The night that changed my daughter’s life forever.
There is one visit to the doctor’s I will never forget. Even though my eldest daughter Millie had been drinking lots of water and visiting the toilet more frequently throughout the night; I still believed the GP would have me down as an over-anxious mother and at worst he’d say she had a bladder infection. The shocked expression on his face said it all, as he confirmed she had an extremely high blood sugar reading. He then proceeded to tell me that I needed to get Millie to the children’s department of the local hospital without delay; she had diabetes.
My head went into a complete spin and I was shaking but trying not to scare Millie, so I tried to remain calm. We had walked to the doctor’s hence the journey back seemed to take an absolute age even though we both walked faster than ever before! It was one of those surreal moments when suddenly a loved one is diagnosed with an illness and within moments you treat them like the most fragile person in the world; even though five minutes previously both of you had been blissfully unaware.
We were rushed into a side room in the children’s A and E department where I entertained Millie with ‘Where’s Wally?’ books whilst they took lots of blood from her. She was so brave and even received a certificate of bravery. Although the consultant was fantastic, his parting words before we left for the paediatric ward were: “diabetes can cause diabetic ketoacidosis (DKA), it’s poisonous and can be life threatening, but you don’t want to hear that now!” Bit late when you’ve already said it. Later I learned that what he had said was true, even though I’m definitely sure I didn’t need to hear that just then. Whenever I begin to dwell on Millie’s condition I do replay those words in my mind, but on a daily basis I push them right to the back!
The next few days were a crash course in nursing. It was like suddenly having your new baby placed in your arms and thinking what do I do now?! But this time the outcome could be catastrophic if I made any mistakes, especially at 5 am! When your child is ill in hospital you feel reassured that the medical staff will do their job and you’ll handle the emotional side. I didn’t expect that on the first night I would be handed a syringe and told to inject my own child! It was the scariest thing I’ve ever done. But there was no time for my own fears to come into it. I had to remain focused and take as much information in as quickly as my brain would let me.
Thankfully, as it was the weekend we got the opportunity to meet the diabetes nurse and consultant before Millie was discharged. That gave me longer to practise my injecting techniques on poor Millie, as well as slowly begin to learn how to carb count! Little did I realise that I would soon learn how many carbohydrates were in everything from apple juice to sweetcorn! The extra days also ensured that Millie’s blood sugar levels decreased sufficiently before leaving hospital.
In retrospect those early days were a whirlwind of information and emotions. Things have settled into a routine now and Millie has even made the transition from insulin pen to pump which is much less painful than having regular injections. Although at present there is no cure for diabetes and it is an element of life which is always present in our daily lives, it is treatable. That is the thought that keeps us going.
The day I almost killed my daughter – keep an eye on your kids!
It started out like any other Sunday. We went to a car boot sale in the morning and gave our girls £1 each. Thing One immediately dropped hers and Thing Two immediately offered up her own £1.
We did not let her give the £1 to her sister. Instead. she carefully chose a little doll in a wood crib, her chubby hand opening like a flower to reveal her sweaty, shiny £1.
“Thank you for mine Dolly.”
…she said shyly to the seller’s shoes.
Back home we dined on Marmite and cheese sandwiches in the garden which was washed down with milk and slices of apple.
I then brushed off the crumbs from my T-shirt and cracked on with digging a large hole to plant an Acer in. My husband got busy laying down foundations for a summer house. The children bounced on their trampoline, they played in their paddling pool and they frequented their cubby house.
I was busy swearing at the Ivy roots that my spade would not cut through and my husband was busy making sure the foundations were flat for the summer house. We had our backs to our babies, as so much more important were our tasks!
We did not notice Thing Two get off the trampoline and wander round and round the garden. Did she stop to pick up a snail or a dying daffodil head before she found the weed killer?
She appeared by her daddy’s side and her mouth was on the nozzle. Her little chubby hand that recently held her £1 was now on the trigger.
We went on our knees, trying to make eye contact and stay calm, but we were begging…
“Did you spray it in your mouth, baby? Tell daddy!”
Too scared to admit the truth, for fear she might be in trouble, she vehemently denied spraying the bottle. She didn’t seem ill. In fact, she seemed fine. She wanted to go back to bouncing on the trampoline.
But, soon the sickness came. She was lying on the sofa, her blue eyes to big for her grey face.
“Baby, do you feel ok?”
“I’m ok…”
… she whispered. But, she was not. She got sick again and again. My husband raced her to A&E and I stayed at home with her crying sisters, pacing, obsessively cleaning and waiting for my phone to ring.
At last.
She is going to be ok. We’ll be here for a while yet, though.”
I crumpled into a pile of her dressing up clothes.
I was not there when she had her anti-sickness and she got treated or dehydration. Apparently, when they asked her to open wide, so they could put the lolly-stick in her mouth, my amazing daughter, with her sore little throat croaked…
“Where’s the lolly?”
When she left she told them…
“I go home, have bath with mine mummy now. Thank you.”
My husband and I were shocked when we found out I was pregnant. We’d been seeing each other for a few months, and weren’t ready to say the least. But we pulled through and now have an amazing daughter that we couldn’t be without. It’s been a struggle by no stretch of the imagination, but seeing her face, her smiles and hearing her little laugh has made it all worth it.
We’d built ourselves up so far from where we’d started, finally starting be able to afford nappies at the end of the month (!). Then I missed a period. We were happy, excited even. Then the realisation of everything that had yet to happen again hit us. I’d have to give up working, we’d have another mouth to feed. It wasn’t just going to be an exciting pregnancy – there was going to be another baby at the end of it. And we could barely afford this one. I know there will be many scornful readers, thinking, “Why have children you aren’t ready for?” – “another mouth for the tax payers to feed”. I’d like to point out that we have never claimed or received any child benefits, other than the £20 a week Child Benefit payments. We spent a harrowing three weeks thinking about everything; I kept looking at my daughter thinking how much I’d hate myself if I couldn’t ever provide the things she needed. Falling short at the end of the month may have been fine for us before she was born, but it’s not something that I can ever allow to happen again.
