Interview with pharmacist and lactation consultant Jana Boleková

BY Ing. Žaneta Milošová (Havírová), MSc. Bára Haliková

Everyone would probably want a miracle pill for all their ailments. Unfortunately, it doesn’t exist. There is a need to look at things comprehensively, and to look for a specialist if necessary. We have to realize that the way we behave, how we think and how we are (nerves, stress, insomnia) shapes our physical state as well. We could not do without doctors or pharmacists, of course. However, it is good to always think about where our problem arose and what options we have for solving it. 

Jana Boleková is a pharmacist with a focus on health prevention and natural medicine, an all-family masseuse (pregnant women, babies, children, adults, and seniors). She is a lactation counsellor with the support of relationship education. Privately, she promotes an unorthodox eco-lifestyle, and an eco and organic household.

You’re educated and operate in different areas connected to each other. Where and how do you apply your comprehensive knowledge of pharmacy?

Jana: Pharmacy in a broader context is also a lifelong hobby of mine. I am an advocate of prevention in the first place. It starts after birth by supporting breastfeeding, contact parenting and relationship bonding. I ran the Natural Baby Care Advisory, which focused on skincare, children’s behaviour, Montessori upbringing, relationships with grandparents, rewards and punishments such as diapers and potty etc. in addition to the topics mentioned.

Another area is the environmental household, in the broad context of the effect on our physical and mental health, directly or indirectly. This includes the individual elements of household equipment and accessories, eco-cleaning, washing, hygiene, and natural cosmetics, and we must not forget the kitchen, which is the heart of the whole household and where the most significant effect is on the health of all members.

From the eco-friendly dishwashing, composition and dietary modification, it’s one step closer to gardening. Whether in an apartment on a parapet slab, balcony or right in the garden. I remember pets as well – hygiene, diet, life support, and natural medicine.

Atopic eczema is a big topic for many parents. On the internet, one learns different and wayward information. You’ve been lecturing on the subject. What’s it really like?

Jana: You’re right, atopic eczema is a big topic. It occurs both in childhood and adult life. Again, its manifestation can be viewed from multiple points of view: mental, contact, digestive organ status, and lymph stagnation.

It is good to treat it holistically as a dietary modification, relaxation techniques, massages, appropriate hygiene, choice of clothing and bed linen (cotton, no applications), eco-washing, avoidance of temperature shocks, adequate physical activity, no smoking, avoidance of alcohol consumption, rest and heavy sleep, natural cosmetics, reducing stress-inducing factors (divorce/break-up, change/loss of job/school/collective/residence, severe health condition of yourself or a relative, traumatic experience, bullying, financial instability).

How to approach atopic eczema with newborns or infants?

Jana: To begin with, I want to mention prevention. It starts with the moment of delivery. The baby comes into the world with a white, thick mint – a vernix covering the entire body surface. It has protective, thermoregulatory, antibacterial and antioxidant effects while hydrating the skin. It should be left on the skin for about 5 days until absorbed. The skin does not yet have a fully developed lubrication capability after birth, nor is natural moisture control fully functional.

A child’s skin is 5 times thinner and more sensitive than an adult’s. That should not be forgotten. Proper care from the first few days can prevent, or at least mitigate, the onset of eczema in children with a genetic predisposition. Bathe the child 1 – 2 times a week, just clean water is enough. Avoid a hot bath, prioritize showering, and minimize the use of soap and if you decide to use soaps anyway, then natural plant-based soaps containing abundant plant extracts.

For dry and damaged skin use natural marigold baby oil added to the bath in lukewarm water, or prepare an oat bath (anti-itching). Dry the skin by gently patting a towel without any friction. Moisturize skin folds or even dry skin after the bath, with high-quality plant-based oil. I recommend organic sesame oil with added biologically grown marigold, which has soothing effects on sensitive skin. Gentle whole-body massage helps to calm and harmonize the baby.

A gentle touch by a loved one has beneficial effects not only directly on the skin but also on the psyche and the entire nervous system. At the same time, it helps to form a healthy relationship bond. Another point is the promotion of breastfeeding as a natural diet.

