What Nobody Told Me About Becoming a Parent

Are the images we see of parenthood realistic?

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Screenshot from Pexels for “Motherhood” taken Nov 18

Back in 2014, I remember it quite clearly, I was sitting in an antenatal class with other expecting parents, who later went on to become good friends. We have often talked about those classes, but one memory which stands above the rest for me is one of the exercises, where we planned “24 hours with our new baby”. I remember filling in hourly slots on the flip chart with stuff like “going to the coffee-shop with the baby” and occasionally saying things like, “Ooh, it has been four hours, so we probably should be feeding the baby now too?” or “Perhaps baby will need their nappy changed now?” It always makes me chuckle when I remember it. I honestly don’t remember if the antenatal teacher tried to question this chilled out picture of the day we painted. I do wonder now how much she was laughing internally at our naivety. The perception some of us had, after babies, was this: the realities of parenting were a well-kept secret, and not to be discussed, at least not until after you have the baby.

Culturally we are all influenced by the image of “happy motherhood”. The commonly sold narrative is that all parents will naturally transition to life with a baby with ease, and will innately understand all aspects of parenting, especially if we buy the right “stuff”. In reality, we are social creatures, and what we learn about parenting, comes from what we absorb, from our wider lives, childhood, and culture. Many of us simply are not around babies and children much, except as children ourselves. We may have had a sibling, but chances are we do not really remember them being babies. We often grow up in small nuclear families, rather than extended families or small communities. We might see a lot of babies on the screen, but many UK parents have rarely held a baby before the day comes when they hold their own.

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Screenshot from Google Search “Motherhood” taken Nov-18

The societal norm of not really talking about how parenting can be unless you are talking to another parent, of not admitting to our real feelings, of not discussing widely how normal it is to find it difficult, perpetuates the “big secret” about what it is really like. Search an image site, or google for the term “motherhood” and what you will find is similar to the photo above; a gallery of soft focus images of babies being cuddled, smiling mothers and heartwarming memes talking about how amazing mothers are. And we are amazing, but that doesn’t mean we feel like we are. Yet we are constantly bombarded with this stuff. “Enjoy every minute, it goes so fast!” the memes cry, or they say things like; “Motherhood is messy, and crazy, and challenging, and sleepless, and giving and still unbelievably beautiful“. And just sometimes, seeing this stuff can make you want to scream; “I don’t feel the bloody beauty! I am tired, I am fed up, I want to shower without interruption, I want to pee by myself, I want a full nights sleep and I want my old life back, just for a day”. It can be especially hard to be a new parent in a world where we can be bombarded with “insta-ready” images of parenting. We see smiling parents in adverts for “stuff”. We see lovely snippets of life with kids on our social media feeds, a place where we compare the best parts of other peoples lives, to our everyday.

Amidst the “pre-baby” expectations of what we might gain- a lovely cute ‘bundle of joy’, love, fulfillment and happiness (all of which may be true) we may feel ashamed to admit if we feel a “loss” too. A loss of our old identity, our autonomy, our old body, our professional selves, our time and our sleep! I clearly remember having the realisation myself that my life had completely changed now. It was never going to be what it was ‘before’ and that there was no break from this, no holiday, no time off- and in that moment the responsibility I felt was completely overwhelming.

When you ask new parents what they feel is the most unexpected aspect of caring for their baby, quite often the knee jerk response is: “no-one prepared me for the sleep deprivation”. Our cultural norms do not prepare us for what normal infant sleep is and fears around bed-sharing, can mean more exhaustion for western parents, who are frequently trying to get babies to “go down” in a separate sleep space or even a different room. Their small human often has an entirely different agenda. When we see babies on the television, or in movies frequently we are shown a picture of a newborn, alone, in a lovely crib, while they sleep soundly. In fact to prove this point, here are the top images from a google search for “sleeping baby”.

