Your baby’s latch is GREAT…..

Is your breastfeeding latch great (or bottle if that’s your chosen method)? This is a little different to my usual blog musings. It’s a little close to heart for many of us working in the infant feeding realms you see, and we witness these things happen in our day to day work. Infant feeding is such an important part of our parenting journey and due to the cuts and lack of funding in infant feeding, this leaves so few people trained in basic breastfeeding support, let alone the complex stuff which comes up, parents are often left wondering what they might be able to do to improve their situation without the support to do so.

Breastfeeding support

Facebook groups are full of peer support in the form of mum to mum groups offering words of encouragement, support and chat 24 hours a day which is great for moral support and a virtual hug at 3am when things are just exhausting, because somebody else is also on the twilight shift, trying to crack that perfect breastfeeding latch. What we also witness in these groups is parents and babies who need individualised support, face to face and from a specialist. One example, quite frankly a scary one, is to see parents of extremely underweight babies told to “just breastfeed, hun”, with no concern or request for review from a healthcare professional, breastfeeding counsellor or IBCLC.

What often happens far too frequently (just reading Facebook groups is enough to gather evidence on this) is that across the UK, no real assessment occurs, any of the parents concerns are not listened to and are often dismissed or trivialised, and you just have to continue because your baby’s latch is fine…….
More and more frequently we hear of peer supporters, Breastfeeding Counsellors,  IBCLCs, midwives, health visitors and even dentists telling parents to “feed feed feed”. This information is all fine and well for a term baby who is drinking well at the breast and having frequent wet and dirty nappies and gaining weight. Feed the baby is always the first rule, but fed is not best as Dr Amy Brown discusses here………..

On the other end of the spectrum, blanket infant feeding information is not so ok when the opposite is happening and the signs parents are reporting show a baby who isn’t transferring milk as well as they could. What are parents to do? Where do they turn when they’ve already consulted *insert infant feeding person* and been told all is well when the actual evidence says differently?

Is baby drinking well and regularly – 8-12 times a day? Are you and baby comfortable and attaching well at the breast in a position that works for you?
Has anybody observed a full feed to check this and reassure you and explain how to recognise the signs your baby is transferring milk well? How many wet and dirty nappies? Are you and your baby getting sleep between feeds? Are their hands relaxed and open, and does your baby sleep after a feed?

As a general rule of thumb, a newborn baby in the first 6-8 weeks of life who is hydrated and feeding well will:

  • have 6-8 wet nappies per day,
  • a minimum of 2 dirty nappies per day (3/4 or more is also normal),
  • show signs of relaxation (hands unclasped and floppy) towards the end of a feed,
  • sleep well between feeds or remain peaceful and calm if they remain awake for a time afterwards.

Feeding plans written by lactation consultants are sometimes put in place where babies have a tricky start because of adverse birth situations, delay in milk coming in or anatomical issues like tongue tie or cleft palate. Where a large weight loss in the early days occurs, those short term combination feeding plans are valuable in protecting milk supply and reduce the risk of deydration and the problems that could occur. Pumping and breastfeeding, an element of topping up with expressed breastmilk or artifical infant milk can support the dyad when early signs of problems haven’t been recognised

Sometimes babies will be finger feeding and breastfeeding or bottle feeding, syringe feeding or using an SNS. A combination of all of these methods is sometimes used –  which can be utterly confusing for somebody who isn’t trained in using supplemental support and may dismiss their validity.
Which qualifications are held by the people providing you with infant feeding support? There are several examples in other blogs about the difference between a peer supporter, a Breastfeeding Counsellor and a IBCLC. And even between all of those roles, there are vast differences across the country in the training and experience each individual may have. It is important to note that whilst some areas have specialist trained midwives and health visitors, many areas do not and parents with infant feeding problems should be referred to somebody who can assess infant feeding where a problem arises because it is not all about the latch.

