02 Dec

Book review: Biological Nurturing, by Suzanne Colson

On reading the second edition of Biological Nurturing, I am reminded of what a powerful influence the first edition has been on my work as a breastfeeding counsellor, both in terms of how I talk about positioning, skin to skin, and the transition from womb to world in antenatal sessions; and how I support mothers with breastfeeding after the birth.

Suzanne Colson has vast clinical experience and research experience of what is now widely known as her method: biological nurturing. Biological nurturing is far more than just laid-back breastfeeding; it is a deep understanding of the needs and abilities of the breastfeeding dyad, almost a philosophy of positioning. It is a mother-centred process, using gravity and both parties’ instinctive behaviour, to achieve comfortable and effective breastfeeding.

It could be argued that this is simply a rediscovery of ancient behaviour: the way women breastfed long before male experts took over all the thinking and management of it, to spare our pretty little heads. Colson describes some of the social and cultural movement away from instinctive breastfeeding, using her own science to show how wrong those 18th and 19th Century men of science were about what we do. As she tells us, “you cannot teach mothers to do this,” (p158) because it is instinctive behaviour, highly dependent on the hormonal environment. So the role of a breastfeeding supporter is to enable that environment to be right for the mother and the baby, and to have confidence that this innate behaviour works.

Colson has a great deal of research to support her work, presenting it here in detail, and yet with accessible language and even QR codes so that the reader can access video clips. She is critical of the deeply entrenched, prescriptive ways that some midwives manage early breastfeeding, and this might be a difficult – but essential – read for those who work in that way. It is a fascinating and useful book for anyone supporting breastfeeding, and for mothers who are interested in a much deeper level of knowledge than they will get from your average book on breastfeeding.

[Disclosure: I was sent a review copy of Biological Nurturing. You can obtain yours, with a 10% discount when you use the SPROGCAST code, from Pinter & Martin].

29 Nov

Book review: Informed is Best, by Amy Brown

This afternoon I opened the latest copy of MIDIRS, and a couple of inserts dropped out of it. They are training modules, one on infant skincare, and one on breastfeeding challenges. I browsed the latter for a moment, noticing a paragraph mentioning a Cochrane review on the treatment of nipple pain:

However, the latest Cochrane review (2014) found insufficient evidence to recommend breast milk or any other intervention for treating nipple pain.”

So I looked up the Cochrane review, and here’s what it actually says:

Currently, there is not enough evidence to recommend any specific type of treatment for painful nipples among breastfeeding women. These results suggest that applying nothing or expressed breast milk may be equally or more beneficial in the short-term experience of nipple pain than the application of an ointment such as lanolin.

The picture above shows who produced this document: Lansinoh. A company with a vested interest in selling an ointment such as lanolin.

With this in mind, I picked up my copy of Amy Brown’s latest book, Informed is Best, a book which purports to help the reader fight their way through the tangle of misinformation, opinion, and hidden agendas that gets deeper and deeper as you wade into pregnancy, birth and parenting. This is a very useful and important book, and is more important than ever in an era of fake news, limited attention spans, and a distrust of experts – as the book itself explains in glorious detail.

What I find amazing about Amy’s writing is her ability to gather so much information, and distil it into meaningful and accessible writing; in fact she quotes a study where a mother describes wanting “mom-level detail from an expert” (p226) and this is exactly what we have in this book. Amy sets the context, looking at how the media, social media, and the patriarchy shape our access to good quality information. She explains different types of research, and even gives us a quick blast of how to understand statistics in a way that didn’t actually make me want to poke my own eyes out. The text is wonderfully seasoned with examples, including unpicking many twisted media reports of research; and presented in her marvellously offhand-but-serious-really style. For a book about research, it’s just such an enjoyable read.

One thing I especially love about this book is her exploration of her own bias, along with sections that really should make the reader reflect on their personal biases. The Dunning-Kruger effect really gave me pause for thought. How often do I dismiss someone’s work because of a connection with something I didn’t like reading or hearing? It definitely happens.

