26 Feb

Book review: Why Mothering Matters, by Maddie McMahon

Why Mothering Matters is a book full of myth and metaphor, exploring the metamorphosis of woman into mother in a world of judgement and inequality. Maddie McMahon is well qualified to write this book, with her years as a doula, doula trainer, and breastfeeding counsellor granting her a profound understanding of the many different forms this transformation can take, and the almost endless pressures and influences that bear down on the work of mothering.

A contemporary companion to Naomi Stadlen’s What Mothers Do, this book starts its journey here in the 21st Century, listening to the voices of mothers who share their feelings and experiences. What this uncovers is a world of contradiction, where we can feel isolated and yet never disconnected from the world, and where advice comes so thick and fast that it is impossible to grasp hold of the threads that might be useful. We see the many different relationships that can smooth out a difficult day, or blow your confidence out of the water, just in a choice of words.

But this book is not all crowdsourced anecdata; and particularly in the chapter on ‘The Chemical Soup of Motherhood’ Maddie gives us the science behind attachment and baby brain development, relating this to the mother’s wellbeing as the foundation stone of healthy growth in both those areas.

We then swim deeper into the global and historical context of mothering, and page by page the book gets more deeply and gloriously feminist, capturing the essence of motherhood: it is hard, we even make it hard for ourselves, and then the world makes it harder; but it is amazing and under-appreciated. What would the world be like, Maddie asks; what would politics be like, if the country was run by a circle of mothers?

It’s a manifesto and a celebration, but also a very personal piece of writing. Maddie writes about how vulnerable mothers can be, and makes herself vulnerable with this subject which is clearly so precious to her. It’s a really beautiful piece of writing, in so many ways.

[Disclosure: I was sent a free copy of Why Mothering Matters by the publishers. You can get your copy here, with a 10% discount if you use the code SPROGCAST at the checkout]

Maddie talks about the process of writing the book in Episode 46 of Sprogcast.

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.

13 Jun

Mommy Wars Much?

Yesterday the Royal College of Midwives released a new position statement on infant feeding. It includes the stunning new idea that ‘the decision of whether or not to breastfeed is a woman’s choice and must be respected.’

Inevitably there is a two-pronged kneejerk reaction to this. The Daily Mail and all radio talk shows trumpet an end to ‘Breastfeeding Tyranny,’ which is that thing where anyone remotely connected with supporting breastfeeding mothers is cast as the tyrant (or other even less savoury words); and parents who have had a difficult experience of breastfeeding complain about a) pressure from midwives, and b) pressure from everyone else.

Meanwhile the above-mentioned tyrants divide themselves into separate camps, those who criticise NCT and those who are NCT (and some have a foot in both camps). In the first camp, we have those who criticise NCT for not covering formula and bottlefeeding in antenatal sessions [Spoiler: we do! Have a look at our Infant Feeding Message Framework, which has been revised this year, but nothing new on formula in there, we’ve been covering it for years]; and those who criticise NCT for not cheerleading about breastfeeding enough (usually members of other breastfeeding charities who exempt the NCT from their non-judgemental approach).

As usual, I’m not here to speak for NCT, despite being proud to have been an NCT breastfeeding counsellor for a decade. However I do want to congratulate everyone responding to this new position statement on perpetuating the divisions in infant feeding. Nice one.

How about instead of the kneejerk reaction, we take some time to reflect on the context in which this statement and the responses to it occur. You really don’t have to look very far for reasons why women feel unsupported, whatever feeding decisions they make. We know very well that the majority of women in the UK see a number of different and busy midwives during pregnancy, and still get asked whether they plan to breastfeed or bottlefeed, without the time it would take to have a nuanced and informative discussion about this. Just asking that question frames it as an either/or choice, never mind the evidence that decision making about infant feeding is so much more intricate than that. The path women take is influenced by their family history and social context, by adverts that tell them their nipples will hurt and news stories that tell them they’ll be thrown out of Sports Direct. By every person who ever tells them not to beat themselves up if they can’t do it.

At birth, pressure does come from midwives who encourage early breastfeeding in the knowledge that the option will disappear for that mother if they don’t try to protect it; what a difficult position for those midwives to be in, within the time constraints of their workload. What would be a better way to address this at such a crucial time? There is no easy answer, because this demands cultural change and an end to society operating on the assumption that breastfeeding is difficult and women will be judged for not doing it. Locally, the well-trained volunteer breastfeeding support has been withdrawn from the wards and now also the children’s centres, because there is no longer funding to run the project, adding to the burden on midwives to handle this with sensitivity, kindness and accurate information. Within the time constraints of their workload.

