Tips for Breastfeeding a Baby With a Tongue Tie

When my daughter was born we had issues establishing breastfeeding. Feeding her was painful, and her weight gain was slow because she was tongue-tied. My memories of the early days of motherhood are still a haze to me, but by far one of my clearest (and saddest) memories was of looking at my perfect baby girl, willing her not to wake up. I couldn’t bear to feed her again. My nipples were bruised and cracked. I was on strong painkillers, because I had an emergency C-section, yet even with those, the pain far outweighed the wound I was recovering from. For various reasons, I was feeding my daughter for seven weeks before her tie was fully released and feeding started along the slow path to improvement. I won’t dwell too much on my story, perhaps I will tell it more fully one day on another blog. The purpose of this one is to share a few things I found helped me during the long weeks, plus a few things I have learned during my training in breastfeeding support.

There may be many reasons you are waiting to have a tongue tie division or indeed you may have decided the procedure isn’t the right decision for your family. Here are a few ideas and tips for you to consider.

Seek experienced feeding support whatever position you find yourself in. Find a lovely boob group too. Whatever happens on your breastfeeding journey, remember it is a journey. Sometimes a division isn’t an instant fix. Ongoing experienced support and moral support can be really helpful. Find a breastfeeding group here.

A breastfeeding counsellor or IBCLC can help you experiment with different positions. Some positions which work well for tied babies include laidback breastfeeding, the rugby hold, the straddle hold. Pay particular attention to the fundamentals of good attachment as this may be a harder to achieve with a tongue tied baby.

Get skin to skin! Skin to skin feeding can really help encourage a baby’s natural latching reflexes and has the added bonus of removing layers which separate you and the baby. It may just make that bit of difference.

Experiment with exaggerated latch techniques. These can be really helpful to encourage a deeper attachment. Options include tilting the nipple (“flipple”) or shaping the breast (“breast sandwich”).

It can be really helpful to use a couple of different positions while feeding when feeding is painful. This is because it stops the same part of the nipple being hurt and potentially damaged at every feed.

If baby struggles to transfer milk effectively while feeding

If feeds are very lengthy, painful or your breasts don’t feel relieved afterwards- there are a couple of things you can try. Breast compressions can improve milk transfer. Switch nursing can keep an ineffective feeder from falling asleep too soon at the breast and maximise milk intake. Combining both techniques can be particularly effective. Using both techniques during a feed might look like this; offer boob one, when the baby looks like their sucking is slowing (fluttering) or getting sleepy use compressions to speed up the milk flow again. You might find that sleepy baby springs awake again because babies often respond to milk flow! Once compressions become less effective, switch baby to side two and repeat. Once the same thing happens, then offer the first side again, and continue switching until baby signals they are done. You will ideally offer 4 sides minimum per feed.

Patience and support are important when feeding tied babies. Feeds may take longer than average and babies may feed more frequently to compensate. It can be helpful to reflect on your wider support network. Can someone help around the house or with other children while this is going on? Can your partner/family/friends offer any extra support?

Keep a close eye on nappy output and weight gain, and keep in contact with that experienced breastfeeding support I talked about earlier. An experienced supporter can help you to decide if your baby needs additional supplements of expressed milk and give you information about how best to do this while protecting your milk supply.

Sometimes the baby may be doing well but you may be struggling with engorged breasts, blocked ducts and even bouts of mastitis. If this is the case, firstly ouch, I am so sorry! One thing to consider may be expressing milk for a short amount of time after feeds to soften the breasts. This may also protect your long-term milk supply. If you need support with blocked ducts this factsheet might be useful.

“I can’t carry on! Feeding is too painful!”

Nipple shields are often considered by mothers in this situation. There can be some pitfalls to using shields, but if it is a choice between a shield or a bottle, a shield might be the better option. Ideally, shields need to be used with support from experienced breastfeeding support. Attention still needs paying to try to achieve a deep latch. Here is some more information to consider while using a shield.

I can empathise when mothers decide to use a bottle because they have tried so many options, and feeding is just too painful. Sometimes a mother may have nipple damage and just can’t bear feeding on demand at that time. I know how tough it is. If this is you remember to talk to your breastfeeding support person. In an ideal world you will still offer the breast for at least some feeds in a 24 hour period. As babies get bigger often latching can improve. It may also help with transition back to fully breastfeeding if this is what you want to do. Continuing to offer the breast, even if it is only a small amount to practise breastfeeding, protects your options down the line. If mixing breast with bottle, paced feeding techniques can be helpful to reduce the risks of bottle flow preferences. There are also alternatives to bottles, for example syringe or cup feeding.

If your baby is not breastfeeding much, or not at all, you may find the following information links useful:

Information on expressing: https://www.laleche.org.uk/expressing-your-milk/

Maintaining milk supply if the baby is not directly breastfeeding: https://kellymom.com/bf/got-milk/basics/maintainsupply-pump/

If using bottles or formula continuing to express when baby has a bottle can help support your milk production. Remember skin to skin is not only great for supply, but does good things for both of you, so keep baby close however you feed them. If you are using some formula it is important to prepare it safely.

Nipple damage

If you have sore nipples but no open wounds, there is no evidence a cream is more helpful than using your own milk rubbed into the nipple.

If you have bruising, the usual treatment for bruising can be helpful such as cold compresses after feeds.

If you have open wounds, moist wound healing may be helpful. This is essentially treating a cracked nipple like a cracked lip and not allowing it to dry out. Cracks in nipples that dry out may split open again at every feed, and this can be very painful. Keeping the crack soft can help healing from the inside out. There is no evidence any one cream is better than another, some mums prefer a lanolin based cream but soft white paraffin (Vaseline) can be just as effective and cheaper. Do use a new pot though and not something that’s been knocking about in the medicine cabinet for donkeys years! Both of these options are safe to breastfeed with, no need to wash off. Just wipe any excess off before feeds.

While we are on the subject of washing, if you have cracked nipples it is essential the wound is kept clean to prevent infections. Some mums use a fragrance-free soap (some babies can be bothered by strong perfumes), others prefer a salt water rinse like the one suggested here.

It might be helpful to start feeds on the least sore or damaged side, babies tend to suck more vigorously at the start of a feed. If you do this, listen to your body to make sure the other breast is still adequately having milk removed, via expression if necessary, to help avoid any engorgement or loss of supply.

If you are in a lot of pain feeding here is information on analgesics which you can use to help.

When you have a long wait for a tongue tie division, I know it can feel impossible. Like an eternity. Those early weeks can feel like months even when things go smoothly. I can totally empathise how overwhelming it might feel. I can’t tell you whether to stick it out, or what is best for you but I can tell you that you are stronger than you know you are.

I remember one day being asked why I had persevered with breastfeeding for so many weeks despite painful challenges. This is something I’ve considered a lot because on that day I couldn’t give an answer.  One thing I have come to understand is often it isn’t really about “the milk”, it is about an inner desire for this connection to our babies. Focusing on that can be more motivating than anything else. Try to remember why you started breastfeeding and why it is important to you. Encourage your partner to remind you of this. Hold on to any moments that are positive. Remember any breastfeeding you can do is significant. Setting small goals can be helpful- try to think about making it to the next day, or next week rather than longer term. This will all pass someday. By setting small goals one day you might suddenly realise you have stopped setting goals to get to next week and will know that the worst is behind you.

Whatever you decide to do, make sure you have support so you can talk it through and feel empowered to make decisions you feel at peace with. Finally, remember, there are lots of us out there to support you. You got this mama💚.

