Tag Archives: breastfeeding

03 Mar

Book Review: Beyond the Sling, by Mayim Bialik

Mayim Bialik is a neuroscientist, an actress, and with this book a real spokesperson for Attachment Parenting. If you imagine a spectrum with absolutely routine-focused, parent-led families at one end, and completely baby-led, bed-sharing, nappy-free families at the other end, then Bialik is telling a story set right at the tip of the baby-led end of that spectrum. The title “Beyond the sling” tells us just how far along it is.

As she tells us at the start, this is not a quick-fix parenting manual. Although she clearly is writing about what, in her view, is the best way to parent, she delivers most of this through anecdotes about her own family. I spoke to a new mother recently who liked that because it gave her a new perspective to think about, rather than telling her what to do.

Attachment Parenting considers parenting to be “the most natural and instinctual event on the planet.” (p11), fostering respectful and loving relationships between parent and child, and ensuring a securely attached, happy individual. Bialik argues that this process is innate and this outcome biologically inevitable, and devotes one chapter to explaining some very basic science behind attachment theory. This section was disappointingly thin on actual science.

Part Two of the book is entitled “What a baby needs,” and covers birth, breastfeeding, babywearing, bedsharing, and elimination communication, which she feels gave her a deep intuitive connection with her children. These chapters are mostly evidence-based, however they frame this style of parenting very much within the limitations of natural birth, exclusive breastfeeding, and easily cleanable floors, which I fear would make her exhortations inaccessible to many parents.

Part Three is about what babies don’t need, and while there is much to admire in keeping one’s home free of battery-operated toys, I absolutely cannot get behind her “informed decision” not to vaccinate her children, and feel that the resources offered to support this very brief section are rather one-sided.

The chapter on discipline gave me a lot to think about; I felt like I violently agreed or disagreed with every other paragraph. There is much clear and logical thinking about how to deal with behavioural matters, but many of the anecdotes about how she and her co-parent implement this thinking seem not to line up with the theory. I think that a child would understand “not for Miles” (p195) to mean exactly the same thing as “no,” but perhaps it depends on the parenting context. I feel like I must be missing some very subtle nuance here.

I would be unlikely to recommend this book to someone who hadn’t specifically asked for something on Attachment Parenting. I am uncomfortable with dogma at any end of the spectrum. Bialik states that “this is not a judgemental book,” nor is it one of those books that “make me feel that I am failing and inadequate,” (p13); and yet this is exactly how I felt reading it – and this is from the perspective of a straightforward birth, bedsharing, full term breastfeeding, and a pretty good grasp of brain development myself. When Bialik claims that she does not need to put her own needs on hold to parent in this extreme way, she also contradicts herself by repeatedly telling us how tired she is, but that it is the right thing to do. I think it would be okay to be honest about the amount of sacrifice needed to parent in this extreme way, and that there are parents who will choose it anyway, or moderate their approach to meet both their own needs, and those of their children.

Disclosure: I was sent a free review copy of Beyond The Sling by the publishers Pinter & Martin. You can currently buy it on their website for £6.99.

11 Feb

My complaint to the BBC

Dear BBC

I wish to raise a complaint with regard to the choice of Clare Byam-Cook, who was represented as a “breastfeeding expert,” a “breastfeeding counsellor,” and a “lactation consultant” on Woman’s Hour on Monday morning. With respect, she is none of these things, and I am deeply unimpressed that BBC researchers were unaware of this, despite complaints every single time she appears.

The information given out by Byam-Cook about tongue tie, milk supply, and the baby’s latch at the breast were fundamentally incorrect. Since the purpose of this piece was to explore the reasons why women feel unsupported and do not breastfeed for long in the UK, I am surprised that this misinformation was perpetuated without comment. This is negligent of the BBC.

Byam-Cook was also allowed to talk about her video and book, and mention that she is available for private consultations. I understood that the BBC was required to adhere to certain standards about allowing advertising. If this had been advertised on ITV I would be making a complaint to the ASA, since her book contains many factual errors that would undermine the breastfeeding experience of most women.

Please do not bother to send me your standard response, as I have read it. I take issue with the statement that ” Unlike other breast feeding counsellors, she doesn’t believe that breastfeeding is the be all and end all.” As a Breastfeeding Counsellor, I am very well aware that breastfeeding is one part of the complex experience of becoming a parent, and I have supported parents in many different situations, making many different decisions. The word “counsellor” should convey to you that we listen and support individual mothers, without an agenda. Nonetheless, breastfeeding is an important public health issue, as shown in last week’s article in the Lancet; and the BBC has a responsibility to give out correct factual information, as well as the helpline numbers from the four reputable organisations whose counsellors are trained to support women in an evidence-based, parent-centred way.

Kind regards
Karen Hall

11 Feb

How not to talk about breastfeeding on the radio

On Monday, BBC Woman’s Hour had what they described before the programme as a “ding dong” about breastfeeding. Ironically I missed the first fifteen minutes because I answered the phone, just as the programme started, to a mother who was concerned about her milk supply. Then I tuned in and cringed to hear the brusque tones of Clare Byam-Cook, a self-appointed “expert” on breastfeeding, telling listeners all about her magic techniques for getting babies to feed, and explaining where we, the trained breastfeeding supporters, are going wrong.