And then there is the rest of the breastfeeding journey, and I know from encounters with women of all ages who tell me, when they find out what I do for a living, stories that some of them have carried for decades. Women feel guilty when they struggle to breastfeed and when they choose not to continue, and they feel angry when they don’t have the knowledge or the support to make decisions they feel happy with; and these stories matter to them. NCT is the best-known of a number of different charities that support breastfeeding mothers, and so of course it is the one that wears the sash of shame about judging and putting pressure on women. NCT is also the one that does most of the antenatal education, including on breastfeeding and on formula and bottlefeeding, and so of course is perceived as a source of guilt and judgement largely because of the impossibility of adequately preparing parents for the realities of life with a new baby. “All my friends found breastfeeding really hard, I’m not going to beat myself up if I can’t do it,” they tell me before their babies are born. And afterwards? “Why didn’t you tell me it would be so hard?” What words, what activities, what level of reflection will square this impossible circle, without changing the entire context?

And that’s why I’m so frustrated, this morning, with all the news and social media that does nothing but reinforce the assumptions and the cultural context within which breastfeeding can be hard, but breastfeeding support can be harder.

08 Mar

What Mothers Are

I’m reading a very interesting book called The Selfish Society by Sue Gerhardt; and while I really like where she’s coming from, it did get me thinking about the general assumption that motherhood is mainly defined by sacrifice.

The things you’re expected to give up, on becoming a mother, include your pre-baby figure, your sleep, your ability to concentrate, your social life, your sex life, and your peace of mind.

The counter-argument to this is always but motherhood is so rewarding; see various mummy-bloggers’ cute anecdotes about hilarious nappy changes, first words, adoring gazes at 4am, and so on. While this is all very well, it does seem to relegate the mother’s enjoyment of life to a second-hand experience.

There don’t seem to be many sources that acknowledge the positive changes that motherhood brings about, specifically for the mother (and I’m not just talking about the oxytocin high of breastfeeding). Motherhood (and arguably, we could say ‘parenthood’ but I’m just writing about me today) can bring about huge personal growth. Understanding and accepting that you are such a key part of someone else’s world is a huge responsibility, and might be impossible for non-parents to grasp in its entirety; but when you take stock of the resources you didn’t know you had, the range of functioning you can manage on limited amounts of sleep, and the sheer protective strength you can find, all this adds up to quite a superhero status.

Motherhood can bring about a growth in understanding and empathy, especially in our relationships with our own mothers. We find out things we never expected to know about our own babyhood. For me a lot of things slotted into place when my mum talked to me about how she had felt, aged 21 alone with a newborn baby and a husband who – I’m assuming – was as emotionally disengaged then as he is now.

I particularly notice the contrast in empathy from other parents, compared with childless friends. Of course these are generalisations, and I have some wonderful childless friends who have been supportive and fun and great with Bernard. Those are the ones I prefer to spend time with, rather than the childless friends who assume I want a break from being a mother (how can I get a break from my own identity?), and that I am bored of talking endlessly about how wonderful my child is. Seriously, that subject can never tire for me, so forget it. Do you want to talk about your favourite subject all the time? I thought so. The people I tend to take a break with are other parents, who can share that feeling of enjoying the sense of freedom, while simultaneously missing the little ones. They don’t expect me not to be a mother.

Nor do you see, from the superficial coverage that is widely available, that all those sacrifices are rarely black-and white. Some of us like our new bodies; there’s a reason for being a curvy mama beyond mere indolence and chocolate biscuits! I have a far busier social life than I had before becoming a mother; and those shreds of my pre-baby social life that remain, are the ones I really value. And who expects their sex-life to remain static?

I don’t think motherhood in its conventional sense came very easily to me. But as far as my identity is concerned, it has made me feel better-defined, more purposeful and more confident. I know this isn’t every woman’s experience of motherhood; I was and am exceptionally well-supported, and that makes a huge difference. What I’m saying is that motherhood can be these things, and perhaps on International Women’s Day we should be calling for motherhood to be valued and supported so that for women, it is these things.

