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Circles of Support

From: LEAVEN, Vol. 44, No. 3, 2008, pp. 14-15

Circles of support are used in conjunction with the 2008 World Breastfeeding Week (WBW) theme to represent the types of support a breastfeeding woman can call upon for help and encouragement. Circles of support overlap, interact, and strengthen each other, with the center circle (women) as the focus. Women rely on support from: family and social network, workplace and employment, response to crisis or emergency, government/legislation, and health care.

The following articles are written by LLL Leaders to demonstrate that Leaders around the world play an important role in supporting women, and have a strong influence in the various circles of support. These articles (as well as additional ones) were written in honor of World Breastfeeding Week 2008 and are available in English and Spanish at


Jill Tyson

Women helping other women -- women educating themselves, asking questions and seeking more information -- women who are not accepting the mainstream status quo without inquiry: these are foundational components of La Leche League International. The seven women who started LLLI in 1956 were questioning, inquisitive, and independent thinkers who not only found information and support, but also shared it.

Humankind is both instinctual and free-willed. Humans are created from birth to cry and seek nourishment to survive. Humans also have reasoning skills that allow them to question the norms of culture or environment. Although the level of potential will vary, depending on the particular culture, country, or even situation, all women want the best for their babies. With information and support, women are able to make decisions for their baby and their families.

Jane Tuttle, Chairman of the LLLI Board of Directors, said recently, "Through mother-to-mother support, La Leche League Leaders offer an informal support system that positively reinforces a mother's sense of accomplishment. LLL Leaders empower mothers to challenge cultural practices that inhibit breastfeeding. LLL Leaders help mothers to learn more, to be independent in their thought and to be reflective about their mothering."

By tapping into natural human energy and reasoning during childbearing years, women can find answers to their questions. As time passes, their confidence grows and women find opportunities to help other women become independent and resourceful.

My personal example demonstrates these points. Almost 20 years ago when I was pregnant with my first child, I began to read about breastfeeding and its benefits. I didn't have a mentor or another breastfeeding woman I could look to for guidance. Yet, something inside of me pushed....I read The Womanly Art of Breastfeeding with zeal. For nine months I studied intently. Looking back I cannot explain why I was so passionate and determined, other than the fact that the power of human reason came to the forefront as I sought to do the best for our growing family and our first child.

After my son's birth, my newfound knowledge was put to the test. I was bombarded by advice, and since I was a novice, I tried to listen. Nine months of preparation helped me to handle the many well-wishers and professionals who tried to get me to supplement, watch the "time" my baby was at the breast, get back to a "normal" schedule, and more. I attended my first La Leche League meeting after the birth of my son. After the meeting, I knew exactly where to go and who to call for answers. This group of experienced mothers had years of wisdom behind them and were living proof in my own "neighborhood" that babies can and do grow on mother's milk alone. They stood against societal pressures, and I knew that I had found a common purpose and universal connection.

My personal story provides evidence for the statement that women are not passive bystanders in the arena of breastfeeding support. Although there are situations when experts in a particular topic or area are needed, it isn't necessary to be an expert for mothers to encourage one another in mothering through breastfeeding. If women are willing to offer their own experience and support, and reclaim the right to share mother-to-mother as common human history teaches, it will make a huge difference to new mothers.

The tradition of mother-to-mother support needs to be remembered, encouraged and continued. Women helping women contributes to the well-being of families worldwide. Women and mothers can and do make a difference!

Health Care

Carolina Tredinick
Translated from Spanish by Priscilla Stothers, Dominican Republic

In the 1940s, during the infant formula "boom" and the technological revolution, breastfeeding rates decreased. The use of formula impacted the medical world, as physicians began to promote this new form of feeding infants and young children. When La Leche League International was founded in 1956, the seven Founders knew they needed the support of the medical community. Fortunately, they had the support and counsel of two physicians: one a Founder's husband and the other a close friend.

Since its founding, LLLI has worked closely with and counted on the support of physicians from all specialties: pediatricians, obstetricians, and family practice. LLLI works with physicians on the Health Advisory Council who are consulted when advice is required, such as with the review of articles to be published. LLLI also organizes Physician Seminars, cooperating with medical organizations such as the American Academy of Pediatrics, and sponsors the Medical Associates Program (MA). La Leche League Leaders identify and invite physicians to become MA members. LLLI workshop and conference programs include presentations by health professionals. The role of LLL, through its meetings, is fundamental to realizing an increase in the numbers of breastfeeding women.

When a mother asks for breastfeeding information related to a medical issue, the Leader calls on the LLL Professional Liaison Leader (PL). The PL accesses a network of medical professionals who serve as resources to La Leche League.

As a result, the mother receives information to share with her physician and a course of action can be taken that takes into account her desire to breastfeed as well as the medical diagnosis. The Leader also supports the mother in deciding what questions she should ask, as well as sharing contacts and resources that are helpful in her interactions with her physician.

