18 Dec

Milk Machine

It makes me feel like a cow, she said.
Just to look at it now.
Its friendly pastel plastic
Fills me with dread
And I can’t get out of my head
The sound of a robot baby
Taking my milk.
It fills me with dread
When I think of the nights ahead,
The stirring and snuffling noises
That will pull me
From my warm bed;
When I think of the nights,
There’s no light
At the end
Just shattered sleep,
Shattered me,
Overwhelmed with dread,
And with longing
That somebody else
Could do this instead.
I’ll be a cow if it means
It’s not just me
Getting up in the night
To sit in the dark
And long for my bed.
I’ll be the cow,
But it fills me,
It fills me with dread.

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.

17 Dec

Baby’s First Year, by Netmums with Hollie Smith

Having read the atrocious Netmums book on sleep, I had quite low expectations of Baby’s First Year. I was also looking at a 2009 edition, and presume that it has been modernised a little since publication. Nonetheless, I found it to contain a good range of highly practical tips, and a reasonably close representation of the evidence with regard to many of the subjects it covers.

Apart from the usual mythology about cabbage leaves and hindmilk, the breastfeeding sections are pretty accurate, although I was disappointed that breastfeeding is referred to as “extended” from seven months onwards. This easily-navigated little manual is also good on formula feeding, expressing, colic, and sex; but there is a huge gaping hole where the discussion of attachment and emotional development should be, which of course allows them to advocate the cruel and damaging practice of controlled crying. Tellingly, they refer to the “handful of child psychologists… [who] believe it could be damaging,” versus “a great many other experts” (none of whom are named) who think it’s fine. Nothing in the book is referenced, so really they can and do just say what they please.

The book is also quite poor on introducing solids, recommending waiting until six months but with only an aside about baby-led weaning (this being one of the topics which they may have updated, to reflect its increasing popularity).

Personally I am left cold by the many quotes pulled from Netmums message boards, but I guess that is their USP, and you can always skim them like I did. For a manual of the basics, Baby’s First Year is good on the first six months, but the second half is probably too general to be useful to most new mothers, who I expect would be figuring things out for themselves by that time, or seeking out more specialised guidance for the issues they might be experiencing. I’d tear this book in half before giving it to a friend, and wrap it with a copy of Sweet Sleep.

09 Aug

Breastfeeding: A dad’s guide

I responded on twitter to a recent post by DaddyBeGood about breastfeeding, ostensibly about how dads can get involved so they don’t feel like a spare limb. Now, there is substantial research literature about the impact on breastfeeding of a supportive and informed partner, including the paper I studied earlier this year. I am absolutely behind helping dads to help mums to breastfeed, but I think it’s a complex subject, and get frustrated by that lowest common denominator, the suggestion that dad can only help by giving baby a bottle of expressed milk.

I don’t wish to be harshly critical of the original post, but I would like to add some more ideas, and to explain why giving a bottle might not actually be that helpful.

I also want to put out there the suggestion that babies might benefit from their different carers loving them in different ways; a parent who does not feed the baby is giving love that is not associated with food. Might this be healthy for the child’s emotional development, and helpful for someone who wants to be able to settle and comfort the child without the assistance of lactating breasts?

Not a lot of bottle
Antenatally, I hear both mums- and dads-to-be ask about expressing milk, so that dad can give a bottle. I suspect that the dads are not always as enthusiastic about doing that 2am feed as their partners want them to be. I suspect also that mums are anxious about the responsibility of being the sole feeder, especially if breastfeeding is as difficult as they have heard it is. There’s also that survival thing where new mums are unconsciously determined to bond dad to baby so as not to be abandoned. And yes, of course some mums don’t want to breastfeed, and that’s their right.

But is it really so straightforward: Dad gives bottle, dad and baby bond, mum gets much-needed break?

Expressing is a chore. If breastfeeding is straightforward, then expressing is not going to be an easier option. Parents of newborn babies are usually experiencing a period of flux and uncertainty, and finding time to express a bottle of milk can be a challenge. Night-time breastfeeding can be less disruptive to everyone’s sleep than getting up to fetch and warm a bottle (and there’s no guarantee mum won’t wake anyway, either because baby cries while waiting for the bottle, or because the longer gap between feeds means, ironically, that she has to express some milk). Expressing milk is less efficient than breastfeeding, and it can knock mums’ confidence to find that it’s hard to pump large volumes of milk. It is not necessarily any quicker to bottle-feed a newborn than to breastfeed. And in those early days when mum’s milk supply is regulating to meet her baby’s need, expressing milk can upset the balance.

So what else can dad do?
To me, the idea that any carer must give a bottle in order to bond with a baby is one of the biggest booby traps of all.

When I meet new families to provide breastfeeding support, I see dads who are totally immersed in the experience of feeding their babies, and their focus is 100% on getting breastfeeding to work so that they can get away from the tyranny of expressing milk. Yes, men feel like a spare limb when they see their partner and child struggling with something as essential as feeding, but they are also learning very quickly what their part in the team is. There’s plenty of research on the benefits of skin to skin contact, and this does not just apply to mothers. Babies get comfort from being close to their fathers, from his familiar smell, the sound of his heartbeat, the rhythm of his breathing, the rumble of his voice. They get antibodies from his immune system. They get social stimulus from him making faces, amusement from him singing to them, security from his arms.

Bonding has the same chemical basis as falling in love: oxytocin and endorphins. If you listened in your antenatal class then you know how to increase levels of these hormones: through relaxation, laughter, touch, eye contact. So any interaction with your child that involves responding to their need for comfort will facilitate bonding. Responding to your baby’s needs helps them to trust you and to feel safe. You don’t have to be armed with a bottle of expressed milk to achieve this.

Dads can give mum a break not by interrupting the flow of breastfeeding, but by interacting with baby at other times. They can carry a colicky baby around in a sling or a baby carrier, bath baby (or bath with the baby), give the baby a massage. They can keep mum company during periods of intense feeding, help her to get comfortable, keep her fed and watered, and give her a hug when it’s needed.

Above everything else, dads can help their partners by getting informed about breastfeeding, and enabling them to access help if they need it.