2015 # 209...Emma was thrilled to conceive after fertility issues, but breastfeeding was an uphill struggle. She and her son have moved from exclusive formula feeding back to partial

mattersmatters breastfeeding Sept/Oct 2015

# 209

Relactation against the odds

Relactation against the odds

Breastfeeding Breastfeeding –– the long game

the long game

Ancient breastmilk for modern debates

Ancient breastmilk for modern debates

La Leche League GB

mother-to-mother support

for breastfeeding

La Leche League GB

For breastfeeding support from pregnancy through to weaning call our

National Helpline

0845 120 2918

LLLGB Office 0115 7270579

Websites

www.laleche.org.uk to find your local LLL contact

or submit a Help Form

www.llli.org La Leche League International for breastfeeding

information

Editor: Helen Lloyd Co-Editor: Justine Fieth Contributing Editors: Emma Gardner,

Lisa Hassan-Scott Graphic Design: Benaifer Bhandari Editorial Consultant: Ginny Eaton

Contributions

Breastfeeding Matters is YOUR magazine, we always need your letters and stories. Photos need to be clear and good quality—please send high resolution digital

photos to the Editors at [email protected]

Personal views expressed here are not necessarily those of La Leche League. All submissions will be

acknowledged and are subject to editing. All articles published in Breastfeeding Matters become the

property of La Leche League. LLLGB does not endorse products advertised or other organisations mentioned in Breastfeeding Matters or

items included in the mailing.

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inside… Mothers’ Stories Relactation against the odds ...................................... 4 Breastfeeding - the long game .................................... 9 Ancient breastmilk for modern debates ....................... 12 Tandem nursing and other challenges ....................... 22 Breastfeeding with tongue-tie ..................................... 26 The brightest force ..................................................... 29 Regular Articles Editor’s letter .............................................................. 3 Mothers on…social lives ............................................ 16 Meet a Leader ............................................................ 18 Leaflet Review - When mum can’t be there ................ 20 News and Events Becoming a Leader .................................................... 8 Become a member ..................................................... 17 How to get help from La Leche League GB ............... 30 New Leaders .............................................................. 30 LLLGB Shop ............................................................... 31

Photo courtesy of Hannah Bussey LLL Farnham

Mothering through breastfeeding is the most natural and effective way of understanding and satisfying

the needs of the baby. (One of the ten LLL philosophy statements)

Helen Lloyd is a Leader in Bath and is mum to Isaac (4) and Aneurin (1). Co-Editor Justine Fieth is a Leader in Cambridge and is mum to Josh (11) and Kezia (7). Join us to chat on Facebook at www.facebook.com/breastfeedinglllgb

EEdidittoorr’’ss letlettterer

A remarkably constant feature of breastfeeding is change.

Your new baby arrives and you learn together, working out how to combine your bodies, support a floppy newborn, nurture yourself physically, and so on. You learn your baby’s feeding cues, how to tel l whether he’s getting enough, how to work out i f he’s feeding well…then wham! As soon as you have it nailed, things change. Suddenly you have a four month old who’s constantly distracted

by everything around him, so you learn a whole new range of tricks to keep him focussed. Move a l i tt le further on, and you have a baby starting to eat solids, so you have to work out between you how to balance mi lk and food, and how to keep the breastfeeding relationship strong once your child can move around. Toddler nursing: again a new set of skil ls for you both, as he tries out acrobatics, and learns new and innovative ways to make his requests. So it ’s not a case of learning to breastfeed, mastering the skil l, and then cruising along (though for many mothers the initial learning is by far the hardest part). For myself, I ’m seeing this al l for the second time, and have had the chance to notice that second babies aren’t necessari ly l ike their brothers, and my top techniques from last time round don’t al l work so well this time. Embracing the constant change, going along with the flow, and enjoying having to adapt to whatever my babies throw at me next: these have all been crucial to keeping my relationships with my boys happy and healthy. Change seems to be a bit of a theme in this issue. You might have noticed a new series, in which we’l l summarise some of our popular information sheets on key breastfeeding topics – if you’ve never looked at our information sheets before, they’re a great source of information and moral support. We’re also trying out a few issues without adverts. Some people loved the adverts, but for some they were detracting from the messages about breastfeeding. This is why the magazine looks thinner – though it ’s sti l l just as closely packed with mothers’ stories and other features. Do let us know if you have strong views on this. I love the piece on page 12 about breastfeeding and antiquity because it shows the fl ipside of change: continuity. Fashions come and go, and our knowledge about the worth of breastfeeding is increasing all the time, but this piece reminds us that as long as there have been people, mothers have been nurturing their babies at the breast. Thank you for supporting LLLGB in our work to let this carry on!

Helen

Relactation against the oddsRelactation against the odds

Emma Hawkins

Emma was thrilled to conceive after fertility issues, but breastfeeding was an

uphill struggle. She and her son have moved from exclusive formula feeding back to partial breastfeeding, and here

she tells us how they overcame their hurdles.

