Nurse In

October 5, 2017

In 2005, Barbara Walters spoke on The View about her discomfort with nursing in public and particularly called out an incident on an airplane where a woman nursed her baby next to Ms. Walters. A group of parents and activists gathered outside the studio in a peaceful protest. I was pregnant with my third baby and was excited to be part of this nurse-in. http://www.nytimes.com/2005/06/07/nyregion/lactivists-taking-their-cause-and-their-babies-to-the-streets.html

Much has changed over the last decade. Breastfeeding is promoted by celebrities and is seen as a good thing generally speaking.

 
As an IBCLC I mentor up and coming Lactation Consultants.

D4ED4097-1D93-4B04-AECD-3588CB481C81

I was contacted by, Perrine, one of my interns last week. She told me that her friend was asked to move and to cover up at a store in Columbus Circle. Perrine is from France and wanted to know what the rules and laws are in the US and NYC.
The laws are clear, you have a right to breastfeed where you have a right to be in NYC.https://www.nysbreastfeeding.org/laws-and-legislation/

My first thought was, “we need a good old fashioned Nurse In!”
Perrine was thrilled. Thrilled to be able to stand up for her friend, to do something that could effect change and to take action.
It was easy to put together. A quick Facebook event and a bit of sharing.
Last Friday, September 29, just before 10:00am I arrived at the Shops at Columbus Circle and the first thing I noticed just outside the store were these beautiful twelve foot Adam & Eve sculptures by Botero.
They are impressive bronze statues that are nude. Of course, Adam & Eve are nude.
I find it ironic that a woman wanting to feed her child in the most normal manner is told to turn away so no one can see her while twenty feet away from these colossal nudes.

By 10:10 several moms and babies arrived at the atrium and gathered in the shadow of the Botero sculptures. A camera man from a local news station walked into the mall. I asked him if he was there for the nurse in. He was but told me he could not film inside the mall. We walked outside the mall and he began to focus his camera on me. A security guard approached us and told the camera man he could not film there. The camera man told him he had cleared it with head of security and to go ask him. As the guard swiftly went in search of his boss I spoke into the camera. I told whomever would be listening that it is important to normalize breastfeeding and that people should not be shamed for feeding their babies. I said that the breast is overly sexualized and that people in our culture cannot separate the sexual from the simply functional.

Back inside as we all gathered I was approached by a man in a suit whom I assume was the head of security for The Shops. Our exchange went something like this:

Him: Hi, what is going on here?”
Me: “Oh, my friends and I are going to do some shopping at Williams Sonoma. And, we may feed our babies if they get hungry.”
Him: “alright.” He nodded his head and smirked a knowing smirk.

We walked into the festively decorated shop, it smelled of cranberries and roasted turkey. We were offered tastes of their mulled cider. It was delicious.
A baby started to wiggle and her mom said her baby was ready to nurse. We were standing next to a beautifully appointed table and I asked an employee if my friend could sit and feed her baby. She smiled and replied, “of course.”
Then other moms pulled out the chairs and nursed their babies. It was beautiful and peaceful and ordinary. I watched the moms one by one get comfortable in their act of “defiance.” A bit sheepish at first then, one by one, easing into a setting of just a few moms sitting around talking and nursing and admiring the beautiful décor.

I asked if I could take their pictures. One of the moms was at first shy about being photographed and then as time went on she said, yeah, I can be photographed. She smiled and looked up at me and said, “I am a Lactavist!” She held her head a bit higher and she beamed at her baby and at herself.

I decided to “out” us. I asked the woman who allowed us to use the table and chairs if I could speak to a manager about an incident that had occurred earlier in the week. She seemed genuinely disturbed that there was an incident and got the manager immediately.
August is a tall man with dark hair pulled into a neat ponytail. He approached me and when I told him of the Perrine’s friend he was upset. He wanted to know which employee it was who had made this mom so uncomfortable. He assured me that the store policy is that a person can feed their baby anywhere and they do not have to hide or cover up. This was heartening and I wondered if I had made a big deal out of an isolated incident.
I approached the moms some of whom were nursing their babies and others whose babies had drifted off into milk drunkenness.
When I told them they were happy. They commented that they were happy to be a part of something.
I realized this is important for them, for the store manager, for the employees, the head of security and the channel 7 camera man.
This was not a big rally but it had an impact. The ripple effects will carry on. The social media sharing that happened continued throughout the week. Every little bit makes a difference. I cannot be quiet when it comes to social justice. I may not always have the right things to do or say but I will not sit idly by and let people be harassed for feeding their babies.

