26 May

Breastfeeding and Exercise

As we come towards the end of Move in May 2022, we are reflecting on the challenge undertaken over the month by many people. 

We are often asked questions about exercising while breastfeeding, and want to share some evidence-based information so you can make the right decisions for you and your baby when it comes to exercising. 

Can you exercise when breastfeeding?

Yes, absolutely. Perhaps not while you are actually feeding baby(!) but exercising is a great way to improve and maintain your physical and mental health.

How soon after birth can you exercise?

We recommend you follow advice given by your GP or midwife, as circumstances can differ based on your birth experience and physical health.

Generally, pelvic floor and tummy exercises can be started within days as well as gentle walking, getting some fresh air with your baby is a great way to get out in those first few weeks.

After your 6-8 post-natal check-up, your health professional will be able to advise what is suitable for you going forwards, so do wait until this health check before you start any high-energy or high-impact exercise like running or aerobics.

Start slowly and build up rather than jumping in, your body has spent 9 months growing a baby and needs time to recover. The newborn stage can be a time of big adjustment and some challenges, so don’t put any pressure on yourself to get back to a pre-baby figure, fitness level or physical health.

Are any types of exercises off-limits?

As long as you feel physically able and are not experience pain or discomfort while exercising, there are no exercise types that should be off-limit while you are breastfeeding.

Some people find it helpful to follow specific post-natal exercise or training programmes as they are tailored more specifically to the recovery needed after pregnancy and birth.

Does it have an impact on your milk supply?

There is no evidence that normal levels of exercise would affect your milk supply. You may find that baby may be a little fussy at the breast due to excess salt in mothers sweat if feeding soon after exercise. A quick shower or wash will help to remove the excess salt.

Strenuous exercise has been shown, in some studies, to lead to a temporary increase in lactic acid levels in human milk – some mothers report their baby is fussy for a while afterwards but they do not report any effect on their milk supply or their baby’s growth.

What should I wear to exercise while breastfeeding?

Anything you feel comfortable in! Try to pick lightweight fabrics as you may feel warmer from the physical activity, and a good sports bra is often desirable to help you feel secure. Some parents choose to purchase post-natal / nursing sports bras, and it’s important that these are a good fit for you – your back and cup shape is likely to change between pregnancy and a few weeks into breastfeeding so be aware of this and check you are wearing the correct size.

When should I feed my baby if exercising?

You may feel more comfortable feeding your baby before you exercise, so you don’t feel ‘full’ while undertaking physical activity.

If you are incorporating your baby in your exercise regime e.g. baby yoga, a sling/carrier workout or a buggy fitness class, it’s best to make sure your baby has around 20 minutes between the end of the feed and the start of the exercise. This helps their stomach to settle and start digesting the milk – the same as we wouldn’t exercise directly after eating a meal!

We hope you find this information helpful to assist in your decision-making surrounding exercising while breastfeeding. Further information and references for this article can be found using the following links: 

Keeping fit and healthy with a baby – NHS (www.nhs.uk)

Exercise – La Leche League International (llli.org)

Breastfeeding and diet – NHS (www.nhs.uk)

 

We want to thank Claire at Natal Active for co-authoring this article as part of our Move in May 2022 campaign.

26 May

Running ‘Top Tips’ by Ashford Striders running club

Ashford Striders is a friendly, not-for-profit running club based in Ashford, Kent.  We meet twice weekly and offer a number of different runs for varying abilities, from complete beginners to marathon runners to triathletes! All money from membership is invested back in to the club, including social events, training our run leaders, as well as other events too.

We asked our members for their top tips when it comes to starting exercise or running. Here’s what they had to say…

“My top tip: Find a running partner or group to keep you motivated!”

“Follow a plan such as Couch 2 5k so you don’t do too much too soon and injure yourself!”

“If you are struggling to increase the distance you run – slow down! If you can’t run more slowly, put in regular walk breaks!”

“Highly recommend going to parkrun, even if just 1 lap and/or jog/walk, that’s where I started.”

“Correct shoes!”

“Try not to eat within 2 hours before to help avoid a stitch”

“Try not to hunch or slouch – keep your head high and look ahead!”

“If you do pursue running, try to cross-train, i.e. the gym, HIIT workouts, cycling etc. as this will improve your running.”

“Don’t compare yourself to others!”

“Embrace bad weather, skin is waterproof!”

“Make sure you stretch after a run.”

“Always wear SPF when running outside!”

“Most of all though, enjoy it!”

If you are local to Ashford and would like to come along for a free trial, please visit our website www.ashfordstriders.uk for more information.