Each chapter ends with a practical list of ways to keep informed, summarising the detail within. My favourite is: “To any female expert reading this, I urge you to have the confidence of a mediocre White man.” (p124). Oh yes indeed.

If you want more, I interview Amy about the book in episode 56 of Sprogcast. To get your copy of the book, use our 10% discount code SPROGCAST at the Pinter & Martin checkout here.

27 Nov

Book Review: Inspired Parenting, by Dorka Herner

Dorka Herner is a Hungarian psychologist and mother of five, and this is her book of reflections on motherhood. Divided into six chapters, such as “Reshaping the patterns that shape us,” it seems to be intended as a tool for learning or developing the reader’s own parenting; however it really is just a series of daily writings, from funny little aphorisms about saying a nursery rhyme and realising it is intended as a tool of mind control; to longer vignettes about her twins getting into a good school. Nothing in the book asks the reader to consider how it relates to them, or to reflect on its meaning. It doesn’t advocate a particular style of parenting, or offer advice on any of the many challenges described – just tells you about them.

Inspired Parenting may offer some insight into someone else’s parenting, and it’s always useful to try to understand how other people live. It’s a pleasant book to dip into now and then.

[Disclosure: I was sent a review copy of Inspired Parenting by the publisher. You can get a copy here, with a 10% discount using the code SPROGCAST at the checkout.]

11 Oct

Book Review: Give Birth Like A Feminist, by Milli Hill

I tried to narrow down who I thought should read this book. Expectant mothers? Their partners? Midwives? Doctors? All humans? Pretty much the only people who don’t really need it, are those of us already actively calling for recognition that birth is a feminist issue, within our working community. I fervently hope that the latter are not the only people who read it.

Milli Hill has a strong history of writing well about childbirth, rooted in her own experiences and capitalising on her work as an established journalist. She is able to talk to more mainstream audiences than many of us, and her writing style is passionate, informed and accessible. A strong tenet of this book is that the truly feminist perspective is to support and respect all birth choices, even if they would not be our own.

In case that isn’t a persuasive enough argument, Give Birth Like A Feminist provides a feminist historical and cultural context of birth, looking at why certain things are done just as they have been done for centuries, with no real evidence base. From induction to lithotomy, she examines the assumption behind birthing protocols, which is essentially that women’s bodies are badly designed and ineffective when it comes to reproducing the species. It’s astonishing that we have survived so long. And can I just say, the Husband Stitch? WTF.

From this context, Milli develops the argument that societal attitudes to women’s bodies and behaviour pressure us to conform to a stereotype of being weak, helpless and incapable. In fact, images and stories that represent women as capable and powerful are often repressed; take for example Facebook’s banning of certain images of birth and breastfeeding, that are no more revealing than apparently acceptable images of underdressed celebrities. Women are both infantilised, and expected to be available for sex/pleasing to men in particular and society in general. A good woman, like a good baby, is quiet, undemanding, and has no leg or armpit hair.

Give Birth Like A Feminist furthers a new narrative of childbirth and women’s bodies, elevating women above the mere vessel for and caretaker of the next generation. Milli Hill is constantly kickstarting this conversation, and challenging the way birth is presented in the media and in the world. Just carrying this book into a room last week gave me an insight into attitudes to both birth and feminism, when people around me raised eyebrows and chuckled at the very idea.

This is a well-referenced book, and Hill supports her points with case law and evidence. She has a tendency to write about her own experience, and I find this a distraction from her important argument that this happens to most women, in one way or another. She also fills the book with other women’s voices, and points out that she does not have to ask around for long to find stories where women felt their choices were shut down, belittled, or never discussed at all; where women are abused and coerced, where midwives are unable to work, where we’re all either baby brain or birthzilla, not human beings at all.

