Why Breast is Best

Magdalena Yniguez, a childbirth educator and lactation specialist at Wilcox, has coached 700 couples and 2,000 mothers over the years, to the healthy benefit of countless Garden Isle keiki

When you think of people who every day have a positive and lasting effect on Kaua’i, include the unsung Magdalena “Nena” Yniguez. A certified childbirth educator and lactation specialist, she has coached more than 700 couples and 2,000 mothers, to the benefit of countless keiki, at Wilcox Memorial Hospital.

And the biggest influence on her choice of careers was her own pregnancy.

“My ‘aha’ moment was when I was pregnant almost 28 years ago in my Lamaze class, and I remember feeling so happy,” Yniguez says. “The environment you experienced was this feeling that you weren’t the only one. It can be a scary time, being pregnant. It’s a time when you may not be feeling that beautiful because you’ve gained all this weight, or you’re feeling scared because you don’t know how to be a parent yet. So I just loved this class. I walked out of there saying, ‘I’d love to do that job.'”

For Yniguez, mother of daughters Veronica, Adel and Luci, and grandmother of Leia, it’s always been about family, whether it’s her own or helping others start one. Perhaps that’s why her girls, as she calls them, all moved from California to Kaua’i within the past two years, rallying around their mother after she went through a divorce.

Magdalena "Nena" Yniguez on Wilcox grounds

“She is such an amazing mom and always has been there for us,” Luci says, “but she also is so good at what she does because it’s an extension of who she is.”

No doubt it’s that maternal, giving quality that resonates so strongly with new parents.

Yniguez, who teaches a childbirthing class at Wilcox in Lihu’e, says childbirth education and specializing in lactation go hand-in-hand. She says getting to know couples before they give birth means by the time the baby comes, there’s trust already in place if they need help with breast-feeding.

“They’re open to me helping them,” she says. “We already know each other and have been through something together, so they’re OK with me seeing them falling apart, or crying, which also can be tears of joy.”

In fact, often it is tears of joy, or even tears of laughter. Ask any of the parents – male or female – she’s coached, and they’re not only effusive in their gratitude toward her, but usually make mention of her disarming humor.

“She’s very educational, but also very funny,” says Rey Tabalba, new father of 1-month-old Heidi. “She had a Spanish nickname for me, ‘Rey-naldo.’ She was giving everybody Spanish names.”

Venturing into the male brain and attempting to explain maternal subject matter is no easy task. But Yniguez, who on the first day of her childbirth education class walks in with “dummy” breasts – which she makes the daddies wear – believes it’s a crash course not only in childbirth education, but in being a woman. And there’s no shame in it.

Doing what she loves the most, spending time with her princess Leia Rey (photo courtesy of Luci Mendoza)

“I make all my daddies wear these,” she says with a laugh. “Breasts are for one thing, and it’s not for what everyone thinks.”

Talking with Andres Almeida, one of the graduates of her childbirth education classes and the proud father of 1-week-old Samantha, Yniguez is holding the recent Time magazine cover featuring a mother feeding her 3-year-old son. Yniguez, who isn’t one to want to “judge mommies,” points out, “breasts sell magazines,” adding, “more importantly, they feed children.

“We see more cleavage on the beach than when a baby’s being fed, yet some people want to lock mommy up and hide her when she’s feeding her child,” she says. “It doesn’t make any sense when you stop and think about it.”

While from an outsider’s perspective Yniguez’s job may not seem like a difficult one – how hard can it be to feed a baby? – debunking myths and misconceptions about breast-feeding, and de-stigmatizing it, can be a challenge.

For example, what many don’t realize is how important it is to help moms have the confidence to continue to exclusively breast-feed beyond the first four months, despite the daunting demands of everyday life. It’s a goal that can help ensure a healthier population down the line, as breast-feeding a child exclusively (no solids, not even poi) during the first year makes them 50 percent less likely to be obese in adulthood. For many, however, exclusive breast-feeding ends much sooner than that.

“We lose a lot of moms in the first four or five days of breast-feeding,” she says.

Growing up in a Hispanic household, Yniguez, who says in both Filipino and Hispanic cultures it’s often the practice to supplement formula in addition to or instead of breast milk within the first week while the mother “waits for her milk to come in,” explains that every culture has its own valuable set of traditions that it passes on to moms. Sometimes an addendum here or there is necessary.

‘Nena’ and Jaeda Elvenia, maternity ward manager, with Kathy Clark, President and CEO of Wilcox Hospital, in Clark’s office

Referring to an ideology called the no leche (no milk) syndrome, Yniguez says because moms don’t usually have milk until the fourth or fifth day after birth, it used to be believed that during that time babies needed something besides the colustrum, or “first milk,” which the mom can offer baby right away.

Colostrum, which Yniguez dubs “liquid gold,” is literally the perfect food for baby, as it’s chock full of anti-cancer cells, antibodies and nutrients.

Eager to point out that Kaua’i is a breast-feeding-friendly place, Yniguez says continuing to exclusively breast-feed for the first year, even for working moms, is backed by law.

“The law supports a woman’s right to breast-feed, though many don’t necessarily have the knowledge about what that means for them,” she says. “Anybody who goes back to work after having a baby has rights. You have the right to breast-feed in your place of work, and if you’re working eight hours, they have to provide a safe room to feed your baby or for you to pump.”

Lunch breaks aren’t the time for that to happen, she says.

Erica and Rey Tabalba loving Nena’s class

“The working mommy has to eat so she has enough calories to be able to feed her baby,” she explains. “If she doesn’t eat lunch, she’s not going to be able to produce milk.” Within an eight-hour workday, a breast-feeding mother has the right to breast-feed or pump twice.

Further, there is no specific age limit for the baby other than succumbing to the pressure of what society finds acceptable. “It’s up to the mother,” Yniguez says.

Having to retrain people’s perceptions about what is socially acceptable and what is best for baby isn’t unusual for Yniguez.

To support a breast-feeding mother and child, education is key, especially since women of Samoan, Hawaiian and Filipino descent are among the highest in terms of using formula in addition to or instead of breast milk from the time of birth, according to the Hawaii Pregnancy Risk Assessment Monitoring System. In addition, that same demographic cluster is the most likely, if they are breast-feeding, to discontinue the soonest (less than eight weeks).

That’s why inviting extended members of the family to a childbirthing class can help support a mother in continuing to breast-feed a baby. Whether it’s teaching a caregiver the importance of using a slow-flow nipple so the baby continues nursing, or having an informed discussion about baby-proofing in this day and age, getting the whole ohana onboard in terms of what is best for baby often makes for a happier family – and a happier, healthier child.

With 4-monthold exclusively breastfed Skyler and Shantelle Higashi

“The classes can consist of the daddy and the mommy, but I have aunties, best friends, mothers-in-law and grandparents who want to support the moms,” she says. “Education for the family can determine whether you’re going to be more successful in what’s best for the child.”

As for her own granddaughter and being there for her extended family, Yniguez, says yes, her granddaughter was exclusively breast-fed.

“What better gift could there be for the love of my life?” she says.

To learn more about the Wilcox Hospital childbirthing class, call 245-1441 or email magdalena.cardoso@wilcoxhealth.org.