Welcome to Guilt-Free Bottle Feeding{1}

I chose to bottle feed.  I made the decision when I was seventeen, exactly seventeen years before I had my first child.

When I say I chose to bottle feed, what I actually chose to do was to have a breast reduction. I was sick of having double-F breasts stuck on a size ten frame, tired not being able to find clothes that fit properly, resented people talking to my chest instead of my face. When my surgeon warned me of the likely side effects of the operation – scars, loss of sensation, loss of milk ducts – I barely gave the potential inability to breastfeed a second thought. What seventeen year-old is thinking about her future lactation? Besides, I was never having kids, I was never even getting married. I was going to be a war correspondent, tied to no-one and nothing but the truth!

So, it was an easy decision to make.  After my boobs were reduced to a regular ole’ C-cup I blossomed with a new found confidence.  I still say it was the best decision I ever made.

What I didn’t realise was how that decision would affect me seventeen years later, when I had got married, and came to the conclusion that maybe adding a baby to my life wouldn’t be so bad after all.

I was prepared for not being able to breastfeed – having a breast reduction is one of the biggest impediments to normal lactation – and I was pretty okay with that.  I hadn’t fondly dreamt about my baby and me snuggling for hours, her at my breast, because I knew in all likelihood, that was never going to happen.

But something strange happened when I gave birth.  Having fallen deeply in love with the tiny creature beside me, and having managed to produce some colostrum, I somehow forgot that I was very likely incapable of nourishing her solely from my body.  I was undoubtedly aided in this by the  midwives, nurses and lactation consultants who encouraged me to ‘just keep going’ and that ‘my milk would come in soon’ even though I told every single one of them that I had had a breast reduction.

Over the next week our delirious happiness alternated with delirium as feeding our baby took centre stage in our lives. I’d sit on the couch, glass of water at my side, pillows strategically placed, and put her to my massive mammaries 10 to14 times a day. As my toes curled up with the initial pain, she would suck, and suck and suck, sometimes for an hour or more. But even though she was at my breast for a good part of the day, she was still losing weight.  My husband and I grew to fear the dark, as she cried every night between midnight and five am, and we desperately tried to comfort and feed her.

Then, on day six, the midwife weighed my daughter, saw she had lost 13% of her birth weight, watched her perfectly good latch, listened to my story about the surgery and said, “I think you should top her up with formula.”   It was all we needed – the medical okay to do what we had instinctively wanted to, but had been too scared to.   Lo and behold, that night she fed and slept and fed and slept, breast topped up by bottle each time, without raging tears. What she had been trying to tell us all along, through all those dark hours, was that she was hungry.

Two and a half years later, we have a wonderfully healthy, happy and intelligent largely formula-fed toddler.  But the experience of being a formula-feeding mum taught me many things.

It taught me how much unrelenting pressure is put on women to breastfeed and how women put this pressure on themselves.  It showed me that whether we breastfeed or not has wrongly become the key measure by which we, and others, judge our success at motherhood.  I learned how, in the quest to promote breastfeeding, formula has become demonised, and how shamefully little practical and emotional support there is for bottle-feeding families.

I’ve started this blog to try to help those of you who, like me, had no idea how to safely make up a bottle.  I also want to show you why there is no need to feel guilty for bottle feeding, because you aren’t guilty of doing anything other than loving and caring for your baby.  Through interviews and videos with experts in the fields of perinatal mental health, child health, sociology and ordinary mums and dads I hope we can provide support and desperately-needed information for bottle feeding families.

There are some wonderful women who have been fighting the good fight for bottle feeding families for a couple of years now – Suzanne at Fearless Formula Feeder and the fantastic team at Bottle Babies.  I hope that between us we can break down the insidious idea we’ve all internalised – that good mums breastfeed and bad mums bottle feed.  My friend Dr Sasha Howard and I have also written a book, (which you can pre-order at Amazon here) to try to do the same.

As a wise woman once told me, good parenting doesn’t come from a breast or a bottle, it comes from the heart.

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  • I’m using formula and I feel guilty… but not for the reason you think

    I’m using formula and I feel guilty… but not for the reason you think

    The guilt started on day four.  Weeping, a heart that literally hurt with pain.  As I put the bottle of formula to my beautiful new baby’s lips I felt overcome with regret.  But not for the reason you think.

    I am perfectly happy to feed my new baby formula.

    The aching guilt I feel is for not feeding my first baby formula sooner.

    (more…)

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  • When the ‘Baby-Friendly Initiative’ is not baby-friendly at all

    When the ‘Baby-Friendly Initiative’ is not baby-friendly at all

    In Britain a quarter of all babies will never have breastmilk touch their lips.  By the time a British baby is two months old, she is more likely than not to be exclusively formula-fed.  Yet there is a conspiracy of silence around formula feeding, that means most of the mothers of these babies will never receive critical information from the people they trust – nurses, midwives and health visitors, about how best to bottle-feed.