As a new parent, you and your baby are learning, you are getting to know each other and how these things work for you personally. Knowing where to find the correct support for individual situations, tailored to you, as well as the basic information about infant feeding is important to your journey. As funds are cut and services are overstretched in maternity and community health visiting, it often results in nobody being qualified, no specialist training in infant feeding or assessment (and remembering that experience and training are not equal across the country). Throughout the training it is often relayed to us that should we see something that is beyond our remit, referral pathways to somebody else who can provide additional help should be the next step.

In an ideal world that’s how it should work…..instead a quick peek is had and parents are often told “you’re baby’s latch is GREAT!” because the subtle differences between a baby hanging out at the breast receiving very little and a baby feeding effectively are missed by the untrained or inexperienced eye. Parents then believe they’re doing all they can and when things don’t go to plan they have no explanation because somebody told them things were perfect.

Below you will find highlighted some of things we see and hear in our work with parents and babies in lactation support.

Your baby’s latch is great…..

  • Your nipples look like a brand new Heather Shimmer and feel as though they may fall off if you ever feed your baby again, yet your baby’s latch is great.
  • Your latch is great when you feel like a cheese grater is attached to your breast and you are convinced a vice would be less painful.
  • Bleeding, agonising, lacerated nipples – your latch is great!!!
  • Your baby’s red book shows slow or static weight gain, and baby’s latch is great.
  • Your shoulders ache as your baby feeds for an hour and comes back to nurse again after a 15 minute break, the latch is great!
  • Your baby hasn’t slept in the first 72 hours hours of life for more than 5 minutes at once, your baby’s latch is great.
  • Your baby has slept soundly for 8 hours and fed 4 times today, your latch is great.
  • You’ve seen no dirty nappies for 3 days, your latch is great.
  • Wet nappies are few, but your latch is great.
  • Five minute feeds and hour long naps before hunger strikes again, your latch is great.
  • You’ve only eaten once today and had no rest between feeds, you’re doing great!
  • After a big, wide attachment which you’ve nailed with military precision, your baby slips to the end of your nipple, and so your latch is great.
  • No swallowing and lots of sucks, your baby’s latch is great.
  • Nipple in babies mouth? Your latch is great!

From Alice: your breast is so swollen-full of milk that your nipple won’t fit in your babies mouth, but your latch is great.

    You might recognise some of these scenarios or feel you’d like to add to this list, contact me if you’d like to add your own. 

    Finding the support you need can be difficult and sometimes confusing for new parents who are not sure who is and is not qualified to provide basic support or when things might need more specialist help. Some areas are a postcode lottery with infant services being cut and training stopped. There are some great places to find support across the UK from online resources, national breastfeeding helplines and asking parents for reviews of those services local to you. Effective feeding signs are the key to success, not what your breastfeeding latch looks like to somebody else.

    I Am Doula

    placenta encapsulation cheshire

    Placenta Encapsulation Cheshire I Am Doula… Doula-ing is probably something I have done my whole life. In primary school I remember being the person who supported my friends in times of need. I would let my own work slack and … Continue reading

    A day in the life of a doula

    cropped-New-logo-1.jpgA day in the life of a doula!

    This year I noted one of my days for a local network group. Here is a rough idea of what I might get upto as a doula, so hopefully you will get the jist

    My working days include various work related tasks. I have started to use a Bullet Journal to my advantage as I can prioritise appointments and personal stuff all in one space! It has been a revelation!

    4.30am – Home from birth-SLEEP!

    7am – Coffee (x3!) and catch up with emails

    8am – Sort out the kid’s schedule for the day which varies depending where I am working (as we’re HE first job is to sort everyone’s schedule for the day, one of the pros of home educating is flexibility!)

    9am – Postnatal visit…..make mum a coffee whilst she feeds baby after the lovely, hot shower she managed to grab when I arrived. Tidy around and prepare lunch for mum and older siblings and pop in the fridge to be grabbed later. Ask if any niggly tasks need doing that mum hasn’t managed whilst getting to know her baby. Sit and have some tea and cake with mum and listen to her story.

    11am – Postnatal visit for breastfeeding support. I support a mum who’s struggling to breastfeed following her Caesarean, and we cover tips on how she can get comfortable and work around her wound.

