breastfeeding | Motherworldly

25 Jun

Emma’s breastfeeding story

Emma is a mum of two girls and juggles motherhood with running two small businesses with her husband. She wrote this post about breastfeeding a little while ago.

Boobs.

There. I’ve said it.

This post is all about boobs.

I spend a ridiculous amount of time with my boobs out at the moment. Not because I’m a weirdo, or a life model or even a glamour model; but because we chose to breastfeed both our children. For me, it was the only choice I felt comfortable with and I was fortunate that both my girls took to it fairly easily.

It’s not been easy though. First time around I had problems with positioning early on and suffered pain from cracked nipples, mastitis and also sheer embarrassment at feeding in front of people. I remember sitting up in bed crying with pain and talking about giving up and trying a bottle but still we kept going to my goal of 6 months. Then we hit weaning and feeds were dropped and before we knew it, we reached a year.

When my first child was 18 months old, I had an early miscarriage. I am pretty sure the combination of breastfeeding and jet lag was to blame. We didn’t tell many people and we ‘buried’ the feelings. It wasn’t meant to be. My daughter still needed me, I was just getting started in the businesses, so there was plenty to take my mind off things. I don’t think we dealt with it very well.

I actually ended up stopping feeding my first at 27 months but I think my daughter would have kept going for longer had I let her. I felt I needed this little bit of my life back – although it was only once a day by that point. We also wanted to try for another baby again and thought a little break between feeding and pregnancy would be nice…

Within 3-4 months, I was pregnant again. Our second baby is now 5 months old and again she is being exclusively breastfed. I’ve been surprised by how hard I’ve found it this time. I’ve had mastitis three times and problems with oversupply. Currently my daughter is so distracted during the day, she chooses to feed mainly at night, so I’m not getting much sleep. Coupled with the fact that I am so tied to the baby as no-one else can feed her, other areas of my life are being neglected somewhat.

I’ve had to feed in business meetings, in school meetings, whilst reading bedtime stories, during mealtimes, in cafes, churches, on beaches; and I’ve spent a stupid amount of time lying down in darkened rooms with only a baby, my naked chest and my thoughts for company.

I am SO over breastfeeding now but I will continue until we both decide we have had enough. Whilst this is me doing this, my husband and I are both in agreement that this is the best thing for us all right now despite the difficulties. I love it and can’t stand it in equal measure but I know I will look back in time and feel so glad that I did this.

20 Jun

Book Review: The Hormone of Closeness, by Kerstin Uvnas Moberg

The Hormone of Closeness: The role of oxytocin in relationships, is the second book I’ve read by Kerstin Uvnas Moberg on the subject of oxytocin, the hormone involved in childbirth, bonding and so much more.

Moberg posits an explanation of attachment theory wherein oxytocin underpins the child’s sense of security through enhanced wellbeing, increased calm, and a sense of satisfaction. She terms the innate and evolutionarily necessary need for closeness and contact with others as “skin hunger,” to equate it with hunger for food. This casts touch and its effects in a useful new light, showing how breastfeeding is about so much more than the transfer of milk, for the mother and the baby.

While much of the evidence in the book is drawn from lab studies on rats, her arguments are logical and compelling. Lay readers might skip the scientific stuff about what goes on in the brain, and read instead the fascinating description of the mother-baby relationship in the first place, which is then drawn into the wider context of our social interactions, stress levels, and the way we live.

Looking forward to the implications of the development of synthetic oxytocin, Moberg acknowledges that artificially increasing oxytocin levels, thereby increasing the tendency to trust, might not always be a good thing, particularly in a setting where we would not naturally be trusting. Evidently it would be better for the individual, and for society as a whole, to find natural ways to increase the world’s oxytocin levels. To illustrate this, she looks at the doula phenomenon, where a trusted woman present at birth can have a positive outcome, by allowing the birthing mother to tune into her body and allow levels of oxytocin to rise, facilitating labour and bonding with the new baby.

She finishes by looking at the possible consequences of our increasingly separate lives, and with a call on behalf of future generations to consider how to bring back social closeness, that “all of us on earth could live in peace and harmony with one another.” [p157]. This is an enlightening and affirming read.

***

To order The Hormone of Closeness with a 25% discount, just follow the link and use the discount code KH25 at the checkout.

[Disclosure: review copy provided by publisher]

14 Jun

Breastfeeding in front of other people

Emma is a mum of two girls and juggles motherhood with running two small businesses with her husband. She has kindly shared some of her thoughts about breastfeeding in public.

