It’s not just formula companies who behave unethically. Sometimes a company who on the surface looks like an ardent breastfeeding supporter can also be known for some pretty dubious marketing behaviour. One of those companies,… More
Across the great divide of what is “best”, much is lost.
I recently made what I thought was a fairly innocuous post on Facebook, mostly about the marketing practices of big food and formula, along with the cultural assumptions and messages we all absorb from some of our big supermarkets in the UK. I wasn’t really expecting the post to blow up quite the way it did. Among the many who completely related to what I was trying to say, was a core of people for whom the message was triggering. I watched in despair as the conversations went down well trod lines.
I had hate messages sent to me personally. I had public abuse. I was accused of wanting to starve babies. Of wanting formula behind the counter like cigarettes. Of assuming everyone who fed formula was a bad mother. None of which is true. It was hard to know how to react for the best. I’m not sure I made the right call on some occasions, but I’m human after all. So I did my best in the face of a barrage of words and some pretty unkind assumptions about what I was trying to say. About who I was.
Inevitably those same old, tired, lines came out.
“BREAST IS BEST!”
“FED IS BEST!”
“FED IS THE MINIMUM!”
And on, and on, and on. The more I watched, the sadder I felt. The media and invested companies whip feelings up, encourage us to see each other as two camps of people and they profit from it. Nowhere is this polarisation more alive than when it is played out on social media, where there are groups whipping up a storm of anger on both sides.
So this is my appeal.
Please can we stop saying “breast is best”. Breastfeeding is an evolutionary norm, a biological function. It is no more possible for breast to be ‘best’, than it is for sweating to be ‘best’. That doesn’t mean I don’t wholeheartedly believe breastfeeding is significant. It is significant to the health of babies. Equally, it is significant to folks in the UK in ways that often have absolutely nothing to do with ear infections and everything to do with the heart💚. Our wider society and systems should support parents who want to breastfeed. It should just be a normal way to feed a baby. We should acknowledge when it is important to people.
Please can we stop saying “fed is best” to people who are struggling to breastfeed or have decided to stop. It can hold truth for some, but be hurtful and harmful to others. Before making assumptions about how anybody should feel- shouldn’t we ask them? Hold a space for them to tell their story and show kindness rather than judgement? We don’t know their stories. We don’t know their truth. If we are behind a keyboard we probably don’t know them. If they need it, we should support them in a way that is best for them, however that looks. Many parents who decide to use formula often say they felt support drop off a cliff at that point. Many will say a formula company helpline was the only source of support they found. Is this right? Parents need independent, good support however they decide they want to feed their babies. Trust me, as a mum who combine fed, it’s not all on the formula packet.
Please can we stop saying “fed is the minimum” when we respond to somebody who says “fed is best”. Telling a parent who spends so. much. time. preparing formula safely, who may even go hungry to buy formula for their baby, who is up in the middle of the night making bottles, who may have struggled to breastfeed in ways you cannot imagine (or may for other reasons, simply have decided not to), who has good days and bad days and hard days and loves their baby just like you, tellling that parent that what they are doing is “the minimum” is unkind and untrue.
Why are we allowing this illusion of a divide between us when in all likelihood we have more in common than not? In the UK, right at this moment, most mothers will breastfeed and bottle feed at some point.
We do not help ourselves, parents and babies by shouting at each other across a chasm lined with privilege.
Let’s hold a space. Let’s tell our stories. Let’s try to remember we are all flawed humans just trying to do our best in this world. Most of all, let’s support each other on this crazy path that is parenting.
“Kindness begins with the understanding that we all struggle.” – Charles Glassman
#breastisnotbest #fedisnotbest #unityisbest #supportisbest #informedisbest
Support for breastfeeding:
Support for bottle-feeding and formula feeding:
Have you fallen into the dark side of night boobing? Are you wondering if night weaning is the answer?
As a breastfeeding support volunteer with a breastfeeding child, I often find myself talking to parents about night weaning. Firstly, there can be lots of pressure to stop breastfeeding your child overnight. Whether you choose to do so is your decision. If you are happy night nursing you crack on, you’re doing a fabulous job! Really, feel totally free to scroll on by. If you are thinking about night weaning, read on (apologies in advance, this is a long blog!).
It is normal for babies and young children to wake at night and sleep isn’t connected to how you feed your baby. Boob is a magic tool for many parents, nobody should feel ashamed for making the most of the gift biology has given them. Night nursing your child is also important nutritionally for babies, especially those under twelve months. Some research suggests they can take up to a third of their calorie needs at at night.
However, eventually some of us hit the dark side of night feeding. For me this was around two to three years in. It can be useful to wait until your baby is at an age where they can properly understand the concept of night weaning, often this is after the age of eighteen months.
When Might Night Weaning be Difficult?
