All content of this blog is my own opinion only. It does not represent the views of any organisation or association I may work for, or be associated with. Nothing within this blog should be considered as medical advice and you should always consult your Doctor.

70% of mums have felt pressure to stop breastfeeding.

Back in August I wrote the post "Guilt If You Breastfeed, Guilt If You Don't" - we hear a lot in the media about the "Breastfeeding Mafia" and how mums are feeling this overwhelming pressure to breastfeed and being "guilt tripped" if they touch breastmilk substitutes.  Now to me, given only 4% of infants are exclusively breastfed at 6 months - it doesn't leave very many people to create this all powerful mafia bringing 96% of mothers to their knees!  I personally think most of us are perfectly capable of guilt tripping ourselves when we read something that worries us, but anyway.  My feelings are that something very rarely acknowledged is the pressure a breastfeeding mother may face for not introducing a bottle or swapping entirely (as discussed in the article above) so I decided to run a poll:

Have you ever felt pressure to stop breastfeeding, or guilt for continuing?

Since August exactly 800 people ticked yes or no to the above question.

The Results:

70% Yes

30% No

Betcha don't read about that in the the mainstream media anytimes soon...

Natalie Cassidy - fame doesn't guarantee good breastfeeding support!

So it seems even fame can't guarantee you good support when it comes to breastfeeding if the latest offering from is anything to go by.  If what's quoted is true, not only has poor Natalie been badly let down, she then (innocently?) perpetuates a whole load of myths - made even worse by the fact Heatworld use the words "ick" and "eeeew" at the fact they are having to mention human milk, in breasts :O drying up. 
"Fact: Natalie Cassidy’s boobs have dried up. Really? Yes. Eeeeeeww….!
Far, far too much information, isn’t it? But the former Eastenders actress has been as candid as ever, letting everyone know of her most intimate of issues."

The beyond childish nature of this comment stunned me for a few minutes, was this written by a hormonal fifteen year old girl I wondered?  The sort who usually blushes at the utterance "breast" (let alone having to type it in an article). It continues:
"This time, she’s been speaking about how gutted she is to be forced into feeding her baby daughter, Eliza, from the bottle instead of by bitty because her breasts aren’t producing enough milk."
Yep, you read it right -  they do actually use the word "bitty" to describe breastfeeding.  I'm now thinking  actually perhaps it's a teenage boy?

But what's worse is that Natalie has been forced into bottle feeding - that is forced as in feels she has no other choice, rather than a team of armed health visitors turning up (just in case you were concerned).  Natalie's next words are telling:
"I'm just bottle-feeding now. I did six weeks but there wasn't enough milk, “ explains Nat Cass, “I was expressing and getting, like, half an ounce. There was just nothing there. My milk had just finished.”
"Just bottle feeding now" implies to me at least that she was perhaps mix/combined feeding both breast and bottle previously - which is one possible explanation for the next words of there was not enough milk.  Expressing isn't a reliable gauge of how much a mother is making - some mums really struggle to let down with a pump, particularly if they are given no support in using it to achieve optimum results.  I personally remember trying to express when my first was five weeks which resulted in only a few drops and a lot of tears!  Milk doesn't just "finish" after six weeks - once the body has been kick started to make milk, it continues to do so as long as the amount removed remains constant.  Sure there are rare cases such as severe shock/trauma that can inhibit milk letdown at least temporarily, but no mention of that here.

Far more common is the scenario where a bottle of formula or a top up is introduced - perhaps around that 6 week mark Natalie mentions, where baby has a huge "growth spurt" and feeds for England.  To a mum not in the know about these spells it very very easy to assume you're simply not making enough milk (BTDT got the shirt!)  so a top up is given.  Baby takes the bottle, appears to zonk and settle as he works to digest the foreign protein; perhaps resulting in a longer feed spacing and perhaps taking a little less at next feed.  After a few times maybe the baby becomes fussy at the breast, now annoyed at having to wait for letdown and so reinforcing to mum baby isn't content/getting enough there.  The supplements get bigger, time at the breast gets shorter and milk supply dwindles.

I decided to have a bit of a hunt and a further Google found this statement made 10th November:
“My adorable angel Eliza appears to have turned in to a little madam overnight. She’s demanding feeds all the time and has gone off my nipple because she has to work for her milk. She prefers it to be poured down her neck in a bottle. I think it’s my own fault for spoiling her in those first few weeks. On the plus side, Adam’s [Cottrell -- Natalie's boyfriend] mum Sheila is staying with us, so it’s lovely to have an extra pair of hands and reassurance that I’m doing things right.
“I was really upset because I'd have breastfed for six months if I could have,”
This is really quite sad, Natalie obviously wanted to breastfeed and yet like so many other mums has ended up at the mercy of the bottle.  Perhaps there was a transfer issue, perhaps supply was low and supplements needed - but with support things don't have to end,
"She drinks 7oz of milk every three and a half hours, like a six-month-old baby. She's really hungry! I loved it [breast feeding], but if you haven't got the milk, you can't magic it up."
Natalie is clearly suggesting she's not producing enough because she has such a hungry baby - but when breastfeeding it doesn't matter if your baby wants that amount at 6 weeks or 6 months, breasts makes it!  It doesn't gradually increase as the months go on and baby gets older - this is why the vast majority of mums with the right support can feed twins.

I'm guessing (hoping) Natalie doesn't mean every 3 1/2 hours day and night, as that would total a whopping 49oz of formula which seems rather a lot?  Perhaps Natalie meant "during the day" and there's a longer stretch at night.

Kellymom states:
In exclusively breastfed babies, milk intake increases quickly during the first few weeks of life, then stays about the same between one and six months (though it likely increases short term during growth spurts). Current breastfeeding research does not indicate that breastmilk intake changes with baby's age or weight between one and six months. After six months, breastmilk
The research tells us that exclusively breastfed babies take in an average of 25 oz (750 mL) per day between the ages of 1 month and 6 months. Different babies take in different amounts of milk; a typical range of milk intakes is 19-30 oz per day (570-900 mL per day).
As a final gem the article concludes:
"Now, seriously Natalie Cassidy… we’ll hold our hands up and admit that it’s a real issue that affects a heck of a lot of us new mums, but come on… some things we just don’t need to know about. Not whilst we’re eating our lunch, anyway! Ick…"
I think perhaps the last paragraph though for me was the most jaw dropping, as it included the words "us new mums" - and it hit me the person writing this with "icks" and "eeews" is a woman with a child!  Not a daft teenager who could be perhaps excused for thinking the word "bitty" is an appropriate term for breastfeeding.

Why not drop an email to give Heat some appropriate feedback for this piece?

Share your experience - Lisa D's Story

Isla Breastfeeding
I didn't read anything about breastfeeding before I had my first baby.  I just assumed it would happen easily, and didn't really involve more than getting your boobs out and popping the baby on. I never thought about all the anxieties, mostly irrational, about my ability to feed my baby. Most things simply didn't occur to me until I actually breastfed.

I got off to a bad start with an unexpected c-section. Drugged, exhausted, somewhat in a state of shock, I suddenly had a newborn baby and holy crap, he wants food and I'm his only means of nutrition. I couldn't position him comfortably and balanced him precariously on a nursing pillow while attempting to avoid putting pressure on my scar.

He doesn't just latch on and feed; he sucks for a minute and pulls off screaming. And by the gods, what the HELL is this awful abdominal pain I'm feeling whenever he feeds? I'm in so much pain, I'm only on paracetamol (because morphine makes me want to throw up), and I can't sleep because I'm stuck in a hospital ward with five other mothers and five screamy babies. In the middle of the night, Jack keeps waking up to feed and I have no idea how to get him latched on. The midwives are so overworked that all they can do is come to my bed, plug Jack in, and quickly dash off to the next person. I don't know how they got him latched on and I'm terrified to move in case he detaches himself and I need to ring that goddamn bell again.
In the days that follow, he continues to latch on (painfully) in very small spurts every couple of hours, screaming between feeds. I don't know what I'm doing wrong and I don't know who I can speak to about it. Whenever Jack cried for a feed, I literally felt ill knowing that I'd have to endure a toe-curling latch and yet another unsuccessful feed. I watched the clock, horrified that two hours had passed so quickly, knowing that another feed was coming.

At two weeks, a health visitor (relocated now, thankfully), advised that I "top up" with formula. I gave Jack his first bottle of formula and it broke my heart. I rang Paul at work sobbing; I couldn't do something as basic as breastfeed, and the guilt was incredible. Supplementing, of course, led to supply issues and by two months, it became necessary to stop breastfeeding completely. Not having to breastfeed any more was actually a relief.