Breastfeeding in public isn’t always easy. I’ve breastfed both of my daughters. I breastfed my eldest until she was 27 months and I’m still breastfeeding my youngest at 22 months. Up to around 5 months both times, I had letdown problems – mainly because of oversupply. I produced a lot of milk and would find I would spray, leak or soak a muslin or several breastpads with the milk I was producing. Breastfeeding discretely wasn’t always easy. Once my girls got to about 3-4 months they would come off my breast mid feed and look around, leaving me spraying everywhere. I preferred to use quiet breastfeeding rooms if I could to minimise the distractions. With my second baby, I found I had to lie down to stop the milk flowing so quickly so feeding in public was very difficult as you can’t exactly lie down in the middle of a cafe! Once I was trying to feed her in a very noisy, busy restaurant in the middle of Cardiff (Jamie Oliver’s actually). Our table was in the middle of the restaurant and there was a draft blowing on us and people kept walking past. She wasn’t really old enough for solids yet so her only source of food was milk. I ended up going upstairs and sitting on a stool in a quiet corridor outside the disabled toilet (which was occupied). I felt like a total idiot when a man came out of the toilet with his son. It was that or sit on the toilet in the ladies – not very pleasant!

I stopped breastfeeding in public both times around 9/10 months in, once most of the daytime feeds had been replaced by solids and restricted feeding to quiet moments at home or in a friend or family member’s home. This is partly because both of my daughters were quite inquisitive and would detach from my breast and have a look around. It was also because they were more likely to help themselves and the position they were feeding in was more toddler like. This made me feel uncomfortable.

I have mostly found cafes, restaurants and so on to be quite accommodating if you ask if there’s somewhere quiet you can go. I’ve not always felt comfortable asking and sometimes others with me have felt more awkward than me around me breastfeeding.

Things that annoy me:
Signs for feeding that imply bottle feeding like a bottle icon – as seen in lots of motorway service stations.
Places that don’t have a breastfeeding/bottle feeding room.
Breastfeeding/bottle feeding rooms (I don’t mind being mixed together) that smell of poo and aren’t clean.
Separate rooms for feeding choice – seems a bit weird to do that but perhaps it’s because people other than mothers can bottle feed and breastfeeding mothers can feel uncomfortable?
The implication that because your baby is over 6 months you should move over to a bottle. The adverts on tv for follow on milk don’t help this. I know many do choose to and have to if they are going back to work but for those of us making the choice to carry on, it makes it harder.

04 Jun

What’s wrong with this poster?

Walking past the Tesco store in Beverley, in the East Riding of Yorkshire, I glanced through the window into the cafe, and saw this huge poster. “Here to help,” it says, in big friendly letters. “Hungry baby? We’re happy to warm your milk for you.” There’s a smiley face, and the name of the ten year old who designed it.

That’s kind, you might think. They’re giving out free jumpers, which on a miserable drizzly day seems like a nice thing to do. And then you would realise that the poster assumes that you are bottlefeeding. And statistically, they may well be right [let’s trot out those stats again: 81% of mothers initiate breastfeeding, 58% are still breastfeeding at six weeks, 12% at four months].

While the poster does not explicitly state that breastfeeding mothers are not welcome, and under the Equalities Act 2010 they are required to accommodate breastfeeding mothers, the underlying assumption that anyone with a baby in the cafe will have a bottle of milk with them simply undermines breastfeeding, and that contributes to the rapid drop-off in breastfeeding rates in the UK. There is no poster welcoming breastfeeding mothers; there would not be room for one anyway, as the bottlefeeding poster takes up the entire wall. And it would make no sense to put up a poster stating that both breastfeeding and bottlefeeding mothers are welcome. That, however, was the response from @UKTesco, when I tweeted about the poster: please be aware, breast feeding is always welcome at the store 🙂

You might think I’m getting a bit stale if I continually bang on about not dividing up the breastfeeding mothers and the bottlefeeding mothers into separate camps. The statistics above tell us that a huge proportion of breastfeeding mothers also bottlefeed, so the distinction is very vague anyway. How hard can it be to make all mothers feel welcome, and advise them that facilities are available for whatever kind of feeding they need to do?

