Wednesday, March 24, 2010

Too many moms can't find help needed to breastfeed

By Catherine Porter
Columnist
Happy pink and yellow Easter eggs dot the walls of the Toronto East General Hospital's breastfeeding clinic, along with pictures of babies sucking peacefully on breasts.

If only it was that easy.

Anxious mothers crowd the space, holding, bouncing, rocking their babies.

They look tired and raw.

"I just can't get him to latch on my left breast," says one, who has driven all the way from Ajax.

"He was crying all night non-stop. He didn't want to suck my breast and he wasn't pooing or peeing," says another, her 4-day-old son finally quiet in her arms. "I was here for two hours yesterday learning how to do it."

You can't be prepared for how hard breastfeeding is. You assume it will happen easily, like popping a cork back into a bottle. It's a skill that can take days to learn, and the consequences of getting it wrong are nipples with bruises and open sores.

I speak from experience.

I think of the two weeks after giving birth to both my kids as my personal version of Guantanamo Bay's frequent flyer program: Never sleeping for more than two hours; awoken by a screaming alarm; forced to drag my swollen bleeding body back into the torture chamber of my child's mouth.

It wasn't any easier the second time, despite having a year of practice.

And I didn't have to face tube-feeding or mastitis – an infected milk duct. Senay Jurkiewicz awoke 10 days after giving birth to 7-month-old Burton with chills and a fever. Her fever went, but the blocked duct never did – it grew to the size of a kiwi.

She called one breastfeeding clinic and got an appointment – in two weeks. Two weeks?

"There's definitely not enough resources," says Jurkiewicz, who found antibiotics, but no breastfeeding help from a family doctor.

This brings me to the point. Toronto Public Health put out a damning report about breastfeeding this week.

It surveyed 1,500 first-time mothers and found 39 per cent left the hospital with free infant formula – despite the World Health Organization, Health Canada, the Canadian Paediatric Society all promoting exclusive breastfeeding to ensure both mama and baby's long-term health. It's like the nurses you sometimes see wheeling patients out to the hospital courtyards for a cigarette break.

While the report lambastes hospitals for not having baby-friendly practices in place for the mother while she is there, there's little discussion of our failures once she goes home. Remember: most moms are only in hospital for a day, maybe two. Then, back at home, the milk comes in and she's left to her own devices.

Hands-on support for breastfeeding has been shrinking for years in Toronto.

First, the North York Hospital shut its breastfeeding clinic. (Dr. Jack Newman set up a private breastfeeding clinic down the road, but he charges $50 a visit to cover his costs.) Then, Scarborough Hospital shut its general campus clinic.

Most of the clinics left open are by appointment, and only serve mothers who delivered there.

The only drop-in clinic in the whole city new moms can rush to, regardless of where they gave birth or live, is here, at Toronto East General. But even it has cut its hours, citing budget constraints and a caseload burdened with patients from as far as Pickering.

"We as health-care professionals are failing mothers because we're not giving them proper help," says Janet Zablocki, the clinic's warm-faced nurse and lactation consultant, rushing between babies.

She lists the medical benefits of breastfeeding a baby: more robust immune system, less chance of asthma, gastrointestinal and ear infections. They're less prone to childhood diabetes and sudden infant death syndrome.

In light of this, the clinic's annual $145,000 budget seems a puny down payment for a long-term windfall.

Why aren't there more of them? Despite all its talk about the importance of breastfeeding, our government has not made it a priority. Unlike Quebec, we don't have a provincial policy. We should.

The mothers who can't find help feel like they've failed the biggest test of parenting – protecting their child's health.

"I spent days feeling so guilty and ashamed," 30-year-old Michi Methven emails me. The mental health administrator switched to formula after two weeks of infected nipples.

"I refused to leave the house for fear someone would see me bottle-feeding and yell at me from the street."

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