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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
By Juno Charlett, on October 27th, 2008 The topic for discussion this week was ‘Basic Breastfeeding Management’, which I imagined to be full of the core elements of the peer counsellor’s ‘tool-box’, I guess – and I suppose it was, but I was surprised at how much of this ground we have already covered. Nevertheless, we did, as always, have some interesting discussions along the way.
So we talked through a variety of factors important to establishing a confident breastfeeding relationship between mother and baby.
Many of us have experienced circumstances with our own babies that help us to understand how frustrating it can be for a new mum who feels things aren’t going well. It’s great that we can use that awareness to help new mums identify what the difficulty is and, most importantly, offer some solutions so that breastfeeding can continue.
We have been told how important early skin-to-skin contact is in establishing breastfeeding and our instructor said that she believes most mothers are given the opportunity of that experience now.
I was thinking about that myself recently, as the first two of my babies had a remarkably different start to the other three, even though they were all born at home.
My eldest was born after a ‘textbook labour’ – a big, healthy baby. I held him, skin-to-skin, for a couple of minutes, during which time it became apparent to the midwives that he was slipping away. He was then taken from me to be resuscitated – which took over half an hour – and then rushed to hospital in an ambulance. I didn’t see him again for an hour or two and didn’t hold him again for several hours. However, at 20 hours old, he decided a drip was not enough and began sucking his fists urgently. Breastfeeding began then and continued (in abundance!) for 8 months.
No.2′s birth was a little different. The two midwives in attendance were obviously uncomfortable with a home birth following our traumatic history. At the appearance of meconium in the amniotic fluid, they urged me to hurry up – completing the second stage in 10 minutes flat. They then took my baby’s temperature and dressed him before giving me the opportunity to hold him. Although I began breastfeeding as soon as possible, I was not as responsive to his cries and did not strive to keep him close to me all the time in those first few hours. He didn’t feed as much, he slept more and consequently he lost more weight and became more jaundiced than his siblings. As it happens, he has also experienced more health problems than his siblings too. However, we did establish breastfeeding well and we continued for 14 months.
It was interesting to hear that lack of the skin-to-skin experience at birth has been shown in research to lead to a greater weight loss and more jaundice – in common with my experience.
The positioning and attachment of the baby can also make a huge difference to the outcome of breastfeeding and we were asked to always consider checking attachment in our roles as peer counsellors, because it is such a common issue leading to difficulties.
As we talked about it, I was reminded of the huge difference in feeding a newborn to my current experience of feeding a toddler – and how easy it is to forget how awkward those first few feedings can feel.
We each talked about the most comfortable positions we had found and I was surprised by how many had used the ‘football hold’, as well as the traditional cradle-hold and lying down. The ‘football hold’ was not one that I remember using much myself, but other mums described how useful it was in feeding a struggling baby – and I could really understand the need for an alternative position. I do remember using swaddling in those circumstances, but there was often a hand popping out of the blanket and getting in the way.
I also found it hugely beneficial to use a sling – especially with my youngest, who always wanted to be carried or fed when I had to do something else.
As well as the different positions, we were reminded that the baby needs to be at the right height to suckle comfortably and most of us remembered using lots of pillows and cushions in the first few weeks. In fact, with my boy being so big now, I still sometimes settle down on the sofa with a pile of cushions, so we can be really comfortable.
We also discussed the importance of feeding on demand. I suppose this is one of the main aspects of breastfeeding which remains at the mercy of our cultural expectations. Lots of the mums in the group knew other mums who, despite adhering to all the other recommendations, felt it was important to feed by the clock. This had led to difficulties with some, but one mum in our group said her son naturally fell into a pattern of feeding ‘on time’ and she found that it didn’t interfere with continuing breastfeeding.
The importance of focusing on the baby’s cues is well-documented. In the early weeks, the mother’s body is responding to the baby’s body by producing more milk, the more the baby feeds. Restricting feeds at this time could lead to a reduction in the mother’s milk supply. Not only that, responding to baby’s cues is part of the dialogue between mother and child that goes beyond the breastfeeding relationship.
However, some babies do settle into a routine early on – and that just goes to show how different babies can be. My babies have differed enormously. My 4th baby rarely cried, sucked her thumb and slept through the night from 9 weeks. Of course we put it down to our fantastic parenting skills – and then we had no.5! He has been the opposite in all those respects!
