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.

Breastfeeding at work - let's stop jerking knees please...

The Daily Mail today published an article by Bridget Harrison - As a nursing mother, the LAST thing I want is to breastfeed my baby by the photocopier and so I thought I would share my slightly different perspective.

As Bridget outlines, a public health White Paper this week encourages more employers to be breastfeeding friendly by being flexible over when breast-feeding women take breaks, provide places where they can pump their breast milk, allow them to go home to feed or even bring their babies into work."


What about the cost, companies can't afford it at the current time!  it will make mothers unemployable! Women will be forced back to the workplace early and with all those bonding hormones going on won't be able to focus on work anyway! 

Before I start tackling some of the employment issues, I thought I would start with some of Bridget's comments (or consequences as she prefers to call them).  Of course Bridget as a nursing mum is entitled to her opinion, but it's also important to realise this isn't the opinion of every nursing mum.
Breastfeeding is exhausting and emotional. Unless you have done it, it is difficult to fully ­understand what an intimate and consuming experience it is.
Breastfeeding in the early weeks can be hard, no doubt about it - but once established it's a lot less exhausting for many than the rigorous formula preparation now advised.  Mothers who return to work co-sleeping and breastfeeding, often report much lower levels of exhaustion than those up a lot with a waking baby.  Realistically having a baby can be exhausting and emotional, regardless of how they are fed.  Breastfeeding only uses the same calories as a gym workout - rather than the equivalent of Superman facing kryptonite!

It seems to me though this isn't about forcing women to breastfeed -  if a mum hates expressing, she is as free to use something else as she ever was.  If she has a hellish commute or nobody to bring the baby in - she doesn't have to!  But not all mums feel the same as Bridget - some feel empowered they can continue to provide milk, happier to return to work knowing baby is still getting it.  Some babies will refuse formula, causing upset and stress for mum if there is no way she can continue to provide milk.

Bridget feels her first child was less clingy because she bottlefed when returning to work, compared to number two who had the "biological tie" and was distressed when she was absent.  The reality is this is far more likely to be about different children!  My first always waved me off with a grin and was happy as larry all day, despite being breastfed!  My second was far more limpet like, because well they have different personalities.  I don't understand how this will force women back to work - most make that decision based on other considerations such as finances.   Bridget herself went back earlier with her second child, she herself says "too early", was that because she could provide breastmilk at work? nope

Breastfeeding is generally so undervalued in our society that I don't often hear of women not returning to work because they breastfeed - instead they are far more likely to not start at all (no point when I'm back to work soon) or wean before they return because their employer may not allow expressing breaks, and this is the crux of the issue.
That said, there are thousands of women who do bravely manage to ­combine breastfeeding with work. 
They carry breast pumps in their ­handbags; slip off discreetly to pump and store the milk in specially designed cooler bags. I support wholeheartedly their right to do so.
But since they are already managing this, why do they need the Government to intervene on their behalf?
At least there's some acknowledgment that despite the anxious, guilt ridden, exhausted, emotional mess that apparently is the working breastfeeding mother - some women "bravely" do both.  But what Bridget seemingly doesn't get is that not all employers are as nice as hers clearly is.  Unlike women in 80 other countries in the world, mothers in the UK have no legal right to express milk or breastfeed during work hours.

Therefore some employers make it really difficult for a mum to continue breastfeeding - in order to support the right of mothers who want to (as Bridget does) this means calling for guidelines that protect this right.  Whilst making informal arrangements with an employer may work for all in an ideal world - the reality is not all employers appreciate the value of breastfeeding and co-operate.

The costs could "cripple" small companies - what a screen, a chair and a coolbox?  sure the mum might get a couple more breaks - but when you consider non breastfeeding mums are absent from the workplace up to 3 times as frequently as non breastfed (due to increased rates of illness in non breastfed children) where's the cost?

In fact, there are a lot of benefits to employers that don't seem to have been considered.  According to the NHS breastfeeding and work leaflet these include:

• Reduced absence due to sickness
• Increased staff morale and loyalty, and a subsequent higher return to work rate
• Lower recruitment and training costs
• An extra incentive to offer potential employees.

The Health Promotion Agency also adds:
Women who breastfeed are healthier and are less likely to suffer certain serious illnesses, such as breast cancer, ovarian cancer or osteoporosis.

The HPA make suggestions very similar to this as to how you can choose to combine working and feeding:

• If you can arrange childcare for your baby close to where you work, you could breastfeed during breaks and immediately before and after work.

• You could continue to breastfeed at home and then express milk while at work. This way you will be able to keep up your milk supply and your baby can be fed your milk from a cup or a bottle.

• You could ask to work flexible hours outside the times your baby would need fed. Alternatively, you might be able to reduce your hours for a short time, just until your baby needs fewer breastfeeds.

• Or you could combine breastfeeding with formula feeds. This would mean continuing to breastfeed when at home and then your baby having formula when you are at work.

