Thursday, February 23, 2012
"Food is for eating, and good food is to be enjoyed... I think food is, actually, very beautiful in itself." Delia Smith
By the time I went back to work after the birth of my daughter, when she was 5 1/2 months old, she was ready to wean. I duly set about buying a few items of fruit and veg to puree for her. Her first taste of food was a baby spoon of banana puree, mixed with a dash of breast milk. She loved it, even though most of it ended up dribbling down her chin, with very little of it actually finding its way into her stomach.
At the time, there was frustratingly little information given to me by the health visitors: only that I should wait until she was six months old before starting the weaning process. I was confused by the information around about what to give her when, and worried about giving her something that she might be allergic to.
I was given a book on weaning by my friend, which became my bible. It made a lot of sense to me because it was written by someone with a lot of knowledge about biochemistry and nutrition, so the weaning process was based on providing the exact nutrients needed for the baby, using a wide range of foods. It was written by a vegetarian, and she pretty much (not in so many words) condemned meat in the first chapter, but I ignored that bit, although I am now a trainee vegetarian!
I am not joking when I explain that when my daughter was ready to eat breakfast, I would drop her off at the nursery with a pot of porridge which consisted of: uncooked, ground-up oats, brown rice, quinoa, bran, and pearl barley. You should have seen what it did to my mixer! The idea was that these ingredients contained a huge amount of vitamins, proteins and fibre, and were perfect to help develop her immunity, organs and generally make her into Superbaby. But that wasn't the whole sum of the breakfast; oh no no no! On top of that, to complete her perfectly-balanced breakfast, was a defrosted cube of pureed, cooked courgette, and a sprinkling of brewer's yeast, all mixed up with 50mls of mama's finest, creamy milk.
Understandably, the nursery staff looked at the green splodgy bowl of porridge with disgust, and at me with hidden contempt: how could I feed my daughter such muck?! But I only cared about making sure she was able to eat the best I could give her. My feeling at the time was that I had breastfed her to make sure she got the best; and for the next six months I was determined to give her the best start to her eating career. On reflection, perhaps I tried a bit too hard with her as far as feeding her went - but she ate EVERYTHING I put down in front of her.
This could be because at breakfast time she was so hungry that she ate the sloppy porridge I fed her just to satisfy her need for food; which, as disgusting as it was, made everything else I offered her taste like the food of the Gods. She ate liver (bleugh) when she was seven months old, one of my proudest moments - if only because I managed to hide my disgust whilst helping her put it into her mouth. I even apologised to her as I sat down at the table with her to feed it to her - but she loved it! (she wouldn't touch it now, though).
And so it went on. Lots of finely-tuned food, biochemically matched to within an inch of a bottom quark (feel free to tell me what one of those is, because I have no idea, although it sends me into schoolgirl sniggers every time I hear or read the words), enough to provide my daughter's gastro-intestinal tract with an abundance of superfood in her first year of life. Each week, my partner and I would spend an hour chopping, boiling, stirring and whizzing up a concoction of brightly-coloured ice-cube trays, which was laborious but always seemed better after a glass or two of wine, banter and food-tasting.
We have asthma in our family, so I was very careful about introducing some foods. She was a year old before she had anything dairy-based or containing wheat. She had refined sugars after her first birthday, and once she had discovered the miracle of cheese, nothing could stop her enjoying a wider variety of foods.
However, my careful diet and desire to give her a great start in life did not prevent her asthma. Although difficult to diagnose in babies, she was frequently wheezing, and required several hospital visits for nebulised Ventolin, and was under the care of a consultant to treat her symptoms. She was so wheezy that she was unable to crawl without coughing or getting out of breath, so she bypassed the whole crawling stage until she could cruise around the room. I couldn't imagine how much worse things would have been if I hadn't breastfed her, or if I had given her dairy at an earlier age.
Then, at the age of three, she developed an intolerance to cow's milk protein. I felt terrible that I had somehow caused it (which I obviously hadn't, but mother's guilt had taken over), but it's apparently quite possible that she developed an intolerance to cow's milk protein following a viral illness.
Happily, things are fairly well-controlled now, and she can tolerate some dairy, but she prefers goat, soya or oat milk. She is nearly 7, and a very good eater - although she likes to take her time at the table, which is a mixed blessing!
By the time my son was born, I had read Jill Rapley's paper on baby-led weaning, which seemed to make so much sense. I decided to opt for this method of weaning, which is a natural progression for breastfed babies.
The reason it clicked with me is that it primarily allows the baby to make its own choices about what they eat: putting a selection of foods in front of them, and allowing them to pick up what appeals to them. Hard foods like carrot will need to be cut into matchstick-sized pieces and par-boiled (not presented raw and whole, as in my picture, above!), and constant supervision is required, but the baby can feed themselves as soon as they are able to. It's also fantastic for generating a social atmosphere for the baby to be involved in: sitting at the table with the rest of the family, eating the same food as everyone else.
Developmentally, a baby will only pick up what it is able to. For example, a big piece of carrot is easier for a 6 month-old baby to pick up than a raisin. A piece of cooked carrot is unlikely to cause choking. If an adult places a raisin into the 6 month-old baby's mouth, it is possible that it will cause them to choke. Babies will regulate what they put into their mouths and what they will swallow, spit out or play with or throw onto the floor. The mature pincer grip doesn't develop until the baby is able to swallow a piece of food as small as a raisin. It's a feature of safety in nature, and to me this makes perfect sense. Why spend ages mashing food up and then spoon-feeding a baby, when it can explore, learn about, and play with its food? Breast-milk should still be a main composition of a baby's diet until around the age of a year, with the weaning process taking a gradually greater role from the age of six months.
