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]

11 Apr

Book Review – Mama: Love, Motherhood and Revolution, by Antonella Gambotto-Burke

Reading Mama is like reading two interleaving books: one collection of vignettes painting a glorious picture of Antonella Gambotto-Burke’s ineffable love for her daughter; and one collection of essays and interviews about parenting in the modern world. There is only the most tenuous connection between the two.

Taking them separately, the vignettes form a profound tribute to love of her family, with whimsical stories of moments when her daughter has made her proud; but also dark tales of her own childhood, displaying a deep resentment of her own emotionally absent parents. The link between the two books, such as it is, is the attempt to explore and understand her own experiences of mothering and being mothered, in the context of the pressures of today’s society. She has learned from her own mother that motherhood has little value in itself, and honestly reports on her realisation of the importance of the slow pace of parenting, that the little things: “kissing, nursing, coddling, caring,” (p60) are really not so little; and yet are perceived by society to be low priorities.

The thesis of the second book is that this society is broken when it comes to parenthood, in that nobody other than a few select parents actually value or appreciate what parenting is, and how it works. This is supported with reference to literature, and interviews with a number of experts who generally make strong statements about how parents (as a generic group) are getting it wrong. Presumably excluding themselves, they largely see parents as a feckless, economically-driven crowd, so welded to their smartphones that they are unable and unwilling to give their children the proper amount of attention. This dysfunctionality is blamed for a range of social and mental health disorders from autism to AGB’s brother’s suicide. There is much handwringing over examples of parenting that have been witnessed by AGB and her interviewees.

Some of the interviewees unfold coherent and interesting arguments demonstrating the feminist nature of motherhood. Stephanie Coontz extends this to argue for the democratisation of care in general. This was the book that I wanted and expected to read, and I was frustrated by the much less coherent inclusion for example of the slow chapter on slow living, and the absolutely harrowing chapter about IVF. Some of the conversations, however, explore the strange and fallacious idea that the world is an unhealthy place, “toxic to children,” (p100), as if there was a time when all childhood was blissful and perfect. Perhaps this was the 1970s; I’m fairly certain that for most of the existence of humanity, children have had to muddle along with the rest of us, taking greater responsibilities at a younger age, subject to real hardship. When the focus shifts to fatherhood, AGB accuses men of “vanishing” (p178) from their children’s lives, yet when in history have fathers been expected to be more hands-on? Steve Biddulph on p83 claims that the children of hunter-gatherers were smarter; how can he possibly know this? And how are modern children even comparable to those whose life expectance was a fraction of ours? Modern concepts of attachment parenting are a very different thing.

AGB is an intelligent writer, and she has had access to some big names in parenting and child psychology. Her feminism rings loud and clear through this book; this is her manifesto for a society that recognises the contribution of mothers. Without the anecdotal chapters, it would be a very earnest book, making some fairly controversial points. Perhaps controversy is necessary to kick-start this important conversation.

After a final chapter on the nature of marriage and what it means to her (a dogmatic view that only marriage – not cohabiting – can facilitate continuity and commitment), AGB bravely completes the book with a heartbreaking epilogue about the horribly ironic end of her own marriage, which must have broken down even as she was writing about her love for her husband. It is hard to read, after some of her strong words (supported by several of her interviewees) about couples not making enough effort to stay together for the sake of their children, and the contribution of divorce to the dysfunctional disconnectedness of society. One wonders where she can go from here, in her thinking and her writing.

Mama presents some important ideas, though none of them are particularly new. I am frustrated and conflicted by this book, which comes out of a deeply personal self-exploration: AGB’s discovery that motherhood should not, after all, be a lesser status; and her shock that the rest of society has not yet figured this out. Because the state of motherhood does include vulnerability, and sacrifice, and menial work; but that does not mean that it wrecks our lives or that we are lesser people for doing it. In many ways, the motherhood she discovered lives up to her own expectations, but she is able to recognise the strengths that mothers must find to fulfil this role in the face of society’s judgement, and the lack of support from the community:

“At the most vulnerable time of their lives, mothers are repeatedly failed by the community.” (p24)

This disconnected, tech-obsessed world is the one we have, and I would rather read a manifesto for the future than a polemic moan about the state of the present, suffused with nostalgia for a rose-tinted past. This is an interesting, challenging read, which left me with much to reflect on.