All photos courtesy of Emma Hawkins

Helpline 0845 120 2918 Page 5

I feel it's best to tell my story from the beginning to get a true sense of it and to enable others to see that relactation is possible even with the odds against you. In our early twenties my fiancé and I decided that a baby was a missing piece of our almost perfect jigsaw puzzle and began trying to conceive. After a year of actively trying and not being successful I paid a visit to the doctors, and was diagnosed with Polycystic Ovarian Syndrome (PCOS). We were assigned a fertility nurse and she decided that the fertility treatment Clomiphene Citrate - commonly known as Clomid - was the best way to go. After a very stressful three months (Clomid can have rather unpleasant side effects) we got the fantastic news that the treatment was a success and I was pregnant. A very anxious, exciting, tiring, delightful, hormonal and happy nine months later I gave birth to an absolutely beautiful baby boy on Christmas Eve 2014. We could not have been happier and finally our puzzle was complete. Due to a breast reduction I’d had for health reasons when I was 18, I was told from the beginning that breastfeeding was something that I wouldn't be able to do. Because of this we had prepared ourselves with all the equipment for formula feeding and packed it in my hospital bag. The birth itself was less than desirable. We had chosen to be looked after by the Midwifery Led Birthing Unit (MLBU) at our local hospital which would enable me to have the water birth I desired. However, late in my pregnancy, after a trip to see the consultant it was decided that an induction would be

the safest method because of reduced foetal movement and therefore the MLBU was out of the question. During pregnancy I suffered with Symphysis Pubis Dysfunction (SPD) and a tilted pelvis, and my tailbone kept shifting, so I was in a lot of pain and spent the last couple of months of pregnancy on crutches. When the time came and I was in active labour it was incredibly painful with Oscar in a back to back position adding to my own back problems and there was no time to administer anaesthetic with the episiotomy. Oscar was delivered by suction cup, he was finally here! An hour after Oscar had been born it was noticed that he hadn't taken his bottle, so a feeding supporter came in to see us and tried feeding Oscar. After several attempts at using the bottle, cup and syringe a doctor from the Neonatal Intensive Care Unit was asked to come in. She asked if she could take Oscar down just to be looked at by another doctor and said he'd be back with us within 20 minutes. Two hours later she came back and informed us that he had a suspected infection and needed antibiotics and a stay in NICU. After a few days there, with a feeding tube, his test results came back and we could take him home. My hormones had been thrown around all over the place and I was again on a high. I couldn't wait to get my baby boy home! We got home on

I was told from the beginning that breastfeeding was something

that I wouldn't be able to do.

Page 6 www.laleche.org.uk

the Saturday tea-time and after opening our Christmas presents - they were still sitting under the tree - we all went to bed as a family. During one of Oscar’s night time feeds that night, I thought the bottle had leaked everywhere but after a bit of confusion we realised it wasn't the bottle, it was me! My milk had actually come in and I was able to breastfeed. We were visited the next day by a midwife who was happy with Oscar’s latch and gave me the go ahead to breastfeed. The day after that we then saw another midwife who noticed he had lost weight, and over the next couple of weeks this continued, with him being weighed at least every other day. It was only two weeks later, when Oscar still hadn’t gained enough weight, that one of the midwives asked us whether anyone had told us Oscar had a tongue-tie. It had, in fact,

been mentioned by several midwives and nurses in the NICU, and the hospital paediatrician was told about it, but no one acted any further. We were then sent for an urgent referral to see a neonatal surgeon who specialised in tongue-ties who confirmed that it seemed to be holding him back from effective feeding. The tongue-tie was snipped and off we went home. When Oscar didn’t start to gain weight immediately, it was decided that because he hadn't been feeding effectively he hadn't demanded the milk and built my supply up, and I was told to formula feed him from the bottle. By this point I was exhausted from all the visits and the worry and I just wanted my baby to be okay, so I agreed. A few weeks went by and Oscar gained weight fantastically. My mood though wasn't so great and after a few people mentioning that I'd been ‘starving my baby’, the guilt caught up with me and in the middle of February 2015 I was diagnosed with borderline post-natal depression. After being on anti-depressants for a few weeks I started to see my experience in a different light. On the way home from an afternoon out with a baby screaming because he didn't want the formula because I hadn't warmed it up, because I'd forgotten the bottle warming flask I suddenly realised - why did I let them take away my chance of nursing my baby