Children will still have developmental leaps and growth spurts after babyhood. These can be the times we think about night weaning the most! They are also the times your child may be least receptive to night weaning. Often during these leaps children are reaching out for reassurance. Night weaning may seem like pulling away. You may find instead of accepting the process your child will become distressed.
If your child is poorly or recovering from illness it probably isn’t a great time to night wean. I would even say if your child is night weaned when they are sick you may still want to use boob to comfort them. That’s totally OK.
Will Sleep Improve After we Night Wean?
I’ve touched on this before in my blog about baby sleep myths. For some parents, night weaning helps. Others may find their child still wakes frequently at night. Just because your child wakes and breastfeeds, it doesn’t mean they wake to breastfeed. Factors that influence a child’s sleep can be multi-faceted. Breastfeeding is often a scapegoat for night waking, but it can actually be useful tool to get the family back to sleep quickly.
Before embarking on night weaning it can be helpful to ask yourself- ‘How will I feel if I do this and my child continues to wake up?’ ‘Am I doing this for myself or for other people?’ ‘Am I truly ready to night wean?’ ‘Is my child?’ The only person who can answer these questions is you.
My Night Weaning Story
I had false starts before I finally night weaned A. In truth, the first times I tried I wasn’t really committed. Night weaning can feel like a huge change! If you aren’t ready it can be emotionally hard and you might find you give up on the process.
Miss A and I had been talking for a long time about Mummy needing to get more sleep at night. We read the book “Nursies When the Sun Shines” together and she loved it. The concept her baboos (her word for boobing) would go to sleep at night though? That was a different kettle of fish entirely!
As more time passed I got to a point where I was ready to stop night feeding, regardless of what happened with sleep. The protests A made when I tried to avoid a night feed also felt like they had changed. It started to feel more like… when I didn’t let her have a cookie, rather than emotional distress. Something had shifted.
I knew saying “no” to breastfeeds wouldn’t go well. During the day when I wasn’t wanting to nurse we had reached a compromise where I allowed her to latch on for a count of ten. I decided to try this at night and it worked well. I kept shortening feeds and after a while it felt like less of a leap to say “baboos in the morning” instead. She accepted it quickly once I made that decision. There were some tears during the first couple of nights but nothing a cuddle couldn’t handle.
I continued to co-bed during this period. She had never settled for her Dad at bedtime and it didn’t really make sense to suddenly involve him. I think it would have only distressed her. I didn’t want to remove myself from comforting, just the boobies!
What worked for me might work for you, it might not, it is an individual process. Here are some other things to consider.
Before you Start
- Communicate. Let your child know what is happening. Talk to your child about boobies going to sleep and having boobie in the morning. Reading “Nursies when the Sun Shines” like I did is one option. Other parents might make their own story book where they say goodnight to things in the house and you say goodnight to boob at the end.
- Small steps first. Consider introducing a comforter a month or so before you night wean. Alternatively introduce a special song, soundtrack or a special scent instead. Other parents stroke their child’s back or shush while feeding. The idea is to create a sleep cue outside of breastfeeding.
- Food and Drink. It might help to take some water to bed. Word of warning, water won’t cut it if your child wants boob cuddles! However, children can get dry mouth at night and may appreciate a drink if they can’t have boob. Let them know a cup of water is there before going to bed. In older children night breastfeeding is often not about the milk as much as the connection, but, do think about their nutrition during the day. If your child is breastfeeding frequently at night will their needs for protein, fats and calcium be covered?
Night Weaning Tips for Toddlers and Small Children
- Drop the first feed- Children often fall deeply asleep when they are first put to bed, so it may be easiest to start with dropping the first feed of the night when they settle to sleep more easily. You can try the other comfort measures you have introduced when they wake. Once they accept not breastfeeding at the first feed, you can drop the subsequent feeds one at a time, until finally all feeds are dropped.
- Shortened feeds- Much like I did with A, you could experiment with shortening feeds. Some parents like to use a countdown like me, others might sing a special song. You can reduce the countdown or drop verses, or even sing more quickly!
- The ‘pull off’ approach- This is another approach to shortening feeds. In her book “The No Cry Sleep Solution” Elizabeth Pantley talks about removing your child from the breast just before the point that they fall asleep. You can shush at this point or use some other comfort method. The idea is that if your child roots for the nipple again, offer it back. The theory is your child will drop off to the other cue and you can begin the process of removing the nipple earlier in the feed until boobing is no longer needed at all.
- Back up buddy- Some parents find if their partner has been involved in settling their little one already, it can work well to send them in for settling some of the feeds. Word of warning, if your child is not used to this it may have the opposite effect! Reflect on how things work in your house and follow your instincts.
- Bed Sharing-If you bed share, continuing to do so might make things easier. While the boobie goes to sleep, the comfort from your presence remains. Taking away both of these things at same time might be a lot of change. Encouraging your child to sleep apart from you can often be worked on later.
