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By Juno Charlett, on December 3rd, 2008 This week’s subject was: ‘Examining Our Attitudes Towards Other People’ – the last module of the course. This was a very interactive session, involving us all in several activities which provoked further discussion.
Firstly, we looked at how we label ourselves and how we might label others – according to the various social groups people appear to belong to. So we made a list, including age, gender, race – of course – but also: habits, behaviour, politics, health, occupation and several more.
We then looked in more detail at the assumptions and stereotypes we might make about individuals, on the basis of these group labels.
Looking at how we label ourselves, it becomes quite obvious that we find it more comfortable to interact and communicate with those that we identify with. It is easier to be open in these circumstances.
When faced with unknown cultural traits, communication is much more of a challenge. We feel less comfortable with the situation and it is even more important that we recognise the need to be non-judgmental and open-minded. This became even more apparent to me in the next exercise, when we role-played the interaction of two culturally different people.
I played an individual for whom it is: impolite to look people in the eye, discuss personal things and sit near someone, or touch them, unless I am married to them; and, for me, nodding expresses everything.
My partner was to be as friendly and open as possible, trying to establish common experiences and to make me feel comfortable.
Throughout the exercise, I found it extremely difficult to find anything to say. I could also feel that my partner wanted me to look at her and I felt quite uncomfortable about denying her that. In fact, I felt so uneasy about it, that it was still affecting me later on in the day.
As I reflected on this session on the way home, it really began to make sense to me. I thought about any scenarios which might leave me finding it difficult to communicate. I realised that if I was met with some quite judgmental attitudes – perhaps a mother who felt very negatively towards a midwife that I know, or perhaps a mother with racist attitudes – then I might find it very difficult to overcome that. My reaction to that, even though it might remain unspoken, might hinder any further communication – because I could be thinking about that, and all that implies, instead of really listening to the mother.
When those thoughts occurred to me, I think I realised what the session was really about.
So how do we overcome cultural differences and avoid feeling uncomfortable or being judgmental ourselves?
We were given lots of pointers towards this and it all seems to come back to ‘being present’. By ‘being present’ I mean being open to the unfolding dialogue, without holding on to any preconceived ideas and without trying to predetermine the outcome.
In practising that open attitude, we will find it easier to learn about individual and cultural differences in a positive way.
Part of that is also letting go of our personal need to establish our own identity – feeling that we must express who we are when we are speaking to someone. One of the pointers described this really well – ‘Refuse to get offended – don’t take it personally’. Of course, that is easier said than done sometimes, but there is no real purpose to being defensive when trying to counsel and support someone else.
We also discussed ways of learning more about different cultures and, in particular, religious attitudes to babycare and breastfeeding. I feel fairly ignorant on this subject, so I wondered if there is a book out there? Surely there must be, somewhere!
It was reassuring to be advised by our instructor that we could ask the mother about her customs if we are not sure what they are and to acknowledge our ignorance and/or discomfort in certain situations.
It was also very useful to discuss the process of reflecting on any negative experiences we may have. This process is very important, to ensure that we don’t carry those negative feelings with us when we encounter similar groups of people. The process goes through an analysis of what happened, to ideas for doing things differently in the future.
I found this session really interesting and I have thought about it a lot since. There has been a lot in this training that has had a positive impact on the way I think about and communicate with people generally and I have really enjoyed that.
This was the last training session of the course. Next week’s session is a review (which I am unable to attend) and then we have a graduation ceremony – with the mayor and the local paper in attendance! So I’ll be trying to get a good night’s sleep before that session then!
If you are interested in training to be a Breastfeeding Supporter yourself, then it is worth asking your local midwife or health visitor if there are any courses in your area. Alternatively, you could contact La Leche League on 0845 4561844.
Thank-you for reading!
Juno
By Juno Charlett, on November 25th, 2008 Wow! It’s hard to believe that we are already at week 10. It’s almost the last week, as week 12 is a review session – and I am unable to make it to that one. After that, we have a graduation!
