Blog - The Breastfeeding Network

14 Dec

Christmastitis: look after yourself this holiday season

Although this Christmas is likely to be a little different, it’s still worth taking into account how you can maintain your feeding “routine” (even if it changes every day!) in among the celebrations. Mastitis is a potentially serious condition resulting from blocked ducts when milk isn’t effectively removed from the breast(s). Here, IBCLC Lucy Webber explains how changes in routine can affect your feeding rhythm – and makes some suggestions on how to avoid “Christmastitis.”

Did you know that rates of mastitis go up around holiday periods? Why? Well, loads of reasons to be honest. Let’s picture it shall we?

It’s your first christmas with your baby. You’re mega excited and so is everyone else to have this gorgeous bundle in their lives. Christmas is going to be AWESOME.

Lots of travelling around in the car visiting friends and family, making the most of maternity leave to see everyone and proudly show off this little person, taking up offers to go over and be cooked for! And that is genuinely fabulous.

But all that travelling leads to lots of time in the car seat, and for most babies the car seat sends them to sleep. And long sleeps mean long gaps between feeds, which leads to full breasts with potential for blockages…

Then the parties, the gatherings, celebrations! Lovely right?! Yes! Except everyone wants a hold of little baby Rupert and once again he has longer stretches between feeds. And when he does come back to you he’s over stimulated and over tired and only takes two minutes on the breast before he falls asleep leaving you with, you guessed it, full breasts….

Or the guests seem to think they know better than you do about baby Josie’s feeding cues and tell you she doesn’t need feeding, they can settle her for you. They talk about how ‘when they had babies you only fed every four hours and it didn’t do them any harm’. You’re then stuck between a rock and a hard place, because you would like to feed your baby, but you don’t want to upset family or the way they did things, and maybe they’re right?

Feeds are often cut short around celebrations, because you have lots of people offering to help and hold the baby so your dinner doesn’t go cold, or guests arrive, or you’re due somewhere, or you’re upstairs feeding and want to get back down to the party…the list goes on. So your breasts don’t get ’emptied’ like usual and can you guess what happens next? Yep….

Maybe you don’t feel comfortable feeding around Auntie Ethel and Uncle Bernard, so you don’t quite expose your breast as much as you might normally, and your clothes/bra are digging in a little and restricting milk flow and cause a blockage…

Maybe you’re sleeping somewhere different, the bed is different, you can’t quite get the angle of the feed right on this squishy mattress and the latch goes a bit dodgy, but you put up with it because you don’t want the baby to cry and wake everyone. Dodgy latch leads to breast not emptying efficiently…and you know the rest.

Christmas is lovely, but for a huge amount of people it’s also very stressful. Stress hormones can impact on oxytocin, which is the hormone needed to let your milk flow. So stress can temporarily inhibit milk flow leading to those full/blocked breasts again.

I might be coming across as a bit Bah, Humbug! but I’ve been around enough mothers with mastitis to know its REALLY not what you want to be dealing with at any point. It is not to be messed with, it is a serious condition and you can potentially end up very poorly.

What I’m saying is, take it EASY. Plan ahead now to make sure this holiday season is one where you can feed whenever and wherever you need to. Be led by your baby. Don’t stretch out or cut short feeds.

Listen to your body, not Auntie Denise.

You can find out more about mastitis, what to look out for and how to avoid it, in our factsheet here.

This post was originally published on Lucy Webber’s social media feeds and is reproduced here with her permission. You can find her on Facebook and Instagram.

20 Oct

Baby-led weaning: where are we now?

Gill Rapley & Tracey Murkett are speaking at the BfN online conference on the 24th October 2020. If you can’t wait until then to delve in to this fascinating topic, here’s a little insight into what they have in store for us:

As baby-led weaning becomes increasingly established around the world, we are often asked about the traditions around introducing solid foods in other countries. This is a difficult question to answer, partly because childcare customs are not always written down and partly because, over the last century, the practice of spoon feeding with pureed foods has penetrated most cultures, pushing out the more traditional ways.

In terms of history, archaeologists have found evidence, from jaw bones, that babies in prehistoric times would have been chewing quite tough foods by around 7 or 8 months. The practice of mothers pre-chewing foods for their babies is also well documented; this persists today although, since the advent of cooking (which enables all types of food to be made soft), it’s more of a symbolic act, rather than being part of day-to-day eating.

We know that it’s normal, in some societies, for babies to forage for molluscs and invertebrates as soon as they can crawl, picking up grubs and insects to taste and eat. We also know that for most of history – and still in much of the world – babies had breastmilk for much longer than is now common in the West. Breastmilk formed an important part of babies’ diets until they were at least three years old, which is likely to have made the move to solids a more gradual process. And we’ve heard from many parents around the world (as well as in the UK) that their grandparents recount how they simply shared their own food with their baby, and the babies fed themselves when they were ready – essentially baby-led weaning, but without the name.