    13.30pm – Midwife visit. Mum wanted me by her side to support her as an advocate whilst dad-to-be is at work. She is struggling to get her birth preferences agreed at the hospital and is meeting with the Supervisor of Midwives to ask for some support from the Midwifery team.

    2pm – Home again for a nap, prepare dinner and cuddle the kids (and the husband!)

    5.30pm – Facilitate birth choices group and set up a pool demo for new parents exploring their options and considering a home water birth

    8.30pm – Catch up telephone calls with other healthcare professionals who I am currently working alongside with a family with complex needs to update them on this week’s visits.

    9pm – Dinner and Bedtime!

    11pm – Called out by parents to a postnatal ward for urgent support

    4am – SLEEP!!!

    I love my work as a doula, and all of the planned and unexpected work it entails. I love the families I support for the short time I am with them. Being a doula is much more than my job, it is who I am. It is most likely something I have done most of my adult life, without realising-many doulas report this experience themselves.

    Doulaing is not always planned, on a schedule or even predictable. And I would not have it any other way, especially when I arrive home on some days,  I am treated to a view of the sunset  <3

    doula day

    Six Reasons to Hire A Doula

    Six Reasons to Hire A Doula

    Cheshire Doula Nikki Mather-Six Reasons (and countless benefits) for Investing in a Doula. Have you thought about having a birth doula or postnatal doula but are unsure whether you need one? Your partner is fantastic, your mother or mother in … Continue reading

    Just ‘Being’ A Doula

    Cheshire Birth and Postnatal Doula Nikki Mather, talks about her visit to Paramana Doula with Michel Odent and Liliana Lammers and just ‘being’ a doula.

    I am not always known for being the quietest of people around friends and family and can have some wildly wacky and opinionated thoughts and discussions when it comes to topics I am passionate about. In a stark contrast, when I am with women and their families, I am calm, quiet, relaxed and just ‘be’.  I listen well, I support wholly and my aim is to enable informed decisions to be made by the women I support. That does not make sense for most people who know me, they cannot understand how I can be so different in my doula role and with the women I have supported over the years with breastfeeding and I guess it is just my way of dealing with the energy flowing around and within me that allows me to direct that energy appropriately.

    When I did my first bout of doula training, or preparation course, what totally resonated with me is that one key ability a doula needs to hold in her toolbox is to just ‘be’, sit quietly, inconspicuously be present but not make a fuss, not make a noise and literally just protect the birth space. I enjoy quiet, I enjoy peace and often ‘switch off’ whilst knitting or crocheting, using tools to turn off my active mind help me to relax and is important to me when supporting families that I am present for them. Birth needs an uninterrupted space, protected space, sacred space, families to feel safe. When women are able to feel safe, birth can move forward efficiently. A doula can hold that space for a family.

    This weekend I have been very blessed to experience many hours of another doula course, Paramana Doula, with Dr Michel Odent and Doula Liliana Lammers, and everything about just ‘being’ was reinforced. Women *need* different things during labour and childbirth, however a common theme to enable smooth transition is quiet, peace, darkness….and for their support network to just be all of those things, facilitates that transition.

    While Michel talks about the physiology of birth, (in his dreamy French accent which almost makes me want to sleep!) which humans have been doing for centuries, he also speaks of the very many things that society has brought into childbirth via cultural changes which inhibit the normal, physiological process of birth. Intervention, forceps, synthetic oxytocin; instead of supporting women in labour can hinder and prolong the biological processes that physiologically, women are born with and have the instinct to use, if allowed. Cord clamping is an example if another process which has been done for many, many years but which does not allow for the physiological process of birth to be completed naturally and research shows optimum cord clamping, or even lotus birth should be favoured where at all possible.

    Listening to Liliana speak of her 400+ births over the past 15 years whilst working as a doula in London only fires me with more energy to support women with their choices; support them to make informed choices and allow them to experience the physiological, biological norm in childbirth. Be by the side of women who are fired up to do more research, ask more questions, find the answers *they* need to support their decisions. Listening to concerns and ‘being’ that calming presence can make a huge difference to a woman’s birth experience and that of her whole family. Undisturbed birth needs to make a come back!