My son's first food was a slice of grilled lamb which he stole from my plate, whilst I had him in my lap. He didn't "eat" it - he picked it up, shook it a bit, then put it into his mouth. He sucked on it, pulled a face, put it back on my plate and picked up a piece of tomato. He tried to put it into his mouth, but he dropped it. This was the beginning of his exploration of food, and one he is still engaging in. He will try anything I give to him, but won't necessarily enjoy it! At the age of 3 he will use a knife and fork; he grazes throughout the day and eats whatever it is that he needs. I don't try to get him to clear his plate - to me it is about providing a feast for the eyes, from which he decides what he puts into his mouth, and how much of it. He's healthy, in proportion, and following his centiles.
So why wait until six months before beginning weaning? There are a variety of factors relating to an increased risk of allergies, gastrointestinal infection, and taking less breast-milk than they need, resulting in a reduction of the nutrients they require. There was a study, published in 2011, in which the authors concluded that weaning breastfed babies before six months would be beneficial. The study was flawed, and three of the four authors had previously worked in the formula or baby-food manufacture within the past three years. Please read this analysis of the paper, disputing their "evidence".
I understand how tempting it is to begin weaning early, but the process should be about looking at the baby. Look for the signs they are ready to wean, take things slowly, have fun, and enjoy watching your baby's next developmental milestones.
My children have a healthy attitude towards food. They tend to graze on healthy food during the day, eat their main meals (as much as they want to eat, with some gentle coaxing if they're tired or distracted), and they know why it is important to eat healthily.
Having said this, as I type there is fish and chips in the oven (slutty food, as I call it) because I have been too busy to make anything fresh today - but with this sort of food it means they get the rough with the smooth, once in a while, so that they know what's right and what's not!
Tuesday, February 21, 2012
"O, thou beautiful damsel, may the four oceans
Of the earth contribute the secretion of milk
In thy breasts for the purpose for improving
The bodily strength of the child
O, thou, with the beautiful face, may the child
Reared on your milk, attain a long life, like
The gods made immortal with drinks of nectar" - Sushruta, translated
The gods made immortal with drinks of nectar" - Sushruta, translated
Charlie, like many premature babies, received donor breast milk in order to protect his gut from developing a life-threatening condition where the bowel becomes leaky, resulting in death of the gut wall tissue; and often has fatal complications. This condition is caused by varying factors, but can be treated with human milk. Babies who are given formula milk have a three to tenfold increased risk of developing the condition, compared with babies who are given human milk.
The UKAMB are a charity which supports milk banks as well as being involved with ensuring the safe practice of milk banking, where donor milk is collected. Donors are screened prior to beginning donating. There are 17 milk bank centres in the UK.
Premature babies also benefit from kangaroo care, which is where the baby is kept skin to skin on the mother's chest for as much time as possible. The benefits of skin to skin contact are important for all babies, whether term or premature, formula or breastfed; but it seems even more crucial in those babies who are born early. Research is showing that babies who are kept skin to skin rather than in incubators stabilise more quickly, and has major implications for the psychological and overall well-being of the parent and the baby.
Recent research has shown that babies can attach to the breast from as early as 28 weeks, and be fully breastfeeding from 32 weeks, so this plus kangaroo care in the premature infant is vital.
As a nurse with 15 years of post-registration experience, including five years in critical care, I have seen the massive benefits in technology and medicine, and the fantastic advances that healthcare provides. I am in awe of the brilliant minds that have enabled what has been previously regarded as unthinkable, or impossible to achieve.
And yet my eyes are being opened wide to the brilliance of our own bodies, the wonderful, incomprehensible, microscopic abilities of the human being. We have all we are equipped to deal with, right here, inside of us all: if only we could tap into every aspect of that in an instant! If an infant is more likely to survive by being given breast milk, which contains so much to protect them; in comparison to a medicine which increases their chance of death, which would you rather provide them with?
If you're a breastfeeding mum and would like to find out more about how to donate, click on the UKAMB link, above. You don't need to donate much - just 30 mls can make a difference - every drop counts. If you're a parent with a baby in SCBU right now, find out as much as you can about breastfeeding and kangaroo care. I hope that you and your little one stay strong and do well.
If you're wondering about Charlie, I do hear from his mum every now and then, and know that he has some health difficulties, but it sounds like he's doing brilliantly.
Above: Some of the 19L of milk I donated in the six months I was eligible to do so. At first, I was only able to express 20mls or so, but by the end of the six months I was able to get 120mls in one go - and feed my son, although it took a lot of time and patience.
Thursday, February 16, 2012
"A baby will make love stronger, days shorter, nights longer, bankroll smaller, home happier, clothes shabbier, the past forgotten, and the future worth living for." Anon
The time has come. The moment you have been waiting for has arrived. You've been ticking off the weeks, days and hours, counting the minutes between contractions - or you've found yourself in theatre gear - ready to meet your baby. In one moment, your baby is still enveloped in the darkness within; the next moment, it is subjected to 100% sensory saturation. You breathe a sigh of relief; feel emotion encircle that moment in time. It is a moment that is forever imprinted in your mind. A flood of complex thoughts, feelings and emotions; coupled with a sense of completion mixed with the start of something new. It's not just your baby who is experiencing a new life: the entity of you as a family unit are a new life in which you are to move forwards together, feeling your way as you go.
The following hours are filled with love, tears, euphoria, laughter, relief, pain, stress, sleep-deprivation, exhaustion, phone calls, text messages, visitors, medical intervention in one form or another... the fog of new parenthood is slowly descending around the new family. Gradually, it seems, the old life has faded away, and been replaced with something unknown, something new, awkward and a little-bit-massively scary. This fog has the ability to bend time, where two hours can feel like a day ago; it can change thought processes, where a seemingly simple decision (jam or marmite on your toast? Tea or coffee?) can feel like a confusing moment when the answer isn't as clear-cut as it could be. The fog sucks every aspect of life into a twisted, dense cloud of matter and emotion, to be cleared momentarily, only to build up again as soon as a challenge presents itself. Every decision suddenly feels like a huge responsibility, and is daunting even for the most practically-minded, clear-thinking, confident person.
