25 Oct

Book Review: What to expect when you’re breastfeeding (and what if you can’t) – by Clare Byam-Cook

This is an awful book. I picked it up, out of curiosity, in a charity shop; and I’m glad I did because for the sake of £1 I’ve saved some benighted new mother a lot of heartache in trying to follow the advice within. I’d go so far as to claim that nobody, following the guidance in this book, is likely to breastfeed happily, or for long.

Let’s start with the author biography, which tells us that “most of the advice she gives in this book is based on the knowledge she has gained… it is not based solely on textbook theories.” This sums up the whole problem with the book. We know that people vary, and a sound understanding of the evidence around how breastfeeding works can be adapted to individual circumstances, BUT this book gives us very little of that evidence, a great deal of opinion, and much advice that is likely to be harmful.

Byam-Cook’s introduction sets out her basic premise, which is that women who have problem-free breastfeeding are “lucky,” and that breasts don’t always work properly. While this may be the case, the survival of our species points to it not being the biological norm. Her tone throughout the book tells us that mothers are feckless, and she is the expert: “I then show her what she should be doing … I have no trouble putting the baby on the breast … I move the baby to the correct position.” (p3) It makes my empowering, mother-centred heart weep.

Chapter One. The phrase that leaps out is “it is essential that a breast-fed baby learns to take some feeds from a bottle.” (p5) Other crazy nonsense includes “It might help to rub your nipples with a dry towel … to toughen them up a bit.” (p8); “If your milk supply is low, eat more.” (p10) and “Fizzy drinks are best avoided as they will tend to give your baby indigestion.” (p12). None of these statements are biologically plausible.

Chapter two has factual inaccuracies on pages 13, 14, 15, 17 and that’s before she starts on “foremilk and hindmilk” on p18.

Chapter three on positioning is overcomplicated nonsense, with the suggestion to give water to a baby with the hiccups thrown in, advice to settle babies to sleep on their side [she recommends putting them on their back on p63], and to let them cry for ten minutes before responding. Also, of course, the obligatory dip into complementary medicine, which if it worked would be called medicine.

Chapter four perpetuates a great deal of conflicting advice, dismissal of hospitals and midwives as sources of information, and the Author as The Best Expert Ever. Yet with her self-styled expertise, she still recommends restricting the frequency of feeds once the milk comes in, gets the storage times for expressed breastmilk completely wrong, and reckons fair skinned women have more “delicate” nipples than normal people (p56).

Need I go on? I read this book with a pen in hand, crossing out whole paragraphs at a time. Byam-Cook has no understanding that a baby’s needs are not purely physical, that breastfeeding is a relationship, that milk removal creates milk production, or that milk is not made from the contents of the mother’s stomach. Her basic biology is ludicrous, and her advice undermines breastfeeding, right, left and right again. She attributes more articulate thought to the breasts than to the mother: on p17 they are making assumptions, on p86 they are getting into “a terrible muddle,” and on p99 they are feeling happy. On p95 “the government recommendation of exclusive breastfeeding for six months is unrealistic and unachievable for many mothers.” With that attitude, it is.

Chapter seven lists all the common feeding problems, suggests the use of nipple shields for most of them, and makes absolutely no mention of community breastfeeding support, qualified breastfeeding counsellors and lactation consultants, or helplines. Most of the common challenges for the baby are apparently resolved by giving something in a bottle, whether formula, expressed milk, water or over the counter colic remedies. Byam-Cook goes on to devote a chapter to bottle feeding, which in this 2006 edition advocates “making up all the feeds at the same time each day” (p169), and has hopefully been updated in line with Department of Health guidelines.

Please don’t buy this book. Please don’t give it to anyone. If you are planning to breastfeed your baby, or experiencing any challenges with breastfeeding, contact a reputable organisation and speak to a qualified practitioner.

22 Oct

Book Review: Fit To Bust, by Alison Blenkinsop

Fit To Bust is something of a jocular memoir about breastfeeding, full of historical fact, amusing anecdote, and “songs,” which are basically re-written lyrics to popular tunes. I particularly like Mammary, to the tune of Memory from Cats (p77).

I have had a few opportunities to flick through it before, but never owned my own copy until I came home one day to find that the postie had brought me a copy signed by the author. Apparently it was sent by my grandmother-in-law, a woman not known for her enthusiasm about breastfeeding, which of course makes this random gesture all the sweeter.