So the HPA obviously don't think these ideas are so "out there" they are ridicule worthy.
Earlier in the year President Obama amended the Fair Labor Standards Act (FLSA), by requiring employers to provide nursing or breastfeeding employees with reasonable break time to express their breast milk.  If as Bridget feels most employers are happy to informally negotiate this anyway, what's the big deal?
As we understand more about the implications of premature weaning from the breast to health, the economy and the environment - it's absolutely right the government look to reflect this in their policies.  Otherwise like much else, it's nothing more than lip service. 

Earth to Aileen @ Herald - your pro formula article sucks!

I can't decide if was having a particularly slow day, or whether they just felt sufficiently sorry for  Aileen Hickie and her emotion fuelled article to run it; but either way beyond bad sums it up quite well.  The article headed "Is breastfeeding really best?  Mum of five Aileen Hickie says mothers should not be bullied into breastfeeding if they don’t want to" unfortunately caught my eye today after being sent in by a blog fan.

The first paragraph sets the tone:
The "breast is best" mantra has lost none of its emphasis or militancy and the breastfeeding mafia has grown in strength and numbers over the years.
Wow we've got to breastfeeding mafia already and we're only in the first paragraph!  For anyone "not in the know" - the breastfeeding mafia is a catch all for anyone who supports mothers and tries to get good factual information out there on which mothers can base their choices.  If you understand "formula isn't as good" then basically you're in.

Far more scary is the "artificial feeding mafia" - rarely highlighted in the press, they tend to lurk in unexpected places waiting to pounce, with breastfeeding forums seemingly a favourite haunt.  When a mum posts a breastfeeding problem and perhaps in desperation mentions should she give formula?  they wait for someone to reply....If alongside lots of information and help, it includes details of how formula can impact - perhaps with some other options, so the mum can make a truly informed choice - BANG you're lynched! (some of the more pro-active members don't even wait for a reply, they head straight on in there)  "you shouldn't feel guilty if you want to give a bottle" - often a weird reply given there was never a suggestion mum should - that was purely how the person replying felt after reading the fact, "formula is NOT poison" - again nobody suggested it was. (although with the recent news about aluminium contamination, I guess that point is now quite debatable) but the mum in the post made it quite clear she really wanted to breastfeed....

Perhaps worse is the fact the artificial feeding mafia can often be disguised as a Health Professional or family friend! "there's no benefit to breastmilk after three weeks", "x brand is the closest to breastmilk" (without a few hundred of the constituents *cough*) "he's not gaining what we expect you will have to stop being silly and give formula, it's not poison" (with the undertone of I have no idea how to help you and I understand formula)

In fact, the artificial feeding mafia seems to be going strong and hitting hard - a staggering 68% of mums from over 600 polled said they had "felt pressure to stop breastfeeding, or guilt for continuing?"  so the "breastfeeding mafia" clearly need to up their game.
Breastfeeding causes women to judge other women. Women, be they relations, friends, acquaintances or complete strangers, seem to feel strangely comfortable interrogating new mothers as to whether they are breastfeeding or not. And if not, then why not?
I think women judge themselves far more harshly than anyone they perceive to be judging them - we all know what a hard time and lack of support women have, 96% are giving some formula by 6 months, so that leaves what 4% to be mafia like?  We hear these claims of women who "interrogate new mothers", but does anyone really know someone who does this?  What about women who tut and shake their heads at someone breastfeeding, or one mum who said to me "you want to knock that on the head and get him on a bottle!" or those who just go "ugh how can you"...
No other aspect of parenting engenders the same amount of tut-tutting or even open criticism of those who either cannot or choose not to breastfeed.
Has Aileen ever stepped onto a parenting forum?  clearly not.  Controlled Crying (the irony is in the name) Cry It Out, whether to "time out" or "naughty step" are all hot topics of debate and criticism.  Sleep is the big one at baby groups - with mothers often feeling like aliens with 3 heads if their infant hasn't been "trained" to sleep 12 hours by a few months old. 
Yummy mummies and other over-achieving middle class women seem to think, quite arrogantly, that it's their God-given duty to inform the sisterhood that breastfeeding is a requirement that brooks no excuses. Indeed, not just a requirement, it is the ultimate badge of responsible parenting. Shame on those who put a bottle of prepared feed anywhere near their precious bundle of joy.
Oh now we've moved on to the old and rather boring stereotype that only mothers of a certain class breastfeed - isn't peer support about PEERS supporting? The clue is in the name.  I actually agree it's not any ones right to "inform the sisterhood that breastfeeding is a requirement" - but then I've often heard this claim when actually all someone has done is given factually correct information, the mother's own feelings have done the rest.