So much emphasis is based on the moments leading up to the birth, partly because it is almost indescribable to someone who has not stepped into the fog of brand-new parenthood. All that can be done is to read, educate and inform ourselves in whatever way suits us - be it through literature, through antenatal classes, television or through our family and peers - to prepare ourselves for parenthood. I've heard women say, "Why did nobody tell me how difficult this was going to be?" For me, my inward answer is, "because it's too difficult for us to hear before we've been through it". For many, just getting through the labour safely and holding their baby is as far as the mind is willing to travel.
So many of us feel we have failed in some way: Either related to the labour; or feeding; or not changing a dirty nappy "quickly enough"'; or responding to a cry; or leaving the baby too long/not long enough between feeds; or sleeping through a feed;not realising the baby is hot/cold; or not being able to get dressed for an entire day because of a fractious, crying baby; or not getting out of the house all day because frankly, you're too tired, still in your pyjamas, or you think you look terrible; or because every time you put your baby down to go to have a shower they start to cry and so you have to go through the entire feed/shhh/nappy change/singing routine without wanting to cry, yourself - in the hope that at some point between now and your baby's first birthday, you'll get to have a shower, and brush your teeth.
I personally find it hard to ask family and friends for help unless I have a problem. I'm hardwired to get things done no matter what. I don't see asking for help as a weakness, I see conducting my life without help as the norm. But that's me, and I can't change that, even if it isn't the easiest way of doing things. I hated the thought of anyone other than my husband being around in those early days where we were able to bond together as a family, and treasure those moments quietly, without fuss, scrutiny or judgement. Having had two caesareans, I found it highly irritating and frustrating that I couldn't "get on" with things - having to rest was hard, but it is what I needed, and what my babies needed. Here is an interesting article about how mothers are cared for in non-Western cultures, after birth.
I believe that the gentlest way of getting through the first days after birth, is to put no expectations on yourself, your baby or your partner. Live moment to moment. Sleep whenever you can - even if you feel you want to carry on - force yourself to sit or lie down and close your eyes. Eat well, drink plenty of water, indulge yourself with something that gives you a feeling of well-being, remind yourself how amazing your body is to have grown, carried and delivered a baby. If things aren't going according to plan, surround yourself with the support you need to overcome any difficulties. Remember that your hormones are going through highs and lows, and that by day three or four, you'll possibly be experiencing euphoria and sleep deprivation in combination with some stress; and possibly trauma of your birth experience; all in combination with the sudden realisation that you've hit the ground running.
But in my opinion, the best gift a prospective parent can give themselves, is kindness. Kindness for themselves, and their partner. It is this kindness that will nurture you in those early days and weeks after the birth of your baby. The kindness of remembering that you don't know what you don't know; so how can you get things right straight away? Your baby can only cry to let you know that something isn't right - even the baby doesn't know what it actually is that doesn't feel right - so how can you, as a brand new parent, expertly identify what that need is?
The kindness of recognising your limitations - and your success - and allowing yourself to take things moment by moment.
The kindness of knowing that things will change. You will get to a point when the fog will start to lift, the tiredness will ease, the confidence will build, and you will look back on those early days with wizened eyes.
Tuesday, February 14, 2012
"People who say they sleep like a baby usually don't have one" - Leo J. Burke
If I were to have another baby, I wouldn't stress about sleep. I wouldn't worry that they would cry each time I tried to put them down in their cot. I wouldn't frustrate myself or my baby by spending an hour at a time trying to teach them to go to sleep on their own. It was all a waste of time and energy.
I wouldn't worry, because I wouldn't expect them to go to sleep all by themselves, I wouldn't spend ages trying to teach them to lie in a cot and go to sleep. I remember what those early days are like: an hour spent feeding, followed by trying to transfer a sleepy/asleep baby from my warm arms, into a cold cot, then leave them alone, only to feel the despair when, just as I sit down to eat my dinner (which has gone cold), the baby wakes and the whole process is started all over again. This was a common theme with both of our children, to the point where we wondered whether they had an inbuilt mealtime detector that alarmed just as the first mouthful was about to be devoured.
The reason I wouldn't worry, is because I would do things differently. When my daughter was born, she slept in a cot in her room. In the middle of the night, when she woke for a feed, I would go into her room, feed her (feeling cold and shivery), then spend ages putting her in her cot and trying to get her to go back to sleep. We would take turns at the 3am baby-calming routine. Sometimes, I would bring her to our bed, feed her, fall asleep, then wake up and put her back into her cot, at which point she would wake up for a feed or cry for a cuddle and the reassurance that we were there for her. It was stressful, hard work for all of us, and I look back on those nights with a sense of guilt that I didn't take her cues, choosing instead to "fit" her into our way of doing things.
With my son, I started off in a similar way. The problem with him, though is that he had oesophageal reflux, so whenever I laid him down, he would scream. I would pick him up again to soothe him. I tried to find ways of propping up his cot to tilt the head end, but it didn't make any difference. In the end, all I could do was to feed him, then keep him upright on his front on my chest, and wait for him to settle. He would cry, throw up, have more milk, doze, then wake up for more milk. The night time feeds became a routine of sitting upright in bed, which ended up being nearly all night, because that was the only way I could keep him comfortable. It took its toll on my spine, though, and I was having a terrible night's sleep. Putting him in his cot was impossible to do for a night: he would spend only a couple of hours each evening in it.