However there is another problem with this poster, which is that it implies bottles could be made up in advance and warmed up. This contravenes NHS guidelines to make up each feed as your baby needs it, because of the risk of food poisoning bacteria in the formula. Perhaps they could go back to offering hot water (over 70 degrees) instead. And perhaps not get ten year olds to devise their policies.

23 May

Sharing a bed with your baby

This week a new study was published in the BMJ which gave rise to headlines regarding the dangers of sharing a bed with your baby: Bed sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case–control studies.

The authors of this report combined the results of five studies done in different countries between 1987 and 1998. The amalgamation of these studies gave a sample size of 1472 babies who died, and a control group of 4679 babies who did not. Each individual study compares the conditions of the babies in the two groups. However the individual studies did not look at the same risk factors. The authors were able to draw out some significant factors, and show the level of risk for babies who were in their parents’ bed, compared with babies who were in their own bed in their parents’ room. The risk factors examined are whether the baby was breastfed or bottlefed, whether either parent smoked, the position the baby was put down in (front or back), whether the mother had had alcohol or illegal drugs in the previous 24 hours.

The report concludes that the lowest risk of cot death is where a breastfed baby of a non-smoking, non-drinking mother sleeps on his/her back in the parents’ room, but not in the bed. That is, in the absence of any of the risk factors studied here, the risk of cot death is 0.08 per 1,000 live births. When a baby with the same conditions shares his/her mother’s bed, the risk increases to 0.23 per 1,000 live births. This was reported in the popular press as “FIVE TIMES MORE LIKELY!!”

The Telegraph headline claims that this report “sheds new light on cot deaths”, which is interesting given that the studies in the meta-analysis are more than 15 years old. There are more recent studies the results of which do not support these conclusions. A number of known risk factors are missing from the meta-analysis, including smoking during pregnancy, use of legal drugs such as the strong painkillers often used in the early postnatal period, parental obesity, paternal alcohol use, prematurity, the conditions of the bed itself (was the baby between the parents or on mum’s side, was the baby on a pillow, were other siblings or pets also in the bed, etc). The authors are open about the fact that some of the drug/alcohol data was missing, so they “imputed” this. A cynical mind would define the verb “to impute” as meaning “to make stuff up.”

A huge flaw in the report, and in most studies of cot death risk, is the definition of a breastfed baby. In most cases “breastfed” includes partly formula fed babies. We know how fast the rate of breastfeeding falls in the UK (79% at five days; 58% at six weeks), so it is understandably hard to generate an appropriately large sample of exclusively breastfed babies. However all studies show a lower risk for breastfed babies compared with formula fed babies, therefore it makes sense to me that partly breastfed babies should be either a separate data set, or included with the formula fed babies. The report also implies that while bedsharing is associated with longer duration of breastfeeding, the risk of bedsharing is not cancelled out by breastfeeding and therefore this cannot be considered as a reasonable justification of bedsharing. This overlooks the fact that cot death is not the only thing that breastfeeding protects babies – and mothers – against. The long-term risks of not breastfeeding are well-documented, and may, for some parents, outweigh the 0.23 per 1,0000 risk of bedsharing.

Of course the media is generally more reticent in reporting the apparent protective effect of breastfeeding, lest we make mothers feel guilty. This delicacy does not appear to apply to parents who choose to share a bed with their baby* who appear to make up a similarly large group to the formula feeding parents. (This of course implies that huge numbers of bedsharing parents are also formula feeding parents, which is the higher risk). So here is the point at which I climb, with a sigh, on to my usual hobby horse of WHY ARE WE TRYING TO SET PARENTS ONE AGAINST ANOTHER? What is the use of demonising parenting decisions, banning common behaviours rather than informing about risk and how to reduce it?

Whether you choose to sleep with your baby in your bed, beside your bed, or in another room, it is important to be aware of safety guidelines. If you think you will NEVER sleep with your baby, it is still important to be aware of safety guidelines, as for a lot of parents this is not a planned thing, and that in itself increases the risk. Let us not make bedsharing a taboo subject, or a polarising argument. Let us accept that we all parent in different ways, and we are entitled to be well-informed, rather than dictated to, about risk.