To be fair as the UK has a National Health Service, one could argue that actually how infants are fed does impact on others - because non breastfed infants cost the healthcare system millions, time absent from work due to increased illness impacts on the economy, the masses of tins, transport and cows impacts on the environment.
It is as though formula is the devil's milk, only invented for second-rate mothers. With those standards, it won't be long before those women will be feeding their children sugary drinks and fast food and then a diet of endless television, a Facebook account and other steps on the slippery slope of bad parenting.
Formula is devils milk this time - interesting variation on the "it isn't poison" stance.  Actually it was invented for foundlings who had no mother, and substitutes are already considered fast food by many - plus it's high sugar levels can cause cavities and "bottle mouth".   I don't think we should label anyone a bad mother without knowing their back story, it's not our place to judge - but clearly Aileen does have an opinion and feels mothers who allow fast food and endless TV to be "second rate".  If someone knows all the heath implications and doesn't even attempt to breastfeed - is there a massive difference? they are making a choice that clearly can impact negatively on the child's health. 
The women who choose to breastfeed believe their child will get the most nutritionally balanced diet from birth and build its immune system. It may help their post-baby weight loss, too. Fair enough.
What a ridiculous idea!  suggesting milk of an infant's own species will give the most nutritionally balanced diet from birth and build its immune system.  Tsk who would believe this?   OK so there are decades of hardcore scientific evidence linking worse outcome to non breastfed infants including SIDS, long lists of the constituents formula is lacking: no hormones, cancer fighting cells, stem cells - heck scientists now know what some constituents do and the impact of not having them, but HELLO which gullible fool actually believes it?
Other women choose to formula feed for many other reasons, some physical and some psychological. There may be difficulty in getting their baby to latch on, inability to breastfeed, post-partum depression or issues of self-consciousness about breastfeeding in public. There may be a need to get back to work quickly or other family considerations that mean the time commitment for breastfeeding is not an option.
Absolutely!  and support in the UK is massively lacking from the NHS - but the answer is not to lie to women and peddle a substitute as nearly as good when it isn't.  Women need support to get their baby to latch on particularly after a difficult birth, not breastfeeding had been linked with increased PND rates not reduced (although trying with bad support doesn't have a great outcome either) and are we shocked women feel self conscious about feeding in public when 96% of infants have some bottles by 6 months?  how many mums witness lots of breastfeeding in public?  it's hardly a surprise new mums feel anxious over it.  Many mums breastfeed and get back to work quickly and breastfeeding often doesn't need anything special if it kicks off well from the get go.  I wonder if we could invent a portable womb too?  then women wouldn't have the inconvenience of constant pregnancy, that could be shared around too!
Surely whichever method a woman chooses is best for her baby; if the mother is happy and comfortable then it is likely that the baby will be happier and less stressed. Stress is far more detrimental to a baby's well-being than not breastfeeding. A child can be clever and healthy without mother's milk.
Although it would be lovely to say yeees, whichever method a woman chooses is best and yeees stress is far more detrimental to a baby's well being than not breastfeeding....the reality is it's not true!  No more than giving junk food or sugary drink is the healthiest choice if the outcome is a less stressed mum - yep those arteries will be fine as long as your mother isn't stressed?!  Of course a child can be clever and healthy without mothers milk, because it's not about "definites" it's about risks and what we do know is not breastfeeding massively increases the risks of lots of things, including serious things. We all know people who ate a crap diet, or smoked 40 per day and were "FINE" - but that doesn't undo all the research anymore than it does with breastfeeding.

Just under 1000 babies in the US died last year directly due to being formula fed - that figure doesn't begin to touch upon those who died from conditions far more common in formula fed infants - a happy mum does not protect an infant from disease.
My issue was mainly about breastfeeding in public -- or even in front of just family and friends. I knew I could just stay indoors but neither did I want to be tied to the house for six months or more.
It was my mother, a former midwife herself, who finally addressed the issue, advising me not to breastfeed unless I was 100pc comfortable with the idea as she felt it would be more damaging to the baby if I was stressed. She had bottle-fed four healthy children and I remembered as a child seeing a tin of formula on the kitchen windowsill to feed my younger siblings. It is still a pleasant image and reminds me of a happy childhood.
And here we have the most telling paragraph of the whole piece.  Ultimately Aileen wasn't breastfed - her mother, one of the afore mentioned health professionals stated that unless she was 100% comfortable she shouldn't breastfeed - and obviously ultimately herself believes bottle is as good; why else would she "advise" her own child not to do it?  She will no doubt have trotted this out to numerous mothers over the years (as still happens today) alongside the NHS lip service "breast is best". 

I expressed similar anxieties to my mum when pregnant - someone who had breastfed (and also formula fed) I was reassured that it was totally normal to feel anxious, but with the super discreet clothing on offer nobody would see anything - if you feel it really essential a cover or muslin can be used.  To try and breastfeed in front of a mirror and realise just how little others can see, and to be proud I was giving my child breastmilk and that ultimately feeding in public was tiny compared to all the health implications.  I had only ever seen two or three breastfeeding mums in public, and always from a distance and yes it does feel strange at first - but pretty soon I could nurse anywhere and everywhere (and did!) and people didn't have a clue.
As for familiar childhood images - I feel similar about my grandad's pipe rack, but have no plans to take up that hobby anytime soon!  Mind you, we all sat in his smokey room and are "fine" right this minute - so perhaps it's foolish believing all those anti smoking mafia types?
Once my eldest child was born there was one last attempt made by a hospital midwife to get me to breastfeed. But to no avail and my baby girl had her first bottle when she was an hour old and sucked happily on that and every one thereafter.
How sad Aileen wasn't even told/didn't believe the reasons colostrum is so important.  Even farmers recognise this and buy it in for their lambs/calves if the mother cannot provide.  Even one day, two days - as long as it was before Aileen wanted to go in public and not feed would have been so valuable to her children. 