Then I heard about co-sleeping at my breastfeeding support group. At first I was worried about it. I didn't trust myself to roll onto him in the night, or that it would risk him being suffocated. However, I soon realised that we got more sleep throughout the nights, because he was in our bed, and could be easily breastfed without the rigmarole of getting up, feeding, settling, and going back to bed, again.
There are benefits to co-sleeping with breastfed babies. Please click here to find out about safety guidelines and considerations if you are thinking about co-sleeping. Co-sleeping is used to describe your baby sleeping in the same room as you, as well as in the same bed. Co-sleeping is different to bed-sharing, where the baby sleeps with the mother in the same bed.
It is easier to breastfeed if your baby is next to you. Crucially, the hormone prolactin, which stimulates milk cells to produce milk, is released in higher levels at night. This means your baby is getting more milk if it feeds overnight, and it helps to establish and maintain milk supply. This is why it is important to feed your baby at night, rather than try to leave them to sleep. Breastfeeding at night is easier if the mother and baby are bed-sharing.
Frequent feeding at night also helps to ease and treat engorgement, which can lead to blocked ducts and mastitis. Our bodies are designed to feed our babies around the clock, not just during the daytime, and the fact that prolactin is higher at night is evidence of our biological need to feed during nocturnal hours.
Babies who bed-share have a lighter sleep pattern, meaning they are less likely to go into a deeper sleep where they may have pauses in their breathing (apnoea). This is thought to be one reason why SIDS is lower in breastfed babies who co-sleep with their parents. Also, mums who bed-share and breastfeed have a lighter sleeping pattern, too, so are more aware of what their baby is doing, even if they're not consciously aware of it. Interestingly, there is no such lighter variation in sleeping patterns for mums who do not breastfeed but do bed-share with their baby.
The baby will have the benefit of skin-to-skin contact, which has many benefits. One such benefit is the way in which the baby's temperature is regulated. The body temperature of the mum will vary to ensure that her baby's temperature remains safe and within normal limits - so if a baby is too warm, its mum's body temperature will cool until the baby's temperature comes down. Conversely, if the baby is too cold, its mum's body temperature will rise. Babies also regulate their breathing with their mum's. Isn't this amazing?!
Bed-sharing allows the baby to feel safe and protected, which has a positive effect on their psychological well-being, bonding, and physical needs.
There are safety factors to take into account if you decide to bed-share with your baby.
Mums who are bottle feeding should not share a bed with their child. Partners, siblings and other care-givers are not as sensitive to the sleeping patterns of the baby, so should not sleep with the baby in the middle of the bed, but at the mother's side.
Don't over-dress your baby - dress them in the same number of layers that you're wearing - to prevent them overheating. Keep their head uncovered, and make sure that pillows are kept away from the baby.
Make sure your mattress is firm and flat. If you can, get a queen or king-sized bed.
Sleep with the bed against a wall so that the baby cannot fall out or get stuck.
Don't bed-share if you or your partner smokes, or if either of you have been drinking alcohol, taking any drugs or medication that can make you drowsy.
Here is some reassurance if you think your baby should be sleeping through the night.
We still have nocturnal visits from our 3 year-old. He climbs in, settles down, and goes back to sleep. We are often joined by our daughter in the early hours of the morning, too. It's all fine until the bickering starts, or worse, if one of them decides they'd like us to read to them, at which point it's common to get jabbed in the eye by a tumbling picture book at 6.30. But at least we're all warm, and it's actually lovely to have cuddles with them - we know it won't last much longer before they'll grow out of it!
Sunday, February 12, 2012
"Every baby needs a lap" - Henry Robin
Once, I was asked by a pregnant friend, "What do I need to buy for the baby?" I struggled to answer her. I think her expectations were a long, concise list of everything her baby needed. I started to write a few things down. "Lots of nappies. A few items of clothing - but don't buy too much, because you will be given lots by others and then gifts of clothes, too. A good quality car seat. A sling. A cot or a moses basket. A baby changing mat. Lots of tea bags, biscuits, and sugar." My list started to dwindle. I couldn't really add too much more to the list. My friend looked bewildered. "Is that it?" she asked. "Nothing else?" "Well," I responded, "some big pants - big, scary, old-lady pants - you'll be amazed at how comfortable they are in the days leading up to the birth, and in the first couple of weeks. You don't believe me now, but just wait!"
I consider late pregnancy and the early days following birth as the absolutely only time in which big scary old lady pants are a perfect item of underwear - essential for comfort and support. Even if nothing else, big, scary old-lady pants make a practical solution if you need an emergency blanket or a sling for your baby, or if in the event of a colander malfunction, I imagine they'd be great for straining your potatoes. They could even come in useful in a damsel-in-distress, railway children sort of way, as a signal to others of your overwhelming tiredness and fatigue, when you find yourself trying to feed the parking meter wine gums; or if you accidentally pour coffee into your change bag whilst soothing your crying, frustrated infant, pretending that you're fine and everything is in control, when in reality you're in need of a hug, a sugar fix, and a few hours of quiet, uninterrupted sleep.
We live in a society where accessories and technology dictate our lives. We are encouraged to think about "teching" out our baby's life, where it's possible to monitor our baby not just from a listening aid whilst in another room, but we can actually spy on them whilst they sleep, by putting a camera in their cot so you can look at them on a tiny screen if they start to cry, rather than attend to them in person. There are apps to tell you when your baby is next due a feed; mats to place in the cot which alarm if your baby stops breathing for a few seconds (and are, so I've been told, fairly unreliable as they can alarm even if the baby is absolutely fine); super-funky buggies; bottle warmers; scientifically-tested formulas which claim to be so brilliant they are almost as good as breast milk...the list goes on and on.
