30 May

Book Review: Birth Work as Care Work, by Alana Apfel

Birth Work as Care Work is an important introduction to the subject of intersectionality in the birth movement, drawing out themes of oppression and inequality through the stories of women.

Alana Apfel and her contributors identify the challenges of a profit-driven healthcare system dominating birth, and a society where “white volunteerism” overlooks the real lived diverse experience of birthing women in communities that are not their own. Apfel creates a space for birth workers to be heard on both a personal and a political level, including four beautiful birth stories.

I found this book challenging to read as a white middle class straight cis woman, because although I am steeped in a culture of empowerment, of being “with woman,” and of respect and awe of the birthing body, the contributors are quite deliberately not talking to me. Reading it has been a good lesson in making myself aware of the water I swim in, and not trying to “fix” others’ experience from within my own frame of reference.

This is a recommended read for anyone interested in the broad political and social context of birth, and wiling to feel like our work is radical, valuable, and important.

[Disclaimer: The author sent me a free copy of her book]. We will be chatting with Alana in Sprogcast Episode 27.

24 May

Basics of Expressing Breastmilk

1. Mothers may express milk for many reasons, and at many different times. A mother with gestational diabetes might express colostrum before her baby is born; mothers also express if they are separated from their baby, if their baby won’t latch on, or to relieve engorgement. Once breastfeeding is established, many families share feeding using bottles of expressed milk.

2. Different pumps may be useful in different circumstances. Hospital-grade electric pumps can be hired locally. If you are only expressing now and then, a manual pump might be suitable. Colostrum can be expressed by hand without a pump.

3. Expressed breastmilk can be stored at room temperature for about 8 hours, in the fridge for 5 days, and in the freezer for 6 months. Defrost in the fridge and warm if necessary by putting the container of milk into hot water.

4. If you are giving both breastmilk and formula milk, you might want to offer them separately, giving the breastmilk first to maximise the amount taken, rather than diluting it with formula.

5. Expressed breastmilk can be given to the baby with a syringe, a spoon, a feeding cup, or a bottle. These will need to be sterilised.

6. If you are only expressing and your baby is not feeding at the breast, it is helpful to express very frequently: around 10 times in 24 hours, including once during the night, to mimic the feeding pattern of a baby.

7. Expressing in addition to breastfeeding usually increases the milk supply. Expressing instead of breastfeeding may decrease the milk supply.

8. Closeness with your baby stimulates release of the hormone oxytocin, which helps the flow of milk. Closeness with your breastpump is less likely to have this effect. Some women find that their milk does not flow easily for the pump. Therefore, the amount of milk you can pump is NOT a good indication of the amount of milk you can produce.

9. Warmth, gentle massage, and the sight/sound/smell of your baby can stimulate oxytocin and help milk to flow. Sometimes expressing in a warm bath can be effective.

10. The best time of day to express is whenever you have the time. Breasts produce more milk when they are frequently used, so it is possible to express before, after, or even during a feed. If you can’t find time to express, and you don’t have to, then leave it for a little while until things settle down.

For support with any aspect of infant feeding, you can call the NCT Feeding Line from 8am to midnight, every day, on 0300 3300 700.

23 May

Basics of Breastfeeding

While the basics of breastfeeding are the same, the experience is different for everyone. If you need help or support, call our NCT Feeding Line on 0300 3300 700, 8am-midnight, every day.

1. Colostrum is the first food for your baby. This protein-rich substance is packed with antibodies, and mothers start producing it during pregnancy.

2. Following the baby’s birth, it is the birth of the placenta that triggers build-up of the hormone prolactin, which controls the mother’s supply of milk.

3. In the first few days, babies feed very frequently (around 10-14 times in 24 hours). Each feed stimulates the release of more prolactin, and builds up the milk supply.

4. Spend as much time with your baby skin to skin on your chest as you can. This encourages newborn reflexes such as mouthing, rooting, and stepping, which help babies to position themselves and latch on.

5. Lots of skin to skin contact helps to stimulate the milk supply too. It also calms the baby, regulates his/her temperature, and helps to populate their immune system. Skin to skin with dad is great too!

6. Around 3-4 days after the birth, the volume of milk increases, sometimes dramatically, and the breasts may get engorged. If this happens, gentle hand-expressing, a warm flannel, or a bath may help.

7. A good position for breastfeeding is any position where the mother is comfortable and the baby’s body is fully supported by her body, not just her arms.

8. Feeds can last anything between 5 minutes and 45 minutes. Follow your baby’s lead, and try not to restrict the length of the frequency of feeds, because this may mean they don’t get enough milk.

9. If breastfeeding hurts (beyond the first few seconds), this is usually a sign that the baby is not well latched on. This can make feeds less effective, and reduce the supply of milk. Hold your baby comfortably so that he/she can open wide and get a good latch. If you need some face to face support with this, there are many local drop-in groups you can go to.

10. Newborn babies need to be close to someone most of the time, so there is plenty of opportunity for dads to help out with soothing, settling and cuddling, and babies will usually sleep well on their father’s chest.

22 May

Basics of Formula Feeding

1. All brands of formula are made to the same standard, so no brand is better than another. You don’t have to stick to the same brand.

2. Each brand produces several stages/types of milk. The only one suitable for a newborn baby is Stage One/First Infant Formula. This is suitable until the age of one, when your baby can have ordinary cow’s milk.

3. Formula comes in ready-made liquid form, or as a powder. The liquid is more expensive, but quicker to prepare. The powder is not sterile, so it is very important to follow the instructions for making it up, to prevent the growth of bacteria.

4. Your baby will tell you when he/she is hungry, by smacking their lips, rooting (head-turning), and sucking their fingers. Crying is a late hunger cue, so try to respond to these early cues, to minimise everyone’s distress.

5. When you bottlefeed, hold your baby close and upright, so you and your baby can make eye contact. Enjoy the opportunity for a cuddle.

6. Pace the feed: Hold the bottle close to horizontal, touch it to your baby’s lips, and allow them to latch on to the teat. When they let go of the bottle, it’s okay to offer it again, but don’t insist they finish the whole feed. Your baby can tell when he/she has had enough.

7. Newborns and breastfed babies trying bottles for the first time often prefer a slow-flowing teat. Be patient while they learn this new skill.

8. Spend as much time with your baby skin to skin as you can. This calms and soothes, and helps to build your baby’s immune system.

9. In the early days, your baby has a tiny stomach and needs small amounts of milk, very frequently. If you are able to give your baby colostrum at this time, even for a single feed, this is a very healthy start for them.

10. If you are in any way unhappy or unsure about your situation, you can talk to a Breastfeeding Counsellor. We won’t try to dissuade you from your decisions, but will listen and support you. You can call the NCT Feeding Line from 8am-midnight, every day, on 0300 3300 700.