There are also some small practical sections describing actions to take or ways to look at evidence, and the BRAIN decision-making tool used widely by NCT is shared again, which can be no bad thing. This is not a practical manual like the Positive Birth Book, but very much a book I would give to a pregnant friend.

Thanks to Milli for the review copy of Give Birth Like A Feminist, and also for sparing time in the summer holidays to chat with me for Episode 54 of Sprogcast.

18 Jul

Book review: Why Breastfeeding Matters, by Charlotte Young

You may be familiar with Charlotte Young, the sometimes-ranty but always well-informed blogger known as The Analytical Armadillo, one of the few reliably evidence-based information sources to be found online. Her wealth of knowledge is collected here into 16 neat chapters on the how and why of breastfeeding.

Like other books in the Why It Matters series, this is small but dense, covering how breastfeeding works; the wide range of normal baby behaviour and parental strategies for coping with it; expressing, formula and mixed feeding; and a couple of good chapters on the socio-cultural context of breastfeeding, and the impact of the formula milk industry.

Young is very aware of being a passionate supporter of breastfeeding mothers, in a bottle-feeding society, so much of her work is around myth-busting, whether she’s addressing the nonsense idea that breastfeeding mothers must eat a bland diet, or the notion that Mommy Wars is a feminist advert. She is careful to reference everything; perhaps a little less careful not to sometimes come across as sarcastic.

If you’re looking for an accurate breastfeeding text that pulls no punches, gives both the practical side of things and the context, and explains all of this logically and clearly, then this book is highly recommended.

[Disclosure: I obtained a free review copy of Why Breastfeeding Matters from the publishers. You can order a copy and get 10% discount using the code SPROGCAST, from their website here]

20 Dec

Book Review: Why the Politics of Breastfeeding Matter, by Gabrielle Palmer

This small book in the Why It Matter series from Pinter & Martin is a distillation of Palmer’s earlier, bigger book with a similar title: a good starting point from which to explore this huge and frankly upsetting subject.

Palmer begins with the well-established health case for supporting and protecting breastfeeding: more than 2,000 baby deaths per day worldwide, as a broad headline; and many far-reaching consequences that affect families every day, in the developed world and beyond. The history of commercial baby milk substitutes going back over 100 years is clearly explained, showing how the creation of a market, rather than the health and wellbeing of infants, has always been the industry’s main motivator. The book explores the ethics of testing the product on the market – also known as giving untested formula milk to babies; as well as the growth of the close relationship between health professionals and manufacturers. This relationship has led to the complete undermining and misunderstanding of normal breastfeeding, to the point at which breastfeeding failure is now framed as a “flaw of women’s bodies” (p45); meanwhile historical practices at the time of birth, and social pressures to parent in certain ways, sabotage the breastfeeding relationship and contribute to this vicious circle of ignorance.

Palmer explains why the ongoing Nestle boycott matters, why the WHO developed the International Code for the Marketing of Breastmilk Substitutes in 1981, and how the milk manufacturers created unnecessary products like follow-on milk in order to exploit its loopholes. One unanticipated side effect of this was to present breastmilk purely as a food product, erasing the importance of the breastmilk relationship, and making it harder for society to value this fundamental aspect of motherhood.

The huge implications of all of this for global issues like poverty and climate change are introduced towards the end, leaving the reader potentially feeling angry and cheated by big business; and hopefully ready to fight for change.

Disclosure: I was sent a free review copy of Why The Politics of Breastfeeding Matter by the publisher; you can order it here, with a 10% discount at the checkout, using the code SPROGCAST.

23 Nov

Book Review: Beautiful Birth, by Suzanne Yates

This is a nice book, a keeper for sure. Beautiful Birth is an attractive, slim volume with an immediate appeal to anyone looking for practical techniques for coping with childbirth.

It has two main sections. The first section covers breathing and visualisation, positions for labour, and massage. It gives an uncomplicated rationale for why these things are helpful, and a step by step approach to practicing them during pregnancy, and using them during labour. It does include a little more chinese medicine and shiatsu than I would normally be comfortable with, but actually the book is so useful that for once I’m not going to make snarky comments about that.