When I got pregnant with my daughter, I was determined to learn as much as I could about breastfeeding and spoke to my independent midwife about needing support, especially in the first weeks. I went over everything that happened with Jack and chatted with mums in "real life" and online. I felt so much more prepared, but more importantly, I felt like I had an arsenal of information and support.
Mia's birth was infinitely easier than Jack's, with no major recovery issues, and this undoubtedly made a difference to breastfeeding this time around.  Also, not having that first time mum learning curve helped. I was more confident and trusted my instincts. I breastfed Mia until she self-weaned at 19 months (when I was pregnant with my third baby, and I think my supply had dipped as Mia kept saying "Gone!" every time she
latched on.) I breastfed Isla until she was 14 months old; it went swimmingly right from the beginning. And for this, I'm very grateful. And very proud.

This is why I jumped at the opportunity when the health visitor suggested that I take a course to become a peer supporter. I knew what it was like to have no one to speak to and to have no confidence in my own abilities, and I knew what it was like to formula feed. I hoped that this would help me give unbiased support and that being a "been there, done that" mum might make mums who are struggling feel a little bit more comfortable talking to me.

Revolutionary Feeding Method – Tru-Breast

Another copied over from the Milk Matters blog for anyone who hasn't seen :)

Taking the parenting world by storm and you can see why!

If you don’t want to waste time sterilising bottles, are too tired to be getting up during the night to make feeds to order and want the ultimate in convenience and hygiene – this could be for you…

No other feeding system offers the following patented features:

Lul-A-Bye Sound Unit – as baby feeds they hear comforting soothing sounds, familiar from the womb; guaranteed to relax both baby and mum.

KWIK-KLEEN™ Teat – Forget latex or rubber, this system features a unique NO STERILISE teat.  No matter how often it’s used or the time between uses, it NEVER needs sterilising.  What’s more you save money as it never needs replacing! (guaranteed)

KWIK-FIL™ Temperature Regulating Holding Tank – Making bottle warmers a thing of the past, this stores baby’s milk at just the right temperature - meaning no risk of nasty bacteria thriving.  Never too hot or too cold, ensuring optimum safety (no need to test each feed). Features automatic refill system so there’s no fuss, hassle or wait when baby is hungry.  What’s more there’s no need to refrigerate left-overs; milk stays warm in the unit - ready when baby is.

ANC™ Auto Nutrient calculator - No more scooping or measuring!  Research shows a large percentage of bottles are made incorrectly – this system ensures optimum nutrient delivery at EVERY feed, guaranteed.

Environmentally Friendly - Although you can buy fabric covers, these are not essential (and many mums find the system is quicker without until they get the hang of it)  All components have a lifetime guarantee.  

Normal Oral Development - we’ve all heard the scare stories about bottle mouth or cavities - you can rest easy with Tru-Breast.

Built In KWIK KLEEN™ Pacifier - Is baby always dropping their pacifier?  Tired of hunting around at night trying to find where it’s gone?  Tru-Breast features a unique built in pacifier which cannot fall to the ground and is always easily located.  Again no sterilising required and lifetime guarantee.  Patented design that causes baby to naturally reduce sucking time as they get older – removing any risk of overuse causing delayed speech.  Approved by dentists to support normal development

Already proving a hit worldwide, parents LOVE Tru-Breast.
My youngest Toby just didn’t get on with standard bottles.  He slept very long periods and when awake was constipated and unsettled.  Since we swapped to Tru-Breast I feel we’ve really started to bond – and you know what they say; happy mum = happy baby.
Mrs C Leavage
Some friends who didn’t choose the Tru-Breast system, claim bottles are fine – I say why settle for second best? demand help from your midwife if you have any trouble using the system.
Miss B Reasty
But That’s not all!

Unique storage system saves the problem of where to put everything in case of future children!  Full range of  sizes, shapes and colours available.  All sizes function with equal efficiency.  Units come in pairs and improve with use.  Traveling with baby is a dream with Tru-Breast - The easier no mess, no worry way to feed YOUR baby.

Tru-Breast comes free with every pregnancy!  

With TRU-BREAST around, why bother with other methods?

If you want to let others know about this fantastic system – share this!
Very loosely based upon an article that used to be widely available on the web.  This version ™Milk Matters LTD

Parents give yourself a big hug this Christmas, NOBODY'S Perfect!

Something that has really hit me since I started this blog, is how much guilt surrounds parenting.  Dianne Weissinger discusses in "Watch Your Language" how easily women feel guilt, and how her own mother has been known to apologise for the weather.

Guilt is described as an emotion we feel when we feel responsible for an error or mistake, yet many of the things parents feel guilty about are either totally beyond their control, or heavily influenced by factors that are.

In my opinion guilt as an emotion is only positive if it causes us to think through the situation and either feel remorse ie in a situation that was genuinely our fault, to prompt a different response in the future OR to establish actually we weren't responsible, who was and therefore again ultimately how can we help prompt a different response in the future.  Otherwise the "beating oneself up" aspect of guilt is purely negative and of no benefit - nor is "working through the guilt" ie learning to live with it, without exploring why we feel guilty in the first place and resolving this with what could happen differently.

Health Professionals giving duff advice is a key example.   With my first child, I was like many and at mercy of the HP's - I knew nothing, they knew it all (or so I believed) so when at four months my Health Visitor suggested formula would help my baby sleep longer, I - albeit a tad naively, assumed they knew best.  My daughter who had always had slightly dry skin broke out in eczema and we were referred to a dermatologist.  Do I think formula was the link? Probably.  Do I feel guilty?  Not any more.  Did I make a different choice next time? Absolutely.

After a good ponder, what I came to feel was the only mistake I had made was to blindly follow someone else's advice, and regardless of the uniform this is never the best plan; so I decided next time I would look for evidence based information to verify what I was told (yeah I kinda ran with that one a bit ;)).  I didn't know about why exclusive breastfeeding was recommended, and assumed the HP wouldn't suggest something that could potentially be harmful.  Given that  people such as Health Visitors are there solely to support parents - it's entirely reasonable to expect them to be knowledgeable.  If I went to the bank for some financial support, I wouldn't beat myself up if they gave me the wrong facts and figures -  I would expect them to do their job properly.

The fact was if formula indeed caused the problem, then the HP recommending the formula was ultimately responsible - and so I contacted the "Head of Health Visitors" for the area I then lived in.  She was horrified to hear what I had been told and promised to immediately implement updated training to ensure other mothers weren't given such advice.  Why should I carry the burden of responsibility for something an expert was paid to help me with?

The big reality of parenting is that nobody is the perfect parent, because nobody is a perfect person; every single last parent out there will have something they would do differently, something they have felt or still feel guilt over - it's part of what makes parenting generally such an emotive topic.  Ultimately it's also part of what makes us better parents in the long term.  Furthermore, there is no shame in admitting you are not the perfect parent!

The big battle of the anxious parenting race begins shortly after birth - can they roll? how are they sleeping?  are they a "good baby" (clearly defined in Western terms as low maintenance, sleeps for long periods without needing contact) how often does he feed? is she doing well with solids?  wow weaning already, how many ice cubes does she have?  parents compare their baby, sometimes almost as a gauge as to how well they are parenting.  Whether your baby is a good sleeper or not is at some parenting groups the badge of  "a good parent", with these parents called upon to share their wisdom with those souls suffering a less than great sleeper.  Sometimes parents say their baby is a great sleeper when they're actually not - because parents are often as nervous as being perceived as a "bad parent" as they are of being one.

A very real fact is all babies are different - some parenting books can make parents feel that their baby is unusual and if they only did xyz, they would have the perfect baby.  I distinctly remember reading a book that specifically said if your baby does not sleep "well" (by current Western standards), it is always something the parent is doing wrong.  After doing little else for nearly a year than trying to improve my daughters sleep; following numerous books, plans and techniques such as "pick up, put down" and "rapid return" (which was anything but rapid with my spirited bean - two hundred and odd returns before I figured that probably wasn't going to work) I accepted, you know what this is not my fault!  No more than it was anything amazing I did that made my second child a typical "great sleeper".  If it were true I wouldn't know as many people who have had one or more sleep loving children before delivering one who wasn't as keen to conform and preferred partying in the crib at 2am.

Some children will express their emotions loudly and passionately from a young age, others will have a more laid back outlook to life and lean towards discussion and negotiation.  Some will naturally be more extrovert and dive to the front at events or group, loving being the focus of attention - others have a far more cautious outlook to life and will sit tight with mum until they are absolutely sure, and even then might decide to stick close or just go a few feet.