[Disclosure: I was sent a free review copy of Mama by the publishers Pinter & Martin]

17 Mar

If only someone had told me…

In the first few weeks and months of parenthood, new mothers and fathers very often comment on the range of knowledge they were missing, and skills they didn’t have, to cope with this new experience. If they paid for antenatal classes, at least they have someone to blame for the gaping mismatch between expectation and reality; but the majority of new parents do very little formal preparation, and unsurprisingly say the same sort of things.

To misquote Tolstoy, “each new family is new in its own way.” This presents a challenge when it comes to helping a couple to prepare for parenthood. Living in the midst of extended family, as they might have done 100 years earlier, the whims and wiles of the newborn baby would have been somewhat less mysterious; or at least the family elders could have helped to unravel some of those mysteries. New mothers might have found themselves less isolated. New fathers might have had more clearly-defined roles. And there would have been none of this pesky research into attachment and brain development, less pressure to have it all, and not so much of an expectation to be the perfect parent.

“I wish someone had told me that cluster feeding is normal… that formula isn’t evil… what ‘broken sleep’ really means…” they say, or write, with the authority of the first fully enlightened human being to have studied this matter. Emerging from the newborn fug into the crystal clarity of a new mum or dad who is finally getting a bit of sleep, the simmering resentments about the truly unexpected turns in their road, and the vast range of surprises that society simply forgot to mention, become pronouncements upon The Things I Have Learned, From Which You Too Must Benefit.

As an antenatal educator, I am often advised of the many ways in which I failed to prepare people for what it’s really like to have a baby, and find yourself relentlessly on call to a tyrannical but adored bundle of cute, who speaks no language that you know, and for whose health and well-being you are entirely responsible.

And I know I would have mentioned cluster feeding, and can think of any number of reasons why they might not have really taken it on board: were they focused on the impending birth to the extent that this was too abstract to be meaningful? Did they think this would never happen to them? Was it one small forgotten detail, many weeks ago now, lost in the fog? Is it actually possible to convey the real intensity of early breastfeeding, with the language we have at our disposal?

I also know I didn’t say that that formula was evil. In fact I may well have given examples of making a positive decision to use it. I explained about milk supply and responsive parenting and feeding cues, but I don’t believe that formula is evil, so why would I have said it? Is it perhaps that they expected me to say that, and didn’t really listen to what I actually said? Or did someone else say it, and they misremember it as being me?

As for sleep: well, some babies sleep, and some babies don’t sleep, and your interpretation of broken might be different from mine. The challenge is to drill down through platitudes and unrealistic expectations, without frightening the living daylights out of people who can’t predict what’s coming their way. In a society where people with some medical or scientific authority still insist, in the face of the evidence, that babies “should” sleep in a certain way, it’s not surprising that the sporadic and uncontrollable nature of newborn sleep should be hard for parents to manage.

I call for people to carry on being this honest about their experiences as new parents, but not to assume their experience is universal, nor to blame the people offering information and support for the fact that parenthood is not, in every way, as you expected. Join your voice to ours in increasing the support available. Ask the government not to cut funding to essential services such as Children’s Centres and breastfeeding support groups. And don’t be part of the problem by telling other parents-to-be what to do: every new family is new in its own way.

15 Mar

Book Review: Why Perinatal Depression Matters, by Mia Scotland

This is the first of the Why It Matters series that I have read, and I am deeply impressed that so much insightful information is packed into this densely thoughtful little book, although I feel that it may have the wrong title. I feel this because any new parent or parent-to-be could learn a huge amount about what they might feel or be feeling, why this happens, and many strategies to protect against or cope with it.

Psychologist Mia Scotland creates a very vivid picture of what perinatal depression is, for those who have never experienced it, and then sets it firmly in its cultural context. The central theme here is support, the concept of the village that it takes to raise a child, and how hard it is in these modern times to manage without this. Her writing style is strong and clear, and she includes a great explanation of research and evidence, and the limitations of applying these to individual circumstances. I found the whole book to be excellently evidence-based and sensible, and at the same time striking a mother-centred and deeply feminist tone.