There are now few countries where traditions of childcare and food are simply passed on, mother to daughter. Childcare in the 20th century was marked by ‘experts’ and doctors telling parents what to do, from Truby King to Gina Ford. One of the effects of taking the expertise away from mothers allowed a new industry to emerge, making money from commercial baby food (and formula), and promoting it as better and more convenient. In most countries today, parents are influenced to some degree by the baby food industry, often via the health care system (despite the best efforts of the World Health Organization and others over many years). The result is similar everywhere: an approach to the introduction of solid foods that is controlled and directed by adults, based on spoon feeding, and structured around timing, measured amounts and the need to introduce foods in a certain order.

Interestingly, the order in which foods are supposed to be introduced, and the list of foods that are not allowed before a certain age, varies from country to country – although each would claim their recommendation is based on science. The amounts dictated (or implied) are different, too. For example, the size of a jar of commercial babyfood is often taken as an indication of the amount the average baby is expected to eat for a main meal by, say, 8 months. But a jar of baby food in Japan is roughly two thirds of the size of the average jar sold in the UK! And of course, the issue of when complementary feeding should start is still hotly debated in many countries, with the babyfood industry campaigning to revert to, or retain, the 4-month rule.

In the UK, as in much of the rest of the world, the perceptions and practices around introducing solid foods to babies have followed a similar path to those relating to breastfeeding. Throughout the 20^th century, most guidance for mothers was based on timing and limiting breastfeeds. Babies’ and mothers’ instincts weren’t to be trusted, and the amount of milk a baby consumed needed to be measured and controlled. This was clearly much easier to achieve with formula than with breastmilk. So, rather than allowing the baby’s development and instincts to lead the way, or relying on the parent’s understanding of what their baby may need, there was unnecessary intervention. The effect of this was to take away the baby’s autonomy and undermine the mother’s confidence (and that of those around her), so that the baby was no longer considered capable of knowing his own needs.

However, there’s been an enormous amount of research around breastfeeding in recent decades. We now know far more now about how babies control their intake of breastmilk naturally at the breast, how the instincts and hormones of mother and baby work together and how babies’ natural behavior should be trusted, rather than controlled or changed. The research around introducing solid food is lagging way behind, and is often compromised by industry involvement. But, as baby-led weaning becomes more mainstream around the world, it’s becoming increasingly clear that we need to take a closer look at babies’ natural behaviour and development around food and eating. Maybe, rather than making assumptions that adult intervention is needed, we should use babies’ instincts and capabilities as our starting point for introducing solid foods.

To find out more about the conference and purchase tickets click here.

12 Oct

Helen Ball: Sleep, Baby & You: development of a support intervention for UK families

Helen Ball has been researching the sleep of infants and their parents for 25 years. She conducts research in hospitals, the community, and her lab, and she contributes to national and international policy and practice guidelines on infant care. She is a Board Member of ISPID (the International Society for the Study and Prevention of Infant Deaths), Chair of the Scientific Committee for the Lullaby Trust, and Assessment Board member for Unicef UK Baby Friendly Initiative. In 2018 Durham University received the Queen’s Anniversary Prize for Further and Higher Education for Helen’s research and outreach work.

In her talk at this year’s BfN Conference, Helen will provide an overview of her latest project to develop and trial a support intervention for parents who may be struggling with infant-related sleep disruption or post-partum fatigue. Here is a brief abstract of the project to whet your appetite!

Disrupted parental sleep, presenting as post-partum fatigue and perceived as problematic infant sleep, is related to increased symptoms of depression and anxiety among new mothers and fathers. Previous research indicates that UK parents would value an approach that facilitates meeting their infants’ needs while supporting their own sleep-related well-being throughout their infant’s first year.

Six initial stakeholder meetings were held with 15 practitioners and 6 parents with an interest in supporting parent-infant sleep needs, to explore existing service provision and identify gaps. The Possums Sleep Program, developed and delivered in Brisbane, Australia in a GP clinic setting, was chosen as an appropriate approach.

Working collaboratively with a stakeholder group, we translated the Possums Sleep Program into an intervention that could be universally delivered in the UK via NHS antenatal and postnatal practitioners. Parent and practitioner views of the initial materials were obtained via feedback questionnaires and the tool was revised. The intervention was then field-tested by 164 practitioners who delivered it to at least 535 new parents and babies over 5 UK locations, to capture anonymous parent and practitioner views of the intervention concept, the materials, and their experiences with both.

The intervention helps parents recalibrate their expectations of infant sleep development, encourages responsive parenting and experimentation to meet their infant’s needs, offers parents strategies for supporting the development of their babies’ biological sleep regulators and promote their own well-being, and teaches parents to manage negative thinking and anxiety that can impede sleep using the principles of Acceptance and Commitment Therapy. The ‘Sleep, Baby & You’ discussion tool, a 14 page illustrated booklet for parents, was field-tested and evaluated by practitioners and parents who offered enthusiastic feedback.