I have issues with the BBC allowing this person to promote her book and simultaneously undermine the work of the breastfeeding counsellors who criticise it. I’ve read her book and it’s hard to see how anyone could have much chance of breastfeeding for long, following its guidance. Callers to the show spoke of pressure, conflicting advice, and not being listened to. Byam-Cook dismissed the issue of tongue tie as “just a trend,” thus dismissing the experiences of thousands of mothers who have struggled to feed their babies precisely because of this. Estimates vary, but it seems that tongue tie affects 5-10% of babies, many of whom will be able to breastfeed, and some of whom are so badly tongue tied that they cannot drink from a bottle. Because it can be hard to identify a tongue tie, and midwives are not universally trained to do so, many mothers struggle with long or painful feeds, and many give up in despair. This is not a positive decision for them, and to hear that it’s a non-issue that doesn’t need to be resolved must hurt in so many ways.

Her fundamental lack of understanding of the way breastmilk is produced is shocking (“it is absolutely not true” that the more you feed, the more milk you produce). The well-established, basic principle is that milk removal creates milk production, therefore the more effectively a baby feeds (that is, on cue, for as long as he/she wants to, without discomfort for the mother), the more effectively the mother produces milk to meet that baby’s needs. Yes it is true that sometimes a baby feeds more (for longer, or more frequently) because the feeding is not effective; breastfeeding is complex, and breastfeeding counsellors are trained to listen to mothers and try to understand the situation so that they can offer appropriate support.

Listeners were also treated to her description of how to get a baby to latch on and feed (“mouth to nipple and squeeze the breast.”) Breastfeeding counsellors all over the country must have been banging their heads on the desk at this point; how many painful feeding experiences have we witnessed, where a woman has been told to squeeze her breast and force the baby on to it? No one-size-fits-all approach can ever be appropriate when we’re talking about human bodies, but there are strategies involving comfort, closeness, and biological reflexes that can make things much easier for both mother and baby.

I understand exactly why BBC Woman’s Hour invited Byam-Cook on to the show: a discussion between two International Board Certified Lactation Consultants about the shocking lack of support for new mothers would not have made such exciting radio. Or would it? As Dr Pat Hoddinott pointed out, the media has to share responsibility for the low breastfeeding rates in the UK, and shows like this are very much part of the problem, not part of the solution.

If you are a new parent and need some support with breastfeeding, there are several helplines run by women trained in listening, and with evidence-based knowledge about how breastfeeding works, including the NCT Breastfeeding Line 0300 330 0700 open 365 days a year, 8am-midnight. We talked about breastfeeding support in our very first episode of Sprogcast, which you can find here.

08 Feb

Book Review: Helping your baby to sleep, by Anni Gethin and Beth Macgregor

Helping your baby to sleep is a book about being kind and gentle to your baby: a persuasive philosophy in anyone’s book. It is divided into two sections: the science of responsive parenting, and the practice of gently encouraging a baby to sleep. Its starting point is very much the argument that “bringing about change by causing a child to be distressed can never be considered a success.” (p.xxi)

Like many, many such books, authors Gethin and MacGregor explain the mechanisms of sleep: cycles of sleep, survival needs, and what exactly does “normal” mean, anyway? Each chapter has a nice summary of key points, useful if you are reading this as a sleep-deprived parent.

Having laid out the scientific support for responsive parenting, the case against sleep training in chapter four makes complete logical sense, if somewhat distressing reading in places.

Moving on to the practical section, they offer a range of “slow fixes” for helping babies to settle and parents to get a less disturbed night, appropriate for different ages and situations, as well as a chapter addressing most of the common sleep difficulties that parents experience.

The book finishes with a helpful section on self-care and support for parents, which really needs to be threaded throughout lest parents give up reading while it all still sounds rather onerous. Of course parents want to be gentle and responsive, but attachment parenting books can appear to ask a lot of parents at a challenging time in their lives. It really helps to have the science of brain development and attachment so clearly laid out, alongside quotations and ideas from other parents. The cartoon on page 130 seems very apt. Buy it and see for yourself!

18 Jan

The Long Run

Our local NCT branches (Wokingham and Reading) are raising money to pay for training a group of Breastfeeding Peer Supporters. These are mothers trained in listening skills and basic breastfeeding knowledge, who can then support other new mothers at drop-in groups and clinics. It costs quite a lot but the return to the local community is great.

I’ve been convinced to have a go at running the Reading Half Marathon, to raise some money towards it. Having never run further than 7.5 miles, the thought is pretty scary. I’m collecting motivation points here: JustGiving Page

08 Nov

A poem about being an “idealistic” breastfeeding counsellor

I had a positive birth and a healthy, full term baby
Then I didn’t know what to do
On the few occasions when he latched on, it really hurt
I still don’t know why.

I started expressing on day two
I can’t remember when I stopped
I went to the breastfeeding clinic twice and called all the helplines
The midwives and the health visitors told me he had a good latch
One of the helplines suggested I use nipple shields so I did
Then he latched on, but it still really hurt.

I cried at nearly every feed for about 12 weeks.
I cried when he didn’t gain enough weight
I cried when he wouldn’t take a bottle of formula
I cried when he woke up to feed in the night
I cried when he wouldn’t nap during the day
I cried when my mother told me I had made a rod for my own back
I cried when he cried.

I cried less and less, week by week.
Breastfeeding became peaceful, but still demanding
Breastfeeding felt good
Breastfeeding soothed him immediately
Breastfeeding was the only time when he was still.

I cried when he decided he didn’t need to breastfeed anymore.

[p.s. At least once a week someone calls me for support with a whole range of feeding issues. How can anyone think I’m idealistic about how easy it is to breastfeed?]

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!

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.