Sunday 31 August 2014

Unrealistic expectations: 16 truths and myths about feeding your baby


Deciding to breastfeed my newborn baby seemed the obvious choice - why would I not want to do something so natural and beneficial to my baby? Every time I went to see a midwife I would be greeted with posters and pamphlets full of pictures of happy mothers breastfeeding their babies. I never once thought that it would be a challenge. The problem is that there are a lot of myths surrounding feeding a newborn baby that can be most unhelpful for new mothers.

Unfortunately, much of the information that new mothers are provided with may leave them feeling like they are doing something wrong, or that they are a failure if they find breastfeeding difficult or if they choose to (or have to) use formula. From the experiences of most of my parent-friends, they didn't realise how much of a challenge feeding could be and many faced disappointment or felt disillusioned in the first months of parenthood.

Below are a list of things I was told as facts before I breastfed my baby, many of which were unhelpful or not founded in truth. I decided to look into these things to see if I could find any evidence as to whether they were actually true or not. I will say though, that although I have tried to research the facts as accurately as possible I am obviously bound to be influenced by my own experiences too. I am not an expert in medical research and would therefore encourage you to look up these things yourself if it is important to you. My aim is to support women whatever their feeding choice and give them better information so that they can be better prepared and seek the right help if they need to and have more realistic expectations of early motherhood.

1. Breastfeeding will happen naturally.
False. Only 23% of mothers are still breastfeeding at six months (1) which gives you a clue as to how difficult it is. What is expected to be the most natural thing in the world takes a lot of practice and determination. As opposed to one popular myth, I do not think babies 'instinctively' know how to feed – it is a learnt process for both the baby and mother. Mothers can develop mastitis, thrush and will most certainly experience some pain in at least the first week of feeding. Many women go on to find that the pain eases and breastfeeding does indeed become easy and even pleasant for them. Each mother will have a very different experience, but it is important to know that if someone finds it difficult it is not always entirely down to technique or perseverance - some babies may just be more difficult to feed than others. Other mothers and babies have medical conditions making it more difficult or impossible. It is important that new mothers are equipped with people to help them in the first few weeks of their baby's life and that new mothers are prepared mentally and emotionally.

2. Mothers who formula feed are more likely to have post-natal depression
Partly true. What this fact doesn't inform you is that the group at highest risk were those that planned to breastfeed but couldn't (2). The study concluded that:

“Our results underline the importance of providing expert breastfeeding support to women who want to breastfeed, but also of providing compassionate support for women who had intended to breastfeed, but who find themselves unable to,” they argue.

If mothers were made to feel supported whatever their feeding choice then I strongly believe that this would benefit both formula fed and breastfeeding mothers and lower post natal depression on the whole. I would suggest that one of the most important things is that you do not take on board unnecessary pressure and that you ask for help if it is needed.

3. Babies who are breastfed do not get trapped wind
False. I was told that only bottle fed babies need to be helped to get rid of excess wind after a feed but my baby was breastfed and needed to be 'winded', otherwise he was very restless. He also had colic which actually seemed to ease once he was on the bottle, but this could have been entirely down to his development stage.

4. Breastfeeding reduces the risk of cancer for both mother and baby
True. But this is only relevant for babies who have been breastfed for over six months. Those breastfed for up to six months do not appear to have any decreased cancer risk compared to bottle fed babies. (3) As most mothers stop breastfeeding by six months I would suggest that this statistic is irrelevant for the majority of the population. There is also evidence to suggest that ovarian cancer is reduced for women who breastfeed but again this is only significant in mothers who breastfeed for two years or more (4) which I consider highly impractical for most women. What does this also mean for women who never have children?