For a comical book, Fit To Bust is pretty thorough, and pleasingly well-referenced, and I would recommend it for readers who are interested in the social and historical context of breastfeeding. It does give some great how-to information as well as some practical strategies for various common challenges; but the main purpose of this book is as a celebration of breastfeeding in all its diverse glory. Blenkinsop’s depth of knowledge and enthusiastic passion shine through. It’s a fascinating book to dip into, and with her musical bent, I’m sure the author won’t mind if I conclude that she may be preaching to the choir. The choir is loving it.

Proceeds from Fit To Bust go to support the excellent Baby Milk Action.

19 Oct

Book Review: The Food of Love, by Kate Evans

The Food of Love is a fun breastfeeding guide full of Kate Evan’s clever pictures and even fuller with words. I think it is aimed at mums-to-be and new mums, but I think it’s also widely enjoyed by people working with new parents.

There is a lot to like about this book. Most of the cartoons are funny (some of them are a bit judgey), and it is jammed with a huge amount of well-researched information. Evans positions herself firmly at the Attachment Parenting end of the spectrum, and is more than capable of backing up her position with evidence. Unfortunately she doesn’t, always, which relegates a lot of her bold statements to opinion. The book would be much stronger if it was better referenced.

In the early chapters, Evans covers the basics of how breastfeeding works, using cartoons to demonstrate very clearly the mechanics of breastfeeding as well as a lot of the interesting sciencey stuff about breastmilk. The section on hand expressing is excellent; the section on positioning is surprisingly prescriptive – I’m sure laid-back Kate didn’t always sit bolt upright to breastfeed.

Evans’ passion and enthusiasm for breastfeeding comes across on page after page of often rather stream-of-consciousness text, as though she has scribbled down everything she can think of about breastfeeding, and when she runs out of that she goes on to talk about parenting in general, sleep, postnatal depression, relationship stuff, and toddler discipline. It’s a really useful general parenting book in that respect and could probably reach a wider market if sold as such.

I enjoyed the lovely bit on the evolutionary context of attachment theory, again illustrated with amusing drawings. Occasionally she follows a fairly idealistic opinion section with a contrasting realistic cartoon, for example the starfish baby in the middle of the bed showing the reality of co-sleeping for many parents.

We have the obligatory dip into alternative medicine (which if it worked would be called medicine), which is a shame when she’s so clear and comprehensive on brain chemistry and other sciencey stuff. The recommendation of homeopathic belladonna as a treatment for mastitis is a highway to a breast abscess.

The chapter offering solutions to common breastfeeding problems includes some excellent flowcharts (pp131-132), however the solutions offered are a bit garbled in places and there is no signposting to reputable breastfeeding support organisations such as NCT or ABM, nor any discussion of breastfeeding support groups (which surely would lend themselves well as subjects for caricature).

In summary, I loved parts of this book but not all of it. I probably would give it to a new parent, but not universally; I think some people might be more receptive to it than others. I’d love to see it repackaged as a general parenting book as it’s so good on attachment parenting. And I can strongly recommend Kate’s blog!

15 Oct

Book Review: Whoosh! by Katie Brooke

This is an appealing little book, chunky and colourful, with some useful informatoin tucked into its bright pages. It might be intended as a way for a woman to tell her partner she’s pregnant, or to share some basic ideas about how the partner might support her in labour. Full of sweet cartoons, this would also be a great format to tell a child about a sibling on the way (or how about one for grandparents; I foresee a whole range of these!).

I liked the spaces for personalisation and can imagine a couple filling it in together; what a nice way to think about birth planning. I felt it could benefit from a little more substance to make it more of a handy pocket guide, but there is no denying its cuteness.

You can get your copy of Whoosh! from the publisher Pinter & Martin, currently priced at £9.99. Disclosure: they sent me a free copy.

12 Oct

Book Review: Baby Sleep Solutions, by Netmums with Hollie Smith

Baby Sleep Solutions is one of several problem-solving books produced by helpful parenting website Netmums. It is packed with information and suggestions, but is largely placed at the non-attachment end of the parenting spectrum, despite its claims to sit within the evidence base.