Even though the section on actual therapy for perinatal depression is quite small, the book offers a range of preventative strategies that would certainly be useful for most new parents. Rather than simply exhorting the mother to seek support or take care of herself, Scotland has plenty of practical ideas about how she can do this, and how other people can help.

This is a sensible, informative book, which I would recommend to parents, expectant parents, and people who work with parents: an absolute must-read.

[Disclosure: I was sent a free review copy of Why Perinatal Depression Matters, which you can obtain from the publisher’s website here.]

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.

29 Dec

The Incompetent Mother

The majority of breastfeeding mothers stop breastfeeding before they are ready, and long before their babies are ready. I will bore you with only one statistic: the World Health Organisation recommends exclusive breastfeeding until the age of six months, but in the UK, fewer than 2% of babies are breastfed for that long, whether exclusively or not.

The knee-jerk response to this is actually not to blame the mothers who stopped before six months, or indeed who never started (although those mothers perceive blame anyway, because feeling guilty is what parents do); but to blame healthcare professionals and volunteers for failing to provide adequate support, to blame employers and economics for forcing women back into a workplace ill-equipped to facilitate breastfeeding; and to blame “society” for disapproving of breastfeeding in public.

These factors do play a part, particularly where the people supporting mothers in the early days with their newborn babies fail to help, and put the blame on the mother by telling her she will never feed, because her breasts are too small, her nipples are the wrong shape, she hasn’t got enough milk, etc etc. A mum I’ve been supporting, despite having such copious milk that she was able to hand-express it prior to giving birth, was then told that she couldn’t feed because she had inverted nipples. One wonders why she had never noticed this before. A few days later another midwife advised her that that was rubbish; in fact her child doesn’t latch on because she has a tongue-tie. But what a great way to make the mum feel responsible for not being able to feed her baby, just because the original midwife couldn’t find a way to help her.

But there are deeper reasons, higher barriers, which are much harder to tackle, not least of which is the guilt that makes open discussion so difficult. But most mothers are not responsible for the difficulties they encounter in breastfeeding, and therefore it is inappropriate for them to feel guilt. Anger, sadness, and more anger, and perhaps acceptance that they can’t change what has happened, but not guilt.

“Guilt is only appropriate when, with full knowledge and free consent, you deliberately chose something detrimental to your baby for some trivial selfish reason.” – Maureen Minchin

The very existence of artificial milk undermines mothers’ belief in their own abilities to feed their babies. The fact that we believe we must have our babies weighed and checked regularly erodes our confidence, and allows an opening for doubts to creep in, widened by the conviction that artificial milk will cure all ills: it will make your baby sleep [research does not show this]; it will help your baby gain weight [so will effective breastfeeding]; it will resolve lactose intolerance [just plain nonsense; what do these people think the sugar in cows’ milk is?].

Added to this is the assumption at policy-making level that there is a widespread need for artificial milk, which at its worst has prevented – in America – publicity about recalls of faulty products. Apparently it is better to maintain the status quo, avoid panicking parents, than to tell people the truth about the nature of the food they are giving to their babies. Surely they have a right to know?

Meanwhile the subtle negatives about breastfeeding appear in literature from supposedly pro-breastfeeding books (What To Expect When You’re Breastfeeding… And What If You Can’t?), to apparently supportive retailers (Boots’ nipple cream advert offers the information that the worst thing about breastfeeding is the inevitable sore nipples, therefore all mothers must need to buy their cream, which cures it. Wrong. No cream will cure pain that is caused by incorrect positioning of the baby at the breast; but correcting the positioning will); to – of course – the babyfood manufacturers (Aptimil follow-on milk, for “when you decide to move on from breastfeeding” – as apparently we all should do before one year, when a child can drink unmodified cows’ milk). The prevailing mythology is that a breastfeeding mother needs to eat more (500 calories extra per day is normally quoted), implying that breastfeeding takes something out of you.

The pressure to get our babies into routines that are usually incompatible with breastfeeding, which works best when the infant is fed on cue in the early weeks; added to the insistence that mothers need to be separated from their babies for their own sanity, and the idea that fathers and grandmothers can best bond with the new baby by being involved in feeding, makes a recipe for inherent difficulties. Routines, separation, and messing with the milk supply by expressing milk or giving the odd bottle of artificial milk are all contributory factors in mastitis and in perceived or actual loss of milk supply.