- Clothing-Think about what you will wear to bed. Clothing which isn’t as easy to access might be useful. I still remember waking up one night after we had night weaned, to a cheeky A sneaking in a breastfeed when she thought I was asleep!
- Don’t say “no”, say “later”- “No” can be such a trigger word for small children!
- Block of time approach- One advocate for this approach is Dr Jay Gordon and you can read more about his approach here. The principle involves picking a block of time- say midnight to 5am- to avoid breastfeeding. During that time you do other things to comfort your child. This might be a tougher one than the other gentle measures I have talked about. It is worth reflecting on how you feel about it, carefully, before starting. Shorter blocks of time to start might be easier. Remember it is OK to adapt things to suit your own child.
You may use a mixture of these strategies or you may find your own unique approach! Listen to your heart, your instincts and your little one.
Tears and Tantrums. When do we Stop?
If it feels hard, it’s OK to stop. It’s OK if there are false starts along the way. You can always try again at a later time. You might find the process is two steps forward and one step back. You may reduce many of the feeds and decide, actually, you are OK with one 5am feed because otherwise your child is up for the day and you don’t want to get out of bed! (Seriously, it is not worth it, CBeebies isn’t even on at that time). All families and children are different. You will know when it feels right.
Importantly though, it is OK to want to night wean. I don’t subscribe to this idea that if you are child led you must completely subjugate your own needs. If you are breastfeeding an older child, let alone still breastfeeding them throughout the night, that is something rare! Feel proud of everything you have done. Great job. You rock. If night feeding your older child is making you feel resentful of your breastfeeding relationship, night weaning might just be the option which helps you to carry on, rather than completely weaning your child. Your needs matter. If you feel conflicted, why not have a chat with a breastfeeding counselor?
Did night weaning improve things for me? Yes and no. Initially, night weaning made no difference to the frequency of A’s night waking. What it did do, was make it easier on me. I couldn’t sleep through her breastfeeding but I could sleep through a cuddle. I was woken for cuddles and drinks a lot for quite some time afterwards. She really started properly sleeping through around six months later (she was about three and a half). She may have done this by herself if I hadn’t night weaned. It is hard to know. Waiting for when I knew we were both ready to night wean, meant I was a peace with what happened either way.
Wishing everyone sweet sleep (or lots of coffee if you have a sleep thief on your hands). Much love, Oxytocin & Other Stories 💚💚💚
Kathryn Stagg IBCLC blogs on toddler night weaning and night weaning toddler twins!
My tips and top links for breastfeeding parents to be!
Having a baby comes with a lot of questions for parents to be. Which pushchair is best? What should my baby sleep in? What clothes do they need? How can I prepare for birth?
If you are anything like me, reading this while pregnant with your first child, the last one might feel a bit all-consuming. When I ‘prepared for my baby’ I read everything possible about birth options. I read next to nothing decent about breastfeeding.
When the midwife asked me how I planned to feed my baby, there was no question in my mind I would breastfeed. It didn’t occur to me I knew nothing about breastfeeding. I thought I had boobs and I would have a baby, and I had booked antenatal classes, so surely that would be enough. I thought my determination would fill in any gaps.
Really, what would have been helpful, was to have done less research into what Moses basket we needed for our baby (spoiler alert: actually a completely useless item) and a more research into breastfeeding. To have had a breastfeeding plan to sit alongside that birth plan. Why is this? For the simple reason, that while breastfeeding is a natural skill, it is a learned skill like walking, not an innate skill like breathing. Much like walking, while you learn to breastfeed you might land on your arse. You might need a bit of support. This is entirely normal in a culture where we do not learn to breastfeed the way we are supposed to. We are meant to learn by watching other people breastfeed, but very few of us see breastfeeding in our everyday lives. Bottle feeding culture prevails in the UK. Quite often, the first breastfeeding baby we might see is our own.
With that in mind, here are a few tips from me, to you, with the benefit of hindsight and a bit of training in breastfeeding support
Book an antenatal breastfeeding workshop
In some areas, your local breastfeeding support groups may hold specific antenatal breastfeeding workshops. While lots of us will do an antenatal class, these breastfeeding specific workshops will be far more in-depth. Your midwives or health visitors would hopefully know if these run in your area. If not, it could be worth getting in touch with local support yourself to check if they have any upcoming sessions.
Sometimes lactation consultants will run antenatal breastfeeding preparation. Depending on the consultant there may be a charge for this.
If a face to face antenatal breastfeeding workshop isn’t available, the Association of Breastfeeding Mothers offer an online course for a small fee (£5.99 at the time of writing this blog).
Getting in touch with support options in advance to do this nicely leads me on to the next tip…
Visit a breastfeeding cafe
Visiting a breastfeeding group antenatally can be well worth doing. It might only take an hour out of your day and there are several benefits; you make contact with the support before you need it, so you know exactly where to go when baby arrives, you get to observe and take in what breastfeeding looks like (so important!) and breastfeeding parents will be able to talk to you about their experiences and what to expect. Breastfeeding groups are often totally free and informal. So you’ve really got nothing to lose💚.