The overall picture of caring for a baby with eczema includes combining a diaper-free method with cloth diapers, minimal cosmetics, cotton airy clothes, eco-detergents, maintaining a uniform temperature for the night, and possibly using cotton gloves. I also recommend avoiding stuffed toys and toys with rough surfaces and sharp edges. When itching, pat or squeeze the skin, or gently moisturize it.

It is also important to respond as quickly as possible to the very needs of the baby. Intense physical contact with parents (wearing scarves/carriers, co-sleeping). Also, responding early to the baby’s needs doesn’t go so well when the baby’s tied up with a swaddle. (Research shows that it is not a good idea to tie a child into a swaddle for long periods or even at night. It suppresses their basic needs and, unfortunately, even today we see it in maternity hospitals that they still foist this method on new mums.) [1]

How to approach eczema in adults?

Jana: In general, dried skin tends to have a greater propensity for different pathologies. First and foremost, not breaking the skin’s natural lipid layer with frequent whole-body washing with excess sanitary products, not bathing in hot water, not using artificial materials for underwear and sheets, sufficient drinking regime, skipping alcohol, smoking and drugs, getting enough rest, exercise, avoiding sharp or sudden temperature fluctuations, not to mechanically irritate the skin and not to over-tan it, to use natural-based cosmetics without preservatives and artificial perfumery, to wash in environmental products and rinse twice, and not to use fabric softeners.

Also try to find out about food allergies as well as environmental allergies, use only the necessary amount of natural cosmetics, and clean up with eco-products and only in minimal amounts. Avoid using air fresheners and other artificial scents, aim for an anti-inflammatory diet, promote the activity of the entire digestive and urinary tract – mainly the liver and kidneys, minimise stress factors, and improve mental health. Learn relaxation, breathing or meditation techniques, regularly attend massages (reflex, lymphatic, local…), and according to the health condition include regular cold hardening or sauna treatments.

Do you still encounter other skin problems that can be cured or improved by “natural” treatments?

Jana: At any age, there are some specific problems. In infancy, there’s diaper dermatitis, in addition to the already mentioned eczema. In the adolescent age, hormonal imbalances overproduce fats and sebum, while testosterone stimulates the production of keratin, which blocks pores. The result is an inflammatory skin disease, often with infected plaques (local, or general approach).

In adulthood, the level of skincare, along with lifestyle, begins to show after 35 years of age (summer, winter, air-conditioned areas, fungal diseases of the skin of the legs and nails, cracked and hardened skin on the feet, candidiasis, diaper rash, varicose veins). In the elderly, dehydration is more pronounced, the skin is dry, sensitive (even diabetic), and itchy.

It is not legally possible to say that any natural ingredients (herbs, oils, etc.) can heal, which is quite a shame, isn’t it? I’m no opponent of modern medicine, but I think it would be nice if modern medicine was complemented by so-called “alternative” medicine. I find modern medicine alternative rather than actual “alternative” medicine because the active ingredients of different plants have been known for millennia. What do you think?

Jana: I’d adjust that a little bit. The medicinal effects of plants have been used for millennia, however, only modern medicine has revealed their active ingredients. Today, even in ordinary medicine, this knowledge is being used, and some drugs are of purely natural origin, but with a standardised content of the active ingredient. Surely a combination of traditional natural medicine and common western medicine is optimal.

Modern medicine has essentially replaced a kind of folk healing. I’m not saying it’s always wrong, but if I’m not mistaken, do drugs (which are much stronger) mimic the effects of plants?

Jana: Plants, unlike chemical pharmaceuticals, have a wide range of different content substances and their effect cannot always be clearly defined. Their composition (and mainly their content) is conditioned by several factors such as location, altitude, weather conditions in a given year, moisture, length of sunshine, temperature, seasons, but also part of the day and harvesting technique, etc.

Chemical pharmaceuticals have precisely defined chemical substances whose effect is given/defined by their physical and chemical properties in the context of physiological and pathological processes occurring in the organism.

When you were still working at the pharmacy, why did people come in most often? What was their approach? A pharmacist told me that people don’t want to change their behaviour, even if it gives them a medical condition. They want a pill for everything so that they can continue with their habits. Do you come into contact with people who want to eliminate the cause of problems and not just suppress the problem? (Corticoids for eczema, insulin for diabetes, makeup for acne, etc.)