How far do we need to go? Isn't is time to just pause the technology, and instead focus on humanity? Beneath the plethora of books, accessories, technology and on-trend gear is a human being. A baby which will be exposed to the latest technological advances throughout its entire life, so why not allow it some time to adjust to the world in a quiet, calm, peaceful, non-intrusive way? Does "less is more" have no meaning, these days?
I don't doubt the safety benefits of some equipment. For example, the mats which sound alarms if the baby stops breathing could be very useful in a premature baby's cot, or for babies that have existing breathing problems. But in a healthy, term, breastfed baby which is placed on his back in a cot without any pillows, cot bumpers or anything else which may be a potential danger, is that a necessity? How much does our market rely on paranoia to sell products? Monitors are useful to hear if a baby is crying, but do you really need to see what the baby is doing, too? The chances are, that if a baby wakes up and starts to cry, they need a feed, they're poorly, they need a nappy change, or they just need some reassurance from human touch and voice. What's a camera going to do?
Trust your instincts. Listen to your baby. Follow their lead.
A baby needs love, warmth, to feel safe and protected, and food. You have all the mechanisms in place to provide these things.
Anything else is an added bonus!
Above: Tammy breastfeeding Izzie. Thanks to Tammy for allowing me to use this image for my post!
Anyone reading this blog so far will have gathered that I am pro-breastfeeding. Why wouldn't I be? There are so many reasons why breastfeeding is the best choice. What I am asking from you as the reader is that, from this point onwards, you either read with an open mind; read to re-affirm what you already know; or read with the possibility that your perceptions of breastfeeding may be positively changed. But to anyone who wants to "shout" and tell me that breastfeeding is wrong/disgusting etc etc - arguably, you are the ones who need to read this more than anyone else.
Ten advantages of breastfeeding:
1. It's FREE
2. It's ready-made, and just right for your baby. No mixing, no measuring, no warming up, and the milk changes to match your baby's dietary requirements
3. Breastmilk protects against ear, nose and throat infections, urine infection, gastro-enteritis (diarrhoea and vomiting). If all babies were breastfed exclusively for at least 3 months, the NHS would save £50 million a year on the treatment of gastroenteritis alone
4. Breastfeeding mums who come into contact with a viral illness will pass on a degree of immunity to her baby (which may prevent the baby from developing the same illness, or lesson the effects of it)
5. Breastfeeding can reduce the likelihood of developing allergic conditions, such as eczema, or asthma
6. Breastfed babies are less likely to be obese in later life
7. Breastfed babies are less likely to develop diabetes
8. Mums who breastfeed reduce their risk of developing breast cancer by 15% for each year they breast feed their baby and for each subsequent breastfed baby
9. Mums who breastfeed reduce their risk of developing ovarian cancer
10. Breastfed babies are less likely to die from Sudden Infant Death Syndrome (SIDS)
My first main point is this: up until the mid 1800's, when powdered baby milk became available, we, as a human race had lived on breastmilk from birth and survived. In fact, it could be argued that breastmilk has helped to preserve the human race from the perspective of immunity and protection of illnesses and diseases, not just from a calorific, free-at-the-point-of-delivery perspective. This means that, in ancestral terms, you are here because your ancestors breastfed!
Secondly, I really dislike the term "breastfeeding nazi". I find it quite offensive, because those who attach this label on to anyone who promotes breastfeeding are simply ignoring the huge amount of money that formula milk companies invest annually into promoting their own products, and the sneaky ways the companies use to compete with each other; and how they advocate formula over breastmilk; let alone the obscene profits they make at the expense of our society. In my mind, the execs at the top of the formula companies are equal to the greedy bankers who are tucking into our pockets. Just something to think about: when was the last time you watched an advert on TV which promoted only breastfeeding?
There are now tight controls on breastmilk substitute companies for the protection of babies all over the world, particularly in developing countries, where formula milk is ridiculously expensive, and dangerous if not prepared safely, which puts millions of babies at risk each year. Breastfeeding advocates aim to protect these lives, as well as the well-being and health of babies in all countries. So let me say here that I am a breastfeeding advocate for all the right reasons, not to impose my opinions or criticise those who choose to formula feed.
In addition, those stories you may read in the newspapers about those poor mums who have been told to leave cafe's or restaurants because they are breastfeeding their baby - in most, if not all cases, discreetly - are in the minority. It makes a good story because it divides opinion.
What society need to acknowledge, is that breastfeeding is normal. As soon as this happens, the "outraged onlooker/cafe owner told breastfeeding mum to leave their premises" stories will no longer be newsworthy, because nobody will be "offended" by it. Breastmilk substitutes are an alternative to human milk.
When I had my daughter, I was determined to breastfeed. I was going to succeed at it because I am actually quite stubborn (but don't tell anyone I admit to that), and I wasn't going to allow myself to fail at something I had set my mind to. But I didn't get enough of the right support at the beginning, so I ended up having some problems. I had trouble with getting my daughter to attach properly, and ended up with mastitis, which - as anyone who has had it will know - was excruciatingly painful.
I was more prepared with my son, and also had a lot more help available from a breastfeeding support group - which, by the way, I recommend as an essential part of your maternity "toolkit" - find your nearest group when you're pregnant, go along to them and meet the mums, breastfeeding counsellors, and peer/mother supporters before you have your baby, to find out more about breastfeeding. Even better, go with a friend and make some more friends in the process!
Breastfeeding isn't always easy to get to grips with, especially at the beginning, but once you get the hang of it, it's such a rewarding experience. Getting help and support is essential to ease any difficulties you have. In an average breastfeeding group, it's highly likely that at least one mum, breastfeeding counsellor or peer supporter will have experienced at least one problem with breastfeeding, so they'll understand how you're feeling and will have some suggestions as to how to overcome your difficulty.