Thank you to Ashford Striders for supporting with our Move in May campaign, contributing this blog post as well as a virtual run with warm-up and cool-down videos. 

05 May

Move in May: our Community Champions experiences so far

Our community champions have got off to a strong start with being active for 30 minutes every day in May.
Here, Cara and Jessica share what they have been up to with their families over the first week of Move in May.

‘We are four days in to Move in May and I am loving the conversations it is prompting in our house, particularly with my four year old. We have been speaking about the importance of moving our bodies and getting fresh air.

Most of the time he is very keen to get involved but, as you can see, he does get tired occasionally!’

– Cara

So far my first week is going ok. Since me and my little one had Covid 3 weeks ago, my energy levels and my mental health have taken a big dip and suffered a lot. This is also another reason why I wanted to take part in Move in May, it’s amazing how even 30 minutes of activity can all help with the recovery process.

On Sunday 1st May, me and my little one had an hour dance-athon to 80s music in our living room as the weather was rather miserable. Then on bank holiday Monday, I decided I would try out my new weighted hula-hoop and give my kids a good giggle. The next morning my hips were pretty sore but we managed a 2 hour walk along Port Solent and Portchester Castle which really helped with clearing my head. There’s something about walking and just listening to the sounds of birds, water etc. that’s so therapeutic. 

I’m looking forward to more activities and plenty of walking over the next few days and weeks and what’s best is I get to do it all with my little teddy

– Jessica

If you haven’t yet started Move in May, or haven’t signed up, there’s still time to join us! By signing up, you’ll get access to our exclusive live-stream workouts as well as weekly emails, updates, tips and more! 

Register here

21 Mar

World Down’s Syndrome Day: Breastfeeding a Baby with Down’s Syndrome

Sarah is the breastfeeding lead for Positive About Down Syndrome, as well as a volunteer supporter for BfN and the National Breastfeeding Helpline, and mother to Zephaniah. Here she gives information about World Down’s Syndrome Day, and how to support breastfeeding a baby with Down’s Syndrome. You can read more of Sarah and Zephaniah’s story on Sarah’s blog, Chromosomes and Curls.

March 21st is World Down’s Syndrome Day. Its part of trisomy awareness month and the date 21/3 is significant to represent 3 copies of chromosome 21.

Each year has a theme and this years theme is ‘Inclusion Means’. What does inclusion mean to you? It often conjures up images perhaps of education/schooling/work place/friendship groups/clubs. However inclusion starts earlier than that at birth and one way to ensure inclusion for babies with Down’s Syndrome is by making sure families get the individual support they need when it comes to their feeding choices. For families who want to breastfeed they can often face negativity right from the offset. Many parents report being told by medical professionals that babies with Down’s Syndrome cannot breastfeed or probably won’t be able to, which along with not being correct, can be hurtful and damaging the breastfeeding relationship. 

For supporters, there is much that can be done and be considered in order to facilitate an inclusive feeding journey for families. Here are some tips when supporting families who have a baby with Down’s Syndrome.

  • Say congratulations! In the same way you would congratulate any new parent. Don’t say things like ‘I’m sorry….’ ‘Oh no….’
  • Make a safe space for the parents. They may have had a prenatal diagnosis and have had weeks or months to adjust to their unexpected news, or they may have found out postnatally, so whilst promoting positive language, it’s important to let them safely sit in their feelings which could range vastly from parent to parent. Avoid leading with intrusive questions around whether the family had any prenatal testing unless they raise it and want to talk about it of course.
  • Back to basics. As with any baby start with position and attachment. Along with some issues that may occur as a result of the baby having Down’s Syndrome, the baby and mother will still face the same challenges as anyone else so those should be worked on and eliminated first. Often the usual challenges are overlooked and then blame is placed on the baby having Down’s Syndrome. This is called medical overshadowing. 
  • Language matters. Avoid using the terms ‘downs baby’. Within the Down’s Syndrome community a person first language is preferred so ‘a baby with Down’s Syndrome’. Also avoid making generalisations about babies with Down’s Syndrome as with any baby/child they are their own person. There are some fantastic language cards available at https://www.languagecreatesreality.com
  • Recognise that it can in some cases take longer to establish breastfeeding in a baby with Down’s Syndrome and sometimes there is a journey involving tubes, bottles, pumping etc before transitioning to feeding directly from the breast and some people continue to use expressed breast milk. It often takes up to 3 months to establish feeding directly at the breast and I’ve seen it as late as 6 months.
  • Familiarise yourself with common issues that babies with Down’s Syndrome face such as low muscle tone, tiredness etc.
  • Make sure the baby’s red book has the correct Down’s Syndrome insert with the separate growth chart to avoid any concerns over weight gain. 
  • Have signposting information to local or online support groups available. It can often be a lonely and confusing time and from experience families sometimes feel alone and isolated, so to have someone to signpost them at this stage is so valuable. 