It is because of those differences that we are encouraged to ‘watch the baby – not the clock’. Although we might want to guide them towards a routine that suits us and our families eventually, at first we must establish what their needs are and how we can meet them.
I feel very optimistic when I hear about this growing trend towards listening to our children, rather than controlling them. I know it isn’t as widespread as we would like it to be, but it is a positive step in a new direction.
Next week, we have a break for half term, so it’ll be two weeks before my next post, but please come back with lots of comments – it always makes for really interesting reading.
Juno
By Juno Charlett, on October 21st, 2008 Dear Granny
Mummy is breastfeeding me because she knows it’s best
But I expect you’re wanting to help her get some rest
I’m very time consuming because I am so new
I know how much you want to help – there’s lots that you can do
Washing, cooking, ironing – you can think of more
Let Mummy do the feeding ‘cos that is not a chore
Both Mum and I need practice until we get the knack
So please don’t say “Good gracious! Another little snack?”
Granny, you’ve got lots of tips – for you are very wise
We welcome your suggestions – but please don’t criticise
You were once like Mummy and now her turn has come
With your love and patience she’ll make a smashing Mum!
Gill Rapley, 1995
This week we had a lively discussion about ‘Barriers to Breastfeeding’. This is obviously a topic of wide-ranging issues and many of the issues raised struck a chord with one or more of the mums in the group.
What sorts of things prevent mums from having a positive experience of breastfeeding? I suppose a large proportion of them can be seen as cultural (in some ways all of them can). For instance: formula and baby-bottle marketing; attitudes of hospital staff; lack of positive role models in the media; attitudes of work-mates and, that old chestnut, ‘Old Wive’s Tales’ (how many have we heard?).
The influence of society and culture around us is so strong though, that it is almost impossible not to internalise the attitudes and the words of those around us. Many fears are instilled in women which become a real barrier to breastfeeding ’successfully’. For example: a fear of pain; of losing freedom; of a change in body-shape; or simply a fear of failure.
For any woman about to become a mother who fears the changes that are inevitable, some sort of support is essential.
If difficulties do arise in the first few days or weeks of breastfeeding (and for many they do), some women find that the solutions offered to them in our culture do not involve continuing breasfeeding. Family, friends and the media may convince the mother that she will have less pain, more sleep, more normality, if she bottle-feeds her baby.
Again, this led me to think that this is about more than just breastfeeding. As one mum told me about formula milk cartons, I found myself thinking, ‘How convenient!’ – then stopping myself with a huge red light: ‘What am I thinking?! What could be more convenient than breastfeeding?’
This culture, that we are a part of, is so wrapped up in consumerism that we can be easily convinced that we need this, or that, to help us fit into our societal roles. So many things come in a package to make our life easier that we have forgotten one of the most important skills that we have as human beings – adaptation.
The instructor told us that she has visited many mums who have asked her, ‘When will life get back to normal?’ Maybe they haven’t realised that what they are describing as ‘normal’ is actually ‘life without a baby’. Life with a new baby hasn’t met their expectations, because those expectations have been shaped by our modern culture.
Of course, having a baby (especially the first time) is a shock to us all – and so we all need support to embrace the change, adapt and find our own parenting style.
It doesn’t help when a midwife on the post-natal ward tells you your baby needs a bottle of formula, because he is hungry, and then presents you with said bottle and the expectation that you will give it to your baby – the experience of at least one mum in our group.
Or when a new mum is told by hospital staff that her baby must experience a bottle before he is a few weeks old, or he may never take one (and you wouldn’t want that, would you?).
Fortunately, our local hospital has now begun UNICEF training programmes, to work towards the ‘Baby-Friendly’ status. This should make some positive changes to delivery, baby, post-natal and children’s wards. Let’s hope that someone sees the sense in passing that information on to all hospital staff. They must remember that all mothers in hospital for non-infectious conditions have a right to breastfeed too.
For some mothers, the choice to breastfeed couldn’t be more difficult. Medical opinion may strongly advise against breastfeeding for mothers who are HIV positive or who are taking medicines or drugs, but it is still the mother’s decision to make.
Our instructor explained that she feels her position, as a medical professional, is to give information to the mother (or parents), so that they can make their own decision. Then she (our instructor) will respect and support that decision, even if she feels it is not the decision she would have made herself.
