Yellow Alert: When Breastfeeding Businesses Behave Badly

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, probably the most famous one, is Medela.

Parents express milk for lots of reasons, many of them will say pumping is absolutely essential to support their breastfeeding relationship and I totally get that. I support parents to exclusively pump or mix pumping/breastfeeding on a regular basis. Lots of us have bought a Medela pump, myself included and so critcising them can feel like a criticism of our choice, especially if we believe using that product saved breastfeeding for us.

Now, some infant feeding training down the line, I wish I’d never bought the round yellow pump everyone loves because:

  • The pump that I chose was an open, single use system so I shouldn’t sell it on.
  • For around the same money I spent on an open system pump, I could have bought a code compliant, closed system double pump.
  • Last but not least, Medela are a WHO code violator so ethically it now makes me feel a bit icky owning one.

Medela being a code-violating company often elicits shock from a community who assumes they promote and protect breastfeeding. Many people, including breastfeeding advocates defend them to the hilt. They make great products! They do lots of research! Surely they aren’t so bad? So why is it that they aren’t the ethical company people think they are?

I’m going to focus on the one area which crops up in my support group on a regular basis. The Calma teat. Medela’s marketing practices around this device have been criticised for years for being code violating and misleading. The below screenshots have been taken from Medela UK website on the 16-05-19. Note multiple claims which break the WHO code of marketing such as “Calma- close to breastfeeding” and “does not interfere with breastfeeding”.

Screenshots taken from Medela UK website

There are many breastfeeding specialists worldwide who dispute this claim including Jack Newman (you can read one of his summaries here). Interestingly I recently found a couple of studies (see screenshots and links below) which show that while marketed as mimicking breastflow, the Calma teat has a comparatively fast flow rate compared to other slow flow teats. Anecdotally, I have myself worked with families who have suffered bottle/flow preferences after using the Calma teat and what makes it worse it usually the family in question believed that buying this expensive system would protect them from this happening. This means folks don’t use techniques such as paced bottle feeding or they give lots and lots of bottles believing it won’t make a difference to their breastfeeding relationship. Sadly, in my experience, sometimes this is just not true.

More study details here:

https://www.michiganspeechhearing.org/docs/Appendix_C.pdf

http://feedingflock.web.unc.edu/files/2014/02/Pados_SNRS_Final1.pdf (Source for right hand image below).

https://www.drbrownsbaby.com/medical/wp-content/uploads/2016/08/DBM-MilkFlowRates-Dayton-Article.pdf (Source for left hand image below).

Medela could be code compliant. They could even sell bottles and be code compliant. I’ve no objection to them being a profitable company or selling matching yellow bottles with Medela on them. I do object to them being sold with statements like “It does not interfere with breastfeeding”, “lets your baby feed the way they learned at the breast”, “makes switching from breast to Calma and back easy” and “Calma- close to breastfeeding”.

I’ve focused on one aspect of their activity here, however, there have been many other incidences of Medela undermining breastfeeding. You can read Baby Milk Action’s summary of their activity here and here you can read about how Medela were removed as a sponsor of an infant feeding conference for WHO code violations.

Just because a company sells products which you think help breastfeeding mothers, doesn’t mean they automatically earn an ethical “white hat” or deserve a free pass. We need to demand better because when families and babies want to pump and feed their milk through another method, they also deserve evidence based and accurate information.

Bottle feeding the breastfed baby- resources

Great article on bottle types for breastfed babies by Rachel O’Brien IBCLC

Best bottle for a breastfed baby? By Philippa Pearson-Glaze

Unicef- responsive bottle feeding

A lactation consultants guide to bottle feeding by Lyndsay Hookaway IBCLC

Video demo of paced bottle feeding by the Breastfeeding Resource Centre

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Responsive Feeding: Why Is It So Difficult?

I’ve just returned from a holiday in Salcombe and aside from the gin and ice-cream, the other thing I found lovely about Salcombe was how many people I saw breastfeeding! I saw breastfeeding on the beach, breastfeeding at the cafes, breastfeeding in beer gardens, breastfeeding at the farm park, breastfeeding at the services. It felt like it was everywhere and it was fantastic.

It was a long time ago now my little girl was a baby but when I saw folks breastfeeding out and about it took me right back.

