ABOUT HER: Jan Ellen is on staff at Charlotte Pediatric Clinic. She is board certified in lactation and co-authored "25 Things Every Nursing Mother Should Know," with Kathleen Higgins (Harvard Common Press, 2009).
Jan Ellen has been involved in the field of lactation for nearly 20 years and has assisted countless Charlotte families. She is a frequent conference speaker and sits on the board of directors of BELLAS (Breastfeeding Encouragement Learning Liaison and Support), a breastfeeding advocacy group. She is also a past board member of the North Carolina Chapter of the Cystic Fibrosis Foundation.
Her clinical interests include low milk supply, nursing multiples, adoptive nursing and dental issues. The mother of two daughters, Jan Ellen enjoys writing, reading, and going to the beach in her spare time.
INTERVIEW TRANSCRIPT:
Empowered Mommies (EM): Ms. Brown, thank you again for giving us the opportunity to sit down with you. You are such a wonderful role model not only as an expert in the nursing field, but also as a lactation and breastfeeding educator. Can you share with us how you began your career and what made you decide to focus on pediatrics?
Jan Brown (JB): Thanks for the kind words…it is a pleasure to talk with you and be part of your website content. I love the ‘empowerment’ aspect of the site and the focus on having a clearinghouse for information. As you have said, mothers are bombarded with conflicting information and advice and it can be overwhelming at times! I began my career by happenstance; I experienced many early issues with nursing my first daughter, KJ. I was very frustrated with the lack of clinical help, even though I had wonderful support from Charlotte La Leche League. My obstetrician even told me I had to wean after a bout with mastitis! Having worked as a dental hygienist in a pediatric dental office prior to having my first baby, I fortunately had some knowledge of medical issues and this led to a pursuit of board certification in lactation. Most of breastfeeding support is counseling and problem-solving, so it is not necessary to have a medical background, but it has helped as I previously worked in a hospital, and now, a pediatric practice. As it turned out, my daughter’s underlying medical issues were from undiagnosed cystic fibrosis. Her poor growth and weight gain were actually a medical issue, not a breastfeeding one. This is what I had suspected. I have learned it is important to trust your mother’s intuition. It spurred me to want to learn more about the clinical aspect of breastfeeding and to empower mothers to trust their instincts. My present position at Charlotte Pediatric Clinic is the ‘icing on the cake’ of my career. I have a comfortable, spacious private office away from the exam rooms and have long appointment intervals so families are not rushed. The pediatricians are available to met with us during the consultation and collaborate when there are feeding plans needed or medical issues to consider. It is seamless.
EM: What do you think are some of the challenges new moms are facing today in terms of newborn care?
JB: The challenges are many. To begin with, the birth has much to do with how a mother cares for her newborn. Despite the best laid plans, she may find she is exhausted,disappointed or even guilt-ridden post-delivery if she did not have the birth of her dreams. This can unfortunately set the stage for how she cares for her baby; plus, fatigue and pain are not good bed-fellows as you try to meet the needs of a newborn. The hospital stay is a time of many interruptions by various staff members and visitors. Even though Charlotte hospitals strive to keep babies in the room with parents and minimize interruptions, parents often leave the hospital confused and bleary-eyed as they embark on the first week of newborn care. Learning to breastfeeding falls smack in the middle of this timeline! It is also a time many parents have relatives and friends in their household. On one hand, the more help the better, on the other, it also adds an element of stress. I see this very often in my practice.
EM: Based on your experience, how do you think breastfeeding has changed over the years and why?
JB: Breastfeeding is now acknowledged in the media, which is, good or bad, how our culture learns about things! Breastfeeding is often depicted in sitcoms, movies and news stories; this is a departure from a few decades ago. The value of breastmilk has been validated by scientists and researchers in the last several decades also. This, in turn, has turned the tide back to breastfeeding and instilled respect for it by the medical community. And with the medical climate of our country, nursing is now seen as a public health issue. I also see corporate America embracing the concept of nursing mothers and their need for longer maternity leaves and lactation facilities for when they return to work. The statistics have always been there in terms of less absenteeism from sick babies, motherhood morale enhancement and more productivity. It is still very far from perfect, but at least the consciousness is there now.
EM: What do you think are the biggest mistakes new moms make when it comes to breastfeeding?
JB: I don’t view them as mistakes but instead, unawareness. How’s that for correctness? New mothers often see nursing as a black and white endeavor and gauge their mothering worth on how they are doing. It is a work in progress for most of us and often takes practice as mother and baby learn the art of breastfeeding. Because we are an organized and goal-oriented gender, new mothers are quick to expect schedules and outcomes. This can be very self-defeating in the newborn period. It is frustrating for mother and baby. It can lead to issues with milk supply and poor growth. Lower the bar on what you can get done in a day and go with the flow, quite literally. While there is plenty of time to impose boundaries and avoid spoiling, newborns are not manipulative and conniving and do not set out to up-end our lives! Mothers can avoid a lot of stress if they surrender to the needs of their newborn in the first few weeks and let a schedule of sorts emerge later. Nap as often as they can and delegate chores and errands. Babies need fed every 2-3 hours whether they are nursing or bottle-fed. For some reason this fact seems to be a big surprise to new mothers! Eventually they go longer between feedings and sleep longer intervals. New mothers should trust their instincts and feel empowered to seek out assistance and make their own decisions as to what works for them and their family.
EM: You recently co-wrote and published your first book with Kathleen Huggins (RN, MS): “25 Things Every Nursing Mother Needs to Know” which has received great recognition and praise. Can you tell us what inspired you to write the book and how did you and Kathleen come together on this project?
Kathleen and I have been friends for years, having met at a breastfeeding conference in the 1990’s. She has written several breastfeeding books but The Nursing Mother’s Companion is her first and most famous, selling over a million copies plus. We often talked about the need for a balance between practical information and anticipatory guidance. This book is third in a series of “25 Things…” Kathleen asked me to co-author so we would have the combination of our experiences to provide the essence of nursing. Kathleen is a wonderful clinician and writer and I was honored to be a part of this series. We are working on another project now that will be released in tandem with her 25th anniversary edition of NMC in Fall 2010. I think this book encapsulates what mothers can expect but also addresses the motherhood journey in general.
EM: If you had to look forward a decade, how do you hope your book will have influenced mothers’ confidence in nursing successfully?
Even thought this is a small inspirational book, I think it addresses many areas not touched on in other breastfeeding books. We talk about options and flexibility for mothers and their choices. We discuss the impact mentoring can have to promote and support each other. We are frank about self-care and post-partum depression. The book is not preachy or cookie-cutter. In this manner, I hope we will influence mother’s confidence in nursing in whatever manner or length of time she chooses. Empowering mothers to seek assistance and use their resources is a main theme of the book. In the next decade, I hope mothers have more time to recover and get to know their babies with longer or flexible maternity leave. I think the medicalization of birth will be less and more baby friendly. The Baby Friendly Initiative (http://www.babyfriendlyusa.org/eng/index.html )should be embraced by then in USA hospitals.