Originally posted elsewhere on 8th March 2011

28 Jan

Nature is Clever

Towards the end of my pregnancy, I remember being advised by friends that it was very important to get out as a couple as soon as possible after having the baby. I know this was coming from a well-intentioned place, but I’m glad I’m grounded enough to know that that wasn’t for me. Talking to new parents, I encounter a wide spectrum of parenting styles, and if you will allow me a sweeping generalisation, the ones who are having the easier time tend to be the ones who don’t put themselves under pressure to ‘get back to normal’ or ‘show the baby who’s in charge’ right from the start.

It may sound deeply obvious, but having a baby is a massive life event. It impacts on the couple as a couple and as individuals. Anthropologists have observed some interesting stuff about how the behaviour of men and women towards each other changes following the birth of a child; new mothers have a deep evolutionary need to remind our partners that they are responsible for us (for example, compulsively addressing him as ‘daddy’). Sorry, Old-Fashioned Feminists, but evolution takes thousands of years, and human behaviour (and biology) still works as though we live in clans with defined roles. My point is that pressure on a new couple to behave as if nothing has changed jars with our instincts and with the reality of life with a new baby.

Consumer-driven Twenty-first Century Western society, of course, has all the solutions for this. New parents can buy whatever they need to help create distance between themselves and this utterly dependent small creature: mechanical rocking chairs, under-mattress breathing detectors, artificial milk; there’s really no need to be at the beck and call of a baby, and it doesn’t do it any harm, does it?

I hate to talk about benefits and disadvantages. I prefer to talk about normal behaviour, biological expectations, and so on. Nature is very clever. Here’s an example: skin contact stimulates the release of oxytocin. What is oxytocin? It’s a hormone that makes you feel good. Remember orgasms? That’s oxytocin. Touching releases oxytocin; holding hands, kissing, nibbling someone’s ear, that all releases oxytocin. When your child grazes his knee and you kiss it better, that releases oxytocin. Oxytocin helps a woman to labour, and releases milk to feed her baby. Cuddling a newborn baby releases oxytocin. For both parties. Wrapping him up in a blanket and leaving him to cry himself to sleep in another room releases adrenaline, which suppresses oxytocin. For both parties.

Last week a couple came round for some help with feeding. It took a while to get mum and baby comfortable, but eventually we found a way [no surprises to anyone with any breastfeeding knowledge: mum reclined, baby self-attached]. The baby fed. Mum said: why does it make me feel so…. good? That’d be oxytocin, along with relief from anxiety and a sense of satisfaction.

Originally posted elsewhere on 2nd February 2011

29 Aug

Book Review: Growing Up Pregnant, by Deirdre Curley

I sat up in bed and admired all the women in the room. All of us had different birth stories, and we each realised how lucky we were to have healthy babies. Although we were all at different stages in our lives, we were all going to be going through the exact same transition into motherhood. (p184)

Deirdre Curley is pregnant and 19. She is surrounded by a supportive family and a loving partner. She really wants to be an actress, and she isn’t at all sure she wants to be a mum.

In Growing Up Pregnant, she tells the story, not just of pregnancy and birth, but all the things that bring her to this point. And then in detail she takes us through the months of her pregnancy, and the reader witnesses her maturing from good-time girl to “the most beautiful pregnant lady” one waitress has ever seen. When she and her partner make up their minds that they will be parents, they commit to the changes they need to make, even when it’s hard to adjust to the loss of old pleasures and still-partying friends. It’s so interesting to read about their mixed feelings as they adjust to this new lifestyle, and the strength and positivity they bring to it is admirable.

Deirdre pauses between each trimester to give a little rundown of what a pregnant woman might be experiencing, how her baby is developing, and any preparation she might consider doing. This includes the most down-to-earth “what to buy” lists of any pregnancy book I have read. She refrains from too much specific detail about pregnancy and birth, but gives a useful overview that would be relevant to a pregnant woman of any age.

This is a properly grounded book, both reflective and informative, and does as good a job as any (and better than most) of getting across what it’s really like to be pregnant and to have a baby. Although the focus is on pregnancy as a young mum, most of the feelings Deirdre expresses are pretty universal: what is happening to me? Will my body ever be the same again? Can I rely on the support of my partner? Am I going to be a good enough mum? Women twice her age think the same things.

I enjoyed taking this journey with Deirdre and her partner Gary, as they put down roots and prepare for the baby. The birth itself is well-written, and early motherhood is covered with both wistfulness and joy. It is a very realistic description and I would certainly recommend this book to pregnant women, whatever their age.