So we made the decision to terminate.
My body had already started doing everything it could to protect the little grape in my belly. It had a heartbeat. And my husband and I were making plans to kill it. Between my early scan and my appointment at the Marie Stopes clinic, I hated myself every single day knowing what I was doing. I’d look at my daughter and imagine that what I was actually doing was killing one of her. I’d go to the bathroom and cry during my lunch break at work. Because I’d made a choice to abort a baby. But I’d also made the choice to prioritise and provide for the baby we already had.
The appointment itself was fairly straight forward, and the staff at the clinic were very supportive. Being in there, I almost felt normal. Felt like what I was doing was okay. I first went into a room to have a scan done, until that point the realisation of the situation’s imminence hadn’t hit me. Then the nurse’s words: “Yes, I can see it”. Was there more than one? Would it have been a boy? Would it have been a girl? Would our daughter have made a wonderful bigger sister? My mind started racing at 1,000 miles an hour. Then I took the first tablet, the tablet that they explained would stop the foetus growing within half an hour. I counted that half an hour minute by minute. And when it was over, I knew. A part of me shut off. We went back a few hours later for the second part; I took four more tablets and was advised to go home and relax.
What followed was a little uncomfortable, lots of bleeding. And two days later a grape sized lump came out as I was walking home. I don’t know exactly what the little lump was for sure, but my heart told me that was exactly what my body had been trying so desperately to protect all of this time. It was over.
I still look at my daughter sometimes and wonder. I’d have been a little over 3 months pregnant by this point. And it still tugs at me when I stop to think. I hate what I did. But if I could go back in time? I’d do the exact same thing all over again. See that’s the thing about being a mum – you’ll hurt yourself a million times over. But it’s all worth it to know that your baby will have everything. Anything, to keep your baby smiling.
Help Getting Pregnant; Ten Things to Improve Your Chances of Conception
Some people can get pregnant at the drop of a hat, while others can find themselves trying for years before having a successful pregnancy. If you are one of the latter, don’t despair. Approximately half of all couples get pregnant within six months. The other half still have a good chance of conceiving, it just takes them a bit longer. There are things you can do to help increase your chances of conception and sometimes you may need a little help getting pregnant. This is nothing to be ashamed of and you’d be among millions of people who have done the same. But for now let’s see how you can give yourself the best chance possible.
Things you can do
Get a health check. A check-up at your local doctor’s surgery is a wise idea. Inform him of your wishes to get pregnant and ask him to check any medications you are taking for possible fertility hindrances. Also it is a good idea to have a sexual health check at your local GUM clinic (Genitourinary Medicine).
Eliminate unhealthy habits. This means both partners should stop smoking, don’t drink alcohol (linked to birth defects) or caffeinated drinks and definitely don’t do non-pharmaceutical drugs. Even some pharmaceutical pain killers and herbal remedies can lower your chances so be careful there too. Did you know that drinking coffee every day can reduce your chances of conception by up to 50%? Avoid eating too much sugar.
Eat healthy food. Get your “five a day”. Plenty of fresh fruit and vegetables, making sure to have a variety of colours and types. Cut out chocolate. I know that one is a huge sacrifice, but it is worth it. Avoid saturated fats. That doesn’t mean all fats, just the unhealthy ones. You should make sure to still have some essential fatty acids in your diet, such as virgin olive oil, fish oils and nut oils.
Familiarise yourself with your cycles and use an ovulation predictor so that you can have sex when you are most fertile. Avoid having too much sex because this can reduce the amount of sperm released (sperm production may be unable to keep up with demand). Once every couple of days is enough, you don’t need to have thrice daily marathon sessions!
Start taking Folic acid supplements.
Maintain a healthy weight. Not too skinny, but not too overweight either. Try to reach your recommended BMI.
Don’t stress. Stress and depression will not help you get pregnant and can affect your hormones adversely.
Take light exercise daily, but don’t overdo it (trying to be super-fit has been linked to fertility problems). Taking up Chi Kung, Yoga or Tai Chi can help both your mental and physical health. I personally recommend Shaolin Cosmos Chi Kung as it has worked extremely well for me.
Drink plenty of clean, ideally filtered, healthy water. Don’t desalinate yourself, just the recommended 8-12 8 oz glasses per day. Very hot climates may change this figure, in which case use common sense. You can add some fruit juice to your glass of water to make it a little more palatable if you wish.
Seek help from a fertility specialist if you are having trouble conceiving. Joining a reputable fertility program, like Pregnancy Miracle or similar will undoubtedly help you get more informed and boost your odds.
Seeking help getting pregnant is not a last resort, but IVF or surrogacy, along with the costly bills associated with them, can often be avoided. It worked for me and it may be possible for you too. So please don’t give up. There is help available. As shown there are plenty of things you can do to maximize your chances of conception. Give it your best shot, relax and enjoy all the bedroom fun that making a baby can bring!
This post is from the UK
Teaching children: criticism or praise?
It only takes a period drama on television to remind us of how far society has moved in a relatively short period of time. I watched the first episode of BBC’s The Village recently, and it was shocking to see how a young boy of 12 could be caned on his hand for something as ‘bad’ as being left-handed or not knowing how to write well. It was the norm in 1914 to be beaten if you stepped out of line as a child. It was the norm much later on than that – in the 40’s or 50’s and possibly later still. Thank God we have got rid of that particular style of teaching and that beating or hitting children in schools is a thing of the past.
The cane left but it was replaced initially by verbal abuse. It was considered unacceptable to hit children but perfectly acceptable to belittle them, demean them, tell them that they would amount to nothing and would have no future, an approach that has caused unending damage to generations of children.