Here at Positive About Down Syndrome we have created a lived experience leaflet sharing peoples breastfeeding stores. You can find that here 

https://positiveaboutdownsyndrome.co.uk/breastfeeding/

We also have support groups on Facebook for expecting and new parents. 

Pregnancy: https://www.facebook.com/groups/dsukpositiveaboutdownsyndromegreatexpectations/

New Parent: https://www.facebook.com/groups/padsnewparents/


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09 Oct

Guest Blog: The story of a grieving mother – written 3 weeks postpartum.

Content warning: baby loss/stillbirth/lactation after baby loss. There is a photo at the end of this post.


You spend time preparing for them. Studying childbirth, hypnobirthing, breastfeeding, harvesting colostrum, bouncing on the birthing ball, helping encourage baby into the correct position, buying all the essentials you require and all the ones you desire. 

When I heard those words – there is no heartbeat – my world fell apart. I did not expect to find joy in the days that followed and yet I did. 

Upon hearing those words you enter a whole new world of information – there are new rules. 

Rules I did not study – trusting the health professionals around me to educate and guide me. Trying to digest what I could while adjusting to navigating this new landscape. 

I was 39 weeks pregnant, having regular false starts to my labour and desperate to meet my baby soon. Unable to walk far with pelvic girdle pain and all the usual aches and pains you get in the third trimester, I was ready. I was harvesting colostrum just in case – my first son had to go to special care at birth, missing the golden hour and having to agree to formula if required. While donor milk is now available, expressing helped give me a purpose. I was preparing for my baby in every way I knew how. 

While we knew that we had lost our baby – he still had to be born and the drug options were slightly different than what we covered in my antenatal class. While I was induced the amazing midwives did what they could to keep my labour as non medicalised as possible. I discussed my wishes to be mentally present – knowing how precious meeting my sleeping baby would be and my pain relief options were discussed in relation to my needs. 

I should add that the second you lose your baby – you get 5 star treatment. Everyone wants to help in any way they can but no one can bring your baby back so they give you all the comfort and support they can. Thanks to the charity Simba and the staff’s amazing fundraising the labour rooms are amazing and kitted out. 

Some women say they prepare more for birth than the baby. This was so true for me. It also feels cruel to birth a baby who you know you have lost – however this process was extremely cathartic for me and I was able to heal some wounds from my previous labour. 

I expressed the wish to save some milk to make into jewellery – as a memento, perhaps with a lock of his hair. A kind midwife suggested I could express drops of colostrum and put them onto R’s lip as a gesture. I was keen not to miss any opportunities and make all the memories I could.

Other midwives were concerned that expressing would encourage more milk to come in – how would this affect me and could it cause mastitis?

I also got offered some medication to help suppress my milk –  not being in a place to think straight, my friend advised me to check the side effects. We had learnt the BRAIN acronym in antenatal class and unable to decide I stuck to the N for ‘do nothing’. Breastfeeding my firstborn had been such a challenge and I was so convinced I would be better educated this time. Whether to suppress my milk with meds was the first real CHOICE I could realistically say no to. 

I was hesitant to take any drugs I didn’t have to. I had just spent 9 months nauseous so why would I take a drug that I didn’t have to with that side effect? 

My caregivers were concerned – a postpartum Mum grieving her baby with her milk coming in. Would that be too much? I knew my boobs though – oversupply was not a problem I had previously had. I also wasn’t afraid of milk. 

In the days that followed I expressed small amounts and had the support of a BfN mothers supporter and other midwives, who reminded me babies feed 12 times a day. Expressing once a day was not going to cause big problems. Expressing my milk felt good, I was and am so proud of my body. This was the right choice for me. 

Sadly I was unable to donate to the milk bank due to my medication but I know some other mothers who have successfully donated following baby loss and found great comfort in this. 

There are lots of firsts I have missed out on with my baby, but the precious memories will stay with me forever. Breastfeeding creates a bond between mother and child and by producing milk I was able to fulfil part of my mothering need.

Hannah Inman


This guest blog by Hannah Inman was posted as part of Baby Loss Awareness Week 2021.

If you or someone you know needs support with lactation following the loss of a baby (whether choosing to express milk or stop the supply), the following links may be helpful:
https://www.llli.org/commonly-asked-questions-about-lactation-after-loss/
https://kellymom.com/bf/concerns/mother/lactation-after-loss/

Alternatively you can call the National Breastfeeding Helpline, where our trained volunteers can offer support and information.

