07 Oct

20th Anniversary Conference live blog

We’ll be live blogging the conference throughout the day here, scroll down and see the live updates below. Here’s the programme so you know what to look out for:

09:30-09:45 Shereen Fisher (CEO) Opening remarks and welcome
09:50-10.35 Dr Amy Brown  

Who really decides how we feed our babies?

10:40-11.25 Dr BJ Epstein  

Supporting LGBTQ families

11:25-11:45                                                          Break
11:50-12:30 Dr Katie Hinde, supported by Professor Sophie Scott What we don’t know about mothers’ milk – video, pre-recorded keynote speech, microbiome, followed by Q&A session.
12:35-13:05 Dr Kirsty Darwent The Infant Feeding Genogram: A tool for exploring family infant feeding narratives and identifying support needs
13:05-13:45 Lunch: including an informal session with Lorna Hartwell and some other founder members looking back at the early days of BfN – sharing their memories and taking you back to where it all began 20 years ago!
13:50-14:50 Small group discussion/training sessions  

Dr BJ Epstein – Supporting LGBTQ families

Lynn Timms – Tongue-tie: how can YOU support these babies with their feeding?
Dr Kirsty Darwent – The Infant Feeding Genogram: Supporting Women and Families in Practice
Walk and Talk – a walk (or run) round Birmingham city centre while chatting about mental health and breastfeeding #RunChatCake
14:55-15:35 Mairi Hedderwick Author & illustrator, Katie Morag (banned artwork)               – The Fuss Katie Morag caused
15:40-15:50 Felicity Lambert  

The National Breastfeeding Helpline Awards

15:50-16:00 Shereen Fisher Closure
Kim Townsend October 7, 20172:48 pm

We are going to share 3 salient points from each of the
break out sessions:

Dr BJ Epstein – Supporting LGBTQ Families

Oversexualisation?

Push society out of overly binary set up

What practical things can we do to help? Start
at home.

Lyn Timms – Tongue Tie: How can YOU support these babies
with their feeding

Listen to the parents. Don’t assume all is fine
if it looks fine

Breastfeeding mantra. Feed the baby. Keep milk
flowing. Keep mum and baby together

Its not all about the tongue tie – support is
vital

Dr Kirsty Darwent – The Infant Feeding Genogram

Importance of confidentiality and consent

The genogram helps to get the conversation
started about breastfeeding (if you haven’t heard of breastfeeding in your
family then most certainly it means formula feeding happened)

The visual representation helps to set people in
their family context and it helps release a bit of the intensity of the
conversation.

Kim Townsend October 7, 20172:37 pm

Mairi Hedderwick telling us all about the image that caused all the fuss!

Kim Townsend October 7, 20172:35 pm

Mairi Hedderwick,
Author and Illustrator, Katie Morag – The Fuss Katie Morag caused

The book that caused all the controversy – Katie Morag and
the Tiresome Ted.

I started out at art school and then did illustrating for
other childrens writers. I loved that job, because you had to be meticulous, if
the author says the child has a green coat then you can’t do it any other
colour! Then an editor said to me, why don’t you write and draw your own story?

Katie Morag is for children, 3-8 year olds, learning to
read. I got to indulge in my children’s upbringing on a island in the Hebrides with
not electricity or water, and so of course I breast fed. The boat only came
twice a week so if you were going to go the route of powdered milk there’s no
way you could have got the supplies. I enjoyed breastfeeding, I felt it was
right.

So when I was given this job we had moved to the mainland so
my children could go to secondary school and I was not happy. I did not want to
leave the island. So the books are a nostalgia re-run of my children’s
upbringing on the island.

You have a limited number of pages – you are told you get 12
double pages – 350 words. So I had to put all the detail in the images. I had
so much I wanted to say, so that is why there are so many details in the
illustrations.

We’ve all read children’s stories that are bland and boring,
so I decided to put some jokes for the adults in my books too.

The shop and post-office is where the child lives because it’s
key to the story that she’s in the heart of the community. I was told to
introduce another key character like the post-man or the milk-man. So that’s
why her Dad runs the shop, and the mother is the Post-mistress. Katie Morag
came out 40 years ago – before Postman Pat!

