postnatal care

How do we prepare women to breastfeed?

Women at the hospital where I work are scheduled to receive breastfeeding information at their 26 week check-up visit.

It’s my favourite visit even though it can be tricky getting through all the information required to be imparted during this time. I make up for this by talking fast!

The midwives have a checklist we have to work through (another of my not-favourite thing) but it covers the essentials – benefits of breastfeeding to mums and babies – (don’t forget dads! They can get better sleeps for years if things pan out…) rooming-in policy, non-giving of formula to babies being breastfed without a medical indication, non-use of dummies in hospital, resources for support after leaving hospital and so on…

We are meant to start by asking how women are “choosing” to feed their babies. Seriously, about 99.9% of women we see – from very varied communities and backgrounds want to breastfeed. Sometimes I would breach protocol and ask “how are you going to breastfeed your baby?”

A Norwegian-born woman in my ABA group told me how the question astounded her: “in Norway no-one would ask – there is only one way to feed a baby!”

Then we are meant to chat about the benefits of breastfeeding. From my days of teaching breastfeeding education classes in the community I know that everyone (and their dog)knows the benefits of breastfeeding (especially the dog, right?). “Breast is best” is a health message breathed in like air. It doesn’t keep women breastfeeding, but it probably starts them thinking that its something they might like to do.

I skip this info – “you will be well aware of the health benefits of breastfeeding to you and your baby”. Lots of nodding…

Then I tell a story to them. It’s the story of what happens when their baby is born and they start to breastfeed.

My plan is to normalise the experience and to be realistic about what the first days with a  newborn are like. Prospective parents are unlikely to hear about this from other people… in fact the families I look after post-natally seem to generally be overwhelmed by their experience in the first days. It is such a short and stunning period of time for new parents that it is quickly forgotten. But this moment is an opportunity to consider what a baby’s first days are like – physiologically, and then to relate this to the experience of breastfeeding in the early days. which we know as midwives is a cruel, intense but life-changing time for parents and their babies.

Here are some things I say:

After your baby is born he or she will be handed directly to you and placed skin to skin with you. Your baby will be dried off while lying on you and be closely observed in the important first minutes as she breathes air into her lungs for the first time.

We know that skin-to-skin is not just a nice thing to do, but actually helps your baby transition to life beyond the placenta. Babies in skin-to-skin contact with their mothers stabilise their breathing and their heart rate and their temperature better. And something else happens too…. babies start to look for the breast. Babies will literally crawl towards their mothers nipple, attach and feed if left undisturbed after birth. I get to see this all the time in my job.

If you want to see babies do this too you can search “breastcrawl” on YouTube and see lots of newborn self-attaching.

We like newborns to self attach if they can because when they do it themselves, they do it properly. Not only that, when they get it right the first time – they go on to do it right time after time from then on.

I talk then about how that first feed should take an hour or even two hours. And about how babies are awake and alert for the first hours after birth – so that they can breastfeed well.  I also mention how oxytocin in the mother’s circulation is making more colostrum available to the baby in that first feed than it will over the next 24 hours – oh, and also how the breastfeed will help to contract the woman’s uterus during this time – to deliver the placenta and limit her blood loss.

Nothing beats the faces of parents-to-be at 26 weeks listening to all this – I think this is often the first time they have really thought about the nuts and bolts of this almighty adventure they’re embarking on! And then we talk about how babies usually have a giant sleep after this – maybe for six hours. More nodding.

How often do new babies need feeding? More is more in the colostrum world – small amounts frequently is key. Thick gooey colostrum – more medicine than milk at this stage.

Every feed is also a good learning time for mum and bub. Also extraordinarily comforting and reassuring for a new baby in a giant world of weirdness.

Sleep? I hear you ask… mmmm – not so much. Here’s what the postnatal ward is like on any given night – it’s party time!

Newborn babies are more like teenagers than any other group I can think of. They behave like angels all day and evening through visiting hours and then at about ten o’clock they all wake up and want to feed. Not once, not twice, but continuously – until about 4am. Then by 6am they are all fast asleep. When the morning shift starts at 7am they find a ward full of sleeping mothers and babies. It’s natural.