The second section is on preparing for birth, and is a straightforward explanation of what happens and how a woman can use the coping techniques from the first section, to help herself have a positive experience. Its approach to planning the birth is about connecting with yourself and reflecting on what kind of environment and support feels best. It touches on decision making when things don’t go to plan, and very briefly on the “fourth stage” of labour, meeting the baby.

I think most pregnant women could find something useful in Beautiful Birth, whatever kind of birth they are expecting; it’s never unhelpful to have some strategies for bringing calm. It’s a shame the pictures are not more ethnically diverse, but I would generally recommend this book.

[Disclosure: I was sent a free review copy by the publishers. You can get hold of it here, with a 10% discount at the checkout using the code SPROGCAST]

22 Nov

Book Review: Truly Happy Baby, by Holly Willoughby

Truly Happy Baby – Holly Willoughby

First, a confession. My name’s Karen and I have no idea who Holly Willoughby is. Having browsed her book, I understand that she is a photogenic mother of three. I assume she’s also some sort of television personality, former pop star, or reality TV type. Why her views on how to parent your baby are important escapes me completely, but an antenatal session rarely goes by these days without someone mentioning her wonderful book.

So I have acquired the wonderful book, and set out to see just how wonderful it truly is.

Holly explains in her introduction that, on becoming a mother, she became the expert on motherhood, and immediately knew she would write a book telling other mothers all the things that nobody else tells them. This is a subject I may have touched on before. Holly’s approach is encouraging: trust your instinct, don’t expect too much too soon, be led by your baby. These are all very important points. She’s also going to be as honest as she can, and give you lots of top tips that worked for her, but you should still do your own thing because every baby is different, and everything will be alright because love.

The book begins with a chapter on feeding, in which she shares some useful information but in the most mealy-mouthed way in order to be inclusive of mums who give formula. In the first few pages Holly provides a useful shopping list, some nonsense about what to eat to “improve the quality and quantity of the milk you are producing” (p17) and a recipe for lactation cookies. There are some pictures to demonstrate positioning, none of which are laid back and there are some helpline numbers for support, none of which are the NCT. She also perpetuates the unhelpful idea of foremilk and hindmilk. Solutions offered for painful nipples are lanolin cream and nipple shields, and absolutely no mention of positioning and attachment, or skilled support.

Moving on to expressing, she points out that “you’ll feel like a cow” (p29), but does at least mention the role of oxytocin in expressing milk.

On formula, she lets us know that she paid a premium for one with a probiotic; other useful information she might have included is that all baby formula must be made to the same standard, and different manufacturers use different names for the same added, unnecessary probiotics. She does describe the recommended method of making up formula, but on the facing page another one of her great tips is not to bother doing it like that because it’s just too much faff to feed your baby safely.

I love the section on winding, in which she says “there’s never a good reason not to wind” (p43) and then goes on to give a good reason not to wind (i.e. your baby doesn’t have wind).

On weaning, again Holly plays fast and loose with the guidelines, because “ultimately it’s up to you.” (p46) Of course this is true, but how can she expect the poor harried mother to decide when the information she shares is so contradictory?

You’d think by this time I would have stopped reading in order to maintain my famous calm, but I couldn’t help dipping into the chapter on sleep. So far so good, we have lots of information about safe sleeping conditions; however within two paragraphs she tells us that co-sleeping is not a good idea, but she did it anyway… on a sofa bed! So about as unsafe as you can get. Remember, she says, do what works for you. Every baby is different. She can’t say that enough, she says. (She can).

Unsurprisingly, Holly recommends getting into a routine from three months. There are lots of nice clock-shaped charts, which she recommends not trying to follow too closely because they worked for her but every baby is different, etc. Apparently turkey is a good food for getting a baby to sleep, who knew. Let’s skip the bit about sleep training, and move on to the useful stuff on getting support for your own sleep deprivation.