For more information and support:

Association of Tongue-tie Practioners for information about tongue tie

If you need support or someone to talk to fast about the issues you are having try the National Breastfeeding Helpline

Facebook tongue tie support group

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CMPA and the Question of Over Diagnosis

Let’s not argue about whether CMPA is over-diagnosed. We need to be angry about poor industry ethics instead.

This week the BMJ released an article raising questions about industry involvement in CMPA diagnosis, questioning the huge rise in babies being prescribed specialist allergy formulas. As an allergy parent who fought for a diagnosis, and a breastfeeding volunteer I have followed the report in the BMJ with interest. Some people feel this article dismisses the struggles many go through to achieve an allergy diagnosis and have been very vocal about expressing this.

I can understand this. I too have mixed feelings about the report. Much of what it says is familiar to me. In the UK, our cultural attitudes toward babies often create issues. Normal behaviours such as wanting to breastfeed frequently and stay close to the mother sometimes end up being turned into some sort of pathology, be that reflux or allergies or tongue tie. In some cases, anxious parents don’t realise that WEIRD nations genuinely do have some weird ideas about how babies should behave.  I have also seen families in the UK move to formula, overwhelmed when CMPA is suggested because giving up milk seems a huge undertaking that no one is supporting them with. Worse, in some cases nobody is even questioning whether it was the right approach for that parent in the first place.

On the flipside as an allergy parent, it really does make me upset that this article release may mean it is now even harder for families to get a non-IgE diagnosis. Many non-IgE CMPA families are still struggling to have their children’s allergies identified or recognised. I experienced this first hand. I worry clinicians may read this article without understanding fully how to identify and diagnose non-IgE allergy; for example, the importance of taking an allergy-focused clinical history. My worry is we will see a swing back to other interventions for families, such as acid reflux medications, which may be more problematic. Especially if we keep failing here in the UK to support families properly.

The UK is often not good at supporting breastfeeding or indeed, parenting generally. We under-fund or cut breastfeeding support services, what’s more, we then don’t give families who are bottle feeding enough support either. We overstretch our wonderful health visitors and doctors so they can’t spend enough time with concerned parents. Our media promote ridiculous ideas about how our babies should sleep, feed and behave. Our government policies result in the shutting down of children’s centres and cuts to children’s services.

However, upset as I am about all of this (and I am) what really makes me furious with CMPA in particular is the industry meddling and sponsorship of research that has been allowed to proliferate. It is this which now threatens to undermine the diagnosis and awareness of non-IgE CMPA. I don’t know if CMPA is being overdiagnosed. I don’t think anyone can say with surety that it is. However, we can’t criticise the authors of the BMJ article for simply pointing out that bias is a problem here. The appearance of bias is a worry regardless of the extent. We can argue forever whether or not this researcher or that researcher was biased. In the end, it doesn’t matter if they can look like they are.

What makes me angry is that big formula sells both the problem and the solution and this is seen as acceptable.

What makes me mad is that big formula has been allowed anywhere near creating the guidelines for CMPA diagnosis. This opened the door to the criticism that has now emerged.

I am not mad at the scientific and medical community for raising a valid concern about bias.

Professionals and anyone speaking publicly about allergy, be that scientists, doctors, charities,  lactation workers or allergy bloggers need to be thinking hard about conflict of interest in their work and the impact this might have down the line on their credibility. It is this we should all be getting angry about. Parents and babies deserve better. After all, ultimately they are the ones who suffer and deal with the consequences.

Update 9-12-18: The BMJ are currently reviewing their policies around accepting advertising from infant formula companies. If it is important to you that parents are given high quality and independent evidence based information please sign this petition.

Parenting with Social Anxiety

Confession time. This is a scary blog to put out there. I’ve dithered posting it and re-drafted it a million times because it is so personal. But here goes. I struggle with social anxiety. Some close friends and family already know this about me. Some people might be surprised I guess. It is something I have lived with to varying degrees since I was a child. Over the years I have developed coping strategies, and mostly, I get by. I can usually play the part of a functional adult. However, still, on very bad days the idea of the smallest interaction with someone else can make me feel pretty stressed.

My anxiety was probably worst during my pre-teen years and adolescence. At its peak, during my first year at secondary school, I barely talked to another person, aside from my teachers, or family. Not an exaggeration. It was a really unhappy time for me. I am amazed now, that not a single teacher spoke to my parents about it. This was during the ’90s. I hope social anxiety is more recognised now, that young people get more support than I did.

What is social anxiety?

Social anxiety isn’t simply shyness. It’s intense fear that can affect everyday life. Lots of people feel uneasy in social situations. However, for someone with social anxiety, those feelings can be very difficult to manage.

According to the NHS, you may have social anxiety if you:

• dread everyday activities, such as meeting strangers, starting conversations, speaking on the phone, working or shopping
• avoid or worry a lot about social activities, such as group conversations, eating with company, and parties
• always worry about doing something you think is embarrassing
• find it difficult to do things when others are watching – you may feel like you’re being watched and judged all the time
• fear criticism, avoid eye contact or have low self-esteem
• often have symptoms such as feeling sick, sweating, trembling or a pounding heartbeat (palpitations)

Personally, my anxiety manifests in a few ways. Much of the above is very familiar to me. For example, in a conversation with another person, I am often half listening, wondering how I am coming across to the other person. What are they thinking? Do they like me? What should I say next? Did they just give me a funny look? Am I boring them!? This distraction isn’t a lot of fun for the other person either to be fair. On bad days this internal narrative is so overwhelming my mind goes blank, and I cannot think of a thing to say. Sometimes, I respond almost defensively to the most innocuous of questions. A simple, “How are things with you guys?” can send me into a panic. I desperately try to think of something interesting to say, and fail, awkwardly shrugging “Oh well, you know, nothing really”. Then I spend the rest of the day (even days) berating myself.

I apologise to all my friends who have endured these painful interactions with me. Thank you for seeing past it all and being kind. In truth, I am luckier than some. I have a loving husband and family, I have had help, my anxiety is always there, but mostly under control. I can go to a party where I don’t know people well. I have some good friends. Held down a career in freelance design. I do volunteer work that I love. You see, I do actually want to be around people. People think socially anxious people don’t want to socialise, and that’s just not true, at least not for me. It is just we also find it incredibly difficult.

Parties or gatherings of large people can be most difficult for me to navigate. I  make sure these days, that I don’t allow my anxiety to control whether or not I go. I used to just turn down invitations to parties. I still get that white-hot fear though, when I walk into a room full of people even if I know most of them. How I feel the event went can have a profound impact on my mood. If I think I managed to navigate it with more ease than usual, I am happy. If I have an awkward moment, not only am I anxious about how that must have looked, but it descends into this horrible feeling of shame and embarrassment about who I am as a person later. The self-loathing sometimes lasts for days. Regardless of how the event went, I am often exhausted afterwards.

At 35, when I had my baby, I was thrown into a new world. I suddenly had to have adult conversations in a room full of parents I didn’t know, a situation which scares the pants off me. I didn’t do many classes and groups. I often found myself making an excuse to avoid them. “Those classes more stress than they are worth” (true, but not entirely the truth). I went to one baby group where not one person spoke to or made eye contact with me. It was such a triggering experience, I didn’t ever try another local village group. Despite tons of breastfeeding issues, I think my daughter was months old before I managed to get to a breastfeeding support group without a friend. The kindness of peer supporters and mothers there made that group my lifeline really. Thank goodness for boob group, NCT friends and Facebook because I think these things actually saved me from acute loneliness in the early days of motherhood.