    They’re not taught by a trusted health professional the best bottle-feeding position to reduce the chance of ear infection, nor  are they encouraged to bottle-feed skin-to-skin to promote bonding, nor are they told it’s important they throw away all unfinished bottles after an hour.

    For the most part, they get basic information on how to make up a bottle from the side of a tin, and pick up other tips through crowdsourcing on the internet.  Because those are really great ways to learn about one of the most important things you’ll be doing for your baby in the first few months of her life.

    This state of affairs is shameful, and negligent, and a large part of the blame must go to Unicef and its Baby-Friendly Initiative.

    The Baby-Friendly Initiative is Unicef’s hospital breastfeeding program.  Its aim is to make hospitals more breastfeeding-friendly places – an admirable goal.  It does this by giving accreditation to hospitals and other health services which implement its policies.  At the moment, around half of the UK’s maternity services and health visiting services are certified ‘Baby-Friendly’.

    Unfortunately, this well-intentioned effort to make institutions more breastfeeding friendly has led to bottle-feeding mothers being ignored, their babies missing out on crucial health information, and promoted feelings of guilt and inadequacy because of its ‘breastfeed at all costs’ mentality.

    Last year the BFI changed some of its guidelines to supposedly better support bottle-feeding parents.

    This week, the lip-service nature of this change has been on full display at the University of Bradford.

    The story goes back a couple of months when myself and my co-author of Guilt-Free Bottle-Feeding, Dr Sasha Howard, were invited to take part in a debate about bottle-feeding by the University of Bradford’s Midwifery Society.

    Fantastic!  We were over the moon.  Student midwives who actually want to learn more about how they can help the 25% of mothers who will never breastfeed in hospital!

    This was a bigger deal than you might think – education about bottle-feeding in university midwifery courses is patchy or non-existent (a result of that ole’ conspiracy of silence again), leaving newly-minted midwives largely ignorant about formula and formula-feeding.

    So, Sasha and the lovely student representative were going back and forth about logistics, when suddenly, she received this email:

    “Unfortunately we have had to put the debate on hold as the university won’t support the event. This is due to the university going through accreditation for BFI and being unable to show support for anything to do with artificial feeding.”

    Yes, you read that right – in order to gain ‘baby-friendly’ accreditation, simply talking about the way the majority of British babies is fed is taboo.

    It beggars belief and logic, and I would suggest the ethics of a caring profession.

    Any mother bottle-feeding mother who has felt let down by health professionals (and that’s most of them) should feel angry that Unicef’s BFI is encouraging a deliberate denial of information to young health professionals who want that knowledge, because they know they are going to need it in order to give the best care they can, to the most women they can.

    How is it baby-friendly to leave mothers with little to no knowledge about how they will, more likely than not, be feeding their baby in two months time?   This ‘promotion’ of breastfeeding through denying the very existence of formula has to stop.  It’s not ‘baby-friendly’, it hurts babies and their mothers.

    And the crazy thing is, the BFI doesn’t even really make that much of a difference to long-term breastfeeding rates.  It has increased the initial uptake of breastfeeding, but a large study of low income British mums found women who gave birth at a BFI-accreditated hospital were no more likely to be breastfeeding at one month than women who had given birth in an unaccredited hospital.

    In Australia, there are far fewer BFI-accredited hospitals, but more women breastfeed, and for longer.  There are many cultural reasons for this, but it shows that the big stick of the BFI is not the answer to improving breastfeeding rates.

    If the Baby-Friendly Initiative were really baby-friendly, it would recognise that the best thing it can do is support all babies’ mothers, regardless of how they feed their babies.  The conspiracy of silence around formula, and the risk that lack of information creates to babies’ health, has to stop

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  • Travel perks for breastfeeding MP mums are unfair – all new MP mums should get them

    Travel perks for breastfeeding MP mums are unfair – all new MP mums should get them

    Australian MPs who are breastfeeding will now be entitled to ask for extra flights to bring their partners and nannies interstate, it’s been reported today.

    Given the recent scandals involving Australian politicians’ travel expenses, the fact that MPs are going to be allowed to claim more business-class trips is raising ire.

    But I’ve got another, more fundamental question – why only breastfeeding MPs?  What about new mums who are bottle-feeding?

    (more…)

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  • Vaccination, bottle-feeding and a moral quandary

    Vaccination, bottle-feeding and a moral quandary

    My father’s friend is incredible.  He never forgets a birthday, an anniversary, an opportunity to congratulate you on your latest achievement.  It’s impossible to out-compliment him; despite rising to the height of his profession of broadcasting, being on numerous national boards, he is the definition of charm and humility.