*How many parents share a bed with their baby?
Data from both studies found that almost half of all neonates bed-shared at some time with their parents (local = 47%, 95% CI 41 to 54; national = 46%, 95% CI 34 to 58), and on any one night in the first month over a quarter of parents slept with their baby (local = 27%, 95% CI 22 to 33; national = 30%, 95% CI 20 to 42). Bed-sharing was not related to younger mothers, single mothers, or larger families, and was not more common in the colder months, at weekends, or among the more socially deprived families; in fact bed-sharing was more common among the least deprived in the first months of life. Breast feeding was strongly associated with bed-sharing, both at birth and at 3 months. Bed-sharing prevalence was uniform with infant age from 3 to 12 months; on any one night over a fifth of parents (national = 21%, 95% CI 18 to 24) slept with their infants.

25 Mar

Breastfeeding and going back to work

In that chaotic blur of cuddles and tears that is the first few weeks with your baby, when you’re taking it one feed at a time, it’s possible that you might miss your working day. The luxury of time to sit at your desk and think, drink a cup of tea while it’s still hot, chat with other adults about matters non-baby, oh those were the days!

And as your baby grows and you settle into your new roles, perhaps the thought of work recedes for a little while; but towards the end of your maternity leave, you have to start making decisions. Whether you will go back or not; would you need to apply to change your hours; what sort of childcare you might need… and if you’re still breastfeeding, how on earth are you going to manage that?

During pregnancy and in the early weeks of motherhood, my assumption was that I would stop breastfeeding at six months, ready for when I returned to work at seven months. I interviewed several childminders and chose the one I was most comfortable with, and her assumption was also that I would be providing formula for him during the day. I arranged the date I would start back at work; and, all this in place, proceeded to wean from the breast.

Only I had failed, yet again, to consider what my son would agree to. Not only did the little terror categorically refuse to eat food of any sort, lips sealed head turned and expressing RAGE with every part of his being; but he was also absolutely not prepared to countenance the nasty bottle I kept trying to tempt him with. It was distressing for both of us. It was distressing for my partner, when he tried to give a bottle. It was a disaster.

Dani says of her daughter,

it never occured to me that she wouldn’t be ok when I returned back to work when she was a year old … it resulted in us both getting very upset & her wanting to feed even more, probably as reassurance more than anything, but I knew she had to be ok to go without when the option wasn’t there & I didn’t know how to prepare her for that without stopping the majority of feeds in the day.

Both Dani and I eventually made the decision not to wean, but to follow our babies’ lead and carry on breastfeeding when we returned to work. In practical terms, by six months in my case and a year in Dani’s, our milk supplies would have been robust enough to cope with a more chaotic feeding pattern, so for example I could feed my son on my days off and at night, and needed to express for the first few weeks back at work.

Ann tells what it was like to arrange to express at work:

My company bought a reclining garden chair for me to sit in, and put it in the shower room (which isn’t as bad as it sounds), it was actually quite pleasant …Except expressing takes ages. I was hand expressing. Every day. For two hours at the beginning to get the 400mls of milk A needed every day.

But two hours was difficult to fit in when I was working on two projects, and I was leaking if I didn’t manage to get away at the right times to express, so I had constantly sore boobs.

Then [I had to work] on site, and the medical room only had a mag lock, and you couldn’t lock it from the inside once you were in, and anyone who had a pass could walk in. And it was also used as the Muslim prayer room. And yes, I was walked in on. Twice.

My bottles of expressed milk in the office fridge caused some raised eyebrows. Ann sensibly recommends putting them in an opaque make up bag. It’s useful to know that expressed milk will keep at room temperature for a few hours, and longer in a cool bag, so you can take it home, refrigerate it, and send it with your baby the next day. If your baby will drink it, which mine did not.

My childminder was frankly horrified, and found it very hard to look after a baby who did not eat a thing from drop-off to pick-up. With my head full of going back to work, I feel I took my eye off the ball and failed to see that for my baby, it wasn’t just the milk he was going to miss, it was me.

In a similar situation, Dani actually made the decision to stop working altogether:

I handed my notice in at work, using the remainder of my annual leave I’d accrued on maternity leave to cover my notice period & once I took the pressure off to reduce her feeds, we came out of a 2 month long fog. I felt happier, L seemed happier & I accepted that was how it was going to be. What I didn’t count on was a childminder who wasn’t to be beaten & she wanted to give L another week.

With a few changes, L settled in and Dani did go back to work. She says I think that letting her do it at her own rate was what helped her eventually be ok without. There is hope for those mummies with boobaholic babies, L shows it can be done!

But babies develop and adjust to change at different rates, and Ann, no longer expressing but still feeding all night, feels that they are not there yet:

I want to continue, but at 17.5 months, I’m desperately tired, and have been horribly ill, and I’m honestly wondering whether it’s worth continuing or not.