Find your local breastfeeding support groups here and here! While you are doing this why not also note down the details for other avenues of support? The group might offer services such as a telephone helpline, a Facebook group or support via social media messaging. Perhaps you have a breastfeeding counsellor locally. You could also make a note of the telephone number for the National Breastfeeding Helpline and your local IBCLC lactation consultant.
Read a good book about breastfeeding
Reading a good book about breastfeeding can be really helpful. It’s also handy to have on hand for those early days when you might feel overwhelmed. It’s easy to forget what was said in the workshop or the hospital especially when you have a small baby. Popping this book in your breastfeeding box (more on this later!) can be super useful.
Like most things in life the quality of breastfeeding advice in print can massively vary so look out for the ones in the picture there. These are my favourite breastfeeding books for parents. All of them are evidence-based and written by people who know their stuff.
Think about safe sleep
Pre-baby it can be really easy to think you’ve got where the baby will sleep sussed. Chances are you’ve bought a Moses basket, a crib or maybe you’ve invested one of those co-sleeper cots that attach to your bed. However, it can be worth thinking about what you will do if your baby prefers to sleep closer to you.
Almost 50% of babies will have slept in an adult bed with one or both parents by three months, whether intended or not. Breastfeeding also releases oxytocin, which is a hormone which can make you sleepy (this is one reason breastfeeding parents are thought to get better quality sleep). There is a significant association between longer duration of breastfeeding and bedsharing. It’s important to be aware of safe bedsharing guidelines. You might not need to use them but it is far better to plan and be safe than it is to not plan and end up in a riskier situation, such as exhausted on the sofa.
I’ve written more about sleep here, click the link to find out more.
Prepare your breastfeeding box!
In the first few weeks of breastfeeding, expect to be breastfeeding a lot. This is normal and it is a good thing because it also encourages new mothers to rest and recover. A breastfeeding box can be helpful, it should be something you can easily move about the house with you. Things you might like to pop into it are:
- Spare breast pads.
- A large water bottle.
- A leak-proof, insulated mug.
- A muslin to catch spit ups.
- The TV remotes.
- Phone chargers.
- Magazine or book, ebook reader or tablet (basically- entertainment)!
- Your breastfeeding book (see above)!
- Details of local breastfeeding support services.
- Tasty snacks.
- A small pot of vaseline- either for your lips, or if you are unfortunate enough to suffer a cracked nipple, to help with healing.
You might also want to throw in a stretchy wrap for those early days. Find a sling library near you for lessons in how to babywear, you will be so glad you did!
If you have an older child, you might want to set up a breastfeeding box for them too. This can include crafts, colouring, puzzles, books, special toys or a special film to watch. Whatever you think will keep the older sibling engaged and happy. Consider things you can help with one-handed if needs be!
Finally, it won’t go in the box, but a Netflix subscription would be a much handier present than flowers… I am looking at you, visitors and wannabe baby cuddlers! #justsaying
Antenatal expression (optional extra!)
For some parents, antenatal hand expression can be great preparation for breastfeeding. This might be for many different reasons. Perhaps you are expecting an early delivery, or you have gestational diabetes, your baby might have been diagnosed with a congenital difference or you might have had a difficult journey the first time around. You might just want an extra bit of reassurance. Antenatal expression of colostrum is just that, an insurance policy. It should never replace at breast feedings unless it is necessary. The ideal situation is that you don’t use it. However, it can come in handy if something unexpected happens which means boobing isn’t going to plan or you are separated from your baby.
One advantage to hand expressing colostrum antenatally is that it gets you familiar with your boobs and how things all work. Studies have found hand expressing in pregnancy helps parents to feel more confident about breastfeeding, and that parents who do this breastfeed for longer.
Antenatal expression of colostrum is thought to be safe from around the 37-week mark. If you want to start earlier check with your midwife or consultant first. You can find out more about the antenatal expression of colostrum here.
You’ve done the prep…so now what’s your breastfeeding plan?
So hopefully after thinking about a few bits, you will have a better idea of what to put on your breastfeeding plan and what is important in order to get breastfeeding off to a good start!
The Australian Breastfeeding Association have some brilliant example plans which you can use or adapt here to suit: https://www.breastfeeding.asn.au/bf-info/your-baby-arrives/my-breastfeeding-plan
Want to read more about early days breastfeeding?
Some brilliant extra reading to prepare you for your breastfeeding journey:
A brilliant video about attaching your baby at the breast, by Global Health Media
Newborn nappy output- what to expect by the NCT
Identifying good transfer of milk, by Global Health Media
Normal newborn behaviour in the first months, by Sarah Ockwell-Smith
Cluster feeding and fussy evenings, by Kellymom
Emma Pickett reassures parents about normal feeding intervals
Whether or not your baby sleeps through the night, remember your success as a parent is defined by so much more.