    He also walks with a cane, a two inch build-up on his right shoe and has limited use of his right arm and right leg.  He was born with polio, which his mother contracted while pregnant with him.  He is a triumph of a human being, and although his polio no doubt helped make him the man he is today, he is also a walking advertisement for why vaccination should be seen as a universal right as well as a privilege and a brilliant idea.

    The Australian government has just announced it will deny childcare benefits worth up to AUD$15,000 to parents who don’t vaccinate their children.

    As a fierce supporter of vaccination I might naturally be expected to shout ‘hallelujah’ at the news, but honestly, it has left me feeling a little conflicted.

    I believe vaccination is, with very rare exceptions, universally good.  I believe it is not only the responsibility of parents to take advantage of this amazing discovery of science to look after their own children, but it is also their responsibility as members of a community to help create herd immunity and protect those who can’t be vaccinated for medical reasons.

    So far, so easy.

    But as a bottle-feeding mother who has openly questioned the dogma of ‘breast is best for all babies at all times’ , in which it often feels like parents are punished for taking a decision outside the government-mandated norm, the idea sits a little uncomfortably.

    Let me be clear; I am not equating vaccination with breastfeeding.  Vaccination stops a host of terrible diseases that kill and maim.  Breastfeeding does not.  Not vaccinating is exposing your child, and other children, to unnecessary risk of serious illness.  Not breastfeeding means your kid might have a handful more episodes of diarrhoea in their lifetime, or potentially one or two more colds.  Not vaccinating is a choice.  For many women, not breastfeeding is not a choice; it is a biological or sociological diktat they are forced to follow.

    So, what makes me squirm a little?  I think it is the punitive nature of the new policy.  I worry that when governments legislate about choices parents make for their child, that they encroach on a domain that is not theirs.  I harbour a fear that if we go down this route, that when it comes to feeding, one day we could all end up like the United Arab Emirates, where it is mandatory for women to breastfeed their children until they are two (and husbands can sue if they don’t.)

    Knowing how demonised bottle-feeding parents can be for their choices, by other parents, but also by some of the medical establishment, often on the basis of ‘evidence’ that is misinterpreted, old, or just plain unreliable, the demonisation of parents who don’t vaccinate makes me feel uncomfortable too.

    The difference is, the evidence on the benefits of vaccination is a lay-down mazere.  The evidence on breastfeeding less-so.

    I don’t want my daughter going to a daycare where kids in her class aren’t vaccinated.  I  don’t want people to be sucked in to the bullshit pumped out by the anti-vaxxers, who prey on vulnerable parents using a combination of half-truths and straight-out lies mixed in with a dogmatic believe in ‘the natural’ and an imaginary media-big-pharma conspiracy.

    It would be travesty if we went back on a century of science, because our Western privilege has made us forget how serious pertussis and tetanus and measles and mumps and rubella are, and how lucky we are to live in a time and a place where we can do something about that.

    I think the question is, will stopping childcare benefits actually change the behaviour and outlook of parents.  Is the stick any better than the carrot in this case?

    I’m not sure.  In my experience, waving a big government stick at people who are already suspicious of government doesn’t really change opinions, it just embeds them.

    But is encouraging uptake of vaccination the aim, or is the aim simply to protect the majority of children?  Surely it must be both.

    So, with some reservation, I support the new policy, and I really hope that it has the effect of not just keeping unvaccinated kids out of daycare, but also of encouraging parents to get jabs for their kids.  Let’s also hope that rather than simply demonising parents, it can also be accompanied with some straight-talking, no bullshit education, because that’s what eventually wins over hearts and minds.

    At its peak in the 1940s and 1950s polio killed or paralysed half a million people worldwide every year.  In 2013, the number was 416.  That was down to vaccination.

    As anyone who has ever known anyone with polio can attest, this is nothing short of miracle – not of God, but of science, education and humanity.

    Vaccination is a good thing.  We shouldn’t need $15,000 in benefits to convince us of that.  But if nothing else will, then we may as well give this a crack.

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  • Breastfeeding, brains, Brazil and a brouhaha about nothing

    Breastfeeding, brains, Brazil and a brouhaha about nothing

    Over the past week the headlines have been triumphant:  “The longer babies breastfeed, the more they achieve in life – major study” from The Guardian. And “Breastfed babies grow up smarter, richer, study shows,” from The Telegraph.

    Around the world, two things happened – breastfeeding advocates shouted “See – we told you so!!!”  And non-breastfeeding mothers either wept over their formula tins or furiously typed into comment boxes, “But I can’t!  Mastitis and… pumping… PND…. Don’t you dare judge me!”