Mornings are very settled times. Then the feeding frenzy begins again after lunch…or at least we’re all trying to get babies to feed again in search of that holy grail – more sleep overnight. Good luck.

Sounds great doesn’t it? Everytime your baby wriggles is a good time to try a feed. Don’t wait for your baby to cry.

Expect lots of sticky black meconium nappies in the first few days. Not much wee until your baby’s digestive system and kidneys start to fire up – and the colostrum increases in volume (that’s happening all the time by the way, as you keep feeding). Black tar poo is replaced by darling green numbers and then mustardy slops that smell like fresh mown grass! yum! Now watch out for the wee fountain on the change mat. Not just for boys!

Now your baby’s tummy is expanding as the volume of feeds increases. And then…..your milk comes in and Everything Changes.

But I tell them not to worry about all that just yet.

The most important thing that I mention is that through all this time there will me midwives like me supporting them.

We are mostly friendly dragons who love babies.

We midwives know lots and lots of things about lots of different babies – but probably very little about your baby. In eight hours you will know more about your baby than us. We can give you info about some principles and tick off important tasks like teaching you to bathe the critter (after 48 hours) or showing you the phone number for the ABA breastfeeding helpline or teaching you “what to do when you get home” (my script for that one still needs work). So just ask us. The questions will start to really flow when we visit you at home in the first week.

A lot of the time we do a version of cheering you on from the sidelines. Cause it’s hard and tiring and being in hospital is mostly crap. But soon you will go home and your milk will come in … and Everything Changes. So now you know.

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Once upon a time there was a hospital…

This is a piece I wrote about a local hospital in the outer suburbs of Melbourne, Victoria, Australia. I know it’s a sensitive topic to many of my colleagues and friends, but I’m writing it because I’m tired of the way women have been used in the media coverage of this issue and the way staff at this hospital (and others) have been vilified.

 

 

The stories that have unfurled over the past four months regarding Bacchus Marsh Hospital’s maternity services have certainly been concerning. More than expected numbers of unexplained baby deaths were the trigger for the hospital’s board to be sacked and for the Health Minister to announce concerns about the hospital’s obstetric practices and standards of care. But the media’s handling of the issue has been focussed on blame and retribution and an almost voyeuristic preoccupation with personal stories of baby deaths and maternal wound infections. There also seems to have been little concern for the reputation of local health services in general.

There have been numerous television and print media stories about the alleged “horrors” of Bacchus Marsh hospital’s obstetric services. Even a newspaper piece written by one of the litigation lawyers.

Many of the stories in these reports have come from women whose babies have been stillborn or who have themselves personally suffered infections or complications post-birth at the hospital. Very upsetting stories. Of an often very personal nature. Life-changing events for these women and their families.

These stories have been used by the media to argue that particular doctors at the hospital are unfit to practice.

It is not the media’s responsibility to judge the competency of medical staff at this or any other health service and their use of women’s very personal experiences to this end does not honour these mothers or the memory of their babies.

Instead, the stories have been used to create emotional leverage bordering on hysteria, all the while touted as “giving mothers a voice”. Meanwhile these women have shared their heart-wrenching stories with the world – but to what end?

Many media segments have similarly implied that every baby death at every Victorian hospital is the direct result of medical mismanagement. Sadly, there are babies born every single day in Victoria who never take a breath. The perinatal mortality rate for Victoria in 2011 was 10 in 1,000 births. The reasons for these deaths are often a complex combination of macro structural issues and individual management – important factors that need ongoing close and careful examination by people with appropriate experience and training such as the Consultative Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM).

One newspaper article last year listed the “likelihood” of baby deaths in specific Victorian hospitals. Interesting stats but what do they really mean and to what end?

These are local community hospitals that people rely on for their healthcare.

There is rarely an alternative service for these people to choose. What do locals do when they lose trust in their neighbourhood health service? And what exactly does it mean that babies are 80% more likely to die at your local hospital? There was no attempt to contextualise these statistics.