People sometimes don’t believe me when I say I now do volunteer work yet am socially anxious. Especially when I say I also do telephone support and they are familiar with me dithering around, taking a week to call a plumber! However, my support work is so much easier to navigate than a baby group. It is like putting on a costume. I have conversational tools from my training to support women. There are some questions you always have to ask, some issues which are so very common, these things form a kind of familiar script, so I always have something to say. Silences are encouraged so it gives me time to think. I am often asked about specific issues and have a bank of knowledge I can draw from to move the conversation forward. Crucially, I am not focusing on myself, but on someone else. I can largely forget about what people are thinking about me. I don’t have to worry about making the mums I support my friends. In fact, it is actively discouraged. The tools I have gained in training have been immensely helpful to me in ‘real life’ social situations, however, and it has really built my confidence.

As my daughter gets older I now find myself often scrutinising her interactions with other children. My biggest fear is that she ends up like me. The maddening thing is, I know the more anxious I am around people in front of her, the more likely this is. This encourages me to navigate situations I would have previously avoided. My daughter drives me on to be my best self. While she is a little shy as a child and often overwhelmed in busy situations, I have seen how well she interacts with other children at nursery or smaller groups. I try to reassure myself she’s doing fine, and no different to many of her peers. Next year she starts school. I cannot articulate how worried I feel for her. I desperately hope she does ok, that she makes friends and has a “normal” experience.

If you are a parent with social anxiety but you push yourself into situations which make you anxious try to remember this: it takes guts. Finding the courage to go to that group is amazing. Even if you don’t speak to anyone, feel proud. You were brave. Being a parent with social anxiety can be hard. You may lose the “crutches” or coping strategies you had developed pre-children. On top of this, as parents, we may be dealing with a loss of our professional identity and other parts of ourselves. You are navigating a new beginning. Like many new starts, if you lack confidence, it can be even more stressful. So give yourself credit where it is due.

I still remember the girl who finally befriended me at school during my worst period of social anxiety. I don’t think she knows what she did but she made a lifelong impression with her kindness. My appeal to everyone is, please say hello to that quiet mum in the corner of the playgroup if you can. Make eye contact, smile, reach out, be kind. Sometimes, someone is standoffish because they are anxious. Please be forgiving. Engage that scared looking person in a conversation. It might not be the start of a beautiful friendship, but you might be the person who helps them get through the day smiling or encourages them to come to the group again. They may actually make a friend or two eventually. Small gestures count. Make them a cuppa. You never know the difference your kindness might make to someone.

Social anxiety support:

If you can relate to the issues raised in this blog, first and foremost, seeing your GP might be helpful. You may also have local counselling services you can self-refer to. CBT is considered one of the most effective interventions for social anxiety.

https://www.nhs.uk/conditions/social-anxiety/

https://www.anxietyuk.org.uk

http://www.anxietyalliance.org.uk/

https://www.mind.org.uk

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Review: Why Mothers’ Medication Matters

Author: Wendy Jones

Publisher: Pinter and Martin

ISBN: 978-1-78066-585-6

“There is evidence out there for the vast majority of drugs that should enable mothers to continue breastfeeding while obtaining the medical treatment they need… none of this is difficult. If we value breastmilk for its wonderful properties, practice evidence-based medicine, and respect mothers, we could transform women’s experience of seeking treatment.” Wendy Jones “Why Mothers’ Medication Matters”

A while ago, I had the privilege of reviewing this wonderful book, my review has now been published, so I am excited to be able to share it with you all here.

Wendy Jones is an inspiring figure in the field of lactation. A massively experienced Breastfeeding Supporter for the Breastfeeding Network and a qualified pharmacist; Wendy has tirelessly worked to help parents who breastfeed. Any breastfeeding supporter or counsellor should be aware of the brilliant “Drugs in Breastmilk Information Service”. This wonderful resource tirelessly gives information to lactating people about medications they may need to take during breastfeeding.

Prescribing medication for breastfeeding parents can be difficult for health professionals yet parents often need medication, whether it is short-term use of painkillers, antidepressants, or drugs to treat chronic conditions. Women are often given misinformation about what medications they can and cannot take.

In this book, Wendy Jones sets out to give mothers and health professionals information they need to make decisions about medication and to reassure fears that parents may have about adverse effects on babies of drugs passing through breastmilk.

Wendy Jones opens her book with an introduction to her subject, providing heartstring tugging examples of why better support around medications and breastfeeding really matters. Putting a human face and empathy on what could easily be quite a dry subject matter is something she continues to do throughout the book. The case studies are really moving, covering examples like postpartum women on a maternity ward being told they could only take paracetamol while recovering from c-sections or episiotomies and mothers dealing with weaning decisions after being given a cancer diagnosis, among many others.

Further chapters explore topics like why prescribing for lactating people can be so fraught with confusion, drugs during pregnancy and birth and their impact, treatment of chronic health conditions and depression as well as looking at ‘lifestyle’ drugs including alcohol and recreational drugs. The chapter on over-medicalisation of common issues like infant reflux, CMPA and colic are a must read for any peer supporter, particularly those among us who provide support on online forums where suggestions of reflux and CMPA are common. Some of the facts and studies Wendy discusses are truly eye-opening and the book is well referenced with a focus on remaining evidence-based.

Wendy ends her book with a discussion about where women can go on to get support around prescribing issues, and talking about milk donation. The final chapters are a heartfelt overview of the differences between breastmilk and formula milk and why we shouldn’t be assuming “formula milk is fine” if a lactating parent needs medication and her conclusions about why medication matters for breastfeeding parents.

This book is about so much more than medication; it is a wide-ranging overview of issues breastfeeding parents may face dealing with their healthcare. The ideal length and level of detail for a breastfeeding peer supporter, as well as a good introduction to the topic for training breastfeeding counsellors and health professionals I would whole-heartedly recommend “Why Mothers’ Medication Matters to anyone.

Buy “Why Mothers’ Medication Matters” by Wendy Jones and other excellent titles from the ‘Why it Matters’ range, over at Pinter & Martin

*I draw no income from my writing, my blog features no ads, be reassured links given to purchase this title are completely independent and not affiliate! #adfree

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The 12 Days of Boobin’! Christmas Tips for Breastfeeding Mums

Enjoying the holidays, and breastfeeding your baby are not mutually exclusive

It’s beginning to look a lot like Christmas! Soon many of us will be spending time with friends and family, and while we may look forward to the holiday, some may find the idea of breastfeeding over the Christmas break brings up a few anxieties.

First of all, in my view, there is one brilliant advantage to breastfeeding over the Christmas period, You have the perfect excuse to slip away and get some quiet time (hopefully with a box of choccies to keep you company) because “baby feeds better without distractions”. Another bonus- you also have the perfect excuse for turning down events you don’t really want to go to. Maybe that’s just me. I am happiest in PJs with a glass of wine.

Other people may prefer to drink their wine wearing their party gear, and worry that this breastfeeding malarkey means they are going to miss out on all the fun.

I know often concerns revolve around family members, particularly breastfeeding in front of them. Some people worry that Auntie Lynda will go on (and on) about how she thinks the baby should be on bottles/formula/Christmas dinner and all the trimmings by now.