…after a few people mentioning that I'd been ‘starving my baby’

the guilt caught up with me…

who may be the only baby I ever have. Within about five minutes I decided to try relactating. Oscar was three months old and my milk had dried up. I spent the next week looking at every piece of advice on the internet, and informed two good friends of mine - one a breastfeeding mother to a baby three weeks younger than Oscar and another who is a breastfeeding peer supporter.Then I started my journey of relactation. I hired a hospital grade breast pump, bought a supplemental nursing system (SNS), took fenugreek, latched Oscar on at every possible moment (I'm sure he got fed up with me waving a boob with no milk in his face) bed-shared, wore Oscar in a sling and pumped like crazy! After a week of pumping with no milk coming out whatsoever - this is a very difficult stage to keep going as you feel like you're getting nowhere - I spotted a few yellow dots on one of my nipples. I carried on pumping and a couple of days later these turned into white dots. Then I started getting drops and eventually four weeks after I had started the journey I got a spray of milk! At the present moment I am feeding Oscar with a combination of breast and formula milk as my supply is not yet enough for his demands. However we are sticking at it and like they say - every drop counts. I'm now able to nurse my baby to sleep and he latches on during the day and night for a feed and comfort too. With an awful lot of patience, perseverance and way too much

pumping to mention I now produce breastmilk. It would not have been possible without the support of good friends and those who support breastfeeding mothers - I was introduced to a La Leche League breastfeeding counsellor - who all cheered me on. I hope that by telling my story I've been able to give at least one person the confidence to trust their instincts and fight for what they really want. My fight was to feed my baby and I won.

…eventually four weeks after I had started the journey I got a

spray of milk!

Mother and baby need to be together early and often to establish a satisfying relationship and an adequate milk supply.

(One of the ten LLL philosophy statements)


Would you like to give something back to

La Leche League for the support you have received?

Would you like to support other mothers to breastfeed?

[email protected]

Then the La Leche League International accreditation process may be the life changing experience you are looking for.

To find out more about becoming an LLL Leader, speak with your local Leader about the prerequisites and the role.

If you don’t have a group near you, contact Tracey [email protected] for more information.

Making the transition from being a mother—to being a mother who is also an LLL Leader could just be the fulfilling adventure you have been waiting for!


Lara Jones LLL Cambridge

Lara shares her experience of using the foundation of a breastfeeding relationship as a basis for mothering her son even beyond weaning. She sees how the close communication and

shared understanding that begins with breastfeeding continues way past toddlerhood.

Breastfeeding Breastfeeding –– the long gamethe long game

Photos courtesy of Lara Jones

To say that when I held my first baby in my arms I found it hard to imagine packing him off to school would be a massive understatement. He was so tiny and I, as a first time mum, was so completely ‘in the moment’ I couldn’t see beyond the next hour let alone into the next four years. Everything with my first was E-V-E-R-Y-THING, he was all I could think about: from the colour of his nappies, to whether I had put his coat on ‘gently’ enough. These concerns and so many others haunted me night and day. And my biggest query, for many months after his birth, was breastfeeding really worth it? I remember a pivotal moment in my breastfeeding journey. Our baby was about two weeks old and I had lost it on a monumental scale. I was hysterical with exhaustion; I felt like I hadn’t slept since the birth. Everything was a catastrophe, especially my chosen feeding method. My husband calmly reminded me that I had wanted to breastfeed, and that we had decided that it would be the best thing for our baby. I sobbed, shouted, and then stormed out of the room. My husband took the baby out in the sling. He’d never been away from me before and as the minutes ticked by I grew more and more alarmed. I needed him back.

I needed to feed him: I needed to know he was OK. I didn’t realise then just how closely needing to breastfeed him and knowing if he was OK were related. They returned and as I rushed to put him to my breast, “Yes” something new inside me said, “Yes, he’s OK.” Breastfeeding solutions to breastfeeding problems is what a wise LLL mother might say, but what she can’t tell you is that there are going to be so many more problems solved by breastfeeding than you can ever possibly imagine as you hold your first limp little bundle. Breastfeeding is a long game, something you do for a newborn. Of course, it is vitally important: But something you do for your future five year old that is no longer nursing? Yes. Why? Let me share a story from my mothering game. One morning on the way to school that same baby announced he was tired; I brushed it off, and said, “You’ll be fine.” But something stirred in me, a familiar nudge to pay attention. When we are breastfeeding our babies we are taking cues from them all the time, the tired eyes, the quivering lip, the enraged scream; we scoop them up or manhandle them into our arms and we nurse them. And breastfeeding works its magic. It is thirst quenched, hunger sated, anger soothed, frustration diminished, tears turned to smiles. When we nurse, mother and baby are enclosed inside a white chalk line a bit like one you might see on the green grass of a sports field. The circle is just big enough for two and as we hold them close we say without speaking “I’m here. What’s going on?” We listen closely. And in a million ways, only perceptible to us, our children explain

themselves. Their breathing tells us something, the way their legs are restless; their temperature against us something else, the way their eyes are wondering or how the colour of their cheek has changed tells us something else again. And we add it all up and we say “Ah, it is this.” And that is how breastfeeding engenders confident mothering and children who are confident in their mothers. A breastfeeding mother knows her child, simply because breastfeeding caused her to stop and notice him right from the start. And if you know your child, believe me you’re on to a winner. As your baby grows you get into the groove, the balls keep coming and each time the speed and the angle get a bit more familiar. That little pitcher keeps trying to throw you off but you’ve been watching, you know all his tells and nothing gets past you. It’s naptime, it’s nurse time, it’s playtime, he’s coming down with something, those sleeves irritate him – you’re on fire!! Your limbs loosen. You’re breathing and enjoying the game, you just keep hitting those balls right out of the park! You’re a mothering champion and your baby knows it. Then the time comes to leave the pitch, and the game is over. Except it isn’t. So there we were, I pregnant kneeling down to him, my maternity leggings going soggy at the knees, autumn