If you're reading this and you're a mum who has not, for whatever reason, breastfed their baby, I am not here to judge, or criticise your decisions. If you tried, but gave up - well done for trying - even one breastfeed is an achievement. If you chose not to breastfeed, I don't want to criticise anyone for giving formula over breast milk. It's your baby, your choice, and I respect that. If you are breastfeeding but having some problems, or aren't sure if you're "doing it right", then read on.
The most important thing a mum who is finding it difficult to breast feed can do, is to seek help from someone who can help. Find your local breastfeeding group; talk to your midwife, health visitor or GP; or contact the national breastfeeding helpline on 0300 100 0212, or click here for more information. Most breastfeeding problems can be overcome with the right guidance and support.
Thursday, February 9, 2012
I read lots of stuff about baby-rearing the first time around; however, although I tried to fit a routine into my second baby, it didn't quite fit. It seemed that most parenting books focused on the first-time mum - as if anyone who has ever had a baby will automatically go to the top of the class for knowing-it-all as soon as they experience the first bout of morning sickness.
Imagine the sheer audacity of absolute knowledge of all-things-baby in a second-timer; compared to the wilderness of know-how for a first-time parent. It couldn't be easier to fit a baby into the packed, busy life of a mum with a child, work, and family life to juggle, can it? What could be simpler than trying to feed a baby at set times, in between taking their older sibling to preschool/school, or picking them up from after-school clubs or play-dates at their friends on the other side of town? How effortless it is to be able to do the school-run, go shopping, feed the baby, do the housework; and prepare a family meal at the height of the "witching hour" of colic between 5 and 8 every evening, whilst fitting in some quality time with the older child, helping them with homework, bathing them and putting them to bed; then settling down for the evening for some grown-up time with their partner, for some scintillating, intelligent conversation. All on 3 hours of broken sleep, with a big, beaming smile on your face, clean, ironed clothes which don't have any stains from milky vomit, or felt-tip pen marks from a fearsome colouring-in session at the table with the older child (one handed, naturally, as the other arm is occupied with holding and feeding your baby). The second-time mum knows Everything There Is To Know About Routine, right?
Well, not me, anyway.
I am not going to name names as far as baby-rearing books go, but generally, there are two camps to choose from. In my first pregnancy, the books I looked at from the first camp were laughed over and thrown away within two chapters, as it was so rigidly prescriptive, I couldn't imagine ever trying to raise a baby with the suggestions put forward; the second was better and helped me to establish myself later on, when my daughter was a few months old, and had naturally settled into a routine of her own. It was this book I tried to follow after my son was born, but I put it down and ignored it within a couple of days as it just did not fit my routine at all. Why? Because I was taking cues from my son, and letting him show me the way.
Baby-led, or demand feeding is the ideal way to breastfeed your baby. Your baby knows when he or she is hungry. He knows that something doesn't feel quite right, and learns quickly that if he suckles on his mummy's breast, he will get something warm, comforting and tasty as a result. Your baby knows that the breast is a source of survival, and she will tell you when she needs it. Amazingly, your baby is working alongside your body so that your milk production is just at the right pace for that particular day, hour, or feed.
Your body has been preparing itself for breastfeeding for several months before your baby came along. When your baby is born, your brain switches on the hormones that make milk. This means that any stimulation to the breast (sucking, licking, pulling at the nipples during skin-to-skin contact) will trigger milk manufacture. So after your baby has been born, even if you don't attach her to the breast straight away, the movements and nuzzling at the breast is enough to get things going. The more the baby does this, and the more the baby attaches and suckles at the breast, the more the hormones (oxytocin, which is the hormone that causes the "let-down" where milk is released from the breast's milk ducts, and is the hormone which makes you feel that devotion and love towards your baby; and prolactin, which stimulates the milk ducts to make milk) are released. More frequent feeding will release more hormones, which make and release more milk. Your baby will want to feed frequently for several days after birth, so allowing that process will result in several things:
Your baby will feel comforted and satisfied
Your body will be ramping up the milk-making process
You will be full of oxytocin, which induces feelings of love, and with the bonding process between you and your baby
Your body will be working hard to get back to its pre-pregnant state. Oxytocin helps to shrink the uterus back down again (some women feel "let-down" pains in the early days during breastfeeding, due to the oxytocin release, which can be painful for some, but do settle down)
So how can demand-feeding a baby be possible when there are lots of other factors to take into consideration (for example, an older child)?
Well, it may not be easy to start, but in the long run, you may find it works better than trying to slot a feed into a space where your baby doesn't want to; or worse, try to do other stuff whilst your baby is hungry, but as far as you're concerned isn't "due" a feed. This goes for night-feeding, too.
Try to invest in a good quality sling (please read this guide to buying slings before you buy one). Slings are great because they keep your baby close to you. Your baby wants to be near you in those early weeks. They want to feel your warmth, they want to hear your voice, your heartbeat, and they want to feel safe. They have their security and comfort with you, because that was all they knew, until they were born. You are not "spoiling" your child by having them close to you, and they won't learn bad habits. If anything, they will feel safe and calm and be more settled, than if you are trying to get them to go to sleep in a cold moses basket, away from you. Also, when you are happy with breastfeeding, you can feed them in the sling whilst you play with your child. Or go shopping (just be careful if you have to reach shelves above head height, to avoid slurping noises, followed by accidental breast exposure, shocked onlookers and a cross baby. Not that I'm talking from experience, or anything...).Or when you're making dinner. My son loves watching me cook, chop and stir, which I attribute to his observations in the sling when he was a baby, because he wanted to be near me whilst I cooked the evening meal. I can safely say that it cut down on the witching hour aggro considerably, and probably prevented me from going bonkers.