27 Sep

#BfNConf21 Guest Blog: Breastfeeding, Peer Support and Perinatal Mental Health

Smita Hanciles writes of the need for more cohesive support encompassing breastfeeding and perinatal mental health services. For more on this subject, come along to the BfN virtual conference on 2nd October, where Smita will be giving a presentation. Click here for full details and tickets.

Up to 20% of new and expectant mothers experience a perinatal mental health (PMH) problem. Depression and anxiety disorders are the most common, affecting 15% of women. However, these figures pre-date the pandemic during which women and their families faced extra pressures on their mental health, including anxiety about giving birth during lockdown.

In January 2016, the Five Year Forward View for Mental Health outlined plans that led to an expansion of specialist community PMH services to work with women experiencing moderate to severe illness.  In February 2019, the NHS Long term plan built on this commitment with the aim of ensuring that women in all parts of the UK have access to specialist community services and inpatient mother and baby units and extending service provision up to 24 months after birth.  It is hoped that by 2023/24, at least 66,000 women with moderate to severe PMH difficulties can access care and support in the community.  This will account for around 10% of women giving birth.  However, some women experiencing difficulties may not disclose symptoms, others may not reach the threshold for referral to these services and even those that are referred may need continued support when they are discharged. Peer Supporters could provide crucial support to these women especially when integrated within universal services.

All women will be feeding their babies regardless of their mental health status and will have feeding assessments carried out by maternity and health visiting services and some will access peer support services for help with breastfeeding challenges or social and emotional support. What role do these services play in supporting the mental health and emotional wellbeing of mothers?  A recent evaluation of the Camden Peer Support service showed that parents reported improvements in emotional wellbeing when receiving breastfeeding peer support even when this was only available via online groups and video calls. Peer support reduces social isolation which is a risk factor for mental ill-health and it also provides listening support and a safe space where women may disclose symptoms or talk through difficult birth experiences. 

If feeding difficulties are playing a part (as is often the case) in how a mother is feeling, then resolving these issues may also be helping to prevent escalation of symptoms of anxiety and depression in new parents.  But the often-complex interrelationship between infant feeding and perinatal mental health is frequently overlooked as services supporting each have developed quite separately from one another. There can be a perception in PMH services that breastfeeding will add unnecessary pressure and hinder recovery from perinatal ill-health, or staff may want to help protect breastfeeding when it is important for the mother to do so but lack the training and skills to enable this. Multi-disciplinary teams within PMH services now include 8 new roles including Perinatal Peer Support workers with lived experience of perinatal ill-health but there are no specialist or peer support roles that focus on Infant Feeding. 

Perinatal Peer Support workers are also being recruited as part of Maternal Mental Health Services that are being set up to integrate maternity, reproductive health and psychological therapy for women experiencing mental health difficulties directly arising from or relating to the maternity experience. Support will be provided for PTSD following birth trauma, baby loss or fear of childbirth and pilot schemes are underway to build the evidence base and identify replicable models. Could this be an opportunity to pilot the impact of including access to specialist infant feeding and breastfeeding peer support within these services? Increasing numbers of women are living with the painful emotions that come with trying very hard to breastfeed but failing, usually due to lack of timely and consistent support.  Any attempt to promote breastfeeding where so many have been failed by an inadequate system is like trying to cross a field littered with mines. Information will be perceived as judgement or pressure and any celebration of breastfeeding could re-trigger painful and traumatic memories. As there is a move towards implementing a more trauma-informed approach to care in the perinatal period, it is necessary to recognise that healthcare teams and peer support workers can potentially exacerbate their own birth and breastfeeding trauma histories when supporting families which can create unconscious bias. How do we build supportive structures for individuals providing care to those experiencing distress related to breastfeeding difficulties and perinatal mental ill-health?  How do we diffuse the emotional land mines to make way for meaningful discussions about the need for investment in Infant feeding support and training across all services that women access in the perinatal period?


If you’d like to see Smita’s presentation (and much more!) at the BfN Conference on 2nd October, please click here for information and tickets:
https://www.breastfeedingnetwork.org.uk/2021agmconference/

#BfNConf21


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14 Sep

Dr Wendy Jones: Drugs in Breastmilk

One of the founding members of BfN, Dr Wendy Jones MBE has been supporting breastfeeding families for more than twenty years. As she heads towards her retirement, she reflects here on her time with BfN, and will give a presentation at our virtual conference next month.


Twenty-three years of providing information and support on the compatibility of medication in mother’s milk has brought about many changes, not least in expert sources available. This past year has brought many challenges for women, particularly when not able to see medical professionals face to face. So often mothers forgot to mention that they were breastfeeding, and doctors forgot to ask when prescribing over the phone.