We are both learning to let go as Ewan moves onto the next

stage in his life.

When we are breastfeeding our babies we are taking cues from

them all the time.

leaves whipping past us while my baby told me in a very circuitous way how he was feeling. And I listened. We had drawn those chalk lines around us again and even though other families were rushing past and I felt an urgency about being on time and an anxiety about toeing the line, I stopped anyhow, I pressed pause. I knew how to watch: alert, open and ready for whatever was coming my way. And it always feels so good to be back out on the pitch. Breastfeeding gave me that. That line brought me time. Time to re-group and to find my centre again. To look at my child afresh and say to myself, “Hey, I can handle this.” I learned to be his helpmate, his friend, his sounding board, and I learned it all without really knowing that it was happening. When he was tiny and I was desperate, I became his advocate, I grew to trust him and to trust myself, and to make decisions based on what I thought was best, as his mother. And now as I watch tearful children and anxious mothers in the playground I realise that I will never regret learning to draw that line. Learning to make a

space for you and your child, together. Learning how to be sensitive to him and how to help him. That line draws the line, it says this is the limit. This is my child’s limit. Now the world, with its opinions and expectations, must retreat so that it can be just us two again. Tears turn to smiles over and over again on our little patch of grass, easily, simply. As simple as a ball soaring into the blue. So I saw his tired eyes and his pale cheeks and I saw that he was in fact tired, too tired for school. I heard he needed me and I heard he wanted me and I said “Alright then, let’s go home.” and we did. I scooped him up, yes I was six months pregnant and yes a four year old is heavy but I was taking my baby home. And if I could have known that when he was two weeks old, if someone had had a crystal ball and shown me that moment I would have stopped sobbing, pulled up a chair and a stool for my feet, told my husband to get me an enormous piece of cake, make that the whole cake, because I was going to be breastfeeding my baby for a few innings yet and I was going to need the energy.

Ancient breastmilk Ancient breastmilk

for modern debatesfor modern debates Laurence Totelin

Romano-Celtic goddess feeding twins. First-third century CE.

Courtesy of the Roman Museum of Lausanne-Vidy, Switzerland.


Like all women, I have multiple identities. To my two boys (Thomas, 8, and Gwilym, 3), I am ‘Mummy’ or ‘Maman’ (as I grew up in Francophone Belgium). To my students, I am ‘Dr Totelin’ or ‘Laurence’. For a long time, I believed in carefully separating my professional and private personalities. I somehow convinced myself that my interest in the history of Greek and Roman gynaecology was strictly intellectual. Things started to change during my second pregnancy, which was much more trying and tiring than the first, and when private and professional collided. All was well in the end, and in many ways, looking after a second baby was easier than the first time around, especially with breastfeeding, which went very well. I just listened to Gwilym’s needs and to my own body’s cues. After a few weeks of recovery, I regularly attended my local breastfeeding support group: Penarth Baby Latte. I met wonderful women, many of whom had breastfed toddlers – something I had not done with Thomas (I stopped when he was one). I also found that these women were interested in my work on ancient gynaecology. One thing led to the other, and I decided that my next work project would be on milk, and that I would reach out of the academic ivory tower and hopefully show that history can contribute to modern debates on breastfeeding. The twins and the she-wolf All Romans were familiar with the story of how the twins Romulus and

Remus were abandoned at birth, and saved by a kind she-wolf who fed them. Romulus went on to found Rome, after killing his twin brother. This is of course a myth. As it happens, the Latin word for ‘she-wolf’ is lupa, which can also refer to a prostitute. The kind she-wolf was most likely a big-hearted whore. Still, the representation of the two babies suckling from the wild beast became a defining image for the Romans. What would they have seen in it? Perhaps they would have imagined that, through her milk, the wolf passed on her wild and brave characteristics to the foundlings. Or perhaps, they would just have – as we do – realised the incongruity of the situation and marvelled at how the two boys survived in those circumstances. For, in the ancient world, one had to be particularly strong to survive on animal milk alone. Human babies are meant to drink human milk. The milk of other animals will be difficult to digest, or not nutritious enough, or plainly dangerous because of the bacteria it contains. Animal and human milk in antiquity Speaking generally, the Greeks and Romans did not drink much raw milk, preferring cheese. However, they used raw milk in medical practice. In particular, animal milk was employed to cause purges, that is, vomiting and/or diarrhoea. This was believed to evacuate bad humours that had accumulated in the body. To cause a purge, milk or whey had to be consumed in large quantities. Still, these amounts are probably not much larger than what many of us