Let me set the scene. A baby starts crying in a cafe. Parents first start cuddling the baby, jigging about, seeing if baby will settle. They might try to wind the baby. Sometimes baby is passed to someone else instead. A dummy might be offered. Rejected. Offered again. Baby might be taken for a walk around the cafe. A toy might be waved. When the breastfeed begins that comes with moving clothing out of the way, unfastening bras, draping muslins over a disgruntled baby’s head, moving to somewhere more ‘private’. Sound familiar? This was me. It was also something I saw again and again while out and about.

And it isn’t just happening in Salcombe. I sit in support groups weekly and see the same thing. Babies headbutting chests, groping at clothing, quietly agitated. Smaller cues are missed while parents wait for “the demand” of a crying baby.

It’s important for me to say here, this absolutely isn’t a criticism of parents. This is something that has become normal for us all, especially out in public. It is done without question, without thought, it’s just what we have absorbed from the world around us. Breastfeeding in public was for me and still is for many, only done if you absolutely are sure you have to do it. In a culture where breastfeeding is considered time consuming, inconvenient or embarrassing, where it is something that we are told needs a special chair or is supposed to be a ‘special moment to treasure’ this is totally understandable.

I’m not sure the same thing always happens at home in private. I speak to people regularly who say things like “I can’t go out because I know they will need a feed the moment I do” or “I panic if I am out and she needs a feed”. Society is largely to blame for this and it’s a rubbish way to have to feel as a parent. I can’t help but wonder how this impacts on breastfeeding. Like lots of little paper cuts, does it all sometimes build up to a more painful issue? What does it do to milk supply? What does it do to parental confidence?

What is Responsive Feeding?

Responsive feeding is one of the pillars of successful breastfeeding but many parents confuse it with “demand feeding”, a term which is still commonly used. When we say “demand feeding” it feels clear what that means. Responsive feeding doesn’t feel so clear cut. We know a demand is a forceful request, so lots of people think demand feeding is responding to a crying baby. In reality, if we feed responsively, there are lots of subtle cues that come before the cry.

Baby Feeding Cues, Early to Late Stage

Breastfeeding responsively does not mean following a baby’s cues to feed alone either. It also means offering the breast because the parent simply wants to breastfeed or using the breast to comfort and reassure a baby.  

As well as nervousness or reluctance to feed in public, responsive feeding in the UK faces other barriers too. Not long ago our parents were told to feed on a schedule, every 3-4 hours and NEVER to feed for ‘comfort’. “Don’t let baby use you as a dummy” is something else nearly all breastfeeding folks hear. Routine based advice is often passed down today and routine is still something parents often strive for. There are dozens of books and articles out there selling routines to us all. Even up to date advice from the NHS focuses on the baby’s need to breastfeed “8 times or more” every day. While this ‘magic number 8’ may be helpful in some situations, it’s easy to forget the “or more” part of this statement. Sometimes 8 feeds a day becomes a goal, not the minimum.

The reality? Studies following folks feeding responsively tend to find babies breastfeed on average between 8 and 12 times a day, most at the latter end of this range and many breastfeed more than this. My own healthy little chunk breastfed somewhere in the region of 14-16 times a day in the early days. Yes it was exhausting and I worried about it all. the. time. Mostly because people told me that she should be going longer or it meant she wasn’t getting enough. I still remember the sting of another breastfeeding mum asking “Is she really feeding again?!” But if a baby is happy and gaining weight well why do we worry about this? Observational studies of the rural hunter- gatherer tribes show a pattern of very frequent, shorter breastfeeds. There is often a huge difference between what culture says, what routine based books say and what our evolutionary norms suggest.  

So why is responsive feeding important?

Milk Supply: Milk production is tied to frequency of nursing or milk removal.  If milk removal slows down the breast will become fuller. Spacing out feeds and not feeding responsively therefore can send messages to the body that milk production needs to be reduced. This can lead to genuine supply issues.

There needs to be a special mention for the possible impact of reducing night feeds in the early months too. Prolactin levels peak at night so overnight feeds create a fantastic positive feedback loop, helping to build up a really healthy milk supply.

The birthing parent’s health: Following on from the above, problems can occur if breasts become engorged because of infrequent feeding.  Aside from engorgement being uncomfortable, it can sometimes lead on to blocked ducts, mastitis and in extreme cases, breast abscesses and sepsis. Aside from supporting a robust breastmilk supply, breastfeeding responsively is hugely important for health reasons.

