Tuesday, June 13, 2017

Things To Know About Storing Breast Milk For A Flight


A horror story about a mom being forced to dump her breast milk in an airport is circulating on Internet. It reminds me about the two years when I was breastfeeding. I travel frequently for work and flew a few times with my breast pumps during that two years. My impression is that traveling as a breastfeeding mom can be challenging, but not impossible. Most agents do understand breast milk security procedures, and mothers should be good if they know the TSA guidelines in regards to breast milk storage.

Here are several things to keep in mind when carrying breast milk on a flight.

Travel with an unlimited quantity of breast milk
According to the TSA guidelines, you can bring as much breast milk as you want. I once flew with a whole gallon of breast milk from Phoenix to Los Angeles, no problem at all.

Declare breast milk to agents
You can travel with as much breast milk as you want, but TSA guidelines recommend you inform a TSA officer at the beginning of a screening process. Alerting agents ahead of time makes the process smoother and faster for everyone involved.

Breast milk will be inspected
Your breast milk may still be subjected to the X-ray machine, but if you don’t want it to go through there you can request an alternative screening method. I tried the alternative method once at the Austin-Bergstrom International Airport. It includes a pat-down and was time-consuming. Personally I prefer they just run my breast milk through the X-ray machine.

Bring small coolers and ice packs
Accessories to keep breast milk frozen, partially frozen, or in a cool state are permitted per TSA guidelines. I always bring a personal cooler with ice packs. Yon can ask a flight attendant for ice if you forget.

Store breast milk safely
The best way to transport breast milk and keep it fresh while traveling is in sealed containers kept in a small, insulated cooler with frozen ice packs. The breast milk should be used within 24 hours. If you won’t be using your milk right away it should go in a refrigerator or freezer as soon as you get to your destination. Always make sure label your breast milk bags with the date you pumped.

Moms don’t have to travel with their children to have breast milk
As explained on the TSA website, you don’t need to have your baby or child with you to travel with breast milk. I often travel for work with my breast pump and breast milk, but not with my child. 

Breast pump doesn’t count as a “carry on”
When bring your breast pump you don’t need to cut it as part of carry ons. Breast pump is considered a medical device and won’t need to be counted. But you should be prepared to keep telling agents that it’s a medical device. However, cooler does count as one of your carry ons. Personally I just bring the pump as a personal item and the cooler as a carry on.

*This is an original post for SDCBC by To-wen Tseng

Monday, June 5, 2017

Raising a bilingual child while losing my accent

Serving as a substitute teacher at my local Chinese-language school.
I’ve served as a judge at some local children’s Chinese-language speech and/or recitation contests on several occasions. I still remember my first time. I saw a little boy in a suit and tie, speaking with a crisp voice, saying, “Summer is my favorite season because the sunny days are cheerful and inspire me to do great things for my people.” When speaking, he raised his two fists high in the air.

Then I saw a little girl in a dress and high heels, with a clear voice she said, “Winter is my favorite season because it reminds me the Chinese fairy tale ‘Snow Child,’ a story that describes the noble sentiments of Chinese people.” Then she wiped her eyes in an exaggerated way.

These children were all born in the States, of Chinese descent. It was surprising to see they speak Chinese in such crisp and clear voices. But the speech content was very confusing. I really wanted to ask the girl what she meant by “the noble sentiments of Chinese people,” or the boy what the “great things” he was going to do for his people. I’ve got the impression that most of the scripts were written by parents.

After the young children spoke, the older kids stepped on the stage. Next, I saw a couple of teenagers in T-shirts and shorts hesitantly walked up, muttering things like, “We should respect our teachers, because…because Chinese people believe in their teachers, well I’m American, not Chinese, but…oh well, let’s just respect our teachers” or, “We should respect our parents because…because they are too old to understand anything we say…let’s just listen to them when we are home.”

It was funny to see young people with apparent Chinese appearance speaking with such strong American accents--so strong that I could barely understand most of them. Nine out of ten parents sitting in the auditorium frowned, clearly not enjoying the speech. Were they sad because their teenagers were not speaking Chinese as well as they had in elementary school? Were they worried because their children’s speech was not good enough to get them into college?

While considering how to score, I thought of my own child. He was then nine month old. I couldn’t help it but wonder whether he would be able to tell the fairy tale Snow Child in fluent Mandarin Chinese. Will he become an American kid with an American accent and complain “Mom is too old to understand anything I say”?

I frowned, like all the parents in auditorium.