The exception to that would be where an issue of child protection exists and I asked if, by choosing to breastfeed against medical opinion when HIV +ve, would that be considered a child protection issue? We were told that only evidence of child abuse occurring – not ‘potential risks’ – would be an issue for us to report.
I also asked if any changes had been made to the level of support given to antenatal women undergoing a HIV test in pregnancy. None have.
Many years ago, I had a HIV test in a London clinic, because I was travelling to an Israeli kibbutz and I knew I would be tested there. In the London clinic, I was given counselling before the test (which reassured me that the behaviour which I had perceived as high risk was, in fact, quite low risk), followed by more counselling before receiving the results and after receiving the results. This high level of care really helped me to deal with the anxiety involved in taking the test.
In current ante-natal screening , mums-to-be receive no counselling at all – unless the test comes back positive, then they are referred to the hospital (but, by then, they have already been given the awful news).
I wonder if this procedure is regional?
Another aspect of parenting that some mums in the group felt the medical establishment needed to catch up on was that of co-sleeping. Although our instructor explained that many professionals accept that mums choose to sleep with their babies, the information given out remains extremely cautious on the subject. My favourite warning is: ‘Do not sleep with your baby if you are excessively tired’ – surely that is exactly when most parents begin co-sleeping!
The implication of the information is still that every parent’s aim should be to have a baby safely sleeping all night through in their cot, even though there is much evidence to suggest that co-sleeping encourages breastfeeding and attentive parenting – particularly in the work of Dr.Sears.
This has been a very long blog this week – following some really enjoyable discussions in the group. If you still have a few moments left, it would be great to see your comments.
Many of the mums in the group have said that they wish they had been on this course when they started breastfeeding and I wondered:
What do you know now that you wish you’d known when you started out on your breastfeeding journey?
Juno
By Juno Charlett, on October 14th, 2008 The subject for this week’s session was ‘The Composition of Human Milk’. In many ways, this subject is quite scientific, which is a challenge for me, as I am inclined to be happy with the thought, ‘Well, it’s natural so it must be good.’
There is also a big overlap between this subject and ‘The Benefits of Breastfeeding’ and I found that this week we revisited a lot of the information we looked at in week 3 – so I shall try not to repeat myself!
In common with looking at ‘The Benefits…’, our discussion of composition led to comparisons with formula milk.
We began by looking at colostrum, which is unique in its make-up and, as I understand it, impossible to copy – even remotely – with current technology.
As well as being a natural laxative, high in protein, low in fat and carbs, high in zinc, vitamin E and salt, colostrum is full of the ‘magic’ ingredients: macrophages and immunoglobulins.
The macrophages digest disease organisms and the immunoglobulins coat the baby’s gut, protect the baby from infections in the environment and (wow) stimulate the baby to produce his/her own antibodies.
Looking at a comparison sheet (sorry, it isn’t dated), immunoglobulins are virtually absent in formula, whereas they are present in colostrum ‘in abundance’.
I have spent some time this week reading a little about human milk composition in La Leche League’s book, ‘The Womanly Art of Breastfeeding’ – a copy of which we have each been given as part of the course. On the topic of immunoglobulins in colostrum, the book states: ‘This is one of the many reasons for insisting that your baby get nothing but your colostrum and milk in the first days of life. Those first doses of colostrum are designed to gently introduce baby’s immune system to the world outside the womb.’ (2004).
As the milk matures, it remains high in these ‘living cells’ – even containing significant amounts of immunoglobulins after baby turns one year.
In looking at mature milk, it can simply be said that the balance of whey, casein, other proteins, enzymes, amino acids, fat and carbs (lactose) are all designed to protect the human infant and feed the growth of the very unique human brain. Not only that, but the complete package is also 100% digestible, resulting in soft stools with a smell not unlike yoghurt or buttermilk (which, like breastmilk, are high in friendly bacteria).