We quietly dispersed, I went home, got my gear and went to see a couple of families in their homes to help them feed their babies. Just another Friday!

 

To Pump or Not To Pump

July 26, 2017

This is a question many new parents are faced with. People do not realize the amount of information thrown at new and expecting parents until they are expecting and new parents themselves.

One of the big decisions parents have to make is how they are going to feed their baby. It seems like most Americans consider breastfeeding. There are many obstacles that interfere with breastfeeding – that is a post for another day but let’s talk pumping milk.

I recall when I was pregnant with my first baby I took a breastfeeding class. I knew I wanted to breastfeed but did not have many role models so I listened intently on how to breastfeed. I remember the instructor talked about pumping and how it is best to rent a pump – I am not sure I remember much more. When Phoebe was born I struggled with how to get her latched and how often to feed her and I had a striped scab across one of my nipples and a hickey on the other from her latching onto the areola. I remember in a fit of frustration telling Rob WE NEED TO RENT A PUMP! NOW!

 

It took a few days for us to figure out how and where to rent a pump – this was 1995! Phoebe and I found our rhythm – she found my nipple I found how to listen to her cues. The pump arrived and I stared at it.

Unknown

For three and a half weeks. We rented it for four weeks. I knew I needed to use it before returning it and having spent over $80 renting and buying parts. I put the shields on my breasts and was impressed that milk came out of my breasts.

Later that night Rob came home from work. This was summer and there had been a storm. The electricity was out. Phoebe started to root around. “You have to give her this bottle! Now! My milk is going to go bad and we do not have a refrigerator and it is 99 degrees!”

Rob grabbed the bottle and tried to feed our screaming baby. I walked out of the room. My breasts began to tingle and leak.  Rob was sweating, Phoebe screamed louder and louder. Her head spinning like Linda Blair in the Exorcist. I started to cry. I think Rob was crying, too.

“Give me the baby.” I latched her on and we both chilled out.

“What do I do with this?’ asked Rob.

“Pour it down the drain,” I told him.

It turns out I did not need to pump. The company I was working for went out of business so I became a full time mom.

I asked Rob if he felt he needed to feed Phoebe to bond. He laughed and told me he felt bonded with here.

Scan 6

And eventually I became a La Leche League Leader and then a Lactation Consultant (IBCLC).

 

As someone who has been in the breastfeeding business for two decades I have seen different trends. With the Affordable Care Act offering up pumps to expecting parents and with social media there is a big pumping culture. And there is so much information shared that it can all be confusing.

If your baby latches on, you feel comfortable and your baby is gaining weight there is no need to pump.

Conversely, I have seen women who were told not to pump for two weeks or for one month or whatever someone told them was a rule. Or no one told them to pump while their baby is being supplemented with formula. In some of these cases this compromises their milk supply. The bottom line is that the baby must be fed. But if your baby is being supplemented and you want your body to make milk then it is important to pump. Milk is made by removing milk form the breasts – this can be with a baby who has a good latch, by hand expressing or by using a good breast pump.

 

Let’s now talk pumps. Pumps are not all created equally and not everyone responds to pumps the same. I have worked with people who pump using their hands – hand expressing – here is a cool video:

hand expressing

 

hand expressing

There are hospital grade pumps, electric single user pumps , and hand pumps.

 

When should you pump?

  • If your baby is separated from you
  • If your baby is not gaining enough weight
  • If your baby causing you so much pain you cannot tolerate nursing
  • If your baby takes a bottle
  • If you are donating milk
  • If you are working away from your baby

There is no need to fill your freezer! Pumping is not an Olympic sport!

How many people compare their milk stash to those they see on Instagram?!

breastmilk stored

You really only need enough milk to feed your baby.

If you want to pump that is cool but if you do not want to pump and do not need to then don’t pump.

People can bond with a baby without a bottle. If you want your baby to have a bottle of breastmilk, then pump.

Each situation is unique and blanket statements do not help new parents. For help call an IBCLC (International Board Certified Lactation Consultant) Find a Lactation Consultant or a La Leche League Leader.La Leche League International

 

 

 

 

This week I was in lactation nirvana.