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Screenshot from Google for “Sleeping Baby” Taken Nov 18

No wonder it can all come as a bit of shock when the reality for many is not a baby who is happy to sleep alone, but is in your bed, latched on. You are in a fleecy M&S onesie with one boob out because you know you shouldn’t use a duvet, and any sheets that do remain have a few dubious stains on- “Is that breastmilk or baby vomit?” you briefly wonder, before turning your attention to other more pressing matters, like getting your baby back to sleep. Again.

And while we often focus on only how the mother is doing after birth, the same difficulties are often true for the other parent too.

Before we had our baby, my husband often remarked he didn’t see how it would change things a great deal. I remember having a conversation with him about how I wanted to make sure I got my hair done before having the baby, as I might struggle afterward. He was confused by my worries, in his mind, of course I would have time. In reality my baby was 6 months old before I got to the salon. The transition to fatherhood was equally hard on him, and I remember he was also emotional and overwhelmed at times. I’m ashamed to say, I resented him for this at the time, I was dealing with my own struggles to breastfeed, and my transition to motherhood. Where previously we would have shown each other empathy, instead we were often in conflict. Having had a very happy relationship ‘before’, the strain we came under came as a shock to me, we hadn’t anticipated it at all. Our experience felt dramatic at the time, it was our first maritial “rough patch” but we weren’t unique. I only realised this a couple of years later, having a lunch date with an old friend, who confided in me (after a few drinks) she had a really similar experience. Difficulties in relationships after having children are well documented, and also backed up by research. Yet it seems like the huge upheavals to relationships and subsequent difficulties are only alluded to in passing conversations, rarely discussed openly, if at all.

Obviously I love my daughter with a passion, I would never change a single thing about her (ok that is a lie, I do kind of wish she would sleep but that is another story). I don’t want to paint a negative picture because I have gained far more than I ever lost, and being a parent really can be so very wonderful. I think parents are amazing, and that we often are far too hard on ourselves. But I think we need to be telling real stories. Parenthood isn’t trite memes. It isn’t soft focus images of cuddled up babies and tiny feet. Breastfeeding isn’t always smiling down lovingly at a suckling baby, especially at first. Sometimes there is pain involved in becoming a parent, physically and emotionally. Often it is hard work. There is a learning curve. We might not be able to fully prepare for it, but we can be prepared to be surprised. And as we shed our old skin, and our old lives, and become something forever changed, we should reflect on the stories we tell to others who might be next. Our real stories deserve to be told. The truth is rarely “insta-ready”, but sometimes it is good to get a little bit real.

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Before You Tell a Breastfeeding Mother to Cut Out Dairy, Consider THIS

Why supporting a breastfeeding parent with their diet is really important if their child has CMPA

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I’ve always felt we need to tread very carefully around suggesting dairy elimination for mothers before basic breastfeeding issues have been worked out, and recently I have had personal experience of why it is so important to be mindful.
I don’t consume any milk products anymore, because my daughter has CMPA and I am currently breastfeeding her. I was keen to keep breastfeeding. Breastfeeding a baby with CMPA is really important, it avoids many of the pitfalls of using dairy free formula (like the bad taste), and it protects and safeguards your child’s nutrition. Mothers should absolutely be supported to do this if they need to. At first, I was amazed at how good I felt when I cut out milk (and I still believe it doesn’t agree with me).
2 years in, I’ve recently discovered the downside. I’m currently taking v high strength vitamin D, calcium and omega 3 oils because despite spending so much of my time supporting others and knowing all the recommendations to supplement and be careful with diet, my levels got low, really low. I actually started to feel quite unwell, mentally and physically.
You see, lots of people like to say dismissively “Pfft, we don’t actually NEED milk”, and this is true, however, our bodies do need the nutrients within it. Fats, Calcium, Iodine, Vitamin D. Some milk also has Omega 3 added to it. Non-dairy milk and dairy substitutes often contain lots of Omega 6 (sunflower oils, nut oils etc) but we need a balance of both Omega 6 and Omega 3 at the very least, and while following a non-dairy diet, if you aren’t careful it can be easy to throw this out of balance. Omega 3 is thought to play an important part in reducing inflammation in the body, inflammation is linked to things like joint pain, chronic illness, weight gain, and depression.
Removing dairy from the diet is a huge dietary change, we need to be mindful of that. In my opinion, breastfeeding parents who need to avoid dairy should be offered support with their diet, rather giving them a blanket recommendation to supplement (NICE guidelines), however, unfortunately, the guidance only discusses dietetic input in regards to the child. I feel this is a huge oversight, when treating breastfeeding parents and children it is surely better to treat the dyad, but that aside, things that can help are:
Sometimes, depending on your diet, considered supplementation may be needed.
It is easy to make light of the impact milk elimination might have on a mother’s body, or to forget about this ourselves, especially when we are busy parents whose primary focus is our child. It is easy to let nutrition slip when you are tired and touched out anyway, let alone if you are avoiding a major food group. So if you have an allergic child, I am sending you so much love, I know it is tough! And what you are doing is so important for your babies, and so wonderful, just make sure to take care of you at the same time.
More information and sources:

10 Tips for Seeking Breastfeeding Support in Online Groups

Navigating the world of online groups and forums

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Lots of people feel passionate about the world of online breastfeeding support. It’s easy to recognise the value. I’m a member of several groups myself, I’ve been an admin in an online breastfeeding support group. Mother to mother support is so important. Many of us have found groups immensely helpful. There’s no doubt for me these online communities save breastfeeding relationships in a world where breastfeeding support groups, and even other breastfeeding parents can sometimes be thin on the ground.

The admin teams of good online support groups are amazing too, they give up so much of their time, for free, to support women. It is an incredibly generous thing to do.

An online support group should ideally be a complement to, not instead of, in real life, face to face support. The best groups know this, and you will often see those asking things like “do you have a local breastfeeding support group?” or “have you thought about seeing an IBCLC?”

Online we often don’t have the full picture of what is going on for somebody. Many of us may have also been unknowingly given ‘advice’ which isn’t always evidence-based when it comes to breastfeeding. And when we start to pass that ‘advice’ onwards, that can be a problem.

Examples of commonly heard phrases in online support groups which may be detrimental to another’s feeding journey:

  • “A gain is a gain, don’t worry about the charts- they are based on formula fed babies anyway” (Incorrect, charts in the UK have been based on breastfed babies for years now, and a gain, unfortunately, is not just what’s important, lower than average gains over a consistent period of time = faltering growth and failure to thrive).
  • “Breastfeeding really hurts at the start but just power through!” (Imagine you are a mum with severe nipple damage hearing this).
  • “Just feed, feed, feed” (What happens if that baby isn’t producing enough wet and dirty nappies? Or has faltering growth? Most of the time cluster feeding is normal, but we need to be sure we have the whole picture).
  • “I used formula top ups/bottles/dummies/weaned early and it was fine! No effect on my supply at all!”

So how, as mothers, do we protect our breastfeeding relationship while still making use of the support and information from an online group?

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Identifying a good online breastfeeding support group and making the most of it- 10 tips!

1. If you are seeking breastfeeding support consider the audience. Is this a breastfeeding specific support group? If not, the responses you will get will be wide-ranging and reflect the nature of the group, and not everyone will feel positively about breastfeeding. Are they selling a service, or affiliated with a brand name? If so, consider the information you get might not be impartial. This is particularly true for parenting groups affiliated with infant formula or baby food companies.

2. Ask for evidence if you feel unsure. Never take something at face value, especially if it doesn’t feel ‘right’. There are evidence-based sources out there you can check in with too, a reliable source will be run by a national body like a breastfeeding charity or in some cases a lactation consultant. Alternatively, the national helplines are on hand to talk things through with.

3. Who are the group admins? Are they active? Are there enough of them for the size and activity level of the group? Do you see them addressing misinformation regularly? Importantly- are they nice? Do they treat the members with respect? All of these points are important for keeping groups a positive place to be.