I've heard guilt from parents over all of the above - baby is too quiet, too extrovert, too "tantrummy", too snatchy, too clingy, too dependent.  Whilst of course some aspects are down to nurture and can be worked with especially as they get older, it's also down to nature - my two were like chalk and cheese from day one, and continue to be so in every way.   It's not about doing xyz to "create the perfect child", but accepting and working with what you have; it's not a case of if I only did xyz better my baby would sleep/become less emotional/not be so clingy - it really isn't.  The minute I accepted my daughter was just one of those babies who thought life was far too interesting to be sleeping, and worked with that to maximise sleep all round, instead of trying to change her into a two naps per day plus twelve hours at night type, life became a hundred times easier.

I later discovered she had an underlying tongue tie, retained birth compression and a couple of other bits that I believe was supporting her maintaining a very switched on state and made it difficult for her to relax - but that's discussed more here.

A mum of many hit the nail on the head a few years ago when she said first babies are really a big experiment and you get a little more right with each one, but ya gotta feel sorry for the first because you know so little. This is so true because ultimately the more we know, the better we do - but we do the best we can with the information and support we have at the time.

Just like no parent is perfect, neither is any child and you know what that's ok too!  Embrace what your child is and view their traits warts and all in the best light you can.  It's hard to hear or read something negative about a parenting decision we have taken - be that sleep training, feeding, discipline or the thousand other things we parents find to beat ourselves around the head about.  But the most productive thing we can do with any piece of information is probably the hardest, to explore why it provokes the feelings within us it does and if needs be, admit we weren't perfect, made a mistake and acknowledge we would make a different choice in future - most of all acknowledge that too is really ok!  Then realise that doing this and striving to be a better parent is actually what makes a good parent an amazing one, that makes a real difference to themselves and their family - not whether they always hit the mark.

So give yourself a big hug this Christmas for being a good enough parent - and why not share this article with someone you think deserves a parenting hug :)

Infant Formula – What IS The Magic More?

My baby needed more than just breastmilk..
Breastmilk wasn’t filling him so we had to give formula.
Baby was big/hungry and not satisfied on breastmilk alone, big babies sometimes need more than exclusive breastfeeding.
My baby isn’t getting what she needs as she wants to feed frequently every evening.
Baby wasn’t gaining enough weight and needed something more.
These are phrases many of us are used to reading online, and I have long pondered – what is the magic “more”?

Firstly let’s think about it logically – human infants are born perfectly designed to consume human milk; just like calves are to drink cow’s milk and piglets are to drink sow’s milk.  For this to be “inadequate” for some infants would make no sense, because before the days you could buy a tin it was the only option.  Secondly the volume of breastmilk isn’t limited to x oz per feed, if baby is hungrier they can drink more and mum makes more!  As the vast majority can (with the right support)  make enough milk for twins, even the hungriest baby can have their fill.

Standard breastmilk substitutes contain around 20 cals per oz, breastmilk contains on average 22.  Fat levels in substitutes are at around 3.5 g per 100ml, compared to an average of 4.2 in breastmilk.  Protein levels in a standard formula are approximately the same as breastmilk, around 1.3g per 100ml.

Breastmilk is often compared to a “healthy salad”, because of how easily it is digested and how the baby feels after feeding; in contrast substitutes are often compared to a “roast dinner”, because baby may zonk out for a long period.  This is partly because it’s easy to inadvertently overfeed with a bottle, but also because milk of another species is much harder to digest – whilst both contain protein, one is human and one is bovine.   In terms of nutrients to grow, breastmilk is no “lighter lunch” than the typical alternative.

So if substitutes offer nothing “more” than breastmilk (and lack all the immunological propertes of breastmilk), why do some parents feel their baby needs them?

I suspect there are several or more answers to this question.  Firstly, formula frequently matches what many mums perceive as a more sated infant, based on cultural expectations.  Many mothers only know infants who are fed substitutes and so their behaviour is held as the norm.   Breastmilk is digested in 1 1/2 - 2 hours, whereas formula can take 3-4 hours; if baby wants feeding every couple of hours or more, mums are often concerned her baby is hungry or “not as settled as they should be”.  The truth is breastmilk is digested at a normal rate - it’s non breastfed infants who often take a longer than normal time to digest, resulting in longer than normal feed spacings.  Nothing to do with “being more content” and all to do with working hard to digest foreign milk!

Some infants struggle so much to digest it results in cconstipation or colic – resulting in less sleep all round – the opposite of the desired result; and for a small proportion of infants the supplement makes absolutely no difference at all to sleep, settling, or frequency of feeding - but a big difference to their gut.
If the sitution in society were reversed and the majority of mums were breastfeeding every couple of hours – a baby suddenly going a long time between feeds would be the cause for concern, not the reverse.  I wonder if the advice then would be to supplement with breastmilk? ;)

It also comes down to ineffective breastfeeding support and education – most babies have fussy periods (previously called growth spurts) where they want to feed much more frequently for a few days, and many in the early weeks cluster feed (lots of feeds back to back early evening) but as a lot of mums are never even told about this, they understandably believe they aren’t making enough milk to satisfy baby, or that for some reason it wasn’t filling enough.  I for one fell into this group with my first and was quite gobsmacked when I read about it online that despite spending 9 months convincing me “breast was best”, nobody had bothered to let me know about that part!

It could also be down to less than great positioning and attachment - baby may not be actually drinking well and so in that case genuinely may need more milk; but that’s because the amount of milk being consumed is too small – not a quality issue.   With good support this can be quickly and easily overcome in the vast majority of cases.

Perhaps the visual aspect also plays a part? we are most used to bovine milk- skimmed is thin and watery, down to full fat which is rich and creamy.  Expressed breastmilk because of the type of protein and fats appears an almost blue colour, and is thinner in consistency than full fat milk; in contrast a bottle of formula appears much more as we expect a richy creamy milk to look.  A good (formula feeding) friend of mine once commented when my first was tiny, that my expressed milk “didn’t look very creamy or rich, was it filling enough?” (First baby didn’t sleep long periods and so the implication was obviously my uncreamy milk!)

Because non breastfed infants often gain more weight than breastfed after the early months, due to either wrong re-constitiuting of powder or overfeeding - perhaps this adds to the feeling formula offers something “more”?

As long as mum is consuming somewhere around the recommended calories per day (1500-1800) and not drastically below, diet has little impact on fat and calorie content of breastmilk.   It can vary mum to mum, feed to feed – but only volume of milk consumed has been correlated with growth.

Lastly the whole “big baby” statement makes so little sense if you think about it.  Those mums who do exclusively breastfeed for 6 months, do so not only when their baby is tiny, but when it is four or five months old too!  Even the chunkiest of newborns or young babies are smaller than this – so why would breastmilk be unable to sustain them when it  can do so fine with older bigger babies?  for those who become chunky – breastmilk made them so, how would it do that if so lacking?

So if anyone does work out what the magic more is, do let me know.

© 2010 milk matters

Introducing solids schedules - outdated advice?

Many starting solids books recommend introducing foods in a particular order - usually something along the lines of:
  • Baby rice with your baby's usual milk
  • Sweet vegetables like carrot, carrots, swede, parsnips, sweet potato & butternut squash
  • Savoury vegetables like cabbage
  • Fruits
  • White meat/fish/green veg
  • Red meat
These recommendations have been around since the norm was to introduce solids from as early as 10 weeks (more on this in a moment).  Initially parents were advised to give baby rice due to its low allergenic properties, moving onto fruit and veg months 4-5, fish and white meats from 6 months and finally red meat around 7 months.

It was believed the immature gut needed time to get used to digesting foods and anything rich like meat could pose a strain.

They were wrong

Science has since highlighted that it's around the middle of the first year before infants are capable of effectively digesting food.  Whilst young babies have an "open gut" which can allow harmful microbes and allergens to pass into baby's blood stream - around six months the gut closes in preparation for consuming food.  This also ties in with when infants can take food to their mouths, but that's covered in detail here.

From six months ish some babies may also begin to need more nutritionally, zinc, iron or B vitamins - but a lot depends on the individual circumstances surrounding birth.  Lower birth weight infants may need iron earlier as studies show infants born below 6 1/2 lb have smaller stores; similarly modern practises such as early cord cutting or cesarean sections have also been linked with reduced iron levels due to baby not receiving their cord blood.

So potentially we have parents waiting until six months (as per the guidelines) and then introducing baby rice which is pretty nutritionally pants.

