak havoc with her gut and immune system, while gently exposing her to a new way of thinking about healing and well-being. When I work with moms over a period of years through my support network (Intuitive Parenting Network) and witness the ways they learn and integrate holistic practices into their own lives, changing the paradigm in which they raise their children and care for themselves and their families, I know that this approach is both needed and valued. I believe we, as mothers, value the wisdom, the knowledge and the skill that allows us to be competent and self-reliant caregivers.

As an LC, and as a mentor in holistic parenting, I am more concerned than ever about medicalization of the normal processes that fill our daily, ordinary lives. More interventions, more drugs and more control does not make for healthier, happy, more productive lives. I think, if anything, it immobilizes us and makes us impotent. That’s one reason why I am so sensitive to the idea that a lactation consultant, another “specialist” has to be much more than someone who simply intervenes and fixes your problems.

While I think mothers learn best from other mothers and truly need and deserve loving support, we live in a culture where breastfeeding isn’t easy and finding the resources that build our confidence in becoming the caretakers of our own families is difficult to come by. Practicing as a holistic IBCLC is my way of assuring that mothers receive expert care while having access to a far broader spectrum of knowledge, options, skills and support than is typically associated with a lactation consultant. It is my intention that in providing access to these resources, I offer mothers a new set of tools, tools that build confidence through competency and allow them to find grace in the problems they have encountered and overcome.

So, Holistic IBCLC it is.