As a classical musician and teacher, I experienced this kind of teaching as a student at conservatoire level. In that rarefied environment, high standards were the only thing that was important and teachers could demand these standards whatever the cost to the student. “Call yourself a musician? Your playing is not up to it! Go away and practice” was something I heard a few times. Did this approach get the desired results? I doubt it. Or rather, if someone experiences this teaching approach and did well as a musician, they might have suffered in other ways that were less obvious – out-of-control nerves, sudden phobias or other such things. So it is clear. This kind of negative criticism doesn’t work. It achieves very little in almost all cases. It is unpleasant and bullying. Coming from this kind of cultural background, it is understandable that parents and teachers want to praise their children. Of course, it is natural and praise is essential. You want to acknowledge the effort a child has made, the ability they have shown, their enthusiasm and more. But I feel sometimes that praise can go too far and can be too effusive, which, in a completely different and arguably far less dangerous way, is not good for children either.
What happens if teachers aren’t allowed to say anything that could be considered remotely negative to children? If they can’t let a child know how s/he can improve for fear of upsetting the child and for being seen as too ‘critical’? If everything a child does is wonderful, where is there room for improvement? How will anyone know if they have really excelled? And what if the praise is actually dishonest and the child hasn’t done well but the teacher can’t bring him/herself to be critical or negative or is afraid of stepping out of line themselves, with their superiors who insist a child mustn’t be upset at any cost? To my mind, this is a swing of the pendulum too far the other way and it must be incredibly confusing for a child.
The ideal is somewhere in the middle. Children need to know where they stand and they need boundaries. They need to know that someone else knows when they are putting in the effort, doing well and excelling themselves and they need praise and support for that. They also need to know that someone else knows when they are not putting in the effort and not doing well. They need to know so that they know where their boundaries are and so that they can learn to judge their boundaries for themselves. There are times when children play up and step out of line. This is when they need to be reminded of those boundaries and shown what they are capable of. When I think back to the times when I have been the happiest and have achieved the most as a young person, it was always because an adult believed in me. I knew this without it needing to be spoken, and I automatically raised my game. It felt magical in a way. Children need praise and they need support – it goes without saying. But they also need adults around them who are discerning, who are not just going to hand out ‘lazy’ praise but are prepared to help them know where they stand, help them know their own standards and develop clear judgment of themselves. But above all, what I feel children need is for their adult mentors to believe in them. This way they learn to believe in themselves and anything becomes possible.
Reference: Trotter S (2008). Breastfeeding basics: advice for new mums. Nursing in Practice (September/October 2008) Number 44 – (Children’s health): 23-5.
By Sharon Trotter ¦ Midwife and Mother & Baby Consultant ¦ TIPS Ltd
Despite numerous initiatives to support breastfeeding mothers, breastfeeding rates continue to drop dramatically within weeks of delivery. This appears to be due to lack of confidence and not, as often mentioned breastfeeding technique.
Recent figures published by the Department of Health show that although the initiation of breastfeeding has risen by 7 percent to 77 percent in the past five years, the drop-off rates in the first few weeks of life are alarmingly steep with only 1 percent of mothers still exclusively breastfeeding their infant by six months of age (NHS 2005).
Exclusive breastfeeding during the first six months of life provides for all the nutritional needs of a baby. Half of these needs can still be met by breastfeeding in the period from six to 12 months. From 12 to 24 months a baby will still receive a third of its nutritional requirements from breast milk alone (WHO 2006).
Early drop off in breastfeeding may be influenced by a number of factors. A generation of bottle feeding mothers is partly responsible for eroding the primary skills needed to support and empower women during breastfeeding. Such skills need to be relearned so that women can once again tune into their own instincts and their baby’s needs. New mothers no longer have the luxury of long hospital stays or the support of an extended family to help them establish successful breastfeeding (NPEU 2006).
Breastfeeding technique plays its part; however, confusing diagrams or hands on manipulation can be deconstructive. Successful breastfeeding has more to do with building and sustaining confidence. Cultural issues (such as the association of breasts with sex in western society) also play a part and it will take time for attitudes to change. Such are the issues that the Scottish Government had to pass legislation guaranteeing women’s rights to breastfeed in public (English legislation is set to follow suit shortly) [OPSI 2005].
This is helpful, but we still have a long way to go before breastfeeding is accepted as the infant feeding norm. According to a new telephone poll conducted by Kamillosan one in four top British restaurants ban breastfeeding (Kamillosan 2008a).
Kamillosan also surveyed 3,500 mums across the nation and the survey reveals new mums are terrified at the thought of breastfeeding in public. Thirty-eight percent of mothers prefer to breastfeed in public lavatories than face disapproving glares from strangers. A fifth of mums are so worried about other people’s opinions they opted to leave the baby screaming for milk rather than breastfeed (Kamillosan 2008b).
In fact, the natural bonding experience is ruined for many by negative reactions, inappropriate comments and blatant stares. A staggering 54 percent of breastfeeding mothers say they have been subjected to unwanted attention.
The question remains as to why, with all evidence pointing to a need for consistent advice and ongoing support for breastfeeding, especially in the early days after delivery, mothers are still left wanting? (Dhandapany et al 2008)
Inconsistent advice – is this the biggest barrier to success?
In an online poll, 125 mothers reported their top three breastfeeding problems (Trotter 2008).Eighty percent of those problems were directly associated with conflicting advice. This led to physical difficulties (such as sore nipples, blocked duct, mastitis, thrush and tongue-tie) as well as psychological problems (mainly lack of confidence caused by conflicting advice). When it comes to breastfeeding advice, midwives are the key source of information for new mothers.
A National Childbirth Trust (NCT) survey found that 77 percent of women receive breastfeeding information from midwives during their pregnancy, while 20 percent get information from health visitors and 7 percent from GPs (NCT 2006). Yet, nearly half of the women surveyed said they did not receive as much support as they needed regarding breastfeeding. As a result of this, more than 50 percent of women stopped breastfeeding sooner than they would have liked.
Women who took part in the Healthcare Commission 2007 survey of NHS maternity services were asked about the advice and support they had received from midwives and other healthcare professionals in relation to feeding their baby (breast or bottle) [Healthcare Commission 2007].Almost two thirds of women surveyed felt that they did not receive consistent advice, practical help or active support and encouragement.