This is then followed by veg and fruit, which as Dr Carlos Gonzalez highlights in his book "My child won't eat" offers little nutritionally to someone with a small stomach.  He says:
"In the early 1900s, vegetables as well as fruits were introduced very late in children's diets; perhaps at two or three years of age and with great caution.  Since they were breastfed, children were fine without them because human milk provided all the necessary vitamins.  When artificial feeding started becoming more widespread, babies started becoming deficient in some vitamins (due to the fact that it took manufacturers decades to add all the necessary vitamins to artificial baby milk).  This made it necessary to introduce fruits and vegetables much earlier. But there was a problem: their low calorific density.  Children have smaller stomachs.  They need concentrated foods, high in calories but low in volume. 
He then goes on to explain that mother's milk has 70 Kcal per 100g, chicken has 186, chickpeas have 150. Yet apples have only 52, carrots 27 and cabbage 15 (assuming they're drained well or nutritional content further reduces).

He continues:
"If left alone small children seldom refuse vegetables.  It is not a matter of taste.  Usually they will gladly accept a few bites of vegetables rich in vitamin and minerals.  But only a few bites. Some mothers try to give them a plateful of these "healthy" foods."

Furthermore, nothing biologically tallies with this man made introduction plan. 

Babies produce enzymes and digestive juices that work effectively on proteins and fats, however the pancreatic enzyme amylase necessary for the digestion of starches - whilst  produced in larger amounts from around 6 months, can take up to 2 years to reach mature levels.  Furthermore carbohydrate enzymes maltase, isomaltase and sucrase, do not reach adequate levels until around 7 months.  Breastmilk does contain amylase to assist digestion, but it rather makes a mockery of the traditional "weaning plan".

Judy Hopkinson, Ph.D., Associate Professor of Pediatrics at Baylor College of Medicine and member of LLLI's Health Advisory Council states:
It is important to remember, that when solid foods are introduced, the amount of breast milk a baby consumes decreases. If protein, zinc, or other nutrients are not provided in solid foods, the amount a baby receives from breast milk could be insufficient for optimal growth during the weaning period. Therefore, adding meat to the diet early in the weaning period may be beneficial.
There is also a small study from Sweden which indicates that infants given substantial amounts of cereal, may have lower concentrations of zinc and reduced calcium absorption (Persson 1998).

A study by Dr. Nancy Krebs found both protein and zinc levels were higher in the diets of the infants who received meat, and they grew at a slightly faster rate. Dr. Krebs' suggests that inadequate protein or zinc from complementary foods may limit the growth of some breastfed infants during the weaning period.  (Krebs 1998).

Meat is also an excellent source of heme iron, which is better absorbed than iron from plant sources. The protein in meat also helps the baby more easily absorb the iron from other foods.  A couple of studies looking at iron status of breastfed infants receiving meat as a first food, found higher levels of hemoglobin circulating in the blood stream. (Makrides 1998; Engelmann 1998)

Many people think the "order of introduction charts" are evidence based.  Not so!

Rachel Brandeis, a spokeswoman for the American Dietetic Association said:
"Most parents are told to start rice cereal at 6 months, then slowly progress to simple vegetables, mild fruits and finally pasta and meat. Ethnic foods and spices are mostly ignored by the guidelines; cinnamon and avocados are about as exotic as it gets, and parents are warned off potential allergens such as nuts and seafood for at least a year.
Yet experts say children over 6 months can handle most anything, with a few caveats."
Dr. Jatinder Bhatia, a member of the American Academy of Pediatrics' nutrition committee says:
"The difference is cultural, not scientific, the American approach suffers from a Western bias that fails to reflect the nation's ethnic diversity."
In a review of the research, Nancy Butte, a pediatrics professor at Baylor College of Medicine, found that many strongly held assumptions such as the need to offer foods in a particular order or to delay allergenic foods have little scientific basis:
Take rice cereal, for example. Under conventional American wisdom, it's the best first food. But iron-rich meat, often one of the last foods American parents introduce would be a better choice.
Dr. David Ludwig of Children's Hospital Boston, a specialist in paediatric nutrition says:
Some studies suggest rice and other highly processed grain cereals actually could be among the worst foods for infants.  These foods are in a certain sense no different from adding sugar to formula. They digest very rapidly in the body into sugar, raising blood sugar and insulin levels and could contribute to later health problems, including obesity.
Yet how often do we see toast, sandwiches, pasta, wraps, crumpets etc featuring as ideal first foods? Some diets are so grain heavy they include cereal for breakfast, sandwich for lunch and pasta for dinner.

What about if I'm vegetarian?
From LLL:
Vegetarian mothers are almost always aware of their need for protein, iron, zinc, calcium and vitamin B12 as well as adequate calories. Those who occasionally add poultry or fish to their diets and those who are lacto-ovo vegetarians, using milk and eggs in their diets, usually have no problems meeting their needs for these nutrients. For vegans, who do not use any dairy products, attention needs to be given to adequate sources of calcium. There are also many non-animal foods that provide iron, calcium, and zinc. Vegetarians may need supplements to get enough B12. Vegetarians who want their children to eat as they do will need to be aware of the same nutrient needs for their children. When starting solids, single foods are given so that any sensitivities or allergies can be noted.
Ultimately regardless of whether you are omnivore, vegetarian or vegan, it seems to make most sense to offer more than baby rice or squished carrot if weaning around the middle of the first year.

Whilst we are on the subject - one of my pet hates, Baby yoghurts!

Teeny pots of sugar laden junk.  The leading UK brand Petits Filous has a staggering 11.9g total sugar per 100g.  A tiny proportion of this is lactose (the naturally occurring milk sugar) - however they add to that 6.9% sugar, 5%  fruit puree AND 3.9% fructose.  Why?

If we consider the maximum daily intake for a toddler is around this mark, a 50g pot is supplying half. Babies have a smaller allowance, and are also getting sugars via their breastmilk and formula.  All it's doing is giving baby a taste for excessively sweet products, and both sugar and fructose are heavily implicated in the obesity epidemic.

The healthiest option is to simply buy natural live yoghurt.  Whilst adults are often used to sugar laden products, infants weaned onto plain natural yogurt like it just as much and may actually wince when they receive a sugar hit version! We seem to think things need sweetening and fruit adding for babies and children, some say their baby doesn't like plain yoghurt because they don't consume lots immediately (like they may be tempted to do with sugar filled Filous), but it can take over ten tastes for a baby to like many foods and ultimately we don't sprinkle broccoli in sugar to increase its appeal?  If you really need to sweeten it fruit should be sweet enough alone, without added fructose?

If we want our child to develop healthy eating habits, which ultimately I'm sure many do - the relationship we develop with food during infancy surely matters?

Updated Jan 2015

Related Post: 

Starting Solids - Can Babies Be Ready Before 6 Months & How Will I Know?/ Baby led introduction of solids

    Breastfeeding and Boozing

    Breastfeeding & Boozing.

    Great article link below looking at breastfeeding and alcohol - a question many ask during the festive season :)

    Couple more key bits of information that may help:

    What influence blood alcohol concentration and what else should I consider?

    1. The amount of alcohol consumed

    Obviously the amount of alcohol consumed will affect blood alcohol concentration. It's not the size of the glass that counts; it's the total amount and percentage of alcohol in the drink. 1 standard drink = 10 grams of alcohol. (See 'How to measure alcohol content in different drinks' further above.)

    2. Length of time over which alcohol is consumed

    Your liver is only able to metabolize (break down) a limited amount of alcohol per hour; therefore, consuming multiple drinks within a short space of time will increase your blood alcohol concentration to higher level than if drinks were consumed over a number of hours.

    3. Food

    The presence of food and the type of food in your gastrointestinal tract when alcohol is consumed, will affect how quickly alcohol is absorbed into your blood stream. Food, slows down the rate at which alcohol is absorbed from your intestines (in particular high-fat foods). The slower alcohol is absorbed the lower the blood alcohol concentration level reached.
    When consumed on an empty stomach peak blood alcohol concentration from 1 drink may be reached in in as little as 30 to 40 minutes. When large quantities of food are eaten with the alcohol, it can take up to 90 minutes for peak levels to be reached. (The slower the absorption, the lower the level reached.)

    4. Gender

    Water content affects the rate at which alcohol is metabolized. The higher the water content the lower the alcohol concentration. The difference in blood alcohol concentration between women and men has been attributed to women's smaller amount of body water.

    5. Body tissue

    Different body tissues absorb alcohol at different rates e.g. muscle tissue absorbs alcohol more rapidly than fat tissue. The absorption into muscle tissue would mean there is less alcohol circulating in the blood stream. Since women generally have more body fat than men, a woman would have a higher blood alcohol concentration than would a man of the same weight.

    6.  Body weight

    The lighter you weigh the longer it will take your body to metabolize (break down) the same amount of alcohol e.g. if you weighted 100lb (45kgs) it will take approx 3.1 hours to metabolize 1 standard drink. If you weighed 160lb (72kgs) it will take approx 1.9 hours.