On Tuesday I attended an all day conference on TOTs – this is Tethered Oral Tissues – this includes tongue tie, lip tie and buccal tie. The conference was put together by Dr. Scott Siegel, a physician and dentist who is uses laser to release these ties. The event was multidisciplinary with sessions given by and attended by IBCLCs (International Board certified Lactation Consultants), SLPs (Speech Language Pathologist) CNMs,(Certified Nurse Midwife) OTs (Occupational Therapist) Orofacial Myologists, doulas, and more.

Tots flyer

I have been in Private Practice as an IBCLC for 15 years. I have worked with hundreds of tongue-tied babies and even nursed two tongue-tied babies. I learned so much and more importantly had explanation for the things I knew instinctively and saw in my practice but could not quite explain. I have a better understanding of the impact of TOTs on people of all ages.

Wednesday night I attended a reading of the book, The Big Letdown by Kimberly Seals Allers. The subtitle is How Medicine, Big Business and Feminism Undermine Breastfeeding. I live this book everyday. The obstacles against breastfeeding are immense. They keep coming. As we solve one issue another pops up.

Kimberly SA & Me

I was asked by a journalist yesterday to answer a few breastfeeding questions. One was “Does my ethnicity affect my ability to breastfeed?” My gut response was, “heck, no! Mammals are mammals.” But the reality is that breastfeeding is a learned and cultural experience.

What needs to happen is that families need to be supported on many levels. Education is imperative. There are so many obstacles. (More on these later.)

Sometimes I get weary of the repetition of some of the problems that could be resolved with education and normalizing breastfeeding. I never get weary of empowering and educating families. And I NEVER get weary of holding babies.

Everly & Me

I will continue to help families, educate myself and keep sharing my knowledge – even when met with resistance.

 

My Brilliant Career(s)

February 12, 2017

I have had many jobs in my life, some career worthy and others just a way to make some extra cash. Some have truly fed my soul while others ate away at my soul. Some were ordinary and others quite fascinating. Here is a list of most of my jobs.

Babysitter – a common first job for preteens – I started when I was eleven years old – when I think about that family leaving me with their toddlers – that was insane but they were expecting their third baby and they had two boys under the age of three – they probably didn’t care who watched their kids – they just needed to get out! They also knew my mom was across the street. I called her when the youngest boy peed everywhere and the older boy spilled milk all over the place

Sales clerk – I loved the discounts I got at Thalheimer’s – I was a “flyer”, this meant I worked in most of the departments, great for me to one day work in men’s cologne, another in children’s clothing and then another in housewares.

Waitress – Annabelle’s was a pub like restaurant at the Cross Creek Mall – I was terribly disorganized so it was good that I was in an Army town and I was cute – the soldiers tipped well and were not too picky

Starmount Forest Country Club – this was a different clientele and there was one cranky old man who always wrote in 10% for tips no matter who served him – the standard was to just sign the bill and the club added 15% – there were a few who wrote in 20% – it was good money to work an event like a wedding or bar mitzvah – there were always extra tips

starmount-postcard-2

Dorm receptionist – I got to know who was dating whom, whose parents came to visit the most and who stayed out all night

Bouncer – OK, the Fifth Season was at the Four Seasons Hotel in Greensboro and I worked the door checking IDs and making sure the guests honored the dress code. Since Daddy was a soldier I knew soldiers were not allowed to drink in public in uniform – I loved telling the soldier to go back to his room and change into street clothes and not disrespect the uniform and our country!

Fragrance model – at major department stores I would demonstrate the free gift or the latest product for beauty companies – I promise I never squirted anyone who did not want to smell of cinnamon or lemon or gardenia or whatever the latest scent was but some people looked at me and ran – one woman actually jumped back three feet in fear of me dousing her in Estee Lauder

unknown

Epilady lady – this contraption had a spinning spring system that literally ripped hair out of your body. At Bloomingdales one day I turned my back away from the Epilady stand for a moment. When I turned back to show the product line to a curious customer I saw a woman wincing as she swept the device across her chin and ripped out the chin hairs! We were trained to never use it on the face but I let that woman have a go at it as I saw her whiskers from ten feet away and I figured I would want to eliminate that extra hair growth if I had it on my chin. I moved my new customer to the teeth whitening EpiSmile!

beautyepilady

Model – I modeled jewelry for private parties for a jewelry designer – I once wore a necklace that cost more than my parents’ lifetime income!