So here are a few of my thoughts on how to make life easier as a breastfeeding mum over the Christmas holidays.

Baby Wearing

Worried about baby being passed around like the tin of Roses, during peak cold and flu season? Wear your baby! You will be surprised how much less well-meaning relatives will demand a cuddle when they see a baby all cosy in a sling.

Wearing Your Baby has the added advantage of keeping them close, which leads me onto my next point…

Expect Baby to Change Their Feeding Habits

Often over holiday periods, things are busier and babies are more stimulated. It is easy to miss feeding cues, or breastfeeds. During long journeys, a baby might sleep more than usual. Lights and music and new people often mean distracted babies that don’t feed as well or cue for a feed less. Quite often babies are being passed around for cuddles. Sometimes Uncle Gary might decide he can soothe the crying baby himself rather than passing them back to Mum. Sometimes mum is distracted entertaining friends and family or making food.

Building in times during the day to breastfeed might be a helpful way to combat this, or alternatively see above; Wear baby more so they stay close! If you are undertaking long journeys build in some rest breaks to allow time for boobin’.

Alternatively, baby might be out of sorts, cranky, overstimulated and want boob ALL THE TIME, also normal! In fact, in these situations, nursing can be a godsend. It is often much easier to calm a baby with a breastfeed.

Nursing also gives you an excuse to get out of peeling the sprouts or doing the cooking. I may or may not have personally used this as an excuse to sit on my bum eating Christmas cake (“It’s for the baby!”).

Make time to express if you are apart from your baby

If you are away to a party, or out for the day Christmas shopping you may want to build in some time to express. This is more important the younger your baby is. Not removing milk from your breasts may lead to engorgement and blocked ducts, and eventually lowered milk supply.

If you do find you develop some blocked ducts or engorgement, following self-care is important, this is great information from the Breastfeeding Network.

If your baby is having bottles while apart from you, making sure responsive feeding methods are used can be helpful. Click the link for a video demo.

Alcohol and breastfeeding

Most sources suggest a moderate intake of alcohol while breastfeeding is fine. You can still have a glass of wine or two and breastfeed. However -and this would be true however you feed- as a parent you need to be careful you are still fit to care for a small child. Bedsharing after drinking alcohol is also a no-no. If you fancy a blowout, expressing some milk in advance might be helpful, as well as enlisting a babysitter.

Some useful links:

https://www.laleche.org.uk/alcohol-and-breastfeeding/

Click to access alcohol%20and%20breastfeeding%20%283%29.pdf

https://www.kidspot.com.au/baby/real-life/in-the-news/formula-is-worse-for-babies-than-alcoholtinged-breastmilk-says-aba/news-story/d330a1a6be9d3489e6f8392abc77b63f

Pass the stuffing, please!

Christmas is often a time when the food police come out to tell you that you can’t eat your veggies because “baby might get windy” or that you need to avoid the stuffing or after-dinner mints because the sage or peppermint might “lower your milk supply”.

The good news is, there is no evidence-based research showing foods themselves will make your baby gassy (unless they already have a known allergy or intolerance to a certain food), and you would need to be eating absolutely VAST quantities of stuffing/mint for there to be any effect on your milk supply, so tuck in, and don’t worry.

In case you overdo things, many indigestion remedies are safe to take while breastfeeding. All on the link there. You’re welcome.

Don’t feed the baby!

I’m not talking about breastfeeding here of course! However, older babies that have solids may be filled up with Christmas ‘treats’. It can be helpful to put aside some time for boobin’ toddlers too unless you are planning on weaning.

Sometimes, you may need to watch out for relatives trying to feed younger babies solids. Remember, some relatives may be from a generation where babies were given solids much younger than they are now, and may have no idea this isn’t OK. If you suspect this might happen, it might be helpful to be upfront; for example saying something along the lines of “It is important to me that the baby is closer to six months before giving them food, the research now suggests this is best for babies, and this is also what our health visitors have recommended”.

You may even want to think about ‘recruiting’ any prime suspect onside, have them “watch out for anyone who might give baby solids accidentally”. It is amazing how well giving people some trust and responsibility can work in your favour.

If well-meaning relatives are convinced giving baby Christmas dinner is the key to a full nights sleep- show them this!

Dealing with criticism

Make sure people know that you are proud of your breastfeeding relationship and that you see it as a good thing. If your relatives don’t see this as a chore they can relieve you of, you might find their attitude changes.

If you feel your choice to breastfeed is questioned, or that those surrounding you aren’t supportive, the “pass the bean dip” approach can be useful: https://twolittlegrasshoppers.com/tag/the-bean-dip-method/

If you have an older nursling, and you are worried about people questioning why you are “still breastfeeding”, Kellymom has some useful suggestions here too: https://kellymom.com/ages/older-infant/criticism/

Family members are generally well-meaning. They may be basing their ideas on outdated things they have been told. They might be open to learning about how recommendations have changed if you approach the subject gently.

Remember, you are the advocate for your baby/toddler/child. They cannot stand up for what they want. Give yourself permission to be unashamed. You do not have to answer to anyone else about your feeding relationship. Your boobs, your baby, your choice.

Choose clothing that provides easy boob access

Worried about feeding in front of family members? Consider practicing in front of a mirror, seeing how little is exposed might reassure you a little, especially if you use the “one up, one down” technique.

If you don’t feel comfortable getting your boobs out in front of family (maybe you have an inappropriate drunken uncle or two), the muslin trick is an inexpensive tip. Using a large muslin, tie one corner to the strap of your bra, and use the loose cloth to cover up any exposed areas. Or employ your partner on distraction duty to get uncle Roy into the kitchen for another sherry if that’s what makes you feel happier. Or, if like me you like a bit of a breather, use it as an excuse to get a bit of peace and quiet. When it comes to feeding, it is about what makes you feel more comfortable first and foremost.

If you need a party outfit or even some new fashion ideas for breastfeeding friendly clothing, why not join Can I Breastfeed In It? They are a UK facebook group, which have fantastic tips and ideas for feeding fashion (and they even have a selling page so you can grab yourself a bargain too).

So there you have it, some helpful tips for enjoying Christmas while continuing to breastfeed. Is there anything you think I have missed? What are your tips for breastfeeding over the holidays?

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Does Big Business Really Want to Help you Breastfeed?

When advice and help isn’t all that it seems

Boots, it seems, want to help you to breastfeed. They now produce a leaflet which you can pick up in store, and have a section on their website devoted to it. I see photos of this leaflet shared on breastfeeding groups, usually with the caption “Found this in Boots, isn’t it brilliant they have this?”

As someone who volunteers in infant feeding, this sort of thing sets off my cynicism alarm. Retailers are in business to sell you things, altruism usually isn’t high on their list of priorities.

Confession time: I’m going to be picking on Boots a bit here. They are one example in truth, they certainly aren’t the only brand to do this sort of thing. Other companies also like to give out information about breastfeeding. Infant formula or bottle companies, for example, often do this too.

Let’s dissect the website information on Boots.com a little and see what we find.

The first sections: “Why is Breastfeeding Good For Me?”

Boots have chosen not to linger on the well-documented child health reasons to breastfeed, with a ‘blink and you’d miss it’ section, but they do have time to mention our appearance.

“There are lots of really good reasons to breastfeed, including benefits to mum. These include: “It helps you to regain your old figure“.

Here we are, in 2018, with Boots suggesting weight loss is a top three reason to breastfeed. Talking about our body image before they mention the reduced risk of ovarian and breast cancers. I’ll leave you to think about that.