NICE guidance for routine postnatal care of women and their babies recommends that all maternity care providers (whether in a hospital or primary care setting) should implement an externally-evaluated structured programme that encourages breastfeeding using the Baby Friendly Initiative as a minimum standard (see Resources)[NICE 2006].
Currently, only 10 percent of women give birth in a fully accredited Baby Friendly hospital. Although breastfeeding rates are considerably higher in such units, there remains a reluctance to implement this standard. This is despite the fact that hospitals with low breastfeeding rates can see these double when they become Baby Friendly. Even hospitals with relatively high breastfeeding rates can see this increase by at least 10 percent with associated savings due to reduced instances of childhood illnesses such as gastroenteritis, asthma and middle-ear infection. A national breastfeeding helpline was launched in February 2008 with a yearly funding of £150,000 (DoH 2008). This service is staffed by trained volunteers from the Breastfeeding Network and the Association of Breastfeeding Mothers who answer calls from their own home. The lines are open from 9.30am to 9.30pm. This falls far short of the 24-hour service breastfeeding mother’s need, as problems are unlikely to be confined to daylight hours. The fact that this service is run by volunteers places undue pressure on women who are likely to be busy with young families of their own. Until provision is made for a fully funded helpline (manned by lactation consultants – possibly as part of the NHS 24-hour advice service) women are unlikely to receive the support they deserve when they need it.
Building confidence is the key to success
As a breastfeeding consultant and author of Breastfeeding – the essential guide, I am all too aware of the common concerns (not necessarily problems) associated with the early days of breastfeeding (Trotter 2004).As already explained, these may include a variety of conditions that must be diagnosed promptly by someone who really understands how breastfeeding works and is able to help correct any aspect of the breastfeeding technique. Central to this process is confidence building. Being a new parent is stressful. Evidence shows that mothers who receive support from someone who believes they can breastfeed will breastfeed for longer (BBC News 2008). Such level of supportive advice from someone mothers trust, together with support from peers (family, friends or breastfeeding support group) is of most help.
Conclusion
It is ironic that the introduction of artificial baby milks in the 1950s, as a way of enticing women into health clinics, has led the trend towards bottle feeding as we know it today (Palmer 1993). The multimillion-pound promotion of these baby milks uses ever more sophisticated marketing techniques to lull parents into thinking that these products are the next-best-thing to breast milk. In reality this could not be further from the truth and the ill effects of widespread formula feeding on infant health and indeed on public health are huge. These include increased financial pressures due to ill-health on our already overstretched health service. This situation will not change overnight, but the more aware we become of the short- and long-term benefits of breastfeeding for mother and baby, the more we will understand the need for effective breastfeeding support to be a top priority rather than an afterthought (NPEU 2006). To achieve this, we must ensure that health professionals are adequately trained. However, it is also essential for support to be targeted more effectively in the early weeks of breastfeeding and for a national helpline manned by lactation consultants to be established.
There are very few difficulties that cannot be resolved and even fewer reasons why women cannot establish successful breastfeeding.
Breastfeeding toolkit:
Health professionals should have access to a Breastfeeding Toolkit in order to provide for the needs of new mums. An example of one such tool is described in an article by Nikki Lee, a lactation consultant. She introduced me to the delights of co-bathing as a tool to assist in the recovery of breastfeeding (Lee 2005).When mum and baby experience skin-to-skin contact in a warm bath, the mother’s levels of circulating oxytocin are raised. Her nipples then become more erect and it is easier for the baby to attach to the breast.
The following advice forms part of my own Breastfeeding Toolkit for new mums. I hope you will find this helpful when supporting new mothers in your care. This is what you may like to suggest:
Surround yourself with positive support and always include your partner
Get help with positioning and attachment from the start – this does not mean “hands on” manipulation of mother and baby but one-to-one explanation and reassurance
Be inventive – there are 360° of attachment so finding the perfect position for you and your baby may take a while and a certain amount of trial and error. You will know when you have achieved this because feeding will be comfortable
Breastfeeding should not hurt – if you are in pain get help from someone who really understands breastfeeding. To have a friend or a breastfeeding counsellor who is experienced in breastfeeding would be a great help at this time. Contact your local breastfeeding association (National Childbirth Trust, Association of Breastfeeding Mothers, Breast Feeding Network or La Leche League) for details of your nearest support group
If your nipples do become sore:
Correct your positioning and attachment to prevent any further damage.
Use a soothing ointment (chamomile, lanolin or similar natural plant-based formulations all work well) to protect them while they heal. Moist healing works twice as quickly than if left dry (Palfreyman et al 2006 & Huml 1999)
Biological nurturing – this is a mother-centred approach. It suggests new ways to hold and cuddle babies and aims to increase the enjoyment of breastfeeding. This can greatly help with positioning and attachment (see Resources)
Listen to a baby’s cues – breastfeeding can only work when it is baby led
Stimulate your breasts – just the smell, sight and touch of your baby will help to do this. This includes co-bathing (see above)
Unrestricted breastfeeding should be encouraged, especially overnight, as this helps to promote and maintain a steady milk supply
It takes around six to eight weeks for the delicate balance of milk supply and demand to be established, so do not be tempted to introduce bottles or formula feeds
During this time I do not recommend expressing as this will not stimulate milk production as well as direct feeding. Expressing also defeats the object when breastfeeding is so convenient
Try not to be separated from your baby – close contact (not necessarily skin-to-skin) greatly helps to stimulate milk-producing hormones
Close contact with dads should also be encouraged. This will help promote a closer bond as you all settle into your new family unit, no matter how big or small
Growth charts used in the UK are based on bottlefed babies so weight gain for your breastfed baby may appear to be slow. These growth charts will be replaced with World Health Organization (WHO) breastfeeding growth charts soon
As long as your baby is waking up for feeds, taking feeds well and having wet and dirty nappies, you can be reassured that they are getting enough milk
It is not unusual for a baby to feed between 12 and 20 times a day in the early weeks. But this will settle down – promise!