This week’s session was a bit odd. There was a lot of material that the instructor was expected to cover, but much of it we have already covered. One aspect for discussion today was, ‘making breastfeeding work in everyday life’, which was actually the title of week 8.
However, we did have another lively and informative discussion and I am finding myself more confident about asking our instructors for more detailed information. It’s as though I have a small foundation of knowledge and experience, now that it has been organised and digested, and I am ready to build upon that.
This week’s session was titled ‘Breastfeeding in Different Situations’, so we were looking at some of the circumstances that can arise unexpectedly and others that it may be possible to prepare for.
Firstly, our instructor emphasised the importance of new mums finding out as much as they can about breastfeeding antenally and seeing a mother breastfeed if possible. It is also important that new mums are aware of the choices and support available to them in those first few days of their baby’s life. This requires good antenatal care, perhaps with classes in breastfeeding. Our Sure Start centre now offers specific breastfeeding information sessions for antenatal parents, because the 4 antenatal classes just don’t give enough time to devote to breastfeeding.
Armed with this knowledge, mums are better able to understand how breastfeeding their newborn might work, but of course not everything can be planned for.
A few of the unexpected scenarios we discussed were:
Separation of mother & baby and the importance of breast pumps, rest and fluids for mum;
Jaundice in the newborn and the knowledge that breastmilk is superior to formula for treating jaundice, despite the perception of hospital staff;
Illness in the mother and the necessity to keep mum & baby together as much as possible;
Cleft lip and/or palate and Down’s syndrome and learning to breastfeed. These conditions present quite a challenge to breastfeeding, though, as always, breastmilk is superior to formula for feeding babies. Down’s syndrome babies are often able to breastfeed successfully and mums can look for the usual indicators to assess the progression of breastfeeding (changes in stools over the first week, weight gain, wet nappies, content baby).
Cleft lip and/or palate can cause serious difficulties for any method of feeding and cleft palate may make breastfeeding directly impossible. However, expressing is the very best a mum can do for her baby in these circumstances and mums should be given the facilities and encouragement necessary to express in hospital.
It is common now for mums to be aware of cleft lip and/or palate from their ultrasound scan and by the time baby is born, mum will already have received the date for the baby’s first operation. This gives the mum the opportunity to plan a little.
If expression and feeding by bottle, syringe or cup is initiated at birth, it may still be possible to begin breastfeeding directly later on – after surgery. Our instructor mentioned how it is still important for these babies’ mums to know that skin-to-skin contact benefits their baby and that they can offer their breast for comfort, even if they are not actually breastfeeding. I thought that was a great idea, though something I would never have thought of!
Here is another great cultural obstacle in breastfeeding – parenting even – I think. It would seem strange, maybe unacceptable, to offer our breast to our non-breastfeeding baby to comfort them, but why should it? Why is that any different to offering our little finger to suckle on, or to cuddling?
It was interesting to discuss some of the situations that are new to me, but I think what I really got from this week’s session was the need to empower us all.
Many of us will have experienced being told by a doctor, or other health professional, that we must do a particular thing, without being told the most important thing of all – that we have a choice.
My partner and I certainly went through this when our eldest was born. We felt pushed into allowing procedures to be carried out that we weren’t comfortable with and we didn’t think were necessary.
However, four years ago, our second son was seriously ill with meningitis. We were fortunate to have a patient paediatric consultant who wanted to inform us at every step – nevertheless, he had procedures which he felt were necessary. My partner & I found confidence and support in each other and we asked questions frequently and held up procedures when we were not convinced, or when we saw that our son was distressed. Our consultant was very surprised by our attitude, but also very supportive.
The end result was that our son probably went through as many procedures as he would have anyway, but we understood why each one was being performed and when we took our son home, we knew that we had done the best for him.
I would like everyone to be aware of their choices – and to be aware that most decisions don’t need to be made instantly. Feeling part of the decision making process has helped us to overcome the trauma of what happened to our son, leaving us without feelings of guilt.