    Now, you might expect a person who wrote a book called, “Guilt-Free Bottle-Feeding:  Why your formula-fed baby can be happy, healthy and smart” to be in the latter category.  But actually my response was a big, fat:

    “Meh.”

    It was so meh that I wasn’t going to bother writing about it, but the continued attention it’s received has drawn me out of my meh-ness, to explain why, as the mother of a predominantly formula-fed child I am not at all perturbed by the study and its findings, and why you shouldn’t be either.  So here goes:

    1) The study doesn’t tell us anything we don’t already know, or didn’t already suspect.  Multiple studies into children have suggested a small dose-response boost in IQ from breastfeeding.  This study is unique in that it tested adults, but it’s not surprising that it finds adults receive a small boost in IQ from breastfeeding if it’s already generally acknowledged that kids do.

    2) The non-breastfed babies in this study received formula that didn’t have added long-chain polyunsaturated fatty acids added to it.  The authors themselves theorise that these brain-boosters, which are found in abundance in breastmilk but not in regular formula, could be behind much of the IQ boost.  If the babies in the study had been given a modern-day formula with added LCPUFAs in it, it is very possible, even likely, that the boost in IQ points might have been less than 4 points.

    4)  Four IQ points ain’t that much.  In practical terms, it has an almost immeasurable difference on day-to-day capacity on an individual level.  Now, the study’s authors posit that the boost they found in the breastfed babies’ incomes in their study was down to the group having a higher IQ.  However, as one of the authors, Dr Bernardo Lesso Horta acknowledged in a Lancet podcast this week, breastfed babies tend to come from wealthier homes, “So there is always a question of whether [an outcome like higher IQ] is a consequence of breastfeeding by itself… The kids who are breastfed are wealthier.”  So, maybe they have other advantages in life which can help boost their IQ.  Either way, I challenge you to tell the difference between someone with an IQ of 112 vs 116.

    5)  There are so many other things than affect a child’s intelligence over time.  The type of parenting a child receives has a far greater effect on intelligence than their early nutrition: the amount of books in a home, the number of words a child hears everyday, encouragement to learn, help with homework, providing a healthy learning environment and a child’s school.  And as Dr Amy Tuteur, ‘The Skeptical OB’ pointed out, the same study actually showed that maternal education, family income and birth weight have a bigger effect on IQ than breastfeeding.

    6)  There are many families where, taken holistically, breastfeeding is the less good option.  For example, if a mother’s post-natal depression is exacerbated by breastfeeding, if breastfeeding hurts due to repeated mastitis, or babies can’t latch, or mothers have to go back to work and can’t or don’t want to manage the burden of pumping.  Or, God forbid, a mother just doesn’t like breastfeeding.  A mother that is happy and healthy is more likely to produce a happy, well-rounded child, and that has effects throughout a child’s life, including in academic and career success.  This likely has far more impact than the purported benefits of breastmilk.

    7)  Forty percent of the original study participants dropped out.  As The Atlantic pointed out, this could significantly affect the outcomes of the study, because it is those on the lower end of the socio-economic spectrum who are less likely to be pinned down and return for follow-up testing.  This may have skewed the results towards those on the upper end of the social spectrum, who are more likely to be wealthy and then produce more wealthy kids.

    To be clear, the study is well-designed, has been well-conducted and its authors are to be applauded for this.  But it is not without flaws and caveats.

    So, formula-feeding mothers of the world, put away those tears and keyboard clicks of rage.  This study changes nothing for you, and your children, whom you are doing the best for every single day.

     

     

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  • Top Ten Tips for bottle-feeding parents

    Top Ten Tips for bottle-feeding parents

    I recently ran a workshop for my daughter’s day care about good bottle-feeding practice.  I was pleasantly surprised by how much the carers knew, and how supportive they were of both breastfeeding and bottle-feeding. The one thing that struck me though was that in the few cases where bad practice was happening, it was coming from the home.  So, the 12 month old who always lies on his back in a crib with a bottle to help him go to sleep.  Or, the 15 month old who walks around with a bottle in his mouth for much of the day and screams if it’s taken away.  The carers said they knew this wasn’t how it was supposed to be, but that’s what the parents had instructed them to do.

    This reinforce why it’s really important for good bottle practice to start at home, and why we need much better education from health professionals about safe and loving bottle-feeding (but that’s another post!).

    To that end, co-author of Guilt-Free Bottle-FeedingDr Sasha Howard, has put together these top tips for bottle-feeding parents. (there are a lot more in the book too)

    1.  Get informed. There is good information out there on bottle-feeding, but it can be hard to come by. See the following tips for useful resources.