    7. Hormonal changes

    It has been claimed that a women's menstrual cycle can influence the rate of absorption of alcohol. Low levels of estrogen have been associated with a higher blood alcohol concentration. When a woman has stopped menstruating due to breastfeeding, her estrogen levels are low.
    However, a Brazilian study which compared alcohol absorption in lactating and non-lactating women, demonstrated that even when matched for age, size and ethnic group, lactating women had slower absorption rates than non-lactating women.

    8. Emotional state

    Fear, anxiety or stress can all affect absorption and elimination rates.

    9. Medications

    Use of aspirin products can increase intoxication by interfering with the break down of alcohol.
    WARNING: Additional care needs to be taken if you are currently taking any medications. Many medications react with alcohol. Protect yourself and your baby by avoiding alcohol if you are taking a medication and don't know its effect. Talk to your pharmacist or health care provider if you are currently taking medications, before you drink.

    Written by Rowena Bennett RN, RM, RPN, CHN, Grad Dip Health Promotion.

    The age and size of your baby is also a consideration - someone nursing a newborn needs to be much more aware than someone nursing a 12 month old.

    Ethanol - the chemical name for alcohol - is approved by the American Academy of Pediatricians for use during lactation.

    Hale (Dr Thoms Hale in Medications and Mothers Milk, international research based textbook) found that a mother needs to have a blood level of 300 mg alcohol per decilitre of blood before her infant shows significant side effects (mainly sedation).

    The legal drink driving limit in the UK is 80mg of alcohol per 100ml of blood.

    100ml is a decilitre so this means you would have to have consumed between 3 and 4 times the legal limit for driving before the alcohol you were drinking had significant effects on your baby….and actually feeding at the time you were affected, too.

    Alcohol reaches the breastmilk shortly after it reaches the bloodstream - so fairly quickly, but in dilute quantities. Hale says ‘the absolute amount transferred into milk is low’. It is estimated less than 2% of the alcohol consumed by the mother reaches her milk.

    You can be sure your breastmilk is clear of alcohol when your bloodstream is clear of it, and the usual guide for this is that the body processes alcohol at a rate of one and a half to two hours per unit. Alcohol peaks in milk approximately 1/2-1 hour after drinking although of course this varies considerably from person to person (see below)

    The La Leche League’s BREASTFEEDING ANSWER BOOK (pp. 509-510) says,
    “Occasional or light drinking of alcoholic beverages has not been found to be harmful to the breastfeeding baby. Moderate-to-heavy regular alcohol consumption by the breastfeeding mother may interfere with the let-down, or milk-ejection reflex, inhibit milk intake, affect infant motor development, slow weight gain, and cause other side effects in the baby.

    Recommended Article: Breastfeeding and Boozing

    What a lactivist is, and isn't...

    Earlier I read How To Support Women Without Demonising Formula and whilst I'm in absolute agreement that demonising women is pointless, hurtful and damaging to breastfeeding advocacy; another part of me as "A Lactivist" feels yet again attacked as a "Breastfeeding Nazi".

    "It can be very tempting to further the normalization of breastfeeding by demonizing formula, or worse, by demonizing formula-feeding mothers.  It calls to you.  The information's right there, and, if you breastfeed, it makes you feel better about yourself and better about your struggles and your hard work to bring it up.  I remember!  It's so tempting to respond to the Similac recall with "Serves you right, you should have breastfed" or "Boobs don't have bugs, this is mom's fault."  Formula sucks."
    Firstly would someone explain to me what demonising formula is?  If someone says x is a risk of formula - is that demonising it?  if so do we not tell mothers about the risk?, do we lie?  I ask this genuinely as I also feel that there are a lot of posts and articles online claiming the "benefits are minimal", or "it's nearly the same nowadays" as per my entry "When you can prove formula is nearly as good we'll talk" - a lot of women still believe these claims are true.

    Demonising women is another issue entirely, but more about that in a second.
    Some of the strongest advocates in the intactivist movement are mothers who circumcised their first children.  Marilyn Fayre Milos, for example.  Some of the strongest advocates for gentle discipline are those who chose corporal punishment first.  Some of the strongest proponents of natural birth are those who experienced an over-medicated labor or an "unnecessarian".  Many cloth diapering mothers chose cloth because their babies' bottoms reacted badly to disposables.

    Most lactivists have never fed their babies an ounce of formula, and some (certainly not all) really seem to enjoy making that fact very known.  They should be proud, but sometimes comments cross the line.  Formula-feeding mothers are referred to as "lazy", "selfish", "lame", "stupid", "irresponsible" and worse.  I'm not pulling this from my own imagination; I am a member of many natural parenting groups and have seen all of these accusations in the last month.
    I won't dispute things like this are said, just like some non breastfeeders will openly state they think "breastfeeding is disgusting", "women who do it are perverts" or "too attached to their child".  Is this all non breastfeeders?  No and it would be silly to suggest it was.  There will always be the gang of school bullies in the playground or the gossips over the fence   But are these people  "lactivists" as a group?

    No, No, No, No, No!

    What is a Lactivist?

    I googled this and here is a good round up of what I believe a Lactivist to be:
    Lactivism (portmanteau of "lactation" and "activism") is a term used to describe the advocacy of breastfeeding.Harmon, Amy. (June 7, 2005). "." The New York Times. Retrieved September 27, 2007. ..
    "I believe anyone who believes in, supports and promotes breastfeeding and the value it provides to mother, who fights the good fight to enable women to MAKE THEIR OWN CHOICE when it comes to breastfeeding (e.g. safely breastfeeding in public, breastfeeding education, access to help, not having formula shoved down your throat at the hospital, etc) makes you a lactivist.  In other words, it's not just about how far you yourself go, it's also about enabling women everywhere."
    For me, lactivism is about supporting the legal rights of mothers to breastfeed where and when they want, for as long as they want, and it's about making sure people are educated on the subject so that they can make informed choices which are right and healthy for their family.  I don't think an individual's ability to breastfeed, or the length of time that they do it, has anything to do with whether a person can be a breastfeeding advocate.
     I think a "lactivist" is someone who actively works to promote, protect, and support breastfeeding.
    Is calling non breastfeeding mothers  "lazy", "selfish", "lame", "stupid", "irresponsible" and worse, in anyway fulfilling the criteria above?  Is it aligned with the role of a lactivist at all?  No. As has been pointed out this is actually harmful to breastfeeding advocacy and doing nothing to educate or support breastfeeding?  One could argue to advocate for something you have to fully understand it, and anyone who fully understands the politics of breastfeeding - wouldn't say the statements above!

    "Acts of lactivism" I've observed recently include: writing to a supermarket that their leaflet was factually incorrect, reporting breaches of the laws surrounding the promotion and sale of infant formula, supporting a mother's right to express at work if she wants to or even telling Facebook, "Hey breastfeeding is not obscene!"  They don't include telling a mother who finds beetles in her baby milk that it's her own fault for not breastfeeding?!  That's like saying if you find a roach in your meal in a restaurant, it's your own fault for eating out!  Utterly ridiculous.

    Whilst many of the women who say the above things may not have ever used formula,  just like the other movements mentioned most Lactivists have either a) had to use some formula, or express and supplement at least in the shorterm, b)  had a really hard time breastfeeding and feels passionate others get better support, c) have worked in a role that led to them witnessing the poor care of mothers and/or learning a lot about breastfeeding or d) have learnt about breastfeeding and it's barriers and have a feminist streak so want to empower others.  The most passionate women are those who have endured something, or observed it, got through it and want to help others.

    A true lactivist does not seek to demonise women, but to empower and support those who need help.  To present accurate, unbiased, unjudgmental information on which parents can make a truly informed choice. Yes we fight the myths and yes many of us feel a need to point out information is wrong when it is.  But most of us understand the myriad of factors that influence breastfeeding choices and chance of success - and we work damn hard in a system that promotes breastfeeding so often, yet values it so little.

    Please next time give women who make comments such as the above a different title, don't demonise the Lactivist.  Without Lactivists there would be no Baby Friendly accredited hospitals, no breastfeeding support organisations, helpines or volunteer drop in groups - and definitely no online breastfeeding resources not sponsored by formula manufacturers or the government.

    If you believe lactivism is about true breastfeeding advocacy, please share this article.

    When you can prove formula is "nearly as good" - we'll talk!