At what point does the media take responsibility for the impact this kind of reporting has on undermining local trust in health services?

Bacchus Marsh is a local hospital. It has been a great option for women in the area with normal pregnancies to receive maternity care and to birth close to home. The number of women booking  to have their babies there increased exponentially over the last ten years.  Despite departmental concerns, the hospital is still open for business and presumably it’s staff are trying to somehow rebuild some of that local trust they gained as the hospital’s birth rate grew and grew over the last ten years.

From all this it seems that there are really two key issues that need addressing in this situation:

1. the professional regulation of medical and allied health practitioners is currently the responsibility of AHPRA, and its actions are being called into question, especially regarding delays into investigations of practice. No doubt this is a complex issue related to process and structure.

2.The other issue involves systems of management and leadership for hospitals in Victoria to ensure safe practice and good health outcomes in these services. Not exactly a racy media hook, but good structures can improve accountability and importantly,  help to ensure that people trust their health services to provide safe care for them.

So why not focus on investigating these issues rather than fishing around for allegedly shonky operators who are unlikely to be solely responsible for large numbers of baby deaths, or bringing down the names of local health services who may or may not have practice issues related to their statistics?

If a health service is truly dangerous it should be shut down – no question.

But my heart is with those dedicated health professionals still working at Bacchus Marsh – battling every day the fallout from media stories denigrating their work.

It’s also with the women and families who have shared their stories of heartbreak publicly. Maybe their experiences will help us see the human side of the statistics.

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The Roar Behind the Silence: book review

Soo Downe and Sheena Byrom are midwives from the UK with long and illustrious clinical careers in midwifery and also many midwifery research projects and publications to their names.

This year they published an edited collection of brief, sharply edited chapters written by 50 (count ’em) different authors.

The topic that the book deals with is the need for maternity services to be based on a philosophy of kindness and compassion: [back cover blurb]

For many years there has been growing concern about the culture of fear that is penetrating maternity services throughout the world, and that the fear felt by maternity care workers is directly and indirectly being transferred to the women and families they serve.

The consequences of fear include increased risk of defensive practice, where the childbearing woman and her family become potential enemies to those providing her care. In addition, the prevailing risk management and ‘tick box’ culture in maternity services encourages maternity workers to give priority to the records instead of the woman. These factors contribute to the dissatisfaction felt by those using and providing maternity services. There is however increasing evidence that kindness, compassion and mutual respect improve efficiency, effectiveness, experience and staff morale within healthcare settings.

The book is divided into three sections:

1. Stories and perspectives from maternity care.

2. Principles and theories.

3. Making it happen: solutions from around the world.

This is an action manual for creating change.

These are issues that are not only for the UK to be concerned with –  in Australia we have important problems to address with regard to how maternity care is provided, how women are respected within particular models of care and, of course, with regard to rising caesarean section rates and the consequences of this.

The chapters in the book are written by people as diverse as…

Kirsten Uvnäs Moberg:  a medical doctor and author of two books on the physiology of oxytocin. Her take on the impact of intervention on the action of oxytocin should make us reconsider the “safety” of many interventions which effectively block the action of the hormone.

Alison Barrett: an obstetrician who practises in New Zealand, and talks about how motherhood is not valued in western culture, “which is a nice way of saying that our culture (still) hates women” (page 63). She describes how every woman in the maternity system deserves the Best of Care. Every woman. She invites us to examine the barriers in our own minds that prevent us from providing this.

Milli Hill:  is a writer and campaigner and author of a book on water birth. She is the founder of the Positive Birth Movement – a grassroots organisation designed to promote discussion amongst women about positive birth. It emerged as an antidote to the widespread cultural fear of childbirth. As she says: “women in the PBM network consistently report that being treated and spoken to with kindness and respect is at the heart of a positive birth experience” (page 189).

Anna Byrom: is a midwifery lecturer who has used drama through Progress Theatre to explore issues through critical reflection and discussion and debate in maternity and general healthcare services. The chapter, co-written with Adele Stanley, Gemma Boyd and Kirsten Baker, outlines how their methods have enabled understanding of different participants’ experiences in healthcare settings as well as personal development – with a view to providing compassionate care.