[Disclaimer: I was sent a free review copy of Growing Up Pregnant. You can order yours from Pinter & Martin, with a 10% discount at the checkout if you use the code SPROGCAST]

01 Aug

RCPCH discovers barriers to breastfeeding

The Royal College of Pediatrics and Child Health has today published new recommendations that women should be supported to breastfeed for as long as they want to. While I’m fully behind that suggestion, I can’t help feeling like this isn’t exactly a new way of thinking. It’s almost as though the RCPCH have just stumbled across the fact that the UK has the lowest breastfeeding rates in the world, and despite their well-established links with the formula industry, are finally catching up with the rest of us.

Their report quotes UNICEF‘s five year old figure of a £40m saving to the NHS if women were supported to breastfeed for a little longer, and this is a compelling argument of course, but what really matters is respect and support for women’s choices, and societal change to make those choices realistic and achievable, so that no mother is judged either for her decision to breastfeed, or for her decision not to.

I do applaud the recommendation to normalise breastfeeding within the PHSE curriculum in schools, but having seen the cringey sex-ed video shown in Year 5, I would love to see this done in a modern, straightforward and unembarrassed way, preferably facilitated by people specifically trained in this sort of education. NCT Breastfeeding Counsellors, for example.

And yes, please do bring back the Infant Feeding Survey, for which funding was withdrawn in 2010, showing just how much of a priority breastfeeding is for policy makers at the very highest level.

Of course I am pleased to see large and influential organisations like the RCPCH talking about the barriers to breastfeeding in our society, and particularly so when there is such a strong media response, raising awareness across the UK. Now let’s see those recommendations put into action.

08 Feb

Book review: Pride & Joy, A Guide for Lesbian, Gay, Bisexual and Trans Parents – by Sarah & Rachel Hagger-Holt

2017-02-07-18-30-37 This is the most perfectly-titled book I have ever come across, a fact which became increasingly evident as I read it – in one sitting – and found it to be so warm and upbeat, a book that is truly full of pride and joy.

Pride And Joy would be useful and interesting for LGBT parents; those considering becoming parents or even wondering if they ever can become parents; children of LGBT parents and other extended family members, and anyone working in a support role including health professionals, antenatal teachers and others. It is packed with anecdotes and quotes from that same wide-ranging group, so that it gives the reader a rich narrative, coherently exploring the broad experiences in the LGBT world. Each chapter ends with some points to consider, with signposting to useful resources, making it practical as well as very readable.

One thing that came across to me was that LGBT families have more common factors than differences with non-LGBT families. The authors treat extended and complex family situations as largely positive, acknowledging that blended families are now the norm for many people in western society, whatever the sexual orientation or gender identity of the parents. Many issues relating to pregnancy, birth, new parenthood, and growing up are not unique to LGBT families, however the fact that much of the support offered in these situations comes from the straight community reminds us of the importance of being open and inclusive when supporting parents. This book is well positioned to increase knowledge and understanding, and I hope it will be very widely read.

[Disclaimer: I was sent a free copy by the publisher. You can buy your own copy from their website, and use the code SPROGCAST at the checkout for a 10% discount]

04 Feb

Welcome to The Motherland

New guidance from the British Medical Association recommends a change of language, from “expectant mother” to “pregnant person,” in order to recognise trans parents who may not identify as women. I confess that this is very confusing for me, and my confusion arises from how, then, we should define motherhood. There is also a conflict between my inclination to accept whatever terms people want to use for themselves, but also to value motherhood in a way that does not easily allow me to erase the “womanness” of it.

Please don’t imagine that my point of reference for motherhood is limited to floating around in a cloud of organic breastfeeding loveliness. In fact, I think that might be the core of the dilemma: this question of whether to use the word “mother” is just terribly reductionist, as though motherhood can be only one thing.

Motherhood emerges in so many different forms, perhaps uniquely for every single person who has – but there’s the problem – has what? Given birth? Some mothers adopt. Parented? Are women who miscarry or suffer stillbirth not mothers? The literature is at pains to emphasise that they are. Does that mean that women whose pregnancies end in abortion are also mothers? Some of them might feel that way; it was certainly the start of the journey into motherhood for me.

Clearly there is not one single event that turns a person into a mother. Motherhood is more like a place you go to, where you experience new things, which you may have expected or not, and which you may enjoy or not, and which change you, but do not turn you into a specific and new type of person. As with travelling, those experiences will affect you to some extent, but will be assimilated into your existing self.

