Thursday, March 7, 2019

What I Learned from a Biopsy while Breastfeeding

Breastfeeding after a breast biopsy (from the breast that being biopsied!)
Last month, I discovered a suspicious lump in my left breast through a breast self-exam. After ultrasound my doctor decided that the lump must be biopsied for assessment.

In the evening before the biopsy, looking at my left breast in the mirror, I realized that I don’t worry about cancer—I have a strong family history of breast cancer; I’ve been seeing and hearing close ones being diagnosed with breast cancer ever since I was a little girl; I am well prepared psychologically. I realized that, however, I worry about my future ability of breastfeeding.

Jasper was 16-month-old and still being breastfed. My plan was to breastfeed for at least 20 months, ideally two years. My doctor told me that I don’t have to wean before the biopsy and my ability to breastfeed after the process depends on the extent of the biopsy. After that, it really depends on the test results of the biopsy.

It’s hard to find breastfeeding-friendly information on this topic, so I turned to several of my trusted IBCLC friends for their opinion. Most of them didn’t see any reason I cannot breastfeed after a biopsy unless the test results found otherwise. I was relieved.

This was what I learned: needle biopsies, including fine needle aspiration and core biopsy can be done on a breastfeeding mother. The smallest needle that will get the diagnosis should be used, and the risk of milk fistula, which is chronic milk leakage, is very rare.

The evening after the biopsy—or eight hours after the biopsy, to be precisely—I was holding Jasper, breastfeeding as usual. I felt grateful. It still felt sore in my left breast and Jasper was curious about the surgical glue over my incision. He tried to peel it off so I had to put another bandage on top of it. Other then that the biopsy barely caused me any problem in breastfeeding. I felt so grateful.

As this article being written, I was still waiting for the results for the biopsy and not sure how much longer I’ll be able to breastfeed. For now, I just wanted to cherish the time with my baby while I still can. Meanwhile, I realized that breastfeeding is such a gift—both for mom and for the baby. It is a shame that there are still mothers who are completely healthy with breasts fully capable for breastfeeding being drove to infant formula due to breastfeeding-unfriendly environments. Mothers have the right to breastfeed their babies and deserve fully support.

I also realized how hard the feeling can be for a mother who may not be able to breastfeed due to disease. All in a sudden I was even more proud of myself being a breastmilk donor (before the lump was discovered) at the Mother’s Milk Bank. It is my sincere wish that one day all the mothers will be able to breastfeed as long as they want with the fully support from the society as a whole. And all the babies will be able to receive donor’s milk when the mother’s milk is not available.

*This post originally appeared on San Diego County Breastfeeding Coalition's Newsletter on March 7, 2019. Photo credit to Mu-huan Chiang.

Thursday, February 21, 2019

Breastfeeding Discrimination at Workplace is Real

When I returned to work as a staff writer at some newspaper in Los Angeles, I sat on the floor in a bathroom stall to pump breastmilk for my then 3-month-old son while my colleagues went to the bathroom, pounded on the door and occasionally complained about me occupying the stall. It was the only outlet I could find in a private location since there wasn’t a nursing room available. The incidences eventually resulted in my separation with that company. Based on a completely unscientific poll on social media, my experience was either unusual or the worst of it among breastfeeding moms returning to work after their child’s birth.

But based on a new, actually scientific study, I would have been in the company of more than half of women who alleged their employer did not provide workplace accommodations for them as nursing moms. In fact, a whooping two-thirds of cases alleging breastfeeding discrimination over the past decade led to the employee losing her jog, the first-of-its kind study found.

We’ve long known that when employers fail to provide adequate accommodations for breastfeeding, it creates health risks for nursing employees and their babies. Now we know the damages can actually extend to mothers’ livelihoods.

“We’re experts in the field, and we were shocked by what we found,” Liz Morris, a co-author of the report and leader of the Nursing Mothers Law Project through the Center for Law at the University of California, said in an interview with Fortune.

Breastfeeding discrimination includes all manner of offenses: denying break requests from employees who are in pain and leaking milk, firing workers for asking for breaks, refusing to provide privacy for workers who need to pump breast milk, and sexual harassment as others in the workplace comment on employees’ breasts. The Affordable Care Act was supposed protect workers with a clean place to pump, 15-20 minute breaks to do so, and a change in duties or temporary reassignment if necessary. But according to a 2016 study, employers routinely break the law when it comes to breastfeeding moms.

For example, one police officer in the study was unable to wear a bulletproof vest while breastfeeding, but was denied a temporary desk job.

Because of these discriminatory consequences, nursing mothers end up weaning earlier than doctors recommend, with a diminished milk supply, or with painful infections—the health risks often associated with the lactation discrimination.

It is unfortunate. Putting more effort into meeting nursing employees’ needs not only benefit moms and babies, but has an upside for companies, too—in addition to the legal high ground, employers end up with cast savings from improved employee retention, reduced sick time, and lower health care costs when they provide what breastfeeding employees need up front.

