Interview with Katja van Steenkiste, midwife and lactation consultant IBCLC, Lansinoh Healthcare Marketing

We speak with Katja van Steenkiste, midwife and lactation consultant IBCLC, Lansinoh Healthcare Marketing, about her passion for her profession, the current shortcomings in obstetric care and receive tips and tricks on the subject of breastfeeding.

1. You are a midwife and lactation consultant. What makes you so happy about this job and why is it so important?

It makes me very happy to accompany families as they grow (together). Pregnancy, birth, and the postpartum period are sensitive phases in a woman's life. This requires a great deal of empathy and human insight. Midwives are specialists in this time.
We midwives support families with warmth and expertise.

2. We often read that breastfeeding is not only good for babies, but also has positive effects on mothers. What are these benefits for mothers, specifically?

That's true. It's not just babies who benefit from breastfeeding. There are also many health benefits for mothers. Breastfeeding mothers are less likely to experience postpartum depression. The uterus shrinks back to normal more quickly. What's less well known is that breastfeeding reduces the maternal risk of breast cancer and diabetes. Incidentally, mothers who breastfeed also return to their starting weight more quickly. This is important to many mothers.

3. How do you support mothers with breastfeeding?

Even during pregnancy, I talk to them a lot about life with a newborn. Many women are surprised at how exhausting the first few weeks with a baby are. Just knowing this helps a lot. Once the baby arrives, I provide the families with advice and support as part of my midwifery care. This includes assistance with breastfeeding or sore nipples, as well as discussions about the parents' current questions.

4. Every woman has the right to choose whether to breastfeed or bottle feed. How do you help mothers who want to breastfeed but can't?

I always follow the path the families have chosen. If women decide not to breastfeed or if breastfeeding is problematic, I try to work with the parents to find options that work for them. If breastfeeding doesn't work, the mothers often need psychological support because they feel guilty about it. Of course, I'm there for them.

5. How can you stimulate milk production?

Milk production is stimulated by the baby's sucking at the breast. Babies should therefore be fed as often as possible and allowed to satisfy their need to suckle at the breast. Sometimes it's necessary to use a breast pump as well. Adequate rest for mother and baby and as much skin-to-skin contact as possible between the two should not be underestimated, as this also supports milk production.

6. What are the first steps in breastfeeding?

It's best for mothers to start breastfeeding as soon as possible after birth. Ideally, within two hours. Midwives in the delivery room will support women by assisting with latching and finding a comfortable breastfeeding position for the mother. After the time in the delivery room, women should breastfeed 8-12 times every 24 hours.

7. How often should you breastfeed your child during the day/night?

Breastfeeding should occur 8 to 12 times in 24 hours. However, more frequent feedings are perfectly normal. Newborns don't yet distinguish between day and night. Breastfeeding should generally occur when the baby gives signs of hunger, i.e., when the baby needs it.

8. When can/should you start using a breast pump? What should you keep in mind?

It actually varies from woman to woman. Some women have to start pumping while they are still in the hospital. This can happen, for example, if the baby is born prematurely or if they have to be admitted to a children's ward for other medical reasons. Many women start with short out-of-home appointments without their child after a few weeks, for example, at a postnatal exercise class. They then occasionally pump. Depending on the purpose for which pumping is required, the exact procedure should be discussed with the midwife or lactation consultant. The general rule is that the woman should be relaxed while pumping. A warming pad on the breast can facilitate milk flow. The scent of the baby (on a piece of clothing or the baby blanket) or a photo of the baby can also contribute to successful pumping.

9. Do you have any tips for reducing pain while breastfeeding?

Breastfeeding shouldn't hurt. The most common cause of sore nipples is incorrect latching. Therefore, proper technique should be emphasized from the very beginning. Your midwife can provide a lot of support here. Sometimes nipple tenderness has other causes. In these cases, consulting a midwife or lactation consultant can also be helpful. In any case, appropriate nipple care should begin from the very first breastfeeding session.

10. The topic of "breastfeeding in public" is always a hotly debated topic. What's your opinion on this, and what advice do you have for moms who aren't entirely comfortable with it?

For some mothers, breastfeeding in public is a real problem. However, this is usually unfounded. Breastfeeding is our children's natural nourishment. In public, mothers can use a nursing scarf or choose a quiet corner in a restaurant. Often, their own car is nearby and they can retreat there. Changing rooms can also be used frequently if they speak to the staff beforehand. Under no circumstances should a breastfeeding mother ask someone to send her to the bathroom to breastfeed. If the baby is a little older, expressed breast milk can also be fed from a bottle. On longer trips, just remember to use a manual breast pump to extract the breast milk from the breast. Otherwise, there is a risk of milk engorgement.

11. The inadequacies in obstetric care and poor working conditions are making it increasingly difficult for new mothers to find a midwife. How can women who haven't found a midwife for postpartum care get advice?

It can be very difficult for pregnant women to find a midwife for pregnancy and postnatal care. This is especially problematic in urban areas. Searching online is a good option. There are now several websites (e.g., hebammensuche.de) that offer midwife searches. I always recommend asking around among friends and acquaintances at the beginning of your pregnancy and contacting a midwife as soon as possible.

12. Is there a perfect time to wean?

The perfect time to wean is determined jointly by mother and child. The WHO recommends exclusive breastfeeding for 6 months and then, after the introduction of complementary foods, continuing after the second birthday, or as long as it is enjoyable for both mother and child.

13. What advice would you give to young mothers regarding breastfeeding?

Breastfeeding is a very special bond between a mother and her child. It's not always easy, especially in the beginning. Therefore, my advice is: stay patient and don't be too strict with yourself! Give in to your baby's needs and trust your gut feeling!

Dear Katja, thank you for the informative interview and your expert knowledge on the topic of breastfeeding.