“How Do I Start Breastfeeding?”

Then we come to the next section “How do I start Breastfeeding”, where Boots have some advice from Clare Byam-Cook, a controversial figure* in breastfeeding support due to her lack of any breastfeeding specific qualification.

“Hold the baby close, facing the breast, with its shoulders and body in a straight line and it’s neck supported but the head free to extend (use a feeding pillow if more comfortable), offer your breast to the baby…”

I am wincing reading that description. “Facing the breast” implies a “mouth to nipple” position to me, something most breastfeeding professionals will tell you is a recipe for a painful latch. This is a good demonstration as to why that is (thanks to the Empowered Birth Company for the video). It also says “head free to extend”, a clearer phrase I feel would be: “head free to tilt back”. Thirdly, “Offer your breast to baby” conjures images of a mother holding her breast and smooshing it into baby’s face, this would likely encourage an uncomfortable feed for the mother in an unsustainable position. Finally, we see them suggest “use a feeding pillow if more comfortable”, with a link taking you a range of pillows. I have nothing against pillows as long as they work for the mother, but this should be your first clue this isn’t a selfless exercise on behalf of a retailer.

“Common breastfeeding niggles solved”

The second passage is “Common breastfeeding niggles solved”. If you used the first section to give you information on how to attach your baby, you may need the information here.

My first problem with this section is it is so negative, it almost seems to scream “Breastfeeding will cause you excruciating pain!”

I am not going to sit here and tell you breastfeeding shouldn’t hurt. That would dismiss the lived experience of many mothers. Breastfeeding has a learning curve, and getting to grips with attaching a baby to the breast when hardly any of us see it on a regular basis can be hard. Sometimes, while establishing breastfeeding, mothers experience pain. What I would say is, if this is you, don’t feel like you have to wait for things to “toughen up”, or that the answer is expensive nipple creams. The research just doesn’t support that. A bit of support with attachment or a tweak may make it feel better.

I do question why, in a limited space, a large portion of this leaflet is devoted to pain? Surely some diagrams of attaching a baby instead, might help their mothers prevent some of these issues in the first place?

Well, reading further it becomes clear. They can sell you stuff to help with pain. We see links to nipple cream and a range of nipple shields. I have no doubt nipple shields are useful for some mothers, I know for some mothers, they kept them breastfeeding. However, they can be an absolute faff to use all the time, especially in public. Babies can get overly reliant on them. They also don’t solve underlying issues the mother or baby may have.

Moving on to “engorged breasts”. Here, we see suggestions that using breast-pumps and bottle feeding until the engorgement subsides is a good course of action. This is the section I find most shocking.

Engorgement is most common in the first days after birth. So why encourage parents to pump and bottle feed instead of using simple techniques to soothe and resolve engorgement, such as hand expressing, nipple stimulation and cool packs? Pumping is known to overstimulate supply in the early days (parents are usually advised not to pump unless necessary in the first few weeks). Using a bottle instead means possibly going longer between breastfeeds with engorged breasts! This is not a good thing for breast health or milk supply. Not everyone can effectively remove milk from their breasts with a pump, at least, not as well as their baby. No mention of how early introduction of bottles may be detrimental to breastfeeding in some cases and that the Baby-Friendly Hospital Initiative advises against bottles and teats in early breastfeeding.

Then we come on to the last “common breastfeeding niggle”, mastitis. Hardly a ‘niggle’, is it? Mum is instructed to go straight to the GP, sensible. A bizarre choice though, I feel, to spend so much time encouraging pumping and bottle feeding through engorgement, but offering no well-known self-care methods for clearing a blocked duct.

“Do I have to breastfeed all through the night?” & Other Anxieties

Not content with suggesting you use a pump once, Boots move on to trying to sell you them again (with handy links to their range of pumps). This time it is to get dad involved in night feeds while mum sleeps. Now, I know this is a strategy some parents will try, and if it worked for your family, great. However, they have omitted the facts that:

• In the early months of breastfeeding, a mother will usually need to pump around the same time in the night, in order to avoid engorged breasts, blocked ducts, and mastitis.
• Quite often a baby will drain the bottle, but still want boob, because breastfeeding is not all about the milk.
• Night feedings can be important in supporting milk supply.

Then there is a section talking about new mothers breastfeeding in public. It’s OK though. Boots have a cover for that they can sell you. Oh and don’t forget about all the leaking. Boots can sell you stuff for that too.

This all seems to me, rather than helpful information, to be a fabulous example of how brands who sell you formula, pumps, bottles, and teats may complicate, or even sabotage breastfeeding, knowingly or unknowingly, in their quest to sell you ‘stuff’.

“What Can I Eat and Drink While Breastfeeding?”

So we come to the final section. The way this is written reads as if a mother needs to be hyper-aware of her diet: “good nutrition is more important than ever”. I find this paragraph pretty undermining. A good diet is important for everyone, it is not a necessity for breastfeeding. If it was I would be worried about my own child, since my early breastfeeding diet was 70% cake, 30% toast. Breast-milk is robust, and will in nearly all cases, still be the healthiest option for your child, (even on a 70/30 cake/toast diet). A mother would need to be malnourished for her breast-milk to be impacted.

“The occasional sweet treat is fine too- goodness knows you deserve a slice of cake”: Wow. Breastfeeding mothers of the world, quite frankly, if you want the whole bloody cake, eat it. Nobody needs permission from a shop to eat cake!

Finally, the article ends with some links showing us more bottles, talking about pumps and baby food (we haven’t even managed to breastfeed yet and Boots are talking to you about baby food? Seriously?) Sadly, no links to any organisation which may help you establish breastfeeding (you can find these at the end of this blog).

Companies like Boots may want you to start breastfeeding. Shops want you to buy stuff for breastfeeding from them. Let’s face it, this is how they make money. I imagine they want to sell you some expensive pumps, nipple creams, covers, bottles, and shields. Unfortunately for some, following this sort of information may mean their breastfeeding journey is over sooner than they hoped.

Luckily, if you do have to stop breastfeeding, Boots have a large selection of infant formula they can sell you, often on code-breaking special displays.

I do wonder what is in it for companies, to suggest things like mothers need to follow a healthy diet to breastfeed? Or to give out information which might make breastfeeding painful for a mother? Or lower milk supply? Why devote so much time to suggesting that breastfeeding usually comes with pain and problems?

I can’t answer these questions for Boots or any other retailer. I don’t explicitly know their intentions. I do think we need to be careful where we choose to get our help from, and that the first question we should ask ourselves when a retailer tries to give advice is- “What’s in it for them?”

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This is an opinion piece, and all opinions expressed here are my own.

*For an example of said controversy Byam-Cook’s last appearance on ITV sparked a petition for them to use qualified breastfeeding experts in future. The petition was signed by nearly 5000 people.

What Nobody Told Me About Becoming a Parent

Are the images we see of parenthood realistic?

Screenshot from Pexels for “Motherhood” taken Nov 18

Back in 2014, I remember it quite clearly, I was sitting in an antenatal class with other expecting parents, who later went on to become good friends. We have often talked about those classes, but one memory which stands above the rest for me is one of the exercises, where we planned “24 hours with our new baby”. I remember filling in hourly slots on the flip chart with stuff like “going to the coffee-shop with the baby” and occasionally saying things like, “Ooh, it has been four hours, so we probably should be feeding the baby now too?” or “Perhaps baby will need their nappy changed now?” It always makes me chuckle when I remember it. I honestly don’t remember if the antenatal teacher tried to question this chilled out picture of the day we painted. I do wonder now how much she was laughing internally at our naivety. The perception some of us had, after babies, was this: the realities of parenting were a well-kept secret, and not to be discussed, at least not until after you have the baby.