Mairi talks us through the book and all the illustrations. (Very image based –sorry)

The image of the naked breast – the editor said ‘I don’t
know about that Mairi’ and I said ‘but it’s beautifully drawn!’ and I talked
her into it.

There were two libraries at least that banned the book!

Kim Townsend October 7, 20171:36 pm

There is a washing line of wishes in our break out area, Here are some of the wishes people have written for the next 20 years of The Breastfeeding Network.

Kim Townsend October 7, 20171:18 pm

Our visual artist, taking beautiful notes from the speeches

Kim Townsend October 7, 201712:52 pm

Lunch time now, and here are the founding members of BfN telling us all about how BfN was founded 20 years ago. A fascinating history that we can all be proud of.

Kim Townsend October 7, 201712:09 pm

Dr Kirsty Darwent,
The Infant Feeding Genogram: A tool for exploring family infant feeding
narratives and identifying support needs.

It’s a tool for how we can support women better with
breastfeeding in the context of their families.

Breastfeeding is entirely based on your family history and
culture. From research family history and culture is really important – if you were breastfed yourself you are more likely to breastfeed.

Important to have a coherent network of support, when there
isn’t a history of breastfeeding families struggled to offer the support that was needed. There’s a lack of fit between family experience and women’s needs.

Despite the significance of family history, this is not
explored antenatally meaning that support needs cannot be addressed. The infant feeding genogram is a way of doing this.

The conversations we need to be having is about women
breastfeeding in their life contexts.

I had a conversation with women through my research and I
explored how breastfeeding was for them in the widest context – I wanted to know what was it like in its entirety and how it fit with their life.

Genograms are structures that you can put lots of info on – it’s
a visual representation of family structure and relationships, summarising complex information.
(A bit like a family
tree with additional information added in. Kim)
You can add in conflicting relationships, broken relationships etc

Kirsty showed us a genogram for her family history.
Breastfeeding relationships are highlighted in purple. She was breastfed by her Mum, her Gran breastfed, it goes right back to her great Gran.

So how could this be useful to us?

Kirsty showed us an example of a research participant who
didn’t have a history of breastfeeding in her family. There were some complex and difficult relationships. And so she could predict this would be a difficult breastfeeding journey, and it was. So the support for this Mum centred around how to cope breastfeeding in a hostile environment. How to deal with negative family experience, covert criticism, lack of support, disapproval etc.

Lots of potential in practice context. It is a rapport
building tool, a framework to collect information for midwives, and others involved in women’s care.

It can begin conversation with women alone or with their
families.

More than anything we need family focussed support. And if
not forthcoming helping women think about how they will manage in a conflicting situation. And helping women understand why their Mum didn’t breastfeed them. If you think breastfeeding is best for your baby, you may want to find ways to make sense of why your Mum didn’t breastfeed you by having a conversation about the history and the context.

Offers health professionals or other supporters a way of
providing tailored support

Could be used to prioritise support for women who don’t have
a family support network

Common formats from television programmes like ‘Who Do You
Think You Are’ means it’s a familiar process. People in my experience do really want to talk about it.

Kim Townsend October 7, 201711:36 am

Dr Katie Hinde, supported by Professor Sophie Scott. What we
don’t know about Mother’s Milk.

This talk is a pre-recorded video of Katie as she is based in
America at Harvard University

(I apologise for these
notes, it was quite a fast paced video and highly scientific – I thought so anyway! So we will try to post the actual video here later so you can watch it for yourself – Kim)

Origins of milk are before the times of dinosaurs. There is
a record of milk teeth in fossils 205 million years ago.

Seals have a lactation period of 4 days.

Orang-utans have a lactation period of up to 8 and a half
years.

Milk teeth can tell us a lot about how long breastfeeding
happened for in fossils. We can see that a middle paleolithic Neanderthal breastfed until 14 months until they abruptly stopped. They introduced foods at 7 months.

Rabbits and hares have milk let down only once a day – which
could have evolved because frequent return to the nest makes them more of a target for predators.

Most primates typically rear one offspring at a time, but
some mammals have huge litters of babies, and this impacts on their lactation strategy.