Without a doubt, sleep deprivation is one of the biggest challenges I have faced to date while raising A. The lowest points were after her twelve week birthday. We went to bed together one evening as normal and instead of the couple of hours I had become used to, she woke up after forty-five minutes. And then forty-five minutes after that. And…well you get the picture. For a long time, she woke very frequently. She was *gasp* a couple of months shy of four before she really consistently slept for most of the night.
I cannot count the hours I spent googling baby sleep. Sleep became an all-consuming topic for me. I read everything. Worried about everything. I was determined to find out WHY my baby would not sleep. I lacked a lot of knowledge about what is normal sleep, not just in babies, but in toddlers and preschoolers. I wasted a lot of time. While we did find some triggers for her frequent waking, some of it was just personality. Miss A is now a bright, inquisitive, smart and curious pre-schooler and sleep, well sleep is boring isn’t it? Her father also gets by happily on less sleep than average. Indeed, some studies have suggested the way our children sleep, may actually be largely genetic.
I really want to say one thing I think a lot of parents need to hear, so listen up. If your baby doesn’t sleep through the night, it is unlikely to be your fault.
Here are some of the most common myths about how and where babies sleep:
Your baby should be sleeping through the night by *insert arbitrary figure here*
A lot of popular information suggests babies should be capable of sleeping through the night from an early age. In reality, instead of talking about “sleeping through the night” we should talk about babies sleeping in ‘consolidated blocks’. In many scientific studies, ‘sleeping through the night’ is defined as sleeping a 5 hour period between midnight and 5am. Not quite the picture parents have in mind! Research has shown huge variance in when babies start to sleep in consolidated blocks and whether they settle themselves, or ‘signal’ (read yell their little heads off) for assistance. We don’t know why there is such a big difference, though many feel the answers lie in the personality of the baby.
BASIS suggests it is completely normal when infants wake frequently for the first year and beyond. Indeed, they say 13% of year old babies, still do not sleep in a consolidated block of 5 hours or more regularly. Gives us a slightly new perspective on those baby sleep books!
Toddlers definitely shouldn’t be waking up at night though right?
Though there seems to be a huge divide about when babies should sleep through the night, it feels like most people are in agreement that toddlers definitely should. However, again, the research doesn’t particularly back this idea up. Studies have shown that toddlers often continue to wake up during the night and need input from their parents, well into the second year of life.
Sarah Ockwell-Smith, someone who has spent an awful lot more time talking in an evidence-based fashion about how children sleep than me, suggests sleeping through is more like a roller coaster, than a linear trajectory. Basically, children are all different, and some may sleep “well” from babyhood, others may well be into their pre-school years before they consistently start to “sleep through”. Both are normal.
Formula or solid food helps babies to sleep better at night
Yeah, I had high hopes for starting solids too. My baby was totally going to sleep through once she was on solid foods! Except she didn’t. Also, formula fed babies still wake up frequently at night, the difference is, you also have to go downstairs and make bottles when they do. When people insist babies fed formula sleep better it is frankly insulting to their hard-working parents, who are up with bottles in the middle of the night. Seriously, it’s not like safe formula prep at 2am is the easy option! I wish we would stop saying that it is. These pervasive myths are by far best addressed by this lovely video from the team at Swansea University (I apologise if the catchy tune gets stuck in your head!):
If you stop feeding your baby at night, you will get more sleep
Sometimes night weaning might be helpful, and sometimes- it might not. This is because advocates of night weaning often forget that night waking is not just about food for babies. Development spurts often play their part. It is particularly common to hear parents asking about night weaning when they are smack in the middle of a leap. This may be absolutely the worst time to attempt night weaning. Your child is waking because they need reassurance, pulling away might actually make things worse or result in a lot of distress. Successful night weaning often depends on whether the child (and the mother) is truly ready.
I gently night weaned my preschooler when she was three. I’ll be honest, at first it made absolutely no difference to her sleep, and in fact, she still wakes up and asks for a cuddle and a drink. So if you are considering night weaning, it might be a good idea to think carefully about how you will feel if sleep does not improve. If your child still wakes up, will night weaning still help you feel more rested? For me, it made quite a lot of difference as I struggled to sleep through night feeds, but could sleep through a cuddle. If you are a mum who finds you can sleep through the night feeds anyway, it may make less difference.
Most gentle parenting and breastfeeding advocates do not suggest night weaning babies under twelve months old. These babies may still need night feeds. Which leads us on to…
A baby no longer needs to breastfeed at night once they have reached a certain age or weight
It is common for people to suggest babies do not “need” night feeds once they are six weeks/six months/double their birth weight etc…
Firstly, can we define ‘need’? Breastfeeding is, as well as a way to satisfy hunger, a relationship. A breastfeed is a cuddle, immunity, reassurance, warmth. How many times a night might you wake and have a sip of water, adjust your blankets, reach out for a warm body to snuggle into?