A close friend tells me that she always knew she wanted to be a mother, by which she means give birth to and raise children, yet a decade in she still feels that this isn’t the real her, these boys aren’t really hers (this existential angst must necessarily co-exist with doing the laundry and preparing packed lunches). On the other hand, I never particularly yearned for motherhood (and I overheard my own mother, when I was six months pregnant, remarking “Karen was never very maternal.”) And yet I simply could not be the person I am now, and do the most fulfilling work I have ever done, without it.

It seems acceptable for other people to identify me as a mother, but I would prefer them to understand that I am not solely – or even mostly – that, while still being that to my very core. Yet having argued that neither being pregnant, nor being a parent, are intrinsic to motherhood, I think we could explore the possibility of having a term that isn’t gendered, to represent having travelled to this place, should it be necessary to reveal that element of one’s identity.

What of fathers, who now are expected to take on more of the nurturing role traditionally associated with motherhood? Up to 50 weeks of parental leave can now be shared in the UK, so dads can take on the majority of the parenting from very early in a child’s life (and technically a man can “father” a child without even knowing about it, so how can fatherhood then be part of his identity?). Perhaps the word “mother” is only differentiated by being the one who is expected to do the majority of the housework, whether he or she works outside the home or not.

[Cross-posted from Huffington Post]

17 Jun

Breastfeeding support matters, but it’s not all about the individual

Will breastfeeding, too, one day have its historian-chronicler who tries to unravel the train of events leading to the early 21st century’s failed mass alternative-nutrition child-feeding trials?
James Akre in the Huffington Post

I recently heard a talk by researcher and breastfeeding advocate Maureen Minchin (and interviewed her for Episode 15 of Sprogcast), in which she discussed exactly this question. Her new book Milk Matters picks up from and expands upon her 1985 book Breastfeeding Matters, a detailed and dense book covering both the political history of breastfeeding in modern times, and specific information on the management of breastfeeding which is useful for both mothers and health professionals alike. In person, her tone is as assertive and her views as uncompromising, as they come across in this book. In 1985, Minchin wrote “Those who conceal information, for the sake of sparing mothers anxiety, are doing greater harm.” She still firmly believes this.

Quoting, with irony, an old Cow & Gate advert, Minchin says that “what you feed them now matters forever.” Her milk hypothesis is that breastmilk is the bridge from the womb to the world, enabling the baby to develop a healthy microbiome, which regulates the immune system and optimises development. Furthermore early nutrition is the single biggest influence on gene expression following birth.

There is plenty of evidence for this, and emerging evidence that exposure to cows’ milk protein actively interferes with gene expression, triggering a trajectory of growth not only for the life of that baby, but if she is a girl, for her children and grandchildren too. More details about this can be found in her presentation here.

Minchin accurately predicted a backlash against honesty about the risks of not breastfeeding, and cites the huge vested interests of the baby milk industry, which has successfully divided mothers for decades, co-opting the phrase “breast is best” to create an aspirational ideal, and undermining breastmilk as the normal infant food for our species.

Why is it so hard to talk about breastfeeding in a positive and helpful way, that doesn’t incite an emotional response? The day after hearing Minchin speak, I was at the Association of Breastfeeding Mothers (ABM) annual conference in Birmingham, listening to speakers who truly understand the challenges of supporting individual mothers, in a social context that is not supportive of breastfeeding. The health, social, and emotional issues are the background noise against which we all work with mothers; but too much of what society knows about breastfeeding comes from a middle class media that categorises women according to the way they feed their baby. As Lactation Consultant Sally Etheridge pointed out at the ABM conference, “just because a mother isn’t breastfeeding, it doesn’t mean she didn’t want to.”

Earlier this year, a report in The Lancet demonstrated that the UK has the lowest breastfeeding rates in the world. Whose responsibility is it to change this? Those whose vested interests lie in women breastfeeding less would have us believe that anyone offering breastfeeding support is a member of the Milk Mafia, with an earnest belief in boosting those numbers bleeding nipple by bleeding nipple. Breastfeeding happens within a complex socio-economic context, and a focus on public health rather than on individuals does not preclude individual support. In fact the goal of most breastfeeding supporters is to help improve individual mothers’ experiences, to support their feeding decisions, and to empower women to make those decisions. According to researcher Heather Trickey at the ABM conference (also on the next episode of Sprogcast), it is not the responsibility of the feeding supporters, or of any individual mother, to improve breastfeeding rates; it is the responsibility of society, of the health services, of government. The only people who gain from pussy-footing around women’s feelings about breastmilk and formula are those who make a profit from exploiting mothers, to the detriment of public health.

[Cross-posted from the Huffington Post]