Baby’s weight gain: Research in 2006 by Hartmann and Geddes discovered breasts had differing amounts of milk ducts and different ‘storage capacity’ with some people storing 2oz in their breasts and others storing around 20oz!

This means we now understand that breasts have differences when it comes to producing and storing milk. In order to make adequate milk somebody who has a smaller storage capacity may need to feed more frequently than somebody with a larger one. Research has also shown the composition of human milk can vary from person to person and varies in composition according to the time of day or even the weather! Set feeding times cannot take into account all these factors. This means a baby who isn’t being fed responsively may have some issues with weight gain.

Confidence in parenting and in breastfeeding: Feeding responsively, and using the breast not just for ‘nutrition’ but for nurturing has been shown to help some people to feel more confident about parenting because it usually has better outcomes for breastfeeding and often results in calmer babies and less crying time.

Recent research has suggested that people who read and attempt to follow routine led baby care books are at greater risk of feeling depressed, anxious and inadequate compared with people who were not following book routines.

A baby’s latch: When a baby is fed responsively to early cues, they are usually calmer when coming to the breast. Delaying feeds may lead to small babies becoming quite distressed, so when they get to the breast they can be a little ‘disorganised’. Some babies may struggle to latch on, especially if breasts have become engorged. A taut, full breast and a frantic baby can result in shallower attachment. This can cause pain or injury to nipples and result in an unsatisfying breastfeed for the baby.

In conclusion? Not feeding responsively can lead to all sorts of problems. and supporting people to feed responsively is a critical part of supporting breastfeeding folks.

8 Things We Can Do As Helpers To Support Breastfeeding Responsively:

  • Offer help! Support people with practical, around the house stuff.
  • Don’t offer to take baby for a cuddle to see if you can settle them, unless the parents ask you to first.
  • Signpost parents to images about feeding cues such as the one above.
  • Reassure them that feeding in public gets easier with time, talk about how generally people aren’t paying attention! Encourage them to practise in front of a mirror so they can see how little is seen. Tell them they are doing a great job and how lovely it is to see baby so happy when they do feed in public.
  • Sometimes feeding responsively feels hard because of another breastfeeding issue such as pain. If this is the case can you help by signposting to effective, experienced breastfeeding support?
  • If you have breastfed yourself, why not talk about how breastfeeding is so much more than food and that it is impossible to measure and quantify comfort and love? Offer reassurance that this is a very short phase. Talk about how breastfeeding patterns change and become less demanding as babies grow older.
  • Talk about normal sleep development and be honest about how babies sleep when we talk to other people.
  • Encourage people to reflect on whether that feeding app is really helpful. Unless there is a clinical need to monitor feeds, ditching the tracker can really help boost confidence and encourage parents to watch their baby instead.
  • Reassure parents that their instincts are amazing and that they understand their baby far more than granny, a neighbour, an app or any book! Just telling them they are doing a brilliant job can go a long way.
Brilliant video by Swansea University about how to support breastfeeding people

Ultimately, cultural attitudes need to change so breastfeeding folks feel relaxed about this stuff. I long for a day where nobody feels like they need to use delaying tactics to avoid feeding until they absolutely have to. I long for a day when boobing to comfort a crying baby is seen as the norm rather than something to avoid at all costs. I long for a day when breastfeeding is unremarkable. I am currently loving campaigns like #FeedOn by the Association of Breastfeeding Mothers which help get real life breastfeeding seen on a wider stage and I particularly love the images where they show groups of people breastfeeding together rather than it being a solo activity. I love it when I see a parent wandering the supermarket breastfeeding a baby as they go about their day, or feeding in a cafe while chatting with a friend, or feeding in a sling as they attend to another child. That might not feel possible for everyone, but those moments when breastfeeding becomes a little less special and a little more mundane are magic. Every time this happens it is one step towards being that much easier for the next person to breastfeed without apprehension. We can’t change the culture around us overnight but together we can all play our part in making society breastfeeding and responsive feeding friendly.

ABM #FeedOn Campaign Image © RÅN studio

Further reading on responsive feeding

Prof Amy Brown for Kellymom on the importance of responsive feeding

Unicef repsonsive feeding info sheet

Emma Pickett IBCLC and Breastfeeding Counsellor on feeding intervals

Unicef factsheet “building a happy baby”

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Facebook and the Question of Baby Milk

You can’t sell a breast-pump, but you can sell prescription formula.