5. Babies who are breastfed have increased immunity and reduced risk of allergies
True. This is probably one of the biggest reasons for choosing to breastfeed because breast milk passes on the mother's antibodies to the baby. There is evidence to suggest that babies who are breastfed have healthier immune systems for the duration of breastfeeding, others say longer. From many of the studies I have found it was hard for me to conclude just how much breastfeeding reduces allergies by. One stated that asthma found in breastfed infants was 7.7% as opposed to 12% of formula fed babies in the first two years of life (5). Another study concluded that children with asthmatic mothers were actually more likely to develop asthma later if they were exclusively breastfed. (6)  There are numerous studies done on this so you may find some of the links at the bottom of this post helpful.

6. Breastfed babies are exempt from infections and illnesses
False. Although babies may be less likely to pick up infections during the period of breastfeeding, it is likely that once they are on solids and in settings such as nurseries and play groups that they will pick up plenty of illnesses in the first 6-12 months of life regardless of if they are breastfed or not.

7. Breastfeeding serves as a contraceptive
Partly true. Although breastfeeding is supposed to have a contraceptive effect this is not a failsafe theory. I know at least two of my friends who have conceived whilst breastfeeding so it is more common that you think.

8. Bottle feeding is expensive
True. Breast milk is free, and although you will most probably be spending more on the weekly food shop for yourself to stock up on calories, your extra expenses may not be as high as a tin of formula. The cost of formula feeding is approximately £40/month for six months (or until your baby is on solids).

9. Breastfeeding prevents obesity
Inconclusive. There are studies to suggest that breast milk lowers the risk of obesity in children, alongside others that say there is no evidence for this (7)  I would suggest that if parents who bottle feed their babies are intentional about giving their children a healthy diet and teach their children about portion control this will have a significantly higher influence on their BMI.

10. Breastfeeding helps mothers lose weight
Partly true. Woman burn up to 500 calories a day by breastfeeding which is all well and good if you are suddenly on a rigorous diet (not very practical or advisable when trying to provide nutrients for your baby!). The reality is that those 500 calories will need to be replenished in order to make sure you have enough energy for you and your baby. I was constantly hungry whilst breastfeeding and put on weight during this period (but this was probably because early motherhood didn't allow time to make myself healthy food and I lived off Haribo instead!).

11. Mothers who breastfeed bond better with their babies.
False. Of course some mothers may find it a bonding experience, and others may not. No one can dictate what is going to enhance that for you and your baby. For some mothers breastfeeding is painful and difficult and they can end up resenting feeding times (hardly a bonding experience). For others breastfeeding is extremely bonding – they feel more relaxed and feel sad when the time comes to give up. Breast feeding may allow for more skin to skin contact, whereas bottle feeding may allow for more eye contact.

12. Bottle fed babies sleep longer
True and false. On the whole formula fed babies will sleep longer because formula keeps their stomachs fuller for longer. Breast milk is easier to digest which means that breastfed babies are likely to want feeds closer together. Other factors need to be considered, though, like the temperament of the baby and other external factors.

13. Bottle feeding is unhealthy
False. Although breast milk is the best option in terms of nutritional value, this does not mean that formula is a bad thing to give to your baby. There has been significant scientific research into creating formula in order for it to have all the nutrients babies need to thrive, otherwise they would not be able to sell it! In some cases formula is better nutritionally if the mother has a deficient diet or has to take certain medication (8).

14. Breastfed babies will have higher IQs
False. One study stated:
"Mums with more resources - with higher levels of education and higher levels of income - and more flexibility in their daily schedules are more likely to breastfeed their children and do so for longer periods of time."
Therefore concluding that intelligence was more directly linked with parenting and resources than any benefits of the actual breast milk itself (9) 

15. Breastfeeding is more convenient
True and False. Many mothers prefer breastfeeding because it is on tap whenever you need it and wherever you go. Breastfeeding also means you are hands free to do things like read a book which you may not find as easy whilst bottle feeding. Other mothers find it an inconvenience having to breastfeed in public or having limited ability to spend time independently. No one method is more convenient than another, it is purely down to personal preference.