It's great Aileen's kids are healthy, I wouldn't wish ill health on anyone - but should they get in later life any of the conditions linked with not breastfeeding, be that 10 or 50 years down the line - will anyone even link this with the first six months of life?  Recently a friend who openly told me she "couldn't be bothered" breastfeeding as she was formula fed and fine, was diagnosed with rheumatoid arthritis at 31.  I doubt she's even aware of the links with formula let alone wondering of the longterm implications for her own children.  No doubt she will advise them to just "give em a bottle!"
Am I happy that I opted not to breastfeed? Absolutely. Would I condemn another mother for choosing to breastfeed? Of course not. Everyone is entitled to their free choice without being made to feel guilty for it.
I guess the sad thing is, not all mothers feel like Aileen - and our of those that do, many wont even know what they're missing... We're also back to the issue of choice - how any mum can make one without all the information still baffles me, if Aileen supported choice she may and try pop a bit of evidence into some of her writing instead of pointless anecdotes based on her own guilt trips.

Ultimately shame on the Herald, for even considering printing something so lacking in substance and which only serves to perpetuate old wives tales and myths - as I've said before, the "choice" that never was.

A moment for Pam Lacey...

It seems only right today, the day of the funeral - to take a moment to remember Pam Lacey, the late great chair of the Association of Breastfeeding Mothers.

As I live at the other end of the country, I never had the pleasure of meeting Pam in person - I had chatted to her on the phone, messenger and email lists; and in all honesty I think it's pretty awesome one person can inspire someone as much as Pam did me, without ever even meeting...

When I first started training I remember reading an email from Pam and it suddenly hitting me how little I knew. Not only did Pam have the most amazing breastfeeding knowledge, but she had a way of expressing things that everyone could understand and which fuelled the passion in others. I can also clearly remember getting firmly put in my place when I used the word "advice", and at first her plain speaking was daunting - but it soon became clear it was because of the passion Pam had herself, not only for supporting mothers and babies, but ensuring everyone else doing so was doing it well! She had an amazing insight and understanding - not just about breastfeeding itself; but the barriers mums face, the tactics companies employ and how we could best support mothers to truly nurture their babies.

I also realised quickly how kind Pam was, how she could always spare time to patiently answer my never ending questions about anything and everything lactation related! When my own preemie had weight issues, Pam was there - the voice of reason, instilling confidence; her fantastically quick and witty sense of humour, and way of turning everything upside down to see it from a different angle.

During her time as chair, Pam didn't only help the mothers and babies she worked directly with - she changed things for thousands of mothers by the impact she made on others. If I can be a tenth of the lactation pioneer or "lactationeer" Pam was, I will feel it's a job well done - but I will also think of Pam, and strive to be that little bit better...
Thank you Pam!

breastfeeding in public is offensive - see for yourself!

I can't take the credit for this (nor can I track down the original author) but it's great and so worth a share :)

I’m thankful for not having boobs thrown in my face all the time by offensive and indecent breastfeeding mothers like the ones below:

Wait…Well, this is a bad example. Let’s try again.

Hmm…Just a minute. I’m sure I can find better ones than these…

Eh, still not offensive enough. I’ll check one more time.

That is better. LOOK AT THAT! I see about a half inch of boob. DISGUSTING.
UGH. Look at that indecency! She must be from some third world country to be exposed like that!

Now that’s just…There are no words to descripe how inappropriate that is. Something needs to be done!

But why stop at breasfeeding women? There are boobs everywhere. Beware! If you thought the above photos were offensive, you WILL DEFINITELY be offended by the photos below.

Not this one, though. This one was in plain view on news stands and in mail boxes in 19 countries world wide!

Not this one, either. This one actually won an award!

Oh, and I guess this one is fine too. Everyone knows you can’t sell jeans without someone being topless.

Or beer, for that matter.

Or sunglasses.

Or movie tickets.

Or CDs…

You know what? Maybe I’m crazy, but I think that someone mixed up some photos here. The first batch are offensive, but the second batch are just fine and dandy???

People who live in glass bras:

Shouldn’t throw stones:

If you think women have the right to breastfeed their children no matter where they are, please repost this…comment vote it popular whatever . Support breastfed babies and their right to eat in public!

Green nappies - what do they mean when breastfeeding?

Green nappies - perhaps one of the most talked about subjects on a lot of breastfeeding forums.  "What do they mean? Is everything ok? What should I do?!".  I've certainly seen some interesting replies, with one popular site suggesting "green stools are a warning!" ooh heck!

There are several reasons for stools veering from the typical yellow/mustard/seedy/curdy breastfed type - like most things there isn't a one answer fits all reply; we need to look at the whole picture.

Firstly if baby is happy, content, gaining weight well and the only issue is stools are green - I think it's Dr Newman who suggests popping on some sunglasses.  Secondly sometimes stools can go green for a day or two due to a bug, teething, medication mum is taking (such as antibiotics or iron supplements), a random food mum ate, supplement (such as spirulina) or just because!  if all else is well, green nappies alone mean very little.