    I feel one weekend with Michel and Liliana was not enough, I feel I could listen to them both for an eternity because everything they spoke about resonated so well. I do hope our paths cross again in my time as a doula, I do hope I can only take a segment of what they offer, from their course, and apply it to my own practice. Women deserve to have the births they want amd wish for, the births in which they are very capable of facilitating in whichever way that is, wherever that may be, from a natural birth to a caesarean, I can just ‘be’ there to support their transition into motherhood.

    The Elements of a Doula

    Nikki Mather Doula
    Hiring a doula can ensure you have the correct support for you-whether it is emotional support or practical, or maybe a combination of the two, alongside educational elements to ensure you can make an informed decision in your birth choices. Confidentiality is an important aspect of a doula’s work, and you can be assured your decisions will be supported, no matter what they are. For more information and doula support in Stockport, Greater Manchester, Cheshire and other North West areas please see the Doula Services page-get in touch if you do not see your area mentioned.In days gone by, mothers, aunts, friends, neighbours would provide the role of a doula to expectant mums without even having to think about it. Heating towels, cooling flannels, preparing nesting areas, fetching drinks and snacks. Listening, supporting, holding, nurturing mum into the transitional experience of birth.Why hire a doula? Well, it is quite simple really, who wouldn’t you want an extra pair of hands around, an extra listening ear, an extra shoulder to cry on…women and childbirth in the 21stC sometimes need additional support to enable informed decisions due to the diverse methods of intervention which are now available, but not always necessary and can, in the majority of births, be avoided with robust information to make informed birth decisions. An important element of being a  doula is the ability to listen to your concerns whilst making informed decisions, ensure you have the information to make those decisions and advocate for you where needed to ensure your voice is echoed.A doulas role is diverse-each birth is individual and therefore has different elements of need. Some may want a hands on approach in the home to support her family, older siblings and husband, while she births and gets to know her new baby in the early days-maybe cook a meal or two or fill your freezer with nutritional meals, some infant feeding or breastfeeding support or just to pop the washer on. Another element is purely emotional support, just ‘being there’ matters, listening to your story; consistent support is a primal need of human beings to feel reassured. The nurturing presence of a doula can support the transitional nature of birth and ensure the primal nature and privacy of birth are protected.

    Nikki Mather is a Birth and Postnatal Doula providing doula support in Stockport, Wilmslow, Macclesfield, Knutsford and wider areas of Cheshire as well as other counties across the North West including Greater Manchester, Derbyshire and parts of West Yorkshire. Feel free to contact Nikki for more information

     

    Baby Scans-The Dangers of Home Fetal Monitoring

     

    Pregnancy_test_resultSo you are pregnant!

    Two pink lines -excitement! Awaiting your first midwifery appointment-anticipation, excitement and nerves like jelly-emotions coming together all at the same time, am I really pregnant? First fetal scan appointment-the want to ‘see’ your baby, the rush of messages from friends and family asking for copies of the black and white picture that result from your scan visit, the relief when you are told everything is ok and come back for your routine appointment at 20 weeks for further tests……

    The female body is made for childbirth.

    The problem with modern day screening, is that confidence of the female body is washed away with the flush of the loo after seeing those pink lines after your missed period. Tests for this, scans for that, research has shown that for every tests done, more tests may crop up and as a result, stress, worry and anxiety start to become the focus of what is meant to be one of the happiest moments of your life.

    Some of the reasons for fetal monitoring are:

    • date of expected delivery-sizing on scans is largely inaccurate and can cause worry about a range of things from growth abnormalities to whether or not baby is ‘due’ and induction/intervention is needed
    • discovery of abnormalities-which can result in false positives and unnecessary termination
    • to detect placenta previa-low lying placentas tend to move up and around the womb as the pregnancy progresses-early diagnostic using scans can cause anxiety and stress-the vast majority of women will have symptoms of placenta previa and so is one instance where a scan may be useful if symptoms are present
    • checking the sex of the baby-a personal choice and not medically required

    The Risks of Fetal Monitoring

    Fetal-Heart-Monitor-Strips2The issue becoming apparent to many is that the dangers of fetal monitoring are never discussed. There are no leaflets designed to show the risks you take by consenting to the routine monitoring of modern day pregnancy and birth.  The risks of ultrasound-significant temperature increased directed through the abdominal wall or vaginally causing damage to the developing fetus such as brain haemorrhages, developmental anomalies and other postnatal affects such as low birth weight, early ovulation, perinatal death and neurological effects from dyslexia and speech delay to a prevalence in left-handedness (Michel Odent)-are not discussed in the hospital waiting rooms or hotel reception rooms of boutique keepsake scans.