Secondly, this doesn’t take into account that all babies are different, and all boobies are different! Have a read about milk storage capacity here. Some mothers may need to feed more frequently to give the baby the same amount of milk per feed as her friend. This is not a mother with a supply problem, but natural variation. In order to support a healthy milk supply, breastfeeding works best when babies are fed to cue. In the first year milk is the most crucial part of baby’s nutrition and what is important is not how much baby gets per feed, but how much they get in twenty-four hours. A set rule for everyone just goes against basic biology.
In many cases, breastfeeding is a far easier way to get baby to sleep more quickly, and get better quality sleep. Use that magic while you can!
Responding to your baby every time they cry at night, makes children dependent and clingy
This is so far from the truth it makes me laugh. There is a wealth of research which suggests responsive parenting promotes healthy, secure and confident children. See Unicef’s “building a happy baby” leaflet or look into “attachment theory”. Not responding to children has been shown to do exactly the opposite of making children independent. Sleep training is a divisive subject and a blog post of its own. I will simply say, it isn’t the magic bullet people suggest, and that more information on it can be found here.
Bed-sharing is *the* most dangerous way for your baby to sleep! Don’t do it!
So this one was a massive bug-bear of mine. We previously have not been having nuanced conversations with parents about where breastfed babies should sleep. Positively, the tide seems to be turning a little recently, with the Lullaby Trust, Unicef UK, BASIS and PHE collaborating on new safe sleep guidelines which finally discuss bed-sharing in the mix.
Why is it important to talk about this? Because otherwise parents do not talk to their health visitors about this for fear of judgement. And then, they do not get the information they need about how to bed-share safely. On any given night 22% of babies will be bedsharing with their parents. Blanket recommendations not to bedshare have been clearly shown not to work and may have even increased the risk of SIDS for our babies.
We have historically focused more on the risk of bed-sharing to breastfed babies than we do on the increased risk of SIDS from other practices which parents might turn to instead- like sofa sleeping or giving formula instead to help their baby to sleep. Why have we not talked more about the impact of alcohol, smoking and drugs on SIDS rates? Risks which are so much greater? Why are we still not getting our knickers in a knot about the relationship between poverty and SIDS rates and holding society accountable for that? Focusing our support and resources on all of these things would have so much more impact.
For a long time health professionals have been in a tricky spot. Advocating 6 months exclusively breastfeeding yet having to advise against one of the tools that help many people to achieve it. Studies suggest “breast-sleeping” (i.e. bedsharing as a breastfeeding mother) supports breastfeeding, with mothers showing increased responsiveness and increased breastfeeding overnight (see below for links to a wealth of research information). Mothers who bedshare also tend to breastfeed for longer than mothers who do not.
I could go on about this forever, but I won’t. I am glad the guidance is finally start to shift in line with the reality for many families. If you are considering bedsharing with your baby, read evidence-based information and decide what is right for your baby. Safety guidelines are really important if you go ahead. You can see these in the new guidance I have already linked, as well as here, and here, and here.
If I could wave a magic wand and change one thing, what would it be? I would love to do away with this culture where parents who announce their child is sleeping well get congratulated. I slept well for years before children. I am pretty sure nobody said “well done” every time I woke up after a full 8 hours. Nobody insinuated this made me a better person, or that it was because of the big dinner I had that night. I want to stop having to reassure and comfort tired parents in breastfeeding groups who think their baby is broken. Not because it annoys me to do so, but because this crippling pressure is unfair to them. We create it with expectations which are so off-kilter from reality it is ridiculous. I would love people to start showing empathy to parents rather than judgement. Maybe help them out around the house, or make them a coffee. In the absence of a magic wand, I hope the myths busted in this blog help. Watch this space, and subscribe or like me on Facebook, Instagram or Twitter for news of upcoming blogs about how to cope with frequent night waking, and gentle night weaning.
You can find more good information about sleep here:https://www.basisonline.org.uk/
Recommended reading about infant and child sleep:
Evidence based bedsharing info from BASIS site
Other useful articles:
The reality of baby sleep: https://sarahockwell-smith.com/2017/07/24/the-rollercoaster-of-real-baby-sleep/
Evidence based information about sleep development: https://www.basisonline.org.uk/
Let’s not argue about whether CMPA is over-diagnosed. We need to be angry about poor industry ethics instead.
This week the BMJ released an article raising questions about industry involvement in CMPA diagnosis, questioning the huge rise in babies being prescribed specialist allergy formulas. As an allergy parent who fought for a diagnosis, and a breastfeeding volunteer I have followed the report in the BMJ with interest. Some people feel this article dismisses the struggles many go through to achieve an allergy diagnosis and have been very vocal about expressing this.