Practitioners reported the ‘Sleep, Baby & You’ materials were easy for them to explain and for parents to understand, and were a good fit with the responsive parenting approaches they employed in other areas of their work. Parents who received the intervention postnatally understood the material and found the suggestions easy to follow. All parents who provided feedback had implemented one or more of the suggested changes, with the majority of changes (70%) being sustained for at least two weeks. Practitioners recommended development of digital and antenatal versions and offered feedback on circumstances that might challenge effective uptake of the intervention.

‘Sleep, Baby & You’ is a promising tool for promoting parental attitude and behaviour-change, that aims to adjust parental expectations and reduce negative thinking around infant sleep, promote responsive infant care in the face of infant-related sleep disruption and fatigue, and support parental well-being during the first year of parenthood. Initial field-testing provided insights useful for further development and subsequent testing via a randomised trial. Support exists for incorporating ‘Sleep, Baby & You’ into an anticipatory, universal intervention to support parents who may experience post-partum fatigue and infant sleep disruption.

Ready to hear more? Get your ticket for the conference here:
https://www.breastfeedingnetwork.org.uk/conference/

30 Sep

Dr Lisa J Orchard: The Impact of Social Media on Breastfeeding

Dr Lisa J. Orchard is a Senior Lecturer at The University of Wolverhampton. Lisa specialises in cyberpsychology and specifically the psychology behind social media use. Here she discusses the subject of her talk for our conference in October – the impact of social media on breastfeeding.

A recent trend on Tik Tok sees the reaction of breastfeeding infants and toddlers when shown the sight of their mother’s breast. Their eyes light up in glee, as they crawl or toddle over for a snuggle and feed. An adorable sight; but what are the implications of the clip being shared on social media? Perhaps the video will attract a series of likes, shares and comments. Will this make the mother feel supported and empowered? Will she receive any negative comments, which could be detrimental to her confidence? What happens when a teenage girl stumbles upon the video? Perhaps she’s never encountered breastfeeding before. Will this be a positive introduction to seeing how a baby is fed?

The hashtag “normalisebreastfeeding” has been used over the last decade across social media to counteract some of the negativities surrounding breastfeeding. This cyberactivism demonstrates that there was always a hope that social media could be used in a positive manner to benefit breastfeeding promotion and support. This makes sense – social media is our ‘go to’ when finding new information or looking for someone to talk to, which is exactly what new parents need. The “new normal” of COVID-19 has meant an even stronger reliance on technology than ever before. However, to make the most out of social media, we need to take stock of content in order to understand its effect. We also need to consider who is using social media, as this will determine what content is seen.

Let’s start with the breastfeeding mother, who may actively search for breastfeeding support groups and information pages. How does she decide what group to look at? What kind of information does she see? What does she find useful? How accurate is the information? Now let’s consider other users, who may only encounter breastfeeding incidentally, through the sharing of a newspaper article or the viewing of a breastfeeding social media influencer. How often do they encounter breastfeeding content? Do negative comments impact on their opinion of breastfeeding? Do they learn about the benefits of breastfeeding from infographics and memes shared by friends?

Dr Wendy Nicholls and I have embarked on a research project to try and answer some of these questions. In our first study we conducted a review of research already looking at social media and breastfeeding to see what has already been found. The research so far suggests that breastfeeding families enjoy social media and find it useful for information and support. However, social media support does not always result in improved breastfeeding rates. Within our research we consider why this may be and suggest that it could be due to the content being seen. From looking across the studies so far, we can make suggestions about ways to improve this content. For instance, it is important for breastfeeding mothers to feel that information is credible and trustworthy. Furthermore, having relatable role models is important. People want to see other people like them breastfeeding.

Our second study is looking at one specific type of content – the breastfeeding selfie, aka the brelfie! We have been interviewing breastfeeding mothers who share brelfies to better understand what mothers think about brelfies and why they feel they are important to share. By finding this information we can hopefully understand the impact of this content and think about how we can use them more effectively.

Social media undoubtedly poses risks for breastfeeding, and not all content will be positive. However, if we understand the types of content available and how they may impact perceptions of breastfeeding, we can work on improving positive content, and minimising the risk of negative content.

We look forward to hearing more at our virtual conference on 24^th October. Got your ticket? Click here:
https://www.breastfeedingnetwork.org.uk/conference/

25 Aug

Black Breastfeeding Week 2020 – thoughts from a mum, midwife and BfN volunteer

Andrea is a trained BfN Helper volunteer based in Wolverhampton. She is a mum of three (now grown up!) children. She worked as an NHS nurse and midwife for 18 years and now works as a Clinical Reflexologist and runs her own holistic therapy business. In this personal account, she shares some of her own views on Black Breastfeeding week, and experiences both as a mum and as a midwife.

I must be honest when I saw the title Black Breastfeeding week. I thought ‘Interesting! Why would we need a separate week looking at Black breastfeeding? Isn’t all breastfeeding the same? Lol!’. I then had a look at some of the links and listened to a talk by Ruth Dennison on YouTube.

I must admit my personal experience of breastfeeding with regards to my family and community has been a very positive one. I come from a family of nine children, two boys and seven girls. I am the baby of the bunch.