Its introduction decries the plethora of conflicting advice that new parents receive from friends and family, then introduces its own team of experts. The whole book tries hard to balance a parent-centred approach with some quite directive advice, generally followed by a proviso basically saying “if you don’t want to do it that way, that’s ok.” What I get from this is an understandable but still slightly confusing melange of approaches. Hopefully what a new parent gets is a range of options, and the possibility of picking and choosing the solutions that feel right to them.

Early chapters include a general explanation of sleep cycles and babies’ needs, then chapters for newborn, 6 weeks to 6 months, 6 months plus, older babies and toddlers. It starts from a very baby-centred point of view, with a straightforward and thorough discussion of where babies sleep, safety, and coping with the normal challenges. As the age ranges go up, the advice becomes more parent-centred, very focused on feeding (especially breastfeeding) being only for food, and other comfort needs now described as “wants” or “habits.” If I had read at 6 months “as long as she’s getting loads of love and cuddles from you in the daytime – she should also be emotionally secure enough to cope without you at bedtime and through the night too,” (p103) I would have felt horribly anxious about what terrible mistakes I was making, that my son clearly still needed me at night.

This, for me, is the difficulty in turning towards sleep training. If it doesn’t work, you’ll feel it’s your fault, you’ve done something wrong. If it works, you thank the expert who told you how to do it, and continue to doubt the effectiveness of your own instinctive parenting. We have to be so careful of the tone we use and the way we present “solutions” that try to find quick fixes for normal behaviours, rather than ways to understand, cope with, and support our babies’ needs.

So, from six months, the book advises you to “ditch” the night feeds, missing the point that breastfeeding is a relationship, not just a nutrient-providing process. It recommends cold turkey on the night feeds, and baby in his/her own room; and then goes on to suggest controlled crying, which it describes as “heart rending” but “gets results fast” (p109) What a dilemma.

Responding to your child is seen here as a “reward” – a concept understood by parents but probably not by a 6 month old baby. The book frequently (but inaccurately) refers to a lack of evidence that these levels of stress do harm, but let’s not forget that this does not equate to evidence that they do not harm. I might have been inclined to present the gentler solutions earlier in the chapter, with controlled crying coming as a last resort rather than the go-to plan.

For older babies and toddlers there is a range of behavioural strategies, and these chapters cover maturing sleep patterns, tips for moving the child out of the parents’ bedroom, cot-to-bed tips, sibling situations and separation anxiety. Finally, it looks at more specific problems including teething, illness, and the ubiquitous reflux; and then the typical parenting book dip into alternative therapy. Which, if it worked, would be called “therapy.”

Despite my detailed reservations, I quite liked parts of this book, where clear suggestions are made and there are matter of fact discussions of the challenges of coping with your baby’s sleep. The fact is that parents who are happy to “go with the flow” (p37) would probably not pick up this book in the first place. Parents who need help will find lots of options here, and may also be reassured by the many quotations pulled from the Netmums forums, from mothers experiencing or moving on from similar situations to their own. I would like to have seen more on coping, not just fixing; including gathering effective support, frontloading and daytime coping, and learning to maximise the sleep for as many members of the family as possible, without increasing levels of distress. It’s worth a read to get basic information about infant sleep, but I’d recommend ISIS as a better and more evidence-based source on this.

It’s available in kindle format from Amazon here, though I bought the paperback for a penny.

09 Oct

Book Review: Bare Reality by Laura Dodsworth

I’ve been keeping my copy of Laura Dodsworth’s Bare Reality on the coffee table, just to amuse myself really. It’s a big book with a lot of naked-chested women on the front, and I have had different reactions from various visitors. If they are curious enough to open it, most people are quickly absorbed into the stories of the 100 women who talk candidly to Laura about their breasts.

Just as breasts come in all shapes and sizes, so do our feelings and stories about them. Bare Reality includes a lot of thoughts on breastfeeding, sexuality, and feminism; and a good mixture of people who like their breasts and people who do not. The headless photographs force the reader to see only the breasts, but the accompanying narrative tells a much bigger story, challenging the contradictory social norms of beauty and prohibition.

Bare Reality shows you 100 perfect, beautiful women and gives a completely unique insight into their perspectives.

[Disclosure: I was given a free review copy of Bare Reality by the publishers]
Bare Reality is currently available for £20 from Pinter & Martin.