Breastfeeding is the most natural thing in the world, but by no means the simplest. Public Health Nurse Johanna provides support to families to make their breastfeeding aspirations come true.
Johanna Koivisto has spent more than 20 years working with babies, families and breastfeeding – first as a midwife, then as a breastfeeding counsellor, and for the last few years as a public health nurse.
“When it comes to breastfeeding and people, nothing is black and white. Every family teaches me something. This is a wonderful field of work," Johanna praises.
Working as a public health nurse at a maternity clinic, Johanna meets with families from the beginning of their pregnancy. It is important to talk about breastfeeding at an early stage, even if it does not seem topical yet.
"Families are often surprised by how big a deal breastfeeding feels once the baby is born. I do not push anyone to breastfeed, as mothers are always free to decide what to do with their own bodies. Instead, my job is to help families make their aspirations come true."
For those who wish to breastfeed, Johanna encourages full breastfeeding from the very first days. The milk order that the baby places by sucking plays an important role: breasts respond to demand by producing more milk.
“On the first day after being born, the baby is tired and does not breastfeed very often. On the second day, the baby often wants more milk than is available. The baby's constant crying and breastfeeding can be frightening if you’re not aware that it is normal. It usually takes only a day or two for milk production to ramp up. By using a bottle, you can unknowingly end up making breastfeeding more difficult."
The full breastfeeding period, with its evening struggles and stretches of frequent feeding, can feel like an eternity. Because of this, the non-breastfeeding parent or other support person plays an important role during this period.
“The non-breastfeeding parent can offer the baby and the mother a completely different kind of rest by preventing the baby from constantly smelling milk during skin contact. If the breastfeeding parent tries to offer the baby a rest in their lap, it's like trying to rest with a chocolate bar under your nose," Johanna illustrates.
When a family needs additional breastfeeding support, they can be referred to breastfeeding counselling. The counselling starts with a short interview, after which breastfeeding is practised together. Johanna often instructs clients to lean back and support their position with cushions.
"We try to make breastfeeding as easy as possible for the baby. Babies like to drink in the same way as adults do – in a symmetrical position with their head tilted back. But getting the baby into that position next to your breast is not that easy.”
The most rewarding thing about Johanna’s work is being able to provide quick relief. "The best part is being able to help families in difficult situations. This is rewarding work because the help is so immediate."
However, even with guidance, breastfeeding does not always go smoothly. In these cases, it is important to provide support to the family.
“Disappointments related to breastfeeding are a really big deal. When we start looking into why breastfeeding is not going well, it almost always turns out that the difficulties are caused by something beyond the family’s control. It's not worth blaming yourself over it,” Johanna reassures.
Babies like to drink in the same way as adults do – in a symmetrical position with their head tilted back. But getting the baby into that position next to your breast is not that easy.
With every new breastfeeding generation comes new challenges and beliefs that Johanna helps to tackle.
"Sometimes social media creates unnecessary pressure about what constitutes successful breastfeeding. While a freezer full of breast milk may look visually impressive, it has no bearing on how much milk your baby sucks or how well they grow."
There have also been positive developments, however: attitudes towards breastfeeding in public have become more tolerant, for example. Still, Johanna would like society to be even more positive about public breastfeeding.
"Mothers often hesitate for an awfully long time before building up the courage to breastfeed in public spaces. I would prefer it if we talked about feeding the baby instead of breastfeeding and paid more attention as a society to the baby's needs. The baby always comes first."