    2. Choose a formula that’s right for your baby. Cow’s milk, goat’s milk or soya? Thickened, partially hydrolysed? Lactose-free? Organic or non-organic? Added long-chain polyunsatuarated fatty acids? All of the different options can be a little overwhelming to say the least. The First Steps Nutrition Trust www.firststepsnutrition.org is a British-based charity providing thorough, regularly updated, independent information on formulas, whilst maintaining a strong pro-breastfeeding stance. A must visit for anyone wishing to cut through formula company marketing when choosing a formula.

    3. Watch your baby for cues they are full. There is more of a risk with bottle-feeding that you can overfeed, and rapid weight gain in early infancy can be associated with later obesity. Feed your baby when they are hungry and only give your baby the amount of feed they desire, rather than trying to get them to ‘finish the bottle’ (an easy tendency when bottle-feeding). In this way they can self-regulate feeds in the same way a breastfed baby would do (where you don’t know exactly how much they’ve had but rely on the baby to stop when they are sated).

    4. Practice good hygiene. The only really robust scientific evidence for the benefits of breast over bottle-feeding is that breastfed babies get fewer gastro-intestinal infections (tummy bugs) in the first year of life. With good sterilization techniques (current UK advice is to sterilise all feeding equipment until 6 months), hand washing and toilet hygiene (!) the risk of these occurring in bottle-fed babies can be reduced. Good NHS guidelines can be found at http://www.nhs.uk/conditions/pregnancy-and-baby/pages/making-up-infant-formula.aspx.

    5. Replace your bottles regularly. We shouldn’t really be using plastic bottles for more than a year, as even if they are BPA-free (which all modern plastic bottle should be) they can become scratched and thus more likely to harbour infection. We should not reuse them for younger siblings or pass them on to other families.

    6. Try to feed your baby in a ‘tuned-in’ way. One of the lovely things about bottle-feeding an infant is the eye contact you get with your little one. This is really special time and it’s a shame if we waste too much of it checking our smart phones. Hold them close, talk to your baby, feed skin-to-skin if you want to – all these things help to be a sensitive and present parent when you bottle-feed (applies to dads as well, of course).

    7. There are many paths up the mountain. Some babies will be exclusively breastfeed, and some will only have formula. But there are lots of mix-and-match ways in between. Some babies need a little bit of formula in the first few days to avoid dehydration (or parental desperation) in the first few days of life before breast milk comes in. That doesn’t mean they can’t be exclusively breastfed from then on. Some women with insufficient milk supply will need to top up with formula. Many babies will be bottle-fed during the day whilst their mums are a work and breastfed morning and at nighttime. Do what works for you.

    8. It is your decision, and you don’t have to justify yourself. You may have to explain to health care professionals that you are giving your baby formula if you do so from day 1, but after that you don’t have to explain yourself to anyone. They have no right to judge you (unfortunately some still might). There are mums who have had surgery for breast cancer and can’t breastfeed. There are mums who couldn’t carry a pregnancy for medical reasons and so don’t produce breast milk. There are babies who can’t breastfeed for a multitude of reasons. There are women who are traumatized by previous sexual abuse for whom breastfeeding may be unbearable. The list goes on and on. Whatever your reason, whatever your choice, it’s your business and no one else’s.

    9. Get some support (if you need it). There are some wonderful support groups for bottle-feeding families. http://www.bottlebabies.org is a great source of information and practical help.  www.fearlessformulafeeder.com provides advocacy for bottle-feeding families, support and intelligent comments on feeding issues. There are an increasing number of localized bottle-feeding support groups on social media. And if you are mix feeding, or bottle-feeding as an interim measure but would like to successfully breastfeed, there are fantastic sources of help including www.breastfeedingnetwork.org, www.abm.me.uk, www.lcgb.org to name but a few.

    10. You don’t need to feel guilty. Whether you opted to formula feed from day one, mixed-feed, feed expressed breast milk via bottle, wanted to breastfeed but weren’t able, wanted to but your baby wasn’t able to, didn’t want to breastfeed. As we explain at length in Guilt-Free Bottle-Feedingwhatever your decision, if you feed your baby in a loving, interested, sensitive manner then that is top-class parenting.

    Tweet Sasha @DrSashaHoward

     

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  • 2015: Year of the anti-Superwoman

    2015: Year of the anti-Superwoman

    Thank God 2014 is over.  Seriously, I was counting down the days until I could usher in 2015.

    My friends can’t understand why I feel like this.  Looking at achievements – those things that are most measurable – it was a great year.  I got a fantastic job that is going well, I published a book that I had laboured over for two years (have you bought it yet?  If not, here’s why Guilt-Free Bottle-Feeding should be your next reading purchase!)  I had a holiday to Italy, my husband and I painted and decorated our house, our three year-old continues to be divine – healthy, curious, hugely loving.