In my family, we speak Chinese at home and English at work or school. My son was a late talker, but our pediatrician comforted us, saying that although bilingual kids can be slow to speak at the beginning, they usually catch up quickly. He encouraged us to insist on speaking Chinese at home.

We tried to create a Chinese-only environment at home with the hopes that the my son's first word would be a Chinese word. But the hope came to naught. His first word was an English word he learned at daycare: “Daddy.” This was my first failure in raising a bilingual child. In spite of this, we continue to speak Chinese at home. Every night we read bed time stories together in Chinese. By the time he turned three, my son could speak fluent Chinese, could tell Snow Child and many other fairy tales without help. I was very proud.

But my pride didn’t last for long. Just a couple of months ago, his preschool teacher told me that he had a hitting problem. The theory was that because my son didn’t speak English as well as other kids, his ability to stand up for himself in arguments was limited, and he turned to physical means of expressing himself.

The teacher suggested that we set an “English time” at home to help my son improve his English. I didn’t like the idea: the more I exposed him to English, the less chance he got to speak Chinese. Didn’t he speak a whole lot of English at school already?

But the hitting problem got worse. After consulting our pediatrician and therapist, I finally gave in and started a daily English story time at home. Kids are really like sponges, and his English improved in no time. He stopped hitting his preschool classmates, but his Chinese language skills went backwards.

I started to understand why I would keep seeing the same thing at Chinese speech and recitation contests: the younger the children are, the better their Chinese language skills as. I started to understand my hope of raising a bilingual child fluent in Chinese might once again come to naught.

I worked as a staff writer at a local Chinese-language newspaper when I was young. Many times, I interviewed outstanding second or third generation Chinese-Americans. When I asked them for a Chinese name for publishing purpose, they often said, “I don’t remember my Chinese name.”

A Chinese-American anti-death penalty activist once “drew” down her Chinese name for me after an interview. I couldn’t read the symbols she had drawn. I tried to guess and wrote down two characters next to her drawing. She read my writing and happily announced, “Yes, that’s my name!”

The article was published the next day. I got a phone call in the newsroom. On the other side of the phone was an old lady speaking Chinese with a sweet Beijing accent. She identified herself as the mother of the anti-death penalty activist, and said that I had gotten her daughter’s name wrong. I apologized, and she said, “That’s okay, I understand. My daughter must made the mistake herself. She never remembered her Chinese name. But I just want to let you know.” Then she was silent. “Hello! Hello?” I said, wasn't sure if I should hang up. Then she started to talk again, asking me where I was from, if I’m married, and if I had children.

At that time I was married but no children yet. The old lady said earnestly, “Take my advice. When you have your own kids, always speak Chinese to them.”

“Sure, sure,” I said, just saying that to make her happy.

Through the years I’ve seen many second generation Chinese-American kids struggling to learn Chinese. Since having my own kid, I often think of the old lady and her daughter who couldn't remember her own Chinese name. The thought is almost painful.

It’s not just the America-born children who are struggling. The away-from-home adults are also struggling. I’m a professional writer who was born to Chinese parents and raised in Taiwan, but who spent her entire adulthood in the States. I struggled to improve my English during my first years in the States. Now I write English more then Chinese. I can see clearly that I no longer speak Chinese as well as I used to. When I was in my twenties, I was eager to get rid of my Chinese accent. Now I’m desperate to maintain my Chinese language skill.

My son will soon be four, old enough to go to Chinese language school. I decided to let him start this fall. He didn’t like the idea of going to school on weekends and asked, “Why do I have to learn Chinese?”

I didn’t know how to explain the concept of culture to a toddler. I just told him, “So you can read ‘Journey to the West’.” The other night I read him the chapter “Monkey Subdues White-Skeleton Demon” from the classic novel. He wanted to know if the Monkey eventually returned to his teacher Xuanzang. I wouldn’t tell him. I told him that he’ll read it one day by himself.

I still hope to raise a bilingual child who speak fluent English and at least understandable Chinese. I don't expect him to love Chinese language right away. Language is always first a tool and then an art. I hope my son will first learn how to use the tool, and then, maybe one day, he’ll truly fall in love with the art.

This is an original post for a World Moms Network by To-wen Tseng. Photo credit: David Sprouse. 

Friday, June 2, 2017

I pumped here and there

The best place I pumped.

According to a study published in the journal Women’s Health Issues, 60% of pumping women don’t have basic workplace accommodations or adequate break times.