To learn more about the business case for accommodating breastfeeding, lick here to sign up the “A Right, Not a Privilege,” SDCBC’s mini-seminar on breastfeeding and the law.

Read more: The best investment you will ever make are your employees

*This post originally published on San Diego County Breastfeeding Coalition's Newsletter on February 15, 2019.

Thursday, February 7, 2019

Governor Newsom Proposed Giving Parents Six Months Paid Leave

Exciting news for Californian parents—Governor Gavin Newsom announced that he hopes to expand paid family leave to six months in California! Here at San Diego County Breastfeeding Coalition, we are happy to start the new year with needed attention given to the dilemma faced by new parents when forced to choose between paycheck and providing optimal bonding for their child(ren).

“This is a necessity–we all know that the first few months are so important for bonding, attachment, and development of a newborn, not to mention it is a crucial time for mothers to establish breastfeeding during the initial weeks. Families should be able to spend this time with their baby instead of worrying about having to rush back to work,” said Nancy Saavedra, MPH, CELE, the current president of San Diego County Breastfeeding Coalition.

The plan, part of our governor’s $209 billion budget plan, would compensate new parents up to 70 percent of their wage when they take off to care for a newborn or newly adopted baby. Two parents or caretakers would be allowed to take advantage of the program for up to three months each.

It’s a major upgrade to the state’s current paid family leave policy, which provides up to only six weeks of partial pay for employees as part of the state’s Disability Insurance and Paid Family Leave Program.

I have first hand experience on the importance of paid family leave for diverse families. I took advantage of the current paid family leave after my first child was born. During the six weeks, I bonded with my baby by breastfeeding him as often and as long as possible; I also built a very good milk supply. By the time I went back to work, I had more than one gallon of breast milk stored in my freezer. With that storage, I was able to continue exclusively breastfeeding even facing challenge related to pumping at work.

I also have first hand experience on why we need an even longer paid family leave. On the day my second child turned 6 weeks old, both my husband and I went back to work under the current paid leave policy. My husband immediately flew to Asia for a week-long business trip. That was a miserable week for our family. At that time, the baby still eats every two to three hours, and sleeps only a few hours at a time, day or night. Breastfeeding became much harder when my partner was not around to help.

Even with the exciting proposal in works, as CNN reported, the United States is still behind what is offered by most developed nations around the world. And we are lucky to live in California, as most states don’t even have the protections and benefits that we are entitled here. The United States is the only developed country in the world that doesn’t guarantee paid time off to new parents. In fact, according to data compiled by the Organization for Economic Cooperation and Development (OECD), the U.S. is the only country among 41 nations that does not mandate any paid leave for new parents.

Still, we are excited about the Governor’s proposal—As they say, baby steps. San Diego County Breastfeeding Coalition is committed to continue the fight for working families’ rights and support for breastfeeding families. We thank Governor Newsom for looking for bold solutions and recognizing the need for California families to have adequate time to care.

Watch the video I produced for World Moms Network: Things I wish My Boss Knew About Maternity Leave

*The post originally appeared on San Diego County Breastfeeding Coalition's Newsletter on February 1, 2019. Photo credit to Bella Baby Photography.

Monday, February 4, 2019

No Candy Rewards in Classrooms, Please

I like to satisfy kids' sweet tooth with healthy homemade snacks. 
It makes me very uncomfortable when I learned some teacher of 
my 5-year-old is giving out candy rewards.

A while ago, a teacher from my 5-year-old son’s Saturday Chinese School gave out candy rewards. My husband and I felt uncomfortable about this.

We have opinions about candy. I don’t eat candy. I don’t spend my grocery money on candies. With that being said, there is no candy under my roof. When my children were offered candies, I say no for them before the they were three. When my first child turned three years old, I first taught him what candy would do to him, and then taught him how to turn down unhealthy foods. However, at special occasion like some kids’ birthday parties, or when my child occasionally crave sweets, I wouldn’t completely forbid it. Sometimes I gave him a doughnut or ice cream treat, but no more than once a week. Everyone in the family knows that sugar intake should be limited.

Occasional candy is acceptable, but there is one thing that I strongly against: candy rewards. I disagree using candy as a reward, or holding candy as a punishment. I believe that food rewards is generally an unhealthy idea, for adults or children. Giving candies as rewards while telling children “this is bad for you” is especially confusing. Research shows that children who receive candy rewards tend to overeat, which leads to over weight and increases the chance of getting type 2 diabetes, high blood pressure, heart disease, stroke, cancer, respiratory problem and even Alzheimer’s disease. Another research proves that to young brain, the effect of sugar is surprisingly similar to the effect of nicotine, heroin, cocaine and other drugs. It is addictive.

Luckily, I am not alone. American Academy of Pediatrics and Centers for Disease Control and Prevention has been warning about candies. A federal regulation requested all the school districts to update their wellness policy regarding this. At our school district, the wellness policy actually states “Non-food items are recommended as incentives and rewards. Candy and soda are not permitted.” Thank the policy, ever since my son entered kindergarten, we never need to worry about candy rewards problem.