Finally, the pervasive images of bottlefeeding make that the normal way that people expect babies to be fed. The Richard Scarry book that I bought for Bernard, having enjoyed it myself as a child, shows one newborn being bottle-fed on her (rabbit) mother’s lap in hospital, and one naughty wakeful child being bottle-fed by her (doggy) father, to get her back to sleep. Meanwhile, how are breasts portrayed by the media in general? As sexual objects belonging to men.

Each of these points deserves far more than a paragraph in a blogpost (perhaps one day I will find the right PhD opportunity!), but surely even this brief outline of the huge barriers to making breastfeeding normal demonstrates one of the most important things I have learned over the last few months: that mothers themselves are the last people to blame for low breastfeeding rates.

Originally posted elsewhere on 15th May 2008

29 Oct

Book Review: What Mothers Do, by Naomi Stadlen


Naomi Stadlen has collated the views of new mothers from hundreds of interviews and conversations. From the women’s words she has defined numerous of the almost-intangible things that mothers do on a daily (and nightly) basis, even though it looks and feels like they are ‘only’ looking after their babies.

She points out that mothering is a unique experience, in allowing us to focus on how badly we are doing, simply because there seems to be no language to describe succinctly all the things we do well.

Some of the things that mothers do are defined as being ‘instantly interruptible;’ comforting; being responsible; coping with tiredness; figuring out what babies want; loving their baby; redefining their own identity; redefining their other relationships, particularly with their partner and with their own mother; and supporting other mothers.

The collection of insights opens one’s eyes both to the huge accomplishments of everyday mothering, and to the subtle pressures and unexpected challenges we encounter. It is so easy for a new mother to feel that she achieves nothing, until we take account of the thousand interruptions and her instant, unconditional availability for her child.

This book along with something on human babies’ normal emotional and psychological development, such as What Every Parent Needs To Know by Margot Sunderland or Why Love Matters by Sue Gerhardt, should be required reading (though perhaps in digested form!) for any new mothers, to give perspective and positive encouragement.

The value of this book for a postnatal doula is in helping her to step outside her own frame of reference and consider the huge variety of maternal experience. Every mother carries the emotional payload of her own birth and postnatal experience, and of course this informs our work with other women; but this book broadens one’s focus and understanding.

I originally read the book when my son was around six months old, and of course my perspective has been changed both by my own experience and by the stories told by the mothers I work with. I feel more removed from the subject matter now, and find it moving to be reminded of the importance of celebrating what seems like little achievements, and of the context in which we become mothers in our culture.

I particularly appreciated the description of how mothers learn about their babies: not from books or gurus, but from their own baby. Stadlen states that ‘Uncertainty is a good starting point for a mother’ (p45) because that is precisely what enables her to learn.

This reassures me that uncertainty is also a good starting point for a doula, and that our role is very much about listening to the stories, pointing out the achievements, and celebrating motherhood.

03 Oct

Closest to breastmilk

While it’s no longer legal in this country for the milk manufacturers to claim that their infant formula is “closest to” or “inspired by” or (yes, this has happened) “better than” breastmilk, the idea that these companies are beavering away trying so hard to come up with the perfect infant food has a fairly strong hold. As long as they are seen to be competing to be the best infant formula, they can hope that we will overlook the fact that they are all nutritionally inadequate in different ways. This makes their claim to be the best yet more irresponsible, as bottlefeeding mothers tend to stick to one brand.

It is simply impossible to support a claim to be “close to breastmilk,” because the components of breastmilk change constantly. They change from day to day, from feed to feed, according to the age of the child, the needs of the child, and even the weather. Seriously. On a hot day, babies drink thinner, more thirst-quenching milk. If formula manufacturers cannot identify all the ingredients, and cannot establish the function of many of those ingredients that they have identified, and cannot synthesise many of those whose function they do understand, and cannot balance the synthetic ingredients to achieve the same nutritional end result, then how can they possibly be selling something that is supposed, in some way, to be equivalent to human milk?