That’s no news. I personally have pumped in many weird places. I returned to work three month after giving birth as a staff writer at a Chinese-language newspaper based in Los Angeles. The company didn't have a nursing room, even though California law requires appropriate reasonable space for pumping.

I pumped in the restroom. When there is a line in the restroom, I pumped in my car. When the weather is too warm or the pump battery is too low, I sat on the floor under my office desk to pump, covering by a jacket. Some male colleagues claimed that I distracted them by sitting under my desk. Later a female colleague helped me to hide in the company storage to pump. It’s dirty in the storage and there were dead cockroaches on the floor, but I am forever grateful for her help.

My job requested frequent travel. Never a time during my entire life that I loved business trips that much. For that’s the only time I got to pump at decent places like an airport nursing station or a hotel room. Collecting and transporting breast milk while traveling is challenging, but not as challenging as sharing pumping room with roaches.

I eventually quit my job and sued the newspaper for sex discrimination. In spite of my effort of hiding myself when pumping, I was harassed. When I washed my pump parts in the kitchen, some of my colleagues would say, “don’t wash your dirty panties in the office.” I reported this to Human Resources, but they never dealt with it. I discussed the possibility of having a space to pump with my supervisor, but was told “nobody ever pumped in the office. We are Chinese company and we don’t follow American rules.”

The suit was settled and one thing I didn’t agree was confidentiality. They wanted to pay me for not talking about this incident again which I refused. Other than that I’m happy about the agreement, it requires the company to change its policies regarding lactation accommodations and to share these policies with staff in multiple languages. Moreover, all supervisors will be trained on the policy and how to respond to requests for lactation accommodation.

I hope I would be the last mother who had to quit her job and go through a law suit simply for a reasonable place to pump. We can do better. Please join me and sign the petition that support all breastfeeding and working moms.

And MomsRising just launched #IPumpedHere campaign that demand to bring breastfeeding women into the pumping rooms they deserve. This campaign kicked in right on time because with the Affordable Care Act (ACA) being repealed, the situation can be worse for millions of working and breastfeeding moms. Please visit IPumpedHere and see what you can do to help your employer help you, and help other women pumping in a bathroom stall, inside a car, or under her office desk.

This is an original for MomsRising.org by To-wen Tseng. 

Monday, May 22, 2017

Baby-Friendly Hospital Initiative Practices: Challenges and Strategies

Left to right: deVigne-Jackiewicz, Wight, Fletcher and White.

There has been lots of discussion about Baby-Friendly Hospital Initiative, a global initiative of WHO and UNICEF. How mommy-friendly is the Baby-Friendly Hospital Initiative? Is the breastmilk-only mandate putting babies in danger?

SDCBC’s recent Spring Mini-Seminar focused on this hot topic. Dr. Nancy Wight (MD, FAAP, FABM, IBCLC), Rose deVigne-Jackiewicz (RN, MPH, IBCLC), Ruth Fletcher (BSN, RN, IBCLC) and Nancy White (BSN, RN, IBCLC) talked about the challenges and strategies practicing Baby-Friendly Hospital Initiative.

What most think of when BFHI is mentioned is the famous 10 steps:

  1. Have a written breastfeeding policy that is routinely communicated to all health care staff. 
  2. Train all health care staff in the skills necessary to implement this policy. 
  3. Inform all pregnant women about the benefit and management of breastfeeding. 
  4. Help mothers initiative breastfeeding within hour of birth. 
  5. Show mothers how to breastfeed and how to maintain lactation. 
  6. Give infants no food or drink other than breastmilk, unless medically indicated. 
  7. Practice rooming in—allow mothers and infants to remain together 24 hours day. 
  8. Encourage breastfeeding on demand. 
  9. Give no pacifiers or artificial nipples to breastfeeding infants. 
  10. Foster the establishment of breastfeeding support groups. 

However, there are “problems” with the 10 steps, especially when it comes to medically fragile infant. A normal infant should loss no more than 8% of his birth weight by day 4 after birth. Certain conditions would make acceptable medical reasons for the use of breastmilk substitutes. The goals of supplementation is to establish and maintain a mother’s milk supply. Skin-to-skin and putting babies to mothers’ breasts are important even when using supplement. Research shows that through practicing in breastfeeding, mothers are giving an active and meaningful role in the NICU, which can build confidence and enable parents to handle their infants.