Our discussions during the session veered towards other aspects in breastfeeding:
from the sweet taste of breastmilk being in synch with the baby’s immature tastebuds (babies have sweet tastebuds from birth, with the other 3 tastes following at around a year);
flavours from the mother’s diet affecting the taste of the milk and the mother’s diet also affecting the baby’s wind – foods which can make us all ‘windy’ being the biggest culprits;
to the possibilities of breastfeeding whilst having breast implants – I didn’t think it was possible, but apparently it is, if the implants are on top of the breast;
and the experiences of breastfeeding in unexpected circumstances – our instructor told us of the relief breastfeeding gave her when her car broke down on a long journey and she was still able to feed her baby. I also described feeding my two year old when he was very poorly with a tummy bug and unable to digest anything but breastmilk – an experience shared by another group member, who found that her son recovered really quickly when he went back to exclusive breastfeeding for a couple of days.
We went on to discuss breastfeeding in public. Touching on that Supernanny programme again, the instructor said how the mother had fed her child in the car, but wondered if she would have felt as comfortable feeding her in the supermarket. I said that I have become less comfortable feeding my son in public as he has got older (although, in some repects, feeding him in front of some family members can be more of a challenge!).
We talked quite a bit about how we might have considered ourselves to be rebellious in the past, or in other ways, and then found that that sense of rebellion has abandoned us when it comes to breastfeeding in public.
It is almost as though we carry around with us a feeling of what is culturally acceptable and I wonder if we would be less concerned about breastfeeding in public if we didn’t feel a public scrutiny on our ‘success or failure’ of our parenting skills and style?
By Juno Charlett, on October 7th, 2008 This week I settled my youngest two in at Nana’s (thanks Mum!) and managed to arrive at the Sure Start Centre early enough to catch a cup of tea before we began. I can’t say I was bright-eyed & bushy-tailed though, as I had been up at 5am feeding my two & a half year old. This was the morning our ID card photos were taken and there was nothing I could do about the bags!
Unfortunately, the session began with an informal chat which left me feeling quite alienated for a few moments. Our instructor this week was chatting about a recent episode of ‘Supernanny’ which had involved the abrupt weaning of a three and a half year old breastfeeding girl and commented on how Supernanny, Jo Frost, had stated that there was no need for a child to breastfeed after the age of 3, as there is no nutritional benefit in it, and that the little girl was controlling and manipulative.
I suddenly felt quite alone in my feelings about – and experience of – breastfeeding toddlers. I have recently read the wonderful book by Norma Jane Bumgarner, ‘Mothering Your Nursing Toddler’, which is a very positive, empowering book about the mother-toddler breastfeeding relationship. The book confirmed what already felt right to me – that a mutually agreeable relationship between the breastfeeding child and mother has a myriad of benefits for both.
Although I didn’t watch Supernanny, I really wonder what is the benefit of a TV programme which encourages us to look at breastfeeding as only being beneficial in a nutritional sense and to consider children as young as 3 to be controlling and manipulative?
Unfortunately I found myself unable to express my upset on Monday (and so it has been saved for this blog!), although I do hope that breastfeeding toddlers will be discussed again at some point.
Given my lack of sleep and my initial upset, I found this week’s subject quite a challenge: Anatomy of the Breast and Hormones of Lactation. We were given lots of handouts and diagrams detailing the many parts of the breast and the ways in which both pregnancy and baby’s sucking stimulates the production of the hormones required to stimulate milk production (commonly known as ‘the Let-Down Reflex’). As we discussed these physical processes, some interesting points came up.
It is the nerves in the breast which make it sensitive and the instructor explained that, in some women, stress and anxiety can inhibit this sensitivity (which is essential to stimulate milk production). We were warned not to underestimate the power of this very real, and debilitating, difficulty that some women experience.
At the opposite end of the scale, one of our group members described having a near-constant flow of milk. Although that may appear to be a godsend to some, it made breastfeeding in public and at night especially awkward and she felt unusual for never having experienced the feeling of milk let-down.
I explained a technique, which I picked up from somewhere, of applying pressure to the breasts to stop the flow of milk when it was not required (the basis of the design of Lilypadz) – although we all thought that applying pressure might not be advisable in the first few weeks, or at anytime when engorement might develop, as it could lead to a blocked duct.
Another member of the group said that she had experienced excruciatingly painful let-downs and warned us to be aware that a mum who described the sensation as painful may in fact be suffering from the condition which she’d had – ‘deep thrush’. It took many years (and a few babies!) for her to discover the cause and find a treatment for it, as there were none of the common visible symptoms associated with thrush.