The Drugs in Breastmilk information service was able to fill in those gaps on so many occasions. There was also a difference in the questions mentioning anxiety and depression (already one of the most common questions) increasing further. COVID and isolation affected us all. Not having the simple meetings where breastfeeding issues are normalised were missed opportunities for mutual support. I know because my daughter had a lockdown baby and as clinically vulnerable myself I wasn’t able to be there to support. FaceTime isn’t quite the same although still invaluable.

But over the past few months I have been joined by a new team of wonderful pharmacists (all registered breastfeeding Helpers) who can share the responsibility of the high volume of social media contacts. I’m looking forward to continuing to develop resources on my own website (www.breastfeeding-and-medication.co.uk) and Facebook page, whilst supporting the dream team on WhatsApp when needed. I’m also going to enjoy more time with my family – two and four legged.

No two days answering questions on the safety of drugs in breastmilk are the same, but everyone matters because behind it is a mum trying to keep her baby safe.


If you’d like to see Wendy’s presentation (and much more!) at the BfN Conference on 2nd October, please click here for information and tickets:
https://www.breastfeedingnetwork.org.uk/2021agmconference/

#BfNConf21


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19 Aug

#BfNConf21 Guest Blog: 10 Things You Don’t Expect About Nursing Aversion

Zainab Yate explains the often complicated phenomenon of nursing aversion. To hear more, come along to BfN’s annual conference on Saturday 2nd October, where Zainab will be giving a talk entitled, “Help! Breastfeeding Makes Me Feel Sad, Mad and Bad.” Tickets for this virtual event are available here.


Many mothers and those who support them do not know that they can experience negative emotions associated with breastfeeding. In modern society breastfeeding is often used – problematically – to exemplify myths about motherhood and maternal love, and is bound up with ideas of what makes a ‘good mother’. In this context nursing aversion and agitation – intense, distressing feelings that are experienced by the mother during breastfeeding – can be both unexpected and hugely upsetting, particularly when women may have already overcome significant challenges in order to breastfeed. In a new book on the subject, When Breastfeeding Sucks, Zainab Yate examines what we know about this poorly understood aspect of infant feeding. Here she sets out the 10 most common misconceptions…

1. Breastfeeding mothers who experience aversion do not always want to stop breastfeeding!

Breastfeeding or Nursing Aversion (aversion) is when breastfeeding appears to trigger particular negative emotions like anger and agitation, skin-crawling sensations and an overwhelming urge to de-latch. You can also feel like a prisoner when breastfeeding or have thoughts of pushing your nursling off you and running away. Although it creates an emotional burden for mothers, and a strain on their breastfeeding relationship, mothers do not often want to ‘just stop breastfeeding’. What most of them desperately want is for aversion to go away.

2. Aversion can strike at any point in any breastfeeding mothers journey.

Whilst many in the infant feeding and mothering world knew that aversion can strike when a mother is breastfeeding while pregnant or when she is feeding an older nursling, it can actually happen at any point in a breastfeeding journey – with some mothers experiencing it at the newborn stage. Even though there is a strong argument that aversion is a natural biological trigger to start the weaning process in older nurslings, if you experience aversion and your nursling is under 12 months old, milk is their main source of nutrition so it is best to seek advice from an infant feeding specialist.

3. One reason for aversion could be oxytocin!

In some mothers, it is possible that they have a negative association to breastfeeding, whether it is due to being a survivor of previous sexual abuse, childhood trauma or simply because the start of their breastfeeding journey was very painful or challenging for many weeks, even months. I argue that these can cause a stress response due to the oxytocin, instead of loving, calming feeling it is well known for when breastfeeding. This is because oxytocin actually plays a role in stress regulation, and can cause fear and stress in negative experiences as it activates a part of the brain that intensifies the memory.

4. Some mothers self-harm in order to continue to breastfeed through aversion if they find breastfeeding painful.

This is known as the gate control method, a scientific theory that asserts the activation of nerves which do not transmit pain signals can stop or interfere with signals from pain fibres. So digging your nails into your thighs or biting down on your hand can inhibit the perception and therefore the sensation of pain in your nipple when breastfeeding. Many mothers in this predicament seem to instinctively do this. This would be a particularly severe level of aversion, as aversion can be experienced on a spectrum. If you feel like this, please seek advice from a health care professional or infant feeding specialist.