Green poo can also occur because baby isn't getting enough fat, or enough in relation to the lactose rich milk at the start of a feed (often called foremilk).  Lactose moves through the system very quickly - without fat to slow the process the baby can't produce lactase (to process the lactose) fast enough.  In response bile is produced which is what gives the stool it's green colour.

The common answer to this is often to block feed, or stick to one side - and in some cases (ie if oversupply is the reason), this will help.  But it isn't the only cause, and so suggesting a technique designed to reduce supply without being sure can be risky.

It could be that baby isn't milking the breast as effectively as they could - perhaps due to tongue tie or positioning/latch that needs a tweak.  If so it can be hard for them to release the fat and in some cases they will tire before they reach it (rather like if we half squish a straw and then attempt to drink) - what happens next depends on the baby and their age.  Some will "power feed", drinking the letdown, pulling off and then repeating an hour (or less) later, some will do this on both sides ie taking the top off each and accessing the fattier milk in neither.  Younger babies often fall asleep quickly at the breast, ie after the letdown - baby may be called "lazy" or a "snacker" but in reality once the milk becomes hard/impossible to reach, a small baby will sleep!

I think what confuses people is that baby falling asleep on the breast is a sign they have "finished" with it and so swap them over.  However, this is when baby falls asleep after actively feeding well on the breast - if a baby is falling asleep because they are not well attached and thus feeding is tiring, they are likely to fall asleep long before they empty the breast!  Watching for active milk transfer not just how well baby appears to be latched is key.

Babies in this group may have lower than expected weight gain and if baby isn't taking sufficient milk, stools may appear dark green/brown and may be small/less frequent than expected.  Others will gain weight very well, due to the regular calorific foremilk hit!  Maximising milk intake by ensuring effective feeding, breast compression & switch nursing can help, further information here.

Another cause can be swapping sides before baby has finished the breast - most often because mum has been told to feed for a set number of minutes. This article explains why.

Antibiotics can cause a windy/fussy green stooling infant which is also worth noting if they begin around the same time as the medication.  A virus can also cause a short term change to stools.

As mentioned green poop can also be down to a large supply, ie mum is becoming extremely full and engorged before each feed (typically once supply would normally have established and level out) baby can sometimes feel satiated before they  get to the fattier milk. Mums usually know if they have a large supply - they may frequently feel engorged (beyond the typical physiological engorgement when milk "comes in") and hard between feeds. Oversupply is most common when baby is around 3 weeks old onwards.

NB - choking/spluttering/pulling back when feeding is often described as a sign of oversupply/fast letdown.  However if baby has a disorganised suck for some reason, and cannot effectively co-ordinate feeding - he will do the above even when the flow is a perfectly normal speed.

Allergy or intolerance to something in mums diet can occasionally be a cause - dairy is the most common culprit (it is thought mum only passes milk protein via breastmilk if she herself is intolerant perhaps without knowing, or has something else causing a "leaky gut") these stools are often described as stringy/mucousy or flecked with red/black.  However mucous indicates irritation of the intestinal lining and so can also be caused by a cold, virus or teething and often passes in a day or two.  In very rare cases bowel movements filled with mucus like jelly streaked with blood, often compared to currant jelly (usually accompanied by abdominal cramps and vomiting) can be caused by a bowel blockage called Intussusception - always consult your doctor immediately if you are all concerned about the health of your baby.

Babies born by Cesarean section are at increased risk of a disturbed gut flora and thus "nappy issues" due to lack of bacterial colonisation via the birth canal, as are infants whose mothers had antibiotics shortly before, during or after labour (or during the duration of breastfeeding), or who have food sensitivities (recognised or undiagnosed) .  Many experts now recommend probiotic supplements for higher risk infants.

Is it Diarrhoea? 

Exclusively breastfed infants will pass poo that is fairly runny as standard; diarrhoea differs in that it is far more watery and mucus-like in consistency. It may leave more of a water stain than a stool as the liquid is absorbed into the nappy.  There is a risk of dehydration if your baby is being sick as well as suffering from diarrhoea, and/or if it accompanied by a fever or sweating - if you have any concerns always consult your doctor.

Activism Isn’t About Being Better Than You

I really liked this article so thought I would share a few extracts - the full article is well worth a read, link below :)
Often people ask why people care. Why do I care about getting out good breastfeeding information?
Why do I care if you breastfeed? Because it’s hard, that’s why. Because there is so much to know, so much to learn, so much to get through, so many obstacles, especially societal and cultural, that stand in your way. There is so much misinformation, and the risks of formula are so insanely downplayed at risk of hurting someone’s feelings that women honestly aren’t making an informed decision, even when they think they are.
Because studies show that formula fed babies are at risk for many more problems, no matter how much formula companies and often formula-feeding moms try to convince you (and themselves) that there’s little to no difference, it’s not true. Formula is an amazing, life-saving nourishment for babies… when breastmilk is not available. 
I certainly understand how many things stand in a mom’s way. I have learned so much over the years, and I want you to know what I know, because I don’t want you to struggle. I want to help you remove so many of the barriers that I had to overcome, without you having to learn the hard way.
I could keep going, I could go into birth explanations, but it all boils down to this: people become activists not because they woke up one day and decided to be an asshole or loudmouth. Something happens in their life that shows them that there is a specific need for more support, more information, more action in a certain area.
Even if “Why do YOU care what I do with MY child?” seems like a good retort, it’s really rather ridiculous, as caring about children and being an advocate for their health is an amiable trait, not one that should be shot down because of “parental choice.” Parents choose to do lots of things, but that doesn’t mean they’re all right or okay or healthy.