Breastfeeding will help you to lose the extra weight your body gained during pregnancy
Breastfeeding is much more than just a way of feeding your baby milk. It provides the emotional and psychological stability your baby needs to become self-confident, relaxed, independent and secure
Above all enjoy breastfeeding – with each feed you will get a rush of endorphins, which are basically “happy hormones”. This makes you and your baby feel good and is nature’s own stress-buster
Department of Health (2008). National breastfeeding helpline launched. Available from: http://nds.coi.gov.uk/Content/Detail.asp?ReleaseID=352806&NewsAreaID=2
Dhandapany G, Bethou A, Arunagirinathan A, et al. Antenatal counselling on breastfeeding – is it adequate? A descriptive study from Pondicherry, India. Int Breastfeed J 2008;4:5.
Healthcare Commission. Women’s experiences of maternity care in the NHS in England. Key findings from a survey of NHS trusts carried out in 2007. Available from: http://www.healthcarecommission.org.uk/_db/_documents/Maternity_services_survey_report.pdf
Huml S (1999). Sore Nipples: A new look at an old problem through the eyes of a dermatologist. Practising Midwife.2 (2).
Kamillosan (2008a). Telephone poll of 100 restaurants to gauge reaction of breastfeeding in public. Available on request from info@kamillosan.co.uk .
Kamillosan (2008b). Online survey of 3500 mothers regarding views breastfeeding on breastfeeding in public. Available on request from info@kamillosan.co.uk
Lee N. Breastfeeding recovery: more tools for the helpers. MidirsMidwifery Digest 2005;15:229-33.
National Childbirth Trust (2006). Midwives top chart for breastfeeding information. Available from: http://www.nct.org.uk/press-office/press-releases/view/13
National Perinatal Epidemiology Unit. Recorded delivery: a national survey of women’ experience of maternity care 2006. Available from: http://www.npeu.ox.ac.uk/downloads/maternitysurveys/maternity-survey-report.pd
NHS Information Centre. National infant feeding survey. 2005 Available from: http://www.ic.nhs.uk
NICE (2006). Postnatal care: routine postnatal care of women and their babies. Costing report. Available from: http://www.nice.org.uk/nicemedia/pdf/implementation_tools/cg37costingreport.doc
Palfreyman SJ, Nelson EA, Lochiel R, et al. Dressings for healing venous leg ulcers. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD001103.DOI: 10.1002/14651858. CD001103.pub2 http://www.cochrane.org/reviews/en/ab001103.html. (accessed on 22/5/08).
Palmer G. The politics of breastfeeding. London:Pandora; 1993
Trotter S (2004). Breastfeeding: the essential guide (ISBN: 0954838106). Scotland, TIPS Ltd.
Trotter S (2008).Online poll of top threebreastfeeding problemscarried out between 2007-2008 by www.tipslimited.com Available on request.
World Health Organization. Child and adolescent health and development. 2006. Available from: http://www.who.int/child-adolescenthealth/NUTRITION/infant_exclusive.htm
Letting baby do the work: Biological Nurturing
It was late afternoon on a dark November day and I was at the end of my tether. Week 6 of breastfeeding and I was wincing with pain every time my baby latched on. The doctor had diagnosed thrush and prescribed a cream for me, instructing me to express all feeds until I am ‘better’. Luckily I’m not one to accept things without questioning and this diagnosis rang alarm bells. Surely, if it’s thrush then my baby would also show signs of it? And what would be the point of treating me without treating my baby? Logic kicked in. This can’t possibly be right.
I sat in my pyjamas and pondered what to do. Believe it or not, since giving birth this was the first time I’d not managed to get dressed by lunchtime – things were obviously bad! Fed up with the constant pain when feeding I started to resent my baby as if she was hurting me on purpose. I dreaded every feed. The only option seemed to be to give up breastfeeding.
Thoroughly confused and worried, I decided to call the NCT Breastfeeding line. A counsellor talked me through the problems I was having and she agreed that I shouldn’t accept the doctor’s advice. She suggested that it was a problem with the latch. I’d religiously followed the ‘nose-to-nipple’ mantra – what more could I possibly do?
“Have you tried biological nurturing?” she said.
I hadn’t. It sounded like a washing powder.
Biological nurturing – what is it?
Biological nurturing is often described as a ‘new’ approach to breastfeeding. It wasn’t discussed in my antenatal classes and most people I mention it to have never heard of it. The technique is based on a baby’s natural instinct to search for the breast when hungry – the adorable and relentless ‘pecking’ they do to any shoulder they encounter. Letting your baby search for the nipple by themselves is said to be the best way to get the most natural latch. No need to direct them or tip them this way and that, just let them make their own way towards what they’re after: hence why it’s also called ‘breast crawl’ or ‘baby led attachment’. This newborn instinct is said to lessen from around 6 weeks of age so if you want to try this technique, it is recommended to do it sooner rather than later.
“I did have an experience of this one morning when my baby was about 4 weeks old. We were lying in bed and he was sleeping on my chest, the next thing I know he had wriggled up to my boob, latched on a perfect latch and had a really good feed. I had an over supply of milk for a long time and usually had to express a few ounces before each feed (which also used to choke him at the start), but I was really amazed that this didn’t happen on this occasion. I never realised that this was the biological nurturing method or I would have explored it further. I remember being really amazed at how such a small baby could find his way to food instinctively.”(B, mum to Adam)
The turning point
A couple of hours after my call to the NCT line I settled myself on the bed with my daughter for her feed. I remembered what the counsellor said and took a deep breath. I couldn’t believe it. There was no pain. No tears. No gritting my teeth. My baby had latched on like a dream.
A simple technique
I found the ‘rules’ for getting a good latch in the traditional cradle position really hard to get right. Trying to remember where my baby’s nose was pointing, whether ‘tummy was to mummy’ and where her chin was resting left me tense before I’d even started. Biological nurturing was described to me in a matter of seconds and I didn’t need diagrams.
3 easy steps
STEP 1: Sit back and relax.
STEP 2: Lay baby lengthways down your chest with their head between your breasts.
STEP 3: Allow baby to wriggle to the nipple, guiding and supporting them as necessary.