We had all had different experiences of after-pains as well. Some women had experienced none at all, one had experienced less with each baby and others, like myself, had experienced the classic increase of after-pains after each successive birth. I explained that these pains had been so strong after my 4th child that I involuntarily physically shook with them and couldn’t hold my baby. I felt thoroughly miserable about it and within days had resorted to keeping myself topped up with painkillers, which I had promised myself I would avoid. When I was pregnant with no.5, I researched some alternatives and used the homeopathic remedy Arnica (in tablet form) – one tablet half-hourly for the first 4 hours, hourly for the next 8 hours, etc. – and I was amazed to have hardly any pain at all.
It was really interesting to hear such different stories from the mums in the group – all the time reminding me that everyone is different and I couldn’t possibly predict the difficulties a mother might come to me with as a counsellor. I would really like to hear more stories from you. If you have anything you would like to share, please leave a comment.
Juno
By Juno Charlett, on September 29th, 2008 This week’s session was about the benefits of breastfeeding. We had a delayed start, which I think was due to my children (particularly my youngest) taking a long time to settle in the creche. Once we were all ready, we had a discussion about the benefits of breastfeeding – both for the baby and the mother.
This turned into an interesting conversation, not only because the benefits are huge (many of which I’m sure most people reading this will have heard of before), but also because we were reminded by our instructor that many breastfeeding statistics are based on global figures, which could distort our view of how those statistics relate to us. The figures will often highlight the hazards of bottle-feeding, which appear alarming and, in our supportive roles, may be best not to emphasize. For instance, we were told that, globally, breastfed babies are six times more likely to survive their first three months than bottle-fed ones. But how relevant is that to a British mother, when it takes into account poorer levels of sanitation and healthcare in developing countries?
So, whilst it is useful to be aware of current research on the benefits of breastfeeding, as counsellors we also need to be aware of the effect that information may have on mothers seeking help.
I find statistics a little bit difficult to deal with. Firstly, I find that, whenever I try to quote statistics, I can’t remember the figures (‘…was that one in 500, or one in 5000??), but also, I can see how research is often used to prove theories which could just as easily be disproved by other research. So, generally, I’m happier to stick with what ‘feels right’ to me – and perhaps this goes back to what was said last week about supporting mums in finding their own solutions. If they find a solution (a style of parenting) which feels right to them, then the statistics don’t really matter.
Saying that, as a mum, it is always handy to be armed with a couple of ‘facts’ when entering a heated discussion with someone who is not pro-breastfeeding – but maybe the best fact of all is, ‘Well, this works for us’.
During our discussions, I revealed that, as a baby, I was fed on cow’s milk (yep, straight from the bottle!). I didn’t go on to say, ‘and I turned out alright’, but I suppose the implication was there. How many of the hazards of bottle-feeding did I suffer? Well, a few, but I also have some of the traits of the long-term positive effect of breastfeeding. This led me to wonder how many of these benefits are purely related to breastfeeding. Taking improved brain development as an example, a breastfed baby receives lots of skin contact, eye contact and night-time contact with mum. This improves the mother-baby bond, the communication between mother and baby and maybe this, in turn, influences brain development. I don’t doubt for one second that breastfeeding is best, but of course bottle-fed babies can have skin contact, eye contact and night-time contact with mum in abundance.
This left me thinking of how this information may be helpful in supporting mums who may be feeling guilt or grief over the end of their breastfeeding relationship (when it comes too early for them). However, I guess there is always the risk that I’ll become over zealous with attachment parenting principles, after convincing myself not to be too pushy with breastfeeding advice!
At the end of the session, we watched a wonderful DVD called: ‘The Mother-Baby Dance’.
( http://www.lllgbbooks.co.uk/go_shopping/videos_and_dvds/baby-led_breastfeeding_dvd )
The film was made by Christina Smilie M.D. and Kittie Franz R.N. and it shows them encouraging babies to seek their mothers’ nipple. The mother begins by relaxing her baby and then holds him, skin-to-skin to her chest (in an upright position). We then saw the baby moving into an optimum feeding position. It really was quite amazing to see such an instinctive journey.
Some of the babies were very young and some were already established in breastfeeding. However, there were a couple of babies who were up to 12 weeks old and who were bottle-fed, yet they had not lost the instinct to seek mum’s nipple! Wow!
I have seen a similar film on You Tube, which shows a newborn baby in India doing the ‘Breast Crawl’.