5. Aversion is different from Dysphoric Milk Ejection Reflex (D-MER)

D-MER is a medical condition that can be diagnosed in a breastfeeding mother when her letdown causes her to feel negative emotions like despair, despondency and hopelessness. It lasts a few minutes and is dissimilar to aversion as the latter can last throughout a whole feed, whether it is 2 minutes or 2 hours – like the breastfeeding-to-sleep-marathon that can happen at night. Mothers can, however, experience both, and I believe if you struggle with D-MER you are more likely to experience aversion due to the added difficulty you experience when breastfeeding.

6. Misdiagnosis can occur with aversion.

Some mothers have sought help and advice from their doctors about their aversion when breastfeeding, but because some of the symptoms of negative emotions are similar to post-natal depression, and because they have just had a baby, health care professionals had wrongly assumed they must be post-natally depressed. If you are otherwise managing fine in day to day life and your emotions, and your difficulty with breastfeeding is just when your nursling is latched, or if anti-depressants the doctor prescribed you do not help your aversion, return back to your doctor and asked for proper screening, assessment and support.

7. Weaning and stopping breastfeeding can be just as hard as carrying on!

Breastfeeding cessation can be very difficult for mothers with aversion because of compounded guilt and shame that they experience in the aftermath of their negative emotions. Even if breastfeeding mothers who experience aversion do decide to wean, many can be surprised at how difficult it is to wean, both practically (if they have a particularly boob-attached nursling), and emotionally, as mothers have to process the feelings of guilt and shame around the negative emotions, and separate that with the guilt of stopping. Understanding that aversion is actually a reasonable response to an intolerable situation, what can alleviate or lessen aversion, and what the weaning process entails can help you get through it.

8. Mothers with aversion fear they are harming their nurslings

So many mothers I support are concerned about having aversion when breastfeeding – that it will harm their nurslings because of the nature of the emotions – but there is no evidence to show this happens. Whether it is feeling stressed or angry when breastfeeding, or even weaning earlier than you or your nursling want due to severe aversion, there is no evidence to indicate there is any long term harm caused to your nursling due to this. We all know the benefits of breastfeeding both mentally and physically as there is a lot of research about this, but we must understand these facts in the context of the research. These studies and statements are about when breastfeeding is going well. With severe aversion and breastfeeding challenges, it is questionable whether all the benefits of breastfeeding and bonding remain, and we know the research shows that when breastfeeding is hard or painful mothers are actually more at risk of post-natal depression.

9. Aversion can lessen or even go away for some mothers

For mothers who figure out their triggers, make lifestyle changes, improve their sleep hygiene, eating habits or use supplements like magnesium, aversion can abate and for some, it disappears as quickly as it reared its ugly head. There is always something you can try, and accessing our free online structured support course on www.breastfeedingaversion.com, or our peer-to-peer support group ‘Aversion Sucks’ on Facebook to get tips and tricks from other mothers struggling can instantly help you deal with aversion.

10. You don’t get aversion with every nursling.

Sometimes mothers worry that because they experienced aversion with their first nursling they will automatically get it again, but this isn’t always the case. As I outline my biopsychosocial theory of the phenomenon of aversion in my book ‘When Breastfeeding Sucks’, I cover why some physiological, psychological and societal causes can mean you experience aversion. I believe forewarned is forearmed, and the second or third time around as a breastfeeding mother you know more and are more empowered to protect yourself against things that can compromise your physical and mental health and therefore to protect you against aversion.

This blog was originally published on www.breastfeedingaversion.com, and is reproduced here with the permission of the author.


Zainab Yate BSc, MSc (Medical Ethics & Law, Imperial College London, UK) is a biomedical ethicist, clinical hypnotherapist, independent researcher and campaigner. Zainab is vice-chair and named qualitative lead of a London Research Ethics Committee, with the Health Research Authority (HRA) and has a background in public health and commissioning with the National Health Service (NHS). She published the first peer-reviewed study looking specifically at breastfeeding/nursing aversion and agitation in 2017 and has published the only book on the topic with specialist publishers Pinter & Martin, London. Zainab has been a breastfeeding peer supporter with the NHS for a number of years and is the owner of the only resource site for mothers and healthcare practitioners on aversion (www.breastfeedingaversion.com), she has helped tens of thousands of women and families when breastfeeding triggers negative emotions – both Dysphoric Milk Ejection Reflex and aversion, through her advocacy, free structured support course and peer-to-peer support groups.


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17 Aug

Breastfeeding through cancer treatment: with help from the Drugs in Breastmilk Information Service

Breastfeeding peer supporter Hannah was diagnosed with bowel cancer in 2020, and was repeatedly told during treatment that she would have to stop or avoid breastfeeding. Thanks to the BfN’s Drugs in Breastmilk factsheets (as well as her own determination and self-advocacy), she was in fact able to continue safely feeding both of her children throughout. Here’s her story.