I watched all my sisters breastfeeding, and skin to skin was always important. My great Auntie would come and do the first bath for the newborn following by her famous stretch massage with olive oil. The baby would sleep for half the day after that.

Preparing a nursery for the baby was unheard of because baby was going to stay in the room with parent/s until he/she could sleep in a bed.

Co-sleeping was also a common thing, although this would only tend to be for the convenience of breastfeeding, or if the child was unwell and wouldn’t settle unless close to their mother.

One true thing about the Black community is they do like to feed! The thought of someone going hungry, or not getting enough nourishment does not go down well.

This is where I think the point Ruth makes in her talk suggesting that black people having the tendency to mix feed comes into play. I believe formula milk was sold to us as ‘good for your baby’. And we still knew deep down that breast was also good, so we would think ‘well why not do a bit of both!’

When I had my children, even though I was only 19 when I had my son, I knew I was going to breastfeed. Establishing breastfeeding was not all plain sailing though! I found my mother and sisters were very encouraging, although having said that, if I was given any advice from healthcare professionals that may well have gone against what we had culturally inherited from our African ancestors, I was encouraged to listen to what the healthcare professionals told me.

For example, I was told to give my baby some formula as he was described as ‘a hungry baby’. I know now that it was probably down to just needing a slight adjustment to the latch. Because of this I did mix feed my son and stopped breastfeeding after 6 months.

Then when I had my twin daughters at the age of 28, and now a qualified Nurse. I was determined they would have no formula. This time I was confronted with a lot of pressure from healthcare professionals to give some formula. I was told “you can’t feed twins”, “they are small they need something more than breast milk” “they are losing weight you need to top them up”.

This time though, I was a little older, a little wiser and was even confident enough to reassure my mother when she thought maybe I should listen to the healthcare professionals. Don’t get me wrong – I would never encourage a women not to listen to the healthcare professionals, as I am one myself. But we do know at times we can give out conflicting advice, therefore I always encourage women to seek evidence based research for themselves enabling them to make informed decisions.

I breastfed my twin daughters exclusively for 6 months until I introduced other foods, whilst continuing with breastfeeding up until 18 months old.

During my time as a midwife I was always an advocate for breastfeeding if this was the women’s choice and I would try to support her and the rest of the family to the best of my ability.

With regards to supporting women from the Black community, I found because I had a full understanding of the cultural background, it would help me to better understand the woman’s needs.

In relation to the recent Black Lives Matter campaign that has been highlighted after the unfortunate death of George Floyd, I would like to share with you two personal experiences that may help to explain some of the inequalities in health related to Black people.

When my twins were born in 1990, a few days after their birth I was approached by a white midwife who had two little injections all drawn up and ready to go! When I asked what it was for she said she was going to give my babies a BCG injection.

She went on to explain the reason I was being offered this was because (in her words) ‘Asian people come to England and they live all together under one roof, they bring TB with them from India and that’s why we offer it to all black and Asian babies’.

Her reply made no sense to me. I was not Asian and I did not live in their houses with them. I lived in a community that consisted of Black, White, and Asian people, yet the injection was not being offered to white babies.

I decided I would try to investigate the matter further by asking other midwives and a doctor why it was so important for my babies to have this injection so soon after their birth. I understood the point being made with regards to some Asian communities, but I did not come under that category.

I could not get an answer that I was satisfied with. I decided not to give my babies the injection at that stage and they proceeded to have the injection in year 6 of school alongside the majority of children.

The moral of this story is that sometimes people of colour are just grouped together without any real consideration or thought. We have white and then BAME!

Secondly, when I worked as a midwife on the ward in the mid 1990’s we were provided with little bottles of ready-made formula milk that mothers could help themselves to whilst they were inpatients. Theses bottles of milk were supplied in such vast amounts that quite often they would go past their expiry date before they could be used.

Being a person that does not like waste I decided to investigate what happens to all this out of date formula milk. My discovery was shocking. It was being sent to places in Africa and given to nursing moms there!

What was even more shocking is that a lot of my colleagues did not see a problem with this, with some suggesting ‘well it’s better than nothing! Because they don’t have much food do they?’

We all know there are deeper conversations to be had surroundings this but I think I have ranted enough. With that said I’m still a little unsure about the title ‘black breastfeeding’.

Breastfeeding has been sold to us all (whatever colour we are) as something that is unnatural, inconvenient, embarrassing and difficult. I believe our biggest challenge is a reconditioning of our minds. Some of the challenges may well differ depending on our cultural backgrounds, but we all face similar challenges when it comes to breastfeeding our babies, irrespective of our colour.

We all have a common interest to make this a better world with less unnecessary discrimination and prejudices that just hold us back.

It’s worth noting that this was some time ago and I know things have changed on maternity units now but it does demonstrate the attitudes that people had then and others have grown up with.

Thank you for sharing your story and thoughts with us Andrea.

07 Aug

Breastfeeding Support in Your Language

As World Breastfeeding Week 2020 draws to a close, we are delighted to showcase our wonderful Volunteer Peer Supporters speaking in some of the different languages that they offer breastfeeding support .