Juno
By Juno Charlett, on November 17th, 2008 This week’s session was about ‘Understanding Baby Needs from Infancy to Toddlerhood’ and it was reassuring to realise that we were all aware of almost all the information that we discussed – particularly regarding new babies.
However, there were a couple of points raised that I found especially interesting and I would like to learn more about.
Firstly, the subject of weaning onto solids. Having had five children over a nine year period, I can vouch for the fact that recommendations on weaning have changed dramatically! With my eldest, I wanted to exclusively breastfeed for as long as possible, but I found an overwhelming amount of advice to begin solids, to help my baby sleep better. The earliest recommended time for weaning then was 14 weeks and so that is what I did. Well, my boy loved food, but he didn’t sleep any better! You’d think that I would have learned from that experience, but I ended up following the same advice not once, but twice, more – with no.s 2 and 3! With my third, I had already heard that WHO were advising six months exclusive breastfeeding and I was crushed when the GP advised weaning at 4 months to help his reflux (as well as his sleeping, which it didn’t).
With no.4 I dug in my heels. Despite poor weight gain and reflux which put no.3 in the shade, I breastfed exclusively for six months – and I did the same with no.5.
So I was really pleased to find that the current Health Authority advice is a definite trend towards ‘baby-led weaning’. That sounds more natural to me, although I hardly know what it means. Wait til six months, offer finger foods (if baby will take them)…. This is all so different from the advice in baby books 11 yrs ago! Can anyone out there tell me anymore?
I had a bit of a Eureka! moment when I was thinking about this the other day. When I began this course, I didn’t think that I had had any particular difficulties breastfeeding. However, I have come to a realisation. It’s been a long time since I felt the need to ask advice about parenting – mainly because I have found I can quietly discover things within a book, without having to consider refusing the advice of the person I have asked, if I didn’t like the sound of it. Thinking back to that time when my eldest was not sleeping well and I was looking for a solution, I was met with the advice to begin solids from both health professionals and relatives and, although I wasn’t happy about it, I followed that advice (and actually felt more disappointed when it failed). It only just occurred to me this week that that advice is the same as saying that my breastmilk was not enough for my 3 month old baby and that if I had stopped to think about how capable my body would be at providing milk for twins, I would have seen how ridiculous that was. I never really saw that as a breastfeeding difficulty, but of course it was. In fact, the difficulties with sleep and my eldest became such a problem for me that I embarked on sleep-training when he was 5 months old. He slept through the night within 3 days and I was incredibly relieved, but that, combined with his early weaning and love of food, led us down the path of reducing my supply. I wasn’t aware of it at the time, but when I fell pregnant when no.1 was eight months, he no longer showed any interest in breastfeeding – although I would have happily continued through my pregnancy.
The other discussion I found fascinating was about ‘nursing-strikes’. I have read a little about this. On occasions a baby may refuse to breastfeed – and this may continue for up to four days! This is obviously very distressing for the baby’s parents and we were given some advice on how to support a mother through a nursing strike:
We must reassure mum that it will pass;
Bottles and dummies should not be offered (in fact, nipple confusion can be the cause of a nursing strike);
Mum should express, to keep up her supply;
It is important that mum rebuilds her baby’s trust with calm, peace & quiet, skin-to-skin contact and avoiding separation from her baby, if at all possible.
There may be other ways to get the baby interested in feeding again, for example: attempting a feed when baby is very sleepy, trying different positions and walking with or rocking the baby.
There are many things that can cause a nursing strike. For example: fright, illness, teething, distractions/interruptions, long separation from mum, a change in routines and arguments or disruptions in the house.
Have you experienced a nursing strike? Did you manage to overcome it? Please write a comment if you can.
Finally, we talked about instances where we had met a new mum experiencing difficulties and had not found a way to help (or, had been that new mum and had not been able to get help from other experienced mums).