4. If it is a breastfeeding support group, are the admin trained peer supporters or above?  If the admin running the group aren’t trained in breastfeeding it might be wise to be a bit wary, as they may not have the knowledge base to know the good from the bad.

5. Is it a closed group, and do you have to go through a screening process to get into the group? If you are going to discuss intimate details of your life, make sure they don’t let any old random into the group. Some popular parenting websites use an open forum format, where anyone can comment or join in, and the results are searchable and completely open to the public. It is worth considering if that is a safe environment to get breastfeeding information.

6. Do they have group rules? Do they seem well thought out? Are the rules enforced?

7. This might be a controversial point, but it is something I feel is important. If we undermine health care professionals in an open forum we breed distrust among breastfeeding parents when it comes to their healthcare. This, in turn, means we see people disengaging with their healthcare services, and this isn’t always a good thing. Nurses, doctors, dentists, and health visitors can also be participants in the group, seeking breastfeeding support themselves. It’s nice to be nice. So thinking about this point, is the group generally respectful towards health care professionals?

Health care professionals are people who take a lot of responsibility for child health if we aren’t in the consultation we do not know the full picture, and we do not know how what was actually said was interpreted or understood. A good group will ensure the members pass on evidenced-based information without insulting the mother’s health care team, and if they are concerned by the actions of a HCP they will pass on details of the appropriate channels to pursue a complaint.

8. If you have a lactation consultant or are already under the care of a real life breastfeeding specialist, remember they are absolutely best placed to support you effectively. It can be sensible to think twice before you throw out a plan from a professional based on advice you get online. Remember you can always go back to discuss it with the trained person supporting you.

9. What rules are in place about recommending other groups? Some support groups will have recommended groups which they know are safe. If there is a free for all around groups, those groups suggested may not be totally evidenced based. It might be worth asking the admin for their opinion on the groups they prefer.

10. Finally, use normal internet caution within a group. Don’t post identifying information, be cautious with your photos, even with a well-run group, trolls can infiltrate.

Make sure that when you are out there in the big wide internet world of breastfeeding support, you keep yourself safe, and remember you are the advocate for your baby-so if in doubt- check it out with a reputable source or seek out a trained breastfeeding professional.

Breastfeeding helplines and websites

Your health visitor or midwife should know details of local groups in your area, or you can search here for information on your local group.

Helplines

  • National Breastfeeding Helpline – 0300 100 0212
  • Association of Breastfeeding Mothers – 0300 330 5453
  • La Leche League – 0345 120 2918
  • National Childbirth Trust (NCT) – 0300 330 0700

Websites

Breastfeeding with CMPA

Identifying CMPA and how to cope if your baby is diagnosed with it

Cows Milk Protein Allergy is a hot topic. Hop onto any online breastfeeding support group, on any given day, and you will find someone asking about whether their baby could have a dairy allergy, or being told their baby might have a dairy allergy. When it comes to colic, reflux, general grumpiness, or a bit of green poo, it seems to be one of the go-to suggestions.

So this is my personal story, and some information about CMPA, covering diagnosis, how to live with it, what it is, and what it isn’t.

What is CMPA?

CMPA stands for “cow’s milk protein allergy” and it is the most common infant allergy in the world. If you look at what the guidance, and some of the research, says it is less common than seems.

Some research suggests:

  • Formula feeding increases the risk of CMPA.
  • 2-7% of formula infants and 0.5% of exclusively breastfed babies are thought to suffer from the condition.

Many people feel these numbers are conservative and research is ongoing. However, I include these figures here to make an important point- often what is going on is a lot more basic, and resolving the issue won’t involve you making huge changes to your diet.  If you are concerned that your breastfed baby may have CMPA, it’s probably a good idea to have a chat with an IBCLC or breastfeeding specialist to rule out other, more common breastfeeding issues, for example, tongue tie, or a shallow attachment.