Positive changes have been seen as a result of the collaboration of LLL and the medical community in the countries where LLLI is present. In Latin America, for example, Leaders in several countries actively work with the medical community to support mothers.

In Mexico, LLL has participated in Pediatric Congresses and shares up-to-date breastfeeding information through pamphlets and magazines with physicians that they, in turn, share with mothers.

In Colombia, LLL has published articles related to breastfeeding in a variety of communication venues, including the journal of the Colombian Pediatric Society and the newspaper El Tiempo. LLL Colombia also publishes Nuevo Comienzo (New Beginnings) a magazine dedicated to breastfeeding mothers, which is read by health professionals and mothers.

In Ecuador, Leaders provide human lactation courses for physicians and nurses in the Andina Simón Bolívar University and also work with the World Health Organization, UNICEF, the Ministry of Health, and others in a national breastfeeding promotion campaign. In Quito, LLL was invited to participate in a Human Milk Banking international seminar.

In Uruguay, LLL works with the National Lactation Committee and other nongovernmental organizations, and with international organizations such as UNICEF and the United Nations Development Programme, to promote breastfeeding.

In Venezuela, results are positive for breastfeeding since the passing of the Law for the Promotion and Protection of Breastfeeding. Hospitals are changing their policies to comply with the law, training their personnel in human lactation, informing mothers of the importance of breastfeeding and creating breastfeeding centers. Local Leaders and the mother-to-mother groups support these changes.

Thanks to the efforts of LLL Leaders, health professionals and other sectors of society, great strides have been made in many countries for breastfeeding. There is still work to be done for breastfeeding to become the norm, and LLL Leaders will continue efforts to protect, encourage, and promote breastfeeding, and recognize that mutual, respectful collaboration with health professionals.

Response to Crisis or Emergency

Jenny Perez-Genge

When a breastfeeding mother faces stressful situations out of her control, such as natural disasters, war or family crisis, nurturing her children can be altered completely. However, starting to breastfeed or continuing to breastfeed can help sustain her own physical and emotional wellbeing, as well as her family's.

In wartimes and natural disasters, international relief organizations support the most vulnerable persons, such as breastfeeding mothers, their babies, and small children. These organizations provide food, water, clothing, and shelter where mothers can breastfeed their babies. Many mothers find that the only food available for their babies is their own milk. These organizations also help by not promoting the use of formula, bottles, or baby food, or accepting donations of these items. Given the water and hygiene conditions in disaster situations, formula feeding is very risky.

In emergency situations, people worry about maternal malnutrition or are concerned that stress can reduce milk production. In fact, even a malnourished mother is capable of breastfeeding. She needs food, additional liquids, and most importantly, support and encouragement to nurse her baby frequently. Stress can affect the flow temporarily, so allowing the baby to nurse freely will help recover the normal flow. It is key to facilitate a safe environment, a breastfeeding room, a space for small children to play in, and provide opportunities for women to support each other.

In Japan, the 2004 typhoon flood and subsequent earthquake caused high levels of stress in breastfeeding mothers in the disaster areas. LLL Japan Leaders answered phone calls and emails from women who had problems such as insufficient milk supply or inhibited let-down reflex. They also collaborated with two other Japanese breastfeeding support organizations and quickly established a special committee. After intense discussion that lasted day and night, the committee published a joint communiqué and "Guidelines for Breastfeeding Counsellors." The main message to mothers was: Keep breastfeeding. (See Leaven, Vol. 41 No. 2, April-May 2005, pp. 38-39).

In 2005, Hurricane Katrina hit the USA coastline and left thousands of displaced people. The response from LLL Groups across the country created a wave of solidarity with coordinated efforts for collecting, storing, and distributing donations of clothing, toys, and households items. In addition, LLL Leaders helped mothers to overcome breastfeeding difficulties. Moreover, LLLI gave replacement sets of breastfeeding handbooks, informational material, and office supplies to Leaders and administrative personnel affected by the hurricane.

A mother from Mississippi, USA recounts that during and after the hurricane, breastfeeding her two children (six months old and three years old) helped them survive and find comfort in each other: "My exclusively breastfed baby stayed hydrated in the sweltering heat. I did not have to worry about mixing formula at a time when we could not shower or flush a toilet." She adds: "My three-year-old decided to nurse again for that brief time, and we were able to share that comfort."

After the devastating earthquake in China in May 2008, LLL Leaders translated and prepared information about breastfeeding in emergency situations and mothers' stories to share with women in Sichuan, one of the most affected places. When a traumatic situation or medical crisis disturbs the daily dynamics of home life, breastfeeding can help the family as a whole to ease the difficult time.

The work of LLL Leaders in emergency or crisis situations implies the qualities of empathy, careful listening, support, and information. These qualities are valuable in any helping situation, but become particularly important when helping mothers who are scared, nervous or anxious. LLL Leaders know the value of breastfeeding in any situation.

Editor's Note: Read these articles in their entirety, along with additional articles about the Circles of Support, at

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