Facebook doesn’t allow the sale of used breast-pumps which I could understand, if they didn’t allow the sale of second hand Tommee Tippee prep machines, used bottles and teats, discounted first formula or the sale of specialist formulas which are likely to have been obtained on prescription.

Aside from the obvious double standards here I can’t help but worry about the hazards posed to babies who are fed formula milk from these products.

Second hand prep machines can get mouldy, especially if not used correctly, bottle teats can build up bacterial bio-films which are hard to clean (hence teats should be regularly replaced), it is illegal to discount first formula and buying it via the second hand market also opens parents up to other risks. Formula is sold or passed on marketplace which is opened, an obvious contamination risk. Formula milk could also be tampered with, it could be cut with other substances to sell it on for a profit. In some parts of the world we see fake formula. We’ve also seen contaminated batches of milk withdrawn from sale. Any of these things could end up on the second hand market. It is also no small thing to sell on or give away prescription formula. Babies could end up being fed specialist milks inappropriately and also- this is illegal practice. Baby milk is a regulated product for a reason.

The consequences of allowing this to continue could be devastating for families and babies. Time for a re-think?

Further reading:

https://www.bbc.co.uk/news/uk-39278690

https://static1.squarespace.com/static/59f75004f09ca48694070f3b/t/5a5f913c0d92977380f39cbd/1516212541405/Statement_on_formula_preparation_machines_Nov+2016.pdf

https://static1.squarespace.com/static/5c6bb04a65a70771b7cbc916/t/5ce2e03b9cfe170001660eda/1558372412884/Removing_iFSMP_from_shelves_May19.pdf

https://www.eadt.co.uk/news/framlingham-mum-in-16-000-baby-milk-fraud-given-suspended-jail-sentence-by-ipswich-judge-1-4788496

https://en.wikipedia.org/wiki/2008_Chinese_milk_scandal

https://www.bbc.co.uk/news/business-42348254

https://news.cgtn.com/news/3d3d414d7759444d77457a6333566d54/share_p.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489094/

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Mummy Wars

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:

National Breastfeeding Helpline

La Leche League

Association of Breastfeeding Mothers

Breastfeeding Network

Unicef (breastfeeding)

Support for bottle-feeding and formula feeding:

Safe formula preparation

Bottle feeding technique

Independent information about formula milk composition

Infant feeding helpline (NCT)

Unicef (bottle-feeding)

Combination feeding

Gentle Night Weaning for Toddlers and Older Children

Image of a sleeping toddler with a soft bear

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

  1. 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.
  2. 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.
  3. 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

  1. 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.
  2. 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!
  3. 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.
  4. 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.
  5. 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.
  6. 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!
  7. Don’t say “no”, say “later”- “No” can be such a trigger word for small children!
  8. 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 💚💚💚

Image of lots of cups of coffee

Further reading:

Sarah Ockwell-Smith

The Milk Meg

Kathryn Stagg IBCLC blogs on toddler night weaning and night weaning toddler twins!

Emma Pickett IBCLC

Nursies When the Sun Shines

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Preparing to Breastfeed

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

breastfeedinggroup

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

recommendedbreastfeedingbooks
Top left: The Food of Love by Kate Evans
Top right: The Womanly Art of Breastfeeding by La Leche League International
Bottom left: The Positive Breastfeeding Book by Amy Brown
Bottom right: You’ve Got it in You by Emma Pickett IBCLC

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

baby-sleep-safe-sleep-image-thanks-to-basis

Image Credit: https://www.basisonline.org.uk/co-sleeping-image-archive/

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.

https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2016/07/Co-sleeping-and-SIDS-A-Guide-for-Health-Professionals.pdf

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.
  • Tissues
  • 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!)

DCF 1.0

Baby being syringe fed colostrum. With thanks to https://www.flickr.com/people/crimfants/

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:

General questions about breastfeeding answered by the Association of Breastfeeding Mothers

Breastfeeding a newborn, what to expect by Kellymom

The First Time You Breastfeed, by Emma Pickett

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

Find an International Board Certified Lactation Consultant

Prepare for the birth, but make sure you also prepare for what comes after!

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