Baby-friendly in the NICU is possible, though there are barriers and difficulties. A Neo-Baby Friendly Hospital Initiative for neonatal wards has been established. There are three guiding principals: Staff attitudes toward the mother must focus on the individual mother and her situation. The facility must provide daily centered care. The health care system must ensure continuity of care from pregnancy to after the infants’ discharge. Lack of lactation support and mother-baby separation are some of the main difficulties when practicing baby-friendly in NICU. Parents education, access to pumps and other tools, and Increased lactation support can be the solution.

Even in daily nursing practice, there are challenges of maintaining BFHI. There are sociopolitical barriers such as patient mix. There are organizational barriers such as hospital policies. There are individual barriers. Personal bias and experience, lack of breastfeeding skills and knowledges among new nurses are all issues. We need cultural strategies, family strategies, patient and family education strategies, and staffing strategies to overcome the barriers. Take time to understand mother’s viewpoints and beliefs. Ask family members their opinions about the importance of breastfeeding. Manage expectations, starting with antenatal education. It’s also important to address staff personal bias.

This is an original post for SDCBC by To-wen Tseng. 

Thursday, March 23, 2017

Highlights of California Breastfeeding Summit



Themed “California Dreamin,” this year’s California Breastfeeding Summit took place at Anaheim, CA in January. At a recent San Diego County Breastfeeding Coalition’s general meeting, the coalition’s Kim Speckhahn (BS, IBCLC), Kimberly Elkins (EdM, IBCLC) and Dr. James Murphy (MD, IBCLC, FABM, FAAP) shared what they took home from the Summit.

Camie Jae Goldhammer (MSW, LICSW, IBCLC): Culture,Trauma and Breastfeeding

Goldhammer explained how culture, trauma and breastfeeding all connected. She worked 11 years as MSW with intergenerational trauma in National American population. In mainstream culture, breastfeeding is seen primarily as a health choice. But in Native American culture, it’s been lost. Galdhammer’s family is an example. Her family’s history of five generations of women endured the shared trauma experienced by Native American population, by the time she was born, her ancestral parenting models had all but disappeared. Breastfeeding didn’t happen. She learned to breastfeed after her birth and that was the beginning of the healing and reclaiming of breastfeeding in her family. She has been serving families families with complex trauma histories since then. She believes that trauma may have been a weapon of mass destruction, but breastfeeding is a weapon of mass construction.

Collen Weeks (LCCE, FACCE, CLE, CSE, RTS): Adverse Childhood Experiences (ACEs) and their impact on Breastfeeding and Breastfeeding’s Impact on ACEs

ACEs impact more than 1 in 3 of the breastfeeding families that Weeks takes care of at Kaiser Permanente Hospital. These are serious traumas that result in toxic stress and can harm children’s brain and prevent learning. ACEs can include emotional, physical or sexual abuse, emotional or physical neglect, mother treated violently, household substance abuse and more. Exposure to childhood ACEs can increase the risk of adolescent pregnancy, alcoholism, depression, drug abuse and heart disease. It reduces one’s ability to respond, learn or figure things out, increase stress hormones which affect body’s ability of fighting infection, lower intolerance for stress. The good news is, resilience can trump ACEs and bring back health and home. ACEs is a really sensitive issue. When teaching resilience, Weeks recommended:

  • Gently address parents and how they may impact breastfeeding or how breastfeeding may impact them. 
  • Initially discuss the issue with the mom when alone with her; follow her lead as the topic comes up. 
  • Be positive and encouraging.


Tista Ghosh (MD, MPH): Marijuana and Breastfeeding

Ghosh is the Deputy Chief Medical Officer atColorado Department of Public Health & Environment. The State of Colorado legalized Marijuana in November 2012. In 2014, 11.2% Colorado women were reported using marijuana prior to pregnancy with a high using percentage among childbearing aged women, 5.7% women reported using marijuana during pregnancy, and 4.5% reported using marijuana lactation. It does create more headaches for the medical community. There is no known safe amount of marijuana use during pregnancy, but THC (the chemical responsible for most of marijuana’s psychological effects) can pass from mother to the unborn child through the placenta. Also, maternal use of marijuana during pregnancy is associated with negative effects on exposed offspring, including decreased academic ability, cognitive function and attention. Effects may not appear until adolescence. THC can also be passed from the mother’s breast milk, potentially affecting the baby. There are moderate evidence showing that maternal marijuana use during pregnancy an breastfeeding can decrease growth in offsprings. For more information on the 2017 California Breastfeeding Summit, please visit http://californiabreastfeeding.org/annual-summit/2017-summit-program-presentations/

This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng. Image courtesy California Breastfeeding Coalition.