( http://www.youtube.com/watch?v=zrwfIcPB1u4 )
Unfortunately, my youngest didn’t settle in the creche at all well this week and he was quite upset afterwards. He’s just not used to being without mum, dad or nan I suppose and I think I will have to leave him with his dad (and his older brothers) next week. It’s not the first time one of our children has responded like this to childcare and I sometimes think we must seem a little strange to others in the way that we deal with these things – but I guess there’s a whole other blog in that!
A couple of interesting questions came up in this week’s session and it would be really good to hear what your experiences are (please leave lots of comments!). Firstly, what made you want to breastfeed? and Secondly, did breastfeeding work as a contraceptive for you?
Juno
By Juno Charlett, on September 22nd, 2008 ‘The wise old owl sat in an oak,
the more he heard the less he spoke,
the less he spoke, the more he heard,
why aren’t we all like that wise old bird?’
This weeks session was about Communication. Just as well, as I left the house having a little tiff with my daughter who wouldn’t put her socks on!
When we arrived at the creche, all the other children were already there and there seemed to be a lot of babies crying and being comforted by the creche workers. My two were trying to get back out of the door to play on the bubble cars outside, so I took a few minutes to explain that they would need to wait until the babies were ok before they could go outside. Then I headed off to the training room.
As the quote above implies, communication isn’t all about talking. This session was invaluable to me, not only because I talk a lot, but also because I feel quite aware that I will not always be talking to someone who has had experiences like me – and I worry that sometimes they might not feel good about the person they think I am. I’m not sure that makes sense. I mean, sometimes I get comments from others like – ‘wow, you must be angelic/supermum/an earth mother’. No, I’m not trying to boost my ego here! Obviously there’s nothing superhuman or angelic about me, but there are a lot of mums who don’t immediately identify with someone who has a lot of children. I’m fearful of putting people off, as I think I may have in the past.
So this session was a lesson in Active Listening for me – and it was a pleasant surprise to learn that Peer Counsellors are not to offer advice. The aim is to listen carefully, to begin a trusting relationship, to ask questions which encourage an opening of dialogue and to offer information. We were reminded that often when someone asks for support, they do not always discuss the most important difficulty first. This struck a chord with me, as I think I do this when I visit the GP. I’ll save up a little list of things to talk about and the one which is really worrying me (like ‘have I got a brain tumour/heart condition/mental illness’!) comes last. Partly because I feel a little silly about it, partly because I feel scared of what I might hear – and in some cases, scared that I might cry. (In fact, really serious difficulties have left me feeling unable to ask for help at all). As the trainer today put it, the client is testing the counsellor – is the counsellor trustworthy? Is the counsellor really going to be supportive of what I want? So the dialogue and the trusting relationship are much more important than trying to impart any wisdom.
We were also told that often the dialogue brings about a number of options for the mother and she is then able to try some techniques and find a solution for herself. This is an essential process as the mother then feels empowered. I then recognised that through my own experience of feeding my babies, I have developed a style of parenting unique to me and my children. This has given me a huge amount of confidence – actually not only in bringing up my children, as it has spilled over into other areas of my life and I am a much more confident person in general than I was pre-children. This is an experience that I would love all women to share. For all mothers it is important to know that the relationship they have with their child is utterly unique – and it is within their power to mould it into the style they feel suits them best. There is no right or wrong way.
This flows neatly into the next point we were reminded of – to be non-judgemental. Although that sounds obvious, there is another side to it – since most breastfeeding counsellors are attracted to the role because they have had a positive experience of breastfeeding, how easy is it to be non-judgemental when faced with (for example) a woman whose mother has told her that bottle-fed babies sleep better? Or a woman whose partner won’t even entertain the idea of his baby being breastfed?
Our instructor explained that we have to leave our personal opinions out of our counselling. It’s not easy to do this. Being judgemental – or comparing myself to others – seems almost second nature, but I have realised that it is just another way of boosting my ego. Obviously I wouldn’t be contemplating counselling if I couldn’t be a bit tactful, but this requires observing my mental attitude and not slipping into a way of thinking which could ultimately destroy my chances of being supportive.
At the end of the session we were given lots of hand-outs with tips about Active Listening, which will be so useful. It was an insightful session for me, giving me a good idea of what the role of Peer Counsellor involves.