Receptionist – this was my first NYC job! I moved to NY, well, I stayed in NJ with my close friend’s family, I arrived on a Wednesday, bought the Village Voice on Thursday and set up interviews for Friday and accepted the job offer that started on Monday and paid the highest. My office skills were limited because I had goofed off in typing class but I could talk and be pleasant and I had college debt and a total of $174 to my name, I needed that job immediately!

Office temp – again, I was a good receptionist but that did not pay as much as people who could type fast so,

Paralegal temp – I was smart despite my inability to process words quickly on a machine, paralegal temping required decent amount of intelligence and paid better than other temp jobs. And it was amazing to hear about frolicking going on between the attorneys and the paralegals and other scandals.

Location Scout – I worked in a location scouting office, mostly representing short term rentals for photo shoots and TV commercials but I liked to be out and about so I always volunteered when an odd request came up or the need to photograph a new spot for our catalogs.

Hair stylist – OK, my location scouting office shared space with a private hair salon, the stylists were top notch but they never learned to French braid. A woman from the pub around the corner popped in because she knew there was a salon in the back and wanted a French braid for a wedding she was attending. John and Terry were at a loss. I told her to sit at my desk and wove her hair into a lovely braid.

Personal assistant – a former boss married a millionaire and needed a bit of help with little things – I was happy to shop for her, to return items after a shopping spree or buy gifts for family and friends, ride around in her town car with Carlos, her driver.

Baker – I have always found peace in creating cakes and cookies so I decided to make it a career while parenting two young children, I baked cakes and pies and cookies in my kitchen and delivered them to cafes or to birthday parties or events – I still love to bake. I was often challenged to go outside of my comfort zone and bake something unusual or important like a wedding cake!photo 2

Caterer – this was an extension of my baking business – my most popular was a menu of friend chicken, potato salad and red velvet cake!

Producer – I produced stand up comedy shows and a full-length off-off Broadway play – sometimes you gotta cast yourself to get the parts you want! We did a two-week run of Crimes of the Heart at the Producers Club on West 44th Street!

large

Actor and Comedian – see above and I continue to dabble a bit here and there – I recently did a show called Moms Cracking up!

Writer – I write for parenting – Bundoo.com, BreastfeedingToday.com and contribute to articles and books

Lactation consultant – this has been my longest career so far. I love helping, educating and empowering families. It is not always easy but it is important and it fills my soul to be in the presence of babies and their families. I see so many emotions bundled up and flying out. I have learned so many cultural traditions and learned to see how much people are different and how much they are the same.

unknown

Life is full of interesting adventures and the career you pick when you are eighteen or thirty-five or any age does not have to define you but it sure can inform your life and enhance your worldview!

 

 

“It is better to look good than to feel good.”

Many mothers tell me that their breasts are painful and they want to know why.

“It could be the latch,” I offer.

“No, it is not the latch, the nurse/doctor/lactation consultant/my mother . . . (fill in the blank) said the latch looks great.”

The problem is that the mouth and tongue are complex and the movements are complex and can be effected by various outside factors.

Do you remember Billy Crystal as Fernando? His mantra was:

“Dahling, you look mahvelous! It is better to look good than to feel good and, Dahling, you look mahvelous!

snl billy crystal

I believe that many health care professionals were trained to assess latch at Fernando’s Hideaway.

The latch is NOT marvelous if the mom is in pain. It is NOT marvelous if her nipples hurt, if the baby is not gaining weight, if the baby cannot maintain the latch for a feeding.

What can cause this poor latch?

There are a number of things that can make the latch un-marvelous. They can include:

  • poor positioning
  • birth trauma
  • tongue-tie
  • weak suck

What are the consequences of poor latch?

  • breast infection
  • low milk supply
  • early weaning
  • gassiness in baby
  • fussy baby
  • poor weight gain for baby
  • engorgement

What can be done?

Understanding what makes a good latch. When there is a good latch both mom and baby comfortable and the baby moving milk appropriately.

Different remedies can help different challenges.

Positioning the baby close to mom is essential – the closer the baby the deeper the latch

czNdKwVlssVSR-u8RnQ-4___TN-640

If the baby is tongue-tied, this is where the frenulum that attaches the tongue to the floor of the mouth is too restricted, this small piece of skin can be released by surgical scissors or by laser.