16. Whatever is most natural is always best
False. Using contraceptives is unnatural but it doesn't stop the majority of people thinking that they are a better option than a house full of children. You cannot conclude that because breastfeeding is the most natural option that it is better - you must conclude it on it's actual benefits (which are, of course, many). Some conclude that bottle feeding is a recent invention and argue that up until recent years women coped without breast milk alternatives. In actual fact babies have been bottle fed for thousands of years.


There are plenty of other facts and myths surrounding breastfeeding and formula feeding which you may wish to look into, (although it is unlikely you will be able to make any substantial conclusions without investing considerable time into it, or conducting studies yourself!). The research is so varied and has different contributing factors which means that it is very difficult to be well informed. I do, however, hope that some of what I have written will dispel some myths for new mothers and enable them to feel confident about their feeding choices.

If you choose to breastfeed then you should be referred to a breastfeeding support worker who can give you help and advice. You may also find The breastfeeding network helpful.

If you decide to formula feed you may find The Fearless Formula Feeder website helpful.

References
taken from hscic.gov.uk
2 Taken from The NHS News, based on latest research.
3 benefits of breastfeeding, Natural resources defence council (nrdc.org)
4 benefits of breastfeeding, Natural resources defence council (nrdc.org)
5 archives of disease in childhood (adc.bmj.com)
6 http://www.ncbi.nlm.nih.gov/pubmed/11182011
7 taken from the American Journal of Nutrition
8 taken from livestrong.org
9 parentdish.co.uk and Bingham Young University, Eurekaalert.org

Other references:
http://www.ncbi.nlm.nih.gov
http://www.unicef.org.uk/BabyFriendly/News-and-Research/
http://kellymom.com







Sunday 17 August 2014

War wounds: coping with birth trauma

Women are amazing creatures. You realise that, no matter how the birthing experience goes, that mothers are pushed to the limits of their physical capabilities. Despite my birth not going to plan I didn't really have time to think about that amongst tackling feeding, changing nappies and an endless washing pile. I talked about my traumatic birth to those close to me but there was no time to process what I'd been through - it was a case of plodding on with the intensity of motherhood. My birth went so wrong that it almost made a good story and I didn't mind telling it, or finding the humour in it.

After the chaos of motherhood had died down and I battled through a somewhat difficult year with a feisty and very hungry baby, I found that certain situations would provoke a reaction in me. Friends would tell me of their 'easy' births (if there's ever such a thing) and I would feel all this anger in me. I would avoid hanging around with people who were blissfully enjoying motherhood because I felt like a failure compared to them. Women who found breastfeeding bonding or enjoyed waking up in the night to rock their little one or loved their new life of mums and tots groups made me run a million miles away. I found myself avoiding certain friendships or conveniently going to the toilet whenever the subject of birth came up. People would ask me "when are you having another, then?" and every time I'd feel like they may as well have said to me that my pain was not valid; that my struggles didn't count. I found the question insulting, as though they'd just asked me when I would be going to war again.

Now, I'm a very open person, but mental health issues are very difficult to talk about. There's almost a taboo about admitting you have any sort of weakness, as though one affecting your mind is less serious than one affecting your physical body. In the light of Robin Williams' death it has helped me to understand the importance of honesty about mental health. I may not be able to tell you these things in person but for some reason I can write about them here.

At a wedding, two years after my son's birth, I'd left him with his Nanan and I was looking forward to letting my hair down. Instead, I found myself sat on a table full of other mothers, mopping up dribble and talking in baby language. I was forced to talk about teething and nappy rashes and I suddenly felt physically sick (and, no, I wasn't even close to intoxication). Someone started talking about how much they were enjoying parenting and how they couldn't wait to have another child, which provoked everyone else to join in with expressing the joys of motherhood, whilst they cooed over their little ones. Feelings of anger and inadequacy rose up and I had to make a quick exit. I sobbed in the toilets for over an hour. Sobbed. For an hour. Two years after my birth. That's not normal, right?

The weird thing is I was enjoying motherhood. My screaming child had turned into an entertainment system that made me laugh everyday, gave me cuddles and was full of character. I wanted to experience that again but I how could I? How could someone willingly go to war?