On top of that, there is the slightest teeny tiny suspicion that sometimes, some of the changes made to the formula might not be entirely attributable to amazing new discoveries about the contents of human milk, but in fact can be attributed to amazing new discoveries about what parents will buy if it is suggested to them that a particular product contains “essential” ingredients for brain growth, prebiotics, or the wonderful immunofortis. And no-one ever calls them to account for the fact that these essential ingredients were missing in the previous formula. Infant formulae are revised over 100 times a year, and each one is more perfect than the last, just as each Mars Bar is the biggest ever.

The bioavailability of nutrients in human breastmilk is high for its human consumers, because of the interaction between the ingredients of the milk, and the body’s mechanism for processing them. If one element is needed to process another, but is not available, then something else will be used, and the balance is upset. For example, too much iron causes a zinc deficiency; yet artificial milk contains twenty times the concentration of iron found in human milk, because cow’s milk lacks human lactoferrin, and therefore the iron in cow’s milk cannot be as easily absorbed by the human infant. Human iron is all absorbed, but the iron added to artificial milk is not, resulting in more waste for the newborn’s body to process, and encouraging the growth of harmful bacteria such as salmonella and candida in the gut. The guts of artificially fed children are already at more risk from such pathogenic bacteria, because they have a higher pH, because the lactose in human milk encourages the growth of friendly bacteria which keeps the pH naturally low. You see? As soon as one domino clicks down, the others start to tumble.

Formula feeding is the longest lasting uncontrolled experiment lacking informed consent in the history of medicine. – Frank Oski, M.D., retired editor, Journal of Pediatrics

Today’s post once again owes a lot to Maureen Minchin – Breastfeeding Matters: What we need to know about infant feeding and the ever-factual Royal College of Midwives’ Successful Breastfeeding. Other sources were Kellymom, and Gabrielle Palmer – The Politics of Breastfeeding.

Originally posted elsewhere on 14th May 2008

21 Sep

No Big Deal

The thing about breastfeeding is that the milk production system is dynamically stable, provided you don’t mess with it, and you ensure it’s operating effectively. The system has all these different elements that facilitate its stability and effectiveness, and when these elements are undermined or misunderstood, that’s when it goes wrong. Sadly the culture we live in is big on the undermining and misunderstanding of breastfeeding, and that’s why the majority of women stop doing it before they feel ready.

Here are some of the indredients in the recipe for no-big-deal breastfeeding.

  1. A newborn baby has a stomach capacity of around 5ml. A teaspoon of colostrum (the kind of milk you have when your baby is first born) is therefore big enough to fill it. It is likely that the tiny tummy will both fill and empty quickly, and therefore need to refill frequently. (Undermined by the idea that colostrum is insufficient therefore artificial milk needs to be given, therefore breastmilk production system insufficiently stimulated).
  2. Short frequent feeds stimulate the milk to change from colostrum to mature milk, which happens over the next days. (Undermined by the idea that baby’s frequent demand for the breast indicates a problem with breastfeeding, when in fact it may be normal, or it may indeed indicate some problem that could be dealt with. Offering artificial milk does not deal with this problem).
  3. Newborn humans are highly dependent and inherently appealing. In cultures where ‘lying in’ is practiced, the newborn’s needs to be close with his or her parents are naturally fulfilled. (In cultures where governments spend 14 pence per baby on promoting breastfeeding, and baby milk manufacturers spend £20 per baby on promoting formula, such as the UK, we have tended to forget about the baby as a person with needs, and started to cast it as a demanding creature that makes its mother’s life difficult). A baby who is kept close to his or her mother is likely to feed little and often, stimulating the milk supply and growing well.
  4. When the change in the milk occurs, around day 4, there will be a lot of milk in the breasts. This is called engorgement. It is what it sounds like. It is important to get this milk moving out of the breasts, using baby or pump as necessary. That’s because milk contains something called Lactation Inhibitor, and if the milk remains in the breast then the LI informs the body that milk is no longer needed. Milk production then decreases or ceases. It’s also because the baby needs to feed on the milk.
  5. Breastfeeding should not be painful. Pain indicates a problem. The majority of the time, the problem is something to do with the way the baby is held, or the way the baby attaches at the breast. The majority of the time, such a problem can be dealt with by giving careful attention to these things, finding a way to make mother and baby more comfortable. If the baby is well-attached, the mother should feel no pain. If the baby is well-attached, then he or she can feed effectively, giving the correct level of stimulation to the milk supply, keeping mum from getting engorged, and consuming enough milk to sustain his or her own growth and development. (Undermined by the phrase of course it hurts, what did you expect? leading mothers to persevere through pain and misery to the point at which it becomes unbearable, and they stop.
  6. Newborn humans may be highly dependent and helpless, but they do have the ability to signal when they are hungry (see above), and stop feeding when they are full. Therefore it should be possible to feed the baby on cue, for as long as he or she needs to feed, without pain, and for breastfeeding to work. (Undermined by pressure from ourselves or others to be in control of the chaos, to get back to normal, to have a life, etc etc etc).