drink on a daily basis. This is a stark reminder that humans have – over centuries – built a herd tolerance to lactose. Since animal milk was considered a purgative, it was not given to babies in antiquity. The only suitable food for a baby was breastmilk. However, evidence relating to breastfeeding in ancient texts and representations is rare. This is perhaps because it was simply too normal for notice. Our information comes from the very highest parts of society, where women often used wet-nurses to relieve themselves from the duty of breastfeeding. That evidence, however, should not lead us to believe wet-nursing was ‘normal’ in antiquity. For the vast majority of the

population it certainly was not. Of course, some mothers found it harder to breastfeed than others. Although we have almost no written sources here, we must guess that these women relied on the help of friends or family relatives, who would have taken care of the infant. Analysis of ancient bones can help us nuance and complement the picture found in ancient texts. By analysing the chemical composition of bones, archaeologists know how long babies were breastfed, and how they were weaned. It appears that in the ancient world, weaning was progressive, with introduction of foods around six months, and complete weaning from the breast

Capitoline she-wolf feeding the twins Romulus and Remus. Renaissance representation of the Roman myth. Museo Nuovo in the Palazzo dei

Conservatori, Rome. Image in the public domain.


occurring between 18 months and three years, with an average around two years. The analysis also shows that weaning was a dangerous time, linked to higher mortality. Other uses of breastmilk in antiquity In antiquity, then, breastmilk was the only really suitable food for babies. Breastmilk, however, was used for many other purposes, some of which are rather surprising to the modern reader. This is what Dioscorides (first century CE), an important writer on pharmacology, wrote about the properties of woman’s milk: Woman’s milk is very sweet and nutritive. Suckled, it helps in cases of heartburn, phthisis, and against poisoning by means of sea-hare. Mixed with crushed frankincense, it is dripped in eyes that have been injured by a blow. Mixed with hemlock and applied as a cerate, it helps those who suffer from gout. (Dioscorides, On the Properties of Medicines 2.70.6) So breastmilk was helpful against heartburn, phthisis (a lung disease), poisoning, eye injuries, and gout. In other texts, breastmilk is also recommended for ear infections, and as an emollient in the application of gynaecological pessaries. It is important to note that, when breastmilk is to be taken by mouth, Dioscorides recommends it be suckled. Now, he is not talking

about the treatment of children here, but rather that of adults. This means that adults sometimes drank breastmilk at the source rather than expressed milk. New suggestions for modern debates Modern debates about breastmilk often mention the ‘breast is best’ catch-phrase. History, archaeology and anthropology tell us that ‘breast is normal’ – even more ‘breast is survival’. Our world is very different from the ancient Greek and Roman one: fewer women live near their sisters and other close family members to whom they would trust the feeding of their babies. That cannot be changed, but I would like to see representation of breastfeeding become the norm in history programmes, history books, and in museums, in particular when they have children as their main audience. One obstacle to breastfeeding is the fact that many women come to breastfeeding without having ever seen anyone else nursing an infant. Little by little, this will be remedied, but in the meantime, history can fill in some gaps and help educate a more breastfeeding-friendly generation. For that reason, I have started talking to social scientists and consultant midwives in order to create activities that will bring families together to talk about the history of infant feeding in local communities.

Human milk is the natural food for babies, uniquely meeting their changing needs.



Mothers on Mothers on ...... ...social lives

We asked mothers how their social lives had changed since having a baby.

Mara Going out for lunch has replaced romantic evening dates. And now children come too. It's not relaxing or romantic but 'we are family'; children grow quickly and we'll be able to go out in the evening as a couple again when they can cope easily without us (so in about a year or so!). But in a year or so, we might equally be too old and exhausted to face it. Telly, chocolate, baby sleeping/feeding on my lap and pot of tea are a middle aged but perfectly nice way to spend evenings in the meantime! Rebecca It's all gone daytime! Which is tricky when you have to match up work schedules, but fits around small children more easily. I have kept some friendships 'ticking over' via Facebook too. I may not be getting up and down the country to see old friends all the time, but at least we can see what each other are up to until the days we're all more mobile again. Marie One thing is having to explain to people that you are not yet ready to go to events because you do not want to leave your breastfeeding baby/toddler. And explaining that's fine with you because you don't feel the need ‘for a break’. Stef My social life wasn't as impressive once I hit my thirties as it was in my twenties and so I don't really miss it too much at all. Now I have my little girl, I have a whole new group of mummy friends that have children of a similar age. I appreciate my life much more now than I did before becoming a mum and I am very lucky to have a fantastic partner who like me loves being a parent. We love spending time as a family and actually don't enjoy going out without our girl as we miss her too much. Chhaya Now it is about going out during the day or meeting up with friends after little one has gone to sleep in the evening. I've met up with friends at about 8.30/9pm when all I want to do is join little one in bed! But once I'm there it’s lovely catching up with them. I tend to stay local too in case there is a problem. I also use WhatsApp so keep in touch that way. And it's easier on WhatsApp as I have groups set up so can talk to friends at once rather than having to message individual ones asking same thing. And if they have children I arrange playdates, although most of those are spent running around children and not catching up! Vicky Our weekend social life has moved from evening BBQs and meals with friends to lunchtimes. Personally I love it, we get fun with friends AND a nice chilled evening at home!