Mothers milk is energy, vitamins, immune factors, microbes,
stem cells, hormones and miRNA – mother’s milk is alive! Milk is food, milk is medicine, milk is signal

For this reason we consider mother’s milk liquid gold.

Each individual mother synthesizes a unique recipe of milk.
There is not a standard. Milk varies across species, across individuals, it can even vary within lactations across months and across hours of the day. This is where I situate my research – the sources of variation, magnitude of variation, and consequences of that variation on growth of baby, behaviour, immune function etc.

What is known about how milk varies across populations?

Premature babies mums make different milk to full term
mothers. Similarly the biological recipe of milk may also be different for sons and daughters. Volume, fat, protein, minerals, and hormones can all be different. Some things are higher for sons, and some higher for daughter. Development trajectories for sons and daughters are different and we can link that back to milk.

Among first time mothers, the mothers age is an important
factor on milk synthesis. Teenage Mums may find it more difficult to synthesize milk. In primates young Mums produced lower volumes of milk. The milk energy available is also lower in young Mums.

Consequences of variations on infants:

Mother-infant interactions, exploration of environment,
playing. All of these early life experiences are fuelled and framed by mothers milk. The milks shapes early life experiences. So we can start thinking about the complexities in breast milk. The nutrients are building blocks and the hormones are blueprints, and they can be used to predict growth trajectories.

Mother’s milk does not just feed the infants. It feeds the
milk orientated microbes in the baby’s gut. Microbes are essential for
recovering additional energy from the diet, they play key roles in immune functions.

Differences between humans and primates – we make more of
the sugars that feed the microbes than primates. Importantly some of these sugars are protective against diarrhoea – a leading cause of infant death.

Maternal genetics also shape the sugars she produces.

The microbes in the gut, which are impacted by breastmilk,
also communicate with the brain, influencing mood and behaviour.

For the most fragile premature babies breastmilk can be
essential for survival. Even for full term, middle class, healthy babies it
contributes to a huge amount of healthy wellbeing in our community.

Can we improve NICU outcomes in milk? Can we start targeting
precision donor milk for particularly vulnerable infants – can we select for sex of the baby, maternal parity, the sugars available in the milk? We now know the biological recipe is unique across mothers, across hours of the day. The milk a mother synthesizes reflects her outer world as it shapes a baby’s inner world.

Kim Townsend October 7, 201710:19 am

Dr BJ Epstein,
Supporting LGBTQ Families

BJ explained that she likes the term ‘queer’ finds it
inclusive and will use it here instead of keeping saying LGBTQ. She says sorry to people who don’t like it.

I am part of a two-Mum family. Between one and ten percent
of people are queer, and around 10% of those people have children. So there are a significant number of people interested in breastfeeding.

Results from a survery I did:

‘when I was in labour the midwife assumed my partner was my
sister’

People assuming the partner is male, referring to the
partner as ‘he’

People assuming the partner who didn’t have the baby is ‘the
man’

Just because a Dad is breastfeeding or chestfeeding does not
mean he is ‘the mother’

Would you ask a straight person the same questions you ask a
queer person?

Some common questions: ‘who’s the mother?’ ‘doesn’t your
child get confused about who you are?’ ‘who’s the father?’ ‘how do you
celebrate father’s day?’ ‘how did you make or get your child?’ ‘how did you decide which one of you would get pregnant?’ ‘what does your family think?’ ‘doesn’t your wife get jealous about your breastfeeding?’ ‘does your child get confused an latch on to your wife’s breast?’

Are these questions necessary, are there polite ways of
saying it?

Pronouns, titles, and terms:

Many women are happy with she, her etc. If you are unsure
you could ask people what pronouns they prefer. Some people use they and their.

Someone in my survey was not acknowledged as a gender fluid
person.

People refer to themselves as Dad, Mum, Dom (Dad and Mum
together), the nursing partner and the non-nursing partner. You can refer to people as partners, rather than picking out who is the Dad and who is the Mum.

In the breastfeeding support world – some people refer to us
as ‘mother supporters’ I prefer ‘peer supporter’ it’s not always the mother we are supporting.

Trans Men who have had to have surgery – many trans men say
they weren’t informed before their surgery that this may impact how they feed a child. Hormones can impact milk supply. These are issues we need to be aware of.