    By any reasonable measure that adds up to a fairly amazing year.  So what have I got to complain about, dammit?!!

    Well, there was our friend dying of cancer before he was forty.   I had two miscarriages, one particularly traumatic.  Book sales have been disappointing.  And there were the downsides of the upsides:  I have a great job and published a book, but I worked my arse off all year, missing out on family time, daughter time and sleep time to keep both jobs (relatively) on track.  I spread myself too thinly, stretching myself in a hundred different directions in any one day, giving too little time to everything – work, family, friends, my health and myself.

    The overall effect was that for the last three months of the year I now realise I was likely mildly depressed, certainly very unhappy and stressed.  Picking up the pieces and getting myself happy and healthy again is going to take months.  That’s okay – I’ve started the process.

    But it’s made me realise how precarious our health and happiness can be when we are trying to be everything to everyone.  This is especially the case when we have children.

    In my case my mission impossible this past year has been trying to work a couple of jobs, balance family, a marriage and friends.  At different stages of motherhood, though, it can be about different things: feeding a baby while caring for a demanding toddler; making homemade purees, pumping, handling daycare drop-offs and working part-time; simply getting through the first baffling, thrilling, exhausting months of a new baby.

    Because we live in a high-achieving society where women and mothers expect themselves to be perfect if they just work hard enough, sleep little enough, try ever harder, accepting that we can’t be perfect is seen as the equivalent of failure.  We didn’t succeed because we didn’t give it our all.   When we’re repeatedly told that we can be whatever we want to be if we just put our mind to it, that makes failure not a function of not having enough hours in the day, or simple lack of physical capability, but our fault.

    But this past year, trying to be perfect has cost me dearly.  So this is my resolution for 2015:  I am not going to be perfect.  I am not going to be the superwoman that my mother-in-law well-meaningly told my daughter I was yesterday (as she reeled off the list of everything I did in a day all I could think of was how most of those things I did badly, or late or at the expense of something else, and how anxious trying to do all these things has made me).  This year I am going to not do everything, I am going to concentrate on a few things that I can do well, and let the rest fall by the wayside.

    In my case my priorities this year are being a more present mum to my daughter, and a more present wife to my husband.  I want to concentrate on doing my day-job well, rather than juggling a full-time gig, writing a book and dozens of other little extras.  For every person though, priorities will be different.  Perhaps this year is the year you need to concentrate on work, and hand over some of the child caring responsibilities to someone else.  That may mean stopping breastfeeding, or letting other people do bottle-feeds.  It could mean stopping trying to do everything at home – the made-from-scratch meals, the craft activities – and recognising that if the kids eat baked beans three nights one week they will be okay.

    Because this is something else that I’ve learned this year – throughout this entire time that I have been twisting myself in knots because I wasn’t at home three or more nights a week for bath time with my daughter, she was fine.  She was very happy to see me when she did, but my husband, who had stepped up to do pickups when I returned to work full-time, did an awesome job.  My daughter was happy on her nanny days, and happy on her daycare days.  While I was slowly pushing myself into a guilty mess, she was just cruising on through.

    A lot of the guilt I was feeling was purely about my expectations of what I should be, rather than accepting what I can be.  So along with not trying to be everything to everyone, my year of the anti-Superwoman means accepting that others are capable and willing, and accepting and appreciating help.

    Whatever your stage of motherhood, whatever particular challenges you are facing at the moment be they feeding-related or not, my 2015 wish for you is that you give yourself a break.  You’re undoubtedly doing the best you can.  Your child is undoubtedly tougher than you realise, and you undoubtedly deserve a bit of self love and appreciation.

    Here’s to 2015.

     

     

     

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  • The tragic case of Charlotte Bevan

    The tragic case of Charlotte Bevan

    TRIGGER WARNING:  This post deals with depression and suicide

    Just watching the video gives me chills.  A new mother, post-birth tummy roundness still visible, walks out of hospital in her slippers, clutching her newborn and no-one stops her.  She heads to a bridge in Bristol and jumps.  Two days later their two bodies are found at the bottom of a gorge.  What must have been going through Charlotte Bevan’s mind is impossible for anyone who has not lived with depression and schizophrenia to imagine.
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  • Breastfeeding targets set new mothers up to fail.  Let’s get real

    Breastfeeding targets set new mothers up to fail. Let’s get real

    This post was originally published in The Guardian

    Governments love a target. We’ve got targets on everything, from economic growth to train delays. They give civil servants and their political masters something to aim for, something to benchmark. But frequently these targets do little more than fill bureaucratic hours measuring them. Sometimes, they even do harm.

    This is the case for the targets on breastfeeding. In case you didn’t know, along with infrastructure and economic patterns, there are government targets on what women do with their bodies when they have a baby. We are supposed to breastfeed exclusively for six months, then continue in combination with other foods until baby is a year old.