    Formula is nearly as good
    "The research isn't that compelling for breastfeeding, it's probably not about the milk but the parenting style of a breastfeeding mother." 
    There's only "a few small benefits" to breastfeeding
    Happy mum = Happy Baby OR A baby is better with a happy mum and bottlefed, than with a mum stressed trying to breastfeed.
    If I read things like this once per week, I must read them twenty times. I even had an email recently asking me if I really believed breastmilk was so much better than formula, the studies can't account for all the variables.  I also want to make it clear I believe in informed choice about infant feeding, you can't beat yourself up for what you didn't know.

    So I decided it was time to reply :)

    Firstly - even the guys making breastmilk substitutes don't claim they are close to breastmilk. (they're not allowed to for legal reasons because it isn't true)  They may claim "closer to breastmilk" - and indeed they may be closer than they were last month, or last year; that does not equate to close.  As I always say, I'm closer to owning a Bentley than I was ten years ago - doesn't make me anywhere near close!  Similarly there are literally hundreds of constituents in breastmilk that are not in substitutes.

    Moving onto the "research isn't compelling".  We seem to be in a position of looking to prove "breast is best" ie prove breastmilk is better and has benefits.  Why on earth are we trying to prove the milk of our own species is better than milk from a cow?  A mammal that bears little resemblance to a human, or it's milk to ours. In fact it isn't at all comparable and needs massive modification to even be tolerated by humans; this makes no sense?!

    The trouble with research is that it will never "prove something beyond doubt", that is not it's purpose.  As many point out because for ethical reasons we can't use control groups and feed one group breastmilk and one group substitutes, research has to focus on people who have already made this choice.  Therefore some argue that it's the parenting style of those who choose to breastfeed that may differ and may confer "the benefit".  Even when studies adjust for variables, some will still argue it doesn't portray a "convincing enough picture".

    Indeed it may not, because control groups in the UK/US of infants who have been exclusively breastfed for 6 months are so hard to find, that researchers often either lump together "any breastmilk" or "no breastmilk" or exclusively breastfed for a shorter period of time eg 3 months.  Both these factors may well skew the data - and dilute the outcome of breastfeeding, because exclusivity is known to be important to protect in many areas, and until the gut closes at around 6 months, any substitute may influence outcome.  This means realistically any studies that could control like for like would be more likely to show a more compelling outcome for breastfeeding.

    But the fact remains - human infants are meant to consume human milk, we should not be trying to prove it "has benefits".  Instead substitutes should prove they are as good as breastmilk, that they don't increase risk of illness or disease, that there are no risks to using them.

    Following my post about SIDS & guilt - I read a reply from one lady on a forum that stated I was wrong, that breastfeeding reduced the risk of SIDS, but not breastfeeding didn't increase it.  Just think about that statement for a moment....if an infant receiving breastmilk has a better outcome than one who doesn't - then it's also perfectly accurate to say that an infant not receiving breastmilk has a worse outcome than one who does...

    As for the "it's parenting style that makes a difference to outcome" - this may sound perfectly reasonable, until you look at all the constituents of breastmilk.  Protein that cause cell suicide in over 40 types of cancer, stem cells that develop into many different cell types in the body, serving as an internal repair system.  Lymphocytes that kill infected cells directly or mobilise other components of the immune system, enzymes, immunologlobulins and a whole lot more, that actively seek out and destroy harmful pathogens, sweeping them from the body and regulating immune response.  Anti infective factors, hormones, growth factors, anti-inflammatories and more.  This poster has lists to compare of what is breastmilk and formula.

    Thymus gland as sized at birth shown by rubber model on baby's chest.We KNOW this stuff is there, beyond any research discussing outcome - we know fundamentally of the massive differences.  So - how about people get to work proving that going without all this stuff, doesn't cause a whole host of problems?  The Thymus (central organ in the immune system) has been found to be up to half the normal size in artificially-fed infants.

    Now do we really think that parenting style is most likely to be the big key?  or might those hundreds of active constituents perfectly made to fight disease actually be playing quite a part?  which logically makes most sense to you?

    What's also striking is that we also know how specific constituents work to protect baby in certain ways - and the research exploring outcomes tallies with what is missing.  The conditions we know the constituents of breastmilk protects against, we find in much higher levels in non breastfed infants.  To state there are only a few "benefits", is not only misleading but incorrect - there are no benefits to feeding a mammal the milk of his own mother, only risks of not doing so.  There are over 101 reasons to breastfeed.

    When those who attack breastfeeding can present good solid evidence there are no risks to missing out on a passive immune system, we'll talk - until then what else is there to say?

    Modern Parenting Techniques, Leaving Infants to Cry & Depressed Toddlers?

    "Oh you're such an earth mother" gushed an acquaintance not so long ago - you're obviously very maternal.  I had to stifle a chuckle because as someone who cared more about shoes and handbags than mother earth pre children, and who upon having a baby couldn't even fasten the (disposable) nappy on properly - it's not something I would have at one time ever thought I would be called!

    So let's look at what I do that makes me an "earth mother"; I breastfed, co-cot slept with my second - first was moses basket and cot and I couldn't cope with being that exhausted again!  Plus I had read material from McKenna and felt as I was breastfeeding, baby was safer with me and at increased risk of SIDS sole sleeping in a cot.  I try to parent respectfully, with my second I used a sling - but heck that was sheer practicality; with an older toddler to chase after, having babe held close whilst I had hands free was genius - not least as it prevented "prodding baby awake to play".  I also found the hours of rocking, colic and fussing were removed by using the sling - hello why would I not use one?  I could never leave either of them to "cry it out" and recently I've got quite good at baking the odd biscuit  - not quite managed this lentil knitting yet though I hear so much about.

    Did I have a pram? yes, a baby swing? yep and a bouncy chair - quick call the Attached Parenting Police quick!  Because that's another label I've apparently earned "Attached Parent".  This phrase confused me for quite a while - because what is the opposite, the "Detached Parent"?

    Here is the "official definition" of an attached parent:
    • Preparation for Pregnancy, Birth and Parenting - I went to a couple of antenatal classes, before dropping out due to a lack of parking and bought some babygrows, not entirely sure that's what is meant though - so I guess a fail here for me.  If you could have a first time again however, I would have definitely done a bit more prep!
    • Feed with Love and Respect
    • Respond with Sensitivity
    • Use Nurturing Touch
    • Ensure Safe Sleep, Physically and Emotionally
    • Provide Consistent Loving Care
    • Practice Positive Discipline
    • Strive for Balance in Personal and Family Life (note "strive" not always achieve!)
    OK, so I guess I sorta take that label then - although I prefer to call it evidence based parenting.  Because that's what I discovered pretty quickly into my parenting journey - the books full of advice from "baby tamers" are just one person's opinion.  They are not fact, not based on any evidence - just the ideas of someone who perhaps doesn't even have their own children.  Does the latter matter? absolutely!  pre children I would likely have backed "control crying" as something essential to get a child to sleep.  Once it's your child you have to leave screaming - all sorts of hormones and instincts kick in, the ones that are there ultimately to protect your baby.  Furthermore there is evidence some techniques encouraged may actually cause harm - as I will come onto in a moment.

    "Attached parenting" is most aligned with what a large body of evidence tells us - and not just from a particular field.  When we examine physical, psychological and emotional evidence from different quarters, it demonstrates a human infant is designed to be kept close to and nurtured by it's mother; that pregnancy, birth and immediately post partum are in fact one long intricately linked continuum.  Babies have certain expectations - parents have others, whether the two meet is another question; like anything else when we veer from this norm, there can be undesirable consequences.

    "Controlled crying" (Perhaps the most ironically termed practice) "cry it out", or whatever new fashionable term has been applied to "leaving a baby to scream", have been shown to flood the brain with Cortisol (a stress hormone) and Adrenalin; which has amongst other things been linked to depression, anxiety and violence in later life.  If the child is comforted, these levels then drop rapidly - if left uncomforted, although the child may eventually stop crying - the levels remain elevated and drop slowly.

    Sears has provided a whole evidence based handout (with references) highlighting various risks:
    One study showed infants who experienced persistent crying episodes were 10 times more likely to have ADHD as a child, along with poor school performance and antisocial behavior.14  Dr. Bruce Perry, researcher at Baylor University found when chronic stress over-stimulates an infant’s brain stem, and the portions of the brain that thrive on physical and emotional input are neglected (such as when a baby is repeatedly left to cry alone), the child will grow up with an over-active adrenaline system. Such a child will display increased aggression, impulsivity, and violence later in life because the brainstem floods the body with adrenaline and other stress hormones at inappropriate and frequent times. 6
    Dr. Allan Schore of the UCLA School of Medicine has demonstrated that the stress hormone cortisol actually destroys nerve connections in critical portions of an infant’s developing brain. In addition, when the portions of the brain responsible for attachment and emotional control are not stimulated during infancy, these sections of the brain will not develop.  He concludes that the sensitivity and responsiveness of a parent stimulates and shapes the nerve connections in key sections of the brain responsible for attachment and emotional well-being. 7, 8  
    Infant developmental specialist Dr. Michael Lewis presented research findings at an American Academy of Pediatrics meeting, concluding that “the single most important influence of a child’s intellectual development is the responsiveness of the mother to the cues of her baby.”
    There's a lot more information including details of physical impact and references on the official handout here.