Before insulting someone or being offended by their passion, maybe you could do what activists are so often told to do, which is find out their story. Because most people start out not caring at all… but something happens that shows them someone needs to, and often, most often, it’s because they wish some activist had been there for them, and because they have something potentially life-saving to teach you, if you actually let down your guard long enough to listen.

Mum 2 Mum Breastmilk Sharing Orgs, Genius.....or not?

The concept of breastmilk sharing, whilst not new - is something most of us have heard more about than usual over the last couple of weeks, due to a couple of new organisations setting up to facilitate easy sharing.

The first official share setup I saw was a couple of years ago now at, and I briefly toyed with the idea of something similar in the UK.  On several levels it appears the perfect solution, mothers who have too much breastmilk can give it to those who don't have enough - easy!  Liberating for mothers, great for those who have older infants and want to donate and potentially capable of aiding a large mental shift in terms of what we feed our infants.  However there were too many questions I didn't feel comfortable with, and in light of the new orgs - I still have these concerns.

Firstly and probably most obviously what about Breastmilk Banks?  I appreciate they don't by any means catch all areas - but there is surely a risk that those who are within area will either not know of this option (if the orgs do a good job of promoting themselves, this could become an more obvious choice) or it could even become preferable.  Will mothers get more "donor satisfaction" from replying to a real life mum who can express her gratitude for the milk?  Banks are usually run by busy medical staff, who perhaps aren't always as obviously grateful as a specific mother.

As it stands many banks don't have enough milk - the health implications of which are significant.  Hospitals with access to a bank give tiny prematures/NICU babies "first dibs" on the milk, they can then if they have enough extend to older SCBU infants or term babies who need support (perhaps born to a diabetic mother and needs more immediately at birth)  Finally if the bank is full to busting - they can then potentially offer excess to the community.  This rarely happens at the moment because most banks aren't full - although an example today was a message circulated from Cheshire & North Wales that they had an excess of pasteurised donor milk which was available free of charge if a mum needed it.

The trouble for Milk Banks is they're expensive - mums are screened, milk is transported, pasteurised and refrigerated which of course all cost.  If donor numbers fall some banks could easily be put at risk.  And what of the prematures?  For a 26 weeker breastmilk can almost certainly be the difference between life and death, they need such a tiny amount (Just a few mls) that standard donations can help so many preemies!  Will mums of an infant in NICU/SCBU soon be having to hit a website to get donor milk?  then sort screening and pasteurising the milk?  It would seem to me it would make more sense to at least run something like this alongside Bank support, or even by them to ensure they had adequate first? although the latter option perhaps not financially viable?

Which raises other questions - Milkshare gives guidelines about screening and details of how to pasteurise at home, but I can't seem to spot these on the UK sites.  I know whether to pasteurise or not is a topic of hot debate - but as home users are unlikely to be able to implement other techniques for testing milk, aren't most going to do this?  Do doctors freely screen mothers at request?  when it's for a milk bank the hospital sends the relevant forms for the donor to take to a nurse/blood clinic and they take care of screening.   How does this work without this referral (I can't seem to locate this information on the sites either)

So far I'm also a bit concerned at the lack of breastfeeding information accompanying the sharing ie do you really need donor milk?  steps to increase your own supply, relactation etc.  Information of where to get support to potentially rectify the situation or at least only use donor milk as a stop gap; whilst it is a better choice than formula, we should also acknowledge it's not comparable to a mother's own breastmilk.

A lot of mothers also don't know they can use their own frozen breastmilk to give their own child in other ways such as on cereals, smoothies or puddings - perhaps when they return to work etc.  When you think it can save the life of a preemie - it seems worth it, whereas I've seen shares for say a 6 month old on solids who is usually given formula but mum would prefer breastmilk.  One solids are introduced, is pasteurised and likely frozen/defrosted breastmilk more valuable to one infant than to the intended child?  particularly given so many are weaned so much before the immune system fully matures and the child self weans.

I'm not sure - I haven't really made my mind up one way or another yet.  I could have a ponder, read more and see things from a different angle so firmly on the fence at the moment.  What do others think?

Breastfeeding mums don't get less sleep! Myth Busted!