I’m Hannah. I trained as a breastfeeding peer supporter with Home Start in Sheffield in 2017 (though this centre has sadly now closed). I breastfeed both of my children (aged 4 and 1). I had come to hear about the Breastfeeding Network early on in my parenting journey – I was on various breastfeeding support forums on Facebook, and BfN’s drugs factsheets were shared a lot whenever someone had a question about breastfeeding and medicines.

In late 2020, I was diagnosed with bowel cancer after waiting 5 months on a waiting list due to the pandemic. I always thought I had bowel cancer but doctors had convinced me it was IBD. I walked into the room for my colonoscopy and said “I think it’s cancer.” The doctor replied, “That’s very unlikely at your age.” But sure enough, within a few minutes of starting the procedure, the atmosphere in the room changed. I was in agony, I knew something was wrong. I was wheeled into recovery and left on my own. I glanced at the report lying out on the table next to me, where under the findings heading, it said Colorectal cancer, 40mm. My heart sank. It’s a horrible feeling to be right all along. It was devastating as my youngest child was only 7 months old, and I feared I would have to wean her.

After that, things moved quickly. Scans confirmed the good news that it was operable and contained in the bowel, and I met with the surgeon the following week. I had to make a difficult decision to remove 80% of my colon to prevent future cancers. I used the BfN fact sheets to check that it was safe to feed after my CT scan, since staff in the CT unit had no idea what was ok for breastfeeding. At my surgeon’s appointment he mentioned I’d have to stop breastfeeding for 24 hours after surgery – thanks to the detailed factsheet on anaesthesia, I knew it was safe to feed after general anaesthetic. So I proudly stood up and told him he was wrong.

When my letter came through for admission, the anaesthetist had also written a note to say I should stop breastfeeding after surgery. I was a bit disappointed that yet another member of staff had asserted incorrect information. I printed off all the factsheets on anaesthesia and pain relief and brought them with me, so I was fully armed to defend myself when I was admitted for surgery a few weeks later. I was very lucky that I didn’t need them, as a different anaesthetist greeted me that morning, and told me it was perfectly safe to breastfeed after surgery. He discussed options for pain relief and had designed postoperative pain relief that lessened the need for morphine in my blood stream. Despite covid restrictions and worsening case numbers, the hospital kindly allowed my then 8 month old baby and husband to stay in the hospital with me. I pumped a sippy cup of milk before I went to theatre and returned 7 hours later free of cancer. Baby survived on snacks but hopped straight back on the boob as soon as I returned. I was discharged 4 days later but I was back in hospital 6 days later.

This is where the factsheets really came to my rescue. I ended up in back in hospital with extreme stomach pain and high fever. The new join in my bowel had leaked gas into my abdomen and it had caused a huge infection. I needed antibiotics. When the doctor arrived with the antibiotics, I asked if they were safe for breastfeeding, and thankfully he answered honestly “I don’t know”. I said “let’s check then”, pulled out my phone and went to the factsheet on antibiotics. We scrolled the sheet together and identified both drugs and verified within seconds they were both safe. Thus I was able to start treatment quickly.

I was discharged after a week without need for further surgery and whilst in hospital received the good news that I was stage 2 bowel cancer and chemo would not be beneficial. Unfortunately I was separated from my baby for a lot of that time, due to a covid case on the ward, where I wasn’t allowed visitors for the last 3 days. Baby survived on artificial milk and food as well as expressed milk when I was well enough to pump. She never took a bottle, but drank from sippy cups and open cups, only taking around 30ml at a time. My supply was very low when I got home, but with the help of my milk loving 4 year old and the baby, my supply returned to normal after a week or so. 

Things I learnt about breastfeeding and medical issues:

  • If a healthcare professional tells you that you can’t breastfeed due to a medicine or medical procedure, don’t just take it at face value.
  • Do your own research, and check facts from reputable sources such as the Breastfeeding Network.
  • Ask for details of exactly what medicines or substances are being used on your body, you have a right to know and to verify their safety for breastfeeding.
  • If something isn’t safe, ask what other options there are. There are always options in medicine, even if one is clearly the best one. You have a right to choose what happens to your body.
  • Doctors and healthcare professionals are experts in their field but they are not often trained in breastfeeding. Do listen to their advice on your treatment, they only want the best outcomes for you, and sometimes stopping breastfeeding for treatment is the right choice.

I am eternally grateful to the Breastfeeding Network and their factsheets. They have saved me from much worry and uncertainty around all of my treatment and surgery, enabling and empowering me to keep doing the thing that gives me the most joy in my life (breastfeeding) during an extremely traumatic time.