If it needs a mantra then it’s ‘chest to chest, chin to breast’. The appearance of a good latch is as with other positions: mouth over plenty of the areola, chin to breast and nose clear. Like any method, it does still require a little trial and error. Biological nurturing relies on using a baby’s natural ability to find the breast to maximise the chances of a more natural, more comfortable latch. It is thought that by allowing the baby to attach itself, it increases the chances of it taking to breastfeeding more easily thus avoiding some of the problems that mums can have with feeding in the early days. Of course, with something as personal as breastfeeding, mums find what works for them and their baby. Biological nurturing was something simple that worked for me.
“My baby has a preference for my left boob and I can spend 20 minutes trying to get him latched on my right but with this method he wiggled himself down and latched on perfectly all on his own! He is three weeks old today and last night was one of the best nights we have had as it was so relaxed not fighting each other to get a good latch.”(M, mum to 3-week old)
The science bit
I wanted to write this based on my personal experience rather than trawling through lots of research. However, the ‘science bit’ is fascinating. A baby’s tendency to search for the breast is a ‘primitive neonatal reflex’ (PNR). This is a spontaneous reaction to stimuli that is innate rather than conditioned or taught. Left to do so, a newly born baby has the ability to find its way to the breast within an hour, provided it has not been affected by drugs administered to the mother during labour. Research suggests that the feeding positions recommended for biological nurturing encourage these natural reflexes to emerge. This is how Dr Suzanne Colson, probably the most prolific advocate of the technique, describes the results of early research:
“The key components of BN [biological nurturing] were a range of semi-reclined maternal postures … These appeared to act in synergy …which appeared to maintain close mother/baby body contact enhancing the expression of PNRs, facilitating … infants to find the breast, self attach and feed even whilst asleep”. *
Dr Colson concludes that:
“…[t]his study… challenges the effectiveness of established maternal breastfeeding postures where the focus of consistent advice is skills teaching within a fixed system of positioning and attachment.”
The suggestion is that the more upright positions mothers are taught to adopt, for example with the cradle position, don’t encourage the baby’s natural reflex to latch on in the way a reclined position does. This leads to a question: how can biological nurturing be a practical technique that is flexible enough to suit a mum’s normal everyday routine?
Not as impractical as you might think
Biological nurturing is often discussed as a technique for establishing a latch in the early days and for bonding. The mother must be reclining and skin to skin contact is encouraged. Some advocates overplay this aspect and thus portray the technique as one that is only practical in your own home, in bed and in private. It is therefore often dismissed as impractical. Yet it is a technique that can be used throughout your time breastfeeding. Even though a baby’s natural instinct to root may lessen, you will by that time have established a comfortable feeding position of your own grown out of baby led attachment. When I first tried biological nurturing, I was indeed semi-reclined and semi-clothed – the ‘prime’ conditions according to medical and scientific experts. Following that first attempt, I soon moved to a more upright position, continuing to utilise the principles of letting the baby lead. Who am I to question science, but it still worked!
Can I do it when I’m out and about?
The short and encouraging answer is yes. It isn’t necessary to have skin-to-skin contact or to be semi-reclined. Neither of these would be appropriate in a public place even for the most liberal of mums! Sitting in a chair, I simply placed my baby’s legs either side of one of my legs and aimed her in the direction of the breast on the opposite side of the leg she was straddling. That way she was more or less in a vertical position and easily held. In fact, if left to attach on their own, most babies do adopt this diagonal position. Even with a big and long baby, this position proved immensely comfortable and practical. The key is to use the basic principle of biological nurturing – the baby’s self-attachment – combined with what is practical and works for you in the environment you’re in.
Conclusion
“The bottom line is that you have to be relaxed for breastfeeding to go well and most situations – in hospital, with people watching and barking instructions, sitting up in uncomfy bed, feeling tense, still sore from birth do not encourage this to happen as naturally and easily as it should.” (L, mum to Emily)
Breastfeeding may be a natural process but it isn’t the most natural thing in the world to get right. It’s not easy and no one should ever feel a failure if they struggle with it or decide to stop. Finding a position that is comfortable is vital to success: relaxed mum, satisfied baby, victorious breastfeeding! Biological nurturing proved a simple solution to the particular problems I was having and made breastfeeding click into place when it seemed impossible to carry on. This technique should be added to every mum’s toolbox for successful feeding.
www.breastcrawl.org – includes an amazing UNICEF/World Health Organisation (WHO)/World Alliance for Breastfeeding Action (WABA) film: http://breastcrawl.org/video.htm.
The legislation surrounding paternity leave is due to change with the aim of encouraging a greater participation by Dads in child rearing and to allow families greater flexibility in who stays at home with the baby. The Government estimates that 4-5% of Dads will exercise their new right to longer Paternity leave. But what exactly are the changes and how will they affect you?
Currently the law allows Dads (or the partner of the Mum, male or female) to the right of 2 weeks off work, paid at the statutory rate of £123 per week. For those whose babies are born on or after 3rd April 2011 this will change to allow the Dad the right of up to 6 months additional paternity leave.
Sounds great- but where’s the catch?
The additional Paternity leave comes from the Mother forfeiting her right to some or all of the last 26 weeks of her maternity leave and a number of conditions must be satisfied in order to qualify.
Additional Paternity Leave (APL) Eligibility
Must have been continuously employed by the same employer for 26 weeks at the end of the ‘relevant’ week which is the 15th week before the expected week of birth
Must still be employed by the same employer at the start of the additional maternity leave
Must be the father of the child or married to or the civil partner of the mother or adopter of the child
Must have or expect to have the main responsibility for the upbringing of the child (apart from the Mother) i.e. not be out on the golf course while on Paternity leave!!
The Mother must have been entitled to maternity leave, Statutory Maternity Pay (SMP) or Maternity Allowance (MA)
Before the Dad can commence his APL the mother must have returned to work (or her SMP or MA must have finished)
So you can tick all the boxes, what do you need to do now to get your leave? Here’s the boring legal mumbo-jumbo.