    The trouble is just 16% of Australian women make it to the six-month-exclusive breastfeeding mark. In Britain, it’s only 2%. These figures have remained stubbornly similar despite the chorus of “breast is best” echoing around us for decades.

    That means 84% of Australian mums and 98% of British mums are officially failures. But it’s not their fault. They have been set up to fail by targets that reflect a one-size-fits-all approach to health that ignore the myriad social, physical, familial and mental factors that go into a breastfeeding relationship. As one well-conducted piece of research into Scottish women’s breastfeeding experiences found, the six-month-exclusive breastfeeding goal is “unhelpful” for individual women.

    It’s time for these targets to be scrapped.

    Instead, what we need are individually tailored feeding plans, developed before a woman gives birth, that take into account all the personal circumstances of a mother and baby, and deliver a realistic goal that acknowledges the modest benefits of breastfeeding for babies in the developed world and is achievable.

    For a woman who has already breastfed one baby, doesn’t have to go back to work for a year and is healthy and active, perhaps six months exclusive and then however long she feels like in combination with other foods is an achievable target. For an overweight woman who had trouble conceiving (both factors can make breastfeeding more difficult), perhaps a more appropriate plan might be to start breastfeeding with added syringed top-ups of formula for a month, then reassess. For a busy mother of three with her own business, perhaps a target of a month’s exclusive breastfeeding then six months of mixed feeding might be an achievable goal.

    I’ve got some skin the game here. When I gave birth in 2011, at every single antenatal appointment I told the midwives I had had a breast reduction, which is one of the biggest impediments to normal lactation. Yet not one of them said to me, “You’re likely to not be able to fully feed your baby, so let’s talk about how you can feed so that she can get what breastmilk you can produce and still gets the nutrition she needs.” Instead, they simply asked if I intended to breastfeed and, when I said yes, ticked a box, undoubtedly relieved that they didn’t have to give me the lecture about why I should.

    After my daughter was born, egged on by the midwives’ apparent lack of concern at my lactation prospects, I tried for six days to exclusively breastfeed. It took my daughter losing 13% of her body weight and about the 10th nurse I had told my reduction story to for someone to give me the official OK to do what I had thought I should do but was scared to do – top up with formula.

    This is not good enough. There are very real consequences when women have unrealistic expectations about breastfeeding. Not only can babies end up in hospital, malnourished and dehydrated because their mother was told to “just keep going”, there are impacts on mothers’ mental health. A large-scale study from Cambridge found that women who planned to breastfeed but didn’t meet their goals are more likely to develop postnatal depression. And then there’s the more low-level “mother’s guilt” that mums joke about but really isn’t all that funny. When a baby is your whole world, and you’ve been led to believe how you feed that baby is the most important part of that world but you’re not meeting society’s expectations, it can be devastating.

    The fact is, impediments to breastfeeding such as obesity, fertility problems, being an older mother or previous eating disorders, to name a few, are becoming more common.

    Three studies done into the delayed onset of lactation – waiting more than three days for milk to “come in” – also illustrate how we need to take women much more seriously when they talk about having difficulties breastfeeding. The studies were done on first-time mothers in CaliforniaPeru and rural Ghana.

    In rural Ghana, just 5% of women waited three days for their milk. In Peru it was 17%. In California it was 44%. Clearly something – or more likely many things – about our modern lives make breastfeeding more challenging, yet we are not adequately preparing women for this or planning how to manage it. Instead we are patting them on the head with a “just keep going” and some helpline numbers, or, as is now happening in England, bribing them to breastfeed.

    Developing individual feeding plans, just as we do birth plans, would undoubtedly take up more time than simply ticking a box on a form for six months. It would also require a shift in mentality by many healthcare workers who are locked in a “breast is best at all times for all families” worldview. But it would be far more beneficial for mothers, who instead of feeling stressed about reaching a one-size-fits-all target could actually feel proud when they meet their individually tailored goal. It would be beneficial for babies, who are deeply attuned to their mother’s physical and mental state. Heck, it might even increase breastfeeding rates, as mothers become less stressed about doing this one thing that has been built up to be the biggest single marker of whether we are good parents or not.

    The one group it wouldn’t be good for are the beancounters who make their living assessing if we are meeting their targets. But I think they’ll cope.

    Let’s ditch the breastfeeding target, replace it with individual feeding plans, and start reaping the benefits.

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  • ‘This whole notion of someone else making them feel guilty is a nonsense’

    ‘This whole notion of someone else making them feel guilty is a nonsense’

    Guilt-Free Bottle-Feeding got a great write-up in yesterday’s Fairfax newspapers, under the title, “Navigating guilt in the milky way.”