None of these decisions are easy, and all come with a payload of guilt, one way or another. If you’re in the tiny percentage of mothers in the UK still breastfeeding beyond six months, it’s hard to access relevant support. It may feel like your peers have all stopped feeding long ago, or that the groups you’ve been going to are mainly focused on feeding newborns; in any case once you’re back at work you no longer have access to the drop-in groups and the whole thing can be very isolating. I retreated very much into online support from various forums where being a ‘toddler-feeding weirdo’ was a point of pride; now I meet such people all the time through my work, and make an effort to put them in touch with each other, so the peer support can continue. If you find yourself reading this and wondering where the help is coming from, or asking yourself who is going to understand, please get in touch, or call one of the breastfeeding helplines, where most of the counsellors answering calls will be or have been, like you, in that tiny percentage.

NCT Breastfeeding Line 0300 33 00 700 7 days a week 8am–midnight

Ann writes at beta parent and is @pixeldiva on twitter.
Dani is @boo_bowglin on twitter.

01 Mar

Comfort Milk

In the last few days we have been hearing news of a shortage of Cow & Gate Comfort Milk and Aptamil Comfort Milk. Danone, the owner of both brands, is reported to have run out of an important ingredient, maize starch, which is a corn-based thickener.

Parents use Comfort Milk for babies who are colicky, have wind, or are prone to possetting (bringing up a little milk after feeds). These are also symptoms of lactose intolerance, as described on this NHS website.

Comfort Milk, according to their website, is “Specially developed with reduced lactose to assist with the dietary management of colic and constipation, keeping your baby more comfortable and giving you a helping hand when it comes to maintaining your little one’s health.” If your baby is constipated, it would be advisable to talk to your GP or Health Visitor.

Packets of Comfort Milk are currently going on eBay for huge sums, to parents desperate to give their baby their usual milk. If your baby usually has a Comfort Milk, and you are unable to get hold of it, you can give any other suitable formula milk instead; switching brands will not harm your baby. All infant formula is made to a set government standard, within very narrow guidelines, and therefore all brands have the same nutritional content. If your baby is under six months, it is important to give milk that is suitable for newborns. Follow-on milk can be used for babies over six months, but is nutritionally unnecessary, and you can continue giving first milk if you wish.

First Steps Nutrition has a good document about different types of milk.

NHS has a step-by-step guide to making up a bottle of formula safely and hygienically.

If you are worried about your baby, you can talk to an NCT Breastfeeding Counsellor on 0300 330 0700

Lots of supportive information about bottlefeeding can be found on our sister website.

15 Jan

Book Review: Bumpology, by Linda Geddes

Bumpology is an attractive and accessible book with a very clear and logical layout, which compensates for the lack of an index. It is as easy to dip into as it is to read from cover to cover; I know because I did both.

This is a marvellously comprehensive collection of research evidence and occasional comment upon the lack of research evidence, for all the advice and received wisdom relating to pregnancy, birth and early parenthood. As Geddes says, the science is out there, but it often takes some digging to find it.

Geddes looks at the big issues such as place of birth, breastfeeding, and all those things you’re told you can’t eat during pregnancy; as well as bringing in some colourful sections on how the growing baby develops in the womb, what senses function from birth, and the role of newborn reflexes. This in itself is a useful part of learning to empathise with the baby, and might influence parenting choices.

I am used to reading far more dogmatic books (from all over the birth and parenting spectrum), so this measured tone is very refreshing. Research in this area on the whole appears to be very thin, often studies are very small or based on the behaviour of lab animals. The book does not offer many definitive answers, but its general message is not to take advice for granted, since much of what we are told from the moment we even start to think about having a baby has no basis in fact. This very important point was made by Octavia Wiseman in a recent Midirs article (July/August 2012:p22), pointing out that much health advice is risk-averse, undermining parental choice, and that “explaining to women the limitation of our evidence base is the first step to take when asking them to make ‘informed’ choices.”