    Penelope Leach, author of "The Essential First Year" examined more than 150 scientific sources and quotes study after study, including one in which three sets of parents looked after babies in different ways.
    The first group fed their children on demand, carried them around with them, slept with them, and responded instantly to their crying. The second group was attentive but strove for the beginnings of some separation. And the third operated on the Fordesque “controlled crying” basis, only picking children up to be fed when the routine allowed

    "At three months the distribution of crying was as you would predict,” says Leach. “The babies who were picked up most, cried less.”
    “Brains that are growing and developing are very sensitive to an overload of cortisol,” Leach says. And, apparently, high levels of cortisol that build up over time can be toxic to a young baby’s rapidly developing brain
    Dr Leach suggested unattended extreme crying bouts of 30 minutes or more could be damaging to babies.
    "If you do not respond, the baby learns no response is coming," she added.
    "The reason that a baby stops crying after fifteen minutes, half an hour, three-quarters of an hour or an hour is that it has given up and that its expectations have been altered.
    "I've heard it said that babies stop crying because they have learned that mummy wants them to go back to sleep.
    "Babies are not capable of that sort of learning."  
    You can read more in the article "It’s dangerous to leave them crying, mum"

    What many parents don't realise is that whilst they understand baby is safe in a cosy house, a baby's brain functions on a different level:
    Our kids don't know they've been born into a loving family in the 21st century- for all they know it's the 2nd century and they are in a cave surrounded by tigers. Our instinctive behaviors as baby humans need to help us stay protected.
    And the tigers. What about them? Define "tiger" however you want. But if you are baby with no skills in self-protection, staying with mom, having a grasp reflex, and a startle reflex that helps you grab onto your mom, especially if she's hairy, makes sense. Babies know the difference between a bassinette and a human chest. When infants are separated from their mothers, they have a "despair- withdrawal" respone.
     Hmmmm not sure I remember any of that being covered in any of those parenting manuals?

    Some infants will quite quickly accept nobody is coming and sleep - thus reinforcing belief the technique "worked".  Others will fight and keep on a yelling - much like some toddlers will happily sit by if someone pinches their toy, whilst others will hang on screeching for dear life!  But even if there hasn't been high stress and hormone surges - is a child realising nobody will come when they cry (the only tool they have given they can't yell out - hey mum my gums are throbbing, or heck I'm a bit worried you've left me behind and need a cuddle) a great outcome?  what are the possible implications of this longer term psychologically? 

    There is absolutely a difference between an older infant who needs to have a bit of a whinge before they can sleep (and my experience is some do) and one crying in distress   I also believe mothers often know the difference - one is a low pitched stop and start "noise", and often the stops get longer until they are asleep.  The other is a high pitched distress cry that makes the mother want to respond NOW.

    So what is the long term impact of detached parenting?

    Well if we know elevated cortisol levels are linked with depression, perhaps it goes some way to explaining why toddlers and children are more depressed than ever before.  In the last forty to fifty years rates have increased rapidly, prompting a major Surgeon General report on children’s mental health, and sending the USA's behavioral health caseload soaring to record highs.

    Contrary to the popular perception of toddlers as "carefree", new research shows clinical depression knows no age. Depression and even thoughts of suicide are as likely to affect toddlers and adolescents as they are adults, and chronic depression can affect children as young as 2 or 3.

    In an ongoing National Institute of Mental Health study, researchers at Washington University School of Medicine revealed that children experience the same symptoms of depression often found in adults, and with the same severity.

    According to the National Mental Health Association, one in three American children suffers from depression. Magellan Behavior Health, the leading mental health provider in the United States, reports that more than 3,500 of its nearly 149,000 members with depressive disorders are under age 10.
    In spite of the staggering statistics, depression remains the most under-diagnosed and under-treated illness among children and adolescents. Unlike the reddish, raised bumps of chickenpox or the leaky nose of the common cold, the symptoms of depression are not so concrete and, consequently, often go unnoticed by unsuspecting parents.

    Of course the most severe levels of depression are found in children who are bereaved or who have a depressed mother, lifestyle may impact - perhaps spending hours watching tv or gaming; but the fact remains early infancy is crucial developmentally, and evidence is showing us how we parent can have a significant impact.
    So next time someone suggests you train your baby or promotes such a parenting book - ask them to provide the evidence it's safe for your baby....

    Is breastfeeding a six year old ok? Er where do you live?

    Cruz Beckham
    Suri Cruise Aged 4
    When people ask what is a "normal" age to wean, my stock reply is biologically or socially?   In the UK people are fine seeing an older toddler sucking on a man made latex nipple - anyone who has even caught five minutes of a Jordan (Katie Price) episode, will know parting Princess from her pacifier is no mean feat!  I had thought for a while it was a custom made version for busy celebs with a "no spit" feature, but after seeing the speed with which it was removed when a camera appeared for still photos - I was relieved to see not!

    Despite the fact there is significant evidence weaning happens very prematurely in the Western World, the knee jerk response to a Daily Mail article published about how freakish feeding a six year old was - sucking on a real nipple no less! (the one that comes without the risks of suboptimal oral development) was staggering!

    Perhaps in the West the culture clash is in part due to the conflicting portrayal of children.  Whilst Suri might like a bottle at four, she's also been clocked tottering in mini high heels.  Cruz Beckham sports a pacifier, but check out his tats and swagger!  There are claims Gwen Stefani has bleached her son Kingston's hair, and I have no words for the recent offering from Katie Price.

    I want to share an article that sums up completely about how it's all about cultural norms.  I first read it in the Spring magazine published the The Association of Breastfeeding Mothers, and more recently it has been shared online by Christie Haskell on The Stir  in her response to said Daily Mail article.  Thought Armadillo readers might like it too :)

    Breastfeeding in the Land of Ghenghis Khan by Ruth Kamnitzer
    In Mongolia, there's an oft-quoted saying that the best wrestlers are breastfed for at least six years - a serious endorsement in a country where wrestling is the national sport. I moved to Mongolia when my first child was four months old, and lived there until he was three.

    Raising my son during those early years in a place where attitudes to breastfeeding are so dramatically different from prevailing norms in North America opened my eyes to an entirely different vision of how it all could be. Not only do Mongolians breast feed for a long time, they do so with more enthusiasm and less inhibition than nearly anyone else I've met. In Mongolia, breastmilk is not just for babies, it's not only about nutrition, and it's definitely not something you need to be discreet about. It's the stuff Genghis Khan was made of.
    Like many first-time mums, I hadn't given much thought to breastfeeding before I had a child. But minutes after my son, Calum, popped out, he latched on, and for the next four years seemed pretty determined not to let go. I was lucky, for in many ways breastfeeding came easily - never a cracked nipple, rarely an engorged breast. Mentally, things were not quite as simple. As much as I loved my baby and cherished the bond that breastfeeding gave us, it was, at times, overwhelming. I was unprepared for the magnitude of my love for him, and for the intensity of his need for me and me only - for my milk. "Don't let him turn you into a human pacifier," a Canadian nurse had cautioned me just days after Calum's birth, as he sucked for hour after hour. But I would run through all the possible reasons for his crying - gas? wet? understimulation? overstimulation? - and mostly I'd just end up feeding him again. I wondered if I was doing the right thing.
    Then I moved away from Canada, to Mongolia, where my husband was conducting a wildlife study. There, babies are kept constantly swaddled in layers of thick blankets, tied up with string like packages you don't want to come apart in the mail. When a package murmurs, a nipple is popped in its mouth. Babies aren't changed very often, and never burped. There aren't even hands available to thrust a rattle into. Definitely no tummy time. Babies stay wrapped up for at least three months, and every time they make a sound, they're breastfed.

    This was interesting. At three months, Canadian babies are already having social engagements, even swimming. Some are learning to "self-soothe." I had assumed that there were many reasons a baby might cry, and that my job was to figure out what the reason was and provide the appropriate solution. But in Mongolia, though babies might cry for many reasons, there is only ever one solution: breastmilk. I settled down on my butt and followed suit.