    Mum Kate van Ingen spoke about the six weeks of ‘hell’ she spent trying to breastfeed her now two year old, and how isolated she felt as she turned to formula.  Dr Nicole Highet of COPE, the Centre for Perinatal Excellence, called for more support for mothers, regardless of how we feed our babies.

    But for me the standout quote of the whole piece came from Jennifer James, a lactation consultant and counsellor with the Australian Breastfeeding Association.  It perfectly illustrates the condescending attitude of some members of the breastfeeding lobby.

    “This whole notion of someone else making [formula-feeding mothers] feel guilty is a nonsense,” she said.  “If you’re a woman who feels very vulnerable, who’s desperately trying to find out how to breastfeed because nothing seems to be working, then any message about breast milk being best for babies and what they need to optimally grow is going to make you feel like a failure.”

    And then, the kicker.

    “The women who don’t even try, they’re the ones to tend to hit out and try to find someone to blame.”

    Ahh, the old reliable passive-aggressive, “it’s not me, it’s you” response.

    Lisa Watson from Bottle Babies has written a very eloquent, from the heart response to to Ms James, but I couldn’t let her comments pass without a response of my own.

    Blaming formula-feeding women for their own guilt and sadness is one of the most insidious tactics the extremist breastfeeding lobby.  And adding ‘it’s just because they’re not trying hard enough in the first place’ demonstrates perfectly the ivory-tower bullying that makes struggling mums feel so rubbish in the first place.

    When everything in our society – from the baby books, to the posters in the GP’s office, to Miranda Kerr’s selfies – tells us that good mothers breastfeed their babies, how can any woman who is struggling to do so feel anything but bad when she fails to achieve this critical marker of motherhood?

    I have spoken to women who have had midwives tell them that their baby will never bond properly with them because they weren’t breastfed.  I know of mothers who have lied to health professionals about topping up with formula because they knew they would be lectured and judged.  Don’t tell those women that they’re the ones making themselves feel guilty.

    Even when mothers aren’t explicitly being told they’re doing the wrong thing, the language often used about feeding is deliberately designed to hurt.

    In a classic essay published in 1996 entitled “Watch Your Language” the world-renowned lactivist Dianne Wiessinger urged other advocates to change they way they speak about breast- and formula-feeding, because using the stick of deficiencies, she argues, is more powerful than the carrot of benefits.

    “Are you the best possible parent?” she writes.  “Is your home life ideal? Do you provide optimal meals?  Of course not.  Those are admirable goals, not minimum standards.  Let’s rephrase.  Is your parenting inadequate?  Is your home life subnormal?  Do you provide deficient meals?  Now it hurts.  You may not expect to be far above normal, but you certainly don’t want to be below normal… The truth is, breastfeeding is nothing more than normal.  Artificial feeding, which is neither the same nor superior, is therefore deficient, incomplete and inferior.  Those are difficult words, but they have an appropriate place in our vocabulary.”(1)

    So when, in The Age, a breastfeeding advocate says, “any message about breast milk being best for babies and what they need to optimally grow is going to make [formula-feeding mothers] feel like a failure,” the response must naturally be, “Of course it will, because that’s what it was designed to do.

    As part of my reading for Guilt-Free Bottle-Feeding I came across some research by Australian psychologists who have observed that guilt about bottle-feeding is so all-pervading has become the ‘normal’ and ‘natural’ response of formula-feeding mothers(2).  In fact, they found that this guilt is serving a psychological purpose – it’s a coping mechanism, a way for us to show that we are still ‘good’ mothers.  It demonstrates our desire to be ‘good’, even though our body hasn’t met the social ideal.

    How tragic is that?  That in order for bottle-feeding mothers to feel as though we fit the ‘good’ mould, we must feel guilty.

    So don’t tell me that any guilt we feel is brought on by ourselves.  Yes, we can face up to that guilt, take ownership of it, recognise it is unfounded and choose not to feel it.  But when every single message in our society tells us that good mothers breastfeed, and by extension, that bad mothers bottle-feed, don’t blame me for feeling the blame and shame that society puts on me.  That’s how bullies operate.

    There are ways to encourage and support breastfeeding without bullying formula-feeding parents.  Fantastic, sensitive breastfeeding advocates manage this day-in, day-out.  Someone should tell Jennifer James.

    1. Wiessinger, D 1996, ‘Watch Your Language’, The Journal of Human Lactation, vol. 12, no. 1, pp. 1-4
    2. William, K, Donoghue, N & Kurz, T 2012, ‘’Giving Guilt the Flick’?: An investigation of Mothers’ Talk About Guilt in Relation to Infant Feeding’, Psychology of Women Quarterly, vol. 37, no.1, pp. 97-112

     

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