I can understand this. I too have mixed feelings about the report. Much of what it says is familiar to me. In the UK, our cultural attitudes toward babies often create issues. Normal behaviours such as wanting to breastfeed frequently and stay close to the mother sometimes end up being turned into some sort of pathology, be that reflux or allergies or tongue tie. In some cases, anxious parents don’t realise that WEIRD nations genuinely do have some weird ideas about how babies should behave. I have also seen families in the UK move to formula, overwhelmed when CMPA is suggested because giving up milk seems a huge undertaking that no one is supporting them with. Worse, in some cases nobody is even questioning whether it was the right approach for that parent in the first place.
On the flipside as an allergy parent, it really does make me upset that this article release may mean it is now even harder for families to get a non-IgE diagnosis. Many non-IgE CMPA families are still struggling to have their children’s allergies identified or recognised. I experienced this first hand. I worry clinicians may read this article without understanding fully how to identify and diagnose non-IgE allergy; for example, the importance of taking an allergy-focused clinical history. My worry is we will see a swing back to other interventions for families, such as acid reflux medications, which may be more problematic. Especially if we keep failing here in the UK to support families properly.
The UK is often not good at supporting breastfeeding or indeed, parenting generally. We under-fund or cut breastfeeding support services, what’s more, we then don’t give families who are bottle feeding enough support either. We overstretch our wonderful health visitors and doctors so they can’t spend enough time with concerned parents. Our media promote ridiculous ideas about how our babies should sleep, feed and behave. Our government policies result in the shutting down of children’s centres and cuts to children’s services.
However, upset as I am about all of this (and I am) what really makes me furious with CMPA in particular is the industry meddling and sponsorship of research that has been allowed to proliferate. It is this which now threatens to undermine the diagnosis and awareness of non-IgE CMPA. I don’t know if CMPA is being overdiagnosed. I don’t think anyone can say with surety that it is. However, we can’t criticise the authors of the BMJ article for simply pointing out that bias is a problem here. The appearance of bias is a worry regardless of the extent. We can argue forever whether or not this researcher or that researcher was biased. In the end, it doesn’t matter if they can look like they are.
What makes me angry is that big formula sells both the problem and the solution and this is seen as acceptable.
What makes me mad is that big formula has been allowed anywhere near creating the guidelines for CMPA diagnosis. This opened the door to the criticism that has now emerged.
I am not mad at the scientific and medical community for raising a valid concern about bias.
Professionals and anyone speaking publicly about allergy, be that scientists, doctors, charities, lactation workers or allergy bloggers need to be thinking hard about conflict of interest in their work and the impact this might have down the line on their credibility. It is this we should all be getting angry about. Parents and babies deserve better. After all, ultimately they are the ones who suffer and deal with the consequences.
Update 9-12-18: The BMJ are currently reviewing their policies around accepting advertising from infant formula companies. If it is important to you that parents are given high quality and independent evidence based information please sign this petition.
Confession time. This is a scary blog to put out there. I’ve dithered posting it and re-drafted it a million times because it is so personal. But here goes. I struggle with social anxiety. Some close friends and family already know this about me. Some people might be surprised I guess. It is something I have lived with to varying degrees since I was a child. Over the years I have developed coping strategies, and mostly, I get by. I can usually play the part of a functional adult. However, still, on very bad days the idea of the smallest interaction with someone else can make me feel pretty stressed.
My anxiety was probably worst during my pre-teen years and adolescence. At its peak, during my first year at secondary school, I barely talked to another person, aside from my teachers, or family. Not an exaggeration. It was a really unhappy time for me. I am amazed now, that not a single teacher spoke to my parents about it. This was during the ’90s. I hope social anxiety is more recognised now, that young people get more support than I did.
What is social anxiety?
Social anxiety isn’t simply shyness. It’s intense fear that can affect everyday life. Lots of people feel uneasy in social situations. However, for someone with social anxiety, those feelings can be very difficult to manage.
According to the NHS, you may have social anxiety if you:
- dread everyday activities, such as meeting strangers, starting conversations, speaking on the phone, working or shopping
- avoid or worry a lot about social activities, such as group conversations, eating with company, and parties
- always worry about doing something you think is embarrassing
- find it difficult to do things when others are watching – you may feel like you’re being watched and judged all the time
- fear criticism, avoid eye contact or have low self-esteem
- often have symptoms such as feeling sick, sweating, trembling or a pounding heartbeat (palpitations)
Personally, my anxiety manifests in a few ways. Much of the above is very familiar to me. For example, in a conversation with another person, I am often half listening, wondering how I am coming across to the other person. What are they thinking? Do they like me? What should I say next? Did they just give me a funny look? Am I boring them!? This distraction isn’t a lot of fun for the other person either to be fair. On bad days this internal narrative is so overwhelming my mind goes blank, and I cannot think of a thing to say. Sometimes, I respond almost defensively to the most innocuous of questions. A simple, “How are things with you guys?” can send me into a panic. I desperately try to think of something interesting to say, and fail, awkwardly shrugging “Oh well, you know, nothing really”. Then I spend the rest of the day (even days) berating myself.
