Welcome to our new interview series on Postpartum Directory, where we dive into the stories and insights of trusted postpartum and prenatal service providers. Today, we’re excited to feature Annette Nel, a certified lactation counsellor.
Annette shares her personal breastfeeding journey and provides expert advice on unique challenges like managing biting at the breast, balancing fertility while breastfeeding, and supporting infants with special medical needs. Join us in exploring her compassionate approach to breastfeeding and her dedication to supporting new moms in nurturing, informed, and empowered ways.
You had a home birth with your son. How did that experience shape your approach to supporting new moms and babies in their breastfeeding journeys?
We are shaped so amazingly – our bodies were created to naturally give birth and breastfeed! It’s so easy to think we need all sorts of modern technology and fancy gadgets to birth and feed our babies, but the best, biological way is just to go back to basics.
What led to the creation of the ‘Breasties Breastfeeding Support’ Facebook group, and how has this community grown over time?
Breasties was created by a group of passionate breastfeeding moms in 2022 to fill the gap of a peer led community to provide moms with evidence based breastfeeding information in South Africa. Besties who breastfeed became…Breasties! Successful breastfeeding starts with education, and that’s something at the core of what Breasties stands for with it’s “where breastfeeding begins” slogan.
Breasties currently has more than 18k members and an admin and moderator team of both moms, Lactation Professionals and Lactation students providing support daily and on demand. Breasties has also helped launch the professional lactation careers of some of the moms involved, and so continues to have a ripple effect into the community for years to come!
You have a special interest in babies who bite at the breast. What are some of the most common reasons babies bite, and how do you recommend moms handle it?
Having “holey” nipples can make any mom want to run for the hills! The most important step is to identify the trigger moment – does baby want to increase the flow speed of the milk? Is there a tooth coming out and gumming at the breast relieves some of that pressure? Has baby turned it into a game of see how mom reacts because your shocked face is just terribly entertaining? I
always tell moms – WATCH. It’s so easy to be on our phones or watch something or daydream when we nurse. But with biters, if we can carefully observe and identify when biting occurs, we can preemptively unlatch or make little changes to how we nurse to avoid the bite ever happening!
Can you explain what ecological breastfeeding is and why it’s a method you support?
In a nutshell, before we used pumps, dummies, babysitters or separate sleep spaces for our babies, there was a natural rhythm and flow to our fertility and how our babies nursed. These things of course have for many mothers become necessities in today’s society, but there has also come a return to an awareness of this way of feeding and the benefits it has for moms and babies if you are able to choose this path of nursing. When you practise ecological breastfeeding you are feeding on demand whenever baby asks – total unlimited suckling!
You’re also never pumping and always directly nursing, letting baby “dummy” at the breast, bedsharing and contact napping, and only starting minimal solids after 6 months. What are the benefits?
Well for one, many women will experience a longer period of lactational amenorrhea which means yay, no period for a VERY long time! Natural spacing of babies, a closer bond and the convenience of not having to rely on “tools” in your breastfeeding journey are the biggest reasons.
How do you approach fertility during breastfeeding, and what advice would you give to mothers who are trying to balance nursing with their fertility goals?
Many mothers (especially those practising extended ecological breastfeeding into toddlerhood) have set ideas of the age gaps they want between their future children. Maybe there are medical reasons involved, or personal reasons, but many women choose not to wait or practise natural child spacing. This can become frustrating as nursing impacts fertility – and many physicians will often advise immediate breastfeeding cessation if you’re struggling to conceive!
Luckily this is very rarely needed, and if you work with a Lactation Professional there are certainly options when it comes to understanding and reaching full fertility while you’re still breastfeeding. Your baby’s unique nursing needs will play a very big role in when your fertility returns.
You have experience with infants who have special medical conditions and require unique breastfeeding support. Can you talk about some of the strategies you use in these situations?
The number one thing in cases like these – the support team. Moms with babies who need extra care need extra care themselves too! Your team can (and should!) consist of baby’s drs or pediatricians, a good lactation professional, possibly a counselor or postpartum supporter for mom, a dedicated partner and ideally lots of extra help from friends and family. The team working together in synergy is what gives these babies the best shot at recovery and a smooth breastfeeding journey for both mom and baby.
What are the key differences in nursing support for mothers of infants with medical challenges
versus those without?
Often times in such cases it’s easy to overlook that the nursing mother is in great need of support as well. Many times medical challenges have come as a complete surprise and pull the rug out from under new moms who had a very different image of what their postpartum period with their sweet new baby would be like. That can be very challenging to deal with emotionally, and physically, especially if there are other older siblings and responsibilities the mother needs to balance. I try to make sure that above all the mother feels capable and supported in embarking on often long and challenging roads to recovery, and a lot of my work then centers around counselling of the mother herself as well.
What role do online support groups like ‘Breasties’ play in helping mothers overcome breastfeeding challenges?