Rebecca My partner is a lovely dad and every once in a while he goes out with friends (without me) and comes home 'merry' and is hungover the next day. I kind of don't mind but I kind of do. I know it's good for him to relax and see friends; after all, I do lots of a different sort of socialising during the day while he's working. But I do find myself resenting it a bit that he has the freedom he has to make that choice, even though I don't necessarily actually want to do it myself. Jess I've found it hard that my husband would still like us to go out in the evenings, but I just don’t want to leave my baby. Sometimes it feels like I’m really pulled between them. There isn’t always enough of me to be mummy, wife and the sociable friend I was before babies! Emma Now my children are older (youngest is 5) I feel more inclined to go out for an evening with friends. My needs and my children’s’ have changed as we've become older. I can’t do more than one evening every few months! And my children are don’t miss me when I do go out. Daisy My social life is now with other families. Predominantly with other mums because of the nature of the average working family. I'm happy to put my adult social life on hold for year or so until my youngest either weans or doesn't feed to sleep. Jaime Breastfeeding means I can take baby with me without the need for masses of preparation.

B LLLGB!

The information and support that LLL Leaders offer are free of charge but getting the information to mothers costs money!

By becoming a member you help us to:

operate our 24/7 National Helpline produce leaflets and information sheets prepare new Leaders start new groups

As a member you will receive this members' magazine Breastfeeding Matters

An annual membership cost only £30 for 12 months An annual membership cost only £30 for 12 months (£18 for an unwaged family)(£18 for an unwaged family)

Join online at www.laleche.org.uk/content/join-us


Tell us about you, your family, and which LLL group you're involved with. My husband and I are originally from Poland and we came to the UK after living for a decade in Germany, however our son was born here and my husband is now British too. I became a Leader with Tyne & Wear nearly five years ago. What was your first involvement with LLL? After a few months of struggling with breastfeeding I ended up expressing and combination feeding and didn't know what to do. Like many mums I see LLL was the last resort. If it wasn't for LLL, practical help, meetings and books I would have given up breastfeeding. Instead I breastfed my son for 4 years and we both we fond memories. ...and what made you decide to become a Leader? I knew I wanted to be a Leader from the first time I met Amanda Dunbar, who then became my supporting leader. The vast knowledge and experience combined with the philosophy really spoke to me. It was LLL and the LLL tribe that helped me to be the mother I am, listen to my baby and seek information and make my own decisions. The way LLL supports mothers by providing information

Meet a Leader Meet a Leader Each issue we talk to a Leader, asking them about their involvement with LLL. This issue we talk to Anna Patecka-Gebka.

Photos courtesy of Anna Patecka-Gebka


In the early years the baby has an intense need to be with his mother which is as basic as his need for food.


and being a sounding board supporting mothers in making decisions is unique. It's very empowering. Plus the various forms we provide support, one-to-ones, Helpforms, Helpline, meetings — there is something for every mother and Leader. But it was too early in my breastfeeding journey for me to apply so I spend several months reading all the books and attending meetings. Determined as I was, my application took five months. What's a typical meeting of your group like? Busy! LLL Tyne & Wear does two meetings a month, one in Washington and one in North Tyneside.

Is there anything LLL does — or could do - beyond your group that you'd like to tell the world about? We have very strong links with LLL Poland and myself and another Leader in Tyne & Wear have helped with application processes for Polish Leaders. If you had a friend with a new baby, what would you take as a gift on your first visit? Flowers and chocolates!

What would you say is the biggest benefit of LLL membership? Knowing each membership directly helps LLL, including LLL Tyne & Wear, to continue to provide support to every mother who needs it. Plus you'll be treating yourself to Breastfeeding Matters!