    Ironically, the tool used to diagnose Intrauterine Growth Retardation (IUGR) is another associated risk of using Doppler-a 30% increased risk according to this Australian study of pregnancy where Doppler screening was used during their pregnancy. Mothers and babies receiving 2 or more Doppler scans during pregnancy were twice as likely to experience perinatal death as a result in a large UK study.

    The odds stacked up….against ultrasound

    These astounding risks have more and more research stacking up against the use of ultrasound scans in pregnancy. Women are still not made aware of those risks in the UK at least, and many countries now have private companies offering tailor-made packages to ;view your baby’ or ‘determine your babies sex 100%’ by way of ‘colour’ or 3D/4D Doppler technology.

    So, now we have additional scans added to the risks of having 2 or more diagnostic scans during pregnancy causing risk. Upon a report into ultrasound imaging by the BBC, Kevin Martin, president of the British Medical Ultrasound Society, said: “Our view is that ultrasound should only be used by those qualified to do so, who are in a position to ensure it is carried out safely. Ultrasound should not used solely for producing souvenir videos in the first trimester because the baby’s cells are still differentiating at that stage. If there’s no obvious medical benefit to the baby at that stage, it should not be put at any risk.”

    Handheld Dangers

    If that is not enough ultrasound dosing to the usual 2 scans minimum in pregnancy, plus the dangers of the ’boutique scan’ we then have the ‘home Doppler’ enabling you to listen to your babies heartbeat at home….I think at this point I just need to remind you that ‘routine tests’ during pregnancy are not mandatory and are part of your choice of how you manage your pregnancy.

    To use a handheld doppler effectively requires great skill and training-something which a regular parent would not be in possession of. False reassurance that baby is fine whilst using these gadgets can defer parents from seeking urgent medical attention as inexperience will result in your hearing the mothers heartbeat instead of the fetal heartbeat. The dangers of home monitoring simply are not marketed along with their product which, quite frankly, is careless and irresponsible of their marketers.

    A spokeswoman for the Medicines and Healthcare products Regulatory Agency (MHRA), which regulates but does not licence the machines, said: “Members of the public using foetal monitors at home are unlikely to have the necessary knowledge or experience to use the device effectively and if they are concerned about the health of their baby they should seek medical advice.”

    21st Century Pregnancy

    The problem is, with parenting becoming the fashion accessory of the 21st century, gadgets and electronic items to ‘enhance’ your pregnancy experience are going to be in the mainstream. Despite the warnings, mothers will still go out and buy equipment they believe will put their mind at rest. In a stark contrast, if women were taught from an early age to trust their bodies to do exactly what they are made to do, there would not be the made rush to go out and buy such equipment, if the boutique keepsake scans were regulated, there would not be any unnecessary exposure to ultrasounds, increasing the risk of dyslexia, brain damage or death.

    Use ultrasound with caution-if a problem is suspected, medically indicated ultrasound, used in minimal exposure, can support the health of you and your baby-in all other instances the dangers of ultrasound scans and dopplers MUST be researched fully for you to make an informed choice.

    http://www.ncbi.nlm.nih.gov/pubmed/1360032

    http://www.bmj.com/content/339/bmj.b4308

    Odent M. Where does handedness come from? Handedness from a primal health research perspective. Primal Health Research 1998;6(1):1-6.)

    http://www.ncbi.nlm.nih.gov/pubmed/15582061

    The Curse of the Baby Whisperers

    In society today there is such a huge difference when it comes to parenting styles in a variety of different communities. Should we be falling into the commercial world of prams, bottles, formula, baby food jars, bouncers-as society we seem to do as others do, or should we be nurturing our offspring by moving away from what is considered ‘normal’ and prepare our children for adulthood on a biologically normal pathway; listening to our own bodies and the needs of our babies.