We hope that you enjoy hearing from them.

Get in touch to find out if we speak your language.

email Admin@breastfeedingnetwork.org.uk
phone 08444 120 995 (Calls to this number will cost a maximum of 7ppm to call, plus your telephony providers Access Charge)

#WBW2020

06 Aug

Breastfeeding support during COVID-19 – A summary report in collaboration with Professor Amy Brown (Swansea University) and Dr Natalie Shenker (Imperial College & Human Milk Foundation)

In May 2020, researchers from Swansea University and Imperial College conducted research in collaboration with the Breastfeeding Network to explore families’ experiences of breastfeeding support during COVID-19.

Click the image to read the full report:

The following summary has been taken from the report, the full findings will be published in a journal later this year.

COVID-19 and lockdown has been a challenging time for breastfeeding families. Many have stopped sooner than they planned. Although this is unfortunately a common issue even outside of the pandemic³, many blamed a lack of support and lockdown experiences upon their decision to stop.

We know that breastfeeding works best when women receive high quality practical and emotional support from professionals and peers including in the community¹. This support had to change once lockdown was in place, with breastfeeding charity organisations making rapid alterations to the way they delivered their service.

Some women were fortunate to be able to access this, evidenced by the multiple, varied queries they had answered during this time, covering both practical and emotional support needs. The majority of those who accessed this support found it useful and wanted it to stay, albeit alongside the benefits of face to face support once possible. For these women, their experience was positive, giving them easy and rapid access to support from the comfort of their homes. Notably, some women accessed this support over and above health professional support during the pandemic. It is clear that breastfeeding organisations provided a valued and needed service at this time – a finding reflected in similar previous research exploring the impact of the Australian Breastfeeding Association during this time⁴.

Unfortunately, two further groups of women did not have the benefit of this support including those who did not realise it was available, and those who accessed it but either struggled or had a strong preference for face to face provision. These women found a lack of in person care challenging, struggling to convey issues or with technology, or simply wanted the reassurance of someone in the room. It is likely these experiences are not equal; those with more resources and fewer challenges at home will find accessing different sources of support in during difficult times easier.

We found that women who did access charity support when they needed it were more likely to still be breastfeeding at the time of completing the survey compared to those who did not. To some extent their ability and willingness to seek support will in itself have supported these mothers’ ability to continue breastfeeding, most likely reflecting high motivation. However, given what we know about the impact of breastfeeding support for new families^1,the range of queries posed to teams, and the positive experiences from some women in this survey, it is evidence that charity breastfeeding organisations have played an important role in ensuring mothers could continue breastfeeding through lockdown.

In terms of where we go from here, the good news is that online breastfeeding support services are working well for many women, helping them to breastfeed for longer. However, many challenges and questions have been set, with some of the answers likely outside the control or remit of organisations offering support. Namely:

How do we ensure better promotion of availability of online breastfeeding support so that more families know they can access it?
How do we ensure these organisations are well funded to be able to meet the needs of more women?
How to we enable all populations to access online support, including those who may not be able to afford technology or high-speed internet connections?
What is needed to recommence face to face breastfeeding support, given other public spaces such as restaurants and public spaces are open?

Given the known impact of breastfeeding upon population health⁵ and maternal wellbeing⁶, the government urgently needs to review its provision of care for new families, considering how it can ensure that more are protected in similar circumstances in the future. Although almost all mothers valued the option to receive online or phone support during lockdown, many expressed a wish for face to face support to continue. Recent press reports have stated that Health Secretary Matt Hancock wishes to encourage future virtual GP appointments unless clinical need, but caution must be urged in relying too heavily on a lack of in person support. It was clear mothers valued both the information they were being given, but also the warmth and connection from face to face support, and engagement with other mothers.

Finally, the impact of breastfeeding charities in supporting mothers practically and emotionally through this stressful period should be celebrated. They have served a community of new mothers, whom without their support may have had a much more challenging breastfeeding experience and likely a premature end to breastfeeding altogether. Their value and contribution must be recognised.

References

1. McFadden, A., Gavine, A., Renfrew, M. J., Wade, A., Buchanan, P., Taylor, J. L., … & MacGillivray, S. (2017). Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews, (2).

2. Unicef UK (2020) Unicef UK Baby Friendly Initiative statement on infant feeding during the coronavirus (COVID-19) outbreak.

3. McAndrew, F., Thompson, J., Fellows, L., Large, A., Speed, M., & Renfrew, M. J. (2012). Infant feeding survey 2010. Leeds: health and social care information Centre, 2(1).

4. Hull, N., Kam, R. L., & Gribble, K. D. (2020). Providing breastfeeding support during the COVID-19 pandemic: Concerns of mothers who contacted the Australian Breastfeeding Association. medRxiv. [preprint] – doi 10.1101/2020.07.18.20152256

5. Victora, C. G., Bahl, R., Barros, A. J., França, G. V., Horton, S., Krasevec, J., … & Group, T. L. B. S. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), 475-490.

