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

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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

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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!

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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!

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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.

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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!

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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

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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?

 

 

To Pump or Not to Pump

March 25, 2012

When I was pregnant with Phoebe is 1995 I took a birthing class and a breastfeeding class. In week six of the birthing class the teacher brought in a guest – a woman who rents breast pumps. The businesswoman made it clear that if a person was to be breastfeeding she would need a good quality pump.

Phoebe and I struggled for a few days but got the hang of nursing and all was well. The pediatricians were impressed with her weight gain and were nearly shocked I was exclusively breastfeeding. Looming in the back of my mind was that little voice of the woman “you need a breast pump, you need a breast pump.”

After about four weeks I found a local pharmacy that rented pumps and plopped down my $212.32 for a two-month rental with all of the supplies. I brought it home and it sat on the kitchen table.  Rob came home that evening and saw the new appliance in the kitchen and said, I see you got the pump.

Day after day, Phoebe and I developed our routine. We both loved nursing and she grew so beautifully. Rob loved watching her nurse and saw how happy she was. When I thought she was nursing too much he is the one who pointed out how happy we both were at these moments.

About two weeks after I rent the contraption I realize I have spent this money and I had better use the thing. Phoebe lay asleep on the bed off the kitchen and as I watched her I set up the machine and began to pump. It was fascinating to watch my milk flow out of my breasts into the bottles. After about ten or fifteen minutes I had collected about three quarters of an ounce. I placed it in the refrigerator so Rob could feed it to her in the next day or so. After all, shouldn’t I let him get involved in this parenting adventure.  Why should I be the only one to bond with our little girl?

That night Rob came through the door beaming as usual to see us at the end of the day. He was followed by a thunderstorm that rattled our little house. The lights flashed off and on and off.  The electricity was out.   My mind went directly to the fridge where my precious liquid gold sat on a wire shelf. Rob, the electricity! My milk! You must feed it to her now before it goes bad! I ran to the kitchen ran the bottle under hot water and handed it to Rob with a hungry wiggly Phoebe in his arms. She started to root on his chest. He placed the bottle in her mouth she looked in his trusted eyes as if to say: What the hell are you doing?  I stared at them and my breasts began to tingle. They struggled, both looking betrayed.

Give me that bottle, I said. I unscrewed the nipple and poured the milk down the drain. Let me hold her. I latched her on and we all melted into the normal little family we knew. Is it okay if I don’t pump? I asked Rob. Of course, I never asked you to. I don’t need to feed her to feel connected. 

The next day Phoebe and I drove to the pharmacy and returned the pump and she never had a bottle.

It is important to know that Phoebe and I were rarely separated in the first year of her life. Well, in her case we were rarely separated for the first few years of her life.

Chloe, my second baby also never had a bottle.

Finn, my third baby was born slightly early and had a severe tongue-tie and lost a full pound by his third day of life.  On day six I rented a pump and for 24 hours I pumped my left breast and fed him the milk. In all, he had about three bottles. When he was about nine months old I left him for a few hours and left behind some milk. Rob said he through it across the room and he didn’t really need it.

That is my story about bottles and breast pumps.

Now I want to address the general population.

For many women a pump is an important tool to continue breastfeeding. Just as my story was unique to my situation, so it is for all moms. In 1995 there were not on-line mothers groups. The moms I met were face to face and the conversations about feedings were that – conversations, two- or three-way discussions. These days moms go to their on-line community and read posts. In many ways these forums are great but they can also be scary and mis-informative.

A recent trend I notice is that moms believe if they do not start pumping right away they will not get enough milk. Another trend is that it is important to have a freezer full of milk. All of this work puts so much pressure on new moms and takes away from the time spent face to face with her baby. It also throws off the balance of her milk supply.

Why do you need to pump?

There are different scenarios where a mom really should pump.

If a mom is directed by her doctor to supplement her baby then this mom should use a hospital grade pump to express her milk. This is so that she has a supplement for her baby and it also will help to establish her milk supply.

If a mom and baby are separated it is important for the mom to pump her milk to again establish her milk supply and/or prevent engorgement.

These days many women work outside of the home. In this case pumping her milk assures she has milk to feed her baby while they are apart.  If the mom is one to three days ahead of her supply she can keep her milk in the refrigerator. There really is no need to have a freezer full of milk.  The idea is to nurse your baby when you are with him and to pump when you are separated.

Some moms would like to have a stash of milk so that she can leave her baby in the care of someone else occasionally. In these situations it is truly fine to keep a bottle or two a week in the mix.

For some moms it truly is nearly impossible to pump while at work. Pumping at home after feedings is one way to save milk for this time. Other moms find they use either donor milk or formula as a supplement. If a mom is not 100% breastfeeding it does not mean she is not breastfeeding. There seems to be this idea that breastfeeding is an all or nothing proposition. It is not. When you are with your baby you nurse your baby.

Some moms like to include her partner or other family member with the feedings. Many moms find this helpful while others prefer help with other aspects of her mothering this new baby. A couple of things to keep in mind: be sure it does not complicate the feedings and not feeding a baby does not preclude bonding.

What kinds of pumps are there?

There are many pumps on the market. It seems everyone wants to get in the game. As a new parent it is important to watch out for marketing. New parents are one of the most heavily targeted markets.

Read reviews, real reviews, not just a couple of posts on forums. And watch for paid advertising. Not all pumps are created equal. Just because a pump costs more than others, it does not mean it works better or even as well.

If you need to pump in the early weeks it is important to rent a hospital grade pump.

If you have an established supply and you are working outside of the home on a regular basis you may need a rental pump or a good quality double electric pump.

Look at the size of the motor. Are you paying for technology? Or quality?

If you just need the occasional bottle often a smaller pump or a hand pump can work well. And do not forget your hand. Learning to hand express is a great gift. You do not need to rely on electricity or batteries. Hand expression is something all moms should know how to do.

Here is a quick tutorial:

You take the pads of your thumb and middle finger and place them just on the inner edge of your areola.

You put pressure as though you are going to touch your rib cage.

Then, imagine there is ink on your thumb – you roll your thumb towards your nipple as though you would make a thumbprint – not a smudge.

Repeat.

If you do not have milk flowing you can massage your breast toward the nipple.

You repeat until you have expressed  enough milk for your particular needs of the moment.

The best place to practice is in the shower. Sometimes you will find a “sweet spot” where you get a nice continuous flow.

When should one pump?

If breastfeeding is going well there is no need to pump right away. Allow time for you and your baby master this art. Let your baby and your body flow into a nice equilibrium. You can wait several weeks to introduce a pump and expressed milk.

If there are hiccups in your situation pumping may be indicated.

When to pump varies from person to person. There is no one size fits all prescription.  If you are not sure contact an International Board Certified Lactation Consultant (IBCLC) or a La Leche League Leader.

Infant feeding can be complicated or it can be smooth. It is important to find your way. Feel free to share it on your forums but please, please put a disclaimer that this is your unique experience.