To my surprise, the problem happened despite the clear text that against food rewards.

I reached out to the teacher and explained that why we don’t want candy rewards. I further offered her stickers and small stationary items as rewards to replace candies.

I thought it was easy fix. But I was wrong. The teacher was furious. In a painfully long e-mail, she complained about not being appreciated, insisted on giving out candy rewards, but “your child won’t get any.”

My husband and I were very disappointed. Teachers have every rights to turn down an offer from a parent, but not the right to ignore school district’s policy. I was happy that she would stop “candy bribe” my child, but on the other hand, I felt that she didn’t see cay rewards as a problem and is getting revenge on parents holding different opinion by picking on child.

I talked to other parents and found the same thing happened to other children before. We then decided to bring the problem to the principal.

At I writing this article, the teacher is no longer my son’s teacher. I’m relieved. But more than that, I wish a healthy learning environment without unhealthy food rewards for all American children.

*This post originally published on Photo credit to the author.

Thursday, January 24, 2019

Born and Raised in Taiwan, I Actually Like How Americans Judge Parents

When my second child was six weeks old my husband had a business trip to Asia for one week. One evening when I was breastfeeding the baby, my first child demanded me to pick him up and carry him to the toilet, “Mom, I need to pee, now!”

I couldn’t figure out how to deliver a 4-year-old child without interrupting the feeding. Plus, the 4-year-old was perfectly potty trained. So I told him, “Come on, honey, you know how to do it by yourself. I can’t pick you up now. I’m feeding DiDi.”

“No, no, no! I want you to take me!”

“I can walk you down the hallway.”

“No, no, no! I want you to pick me up!”

I didn’t know what to do. My husband wasn’t home to help. I was tired. Now I was trying to nurse my baby to sleep while my young child throwing a tantrum, which really adds in salt to injury when being sleep-deprived.

Then he peed his pants and had a meltdown.

“Honey, honey, that’s okay!” I tried to calm him down, “We all have accidents. Now you take your pants off and wrap yourself in this towel. Then come sit with me. We’ll clean you up once DiDi are done eating.”

But he was crying like his head is being cut off. He cried too hard to hear me.

The baby finally fell asleep. I put him in his crib. Then I picked up the crying child and cleaned him up. He must have been crying badly, because when we were in the shower, I heard the doorbell.

A police officer stood at my door and asked if everything was alright in the house.

“Yes, yes,” I told him, “My child had a meltdown. But we’re good now.”

He asked me a couple of questions to make sure I was okay. Then he wished me a good night and left.

One of my neighbors called 911 and reported the cry. Realizing that, I actually felt peace, knowing someone cares about what’s happening in my house.

I was born and raised in Taiwan. At about my son’s age, I was beaten up by my parents almost every day. There was always crying, often blood. But no one ever showed up at our door and asked if everything was alright. Our neighbors looked at me pitifully when I walked home from school. Then they turned around and chatted in low voices. I could tell that they all know something was happening in our house. Yet no one ever asked.

I finally escaped from the horror. I fled to America, left behind an irritable father, a depressed mother, and an anxious sister.

I finished journalism school in America and became a journalist. I write about parenting, education, family lifestyle, maternal and infant health. Currently serving as the US correspondent for a Taiwanese parenting magazine, I frequently write about how people in America parent differently from people in Taiwan.

Last year, a Taiwanese couple posted prank videos with their kids on Facebook. In the video, the parents scared their 5-year-old and 3-year-old with a vacuum machine until the kids cried. After trying to fight back and protect his little brother, the 5-year-old was spanked by the dad with a clothes hanger. The video angered its audience, but nothing happened to this couple.

At about the same time, the controversial American Youtubers “DaddyOFive” were sentenced to probation for similar videos with their kids. I wrote about the case for the magazine. A Taiwanese pediatrician commented, “Many young lives could be saved if only we judge parents like Americans do.”

I could have escaped from the horrible domestic violence much earlier if my parents were being judged. My sister didn’t have to suffer from anxiety disorder if my parents were being judged.

In 2016, 16 children under six died in car accidents because they didn’t use car seats (Jing-Chuan Child Safety Foundation, 2017). There is a car seat requirement, but no one would say anything if parents don’t use car seats or leave their children in a car alone. Those 16 children didn’t have to die if their parents were being judged.

Three years ago in Taiwan, I saw a father slapped his toddler in a restaurant. At the scene, I seemed to be the only one who was shocked. Others shushed me, “it’s none of your business to judge other’s parenting.” I silenced. I still feel bad after three years.

That night when the police showed up at my door and questioned my parenting, I knew I was being judged. Being judged doesn’t make me feel like a terrible mother, as long as I know I did nothing wrong. I don’t feel attacked or ashamed for being judged. I feel safe, knowing we, as parents and a whole-of-society, are watching each other. And by so doing, we protect our children.

*This post originally published on World Moms Network. Photo credit to Mu-huan Chiang.