My decision to have another child, nearly four years later, didn't come easy. Deep down it was what I wanted and I was so used to blocking out negative feelings about birth and avoiding other mothers (and weddings) that I just allowed myself to think of all the good times of having a child and the life we would have in the future.

And then I got pregnant.

And it was like a hurricane just blew threw my house and I couldn't see for all the dusty memories I'd swept under the carpet which were now encircling my head. I started to panic. I would literally wake in the night in a sweat. I needed to tell others of my 'joyful' news and instead I wanted to bury myself into a hole and hide. I felt really scared and overwhelmed and no one would understand me. How could you plan a pregnancy that you don't want to go through? It's the most ridiculous thing. I would either be met with expressions of extreme excitement or looks of "what the hell are you doing?" I found neither response helpful. But I wanted another child more than anything.

Thankfully, due to a previous emergency c-section, I was given the option of having another one and Neil and I had decided to grab this opportunity, knowing that I could change my mind at any point. The consultants were, of course, pushing me to have a vaginal delivery but we stuck to our guns because of my past experience. It felt like a weight had been lifted and I knew that I didn't have to deal with any feelings of uncertainty, extreme pain and failure again.

But the feelings of relief were short lived. Something was deeper.

I was referred to see a consultant midwife to discuss my feelings about the birth. She was the first person who validated what I'd been through. She looked through my pages of notes from my delivery and expressed her total understanding of me wanting a c-section. She listened to me and she made me feel like I was not the weak person I thought, but I was, in fact, extremely brave. She told me I had symptoms of post traumatic stress and referred me to a clinical psychologist who I am now seeing on a weekly basis.

I'm finding this time in my life the most intense I've ever been through. There are things that have come to light that are much deeper than childbirth or physical pain. I have deep-rooted beliefs about myself which are extremely unhelpful and affect my daily life. My life has been about avoiding failure, avoiding pain, avoiding mistakes. If you're a parent you will know that's impossible.

When I started this process I wished I had done it sooner after my birth. Now I wish I'd done this long before I'd even thought of having children. Motherhood is such an intense time and brings about all sorts of emotions which you can brush under the carpet or deal with. This is not always easy and can be very painful, but vital none the less. If you've had negative emotions connected with pregnancy or parenting (or anything, actually) I would urge you to pursue help. Please don't let your fears control you and stop you from having the life you want.

If you're struggling with birth trauma or negative feelings associated with birth or motherhood you may find these links helpful.

http://www.birthtraumaassociation.org.uk
http://www.pandasfoundation.org.uk






Sunday 10 August 2014

The twelve things new mothers need to know.

no pain relief, childbirth, things all mothers need to know, birth certificate, mother diaries, parenting, motherhood
www.lisamaltby.com
If you're pregnant or a new mother you will probably find that you are bombarded with advice about how to be a parent. I listened to a lot of stupid things I shouldn't have and put way too much pressure on myself as a new parent. Looking back I wish I had listened to these things instead:

1. Your birthing experience will not go on your resume.
Whatever your birth is like, whether you deliver your baby in two hours or thirty six, whether you have no drugs or an epidural, it DOES NOT MATTER. Please don't put pressure on yourself to have a particular birth – preferences are great but ideals are not. However your delivery goes you deserve a medal just for bringing a little person into the world.

2. Trust your own instincts.
The love you feel for your little one will be overwhelming. You'll be bombarded with advice about what is best for your child but don't allow it to consume you – only you will really know what is best for your baby so trust yourself and don't feel guilty about saying "thanks, but no thanks" to any advice that isn't helpful. Take others' comments with a pinch of salt and trust your own instincts.

3. Take all the help you can get.
If a friend offers to cook you a meal, look after your baby to give you a break or clean your house then two little words are in order: "yes, please." Grab all the help you can get because you would be crazy to think that you can do it all on your own (unless you have super hero powers). You don't get any medals for seeing how little sleep you can live off or for cleaning your house one handed whilst feeding a baby. You are human. You will need help.