Jana: My childhood dream was to help people with their health. That’s why my mom and I ran 4 pharmacies of our own. Two in the country and two in Bratislava. A really diverse set of patients have passed through our hands. Unfortunately, most of them didn’t really want to get rid of their health problems, even though they accented to it verbally. Their goal was to stamp out problems quickly, preferably without their personal involvement.

Privately, I call it “pink pill syndrome”. I live my childhood dreams to the fullest outside the pharmacy as a health consultant. That’s when I have a better chance of being approached by people who truly care about improving their health and are aware, and therefore willing, that they will have to do something themselves. I can accompany and guide them on their journey, but they must go through it themselves.

Our minds do not exist independently, they affect our physical being, fortunately, even some doctors work with this ancient truth. How do you work with the problems and how do you approach them, and why?

Jana: I am glad that psychosomatics has already been translated into classical medicine. Only marginally so far, but they already have an integral place there. Physical and mental health go hand in hand. First, there’s some psychological imbalance, and if we ignore it, the first physical warning comes in the form of an acute illness. However, if the psychological burden persists, then the disease deepens as well, becoming chronic.

An integral part of the initial interview is (in addition to health problems, along with family history, eating habits, and lifestyle) questions about current but also past stress factors, experienced traumas, hardship, family and employment relationships. Some health problems can be “blamed” already for the accompanying mental state. It works the other way around as well, of course. That’s why “under the skin” issues are part of my practice.

I keep saying that the extent to which the patient opens up to me, is the extent that I can help them. It’s like a puzzle. The more pieces we know, the more complex the picture we see.

The fact that conventional cosmetics (commonly available cosmetics in stores and on e-commerce) contain harmful and sometimes truly health-threatening substances is already well known. Do you perceive, from the perspective of your practice, that just after your patients stopped using any cosmetic products, their health problems have gone away?

Jana: It’s not just skin. Hair and body cosmetics, perfumes and deodorants, various air fresheners, clothing (mainly underwear)…

Do you see it in laundry detergents or cleaning products as well?

Jana: Without question. This includes laundry detergents and, most importantly, fabric softeners, and a wide range of different cleaning products for floors, windows, bathroom, toilet, carpets, and cars, as well as for washing dishes.

Often parents do laundry with aggressive products to wash stains and otherwise dirty children’s clothes. It worked for me: don’t overfill the washing machine, add soda (Peru in eco powder/soap. Soap nuts only work for regular washing, but not for spots, or I raise the temperature. Any recommendations from experience?

Jana: Washing as such is pure alchemy and ecological all the more so. For commercial laundry detergents, a mixture of chemicals solves the problem for us. In eco-washing, it’s not enough to trade a commercial product for an eco-friendly one. There will be a disappointment. That’s not how it works.

The first step is sorting the laundry into every day and more dirty clothes. For dirtier clothes, soaking, or local treatment and washing of stains according to their nature, with bile soap, olive soap with lemon, or an oxygen-based product.

This is followed by a water softener for the washing machine along with an organic product. This is then accompanied by washing soda, bile soap flakes, and an oxygen-based product (white and slightly disinfecting) as necessary.

Finally, a citric acid-based rising product is used to neutralise the rinsing solution and remove the residue from the detergent.

Often even “natural” oils irritate the skin and there are allergies to them or some of their ingredients (eugenol, linalool, etc.). Can cosmetics be used without these otherwise beneficial oils? I mean, what do you recommend to a patient like that?

Jana: Indeed, allergies can also occur to natural ingredients, especially in sensitive and predisposed individuals. As with commercial cosmetics, with natural cosmetics, the sensitivity of the individual must be taken into account in the first place. It is ideal to apply the sample to the forearm and observe the local reaction. Natural cosmetics without perfume are also available on the market, with minimal ingredients and designed specifically for irritated skin. It is also an option to choose products for infants, based on quality natural oils, of course. It’s good to learn that the less the better.

Unfortunately, even today, some maternity wards or lactation counsellors recommend so-called “hats” and various ointments for nipple injuries, e.g. lanolin. I know from my own experience it’s not good. Mothers often stop breastfeeding then, which is a huge shame. (Only 13 % of women breastfeed after 3 months.)