6. Brown, A. (2018). What do women lose if they are prevented from meeting their breastfeeding goals? Clinical Lactation, 9(4), 200-207.

7. BBC (2020) ‘More Zoom medicine needed’ in NHS says Hancock https://www.bbc.co.uk/news/health-53592678

Download the Summary Report in PDF

05 Aug

No experience needed, but prior knowledge advantageous: What I learned about breastfeeding second time around – by Alyson Spicer

“Mmm, you’re feeding him like a multip.”

The midwife preparing to discharge me gave a satisfied nod. I wasn’t sure what she’d said. “Like a what?”

“A multip. You’ve had a baby before, haven’t you?”

Oh Christ, was it that obvious? Had parenting a toddler really left me looking so noticeably haggard? Did I have Weetabix in my hair? But then I looked down. I was (slightly wonkily) cradling my not-quite-a-day-old son in one arm, while making notes with the other hand and occasionally pausing to guzzle more peppermint tea or tweak my top out of the way. He was doggedly cracking on and doing his thing.

It occurred to me that I hadn’t really paused in my conversation, and that it probably looked like I wasn’t paying much attention to what he was doing. It was pretty clear how this contrasted with my first days of learning to breastfeed three years before: constantly questioning, “Am I doing this right? How do I know?”; watching like a paranoid hawk for every possible feeding cue; requiring all body parts at exactly the right angle, precisely the right arrangement of pillows, no distractions…it was all a world away from the sort of casual lolling that baby number 2 and I were currently engaged in.

So I took her point.

But, previous time served in the breastfeeding trenches aside, I also had another secret weapon that she wasn’t aware of. When my first baby was a year old, I’d trained as a breastfeeding peer supporter, with the Breastfeeding Network. I’d volunteered at drop in groups for parents and their babies, offering information and support to help establish and maintain breastfeeding – everything from explaining how milk supply works to practical tips on positioning the baby at the breast…even ideas for gently handling well-meaning but clueless family members.

So when it comes to breastfeeding I should, on paper at least, have a fair idea what I’m doing.

Working as a peer supporter and then going back for another crack at breastfeeding myself has been an interesting experience. At almost 6 months in, it feels like it’s come easily this time. In some ways that’s definitely true – no cracked nipples, no worries about supply, no issues with baby’s weight, no mastitis. But there have also been times when it is the most challenging and frustrating thing in the world (Newsflash: being a trained peer supporter does not make you immune to all breastfeeding issues. Who knew?). Oversupply. Screaming baby. Sleepy baby. Uncomfortable boobs. Always being on call. Cluster feeding. Sleepless nights. Exhausting days.

Not to mention the fact that, when my baby was just nine weeks old, lockdown was announced thanks to COVID-19. The prospect of getting out to a breastfeeding cafe to get support or meet other mums – something I was particularly looking forward to, having just moved to a new area – disappeared faster than you could sing Happy Birthday (twice).

These were all challenges to push through, with the aid of hundreds of biscuits and gallons of tea (and a few glasses of wine along the way). Not because I’m supermum/a martyr/a masochist. At one point I found my hormone-addled brain thinking I must have been blessed with some sort of brilliant talent for breastfeeding (My calling at last! Are wet nurses still a thing?) – but that’s nonsense.

Why does it feel easy this time? Because I was armed with knowledge about breastfeeding. That’s all. So when I hit those challenging and frustrating times (which are so often just a normal part of getting breastfeeding established), I usually knew what I had to do to fix them. Or at least how to push through until they fixed themselves.

I knew that babies usually feed incessantly for the first few days, and I knew it didn’t mean I didn’t have enough milk. I knew the difference between a bad latch and a good one. I knew that a sore spot was a warning sign of a blocked duct, and I knew how to clear it before it got worse. And most crucially, if I didn’t know what to do, I knew where to go for support and information.

Sure, the local group was closed, but the breastfeeding community is an incredibly committed one, and nobody was going to see parents left in the lurch if they could help it.

Within days of restrictions being imposed, virtual support groups were set up on Zoom. Lactation consultants increased their Skype support offerings. Midwives posted how-to videos on hospital Facebook pages. Breastfeeding supporters on maternity wards donned layers of uncomfortable PPE and soldiered on. I even heard of peer supporters coming out of retirement to volunteer on the National Breastfeeding Helpline, where demand rocketed. Support was out there, even if it couldn’t always be offered face to face.

But what about first-time parents – not just those raising their babies under the shadow of a global pandemic, but anyone who doesn’t know what to expect or who to ask. Who have been told “breast is best” (a truly unhelpful phrase, but that’s a whole other essay) but not offered any follow up support, and have expected everything to just naturally fall into place.

Looking from that perspective – without the knowledge that it could and would get better, and working on the assumption that if this natural process didn’t come naturally, then it just wasn’t meant to be – there were many points where I could very easily have thrown in the towel, very quickly.

Even with the knowledge that I have, there have still been days when it’s bloody hard. It has become blindingly obvious to me why many parents have a tough time breastfeeding, and why breastfeeding rates aren’t higher (only 1% of babies in the UK are being exclusively breastfed at 6 months of age, as recommended by the World Health Organisation).