I see a big circular diagram with lots of arrows connecting all these things together. The challenge for me is to convey to pregnant couples that for breastfeeding to work well and fit easily into one’s life (an oft-stated aim), it is necessary to optimise all of these elements. I fear that what this comes across as is an edict that you have to Give In To Your Baby, otherwise you are a Bad Mother Who Never Really Wanted to Breastfeed Anyway. Our modern culture clashes horribly with the needs of a breastfeeding mother&baby. I can understand how hard it is for so many of the women I meet, coming from Important Jobs and busy lifestyles where they are used to having control and predictability. Many work until very shortly before the baby is born, and it seems to me when I meet them in classes that the baby is still very abstract, and their idea of what life is going to be like is unrealistic. Perhaps we should be encouraged to stop working a good month or more before the due date, and spend that time hanging out with new mums (Hm, isn’t that what NCT Bumps and Babies groups are for?). Initially this would be disastrous because all they would hear is the horror stories, but perhaps slowly an understanding of the necessarily fuzzy boundaries of new motherhood might develop.

01 Aug

Nestle Box Top Scheme

Ms Head Teacher
My child’s school

9th February 2011

Dear Ms Teacher

Nestlé box top scheme

I was sorry to read in the most recent newsletter a plea to parents to collect Nestlé box tops, and I wish to register my opposition to the Nestlé box-top scheme.

As the NCT Breastfeeding Counsellor for this area, I support the Nestlé boycott and I do not wish my son to be encouraged to ask for Nestlé products. Nestlé is the target of a boycott in 20 countries because of its unethical and irresponsible marketing of breastmilk substitutes.

According to the United Nations Children’s Fund (UNICEF):

“Marketing practices that undermine breastfeeding are potentially hazardous wherever they are pursued: in the developing world, WHO estimates that some 1.5 million children die each year because they are not adequately breastfed. These facts are not in dispute.”

Monitoring conducted by the International Baby Food Action Network (IBFAN) shows Nestlé to be responsible for more violations of the marketing requirements than any other company. Nestlé is excluded from the relevant ethical investment lists produced by FTSE4Good because of these activities, which contribute to the unnecessary death and suffering of infants. Instead of making the required changes to its marketing policies and practices, Nestlé embarks on public relations exercises, attempting to improve its image. The box-top scheme fits this pattern.

If Nestlé really did care for children, it would stop its aggressive marketing of baby foods. And it would stop promoting unhealthy cereals to children. Nestlé makes much of its Shredded Wheat, even advertising it claiming “You’d never add salt. Neither would we.” But most Nestlé’s cereals do have high levels of added salt, according to Food Standards Agency definitions. The sugar content has also been criticised. It is not appropriate on health grounds for the school to encourage children to consume these products by promoting the box-top scheme, and goes against the school’s healthy eating policy, whereby you explicitly discourage unhealthy snacks, crisps and chocolate in the children’s lunches.

I would like to think that the school will look at the wider picture: what does a commercial relationship with the world’s most boycotted company teach the children? Nestlé’s generosity amounts to a penny per serving (much less than this in practice as many box tops will not be redeemed), so you could ask children to put by a penny each breakfast to send to the school, whether the breakfast is cereal or something healthier.

I for one would be more than willing to donate a book each term, rather than have Nestlé benefit from this free advertising directly at our children, and I feel confident that if other parents were aware of the global and local effects of their unethical practices, they would probably agree.

I have enclosed some further information. You can also look at http://www.babymilkaction.org/, and finally, I would be more than happy to come in and talk to you about this interesting subject!

Yours sincerely

Karen
NCT Breastfeeding Counsellor

Views expressed here do not represent the views of NCT.