You must give your employers eight weeks notice, in writing, of your intention to exercise your right to APL and inform them of the expected week of the child’s birth (the due date that was on the MATB1 certificate), actual date of birth and the proposed start and end dates of the leave.
Leave must be taken continuously and has to be a minimum of 2 weeks up to a maximum of 25 weeks. The earliest it can be taken is when the baby is 20 weeks old.
When requesting the leave a declaration must also be included stating:
The purpose of the leave is to care for the child
That he is the husband, partner or civil partner of the mother and that
He expects to have the main responsibility for the upbringing of the child (apart from the Mother)
It must also include a statement from the Mother including:
Her name, address and NI number
The date she intends to return to work (or the date her SMP or MA will expire)
That the employee satisfies the conditions as stated in the leave notice and is to her knowledge the only person claiming APL for the child
Her consent to the processing of her information in the declaration
Your employer has the right to request to see the child’s birth certificate and the details of the Mothers employer or her business address if she is self employed, probably so they can check that she has returned to work and isn’t still claiming maternity leave whilst you intend to claim paternity leave!
So what rights will you have while on Additional Paternity Leave? Well, the regulations set out that all the terms and conditions of employment stay the same, with the exception of remuneration (pay – it is at the employer’s discretion if they want to pay higher then Statutory Paternity Pay, which is £123 a week). You have the right to return to work, an option of an early return to work (although 6 weeks’ notice is normally required) and a right to 10 keeping in touch (KIT) days. You would also have the right to be consulted in the same way a woman on maternity leave does if there was a risk of redundancy whilst on APL.
So on a positive note, the updated regulations give Dads a greater opportunity to be at home with their baby during the early, formative weeks and a chance to create stronger bonds as a result of extended paternity rights. But the disincentives are that men are often the highest earners in a family and must have satisfied the lengthy criteria to apply for the leave. But at least it’s a step in the right direction considering paid Paternity leave has been around for 8 years.
Natalie Maltby (NCT Chair of Cheshunt and Broxbourne District Branch)
For as long as I could remember I had played with dolls lovingly; dressing them, bathing them, hugging them, rocking them to sleep in the cradle Grandma bought me for Christmas in 1973. First, there was Ben, a funny doll who for some reason I decided was a boy. He had one eye that was stuck and never closed when you lay him down and a strange collection of blue ‘boy’ clothes but I loved him and I took him everywhere. Admittedly he was often upside down, semi-naked and rather grubby but he was my baby nevertheless. Then came Tiny Tears. She was perfect (although the hairstyle looking back on it was decidedly seventies and not in a funky way) with blue eyes and a Clara bow mouth complete with hole for you to put her dummy in whenever your maternal instincts told you she needed extra soothing. When we used to go to Little Chef on the many long motorway journeys to and from various relatives or house hunting for the latest move, I would always give Ben and Tiny Tears the sticker rewards that they gave you for eating up all your food and I would have the lolly. We were a team, me and my ‘babies’ and we took care of each other.
Now, of course, I did all the normal big girl things as I grew up; bike rides, school discos, tentative snogs at the youth club leading to disastrous relationships at the student union bar. I even managed to get a degree and find a job and Tiny Tears and Ben were left languishing at my parents’ house wondering if anyone would cuddle them again! I never forgot them and most significantly whenever there as a clear out and my mother asked what she could throw or give away that I no longer wanted to be stored in their house and not mine, I never gave up on them. That is because whilst concerts and smart restaurants are fun and spending all your money on shoes is great for a while, ultimately it was not what I wanted. I always wanted to be a Mum. It is not a lofty ambition, it won’t be remembered for the works of Einstein or Gandhi but it was my strongest and most burning desire. I will not apologise for that.
So when the time came for a good man to come into my life and a lovely wedding, followed by a lovely home, it was not long before the talk of starting a family became more than just talk and so we began ‘trying’. I was already 29 at this point and my husband was over 30 so I hadn’t been completely obsessed with parenthood prior to that. Now though everything felt right. However, everything wasn’t right. Far from it and despite the initial thrill and a whole lot of smugness at getting pregnant the first month of trying, we were soon to begin a very hard journey to parenthood. 8 weeks into my first pregnancy and only 4 weeks since that joyful positive test, I started bleeding. A few spots quickly turned into a full on bleed and before we knew it we were in the early pregnancy unit of UCH being told there was no heartbeat and a blood test would confirm that I had indeed miscarried.
So home we went, sad and empty but still with an element of optimism thanks to the cheerful blasé attitude of the staff and all our friends telling us that we would be pregnant again in no time and there really was nothing to worry about. Months went by. We took temperatures, we peed on sticks, we analysed every twitch of my cycle and of course, we shagged like rabbits. Quite a shock to my husband to have me initiating sex every night I can tell you! In the beginning, I think he rather liked the ‘trying’. But excited optimistic sex can quickly become desperate, needy, necessary sex and months later with no sign of another pregnancy, the strain very definitely took its toll. How we survived that year and the many that were to follow in our quest to become parents is still a wonder to me. It is to our very great credit that we kept talking and sharing and shouting and sulking and finding ways to cheer each other up because we did it together. We quickly realised that no one else understood what we were going through as well as each other. So no matter what anyone else said we always had someone we could turn to and they always agreed and they always said the right thing. We finally admitted defeat and went to the GP who started with some very simple tests, a smear, a sperm test, some hormone level blood tests, etc. All came back normal and as is so often the case, within a month of talking to the GP, I found myself pregnant again. This time we only had a week of optimism and once again I was bleeding, waiting for hours at the early pregnancy unit of UCH and yes, ‘we are really sorry but there is no heartbeat’. In fact this time there was nothing at all so it was highly likely it had been a chemical pregnancy that had never formed a sack or proper embryo.