Rearch published this month in the European Journal of Paedatrics, by Dr Hawley Montgomery-Downs of West Virginia University, contradicts the myth that breastfeeding moms get less sleep.  Dr Hawley said:
"The results represent good information to be able to tell women; that not breastfeeding is not going to help you get better sleep.  There has been an "urban myth" that women who breastfeed get less sleep, which may cause some to hesitate to do so.  Indeed, babies digest breast milk faster than formula, the researcher said, so breastfed babies may need to be fed more often in the middle of the night."
When Montgomery-Downs and her colleagues asked 80 new mothers to report how often they woke up and how rested they felt, and to wear sensors that measured how long and efficiently they slept, they found Breastfeeding mothers slept just as long and felt just as rested.

This suggests that "there may be some kind of compensation" for breastfeeding mothers, Montgomery-Downs said in an interview.  "For instance, babies who breastfeed may wake up more (and wake up their parents more), but those nighttime feedings may have less of an impact than if they were drinking formula", she suggested. "In order to prepare a bottle, women often have to get up, turn on the lights, and move around quite a bit, all of which may make it harder for them to go back to sleep."
"Alternatively, when breastfeeding, women may be awake for shorter intervals, and be less active, which makes it easier for them to go back to sleep. Women who breastfeed also have higher levels of the hormone prolactin, which facilitates sleep," Montgomery-Downs noted. "And if the babies are sleeping next to the mothers, they may feed while the mother is sleeping, she added".
"Better sleep really is not a reason not to breastfeed," she concluded.
These findings are consistent with other recent evidence.  Several studies between 2004 and 2009 have indicted exclusive breastfeeding mothers got more sleep; three sets of parents have been studied: those that were exclusively breastfeeding, those that were breastfeeding AND formula feeding, and those who were feeding only formula.  Although, the exclusively breastfeeding mothers were awakened more times throughout the night than the other mothers, they still got an average of 40-45 minutes MORE sleep each night.

Not only did the breastfeeding mothers get more sleep, they got BETTER SLEEP. The studies showed that REM (rapid eye movement) sleep was similar within the groups, but the difference in slow-wave sleep (SWS) was remarkable. People who get less SWS report more day-time fatigue. Studies also show that those who get less SWS are more likely to suffer depression. To be clear, the “breastfeeding mothers got an average of 182 minutes of SWS. Women in the control group had an average of 86 minutes. And the exclusively bottle-feeding women had an average of 63 minutes.”

In short, women who do not exclusively breastfeed get less sleep, get less restorative sleep, and are more likely to suffer depression.

Doan and colleagues noted the following.

“Using supplementation as a coping strategy for minimizing sleep loss can actually be detrimental because of its impact on prolactin hormone production and secretion. Maintenance of breastfeeding as well as deep restorative sleep stages may be greatly compromised for new mothers who cope with infant feedings by supplementing in an effort to get more sleep time. In sum, advising women to avoid nighttime breastfeeding to lessen their risk of depression is not medically sound. In fact, if women follow this advice, it may actually increase their risk of depression.” ibreastfeeding with references

New Independent Breastfeeding Support - Milk Matters

Today I launched  - so I thought I would share here to tell everyone a little bit more about it :D

As some of you may know from reading this blog, I work quite a lot on a voluntary basis; answering helplines, the blog, another website etc.  I do this probably obviously because I'm passionate about trying to help mums who want to breastfeed do so.

At the moment NHS care is a postcode lottery (going to cover this in a blog post very soon!) and many women are left with inadequate support to have a chance.  Unfortunately there's only so much we can do in a voluntary capacity - for example I can't regularly offer 1 2 1 home visits.  Why?  Here's an example: It was Sunday and a mum got in touch who was desperate, she didn't think she could get through to Monday and I could hear her baby screaming in the background.  Mum was very distraught because she really wanted to breastfeed but just didn't know what to do.  So, on a Sunday - the only day I have with my children and family, I set off to make the 40 min journey to her house, was there over an hour and then did the 40 minute journey back.  I don't even get petrol money covered.....

Do this on a regular basis (as I used to) and pretty soon it's costing quite a lot!  This also means the voluntary organisations are losing an awful lot of really good counsellors, because they need to get back to work and earning money - so their 2/3 yr training is left behind, and the organisations bear the cost to retrain someone else.  I'm finding that less and less counsellors are offering home visits, leaving mums with often only NHS support if there are no lactation consultants in their area - or perhaps a once per week group, often of variable quality depending upon who is running it.  At the moment some areas are using peer supporters (8-12 weeks training - designed to be a well informed friend and support with what is normal, nothing more) to run antenatal, birth and postnatal breastfeeding, education and support.  I frankly find this really quite scary!

Over the past year or so, more and more mums have been contacting me asking if they can pay for support - but on a National level things are still sadly lacking (as the comments on many of my articles here will testify!) and so we hope Milk Matters can help with this.

We are independent - which means parents can pay for a range of services depending upon their situation.  Mums who want can take a full bump to breast 1 2 1 package, but we also offer this as a group option to reduce costs.  We offer a second time mum "debrief" to help establish why breastfeeding didn't work with a previous child, stand alone antenatal sessions, plus a "need help now" emergency option!

We have launched in North & West Yorkshire, but we hope to extend this to other parts of the country over coming months.  Only those who are qualified as a breastfeeding counsellor with one of the main organisations or IBCLC lactation consultant will be able to offer this service; ensuring quality of care. 