Culturally we are all influenced by the image of “happy motherhood”. The commonly sold narrative is that all parents will naturally transition to life with a baby with ease, and will innately understand all aspects of parenting, especially if we buy the right “stuff”. In reality, we are social creatures, and what we learn about parenting, comes from what we absorb, from our wider lives, childhood, and culture. Many of us simply are not around babies and children much, except as children ourselves. We may have had a sibling, but chances are we do not really remember them being babies. We often grow up in small nuclear families, rather than extended families or small communities. We might see a lot of babies on the screen, but many UK parents have rarely held a baby before the day comes when they hold their own.

Screenshot from Google Search “Motherhood” taken Nov-18

The societal norm of not really talking about how parenting can be unless you are talking to another parent, of not admitting to our real feelings, of not discussing widely how normal it is to find it difficult, perpetuates the “big secret” about what it is really like. Search an image site, or google for the term “motherhood” and what you will find is similar to the photo above; a gallery of soft focus images of babies being cuddled, smiling mothers and heartwarming memes talking about how amazing mothers are. And we are amazing, but that doesn’t mean we feel like we are. Yet we are constantly bombarded with this stuff. “Enjoy every minute, it goes so fast!” the memes cry, or they say things like; “Motherhood is messy, and crazy, and challenging, and sleepless, and giving and still unbelievably beautiful“. And just sometimes, seeing this stuff can make you want to scream; “I don’t feel the bloody beauty! I am tired, I am fed up, I want to shower without interruption, I want to pee by myself, I want a full nights sleep and I want my old life back, just for a day”. It can be especially hard to be a new parent in a world where we can be bombarded with “insta-ready” images of parenting. We see smiling parents in adverts for “stuff”. We see lovely snippets of life with kids on our social media feeds, a place where we compare the best parts of other peoples lives, to our everyday.

Amidst the “pre-baby” expectations of what we might gain- a lovely cute ‘bundle of joy’, love, fulfillment and happiness (all of which may be true) we may feel ashamed to admit if we feel a “loss” too. A loss of our old identity, our autonomy, our old body, our professional selves, our time and our sleep! I clearly remember having the realisation myself that my life had completely changed now. It was never going to be what it was ‘before’ and that there was no break from this, no holiday, no time off- and in that moment the responsibility I felt was completely overwhelming.

When you ask new parents what they feel is the most unexpected aspect of caring for their baby, quite often the knee jerk response is: “no-one prepared me for the sleep deprivation”. Our cultural norms do not prepare us for what normal infant sleep is and fears around bed-sharing, can mean more exhaustion for western parents, who are frequently trying to get babies to “go down” in a separate sleep space or even a different room. Their small human often has an entirely different agenda. When we see babies on the television, or in movies frequently we are shown a picture of a newborn, alone, in a lovely crib, while they sleep soundly. In fact to prove this point, here are the top images from a google search for “sleeping baby”.

Screenshot from Google for “Sleeping Baby” Taken Nov 18

No wonder it can all come as a bit of shock when the reality for many is not a baby who is happy to sleep alone, but is in your bed, latched on. You are in a fleecy M&S onesie with one boob out because you know you shouldn’t use a duvet, and any sheets that do remain have a few dubious stains on- “Is that breastmilk or baby vomit?” you briefly wonder, before turning your attention to other more pressing matters, like getting your baby back to sleep. Again.

And while we often focus on only how the mother is doing after birth, the same difficulties are often true for the other parent too.

Before we had our baby, my husband often remarked he didn’t see how it would change things a great deal. I remember having a conversation with him about how I wanted to make sure I got my hair done before having the baby, as I might struggle afterward. He was confused by my worries, in his mind, of course I would have time. In reality my baby was 6 months old before I got to the salon. The transition to fatherhood was equally hard on him, and I remember he was also emotional and overwhelmed at times. I’m ashamed to say, I resented him for this at the time, I was dealing with my own struggles to breastfeed, and my transition to motherhood. Where previously we would have shown each other empathy, instead we were often in conflict. Having had a very happy relationship ‘before’, the strain we came under came as a shock to me, we hadn’t anticipated it at all. Our experience felt dramatic at the time, it was our first maritial “rough patch” but we weren’t unique. I only realised this a couple of years later, having a lunch date with an old friend, who confided in me (after a few drinks) she had a really similar experience. Difficulties in relationships after having children are well documented, and also backed up by research. Yet it seems like the huge upheavals to relationships and subsequent difficulties are only alluded to in passing conversations, rarely discussed openly, if at all.

Obviously I love my daughter with a passion, I would never change a single thing about her (ok that is a lie, I do kind of wish she would sleep but that is another story). I don’t want to paint a negative picture because I have gained far more than I ever lost, and being a parent really can be so very wonderful. I think parents are amazing, and that we often are far too hard on ourselves. But I think we need to be telling real stories. Parenthood isn’t trite memes. It isn’t soft focus images of cuddled up babies and tiny feet. Breastfeeding isn’t always smiling down lovingly at a suckling baby, especially at first. Sometimes there is pain involved in becoming a parent, physically and emotionally. Often it is hard work. There is a learning curve. We might not be able to fully prepare for it, but we can be prepared to be surprised. And as we shed our old skin, and our old lives, and become something forever changed, we should reflect on the stories we tell to others who might be next. Our real stories deserve to be told. The truth is rarely “insta-ready”, but sometimes it is good to get a little bit real.

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Breastfeeding a Baby with Reflux

How to get the support you need

As a breastfeeding support volunteer, I generally avoid sharing my own story as I prefer to focus on the parent in front of me but bear with me because my story is relevant to why this blog has been written and it is one of the reasons I am so passionate about infant feeding support.

My daughter was a “reflux baby” and she was treated with anti-acid medication for a long while, so when I talk to you about reflux, believe me, I know it, and I know how hard it can be.

I joke that when A was born she cried straight away and didn’t stop! My poor baby spent her first weeks wailing, coughing, writhing and red in the face, pretty much all day and most of the night. I felt trapped in the house. I remember feeling so desperate I wanted to cry when the health visitor left me in the house alone, with a baby who did nothing but scream at me. It was a pretty awful introduction to parenting. At 5 weeks old, she was diagnosed with reflux and we were prescribed infant Gaviscon by our GP. Like many parents, I took the prescription gratefully, and the numerous prescriptions that followed. It was the beginning of a journey which didn’t resolve for another twenty months.

What is problem reflux, or GORD?

Reflux simply means “a flowing back” and many babies spit up and vomit without being bothered by it at all. Problem reflux (GORD) has a variety of symptoms, which you can read more about here. Certain conditions can contribute to reflux, for example, it is more common in babies who are premature or babies who have other health conditions.

A baby who is spitting up a lot without distress or without other problematic symptoms it is unlikely to have reflux disease. If your baby is crying mostly during the evening hours yet content most of the day, they may be experiencing normal baby evening fussies.  So while these things can be alarming for parents (and messy!), it is important to be aware of the difference between what is normal and what is “reflux disease”.