This form of parenting takes a little getting used to, and some patience. But I found that it revolutionised my own routine because as soon as I accepted that I couldn't squeeze my son's feeding regime into convenient blocks of time around the rest of my life, a weight was removed from my shoulders. I fed him whenever and wherever he needed to be fed. I even attached him whilst in the sling, on my way up the hill for the school run. Nobody knew. He'd had his fill and fallen asleep by the time I got to the gates, the result of which was one happy boy, one happy girl who had a bit of time with mummy before her baby brother woke for his next feed, and one guilt-free mum who wasn't beating herself up over how inadequate she was at not being there for both her children when they needed her.
Here is some information about baby-led feeding, including recognising when your baby is asking for a feed.
Here is some information about biological nurturing, or laid-back feeding, which you may find helpful.
Please note that I am supportive of breastfeeding, but skin to skin contact and slings are just as helpful for babies who aren't breastfed, too, it's just that you may need to be a bit more resourceful when it comes to feeding and looking after older children. I don't judge, just offer a different option!
Tuesday, February 7, 2012
On one, dull March lunchtime seven years ago, I went to my midwife appointment for my 40-week check. I had been having contractions throughout the morning, so I asked my husband to drive me. He didn't really believe that I was in labour, which meant either I was hiding it well, or he was in denial. The midwife checked me over, then confirmed that I was in labour, advising us to contact the hospital to let them know. She added that we might like to do this, quite soon.
We went home, had a cup of tea and some toast, watched Neighbours, and listened to the silence of the house. My partner put the bag into the car, went around the house checking windows were locked, turned lights on, and put the radio on - the routine he did when we went on holiday! I remember feeling excited, nervous, and apprehensive. A sense of calm had descended around me, making me feel like I was in a protective bubble. As we left the house and I shut the door, it occurred to me that when I next walked through the door, I would be a different person. I felt as though I had shut the door on a part of my life which had passed.
I remember three things about the car journey:
1. It was the most uncomfortable trip of my life
2. I had a contraction at a set of traffic lights, where a man in a white van next to our car was watching me with an expression of fear mixed with fascination
3. The trees along the road leading to the hospital were budding, awaiting the signals of the arrival of Spring
When we got to the hospital, the birthing pool was occupied, so I waited, hoping that it would become available soon. But the calm, quiet birth I had hoped for wasn't to be, and so several hours later I found myself in theatre having an emergency caesarian section. The sensation of being in indescribable pain in one moment, and feeling completely numb the next is a surreal experience. My daughter was delivered, bundled into a towel, and handed to my husband.
I waited an hour for my first cuddle with her, and later was sent up to the post-natal ward. My daughter and I were separated by a cot, the spinal block that prevented me from moving for several hours, and a "no lifting" policy which the staff told me meant that they were unable to help me sit up to attempt to feed my baby. They were too busy to help me, so it was hours before I was able to properly cuddle her and feed her, giving her the skin-to-skin contact she needed. Needless to say, within a couple of days she became jaundiced and required a few periods on the bili-bed, of which I was given no warning, other than the NICU nurse arriving suddenly late into the evening, stripping my baby girl down to her nappy, and putting her onto the bed. The nurse left without explanation. I was furious, confused, and upset.
In my mind, I had failed my daughter. I had failed to bring her into the world quietly and calmly; I had been unable to give her the skin contact I wanted to; and I had failed at feeding her enough milk, resulting in jaundice which required medical intervention in order to make her better. When I reflect on this experience, as a trainee breastfeeding counsellor I know that the problems I had with feeding her - painful nipples, difficulty latching on, and later mastitis was because I wasn't attaching her correctly to the breast, and she was unable to suckle properly. The midwife breastfeeding co-ordinator at the hospital was simply too busy to spend any length of time with me to observe a feed and help me with positioning and attaching, but she did, at one point, grab my boob and push my daughter's head onto the breast! I am pleased to say that this is a no-no, nowadays - but at the time it added to my feelings of failure and lack of confidence.
Four years later, and I was about to have my son, this time as an elective c. section. We had moved to a different part of the country. My midwifery care was excellent all the way through the pregnancy. I was told about a "natural caesarian" where the baby is placed onto the mum's chest after delivery to optimise skin-to-skin contact. I opted for this and had a wonderful, beautiful, calm birth. This time, though, I didn't have my partner with me, as our childcare for our daughter had fallen through at the last moment, so he stayed with my daughter. The staff invited them to sit on the "sidelines" of theatre, separated by a screen. After spending some time nuzzling and staring at me, my son was taken to meet his daddy and big sister. Behind the screen, his cries were hushed as my daughter quietly sang "twinkle twinkle little star" to him. It was a moment to cherish, and one we remember and recount to our son.
The staff helped me with skin to skin contact, breastfeeding, and put all of my ghosts of the birth of my daughter, to bed.We spent hours just staring at each other, my daughter and partner getting close and cuddling, too. He attached himself to the breast and with some jiggling around a little, and some slight shifting about in the bed, we got going very quickly, and with only a little discomfort. It was a fantastic experience!
It seems that, within a comparatively short space of time, care and practice for skin to skin contact has advanced and improved greatly. Skin to skin contact after delivery and in the first weeks of life help with all sorts of things. Immediate placement of the baby onto mum's chest (or dad's if mum isn't able to do so) helps to mix the parent's natural skin bacteria with the skin of the baby, which helps with the newborn's immune system; it also helps to regulate temperature, raise the baby's blood sugar levels; regulate heart rate and breathing, and any nuzzling, suckling, or even touching the nipples by the baby will help to stimulate the hormones required for milk production (International breastfeeding centre). You can read more about the importance of skin to skin contact here.