I fall into the first category, as I found it extremely difficult to pinpoint the problem when my relative was having difficulties breastfeeding – and my frustration was compounded by the huge changes that would occur in just 24hrs. 24hrs is such a long time in the life of a newborn and his mum, but a mere blink of an eye to the rest of us!
Our instructor reassured us by saying that for breastfeeding difficulties involving newborns, it is vital to spend lots of time with the mother. Only by doing this will we develop a full awareness of the difficulties the mother and the baby are experiencing.
I am sure I must be more prepared for my role of supporting breastfeeding than when I began this course, but I still worry that I might be met with that situation again – where I don’t know what I can offer to help. At least I am aware now of the team of people who can be called upon to help alongside myself.
Juno
By Juno Charlett, on November 10th, 2008 We’re two thirds of the way through the course now and I am a little clearer on what will be expected of me in my role as Breastfeeding Peer Counsellor.
Last week I attended a one day training workshop in ‘Foundation Skills for Helpline Workers’, with the Telephone Helpline Association (THA), for a role that I have taken up with another organisation. It was a fascinating day, but I was surprised at the great difference between my helpline role and my Breastfeeding Peer Counsellor role, which became apparent throughout the day.
The biggest difference is that it is not considered good practice to talk about yourself in the helpline world – and this is something I can very much understand. In a role-play exercise where I did exactly that, it became obvious to me that my focus had shifted from the caller’s story to my own. My mind was thinking of responses before the caller had finished speaking. I was no longer listening.
The expectations of Breastfeeding Counsellors are quite different. Research consistently says that the best people to support mums in breastfeeding are other mums – women who have experience of breastfeeding, who have developed confidence and have ‘mother wisdom’ (in the words of La Leche League) to share and reassurance to give.
We are actively encouraged to share tips and stories, in support of keeping mums breastfeeding – and there the line is drawn in a slightly different place to the helpline worker. In my role as peer counsellor, I need to develop the skills to offer my experience as information where necessary, but to hold back from being pushy, emotional or overloading the mum with too much information. This support is reassurance, sharing, kindness – without persuasion.
This difference of skills is reflected in the title on my ID card:- Breastfeeding Supporter. Not Counsellor, not Peer Counsellor even, because the role isn’t exactly counselling.
And this week’s session was a discussion of the information we have to share (our ‘mother wisdom’!) on ‘Getting Ready for Baby and Ideas to Make Breastfeeding Work in Day-to-Day Living’. It was fun to discuss our stories and I would also love to read yours – so please add a comment if you can think of any really useful tips.
Our instructor encouraged us to become familiar with the latest practices in birth-care and in the latest items available for babies and mums in the shops.
She also passed around some fabulous teaching aids, some of which you may have come across:
-Knitted breasts;
Now I have a couple of these, bought from Lisa at Lactivist.co.uk, but we were also advised to obtain a puppet (or a pattern for knitting one perhaps?) of a baby, whose mouth will open wide – like a sock puppet. I have searched around, but I can’t find one. If anyone knows of any that are suitable, please let me know.
-Marbles, illustrating babies’ tummy sizes;
These are fantastic! Very simple, but they illustrate perfectly the size of a baby’s tummy at four ages between birth and 10 days. They were free from the Medela website, but that was some time ago and they may not be available anymore. I want some!
-Breastfeeding dolls and breasts;
I wasn’t so keen on these. The breast was quite good – and it was possible to feel a lump and show how to massage it – but the doll was quite rigid. I didn’t think it would be that useful to show different positions.
We then went off into groups to discuss our practical tips for making those first few days of breastfeeding as easy as possible – and there were many! It made me realise how much easier it is when you’ve done it before and so how useful it could be to a new mum to know some of what might help.
I think my favourite (which I’d never heard before) is to stay in your pyjamas, because it sends a message to older children and visitors that you’re not available for household chores, making cups of tea, etc. – that your focus is on your baby. I suppose it might prompt a visitor to offer to hold the baby whilst you have a shower, but then I guess you could accept and then put on a fresh pair of PJs!
Juno
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