    A Working Boob Hits the Streets
    In Canada, a certain amount of mystique still surrounds breastfeeding. But really, we're just not very used to it. Breastfeeding happens at home, in baby groups, occasionally in cafes - you seldom see it in public, and we certainly don't have conscious memories of having been breastfed ourselves. This private activity between mother and child is greeted with a hush and politely averted eyes, and regarded almost in the same way as public displays of intimacy between couples: not taboo, but slightly discomfiting and politely ignored. And when that quiet, angelic newborn grows into an active toddler intent on letting the world know exactly what he's doing, well, those eyes are averted a bit more quickly and intently, sometimes under frowning brows.

    In Mongolia, instead of relegating me to a "Mothers Only" section, breastfeeding in public brought me firmly to center stage. Their universal practice of breast feeding anywhere, anytime, and the close quarters in which most Mongolians live, mean that everyone is pretty familiar with the sight of a working boob. They were happy to see I was doing things their way (which was, of course, the right way). When I breastfed in the park, grandmothers would regale me with tales of the dozen children they had fed. When I breastfed in the back of taxis, drivers would give me the thumbs-up in the rearview mirror and assure me that Calum would grow up to be a great wrestler. When I walked through the market cradling my feeding son in my arms, vendors would make a space for me at their stalls and tell him to drink up. Instead of looking away, people would lean right in and kiss Calum on the cheek. If he popped off in response to the attention and left my streaming breast completely exposed, not a beat was missed. No one stared, no one looked away - they just laughed and wiped the milk off their noses.

    From the time Calum was four months old until he was three years old, wherever I went, I heard the same thing over and over again: "Breastfeeding is the best thing for your baby, the best thing for you." The constant approval made me feel that I was doing something important that mattered to everyone - exactly the kind of public applause every new mother needs. 

    The Lazy Mum's Secret Weapon
    By Calum's second year, I had fully realized just how useful breastfeeding could be. Nothing gets a child to sleep as quickly, relieves the boredom of a long car journey as well, or calms a breaking storm as swiftly as a little warm milk from mummy. It's the lazy mother's most useful parenting aid, and by now I thought I was using it to its maximum effect. But the Mongolians took it one step further.
    During the Mongolian winters, I spent many afternoons in my friend Tsetsgee's yurt, escaping the bitter cold outside. It was enlightening to compare our different parenting techniques. Whenever a tussle over toys broke out between our two-year-olds, my first reaction would be to try to restore peace by distracting Calum with another toy while explaining the principle of sharing. But this took a while, and had a success rate of only about 50 percent. The other times, when Calum was unwilling to back down and his frustration escalated to near boiling point, I would pick him up and cradle him in my arms for a feed.
    Tsetsgee had a different approach. At the first murmur of discord, she would lift her shirt and start waving her boobs around enthusiastically, calling out, "Come here, baby, look what mama's got for you!" Her son would look up from the toys to the bull's-eyes of his mother's breasts and invariably toddle over.

    Success rate? 100 percent.

    Not to be outdone, I adopted the same strategy. There we were, two mothers flapping our breasts like competing strippers trying to entice a client. If the grandparents were around, they'd get in on the act. The poor kids wouldn't know where to look - the reassuring fullness of their own mothers' breasts, granny's withered pancake boasting its long experience, or the strange mound of flesh granddad was squeezing up in breast envy. Try as I might, I can't picture a similar scene at a La Leche League meeting. 

    When They're Walking and Talking... and Taking Their Exams?
    In my prenatal class in small-town Canada, where Calum was born, breastfeeding had been introduced with a video showing a particularly sporty-looking Swedish mother breastfeeding her toddler while out skiing. A shudder ran through the group: "Sure, it's great for babies, but by the time they're walking and talking ... ?" That was pretty much the consensus. I kept my counsel.

    It was my turn to be surprised when one of my new Mongolian friends told me she had breastfed until she was nine years old. I was so jaw-dropped flabbergasted that at first I dismissed it as a joke. Considering my son weaned just after turning four, I'm now a little embarrassed about my adamant disbelief. While nine years is pretty old to be breast feeding, even by Mongolian standards, it's not actually off the scale.

    Though it wasn't always easy to fully discuss such concepts as self-weaning with Mongolians because of the language barrier, breastfeeding "to term" seemed to be the norm. I never met anyone who was tandem breastfeeding, which surprised me, but because the intervals between births are fairly long, most kids give up breastfeeding at between two and four years of age.

    In 2005, according to UNICEF1, 82 percent of children in Mongolia continued to breastfeed at 12 to 15 months, and 65 percent were still doing so at 20 to 23 months. A mother's last child seems to just keep going, hence the breastfeeding nine-year-old - and, if the folk wisdom is right - Mongolia's renown for wrestling.
    At three-year-old Calum was still feeding with the enthusiasm of a newborn and I wondered how weaning would eventually come about, I was curious about what prompted Mongolian children to self-wean. Some mothers said their child had simply lost interest. Others said peer pressure played a part. (I have heard Mongolian teenagers tease each other with "You want your mommy's breasts!" in the same way Canadian kids say "Crybaby!") More and more often, work commitments force weaning to happen earlier than would otherwise have occurred; children will often spend the summer in the countryside while a mother stays in the city to work, and during the extended separation her milk dries up. My friend Buana, now 20, explained her gold-medal breastfeeding career to me: "I grew up in a yurt way out in the countryside. My mom always told me to drink up, that it was good for me. I thought that's what every nine-year-old was doing. When I went to school, I stopped." She looked at me with a mischievous twinkle in her eye. "But I still like to drink it sometimes."
    Pass the Milk, Please
    For me, weaning from the breast seemed a fairly defined event. I always expected that, at some point, feedings would decrease, and continue to taper off until they ceased altogether. My milk would dry up, and that would be that. Bar closed.

    In Mongolia, that's not what happens. Discussing breastfeeding with my friend Naraa, I asked her when her daughter, who was then six, had weaned. "At four," she replied. "I was sad, but she didn't want to breastfeed anymore." Then Naraa told me that, just the week before, when her daughter had returned from an extended stay in the countryside with her grandparents and had wanted to breastfeed, Naraa obliged. "I guess she missed me too much," she said, "and it was nice. Of course, I didn't have any milk, but she didn't mind."

    But if weaning means never drinking breastmilk again, then Mongolians are never truly weaned - and here's what surprised me most about breastfeeding in Mongolia. If a woman's breasts are engorged and her baby is not at hand, she will simply go around and ask a family member, of any age or sex, if they'd like a drink. Often a woman will express a bowlful for her husband as a treat, or leave some in the fridge for anyone to help themselves.

    While we've all tasted our own breastmilk, given some to our partners to try, maybe used a bit in the coffee in an emergency - haven't we? - I don't think many of us have actually drunk it very often. But every Mongolian I ever asked told me that he or she liked breastmilk. The value of breastmilk is so celebrated, so firmly entrenched in their culture, that it's not considered something that's only for babies. Breastmilk is commonly used medicinally, given to the elderly as a cure-all, and used to treat eye infections, as well as to (reportedly) make the white of the eye whiter and deepen the brown of the iris.

    But mostly, I think, Mongolians drink breastmilk because they like the taste. A western friend of mine who pumped breastmilk while at work and left the bottle in the company fridge one day found it half empty. She laughed. "Only in Mongolia would I suspect my colleagues of drinking my breastmilk!"

    Living in another culture always forces you to reevaluate your own. I don't really know what it would have been like to breastfeed my son during his early years in Canada. The avalanche of positive feedback on breastfeeding I got in Mongolia, and Mongolians' wholehearted acceptance of public breastfeeding, simply amazed me, and gave me the freedom to raise my child in a way that felt natural. But in addition to all the small differences in our breastfeeding norms, the details of how long and how often, I ended up feeling that there was a bigger divide in our parenting styles.
    In North America, we so value independence that it comes through in everything we do. All the talk is about what your baby's eating now, and how many breastfeedings he's down to. Even if you're not the one asking these questions, it's hard to escape their impact. And there are now so many things for sale that are designed to help your child amuse herself and need you less that the message is clear. But in Mongolia, breastfeeding isn't equated with dependence, and weaning isn't a finish line. They know their kids will grow up - in fact, the average Mongolian five-year-old is far more independent than her western counterpart, breastfed or not. There's no rush to wean.
    Probably the most valuable thing about raising my son in Mongolia was that I realized that there are a million different ways to do things, and that I could choose any of them. Throughout my son's breastfeeding career, I struggled with different issues, and picked up and discarded many ideas and practices, in my search to forge my own style. I'm glad I breast fed Calum as much and as long as I did - it turned out to be four years. I think breastfeeding was the best thing for my son, and that it will have a lasting impact on his personality and on our relationship.

    And when he wins that Olympic gold medal in wrestling, I'll expect him to thank me.