I’m not saying that every breastfeeding issue can be solved by reading a leaflet or spending half an hour with a peer supporter. Of course it’s never going to be that simple (and Professor Amy Brown explains the reasons for that far more eloquently than I ever could). But the right information and support can truly make the difference between having to stop breastfeeding, and being able to continue.

It allows every parent to make an informed choice about how to feed their baby (and if parents choose not to breastfeed, as is their right, at least that decision would be based on knowledge of the facts rather than an automatic adherence to prevalent bottle feeding culture). As a bonus, better breastfeeding support could save the NHS billions, through prevention of future health issues in both the child and the mother.

Information on breastfeeding isn’t a secret – but it’s not always easy to find, and not everyone has access to the same level of care. Every GP and midwife in the country will likely tell you the benefits of breastfeeding your baby and will encourage you to do so. Not all of them are able to support you to actually do it, or even point you in the direction of someone who can – usually because of cuts to local authority funding.

It’s cruel, when you think about it (Emma Pickett, chair of the Association of Breastfeeding Mothers, calls it “inhumane”): to dangle the carrot of how brilliant breastfeeding is, but then snatch it away again if you don’t live in the right postcode. This isn’t a criticism of GPs or midwives, who do a fantastic job – it’s just often the case that they don’t have enough time, resources or training to offer the support that is so badly needed.

So what can we do? If you’re about to have a baby, you’re probably (understandably) preoccupied with the matter of safely getting another human out of your body. But try to also focus a little further down the road – find out as much as you can about feeding your baby, as soon as you can. It can feel daunting, but even a little bit of knowledge of what to expect will help.

Follow the Breastfeeding Network and Association of Breastfeeding Mothers on social media, and check out their websites – they have so much amazing information available. They also jointly run the National Breastfeeding Helpline – save the number in your phone, and call them whenever you need to speak to a mum who’s been there, and has been trained to help you out.

There are some really helpful books out there – head to the library if you don’t want to buy your own copies. Ask your midwife or health visitor about support available in your area – make a note of where drop-in groups are held, which days they run and contact details for the organiser. Consider checking them out before the baby arrives – if it’s a face to face group, at least you’ll know where you’re going if you need to pop along again with a baby in tow.

As previously mentioned, under the current circumstances many groups are now online and are offering virtual support – from the comfort of your own sofa! Arm yourself with the knowledge that breastfeeding may be difficult in the beginning, but that most issues can be resolved. Perhaps most importantly, make it clear to your family and friends that breastfeeding is important to you and that you’ll need their support. Make sure everyone is on the same page.

We all have a part to play in creating a society that supports breastfeeding. Look out for your breastfeeding friends and family members. If they’re struggling, don’t reflexively tell them it doesn’t matter – ask them what support they need. You could also write to your MP, asking them to attend meetings of the APPG on Infant Feeding, to help make sure infant feeding support is on their agenda.

You don’t need to be an all-knowing guru, or be blessed with a magical talent for feeding babies. There’s no flashy product or clever gadget to buy. Just knowledge, kindness, support, perseverance.

For most of human history, it would have been passed to you by your mother, your sister, your aunt, your friends – cultural shifts mean that this is often no longer the case, so we can all step up to fill the gaps. A little information can go a long way towards helping to achieve breastfeeding goals – whether that’s feeding for a week, a month, a year, or longer.

As I finish writing this, I’m so grateful to everyone along the way who has supported my breastfeeding journey, and allowed me to reach a point where I can type with one hand while my baby nods off during his bedtime feed.

The midwives on day 1 in hospital; my husband helping me stick to my guns through the tough bits; my breastfeeding friends who gave me tips; the peer supporter who went above and beyond to help me; the tutors and supervisors who trained me and taught me so much (not just about breastfeeding!); and, through it all, my two sons who have somehow shown me the ropes even while learning alongside me.

I obviously couldn’t have done it without them, and I’m so proud of what we’ve achieved together. Even if they do leave Weetabix in my hair.

31 Jul

Victoria’s Positive Peer Support Experience

I feel very lucky that I had my baby pre lockdown, as I was able to access the face to face support from infant feeding specialist, BFN volunteers and peer support workers.

My first baby was born just before Christmas 2019. I planned a hypnobirth, because I wanted a calm drug free delivery. Unfortunately, my waters were low, when I went for a scan just before and everything changed.

Between Monday and Wednesday, I had multiple interventions ending with me attached to a hormone drip. By Thursday morning I was only 3 cm dilated, my baby was in distress and I had spiked a temperature of 40 degrees. My baby was finally born by emergency caesarean. I was gutted.

My baby girl was put on my chest briefly, then whisked away to neonatal. We were both treated for sepsis and had cannulas fitted – which was very uncomfortable for us and for feeding. I worried about hurting her and I was in pain because of my surgery.