A mom I worked with recently said to me – “I just feel so alone.”. When it’s 3am and you’re doing that bleary eyed night feed with milk stains on your pajamas, or when you’re sitting cluster feeding a newborn while your family is having a ball of a braai downstairs, or when you wonder if any other moms have letdowns when they hear someone else’s baby cry in public, or, when you take a picture of your baby’s PERFECT MILK DRUNK LITTLE FACE – you want to share it with someone. You want someone to understand. To say, I get it, I’ve been there too. And you realise you’re not alone. Thousands of other moms work that 3am shift with you. Many others are all wearing the same ratty old nursing bra’s!
Above and beyond overcoming challenges, peer support and community is what ties us together as women, as mothers, as partakers of Matrescence and Motherhood. Seeing that other moms around you struggle too, and sharing in their troubles – and victories! – is often what is the most motivating and special about these kinds of groups.
In your experience, how important is peer support in a mother’s breastfeeding journey? Do you have any advice for moms looking for that support?
We live in a time where unfortunately globally due to issues like predatory formula marketing, the workforce and how it doesn’t cater to mothers has made breastfeeding rates absolutely TANK globally. Formula feeding has become normalized beyond being a medical intervention and
many women simply haven’t even SEEN another woman breastfeed!
I always tell my clients the story of a study conducted in a zoo with two groups of new chimpanzee mothers. The one group with their newborns was placed with the rest of the troupe, and the other group and their newborns were completely separated from everyone else. The separated group couldn’t figure
out how to feed their babies! Breastfeeding seemed a mystery to them. They struggled with latching and eventually some of the babies had to be removed and received special care. But the other group who were amongst the rest of the troupe thrived. They watched the older chimpanzee mothers nurse their own babies and copied them, they received help from them and had no issues breastfeeding at all. We are certainly not monkeys, but as mammals we share this sense of community and need to pass down knowledge, to learn from our “tribe”. That is peer support.
Important for new moms to know though, is to test and discern thoroughly where they get this support from. A proper breastfeeding peer support group will have trained and knowledgeable counsellors presiding over the group and meetings. And in the same way you wouldn’t ask your butcher for cake decorating advice- a mom who only breastfed for a month and then formula fed isn’t the best bet or peer supporter to assist you with lactation problems.
What are some common misconceptions about breastfeeding that you’d like to address?
That it has to be very difficult and challenging and oh so hard and painful! Yes, breastfeeding is hard work. But it’s also rewarding work, stimulating work, deeply satisfying work. It will stretch you as a person and as a mother. With the right information and the right support, there doesn’t have to be a struggle from the start. Moms that are prepared find their journeys a lot smoother than those who go in blind! It’s very very rare medically that a woman isn’t able to breastfed.
True medical reasons for inability to breastfeed really only account for 3-5% of cases. In most cases problems are easily solved with support and the correct info on infant feeding.
Also, you can eat everything. *wink*. Unless your baby has food allergies to the usual culprits like dairy, wheat or so, there’s biologically no way the gas created in your stomach from digesting onions or broccoli can travel into your bloodstream where milk is made from, into your breasts, into baby’s stomach and magically cause gas and cramps there. We have never as a species needed to follow special diets to breastfeed. Go have that curry please and dankie.
What advice do you have for mothers who may feel overwhelmed by the pressure to breastfeed,
especially when they face challenges like biting, low milk supply, or personal health issues?
As little as 60ml of breastmilk a day has lifelong health benefits. Literally every drop counts. Every moment of nursing matters and shapes your baby forever! There is so much help and support available if moms are willing to reach out.
Can you share one of the most rewarding moments you’ve had in your work as a lactation consultant?
Wow, every moment is rewarding! Small victories – a baby latching for the first time after weeks of breast refusal. A mom realising she doesn’t have to keep cutting out tomatoes and onions out of her diet and eating her first postpartum burger! Spotting signs of tension, having baby get some bodywork done, and boom, suddenly nursing well. Lactation work is a bit like being a detective – when you and the mother finally solve the mystery together, it’s very satisfying!
What are your top tips for mothers starting their breastfeeding journey, especially in the early weeks of postpartum?
Talk to other women who breastfeed / have breastfed successfully! Having realistic expectations of biological baby behaviour is so important. There are marked differences in the feeding, soothing and sleeping habits of breastfed Vs formula fed babies. Your breastfed baby can’t thrive on the same schedule (or volume of milk) as a formula baby. It’s a whole different game!
Also, enlist the village and be open to help. Breastfeeding in the first few weeks is a full time job, and the more meal trains and housework you can get taken care of, the less pressure on you so you can only focus on completing the very important and often overlooked Fourth Trimester.
Where can mothers find additional resources or support if they’re struggling with breastfeeding?
Apart from professional help from certified lactation specialists doing your own research to empower and inform especially with breastfeeding can set anyone up for success.
My favourite two resources are run by IBCLC’s. Nadine Theunissen is a Saffa who now resides in NZ and covers literally every topic one could ever wonder about. Her site is https://evidencebasedbabies.com
Another favourite is by the well known Kelly Bonyata – https://kellymom.com/.