Mums who worry their baby has reflux often say to me, “I think it’s reflux because he just won’t let me put him down in the cot! I think he hates being on his back.” Here’s a secret which might help you feel better: most newborn babies hate being put down and prefer to be held. That’s normal baby behaviour.

Many medications used in the treatment of reflux disease are used “off-label”, they weren’t originally developed with infants in mind, and there are some studies which raise concerns about their use, especially over long periods of time.

If you’ve read all of the above and you are still with me at this point, I’m sorry. Dealing with reflux is a really distressing and difficult thing to cope with, and I know how it can feel relentless and never-ending. Here is some more information for you to consider.

Some common causes of reflux in breastfed babies

(This is not an exhaustive list!)

1. A shallow latch, or otherwise disorganised feeding

If your baby is not attached deeply to the breast or has a disorganised suckle they may take in more air as they feed. When air is expelled it can result in spitting up. Trapped air can also be very painful for the baby. This can result in reflux symptoms such as back arching, crying, and hiccoughs. Babies with shallow attachment may also struggle to transfer milk, leading to a fussy baby who wants to breastfeed 24/7.

This is why NICE recommends a breastfeeding assessment first as part of its quality standards: “A breastfeeding assessment should be the first step in supporting parents and carers with managing frequent regurgitation of feeds associated with marked distress. Correcting the breastfeeding technique for breastfed infants (for example, positioning and attachment) can improve or eliminate the symptoms.”

Sorting out a shallow latch can be as simple as doing a little work on positioning and attachment. Some babies with shallow attachment may have anatomical differences which hinder deeper attachment, for example, tongue tie or a high arch palate.

This is a great resource to help you with attaching your baby.

2. Breastfeeding management

In the UK we have a cultural expectation of having a few hours between feeds and this impacts on how we feed and treat our babies. Instead of smaller, frequent feeds sometimes we encourage our babies to “go longer” and take in more milk, less often. Some babies cope with this just fine but others may struggle, with large volumes of milk hitting the stomach and then coming straight back up. Some babies may protest- loudly!- about having their feeds delayed. So responsive feeding, and watching our babies instead of the clock may help. More about responsive feeding.

Our babies also spend a lot of time on their backs, which is no help for reflux. We commonly feed babies in the cradle hold, and then they are placed on their backs in Moses baskets and in prams. However, our babies evolved to be held. You cannot cuddle a baby too much. Simply carrying our infants more and experimenting with other feeding positions can go a long way towards helping babies with a tendency to reflux feeds.

3. Food intolerances and allergies

If your child has been properly diagnosed with GORD, and you’ve had a breastfeeding assessment which found no problems, it’s interesting to note research suggests a significant link between food allergy particularly CPMA. Some studies show a link of up to around 40%. CMPA is discussed in the NICE guidelines as one differential diagnosis for GORD.

Does that mean all parents with reflux babies should immediately be told to cut out dairy products? No, I don’t think so.

As you can see above, there are other things to explore before taking drastic steps, unless your child is exhibiting other clear symptoms of cows’ milk protein allergy. If you want to learn more about CMPA you can read my blog, or the BfN factsheet might be helpful.

Addressing attachment, examining the oral anatomy and considering breastfeeding management first is usually quicker and easier than making big changes to your diet. It is far more likely a more commonplace issue is the problem and it can take 4-6 weeks for both mum and baby to be totally free of dairy protein. Looking at the basics first is really important.

If you are concerned about CMPA it’s also a good idea to speak with a GP or health visitor as you may need support from a dietician.

4. More great reading on the management of reflux and other potential causes here.

You’ve had a reflux diagnosis for your breastfed baby. What now?

We’ve talked about the NICE guidelines above and so we know a breastfeeding assessment may be helpful. It’s worth making sure the person who does the assessment is skilled and experienced in doing this, so you probably want to see a breastfeeding counselor, La Leche League leader or IBCLC.

It might be a good idea to make sure you see somebody who is familiar with tongue tie, just in case this is a factor.

The great thing about doing this is that an IBCLC can help you look at the full picture and consider all the angles such as:

• Attachment and positioning.
• Your baby’s suck/swallow/breathe pattern.
• If there signs of oversupply or milk transfer problems.
• Indications or risk factors for allergies.

In some cases, after doing all of this, medications can be appropriate and necessary. A pediatrician can discuss with you the risks and benefits so you can make an informed choice about the best way forward.

Coping with a breastfed baby with reflux

I’ve made this into a meme, for easy sharing and saving. Basically, “Think Boobs!” (I know, I’m a cheeseball, but I couldn’t resist):

Reflux does generally pass and get easier with time. With some help and support, it may pass more quickly. Asking the right questions is the first step to moving forward.
How did my own story end? Well, after getting some support from an IBCLC, my daughter was diagnosed with a cows’ milk protein allergy. We finally came off all our medications and beat the demon that is reflux. She still didn’t sleep in her cot, but that’s okay – I liked the cuddles ❤.

This blog is not intended to replace the advice of a medical professional, simply to give information for further discussion. Please make sure any concerns about your baby are discussed with a medical professional or a health visitor.

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Further reading:

GPIFN: https://gpifn.org.uk/reflux-and-gord/

Kellymom: https://kellymom.com/hot-topics/reflux/

*This blog has been substantially updated from an article I wrote for Breastfeeding Support and Information UK‘s blog “Through the Eyes of a Breastfeeding Support Group” if you like you can still read the original here *

Before You Tell a Breastfeeding Mother to Cut Out Dairy, Consider THIS

Why supporting a breastfeeding parent with their diet is really important if their child has CMPA

I’ve always felt we need to tread very carefully around suggesting dairy elimination for mothers before basic breastfeeding issues have been worked out, and recently I have had personal experience of why it is so important to be mindful.

I don’t consume any milk products anymore, because my daughter has CMPA and I am currently breastfeeding her. I was keen to keep breastfeeding. Breastfeeding a baby with CMPA is really important, it avoids many of the pitfalls of using dairy free formula (like the bad taste), and it protects and safeguards your child’s nutrition. Mothers should absolutely be supported to do this if they need to. At first, I was amazed at how good I felt when I cut out milk (and I still believe it doesn’t agree with me).

2 years in, I’ve recently discovered the downside. I’m currently taking v high strength vitamin D, calcium and omega 3 oils because despite spending so much of my time supporting others and knowing all the recommendations to supplement and be careful with diet, my levels got low, really low. I actually started to feel quite unwell, mentally and physically.

You see, lots of people like to say dismissively “Pfft, we don’t actually NEED milk”, and this is true, however, our bodies do need the nutrients within it. Fats, Calcium, Iodine, Vitamin D. Some milk also has Omega 3 added to it. Non-dairy milk and dairy substitutes often contain lots of Omega 6 (sunflower oils, nut oils etc) but we need a balance of both Omega 6 and Omega 3 at the very least, and while following a non-dairy diet, if you aren’t careful it can be easy to throw this out of balance. Omega 3 is thought to play an important part in reducing inflammation in the body, inflammation is linked to things like joint pain, chronic illness, weight gain, and depression.