0907081245a

This procedure is quick and can prevent a host of problems both immediately and down the road including poor weight gain, the need for orthodontia, digestive issues, premature weaning to name a few. Often when the tongue-tie is present there is also a thickened frenulum under the upper lip. This, too, should be evaluated.

If there is birth trauma healing can happen by bodywork by a practitioner skilled at working with babies.

-QVtW1Nz2CcGcCBvWBhFM___TN-640

This can include a chiropractor, a craniosacral therapist, an osteopath or a physical therapist. These folks are trained to help relieve muscle tension and to release the fascia. With birth trauma there can be misalignment in the babies oral structures. Sometimes the roof of the mouth is highly arched which can make the latch very uncomfortable as the breast tissue can be pressed into this area by the baby’s tongue. If this is the case often the baby feels tension and this makes his sucking more “chompy.”

Releasing the tension can help alleviate this pain and help to reorganize the baby.

If the baby has a weak suck there can also be therapies to help as well as suck training.

If there is a breast infection the mom can continue to nurse but she must be treated.

b_cRrtHK2pkrG9y-N0od8___TN-640

No matter what it is important to get the baby fed. It is also important to protect the milk supply.

When there is engorgement the mom can hand express, pump and/or nurse the baby.

zP3mOcIgvb1630I5CtcPw___TN-640

When needing help with breastfeeding please do not accept that if it looks good then it is good. It should feel good and it should function appropriately.

If someone says “It looks good,” this is time to seek help by someone trained to assess the latch, inside and out.

In most cases that someone is an IBCLC – International Board Certified Lactation Consultant.

This morning I attended a panel discussion of the Children’s Health Council at Cornell Weill Medical College on New York City’s upper east side. The topic was Tots to Teens: Sleep and Your Child.

The panelists were Vikash K. Modi, M.D., FAAP, Haviva Veler, M.D. and Mary J. Ward, Ph.D.

The topics they addressed are the things I discuss with my clients: routine, rhythm and consistency for good sleep hygiene. The topic of co-sleeping was mentioned but was never actually addressed during the panel discussion. It was great to hear these panelists discuss normal sleep behavior and when medical conditions get in the way.

Then they talked about the importance of letting babies learn to sleep on their own. They even encouraged Cry It Out. What was especially compelling was the fact that the two moms on the panel confessed their own discomfort with letting their own babies Cry It Out. I was relieved to hear this because it confirmed I was listening to real people with real life experience. But I wonder why. Why they have expectations that others should “do as they say, not as they do?”

They discussed the problems of electronics and irregular schedules. They discussed how light disrupts the excretion of melatonin.

They never discussed diet. They touched on allergies, mostly airborne allergies causing inflamed adenoids and obstructing airways. But they did not discuss what and how babies are fed. I wonder if they considered this in their research.

They talked about sleep associations like music, blankets and parents. They insist these “objects” need to not be there when the baby falls asleep or they will need these associations when they wake in the middle of the night. They did not discuss breastmilk or the melatonin levels that change throughout the day to help babies to sleep more. They discussed circadian rhythms.

I learned the two factors that determine the need for sleep are 1)circadian rhythms and 2)how much time has elapsed between sleep sessions.

During the Question & Answer period there were many parents asking about their own children’s sleep issues. Luckily I got a chance to ask my question. Into the microphone, I spoke, “I am a Private Practice Lactation Consultant and one of my favorite things to show new families is how to SAFELY lay down and nurse their babies and to know how to SAFELY fall asleep if that were to happen. Why then when families pass into the borders of the United States do their bodies suddenly become dangerous?”

Dr. Ward admitted that she may be biased toward Western philosophy and mentioned a study that showed most parents do not like sleeping with their babies or children.

It made me wonder if the participants in that study answered that they don’t like it because they are conditioned to think it is bad? Are they conditioned culturally to think that babies are not supposed to cross the border of the marriage bed? Maybe I am reading too much into it. Maybe my personal bias towards wanting more sleep and wanting to breastfeed comfortably colors my thoughts on this controversy.

Gerald M. Laughlin, M.D. suggested that in this country the mattresses on adult beds as so soft as to cause suffocation as opposed to the hard mattresses in Asia where co-sleeping is the norm. I am not an anthropologist but I do sit on a lot of beds and very few I have examined are soft enough to cause a risk for babies.

