Liberian trip highlights why breastfeeding education important

Because she is a doula, Lindsay ended up providing a great deal of breastfeeding education during a recent mission to Liberia.

A Warman mom and doula recently saw first-hand the contrast and importance of available birth education, especially around breastfeeding, when she supported new moms in another continent.

This past spring, Lindsay Bitner travelled to a town near Monrovia, Liberia for missionary work. She and five other members of the Awakening Church in Warman joined two others from Winnipeg, and formed a team with a medical doctor, three nurses, and two support people from British Columbia.

The team set up a clinic that was based out of an orphanage, using the school on the compound. There were separate rooms for registration, nurses, treatment, the doctor to see patients, prayer, and then one set aside for long-term care. Many people who needed IVs stayed in that room, but it was also where Lindsay did breastfeeding education.

“Once they (the team) found out I was a doula, they were like, ‘OK, all the pregnant moms, all the newborns, are coming to you.’”

Lindsay, who is a mom herself with three young children, saw any new mom that came through, offering her breastfeeding tips and education, including checking their latch. A big part of education was talking about mom’s nutrition. She says many moms were only eating once a day and often only drinking two cups of water a day, so we had to see if they could eat or drink more.

The struggle there, says Lindsay, is that the country has 80 per cent unemployment, so sometimes eating more food just isn’t an option.

Many moms asked for formula or hinted about it (at least 80 per cent, but she says it could have been almost 100), noting the baby would cry after a feed and worrying they weren’t getting enough, and if a baby was malnourished, they were given a bottle of formula.

“There were maybe 2 or 3 moms who were confident they were feeding their baby well. I did see ads for formula, which really broke my heart, because there’s no advertising for breastfeeding.”

Lindsay says the work was
As a mom and doula, Lindsay ended up providing a great deal of breastfeeding training to moms on a recent mission to Liberia.

Given the unemployment situation and concerns around safe drinking water, the big concern is formula isn’t a sustainable option for many.

“I did make sure to tell every one of them that what they were eating was really important to make the best milk for their baby. I made sure to emphasize that if you keep nursing and if you’re eating and drinking enough, your body is gong to make exactly what your baby needs, and formula can’t do it. And also making sure they understood that as soon as you stop nursing, it’s really hard to get it going again.

I explained it as a vitamin for them versus a dependency on it for all of their meals in hopes that it would last.”

“Trying to educate them that if you only do this, then you won’t have milk left, and you won’t be able to afford formula,” explains Lindsay.

“I taught a lot of moms that: if a baby looked malnourished, we would give formula, but encouraged them to keep breastfeeding and more often, because it is clean and affordable. The hygiene of it and affordability of it are the important factors, whereas here it’s not as big of a deal.”

A couple stories really stood out for Lindsay. The first woman she saw had her seventh baby with her, who looked undernourished.

“The mom said, ‘I can’t feed her because it’s so painful.’ Her nipples still looked really raw and awful even though the baby was four weeks old. I showed her how to get a wider latch.”

And even though many patients spoke English, the team often had a translator – a 22-year-old guy.

“By the end, he had a breastfeeding education and could tell the moms what to do without me explaining first for him to translate,” laughs Lindsay.

“Once this particular baby got a good latch, the mom exclaimed, ‘Wow, that doesn’t hurt as much,’ and that felt really good because I was helping one mom.”

Anyone I taught, I said, ‘Make sure you tell everyone you know that you need to have the areola in the mouth!”

A heartbreaking story that stood out was an auntie who brought in her three-month-old niece, whose mother had passed away two weeks ago. The baby was being fed water and glucose.

“We made up formula for baby, who took the bottle well. In the hour that she was there, she brightened up a lot. We sent that auntie home with four cans of formula in hopes that that would tide them over until they could get some money to get some formula.”

One of the interesting parts of her experience was hearing the moms talk about their birth experiences. She noted many aren’t afraid to have a home birth, and was fascinated because their rates of epidurals versus not were the exact opposite as here.

“I talked to a midwife and we were talking about the differences, and she said they have a 15% epidural rate (only for emergencies), whereas I heard a nurse say with a client of mine that there is an 85% epidural rate here.”

Lindsay says some of the teen moms who came through the clinic were afraid of birth and labour, so she did a mini prenatal prep class for them, but she says any mom who had had a baby wasn’t as worried.

Lindsay admits that while the experience was enriching and rewarding, it was also heartbreaking.

“We had seen the community Monday, Tuesday, Wednesday, and it got pretty overwhelming because by Wednesday, it was the people who were pretty desperate. I had to take a longer lunch, I just wanted to do more. ‘Can I not eat today so they can eat?’ I asked.  Our team leader said, we are doing the best we can, we have to help the one person in front of us, we have to love the one person in front of us, and hope that it goes beyond that.’

“I clinged to that because what else can you do? There is nothing else you can do.”

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