Can you say or recommend something on this topic? Why is it wrong, what is the better or healthier choice to solve the problem, and why does it arise in the first place?

Jana: The issue of sore and injured nipples is considerably more extensive than many think. Breastfeeding shouldn’t hurt. Not even at the beginning before the nipples “get used to it”.

Pain is a signal that something is wrong and the condition needs to be addressed urgently so that it does not escalate into a larger and longer-term problem. You need to adjust the position and latching of the baby or check their sublanguage wall.

Soreness causes lower breast milk intake and consequently lower breast milk production, and of course, a dissatisfied infant, who latches onto the breast nervously, disconnecting, drinking briefly, is not saturated. Mum subconsciously prolongs breastfeeding intervals and also shortens individual breastfeeding due to soreness. A vicious circle is forming.

The starting point is the aforementioned position adjustment and suction. Squeezing the breast and replacing the breasts when the baby is still suckling but no longer drinking can help as well as not delaying breastfeeding, noticing breastfeeding signals, prioritising breastfeeding after waking up over changing the diaper, and physical contact with the skin thanks to carrying around. There is a lot to do. A lactating counsellor will help to not get lost in all that.

By six months of age, breast milk is the only and most appropriate diet for a baby. The use of substitutes is recommended only when justified on the advice of a doctor. According to the most recent studies, intermittent breastfeeding reduces a child’s risk of dying from an infectious disease by up to seven times. Only 43 % of newborns in the world receive breast milk in the first half year of life. Does breastfeeding also affect any skin problems and allergies [2]?

Jana: Some babies are already born with a genetic predisposition for skin or allergic diseases. Their onset depends on many factors, and one of them is natural nutrition without supplements right after birth – breastfeeding. Its length is counted in years and not just in months. However, it may not prevent its outbreak altogether.

Breastfeeding should be encouraged throughout its whole duration and not only in the first few weeks or a few months after birth. It is a natural nourishment continuing indefinitely even later on in addition to the baby foods which help mature the digestive system and build the immune and nervous systems. Breast milk is important for the health of the baby (and it is important and good for the health of their mother) because the positive effect of breastfeeding on the child’s health is dependent on the amount of milk drunk and the overall duration of breastfeeding – in other words, the effect is dependent on the “dose”.

According to the latest study in the prestigious Lancet medical journal, the more “doses” of breastfeeding the better a child’s health [3].

“According to UNICEF, if all babies were breastfed from the first moment of being born until they were six months old, 800,000 fewer babies would die in the world every year [2].”

It is also recommended that parents apply different moisturizers, powders and ointments to children under diapers, products, which have been on the market for decades and are targeting parents by saying that it is the best thing for the child (the ingredients often say otherwise). I used something a couple of times when my daughter got a rash, but it seemed pointless after all. All I had to do was to leave the baby without a diaper as much as possible and rinse the sensitive parts only under running water. Am I lucky, or does this method work in general?

Jana: You are not the only one with such experience, but also other brave moms who haven’t succumbed to the lobbying of beauty companies. The ideal solution is a combination of a diaper-free method with washable unbleached diapers. Once emptied, rinse the child’s bottom with water (do not use damp wipes) and dry gently. When using any diapers, they should be replaced as soon as possible. There is no need for moisturizers or powders, even in newborns. The rule of the less the better applies to this as well.

What about disposable moistened napkins? They didn’t exist before, how did the parents handle it? What are the options today? Personally, I only use the occasional perlan, which I soak in beforehand (just to clean a baby that’s peed themselves. Then I wash it. It’s made of nonwoven fabric made of 100 % viscose – a natural material, easily breakable and it’s cheap.) For travelling and outside I have disposable moistened napkins, which are degradable and free of toxic substances. However, maybe there’s another simple eco way?

Jana: At home, prioritise running water, outside, and cotton napkins moistened with clean water, which you wash at home.

Bathing babies and children – this is where I also find it unnecessary to have X amount of products. All I have is pure oil, which I add to the bathwater, so I don’t moisturize the baby afterwards. I don’t use shampoo or soap, but I’ll probably be later. When to start using, say, shampoo, soap, etc., and how sparingly to the child and nature?

Jana: Children’s skin is 5 times thinner and more sensitive than an adult’s. It is true that “what we apply on the child as if we have handed him by mouth.” I’ll go back to prevention again.