It is lovely that the text is scattered with anecdotes about the author’s personal experience, but for the most part this book is about facts not feelings. It largely ignores ‘soft’ aspects such as how parents feel about risk, and how mothers experience birth and early motherhood. Statistical comparisons of different aspects of birth look at outcomes and define those in terms of health of the baby and mother, taking little account of how women feel during and after the experience. For example lying down or being mobile during labour may make no difference to the outcome in statistical terms, but different women may experience these scenarios as more or less positive. Lying down in a room full of medical staff may feel disempowering; a woman being made to walk around may feel bullied. Working with parents both antenatally and postnatally, I know that scientific evidence may not always be the most important factor when making decisions. A good example of this would be the decision to share a bed with your baby: whether, according to various studies, this increases the risk of cot death; or whether it increases your child’s self-esteem, are less likely to influence the decision to bedshare than the fact that it might just be easier not to have to get up in the night. This does not, of course, detract from the fact that parents can and should be made aware of the evidence in order to make an informed decision; and to be fair, Geddes does not set out to explore the qualitative aspects of parenthood, but to present the facts and figures, and bust the myths: a very worthwhile mission.

I would recommend Bumpology to anyone expecting a baby, but I think it is also essential reading for anyone working with parents, antenatally or postnatally. It is so important for us to get our facts right, to counter the myths and enable parents to be confident in their decision making. Very few of the books I’ve seen are so robustly evidence-based, and an awful lot of people working with parents will repeat advice without giving any critical thought either to the evidence behind it, or the effect it might have in an individual situation.

Bumpology Blog
Sense About Science
Linda Geddes on Radio 4’s Today Programme with Belinda Phipps, CEO of NCT

26 Nov

Fiona’s story of Breastfeeding Twins

As a mum of two already, I knew the benefits of breastfeeding and also of natural birth and wanted both for my twin delivery and well-being when they had arrived. We joined Penny Price’s ‘Having Twins’ classes and made some great friends and learned loads. One class was tailor made for feeding, it was totally un-biased and we all discussed several ideas, different bottles, sterilisers, breast pumps and all our options also having a long session with an NCT breast feeding counsellor who talked about feeding two and showed us pictures and ideas of how to try, should we wish to.

I think if the boys were my first pregnancy I would have taken professional medical advice about delivery and feeding which in my opinion now, would have been a mistake. The Royal Berks deliver 90% of their twins by C section and the research behind this (which I extensively trawled through) is that it’s ‘safer’ to plan and deliver twins by C section. Midwives are also out of practice delivering twins, the less they deliver the less experience presumably they get and it becomes a ridiculous ever decreasing circle. I was very stubborn throughout and insisted I wanted to deliver them and feed them myself but came across very negative medical professionals. As it was they were both breech throughout my preganancy. My Consultant told me that no.1 had to be head down or it’s a non-starter anyway. Harrison turned round and engaged the night before my section… Apparently an impossibility itself and “too late” to change their plans at the RBH. Obviously the Specialist had a round of golf booked at 2pm.

Once they had arrived at just before noon, Harry roared in indignation at being removed and then decided that he couldn’t be doing with this breathing lark, causing mild hysteria and a quick trip upstairs to SCBU. It took the staff about 5 mins to realise he was a total drama queen (like me) and well over four hours (paperwork and procedures) to return him to his anxious mother.

Alex latched on in ‘Recovery’, beautifully, encouraged by a smashing midwife and we admired him for what felt like hours. He had several snuggles and sucked away like he had done it many times.

At about 5pm we were reuinted as a family and I was relieved no-one had given, Harry any formula. He was quite wriggly but we had a go at double feeding. I had my best friend and fantastic doula Ailsa on hand and she propped me up in bed with two V shaped pillows and tucked a baby under each breast (rugby ball style) and we were all happy and comfy. It was frankly a euphoric moment and one I will treasure forever.

We slept like that, I had my catheter in still and a steady stream of drinking water, biscuits and my iPhone so why move? In the morning the midwife was amazed and asked me if I was ok and did I need any formula. We had had a good night, just the three of us. We all drank, snuggled, snoozed and updated facebook. Why would I have needed formula?

I stayed in the RBH for a week which is unusual but the boys weren’t putting on ‘enough’ weight … and I was encouraged many times to give them a bottle. I have to confess to feeling I would be a failure if I did. It got to a point where I just wanted to get my boys home and settle so I tried the bottled milk, I always fed them myself first and then topped up with a weeny dose of the stuff. It worked a treat and we trundled home like a travelling circus of bags, balloons, flowers, buggy.

We managed to breastfeed Alex and Harry for the first six weeks of their lives. I was lucky enough to always have Carl on hand to help, Ailsa my doula ‘extraordinaire’ and a huge circle of family and friends who cooked for us, walked dogs, got our shopping, did the school run and endless errands and jobs.