4. Be kind to yourself.
It seems ridiculous when you're a new mother that you should ever prioritise yourself over your baby, but it's really not. A happy mother is a happy baby – I honestly believe that. Make sure you put yourself first every so often. If your baby naps and you have a choice between hoovering up and grabbing some sleep too, take the sleep! Life always feels much better after a nap. And if you haven't started the day with a well needed coffee then put your baby down for two minutes. Babies don't have to be held all the time and, believe it or not, they can wait a few minutes longer for food. Get a baby bouncer so you can do things like get a sandwich or have a shower whilst supervising them. Choose the things that make life easier for you and don't beat yourself up.

5. Be real.
You will have days where you feel like you can't cope, days when you want to chuck your baby out of the window and days when you feel like you're the on top of the world. Learn to be a little more rational and try to take your emotions with a pinch of salt because they may well be all over the place. If you can't face seeing people right now that's okay, just know that after a nap, some food or on a day where your baby isn't crying all day you may well feel like a different person. However, being a mother can be really tough so it's important that if your feelings get too overwhelming that you are honest with people. Motherhood is often idealised and makes new parents feel less able to talk about any negative emotions associated with having a baby. It's important to always be real with yourself and others so you can get help where it's needed.

6. What feels like forever will feel like five minutes in a few years.
You'll feel like you're the only mother up for hours in the night or that you'll be physically feeding them forever. Although it will seem impossible to get your head around right now, there will come a time when you will have a full night's sleep again, your child will feed themselves and you can leave them in front of a whole Disney film while you read the paper. Try to gain perspective and enjoy the cuddles and smiles, knowing that the dirty diapers and sleepless nights will also be over before you know it.

7. It doesn't matter how you feed your baby (within reason!).
It is no one else's business how you choose feed your baby and both breast milk and formula are healthy methods of feeding. Whatever choice you make do it because it is genuinely the best for your family and your sanity.

8. Everyone is different.
Every woman will have a completely different birth experience and will also choose completely different parenting methods. Every baby will be completely different and respond to different parenting techniques in different ways. Just because one piece of advice worked for one baby it doesn't mean it will work for yours. Take the advice that benefits you and leave the rest. Please don't take on board other people's judgements of your parenting, but likewise have grace for others who choose to do things differently to you.

9. Have a sense of humour.
Laugh. Laugh at discovering you have sick all over your back when you're walking down the street or that you accidentally flashed your boob to the mailman mid-feed. If you can laugh at the downs you will never have laughed so much in your life. Take yourself a little less seriously and you'll have a lot more fun because of it.

10. Give your body time.
Your body has gone through a massive trauma by delivering a baby into the world, give yourself time to heal. So many mothers agonise over how their body has changed or are too keen to get into the fitness regime and lose the baby weight. Concentrate on getting used to life with a baby first - respect your body for what it's been through and try not to speak negatively about it. You will be able to lose the baby weight but these things take time and commitment.

11. Think of crying as baby talk.
Babies cry. A lot. Some babies cry more than others. If you have a baby that cries a lot this has no reflection on your parenting skills, it just means they will probably grow up to know more of what they want in life and be a good communicator. Babies cry in the most awkward of situations (like when you're driving!) so try to keep your cool. If you can't work out why your baby is crying after you've checked for the obvious (hunger, tiredness, signs of illness etc.) then it's okay to leave them for a few minutes whilst you grab yourself that well-earned coffee.

12. Don't forget who you are.
Please, please, promise me that after a year of parenting you will not have filed away your favourite past-times or ambitions. You are still the same person you were before you had a child – sure, it may be harder to do the things you did before but you can still bring elements of them into your life. Don't become so consumed in diapers that you forget what you're about. You will do your chid a favour by letting them know that, although you love them more than anything, your world does not solely revolve around them.

If you're a mother, what advice would you have given yourself as a new parent?