I apologise to all my friends who have endured these painful interactions with me. Thank you for seeing past it all and being kind. In truth, I am luckier than some. I have a loving husband and family, I have had help, my anxiety is always there, but mostly under control. I can go to a party where I don’t know people well. I have some good friends. Held down a career in freelance design. I do volunteer work that I love. You see, I do actually want to be around people. People think socially anxious people don’t want to socialise, and that’s just not true, at least not for me. It is just we also find it incredibly difficult.
Parties or gatherings of large people can be most difficult for me to navigate. I make sure these days, that I don’t allow my anxiety to control whether or not I go. I used to just turn down invitations to parties. I still get that white-hot fear though, when I walk into a room full of people even if I know most of them. How I feel the event went can have a profound impact on my mood. If I think I managed to navigate it with more ease than usual, I am happy. If I have an awkward moment, not only am I anxious about how that must have looked, but it descends into this horrible feeling of shame and embarrassment about who I am as a person later. The self-loathing sometimes lasts for days. Regardless of how the event went, I am often exhausted afterwards.
At 35, when I had my baby, I was thrown into a new world. I suddenly had to have adult conversations in a room full of parents I didn’t know, a situation which scares the pants off me. I didn’t do many classes and groups. I often found myself making an excuse to avoid them. “Those classes more stress than they are worth” (true, but not entirely the truth). I went to one baby group where not one person spoke to or made eye contact with me. It was such a triggering experience, I didn’t ever try another local village group. Despite tons of breastfeeding issues, I think my daughter was months old before I managed to get to a breastfeeding support group without a friend. The kindness of peer supporters and mothers there made that group my lifeline really. Thank goodness for boob group, NCT friends and Facebook because I think these things actually saved me from acute loneliness in the early days of motherhood.
People sometimes don’t believe me when I say I now do volunteer work yet am socially anxious. Especially when I say I also do telephone support and they are familiar with me dithering around, taking a week to call a plumber! However, my support work is so much easier to navigate than a baby group. It is like putting on a costume. I have conversational tools from my training to support women. There are some questions you always have to ask, some issues which are so very common, these things form a kind of familiar script, so I always have something to say. Silences are encouraged so it gives me time to think. I am often asked about specific issues and have a bank of knowledge I can draw from to move the conversation forward. Crucially, I am not focusing on myself, but on someone else. I can largely forget about what people are thinking about me. I don’t have to worry about making the mums I support my friends. In fact, it is actively discouraged. The tools I have gained in training have been immensely helpful to me in ‘real life’ social situations, however, and it has really built my confidence.
As my daughter gets older I now find myself often scrutinising her interactions with other children. My biggest fear is that she ends up like me. The maddening thing is, I know the more anxious I am around people in front of her, the more likely this is. This encourages me to navigate situations I would have previously avoided. My daughter drives me on to be my best self. While she is a little shy as a child and often overwhelmed in busy situations, I have seen how well she interacts with other children at nursery or smaller groups. I try to reassure myself she’s doing fine, and no different to many of her peers. Next year she starts school. I cannot articulate how worried I feel for her. I desperately hope she does ok, that she makes friends and has a “normal” experience.
If you are a parent with social anxiety but you push yourself into situations which make you anxious try to remember this: it takes guts. Finding the courage to go to that group is amazing. Even if you don’t speak to anyone, feel proud. You were brave. Being a parent with social anxiety can be hard. You may lose the “crutches” or coping strategies you had developed pre-children. On top of this, as parents, we may be dealing with a loss of our professional identity and other parts of ourselves. You are navigating a new beginning. Like many new starts, if you lack confidence, it can be even more stressful. So give yourself credit where it is due.
I still remember the girl who finally befriended me at school during my worst period of social anxiety. I don’t think she knows what she did but she made a lifelong impression with her kindness. My appeal to everyone is, please say hello to that quiet mum in the corner of the playgroup if you can. Make eye contact, smile, reach out, be kind. Sometimes, someone is standoffish because they are anxious. Please be forgiving. Engage that scared looking person in a conversation. It might not be the start of a beautiful friendship, but you might be the person who helps them get through the day smiling or encourages them to come to the group again. They may actually make a friend or two eventually. Small gestures count. Make them a cuppa. You never know the difference your kindness might make to someone.
Social anxiety support:
If you can relate to the issues raised in this blog, first and foremost, seeing your GP might be helpful. You may also have local counselling services you can self-refer to. CBT is considered one of the most effective interventions for social anxiety.
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