Maternal and Infant Nutrition and Nurture …oh my!

10 things I learnt and loved about #MAINN2014.

This conference is usually held each year in Grange-over-Sands in the UK, by the University of Central Lancashire. It is a conference dedicated to presenting and discussing research on infant feeding with an emphasis on alternative, contextual approaches to the subject. This year it was held at the University of Western Sydney in Parramatta. These are some of my personal highlights…in no particular order and with ruthless editing to make it digestible to others. Thanks to Virginia Schmied from UWS for making it happen.

1. Exploring the highs and lows of the Baby Friendly Initiative with Fiona Dykes from the UK and Danielle Groleau and Sonia Semenic from Canada. Good to know that there are people interested in the way that health professionals (midwives) live with the 10 steps and the culture of the accreditation.  Fiona spoke about the problems with a “top- down”approach with any behaviour change, but also about the promise of relationships in breastfeeding support.

Sonia spoke about the challenges of introducing the 10 steps into NICU units worldwide: there is a general pre-occupation with infant growth, calories and volume. There are also significant challenges associated with baby illness and feeding. It will be so exciting to see the progress with this work.

Danielle’s work looked at the varied impacts that BFI facilities seemed to have on women’s breastfeeding behaviour in the longer term. She highlighted the  need for more research into the impact of BFI on women from low income groups. She also spoke very clearly about the sociological theory that shines a light on the the problematic issues of breastfeeding cessation amongst women from low income backgrounds and breastfeeding in public. Symbolic capital…mmmm.

2.Renee Flacking reporting on her ethnographic study of four NISC units: 2 in Sweden, 2 in UK. eleven months of fieldwork (phew!).  Her comparison of the different models of care was effective in demonstrating the many benefits of the “womb” model: continuous skin to skin with mother (and/or partner), a separate, private space that allowed families to “focus within”, with the baby as the context.  Interactions between mother and baby “effortless”. Importantly, parents can “be who they are”. Her description of the “standard” nursery care with one uncomfortable chair for mama highlighted the culture in many nurseries of parents being expected to stay an hour or three, but not for longer.

3. Investigations of the impact of peer support for breastfeeding in the UK with Gill Thomson.

Nursing Mothers and the Australian Breastfeeding Association have done this en masse in Australia over the past 50 years. Yup, we reckon it works. Kate Mortensen from ABA is investigating breastfeeding peer support globally and the RUBY study  (Ringing Up about Breastfeeding) will examine the impact of telephone peer support for breastfeeding mums in Melbourne, as presented by Heather Grimes from La Trobe University… it’s already under way.

4. Shanti Raman’s ethnographic study of families in Bangalore,India: “nothing special, everything is normal”. How pregnancy and childbirth is part of the discourse of everyday life in India, and how it is woven into the rich repertoire of celebration and ritual. This resonated with my own experience of providing care for Indian families in Australia… somehow enviable in our culture where pregnancy and childbirth seems so “other”.

5. Gold star to Charlene Thornton for making me like stats!  Her “normal woman” enables effective comparison between care models. Some juicy details: C/S rates, inductions and episiotomy in  private compared to public.

6. Deborah Lupton – renowned health, food and  now digital sociologist.  Enjoyed her quick summary of her own work and directions over the past 20 or so years, with some emphasis on the sociology of risk: “The precious foetus” and more. Mothers place so much pressure on themselves to perform as guardians of their children. Children are both beloved and reviled in our society. Food for thought …

7. Examination of the breast pump discourse: Helene Johns, Kath Ryan and Athena Sheehan. Soft touch indeed. The impact of advertising culture on breastfeeding culture: when breastfeeding comes to equal breastmilk.

8. Talking at meal breaks.  To anyone and everyone – so friendly! What is it about people who do research into breastfeeding and birth? I’d like to think we are uncorrupted by wealth or status!

9. Meeting strangers at dinner. Actually, turned out to be new friends.  This was the kind of conference where, no matter who you spoke to, they were interested and involved in breastfeeding research  and/or clinical practice. Often both. I found out a great deal about what breastfeeding support looks like in Queensland. I also was delighted to share my own plans for research (thanks guys!).

10. Being at UWS in Parramatta. Home of the Whitlam Institute. The campus is an oasis from the traffic and noise of the bustling city.  It’s also a stunning combination of old architecture and new as well as useable and attractive open spaces.  An amazingly culturally diverse community in Parramatta and a calm and beautiful walk each day along the beautiful Parramatta river. Harbour? Who needs a harbour?!

 

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bash the breastfeeding supporter

Is it me?

Probs it is me.

It’s like when you notice women with prams everywhere when you’re pregnant.

Seems to me there’s a bit of beating up of breastfeeding supporters and advocates going on.

Allegedly they (we) are making women feel guilty about not breastfeeding.

Even when a woman has had a bilateral mastectomy for breast cancer (if you must know) … see Emily Wax http://www.theguardian.com/lifeandstyle/2014/oct/18/breastfeeding-mothers-formula-breast-cancer%5D

A couple of my thoughts on this:

1.96% of women in Australia initiate breastfeeding. In my professional experience, first-time mothers who plan to bottle-feed their babies from the go-get are as rare as inverted nipples*. I’m guess I’m saying this is a very small group of women to be getting an awful lot of words written about them. They in no way should be judged for their decision, but I would hope that their decision is an informed one.

2.Women who are feeding their babies at least some formula are more and more numerous as time goes by…85% of Australian mothers, in fact, just before their babies turn six months old. So formula feeding to some extent in our culture is not a rare occurrence, although as to why this is….it’s complicated. But women who are formula feeding shoudn’t really feel like a marginalised group. By six months they are firmly in the majority.

What happens?

Lactation Consultants and midwives and peer counsellors who provide care for women and their newborn babies really  want to help the 96% of mothers  fulfil their goal of breast-feeding their babies.  Women need some/none/mega amounts of support to do this.

Some breast-feeding supporters are over-enthusiastic in the way they explain breastfeeding, or in the way they explain the benefits of breastfeeding. It’s all a pretty embarrassing scenario really, with breasts and nipples and crying babies and stuff.

And it’s also in the context of recovering from childbirth (with maybe one third of women recovering from major abdominal surgery), no sleep, managing visitors and a lack of privacy in hospital, perhaps a lack of general support from home too…

All in all it’s a very challenging environment to be teaching people about a new life skill. No wonder misundertandings arise.

Breastfeeding supporters know that this postnatal environment is a tough gig. It’s neither “technologic nor dramatic”.

They (we) do it because they feel privileged to be a part of this time with a family and their new baby – and all the promise it holds. Many do it because they themselves had difficulties with their own first or subsequent babies. Some do it because they feel that this time is one of the most important in a new family’s life, even though it’s the cinderella of maternity care (few doctors are interested or present, many midwives are more interested in labour and childbirth, it’s all happening in a pretty tricky environment,as I mentioned earlier, of sleep deprivation, post-operative pain, sore bums, bloody pads and renogotiated family relationships).

I’m saying that we’re not in it for the recognition or the laughs.

But we believe that if women set out to do something like breastfeed their baby, we’ll help them to, even when it gets tough.

Because they, and their babies are worth the effort.mother_BFing

 

*very uncommon indeed.