Depression is more common in the queer community – we need
to be aware of that as an issue.

Other issues to be aware of:

fertility treatment is very common, how do you breastfeed
through fertility treatment. There is a good facebook group for this.

Induced breastfeeding is possible in families with two sets
of breasts. Induced lactation is possible, there is a protocol, it’s good to be aware how this works when supporting people. There’s also non-induced lactation and that can happen.

Chest feeding is possible. As is two Dad families using
donated breastmilk.

Sensitive topics:

Getting pregnant, giving birth, breastfeeding raises
feelings for everyone. Certain issues affect queer families more.

Is feeding something that is only for women? For trans-men
that is a challenging thought – seen as something women can do but I identify as a man

Feelings of insecurity, jealousy, regarding getting pregnant
and feeding. It could be that one of the women in a two Mum family couldn’t get pregnant, tried but couldn’t.

Homophobia, transphobia, not being recognised as a family.
Being asked ‘where is the Dad’ things like that.

High rates of depression in queer families, post natal
depression

Lesbians generally have less money than other groups in
society. What does that mean for trying to raise a family

Children from previous relationships and custody issues.
Could have a situation with a known donor – how much is the known sperm donor involved? Sometimes these things can go wrong, people go against agreements. Some people have a contract.

Simultaneous or closely consecutive pregnancies. Some people
want to get pregnant together. This can have an influence on giving birth and breastfeeding. Who is there to support the labour, what if one partner finds it easy to breastfeed and the other doesn’t?

Shared parental leave – how does that impact the
breastfeeding relationship.

To sum up – some suggestions from my survey

Ask questions but politely and respectfully

Don’t make assumptions

Listen, don’t talk over people

Treat everyone equally

Don’t judge people ‘it was constantly assumed I wouldn’t or shouldn’t breastfeed, I constantly had to fight to prove my
intelligence’

-Talk to both or all parents – sometimes there
are more than two people involved. We know that partner support is vital

Non birth mothers are mothers too if they choose
to use that term

Non birth parents may choose to nurse or feed

Bear in mind that in most cases queer families
have had to fight long hard battles to bring their children into the world, so will have thought a lot about how they want to feed their babies.

How queer parents meet one another – we have a
queer family network where I live. We get together once a month. If you know other families in similar situation you could ask if they want to meet.

Titles of books ‘the womanly art of breastfeeding’ is a title that might not appeal to everyone. You could say ‘this is a good book, just ignore the title’. Or just recommend something else.

Kim Townsend October 7, 20179:40 am

Amy Brown, Key Note
Speaker, Who really decides how we feed our babies?

This all started for me when I was doing my PhD, a few weeks
in I found out I was pregnant. By the time I was 28 I had 3 babies! I was 23 when I started my PhD and I had no idea – I just thought you either breastfed or bottle fed and that was it – not quite as simple as that!

Going along to baby groups Mums were telling me the same
things – I couldn’t breastfeeding because he fed too much, I didn’t have enough milk etc. So I went back to the academic literature which said that most women should be able to breastfeed. So what is going wrong?
Amy showed us a graph from the lancet, showing differences of breastfeeding rates between countries. As you can see people in Ghana have much better breastfeeding rates – perhaps because they need to breastfeed more than we do. So what’s going wrong here?

But Mums do actually want to breastfeeding, there’s lots of
feelings of failure out there, guilt, regret, frustration. A lot of the
symptoms that women are telling me about are similar to symptoms of trauma.

So what’s going on? Because it’s not biological. It doesn’t
help to say ‘breastfeeding is best’ the word best isn’t helpful. It’s not best – it’s biologically normal. It doesn’t help you to breastfeed by saying it’s best. It’s all about the support around you, the systems, the politics.

But yet there are subtle barriers out there to stop you from
breastfeeding. Images of breastfeeding being banned from Facebook, people being told to cover up in public, advertisers like Dove doing polls on whether it’s OK to breastfeed in public! Would they do that about any other law – like a poll on whether its ok to smoke around children! Probably not!

Amy showed us some images of perfume adverts – apparently breasts
sell perfume! It’s OK to see breasts on perfume adverts, but not to see them feeding a baby.