We were also sent away with a CRB form to complete, which is a necessity for the course.
Things didn’t go so well for my children this week, with them being brought into the training room more than once – and ending the session with both of them on my knee! I’m not sure why they didn’t feel settled in the creche, after the babies calmed down, but the creche manager assured me that they would form an ‘action plan’ to find ways of keeping them interested. At 2yrs & 5yrs, my two are amoung the eldest three children in the creche and the women there are now planning some more activities for them. It is really good to know that they are prepared to do that, so that I can continue.
Juno
By Juno Charlett, on September 15th, 2008 This week I began my training for Breastfeeding Counselling – as a Peer Counsellor. To explain what that is: Since 1988 La Leche League have been training Health professionals (mainly midwives & health visitors) to train local mums to offer support and facilities to breastfeeding mums in the area. Those trained mums are called ‘Peer Counsellors’. So I hope that this is the beginning of a journey for me, towards a rewarding career of supporting mothers (I would like to become a Doula one day).
Perhaps I should say a little about myself here – as you do at the beginning of a training session! I have five children, ranging from 11yrs to 2yrs (four boys and a girl). I started out determined to breastfeed my first and I was very fortunate in that I had support from a lovely nurse right at the beginning and my first child was, as she put it, a natural. Perhaps it wold be more accurate to say that he was hungry and as determined as I was to get it right! So I have been very lucky that breastfeeding has been a breeze for me. It has also been such a wonderful experience that I want to do everything I can to help other women who want to breastfeed, but this training is going to help me understand the ins and outs of overcoming difficulties and communicating to mums in their time of need.
It’s a bit of a juggling act at home, because I also (with my partner) home educate our kids, but it feels right for me to be doing this little extra bit for me, & others, right now.
So on Monday morning I found myself booking my youngest two into the creche at the Sure Start centre in a nearby town. After having my children around me most of the time, this was quite a step for all of us, but the women at the Sure Start centre (the venue for the course) are fabulous and anticipate that there may be some problems with children settling. Nearly every mum in my group, of about 10, have also put their young ones in the creche for the first time, so we are told that this session will be an informal one and the few interruptions are normal. Bringing a sigh of relief from me, as I was dreading having to leave if my two became upset.
The session lasted about two hours and we were introduced to some of the professionals who will be training us (Sure Start workers, Midwives and Health Visitors) and some Peer Counsellors who trained last year and talked a little about what they are doing with their skills now. They are currently running a couple of drop-in sessions at the Sure Start centre, where mum’s can come along & comfortably breastfeed, with Peer Counsellors present to offer support or just to chat to. I was really encouraged to hear what they have accomplished in an area which has had its problems in the past.
It is also very reassuring to learn that I will become part of this team – a network of volunteers supported by the Primary Care Trust – so I won’t be alone in the rather daunting task of helping someone with a problem. In fact, the counsellors have a meeting once a month, with a creche available.
It was explained that many counsellors come and go, as their personal commitments change when their children get older and mums go back to work. Because of this, there are never really as many counsellors as they would like. Even committing ourselves to one event every two months would be very helpful to the team. It was good to get an idea of how much I’d be expected to do.
Some of the work also involves going along to Parentcraft sessions, to talk to mums and dads antenatally and one of the professionals present has a session booked for next week, which she invited us to. I am hoping to go along and I have since received a call from a current counsellor who is booked to go in that night. It’ll be great to see how she works and perhaps to chat to a few mums and dads myself. Now I just have to arrange it with my partner – having to put our five kids to bed alone is a daunting task!
At the end of the session we were set homework (shock! horror!). Oh, but it wasn’t so bad – just to log how many people we speak to about breastfeeding, or about the course, during the week. So, lots of feedback please folks, so I can tell them I’ve told several hundred people, lol! Seriously though, any questions, please ask.
Aferwards, I went along to pick up my youngest two from the creche and found that they just didn’t want to leave! They have been talking about it ever since and can’t wait to go back – what a relief.
Here are the aims of the Breastfeeding Peer Counsellor programme:
- To increase the incidence and and duration of breastfeeding in the area.
- To increase awareness of nutritional and emotional needs of babies and the role breastfeeding can play in meeting those needs.
- To establish a structure to provide ongoing information and support for breastfeeding mothers in the area.
Juno
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