You can find the Drugs in Breastmilk Information Service factsheets here:
https://www.breastfeedingnetwork.org.uk/drugs-factsheets/

If the medication or treatment you need isn’t listed, or you have questions, please contact the service directly. Email druginformation@breastfeedingnetwork.org.uk, or send a private message to the Drugs in Breastmilk Facebook page, and one of our team of volunteers will be in touch.


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09 Apr

Guest blog: Breastfeeding during Ramadan

BfN peer supporter and Camden Baby Feeding Team member Zamzam Elmi talks about her experience breastfeeding 4 children through Ramadan, and the decision she made each time. She also explores how we can best support Muslim mums to breastfeed during Ramadan, whether they decide to fast or not.

Ramadan Karim! May we all have a fulfilling and blessed month.

Firstly, I would like to say that Allah is aware of what you can bear or manage and will not expect beyond that.

Deciding on whether to fast or not is a tough and spiritually challenging decision to make especially knowing how blessed/special the month is, but we are fortunate that we have been given concessions by his mercy.

Remember that breastfeeding is a form of worship if done with right intention, and taking advantage of the concession is God given right to protect us and our babies.

Listen to your body and keep an eye on your baby if you do decide to fast, speak to a health professional if you have any concerns or worries. Also take your prenatal vitamin as levels of nutrients such magnesium, potassium and zinc may be affected.

Every drop of breast milk is reward gained and you can still gain more spiritually by reading the Quran and doing your dhikr whilst breastfeeding or bottle feeding. This is a lovely time to bond with your baby as well as lifting you spiritually and emotionally.

With all my children I did different things depending on the situation.

  • My first child was premature and I was expressing, so during his first few week of life I fasted some days and not others.
  • With my second child, I could not fast at all as she feed frequently. I made up the fast later once she was weaned.
  • As for my 3rd child, also exclusively breast fed, I managed to fast the full month with good preparation and knowing how to take care of myself whilst fasting.
  • With my 4th, I also fasted most days, and I gave fidya [feeding the poor for each day missed].

Supporting Breastfeeding During Ramadan

As peer supporters, we have great duty in supporting mums to feel empowered to achieve their goals by giving information so their decisions are informed. Supporting mothers during Ramadan is no different to helping mums reduce factors that may have a negative impact on their breast feeding or supply.

Things to consider are:

  • If a mum is fasting during the summer months (this usually an 18hr fast with 5/6hrs window to eat) she will need to drink little and often and during the times she is allowed to eat and drink.
  • Mums will need to eat high nutrient dense food such as date, fruits and nuts to help replace the magnesium, zinc and potassium levels that may reduce during fasting.
  • Avoid drinking too many caffeinated drinks and replace with water, fresh fruits juice, herbal teas and green smoothies.
  • If a mum is fasting during the winter months which can fall between 10/12hrs of fasting, this is much easier as the sunset is much earlier and they have a longer period to eat and drinking during dawn. So really its like having a very late lunch.

If a mum is exclusively breastfeeding and has a baby of 0-6months, its highly not recommended she fast at all, this is because of the increased nutritional demand. As I have done on many occasions, mums can make up the fast later or feed someone poor as a compensation but to also feel the spirit of Ramadan.

Some of the questions mums may have during Ramadan will be around supply and how best to protect it. Also, just as a reminder feeding support will not differ as the same information will apply when it comes to protecting supply and breastfeeding. Success in having enough to feed the baby depends on staying well hydrated, reducing stress and keeping breastfeeding as close/normal to when they are not fasting. If a mum is mix feeding, it’s important to give the usual information on how bottle feeds can impact the breastfeeding, as well as the fact that she maybe more likely to increase the bottle feeds to help cope with demand. It’s important she has the facts so she is aware of the possible risks.

We must remember to keep giving mum a safe space where they feel they have permission to come and talk through their decisions without judgment or fear of being misunderstood. This will help you protect the well-being of both mum and baby. Another question might be how do I know if I or baby are dehydrated? When should I seek help? It’s important to make sure a mum feels safe to come for support if her decision to fast has had an adverse effect on their health.

Muslim mums know they may be able to fast if theirs or their baby’s health is not adversely affected during that period of fasting. It’s good to remember they are well experienced in fasting and they come from a place of having knowledge of what its like.

For peer supporters who are not Muslim or who may not know much about Ramadan, it is imperative to keep in mind that choice should always be at the forefront of any breastfeeding journey and the support we provide will very much be based on an individual case by case basis. It’s also okay to say I’m not sure and signpost/refer mums to other sources for more information.

For more information on breastfeeding during Ramadan, click here: https://breastfeeding.support/breastfeeding-during-ramadan/

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