Dr. Veler stated that there is research that states that there is an increase in SIDS when sleeping with parents. I told her I have research that negates that untruth.

Unknown-1

I brought along two copies of Sweet SleepNightime and Naptime Strategies for the Breastfeeding Family, the new book by Diane Wiessinger, Diana West, Linda J. Smith and Teresa Pitman published by La Leche League International. This book debunks many myths around sleep. The authors really went through many studies with a fine tooth comb and proved that in specific circumstances co-sleeping is the safest for babies.

They talk about the Safe Sleep Seven. For this to work a mom needs to be:

1) a non-smoker

2) sober

3) breastfeeding

the baby needs to be:

4) full-term and healthy

5) kept on his back when he is not nursing

6) unswaddled, in a onesie or light pajamas

and they both need to be

7) on a safe surface.

images-1

This is nearly a five-hundred-page book so if you are really interested I recommend you check it out – many of those pages notes with citation of studies and research.

I gave one to Dr. Veler and the other to Dr. Loughlin.

It is my hope that these doctors will really look at them, take in the research and consider their words when they are asking parents to do what goes against their instincts.

I did take away some good information about my own older children. I learned how sleep works. My knowledge of the technology interfering with sleep is a real thing. I learned that it is absolutely normal for my thirteen year old to not want to wake up early in the morning.

I also learned that by trusting my instincts and paying attention to my children’s sleep I know what works against them getting good sleep and what helps. As babies we all slept better together. I did not mind being their sleep association “object.” It reminds me of the time when Phoebe was a toddler and she was holding onto her little red Elmo and another mom asked me, “Is Elmo her security object?” I was stunned then I realized what she was asking. “No.” I replied. “Well, what is,” she needed to know. “Um.” A beat, then “I am,” I beamed.

Image

 

I have seen the documentary Breastmilk twice.

The first time around I was happy to see the diversity of the subjects, the inclusion of gay families and the normalization of milk sharing.

 

I came away knowing that Dana Ben-Ari is a true documentarian in that the viewer is brought into the scenes unobtrusively. We observed real life situations and outcomes.

The second time around I was sitting next to woman who nursed her child a decade earlier. She squirmed in her seat and whispered to me, “If I had seen this before having my son I would’ve been afraid because it seems so hard to nurse.”

 

Certain elements were left out that I believe only a seasoned eye would catch. Missing from the film: physicians trained to support breastfeeding, pre-natal education, support for the mom and baby and extended work leave. Were with these elements missing from the film because they are missing in real life?

 

There were a handful of subjects followed from pregnancy through the first birthday of the baby. In the end only one of those babies was nursing.

 

The moms who experienced premature weaning talked extensively about how was “really okay”, that “the doctors were right”, they “had their baby’s health in their best interest” and “thanked goodness that their baby was healthy.” What I saw behind those words was grief, defeat and lots of justification for their unplanned weaning.

 

The producers, Ricki Lake and Abby Epstein, say the outcomes of the subjects of their film align statistically in the United States with breastfeeding rates.

I believe documentaries are made not only to show real life but to affect a change or to educate or to inform.

 

There were experts talking about the cultural anthropological aspects of breast-feeding in the Western world but there was no real information on how to make breast-feeding easier or even pointing out what got in the way. We did see a bit on how our culture gets in the way: the boyfriend who not wanting to be patient as his baby nursed, the nurse not wanting to be patient as the parents wanted to baby to self attach, the moms who had to go to work and could not keep up making milk. Once again women, these new mothers, are at the mercy of the system, a system that does not support women or children.

 

In my documentary I would show women all of the world breastfeeding. I would show statistics on breastfeeding rates in different countries. I would show how birth practices impact breastfeeding, how working outside of the home impacts breastfeeding, how education and lack of education affect breastfeeding.

 

But I am not a filmmaker. I am a lactation consultant, a La Leche League Leader, a mom, a friend. I am working in the field daily to support mothers and babies one by one.

 

The longer I work in this field the more obstacles I see. What do you think? How do you see breastfeeding? Do you see it as easy? Do you see it as a privilege? Do you see it as impossible? How does a baby see breastfeeding? What if we asked babies? Would that change our outcomes? Would that change our culture?