If I don’t interfere with the forming protective film on the skin, then I will prevent any later problems. What that means in practice – after birth, let the vernix layer absorb (about 5 days), then just bathe the child 1 – 2 times a week with clean water and then apply a thin layer of vegetable oil to the moist skin with a gentle massage. Alternatively, the oil can be added to the bath.

Only use soap in case of thicker, or dried, stool staining. Babies in the first few months have no way to get dirty and therefore it is not necessary to use soap on the whole body. It’s enough to start using it when the baby starts crawling or walking and when it has more independent movement.

Start using shampoo during the crawling season because there’s enough dust on the ground.

Dental hygiene in the baby and then an older child – are you also an advocate of minimalism in this case? What did your practice prove to be true? (What to use, when to start, just outline this topic we’ll have an article and a conversation with the dentist, but it’s nice if more people comment on the issue.). What about fluoride in children’s traps?

Jana: I’m a believer that we already have, or we may have enough fluoride in our diet. Dental “hygiene” begins at the start of the growth of the first teeth. The baby itself favours biting for growth relief. At this time, alongside the starting side dishes, we can start by gently massaging/”brushing” the teeth with a silicone finger brush.

If a baby is grasping and putting objects in its mouth, we can also give it the first baby toothbrush to play with. Toothpaste isn’t all that important in the early days. Mechanical cleansing is more important. And I’m a proponent of “game cleaning.”

The use of toothpaste occurs only when the child can keep it in their mouth for at least a while and not eat it right away. Since swallowing cannot be prevented, a children’s dental gel without fluoride is suitable, containing only natural ingredients that do not cause difficulty when swallowed.

The coating on the teeth also depends on the type of food consumed. Fluorides are naturally found in breast milk and are added to replace artificial nutrition.

What about diapers? One can find a lot of information but how is it in reality? Cloth vs. disposable? Are cloth diapers gentle/friendly to children’s skin?

Jana: For both types of diapers, diaper rashes are prevented by frequent replacement. I don’t see the difference. The difference is the materials. Commercial diapers have a superabsorbent layer in the core and are bleached with chlorine.

Children’s skin should not come into contact with artificial materials (this also applies to clothing). I also call disposable nappies a “chemical factory” and it has nothing to do with delicate, sensitive skin.

Fortunately, there are already washable nappies designed according to disposables – they have an absorbent core of natural materials and fastening. They certainly leave a smaller ecological footprint while being more skin-friendly for babies.

It is best to combine a diaper-free communication method with the use of washable “disposable” diapers. At the same time, this combination naturally promotes the control of the baby over its secretion and the natural transition to “undiapering”.

Is there anything you’d like to recommend to parents when it comes to childcare?

Jana: In this internet age of revolutionary technologies, it is difficult to navigate and not succumb to marketing offers. And, of course, various discussion forums. These will do more harm than good.

For counselling, I encourage new moms to listen to their intuition, to engage common sense, to perceive their baby’s needs, to accommodate and fulfil their needs, not to leave the baby alone and not to leave it crying, and together with daddy to give them as much physical contact as possible (in the first days after the birth, uninterrupted physical skin-to-skin contact, further co-sleeping, wearing a scarf, full-body massages) and thus ensure a sense of security. Nor must we forget the proportionate number of appropriate incentives.

In a stress-free environment, the baby has the opportunity to develop healthily. Each baby is unique and so the experiences and recommendations of others are not to be taken literally, but rather as a guide through learning and meeting the needs of your children.

Authors

  • Ing. Žaneta Milošová (Havírová)

    She does what she enjoys – works as CEO of GreenScan. She studied at Technical University of Ostrava, where she got a master’s degree in Environmental engineering. She always cared about nature and things around it. She loves mountains, forests, animals and embraces modernity as well. That’s why she tries to look for a balance between nature and modern world.

  • MSc. Bára Haliková

    Completed her master studies in environmental management and waste management at GCU in Glasgow. Currently, she works for the organisation CEEV Živica on project GreenGate, whose main goal is to educate the public about dangerous substances in cosmetics. She currently lives with her partner and daughter in the countryside of Slovakia, in a small mobile home, which they built themselves.

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