Santa Rosa's Breastfeeding Cafe helps mothers overcome feeding challenges

With her first two kids, Erika Viramontes was determined to breastfeed. And both girls took to it like little champs from the first time they emerged into the world.

But baby sister Abigail, who arrived a month ago, just didn’t seem to be catching on. Sisters Luz, 10, and Maryellen, 4, tease that the baby, a tiny mite still less than 7 pounds, with a thatch of thick dark hair, is just being “lazy.”

In truth, some babies and their moms need help, particularly after a cesarean birth like Abigail’s, with the disruption and physical trauma that come with it.

That’s what brought a tearful Viramontes to the “Breastfeeding Cafe.” You can’t get a latte here, but moms can get help serving the best milk possible to their babies.

The cafe is a free drop-in program in Santa Rosa. Twice a week, mothers of infants who are having trouble latching on or who need some advice, can relax on a comfy couch or upholstered chair in a homey, living room like setting, and join a support circle. It includes professional help from nurses and lactation specialists as well as other mothers going through the same challenges to getting their babies to feed as nature intended.

“When I gave birth to Abigail, she was dropping a lot of weight and I was having trouble with my milk supply,” said Viramontes, a soft-spoken woman from Forestville, who breastfed one daughter until she was 5 and the other until she was 2.

But Abigail was delivered by C-section, which contributed to a lower milk supply. Viramontes said she was suffering postpartum depression, exacerbated by not being able to feed her baby.

While breastfeeding is completely natural, it doesn’t always go smoothly. Babies don’t take to it for various reasons. And because a woman’s milk production is tied to how much an infant feeds, any disruption can lead to less milk for baby and a higher likelihood that a new mom may start supplementing with formula, or give up on breastfeeding altogether, said Roseanne Gephart, who runs the cafe through a non-proft organization she founded called Better Beginnings, aimed at providing support for women at birth and with nursing their babies.

A nurse-midwife and nurse practitioner who has been bringing babies into the world for more than 30 years in Sonoma County, Gephart founded the The Santa Rosa Birth Center, (formerly the Womens Health and Birth Center), one of the first out-of-hospital birthing centers in the state. Although she sold it several years ago, she volunteers her time to Better Beginnings, troubleshooting, coaching and encouraging nursing mothers out of the belief that breastmilk is the foundation for a healthy start in life.

At the cafe, which is open Mondays and Fridays from 9:30 a.m. to 11 a.m., women get both practical information and emotional support. As they settle in they are served a special tea and cookies with ingredients that are good for milk production. Any nursing mother is invited to come by at no charge. Babies are weighed before they feed and after, to see that they’re getting the requisite 1 1/2 to 2 ounces of milk. If not, Gephart or another volunteer lactation specialist, try to get to the bottom of the problem.

“It’s a community like how it used to be like in biblical days when they had the red tent and women would surround younger women and teach them and guide them into motherhood,’ said Emily Lewis, 37, who wound up at the cafe after delivering her first baby by C-section.

“It was … definitely a difficult experience to get him out. His heart rate dropped. All around it was a traumatic experience and him not latching on was the icing on the cake.”

There is something both reassuring and soothing about getting one-on-one help from other women bent on their success.

“They all sat there and listened to me and my feelings and frustrations of not being able to have the baby nursing. They worked with me hands on,” said Lewis. “It was like having a mother or an aunt. I immediately felt their empathy. They were so supportive it gave me hope.”

Gephart donates her time to a cause she believes is vitally important to get babies off to a good start in life.

Ninety percent of mothers in California start out breastfeeding their newborns, according to a “Breastfeeding Report Card” issued by the U.S Centers for Disease Control. But by the time their babies are six months old, the number of moms still breastfeeding has fallen to less than 60 percent, a drop-off that dismays Gephart, who knows that many of them stop far short of six months.

“The number of women in Sonoma County who start out breastfeeding is probably more like 96 percent. But by two weeks after delivery a huge percentage have quit because they have had problems and they haven’t been able to get help,” Gephart lamented.

The American Academy of Pediatrics recommends that women give their babies breast milk exclusively for the first six months, and then as a supplement to solids until they are a year. The World Health Organization goes even further, recommending that all babies be breastfed for as long as possible.

“It sets them up for a healthy life,” says Gephart, “There are no detriments.”