Removing dairy from the diet is a huge dietary change, we need to be mindful of that. In my opinion, breastfeeding parents who need to avoid dairy should be offered support with their diet, rather giving them a blanket recommendation to supplement (NICE guidelines), however, unfortunately, the guidance only discusses dietetic input in regards to the child. I feel this is a huge oversight, when treating breastfeeding parents and children it is surely better to treat the dyad, but that aside, things that can help are:

• Eating other calcium-rich foods.
• Getting plenty of sunlight, particularly between March and October in the UK.
• Taking a vitamin D supplement as recommended by the NHS, especially if you have a darker skin tone.
• Replacing those lost dietary fats-think about things like olive or coconut oils, fish, avocado, or other animal fats (if you eat meat).
• Making sure some foods you eat contain iodine.
• Including more Omega 3 rich foods into the diet may be helpful, to balance any increased intake of Omega 6, this means including in the diet foods like oily fish or eggs (remember the NHS suggests no more than 2 portions of oily fish a week for breastfeeding mothers).

Sometimes, depending on your diet, considered supplementation may be needed.

It is easy to make light of the impact milk elimination might have on a mother’s body, or to forget about this ourselves, especially when we are busy parents whose primary focus is our child. It is easy to let nutrition slip when you are tired and touched out anyway, let alone if you are avoiding a major food group. So if you have an allergic child, I am sending you so much love, I know it is tough! And what you are doing is so important for your babies, and so wonderful, just make sure to take care of you at the same time.

More information and sources:

https://en.wikipedia.org/wiki/Omega-6_fatty_acid#Suggested_negative_health_effects

https://en.wikipedia.org/wiki/Omega-3_fatty_acid

https://breastfeedingnetwork.org.uk/wp-content/dibm/cow%27s%20milk%20protein%20allergy%20and%20breastfeeding.pdf

https://www.vrg.org/nutrition/calcium.php

10 Tips for Seeking Breastfeeding Support in Online Groups

Navigating the world of online groups and forums

Lots of people feel passionate about the world of online breastfeeding support. It’s easy to recognise the value. I’m a member of several groups myself, I’ve been an admin in an online breastfeeding support group. Mother to mother support is so important. Many of us have found groups immensely helpful. There’s no doubt for me these online communities save breastfeeding relationships in a world where breastfeeding support groups, and even other breastfeeding parents can sometimes be thin on the ground.

The admin teams of good online support groups are amazing too, they give up so much of their time, for free, to support women. It is an incredibly generous thing to do.

An online support group should ideally be a complement to, not instead of, in real life, face to face support. The best groups know this, and you will often see those asking things like “do you have a local breastfeeding support group?” or “have you thought about seeing an IBCLC?”

Online we often don’t have the full picture of what is going on for somebody. Many of us may have also been unknowingly given ‘advice’ which isn’t always evidence-based when it comes to breastfeeding. And when we start to pass that ‘advice’ onwards, that can be a problem.

Examples of commonly heard phrases in online support groups which may be detrimental to another’s feeding journey:

• “A gain is a gain, don’t worry about the charts- they are based on formula fed babies anyway” (Incorrect, charts in the UK have been based on breastfed babies for years now, and a gain, unfortunately, is not just what’s important, lower than average gains over a consistent period of time = faltering growth and failure to thrive).
• “Breastfeeding really hurts at the start but just power through!” (Imagine you are a mum with severe nipple damage hearing this).
• “Just feed, feed, feed” (What happens if that baby isn’t producing enough wet and dirty nappies? Or has faltering growth? Most of the time cluster feeding is normal, but we need to be sure we have the whole picture).
• “I used formula top ups/bottles/dummies/weaned early and it was fine! No effect on my supply at all!”

So how, as mothers, do we protect our breastfeeding relationship while still making use of the support and information from an online group?

Identifying a good online breastfeeding support group and making the most of it- 10 tips!

1. If you are seeking breastfeeding support consider the audience. Is this a breastfeeding specific support group? If not, the responses you will get will be wide-ranging and reflect the nature of the group, and not everyone will feel positively about breastfeeding. Are they selling a service, or affiliated with a brand name? If so, consider the information you get might not be impartial. This is particularly true for parenting groups affiliated with infant formula or baby food companies.

2. Ask for evidence if you feel unsure. Never take something at face value, especially if it doesn’t feel ‘right’. There are evidence-based sources out there you can check in with too, a reliable source will be run by a national body like a breastfeeding charity or in some cases a lactation consultant. Alternatively, the national helplines are on hand to talk things through with.

3. Who are the group admins? Are they active? Are there enough of them for the size and activity level of the group? Do you see them addressing misinformation regularly? Importantly- are they nice? Do they treat the members with respect? All of these points are important for keeping groups a positive place to be.

4. If it is a breastfeeding support group, are the admin trained peer supporters or above?  If the admin running the group aren’t trained in breastfeeding it might be wise to be a bit wary, as they may not have the knowledge base to know the good from the bad.

5. Is it a closed group, and do you have to go through a screening process to get into the group? If you are going to discuss intimate details of your life, make sure they don’t let any old random into the group. Some popular parenting websites use an open forum format, where anyone can comment or join in, and the results are searchable and completely open to the public. It is worth considering if that is a safe environment to get breastfeeding information.

6. Do they have group rules? Do they seem well thought out? Are the rules enforced?

7. This might be a controversial point, but it is something I feel is important. If we undermine health care professionals in an open forum we breed distrust among breastfeeding parents when it comes to their healthcare. This, in turn, means we see people disengaging with their healthcare services, and this isn’t always a good thing. Nurses, doctors, dentists, and health visitors can also be participants in the group, seeking breastfeeding support themselves. It’s nice to be nice. So thinking about this point, is the group generally respectful towards health care professionals?

Health care professionals are people who take a lot of responsibility for child health if we aren’t in the consultation we do not know the full picture, and we do not know how what was actually said was interpreted or understood. A good group will ensure the members pass on evidenced-based information without insulting the mother’s health care team, and if they are concerned by the actions of a HCP they will pass on details of the appropriate channels to pursue a complaint.

8. If you have a lactation consultant or are already under the care of a real life breastfeeding specialist, remember they are absolutely best placed to support you effectively. It can be sensible to think twice before you throw out a plan from a professional based on advice you get online. Remember you can always go back to discuss it with the trained person supporting you.

9. What rules are in place about recommending other groups? Some support groups will have recommended groups which they know are safe. If there is a free for all around groups, those groups suggested may not be totally evidenced based. It might be worth asking the admin for their opinion on the groups they prefer.

10. Finally, use normal internet caution within a group. Don’t post identifying information, be cautious with your photos, even with a well-run group, trolls can infiltrate.

Make sure that when you are out there in the big wide internet world of breastfeeding support, you keep yourself safe, and remember you are the advocate for your baby-so if in doubt- check it out with a reputable source or seek out a trained breastfeeding professional.

Breastfeeding helplines and websites

Your health visitor or midwife should know details of local groups in your area, or you can search here for information on your local group.

Helplines

• National Breastfeeding Helpline – 0300 100 0212
• Association of Breastfeeding Mothers – 0300 330 5453
• La Leche League – 0345 120 2918
• National Childbirth Trust (NCT) – 0300 330 0700

Websites

• The Breastfeeding Network and the Association of Breastfeeding Mothers provide breastfeeding support and information.
• La Leche League offers mother-to-mother support with breastfeeding.
• LCGB can help you find a local IBCLC
• The National Childbirth Trust (NCT) is a charity that provides information and support on all aspects of pregnancy, birth and early parenthood via their branches and helpline (above)
• Best Beginnings have a wealth of information about breastfeeding premature babies.
• Breastfeeding Twins & Triplets have a brilliant website and a supportive Facebook group for breastfeeding parents of multiples
• UK Association for Milk Banking can help you with enquiries about donated milk or becoming a milk donor.