The next chapter is on wellbeing, and is actually a very useful and comprehensive guide to caring for a newborn. I’d be inclined to pull this bit out of the book and offer it to people who feel they need some sort of baby manual; it’s far better than the rest of it.

Chapter four, named Lifestyle, seems to be an extension of the wellbeing chapter, with a few extra bits about how to register a birth and how to go on holiday with a baby. None of this is particularly ground-breaking or unavailable online.

And finally, Looking After You. Here we learn about piles and postnatal depression. Interestingly, we get fewer personal anecdotes in the pages about resuming your sex life, but Holly does advise that it’s scientific fact that new mothers don’t love their partners for the next 18 months. No reference is provided for this fascinating piece of research.

So in summary, Holly Willoughby has three babies, but all babies are different and you should do what’s right for you. For £16.99 you too can benefit from this profound wisdom.

16 Nov

Book Review: Trust Your Body Trust Your Baby, by Rosie Newman

Rosie Newman’s book aims to inspire confidence and trust in a mother’s own instincts, through pregnancy and birth, feeding and mothering. It is a book for women who need help with the paradigm shift of becoming a new parent. One of the things that really comes across is the value of surrounding oneself with like-minded, positive people. Newman is well-read and draws extensively on the literature of attachment parenting and straightforward birth.

Trust Your Body Trust Your Baby is sensibly structured with a logical progression, starting with a practical chapter on preparation for the baby’s arrival. The birth chapter gives an interesting history of obstetrics, an explanation of the role of hormones, and a valiant attempt to convey the reality of labour.

The following chapters cover life after birth: establishing breastfeeding, sleep, attachment, and the emotional and psychological adjustment. All of this is extremely good stuff that I would recommend to new parents; it is well-referenced and although it comes from a firm base in attachment parenting, and includes a great deal of Newman’s own experience, it is written with empathy and compassion for both the mother and the baby.

The last chapter is on elimination communication, and might make some new parents wonder if this really is the book for them, or whether it is too far from the mainstream. My clients tend to think The Baby Whisperer is a “a bit of a hippie,” so I’m conscious of wanting books like this to be accessible. Of course there is a huge part of me that really doesn’t want to pull any punches, too.

I was writing this review at a very quiet breastfeeding drop-in. Two mothers came in and we were talking about the conflict between trusting your instincts as a mother, and coping with the pressures of modern life, lack of sleep, lack of support, and the weight of expectations that babies should behave in a certain way by a certain age (both babies were 3 months old and not behaving in a certain way at all). So I gave one of them the book; may it help her find her way.

[Disclosure: I received a free review copy of this book from the publishers. You can get your own copy here, and a 10% discount using the code SPROGCAST at the checkout].

28 Aug

Book review: Why Your Baby’s Sleep Matters, by Sarah Ockwell-Smith

I am full of admiration for Sarah Ockwell-Smith in her firm and thorough representation of attachment parenting, particularly around the difficult subject of infant sleep.

Her Why It Matters book tells us how infant sleep really works, with technical information in the early chapters, and then a good section on the historical context of social attitudes to sleep, advice, and “experts,” which really feels like the most important part of the book. Having read a great deal about the science of sleep, these sections give some interesting statistics, but didn’t really break any new ground for me. The chapter on the Science of SIDS however was particularly useful and gave me much to reflect on.

Ockwell-Smith writes with a tone of despair that sometimes comes close to contempt for the naivete of society and the many common misconceptions and misunderstandings about infant sleep, and while what she says is satisfyingly evidence-based, referenced and well-explained, I do think the tone could be kinder and more compassionate. The fact is that she pulls no punches, hence my admiration, but this might not be the first book on the subject that I would offer to a parent.

[Disclaimer: I was given a free review copy of this book by the publishers. You can buy it from their website, and get a 10% discount with the code SPROGCAST]