My advice to any Twin parents would be

To prepare in advance and do all the research so you know how to breast feed and where to get help if it gets tricky
To get hold of several pillows (V shaped are awesome) and take them into hospital
To remember you are not ill (and neither are they) so medical professional may not be the ideal source of advice. You are the parents and most likely your gut feeling is right; join twin clubs and make other twin parent friends and ask them what they have been through and tried.
To accept ALL help available
Cherish every moment, it’s a unique club and although its hard work I genuinely believe its not all that much harder than a single baby, just a million times more special.

NCT Breastfeeding Counsellors can support you with feeding twins. Call the NCT Breastfeeding Line between 8am and midnight, 365 days a year, on 0300 3300 0700

06 Jun

What backlash?

The recent Time article has provoked quite a controversy, not least (in my opinion) the decision not to use that cover in the UK. According to The Guardian, this controversy about a photograph of a mother breastfeeding her 3 year old constitutes a ‘backlash against breastfeeding,’ and at the weekend they published Zoe Williams’ wide-ranging thoughts on this matter.

Williams’ article is littered with factual errors, assumptions, judgemental remarks, and references to ‘protests’ that never actually happened. She refers to extended breastfeeding in the first paragraph, but then goes on to discuss ‘breast is best,’ attachment parenting and government policy on health promotion, without ever coming back to her initial, rather impolite remarks that breastfeeding advocates are ‘evangelical to the point of dogmatism,’ and that she thinks we think ‘extended breastfeeders make [us] all look a bit weird,’ and that this is why we don’t discuss extended breastfeeding very much. In fact, we don’t discuss it much because it doesn’t happen much. If fewer than 2% of babies in the UK are exclusively breastfed at six months, just try and quantify the number who still get any breastmilk at all by the age of three years.

Williams goes on to dismiss the ‘benefits’ of breastfeeding as mostly syllogistic, methodologically flawed, and generally ignored by parents, while also noting that “I didn’t care whether of not the health benefits were real, I’d do it again even if it made the baby’s IQ go down,” thus negating the point of her entire argument against the ‘benefits’ of breastfeeding: like most mothers, she is not basing her decision on health or any other benefits. Mothers are biologically driven to nurture their young.

I use the term ‘benefits’ very cautiously. Breastfeeding is the baseline; it is formula milk that needs to prove its case. Research into breastfeeding may be methodologically flawed (because how can you carry out randomised controlled trials on babies?), but there is certainly no robust research showing health benefits for formula. As for the research, Analytical Armadillo has recently posted an excellent round-up of some very current research from a number of peer-reviewed journals. Williams’ guru in this matter is one Joan Wolf, who supports her view of parenting as a world of extremes, without nuance.

Moving on to attachment parenting, Williams quotes feminist criticism of co-sleeping which describes “putting the child in the bed between the father and the mother.” This is an unsafe practice, and UNICEF guidelines for safe co-sleeping can be found here. The feminist angle here seems pretty spurious, pitting notional extremes of motherhood against each other. Feminism, surely, means we all have the right to choose our own pathway?

Mothers do not divide neatly into two camps: Breastfeeding Mothers versus Formula Feeding Mothers. As Williams points out, the majority of mothers in the UK do initiate breastfeeding (though she quotes an imaginary 91%; the most recent Infant Feeding Survey gives an initiation rate of 81%). NHS South Central provides some interesting data on duration of breastfeeding; locally, we have a high initiation rate of 88%, down to 79% by five days, 72% at two weeks, and just 58% of mothers are still breastfeeding at six weeks. Therefore most of the mothers in the supposed Formula Feeding camp are mothers who have breastfed for at least some amount of time, some of whom will have made a positive decision to stop; but we know that 90% of the mothers who have stopped by six weeks would have liked to continue for longer. So it’s not the case, as William proposes, that the majority of people are not taking any notice of the public health messages about breastfeeding. In the 2005 Infant Feeding Survey, 84% of mothers said they were aware of the health benefits of breastfeeding; those who stopped before six weeks cited, in the majority, lack of support. Williams lightly dismisses the struggles and the disappointments felt by women who choose formula feeding because it’s the only choice they have.

Williams’ main premise seems to be that the government is trying to brainwash mothers into breastfeeding out of misguided social policy. She misses the point, and she misunderstands the research, but at least she gets a plug for her own book.