CARING FOR THE BREASTFED BABY Mothering through breastfeeding is the most natural and effective way of understanding and satisfying the needs of the baby. Nature intended mothers and babies to stay together as much as possible because breastfeeding is the normal way to care for a baby—providing him with the comfort and security of his mother’s presence as well as with milk which helps protect him from many illnesses. Babies and separation In the early years the baby has an intense need to be with his mother, which is as basic as his need for food. A breastfed baby’s ‘primary attachment figure’ is likely to be his mother. Separation from her will be distressing for him unless he is in the care of another person with whom he has already formed an attachment. Otherwise, however kind and caring that person may be, it is frightening for a young child. Many babies and toddlers show distress at separation by becoming upset or misbehaving. Others become quiet, withdrawn or may sleep a lot. It’s important to know that a quiet baby is suppressing his emotions and is in need of care and attention just as much as a baby who cries or protests. These behaviours are less likely when a baby knows and trusts his carer.

For the carer—before a baby you will be caring for is left with you, allow as much time as possible for him to form an attachment to you whilst still in the presence of his mother. A breastfed baby is more likely to allow someone else to feed him if

his mum isn’t present. So phase in your caring very slowly. Breastfeeding considerations Try to keep separation short at first, especially for a very young baby. It helps if the baby’s mother can nurse before she leaves and immediately on return. Breastfeeding is the perfect way for mother and baby to reconnect, so avoid feeding the baby a large amount near that time. If the baby can have access to his mother during longer separation that is better for the mother’s comfort and baby’s anxiety. Food and drink Breastfed babies are often good at moderating their intake to only what they need. A happy baby is more likely to take any food and drink that is available than go hungry or thirsty. If a baby is eating solid foods, this will help if he is reluctant to take much expressed breastmilk. Many foods contain water, especially fruits. It’s also possible to offer expressed milk mixed with solid foods. Baby-led weaning around six months where the baby helps himself can be a fun way to pass the time. Sleep Being cuddled and rocked, carried in a sling or perhaps taken for a walk can help a baby ease into sleep when he’s showing signs of tiredness.

When mum can’t be there LLLGB Information sheet LLLGB produces a range of information leaflets and booklets on many aspects of breastfeeding. Here, in the first of a new feature, we summarise one of the practical leaflets which is written for someone who may be caring for your baby if you are away.

Support is absolutely Support is

Leaflet ReviewLeaflet Review

FEEDING A BREASTFED BABY A baby can be offered breastmilk in several ways depending on age, comfort levels and his mother’s preferences. Many breastfed babies never have a bottle—even when separated from their mothers. Expressed breastmilk A mother’s own milk is the best possible food to help her baby grow and develop and is full of antibodies, live cells, and other substances to protect him. Expressed breastmilk is remarkably resilient and stores well due to its antibacterial properties. Comprehensive information on how to store breastmilk and prepare it for use is included in LLLGB’s information sheet Storing Your Milk. Feeding options Using either an open cup or a baby beaker with a simple spout (no valves) is an option for a baby from three months old. A younger baby can be fed his mother’s milk using a small flexible plastic cup, medicine cup or spoon filled half-full. Hold the baby upright and close. Rest the cup gently on his lower lip and tip it so a small amount of milk touches his lips. This will encourage him to extend his tongue to lap the milk. Don’t pour milk into his mouth, leave the cup in position as he swallows, then offer again. Let the baby set the pace, lapping the milk. An oral/medicine syringe (ask for one in your local pharmacy) can also be used to drip milk slowly into his mouth just inside his lower lip or gum, so he has chance to taste then swallow without choking. How much milk? Much will depend on his age, how well fed he is beforehand and for how long he is left. You will become used to how much he takes. Fully breastfed babies require less milk than formula fed

babies—as much as 25% fewer calories at four months. Most breastfed babies take between 60–120ml about 8 to 10 times per day. Don’t be surprised if the baby doesn’t drink much milk. A baby may adapt to his mother’s working hours, taking very little milk from his caregiver and then nursing very frequently when his mum is around—this is perfectly normal. How often? There are no routines. Learn about feeding cues like fussing, rooting and fist sucking—all early signs of hunger. A nursing baby is used to feeding frequently so offer his mother’s milk quickly, before he gets frantic with hunger—little and often works well for most breastfed babies. Reassurance A nursing mum and baby will find it hard to be apart from one another. The separation will be much easier on both if the baby has an attachment to you and his mother knows she can trust that you’ll do your best to meet his needs whilst she’s away.

Written by Karen Butler, Sue Upstone and mothers of LLLGB. Abridged by the editors.

This, and many other leaflets, are all available from www.lllgbbooks.co.uk


Tandem nursing and other challengesTandem nursing and other challenges

Abigail Axton LLL Chilterns

Abigail and her daughter, Rose, had some issues getting

breastfeeding going, but she was determined to continue for the long haul, and they continued when her son, Edward, was born. Here she tells us about their tandem nursing journey so far and the extra challenges of breastfeeding

children with allergies.