To be honest, the hospital offered no specific breastfeeding support – and some of the midwives showing me had never breastfed before themselves. One midwife suggested I use a rolled up towel under my ‘pendulous” breasts’ but the sister in charge told me off for doing this.

Then my baby lost weight and I was pressured to cup feed. It was a very bad experience and I felt at a loss. I was desperate to get out of hospital and get the breastfeeding support I needed in comfortable and familiar surroundings. Once I was allowed home (on a feeding plan a week later)

I had a breastfeeding peer support worker come to my house and spend over an hour with me working on positioning and attachment. She suggested tongue tie and I got a referral to the hospital where they said there was no tongue tie. But I was still experiencing issues and painful nipples.

When my baby was two weeks old, I attended the BfN Bolsover breastfeeding support group and the support they gave was outstanding. To hear similar experiences from other mums was great. I cried the whole meeting. They offered me cake and comfort.

I finally got a referral to an infant feeding specialist, who came to the house and confirmed that my baby had a posterior tongue tie. When my baby was 6 weeks old, we got her tongue tie released. I also got advice on positioning, and attachment which really helped.

All this time I continued attending BfN support group at Bolsover, then the new Chesterfield support group that opened. By the time baby was 10 weeks old, I was no longer experiencing pain! I was so relieved.

During lockdown I have still been able to access support on the phone from national breastfeeding helpline, health visitors and weekly zoom video calls with bfn support groups.

I can’t bare to think if I’d had my baby during lockdown. I don’t imagine I’d still be feeding now. It makes me sad to think there are women out there struggling without the hands on face to face support.

BfN peer support volunteers helped me with so much – with positioning and general confidence boosting. My husband came to the groups too, they helped him as he felt like a spare part until then!

My baby is now 7 months old, exclusively breastfed and I’ve even mastered feeding her in a sling! Thank you!

Victoria and baby Alessia

10 Jul

National Breastfeeding Helpline – Summer Update

Last time I wrote an NBH update, we were in the very early stages of our response to the Covid 19 crisis, but already I had been amazed at how our helpline volunteers had responded.

I can honestly say that over the last couple of months, they have continued to step up and do so much to meet increased demand for helpline support.

As lockdown was announced in March we applied to SERCO (one of the NBH funders) for additional funding to help us meet the need for remote breastfeeding support. They approved our request and we quickly used this to set up a voicemail option on the helpline.

So now if callers are unable to get through when they ring us, they have the option to leave a message, and one of our fabulous team of (paid) voicemail supporters will call them back as soon as possible. This intervention has meant that we are now able to either answer or give the option to leave a voicemail to every caller to the helpline during opening hours.

We have some amazing statistics from April and May. Over those two months alone, our volunteers answered over 3000 calls! They spent over 1015 hours actually in calls (112% increase on this period last year). So not only are we answering more calls, we are also talking for longer – the average call length has increased as well.

In addition to this, our voicemail team have returned nearly 700 voicemails since the 23rd March when this feature was introduced. As well as our voice support, we have also answered 455 web chats and we have responded to 553 social media messages – a 48% increase on the same period last year on social media alone!

All of this during a time when everyone’s lives have been turned upside down – volunteers, like everyone, have faced uncertainties about work and income, kids suddenly at home all day needing help with home schooling, emotional worries about their own health or that of family members and friends.

It’s been a truly challenging time but the amazing effort that our volunteers have put in on the helpline, web chat and social media has shone through and created a real beam of positivity.

We’ve also had more opportunities during lockdown to get together virtually which has been lovely – we’ve had virtual breakfast get togethers, a virtual afternoon tea celebration during Volunteers Week, plus online Zoom chats to allow volunteers to discuss issues that are important to them. It’s been lovely to see so many people attending these virtual events.

The thousands of families our volunteers have supported during this period will remember them forever. I want to say a massive thank you so much to every single volunteer for being there for other families during this time.

Felicity Lambert, NBH Manager

Some quotes from callers:

“Throughout lockdown accessing breastfeeding support has been really challenging, however I am very grateful for the knowledge, passion and empathy shown by the volunteers at the National Breastfeeding Helpline. Thank you very much!”

“This call has been a blessing I think I was meant to talk to you, I was ready to throw in the towel but after speaking to you I feel so reassured, the information you have given me is gold dust thank you so much.”

“I first rang when my baby was 3 days old and things were not going well. You kept me going. A huge thank you to all of you, you are a very special lifeline to new mums like me right now.”

“Surprised to be able to speak online with someone on a Sunday after 8pm but truly grateful.”

“I am so very grateful to be able to access support from you and grateful to you volunteers for giving up their time to help. The volunteer was able to answer all of my questions and was so helpful. Thank you again.”

The National Breastfeeding Helpline is run in partnership between the BfN and the ABM. The initiative is funded by PHE and the Scottish Government. All calls are answered by trained volunteers, working in their own homes, using a virtual call centre. The helpline offers evidence based, non judgmental, friendly information, reassurance and support and is open every day of the year from 9.30am-9.30pm on 0300 100 0212. Support is available in Welsh and Polish on the same number.