    Babies, toddlers, children; no manual!! Why no instructions?

    Gina Ford’s ‘Contented Little Baby Book’ tells us she can fix all the problems which stem from Mother Nature’s omission of an instruction book by supplying us with her self devised code, a manual in order to complete the ritual of parenthood and survive that first year, without every experiencing parenthood herself. Working with 12 hour time periods, 7am-7pm, Gina Ford tells us that strict feeding regimes and sleeping patterns are the only way our babies should be nurtured-leaving babies to cry for periods of time so they can ‘adapt’ into self-settling techniques by being ‘taught how to sleep’.
    The issue with this is that babies, quickly become despondent, amd as clever as they are, realise that crying is actually a waste of time and energy. In order to conserve energy, they tend to then fall asleep exhausted from the crying and screaming, with the harsh reality that their caregiver will not be there for them in times of distress. Recent studies over the past few years show that ‘controlled crying’ or ‘crying it out’ can be damaging to neurological connections and the continually rapid development of the newborn brain. Sleeping with our babies, whether co-sleeping in the right conditions or sharing the room with baby not only ensures baby’s needs are immediately met but it cannot be ignored that this practice, which is the norm in large communities across the world, reduces the risk of SIDS-Sudden J
    Infant Death Syndrome-no mention of that though as co-sleeping would go against the grain of and follow the trend of the abundant non – evidence based ‘advice’ of the Gina Ford Philosophy.

    Feeding babies on a schedule, instead of feeding on on baby’s cues can be just as damaging, irrespective of whether baby is receiving breastmilk or formula. Gina tells us that feeding 4 hourly is the norm and must be regulated. Feeds must be at 7am, 11am and not a second earlier, and do not dare to enter the separate-room-on-the-other-side-of-the-house your baby is crying in, should they dare to awaken before Gina says they should. Picking your child up at that point-your child has won, according to Miss Ford. Evil, coercing, manipulative babies! *tongue firmly in cheek*.

    Brought into the brightness of day, is the Gina Ford assumption that you have birthed a milk-guzzling, sleep depriving, screaming human into the universe to disrupt your life for the rest of eternity! Unfortunately, what could have been a great book *cough* ended up telling mums that baby was broken or their parents were inadequate-6 feeds in a 24 hour period, especially in a breastfed baby, will most likely be detrimental to the breastfeeding dyads relationship; regular feeds are needed to ensure your supply is sufficient and your babies needs are met when you parent in a child-led environment.

    The Gina Ford suggestion of expressing milk to ‘see how much baby gets at a feed’ is irresponsible and inaccurate, and is just one more way for a mum to doubt her body and the skills evolution has supplied her with.
    Gina Ford’s way of making a living is to force new parents into feeling inadequate and unable to cope, using her regimented, prescriptive regimes and schedules. She disappointingly underpins the societal belief that babies should sleep through the night from day 6, should take 6oz on week 6 and will not settle unless they are left alone and cry themselves to sleep six times every day. When these ridiculous and somewhat dangerous routines fail, parents feel they have failed themselves, their families and their babies.

    What happened? What happened to nurturing our young? Biologically caring for our young, keeping them close, sleeping, eating and drinking with them, comforting them. It all came to a stand still when society started to get busy and began to use the tips, tricks and commercialised baby rearing objects of a ‘let-somebody-else-mind-the-baby’ ideology; prams and cots, separate rooms and bouncers-anything to avoid picking your baby up and giving them the love and security needed. Arms to hold, hands to caress soft faces, breasts to comfort and feed and nurture.

    Instead, the likes of Gina Ford have stepped into the long line of other ‘experts’, existing only to berate and ridicule biological nurturing of the newborn. Cuddle, pick up, feed, kiss, cuddle again; listen to your instincts, and follow what you feel is right for you and your baby. One day, humans everywhere will accept biological norms. Time for a change; EDUCATE.

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