There are two kinds of allergy response to consider:

  • ‘IGE allergy’ is what people commonly identify as an allergy- in its most severe form it includes anaphylactic shock. Symptoms of IgE allergies include hives, wheezing, swelling, and projectile vomiting.
  • ‘Non-IgE allergy’ used to be called ‘intolerance’ or ‘CMPI’. Non-IgE allergies are delayed response allergies, meaning they can occur up to 72 hours after exposure. Symptoms of Non-IGE allergies include reflux (GORD), eczema and ear infections.

It’s possible for a child to have a combination of IGE and Non-IGE symptoms.

The Breastfeeding Network has a great fact sheet on CMPA here which talks about the symptoms.

CMPA symptoms

BfN CMPA symptoms list

Is CMPA the same as Lactose Intolerance?

I want to shout this from the rooftops. CMPA is NOT lactose intolerance! (more here).

Lactose intolerance is fairly common in adults. It is caused by the body not producing enough lactase to digest sugars in milk. Lactase production declines as we get older, and in some adults, it declines to a level where it is a problem.

Babies and infants normally produce plenty of lactase, which would make sense since their diet is entirely milk. Lactose intolerance from birth is a different condition. It is a very rare enzyme disorder, not an allergy. Lactose-free products are not suitable for anyone dealing with a cows milk protein allergy.

Diagnosing CMPA

My daughter has both CMPA and a soy protein allergy, which was diagnosed late on. Unfortunately, no-one involved in our care took an allergy-focused clinical history which might have speeded up the diagnosis. A’s Dad suffers from a few allergies. We have extensive food allergies on my mother’s side of the family. My daughter suffered from silent reflux, mild- but difficult to treat- eczema, and recurring ear infections. She was congested a lot of the time, so she snored loudly, slept with her mouth open, and had a persistently shallow latch (due to a blocked nose). It was an IBCLC who suggested CMPA to us after I visited her. She was 12 months old. I was slightly desperate at the time due to the fact she also woke up around once an hour (or more) so I was up for trying anything that might help. My husband and I were also concerned we were still medicating her for reflux, and as her eczema only seemed to be getting worse, we decided it was worth investigating it further. I went to talk to my GP.

To confirm whether or not A had CMPA I followed the NICE guidelines which meant removing all milk products from my diet for at least 4 weeks. An elimination diet like this is considered the best way to confirm allergies in infants. The reason for this is that tests to confirm allergies in babies are unreliable, and they will not identify Non-IgE allergies.

I also avoided soya milk, yoghurt, and cheese as replacements for cows milk products. I had learned a large percentage (somewhere between 20 and 60%) of babies with CMPA will also have a soy allergy and I was keen to not confuse things with the elimination trial. This was my personal choice, it certainly isn’t a blanket recommendation, but it is something to bear in mind and discuss further with your health care team.

I carried on breastfeeding while I followed the elimination diet, it’s rare for a mum to have to stop breastfeeding if CMPA is suspected.

We saw an improvement in A’s symptoms within a few weeks. After six weeks I “challenged” to be sure we had an issue with CMPA- this involved simply having a glass of milk and watching for 72 hours to see if her symptoms returned, which they did.

In cases of children with severe allergies, this process must be managed under medical guidance My daughter didn’t have a severe allergy so we could do this at home without supervision- do check with a health care professional if you are unsure.

Once you have confirmed CMPA it is important to have some input from a dietitian (especially if the baby is on solids). It is also really important to consider how you will replace essential nutrients which may be lost from your diet if you eliminate milk longer term. More on this here.

“What do you mean there’s milk in the pickled onions?”- Living with CMPA

I quickly had to get to grips with checking labels! I’ve found milk in wine, crisps, chorizo, bread and yes- pickled onions! I quickly learned you cannot assume something will be okay.

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This wine reduced me to tears one Friday. Proof– wine can contain milk! So check the labels on everything!

In the UK we have strict labelling requirements and common allergens need to be highlighted on the label in bold, which makes things easier for sleep-deprived parents!