Unicef baby friendly- we need to change the conversation
around breastfeeding. I want to talk about two things that aren’t related to breastfeeding but contribute.

1.Accepting normal new born behaviour.

Feeding whenever baby needs to be fed, watching their
signals. But what does society say to that? Society tells you that’s wrong on every level.

When you have a new baby people ask you 3 questions: Is it a
boy or a girl? How much did she weigh? AND Is she good?

Good babies according to society sleep through the night and
don’t need picking up very much and let you get your life back to how it was before you had a baby.

And those remarks that make you question everything: She can’t
be getting enough if she’s feeding again, have you tried just not feeding her, of course she’ll wake at night if you keep feeding her.

Then we end up with Mums worried about everything – what if
I’m doing it wrong!

This can lead to depression.

We need to convince society to value and care for our new
mothers better.

2. You need to get your life back after having a
baby

Amy showed us google searches and magazine covers
encouraging mothers that they need to ‘get their life back’ after having a baby.

Latest trends for helping your boobs be more pert, less wrinkly.
Trends for nipple bleaching, and plastic surgery to make nipples smaller.

Devices being marketed that rock your baby to sleep, hold
the bottle for them, even help tell you how much milk is in your boobs! Devices that get in the way of the mother/baby bond

Parenting books that advise things like ‘when they wake up
in the night don’t look at them!’

And formula marketing that subtly implies that formula makes
your baby sleep better. And formula helplines that claim to give breastfeeding advice.

Amazon giving away free baby bundles to people who have
Prime that include bottles and formula.

Celebrity Mums, for example Jordan, doing spreads for Hello
magazine including huge adverts for formula companies.

So what do women really want?

5 main things they have told me:

·Breast is not best it’s normal

·Tell us the truth – it is challenging

·Don’t focus solely on health impact of
breastfeeding

·Recognise that every feed makes a difference

·Target a wider audience – not just Mums, but
society.

Research showed that when a woman is shown breastfeeding on
tv she is looking exhausted on the sofa in a dressing gown, but when she’s bottle feeding she’s out and about.

Twitter emoji for when a woman is having a baby is a bottle.
Rooms for baby feeding have symbols of bottles on the door.

But there are some good examples of public images showing
breastfeeding. Amy showed us a selection. Some celebrities showing themselves breastfeeding – like Pink.

Finally – we should go into schools to talk to children
about breastfeeding and normalise it before someone gives them the idea that breastfeeding is something to be ashamed about and formula milk is normal.

We’ve lost sight of what its like to breastfeed and need to
get back to understanding and caring for new mothers.

We need to change the conversation around breastfeeding – we
need to care for new mothers better, to mother them.


Kim Townsend October 7, 20178:45 am

Conference Chair, CEO
Shereen Fisher’s opening remarks:

Shereen started with leading a round of applause for the 20th
anniversary of BfN.

Today we will try and rethink the barriers to breastfeeding –
what needs to change to give mothers options.

We’ll be exploring the mysteries and marvels of mother’s
milk through scientific discoveries

We’ll be offering expertise on practical support and how
best to support Mums with breastfeeding.

We’ll also have a twist – Mairi Hedderwick author of Katie
Morag will be speaking, we’ve got some singers, and a washing line of wishes
for the Breastfeeding Network.

And of course a BfN conference wouldn’t be complete without
cake – there’ll be lots of that!
(sorry
for those of you following virtually!)

We’ll also have a visual artist following the conference (I will try and capture this on for you the
blog
)

During the lunchbreak one of the founding members of BfN
will be sharing thoughts on the last 20 years of BfN.

Finally, It’s been a challenging year yet again for
breastfeeding, we’ve had more cuts in services, but we don’t want that to get
in the way of celebrating all the great work that goes on, and all our
volunteers. Today is for you, please use it as a learning event and networking
opportunity. We want to mark the past as well and consider the origins of the
charity which is mother centered and commercial free, and evidence based. These
principals are still very important to us still today.

Kim Townsend October 7, 20178:36 am

Hello, Kim here. Sat and the front and ready to blog for you. Just to let you know how I will be doing this. I think, to make reading easier for everyone, I will write notes from each talk in one go, and then publish after each one. So you will get to follow, if not instantly, shortly after each speech.