Mavis Kirkham:  is a midwifery researcher who has written about and researched midwifery for 40 years. Her work has often focussed on the context of midwifery work and what kind of care this produces. Her chapter argues that  the NHS maternity care system is a powerful shaper of how midwifery care is delivered. We can’t ignore the impact that a system which oppresses midwives has on the way care is given.

Hannah Dahlen: is an Australian midwife researcher and practising midwife who is a professor of midwifery at Western Sydney University. Her research has covered topics such as episiotomy rates, perineal safety during birth and the impacts of place of birth and antenatal care on birth outcomes. Her chapter in the book (co-authored with Kathryn Gutteridge) looks at how the fear of midwives impacts on the experience of women during pregnancy and birth – how models of care based on risk alone take so much away from the the miracle of the
experience…and also the joy of doing midwives’ work.
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Maybe you don’t usually read books about midwifery?

That’s ok.

This is unlike any midwifery text I’ve read – the chapters are readable, understandable, distinctly lacking in researcher or academic jargon, and contain many stories.  They are also SHORT, concise and written in such a way that if you want to find out more about a particular person’s work or point of view, you can easily do so by looking at the reference list for each chapter or googling the organisations and publications referred to.

It is also a great way to find out the names of people who are doing interesting and stimulating work in our profession.

The other amazing thing is that at the end of each chapter there are summaries of key messages, and then a list of action points: what you can do – as a midwife.

I’m excited about this book because it has the potential to enliven and excite our profession towards change – a change that is centred on kindness and compassion for the women and families in our care.

The book is available for purchase online (for less than 20 bucks) via Amazon or Book Depository or locally through Capers: http://www.capersbookstore.com.au

Do yourself a favour.

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10 things I want to tell you about midwives.

Aaah…listicles. The favourite friend of the blogger.  I’ve got some thoughts to share about midwives. Thought you oughta know.

1. Midwives are trained to care for the “normal” in pregnancy and childbirth.

“Normal”, however, is a setting on the washing machine.  Midwives actually have the skills to provide care for ALL women during pregnancy and childbirth. Sometimes this care is in collaboration with a qualified or trainee obstetrician, and sometimes other medical specialists too. Midwives can stay focused on the woman’s transition to motherhood – psychologically and emotionally, while others provide their expertise.

2. Midwives like looking after “normal” pregnancy and birth.

Often the midwife’s work is to keep pregnancy and birth normal or even take steps to bring it back to normal when things go astray. Sometimes this can be bloody hard work, especially when other forces seem to be pulling in different directions.

3. Midwives take postnatal care seriously.

It’s neither “dramatic nor technologic” but it matters. To mothers, to families and to our world. And midwives do it. No other group of professionals have the expertise or passion that midwives have to provide this care. But women have low levels of satisfaction with their postnatal care, compared to other episodes of maternity care. We don’t know why…is it the care or is it something else – like the questions we are asking…or comparing it with other episodes of maternity care?

4. Wherever midwives are recognised care providers in the world, normal birth is advocated for.

http://midwives4all.org promotes the evidence that proves midwifery care assists in reducing maternal mortality and morbidity rates and neonatal mortality rates. All women deserve midwifery care.

5. The world needs more midwives doing research into midwifery.

There is very little encouragement for midwives to do postgraduate study and learn how to do research. Consequently the research focus in many maternity hospitals is determined by medical staff.  Midwives need to be equipped to do their own research – that way they can investigate the issues that matter to them as a profession and find solutions to clinical problems that matter. Dollars and pathways are needed.

6. Midwives are revolutionary by nature.

Even when they work in institutions, midwives know they do their best work when then follow the needs of the women they care for. This means they often have to defy the needs of the institution in which they work. When midwives work outside of institutions, they are criticised for doing ‘risky’ work.

7. Midwives are often oppressed by the structures they work in.

This can be especially problematic when the policies of that institution prevent them from providing the care for women that is needed and wanted. This makes them seem rebellious at times, and difficult to manage. Sometimes they go “underground” in order to do their job.