Sticking to chain restaurants when eating out made our lives easier. Big chains tend to take allergies seriously, and often have a special folder or menu for people with allergies. All places which serve food have to be able to tell you (at least verbally) what allergens their food contains. Zizzi, Pizza Express and Pizza Hut all now offer vegan cheese and have dairy free pizza bases. Who would have thought you can still go out for pizza and be dairy free?

Make your server aware you have a milk allergy so they can take care not to cross contaminate food as they prepare it. It is always worth asking “what’s in that?” rather than just “what is dairy free?” You don’t know what the person serving you understands as dairy. Many people assume eggs are dairy so they may be excluding things from the menu unnecessarily or worse, may assume something isn’t dairy when it is.

I also always make sure I take ‘safe’ snacks with me or a packed lunch for Amy just in case if we are going out now she eats solid foods and a small pot of alternative milk for me.

The thing about cheese and chocolate

Good news- there is amazing dairy free chocolate! Most dark chocolate is dairy-free and many are soy free too. There are also specialised “free from” chocolates like “Moo Free” and “Booja Booja” (who do the most amazing ice cream too)!

I’ve personally found vegan cheese can have a bit of an aftertaste, as well as a strong smell! If you are going directly from eating proper cheese to ‘chease’ it can be a shock! I found after giving up on cheese for a while I was happier with the vegan stuff. The major supermarkets all seem to have a wide variety of dairy and soy free cheeses which makes life a lot easier. Currently, the ASDA cheeses are my favourites, they have a mozzarella alternative (which is also available at their pizza counters!) and a cheddar which are pretty good.

The bad news? I, unfortunately, didn’t lose weight on a dairy-free diet after I discovered loads of biscuits were dairy free…

Cookies on Bowl

May Contains- to eat or not to eat?

One thing which can be confusing when you first go allergen free is the labelling on products like “may contain milk” or “not suitable for milk allergy”.

What may be useful to know is that a ‘may contain’ label isn’t a legal requirement. Any food you buy which is pre-prepared, in a café, or restaurant is a ‘may contain’ even if it doesn’t say this. If you still prepare dairy foods in your own kitchen, this means everything you make is a ‘may contain’! Avoiding ‘may contains’ can make eliminating dairy or other allergens difficult. The risk of reaction from these products is often pretty small, so parents tend to make a risk/benefit based decision, if they have children who do not have life-threatening or very severe reactions some parents will decide not to avoid ‘may contains’.

Adjusting to your new normal

It can feel overwhelming when you first go dairy free. That’s okay. It’s not selfish to feel fed up about not being able to have cheese or to feel upset because OAT MILK IN YOUR TEA IS NOT THE SAME. I get that. It does get an awful lot easier as time passes.

It helps to seek out ongoing support, either in real life or online. There are some fantastic breastfeeding support groups on Facebook (
https://www.facebook.com/groups/breastfeedingwithallergiesUK/ is my favourite and you will often find me chatting there). You can get recipe ideas, tip-offs on CMPA friendly treats and generally have a rant if you need to.

It probably took about 6 weeks to come to terms with my new diet, and it was all worth it in the end. The end result was a much happier tot! I’m so grateful I was able to breastfeed her. My milk means I have never worried about my daughter’s nutrition or tricky prescription formulas and for me, that all makes it worth giving up cheese.

This blog is not intended to replace the advice of a medical professional, simply to give information for further discussion. Please make sure before making significant changes to your diet or your child’s diet to discuss this with a medical professional or a health visitor first.

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More information on CMPA

Finding impartial information on CMPA can be difficult. Unfortunately, this is one area where industry (namely infant formula companies) are very heavily involved. The conflict of interest is clear so I won’t go into too much detail here other than to say the below resources will provide reliable, independent information, fairly free from industry bias.

Further information from:

GPIFN (GP Infant Feeding Network)

Breastfeeding Network

NICE guideline for the diagnosis and management of CMPA

iMAP guideline for the diagnosis and management of CMPA

“We don’t need to promote breastfeeding in western societies we need to enable it”- Maureen Minchin