What could be more rewarding than, at the end of labour, to snuggle up with your baby on your chest, resting, staring into each other's eyes, with partner and siblings cuddling and stroking your newborn's skin, and getting to know each other...apart from a cup of tea?!
Monday, February 6, 2012
When I found out I was pregnant with my daughter, nearly eight years ago, the first thoughts I had were based along my career. I was in my late 20's and had got to a stage in my nursing career where I was in the "right" place: I enjoyed my work, I was progressing my career nicely, and I was about to embark on a 2-year degree which would take me further up the career ladder. We wanted to start a family, and were on the "if it happens it happens" stage of the process. We hadn't expected it to be successful straight away - we had allowed ourselves at least a year of trying! We were very lucky, and although I was over the moon when I saw the little blue line appear on the test stick, it was still a shock, and my mind was filled with questions, like "how will I work after the baby is born?" "How will I cope with sleepless nights and work?". I was very career-led at the time.
Next, I dashed to the bookshops in town and bought several books on pregnancy and birth, mostly for the benefit of my husband, who I'd told over the phone whilst he was at work, because I was too impatient to wait for him to come home that evening. I could almost hear him swaying on the end of the line as I told him.
For the next eight or so months, we read and re-read as much information as we could. We went to our antenatal classes, and made friends with couples in the same stage as us. We all knew we were going to have a baby, but we were focused on getting through the pain of labour in order to actually see and cuddle what had consumed our entire lives to that point. Few of us, I doubt, had considered what was to come in the following weeks and months, let alone prepared ourselves for what may happen if things didn't go according to our own expectations.
During that time, relationships with family and friends also began to change. Friends with children became closer, sage wise ones - dishing out advice at every opportunity - which was either politely taken on board for the recycling bin; or stored in the memory bank for later. For some of our childless friends, the dynamics changed to a more distant, less cosy relationship, whilst others enjoyed seeing how our lives were changing and were keen to celebrate these changes. The relationship with my in-laws became tense: I was constantly told I looked tired and exhausted, and whenever I put some food in my mouth the infuriating "eating for two, eh?!" comment would surface. At one stage, I was asked to perform a 360' turn to see where the distribution ratio of fat:baby bump was. This inevitably put strain on me and led to me keeping them at arms length to preserve my sanity. I am sure they didn't mean to make me feel scrutinised and judged, but that was how it felt, all the same.
Isn't this how society dominates the human pregnancy? The moment a woman finds herself pregnant, she is sitting in judgement of others. What she eats/drinks/wears; whether she looks "blooming", tired, or is having a "hormonal moment" is all the scrutiny of those around her. And how many people, including strangers, touch the "bump"? I personally found it an invasion of my space, and couldn't understand why complete strangers would come up to me (on three separate occasions) and rub my tummy! I would feel like saying, "I'm not Buddha, and I don't pass out good luck to all who rub my stomach!" But I was frequently mindful of being judged.
We were baffled, soon-to-be parents at what we actually needed to buy for our baby. We would take trips to well-known department stores to gawp at the prices for cots, mattresses, clothes, nappies, and maternity wear. We would stare in wonder at the array of "goods" needed in order to keep our baby happy, and safe. "Why on earth do we need cotton buds?" or, "what is the point in talcum powder? Isn't that carcinogenic?" "Does a newborn baby really need to have a comb? Surely that will be a pointless object?" These conversations were prolonged, subjective, confusing and often resulted in heated, loudly-whispered debates in the maternity pad aisle, next to the haemorrhoid creams section. But we were both suckers for the soft, fleecy cot toy which played tinkly music and resulted in us both welling up and hugging awkwardly before leaving the shop having purchased the said item and ignored anything remotely practical and needed in favour of a treasured trophy which, to this day, has us both grinning at each other wistfully as we are reminded of that moment of love and excitement at the prospect of welcoming our daughter into the world.
Then there were the questions about how I wanted to have my baby. "Safely" was my most repeated comment, and again, I felt judged if I mentioned I'd quite like a quiet water birth without drugs. "Oh you'll never cope without drugs!" I was told. "I bet you'll be screaming for an epidural after your first contraction!". This made me feel cross. How was anyone else to know my pain threshold? And wasn't the way I intended to give birth a personal matter between me and my husband, and the hospital? If I chose to give out these details, it was a different thing, but the boundaries were crossed at frequent times. Or the other person would give a graphic, detailed description of their birthing experiences. I wasn't always sure if it was an attempt to prepare me, or to frighten me. Either way it didn't bother me, as I still had fresh-ish memories of being a student on a labour ward, and had regular contact with other pregnant women and newborns in my job. My husband, however, grew more anxious about the birth as the date approached.
The most frequently-asked question though, was how I planned to feed my baby. I had decided that I was going to give breastfeeding my best shot. With that in mind, I didn't buy any bottles or teats. I was given a sterilising unit, but had no idea about using it. I read up a bit about how to do it, and expected the midwives at my hospital to help me out. That was what I'd seen in my training. I was told by my antenatal midwife to buy some formula just in case I couldn't breastfeed. I decided to ignore her. I was going to breastfeed, and that was the end of that conversation!
- Nikki Harman
- I am a mum to two children, a registered nurse, a trainee breastfeeding counsellor, reiki practitioner, photographer, and generally into keeping things natural. Going back to the basics in life, respecting nature, the planet, and each other. Teaching this to my children and others who are interested. This blog comes from a good place, and is intended to give the reader an opportunity to look at things from a different perspective, and make an informed choice. I welcome constructive comments and would like it if you could share (acknowledging me as the source) and follow the blog. Many thanks!