Breast milk contains antibodies that help babies fight off viruses and bacteria. Breastfeeding also lowers an infant’s risk of developing asthma or allergies. Studies have shown babies who are breastfed exclusively for the first 6 months, without any formula, have fewer ear infections, respiratory illnesses and diarrhea. It also protects a baby against constipation, cancer, diabetes, tooth decay, and Sudden Infant Death Syndrome (SIDs), according to the Sonoma County Department of Health Services.

Many hospitals and birth centers and clinics do provide breastfeeding support for new moms, both immediately after birth and through clinics once they’re discharged. And women with the income to pay for it can hire their own lactation consultants. But the services are not consistently available when needed, either in the hospital or post-discharge. It’s is particularly hard for low-income mothers, said Gephart, even just getting there and at the right time. And time is of the essence to keep the milk supply up and to provide the perfect nutrition and protections available in human breast milk.

Lewis said she received a lot of support from the lactation consultant at Sutter Santa Rosa hospital. But her baby still hadn’t mastered latching on. She went to a clinic sponsored by Sutter for extra help after she got out of the hospital.

“There were so many women in there I didn’t get that one-on-one care. It took an hour and a half for someone to help me. It was so frustrating,” Lewis said.

Then she found out about Better Beginnings. Gephart, who is on call at all hours, came to her home, right afer getting off a plane.

“She [made a] cutout in one of my husband’s shirts and put the baby in it and had me lean back in the chair with the baby in the shirt on my chest so he felt comforted, like the womb,” she said.

Lewis used a breast pump and finally at 3 1/2 weeks, her son latched on. By nine months he was a robust 23 pounds and is in the 89th percentile for weight.

Better Beginnings functions primarily with volunters, who are nurses, board certified lactation consultants, lactation specialists (who go through a three-day program for training) and doulas - women trained to provide support, coaching and encouragement during childbirth. For women who find themselves going into labor without a partner or coach available, Better Beginnings has an “In-a-Pinch” Doula Service. They will send an emergency doula to help them through. Donations are appreciated from those who can pay, but there is no set charge for the services.

“We do make sure our clients qualify for Medi-Cal,” said Amy Popplewell, a Better Beginnings doula who is completing the pre-requisites to enter a graduate program for nurse midwifves.

There are a number of studies that show a reduction in complications from births when you have a doula present. Most important for our clients, if someone is low income and can’t afford one, but really wants one, we’d like to be there for them if a mom is along and scared and in the hospital. Having someone there is just invaluable. They can look to me and I’ll be their rock in the room.”

Gephart and her team believe women are often up against multiple forces that sabotage breastfeeding. Some clinics and doctors are rightfully concerned that a baby gets enough nutrition, so they encourage supplementing with formula. But it’s a baby’s nursing that increases the milk supply to meet its needs, she said.

“The hospitals are trying harder. But there’s a lack of support from the time a mother leaves the hospital or the birth center until she comes in for her two-week visit or for the baby’s one-month checkup,” said Gephart. “A whole bunch of moms start adding forumala. And the minute you start adding artificial baby milk you start seeing a decrease in the benefit of breastfeeding and a decrease in the mother’s milk. It’s a supply-and-demand thing.”

On her visit to the cafe, Erika Viramontes is coached how to hold baby Abigail so her whole body is facing her mother. She’s taught how to listen to make sure the baby is swallowing.

Meanwhile, there is a room for her daughters to play and Gephart, like a nurturing grandmother, has made a berry crisp for her, filled with nutrients like oats that help produce milk.

“It is my gift to the world, seeing these kids grow up has been just wonderful. I’m trying to make a difference, one baby at a time,” said Gephart, who also is a board-certified lactation consultant.

The cafe is held in space donated by Bridges, a prenatal clinic in Santa Rosa. But the two organizations are not affiliated. Gephart said Better Beginnings is nonreligious and operates on a small budget of about $10,000 a year, with donations supporting insurance and incidentals and to reimburse some doulas, although most wind up donating their time.

She’s hoping to encourage women who have benefited from the help to come back and provide peer support.

“In the old days, women would meet at the well,” Gephart said. “Everybody had to go to the well to get their water, The babies were tied on. Everyone would sit at the well and say, ‘How is your baby doing?’ There’s lots of that still going on now, but it’s underground.”

Lewis said she’s already made connections with other breastfeeding moms and hopes to do more.

“It was nice to have been a support to these women. I got a couple of phone numbers. One text messaged me and I was able to give her information that was given me, about drinking mother’s milk tea. It felt good just enccouraging her and being part of a community and support system during that time of struggle.”

You can reach Staff Writer Meg McConahey at meg.mcconahey@pressdemocrat.com or 707-521-5204. On Twitter @megmcconahey.