Now the depression really kicked in. I was a woman obsessed. I was made redundant and as my husband was earning good money I begged him to support me as I went freelance and cut down my hours. I took vitamins and minerals, I bought every book, read every article, I tried acupuncture (ouch!) and finally reflexology. Now for me reflexology probably saved me. It gave me a release. An hour a week my brain stopped whirring, took a break and totally switched off and knowing I was able to turn my brain off like that whenever I wanted to keep me sane. I couldn’t look at babies having been the first to cuddle or coo whenever one came near me. I used to be great with kids, everyone said so. ‘Give her to Charlotte, she knows what to do’ was always what the friends and relatives would say when one of the cousins was whining or crying. And I did, I soothed, I laughed, I made up great games and they loved me. Not now. Now I was grumpy Aunty Charlotte who doesn’t like kids and does not want to hold your baby and would rather go now thank you very much.
I couldn’t watch TV or films if there was any hint of happy families, childbirth or pregnancy. I remember Rachel in Friends was pregnant at the time and I used to weep every time my once favourite show came on. My husband had to physically hold me back one day when we walked past a heavily pregnant woman in a hospital gown standing outside the maternity unit having a smoke with her other child in a pushchair beside her. Me! Who never raises her voice to anyone and would rather die than confront a situation and yet here I was ready to scream in a total stranger’s face because she had what I wanted more than life itself and she didn’t seem to value or appreciate it.
Life itself. That became really difficult. I don’t just mean when there were babies to face or emotional triggers to deal with. I remember my mother telling me to just ‘pull myself together; it’s not the be all and end all’. In fact, I remember how much that hurt as acutely now as it did then. Actually, unless you have been through this, you have no idea how very much it is the be all and end all. A woman is totally driven by her hormones and what stage of her cycle she is at. It dictates whether you feel like dancing or not, which clothes you feel comfortable in, what you fancy eating, whether you are happy or sad, grumpy or reasonable. Do I like what I see in the mirror today? Am I spotty? Does my tummy hurt? And I had particularly rubbish periods so it really did dictate my every move and that was before I cared about when I was due on and whether I was going to be pregnant or not. Now it truly affected EVERYTHING. And one day I found myself in a total panic because what if I could never have a child? What if there was no hope? What would there be for me if I was ever going to be a Mum? I couldn’t bring myself to think the worst but I certainly knew in my heart that at that point I could not see how I was going to live.
This pain went on for another 2 and a half years until a friend of mine said, ‘Enough’s enough. You can’t deal with this on your own anymore. You need help’. She was right. It was the time I took back control. I went to my GP and poured my heart out and he said he would refer me to the specialists at UCH and I should be in their care within the month. He was right. On my 33rd birthday I was sat in front of a consultant in the reproductive medicine unit and for the first time, my husband and I had someone telling us they would help. No, we didn’t have to give up, no it was not crazy for this to be terribly important and yes there were resources available who would help us to be parents. There was even a therapist if we wanted. First, they wanted to do tests, more bloods and lots of scans. Then they would try Clomid then they would try IVF. Nothing seemed to be wrong apart from one slightly raised hormone level indicating I was further down the path to menopause than someone of my age would normally be. Possibly all my eggs were a bit old and so they were either too damaged to be fertilised or if they did manage that part they were definitely not able to sustain a pregnancy. Miscarriage is actually a marvellous thing. No, I have not lost the plot, it really is. Your body is that clever that it can tell from a tiny bunch of cells that something minute is not right. It saves you the considerably more agonising heartache of possible stillbirth or a lifetime of caring for a very poorly child by realising this ‘flaw’ at once and rejecting the pregnancy quickly and efficiently at a very early stage. Well, that’s how it worked in my case and none of my failed pregnancies ever lasted more than 8 weeks. I can only talk from my experience and in the end, I realised that the rather brusque nature of most of the medical staff was not because they didn’t appreciate what you were going through but rather than they knew the stats and the NHS are all about the stats. The truth is at least 1 out of 4 pregnancies miscarry and they are invariably followed by perfectly healthy normal babies being born within months or years to the same couple. They saw this with their own eyes day after day. Convincing me, however, took a while! So I began my first course of Clomid, had the most horrific period (had to make an excuse to take an early lunch from my latest client who fortunately only was 20 minutes bus ride from my house) to go home with my coat tied around my waist covering the evidence that I had bled everywhere and needed to completely change my clothes but 4 weeks later there we were staring at a positive pregnancy test. It was now 4 years since we had started our journey to parenthood and we were now cynics. So we waited terrified until the 8-week scan to see if there was going to be a heartbeat and this time there was! We were advised to still be cautious which we promised we were whilst secretly looking at each other with nothing but joy in our eyes. A couple of weeks later they checked again and all was well. Our bean was growing nicely and it was time to be discharged from the RMU and be ‘normal’ antenatal patients. And so we were until the 20-week scan revealed by cruel coincidence that I was Grade 4 placenta praevia, high risk of haemorrhaging and would certainly have to have a caesarean. Indeed I bled at 28 weeks and again at 29 weeks and then had the riot act read to me about how I should live in the hospital and if I was going to insist on going home I had to have someone with me 24/7 in case I bled out and died! Marvellous!
I woke up on the morning of May 17th, 2005 with a warm wet sensation and indeed I was haemorrhaging. A lot of blood later (which my poor mother scrubbed and mopped whilst trying to take her mind off the fact that her only child was in surgery and she had no idea if she or her first grandchild were ever coming out), a tiny little boy was delivered. He weighed 1669g (3lbs 10oz), had an initial Apgar score of 3 but he was alive and he was alright. I first saw him as I awoke from my anaesthetic on a Polaroid picture. He had a sunken chest, brown shiny skin and I had absolutely no idea what he looked like for a week after he was born when they took the eye protectors off him and peeled off the CPAP device that was squishing his nose and cheeks but keeping him breathing! 10 years later from when we first started ‘trying’, my son is nearly 7 and my daughter (born after 3 further miscarriages) is nearly 3. They are perfect and we are parents in every sense of the word. We are tired, exasperated, happy, silly, bored of Cbeebies, fed up of Peppa Pig but everything is exactly as we dreamed it would be. I am a Mum and my son; well naturally I called him Ben.