We are also in the process of becoming a social enterprise, as we plan to donate any profits back in to the voluntary organisations that are training counsellors  (proportional to which organisations our specialists are trained by) and back to those working to develop support, resources and research.

There will of course be strict ethics and guidelines in place, to ensure mums who take a voluntary call do not self refer for payment - which is why we call ourselves "breastfeeding specialists" to try and separate the two roles.   But we hope our services can help to go some way to filling the gap that currently exists in the system - where Health Visitors are referring to volunteers, no continuity of care is offered, and as per one mum I spoke to today - left paying £70 for a breastpump (for the last 6 weeks!) because they can't find anyone to help transition baby back to the breast.  Mum had NO support and couldn't find anyone - hence why she ended up expressing and supplementing.

There's lots more information on our website, and I will also of course be happy to answer any questions anyone has :)

A word from Annalisa
“Breastmilk provides the very cornerstones on which a human’s health is built. There are too many myths surrounding breastfeeding, myths that sometimes stop women continuing, even though they want to.

When I had my first child, I got so much conflicting advice from people, my head was spinning. Some of that advice I later found out was factually incorrect and hugely damaging. One friend told me her GP had told her that there was “no benefit to breastfeeding past seven weeks”. Well! This is just codswollop. Luckily I got proper help just in time and was able to salvage my breastfeeding relationship which had got into a right old mess: I gave formula within 24 hours of my daughter’s birth, I stopped breastfeeding for a while, I was mix feeding, pumping, I re-lactated…With the launch of Milk Matters, we hope that with qualified, specialist support the women who want to breastfeed will get the best help possible. Jamie Oliver has campaigned very effectively to raise awareness regarding wholesome school dinners, but good child nutrition starts way before solids are even introduced.”

Ask The Armadillo - How Frequently Should Baby Feed?

Q.  Dear Armadillo
My nine week old feeds every two hours during the day, everything feels very chaotic and I'm wondering when I can expect her to go longer? 

A.  Hi Emma
Chaotic is a great way to describe life with a newborn, life is suddenly so different than before - with everything focusing around this tiny being.  Many mums have expectations their baby will go 3 1/2 - 4 hours between feeds, and of course be sleeping through the night by six months!  As the vast majority of infants are not breastfed after the first few weeks - these expectations are based on what is normal for infants fed a breastmilk substitute, which is often different to normal behaviour for a breastfed baby.

Breastmilk is what a young baby's digestive system is built to digest, therefore it quickly and efficiently does so within an hour and a half to two hours.  Breastmilk substitutes are based on cows milk (generally) and thus a lot harder work for baby to digest.  The amounts consumed are also different - formula is a static unchanging product, each the same as the last.  Breastmilk changes not only in composition, but also the amount taken at each feed.

On top of this whilst mothers can make roughly the same amount over a 24 hour period - the amount available at each "sitting" varies mum to mum, so some infants will need feeding much more frequently than others.  How effectively baby feeds is also a factor - some power feed whilst some feed much more slowly; often infants who feed very frequently during the day will have a longer stretch at night, and vice versa, but there's really no rules.  Some babies will only take one side per feed, others will take two - generalising how much and how often baby should eat simply doesn't work.

Breastmilk is also about much more than food - it's emotional and psychological comfort, pain relief, has hormones to relax and get baby to sleep, contains a massive range of anti-viral, anti-infective, anti-microbial, anti-bacterial properties; providing it's own immune system.  This means babies often want to feed more when unwell, teething or hitting a developmental milestone.  Young infants also have a need to suck for appropriate neurological development - scheduling feeds deprives baby of all but nutrition.  All this means that baby can have phases of frequent feeding, combined with phrases of sleeping a little longer - it really is not the case that once they can sleep through (defined as 5 hours) they do every night!

Even sleep patterns are different depending upon how an infant is fed, with some experts suggesting it is the longer and deeper levels of sleep that increase risk of SIDS.

Unfortunately - much of this natural behaviour is a big clash with expectations and cultural norms.  Modern mums are used to structure, routine and predictability.  In response mothers often try and stretch out or schedule feed - for a small percentage breastfeeding will still work.  For many more problems with supply/insufficient weight gain in baby, or both will occur - sometimes not apparent until around 4 months when prolactin levels drop.

But let's look at what's involved with feeding.  When you consider the guidelines for formula preparation - you can see why mothers are tempted to try and encourage baby to "finish the bottle", hoping for a decent gap before the next feed.  In comparison breastfeeding involves simply picking baby up - is it really a biggie if it's more frequently?

Instead of battling to regain structure - why not just go with the flow and take each day at a time?  your baby is still so young and within a very short period of time your baby WILL go longer between feeds and before you know it they are too busy to feed, not every need can be met by the breast and long lazy snuggly feeds become a distant fond memory; all without you doing anything at all.  It can be easy for mums to feel they are doing something wrong if they don't have a set routine or pattern, it's simply not so and mums often find taking things as they come can make young babyhood so much more enjoyable.

Hope this helps