8. Midwives gain immense satisfaction from the work they do.

This means they often put up with a lot of criticism and confrontation to keep doing their job.

9. The work of midwives has consistently been undermined by others with vested interests in their sphere of care.

These interests are invariably about the amount of money to be made by providing alternative care to that of midwives, not in providing safer or better care for women. When history is read from the point of view of hospitals and the public health service they have provided, it may appear that they were trying to protect the interests of women. Complication rates were initially very high in these institutions, however, and were patronised by women who were too poor to even give birth at home.

10. Midwives have a significant role to play in public health.

Midwives provide primary health care at a significant time in a woman’s life. They have the potential (often realised) to encourage significant health behaviour change in a woman and her family during this time (think: smoking, nutritional choices, illicit drug use, general exercise and activity levels). Midwives primarily enact these changes through their care relationships with women.

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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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Scientific Motherhood

ModernPriscilla1929-03When I was studying midwifery, approximately 100 years ago, I decided to write an essay on parenting advice.

It was probably a pretty crappy piece of work.

The internet was not really something you surfed back then. Research was all about library books on shelves and some midwifery journals (paper ones, in the library).

None of which seemed to have anything to say about this topic.

I can’t remember the major texts I cited back then, but I do remember coming to the conclusion that parents should be encouraged to trust their own instincts with regard to parenting.

Controversial stuff for a student midwife with no experience of parenting at all. Partly, I think I was overwhelmed with the prospect of teaching new parents about something I knew nothing about. Hand it over to them, sister. It made sense.

Turns out maybe I wasn’t so wrong.

The last hundred years or so in the industrialised world has seen a bunch of people termed “parenting experts” telling parents how to raise their children. Given that not so long before that children were usually seen as economic units: mini- adults suited to working in confined areas, like chimneys and sweat shops, I guess it was nice at least that someone took an interest in whether they lived or died.

Mothers were also seen to be solely in charge of child raising (see my post on the Cult of the Mother). Sounds good, but unfortunately they ended up caught in a trap: when concerns arose over infant mortality rates in urban areas in the US, mothers took the lionshare of the blame. Mothers were collectively blamed for poor hygiene, poor diet, not breastfeeding or breastfeeding poorly.

Germ theory made a few things clear, but it took years for the message to get out: babies got ill because of exposure to viruses and bacteria, viruses and bacteria thrived in dirty drinking water, poor people often had to rely on contaminated drinking water…should do something about that dirty drinking water.

The new profession of paediatrics leapt into the task of developing formula for babies whose mothers were unable to breastfeed them.  This was much needed, when so many babies died before their first birthday.  This unfortunately turned into a way to feed babies when women were having problems with breastfeeding, and then, into just a different way to feed your baby. Formula feeding was, initially at least, managed by the medical profession. Paediatricians’ main work was largely in infant feeding plans.

Parenting books started to be written in the 1920’s, but Dr Spock was the breakthrough text in 1946 with his Baby and Child Care. 

The book was predicated on the idea that parents “know more than they think”. There was gentle encouragement for parents to “trust their instincts”. Unfortunately most of the information in the book related to bottle fed baby behaviour. Again parents were gently encouraged to breastfeed, but if it proved difficult, there was always bottle-feeding.

And there were regular reminders to consult with your doctor to check that your instincts were indeed right.

Today there are approximately one gazillion people who write and blog and speak about parenting. Some of these instruct  inflexible and routinised methods to make absolutely sure babies will sleep for long periods.

The good ones let parents know about normal baby and infant behaviour to help them adjust their expectations of what “normal” is (it’s a cycle on the washing machine last time I checked).

Then gentle encouragement to go for that elusive goal: “what works for you”.

A thing I say when talking to parents-to-be in antenatal clinic: “we midwives know a bunch of stuff about lots of babies, but not about your baby …. pretty soon you’ll be the expert there.”

Here are some links to good baby stuff:

http://www.pinkymckay.com

http://raisingchildren.net.au

https://www.breastfeeding.asn.au

 

 

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.