Photos courtesy of Abigail Axton


Breastfeeding Rose had been a struggle in the early days. She had tongue-tie and severe colic, and was later diagnosed with cows’ milk protein allergy which meant that, if I wanted to continue breastfeeding, I had to stop eating anything containing dairy. I decided I was going to breastfeed until at least two years as cows’ milk substitutes (almond, soya etc) are not suitable as a main drink for children under two. So we waited to expand our family as I was concerned about pregnancy-induced weaning. As it turns out I need not have worried. It seems nothing and nobody was going to come between Rose and her ‘beebies’. When I was pregnant with Edward I had a copy of Adventures in Tandem Nursing on my desk, unread, for a long time. When I finally got to read it, hugely pregnant, I was surprised at how much was in there about continuing to feed your older child while pregnant. Looking back I can see how nursing while pregnant was very much part of my tandem feeding journey; after all I was nourishing two children and had to find room on my lap for two as my bump got bigger! We continued to co-sleep for the first half of the pregnancy and during that time I was exhausted with constant nausea so I slept with Rose at nap time too. My supply did eventually drop in the later months and she did dry nurse during the night. I asked her once how much milk she was getting:

whether it was a little or a lot and she said it was “much milk” but I don’t know if she was worried I would say stop if she said it was only a little! During the pregnancy I got vasospasms (excruciating pain caused by reduced blood flow) in my nipples if they were exposed to cold for a period, which got increasingly worse as the pregnancy progressed. Nursing became increasingly uncomfortable and Rose’s sleepy, comfort nursing latch was quite bad. I often experienced nursing aversion at this point but literally gritted my teeth through it as my need for sleep was greater than the aversion. We had transitioned her into her own bed by this point but she was still waking (and being fed back to sleep) up to five times a night. I think the regular day and night nursing did help maintain my supply but it was hard and got increasingly more difficult being in her bed or getting up and down to her as my pelvic girdle pain worsened. I had to go into hospital to be induced and it was so hard leaving her behind. We had special milky hugs before I left and the photos my husband took are some of my favourite from my pregnancy. She was able to visit me once a day and have a short feed but those three days stuck on a ward, waiting without her, were horribly long. The only thing that stopped me doing a runner was hearing how wonderfully she was coping without me. Eventually our new baby arrived and to my amazement he took to breastfeeding like a complete pro! He was a big baby (10lb 8oz) and had good head control and no tongue-tie. From the very first feed he was pretty much latching on himself. Our first

…nothing and nobody was going to come between Rose and her ‘beebies’..



Tandem feeding children with allergies is double the

responsibility and worry.

tandem feed wasn’t until day two when the three of us snuggled up in our bed for a well-earned cuddle. It was bliss. I was so happy to be home. On the morning of day four I woke up and my milk had come in. I had talked to Rose during my pregnancy about how once the baby was born my milk would go back to normal and there would be lots of yummy white milk. So when she snuck into bed that morning I told her she had an important job and how I needed her to have special mummy milk very gently as my ‘beebies’ were very full and sore and I needed her help to empty them a bit. She was very happy to oblige! I decided early on that while it was nice feeding them both together (and saved a lot of time) I didn’t want to be pinned under two children for large portions of the day so I tried to limit the times where I was feeding them together while still giving Rose as much milk and mummy time as she needed. She got a little milk-drunk during the first few months and wanted milk an awful lot; I didn’t agree to every request but I said “Yes” as often as possible… even if it came with conditions. I hadn’t previously time-limited feeds, but I was surprised at how often she was happy with ‘milk for 10’ where I just counted to 10. It seemed to often meet her need for connection and reassurance. I never enforced it and if she seemed upset that it was too short we’d keep going until I felt she had enough. She also went through a phase where she would get upset if I counted aloud. She was happy to stop after the allotted time even if it was only three seconds but it had to be counted silently! Soon it became a game where we could negotiate how long it would be if I could only do

‘quick milk’ and we could practise her counting skills past 10. Gradually her milky demands got less and I was able to spend time doing activities like play dough with her while Edward slept in the sling instead of trying to work out how to get a boob out of my top and the side of the Moby wrap without waking the baby! Edward started to get the familiar colic symptoms and we found out he was allergic to both dairy and soya. Tandem feeding children with allergies is double the responsibility and worry. One slip-up with dairy means over a week of cramps and upset tummies for both children and hardly any sleep for anyone in the house. And of course constant waking means constant feeding back to sleep and lots of milk for comfort during the day too. I don’t mind that too much as I know that, even when contaminated with an allergen, breastmilk is still doing a great job of healing any damage done to their little intestines. The lack of sleep, sore nipples and terrible guilty feeling of having ‘poisoned’ my babies can be very hard to cope with though. A year on and we have a regular pattern. They have assigned ‘sides’ for their shared morning and night-time feeds, Edward feeds before and after his two day time naps and for his frequent night wakings but the rest is negotiable for them now. I only ever feed Rose at night now if she is very poorly and try and send Daddy in to



her if she wakes to avoid having to refuse her, but in fairness she hasn’t asked at night apart from when sick. And I am mainly glad about that, though it has been an adjustment for me to get used to her being settled by him when before only milk would do. Tandem feeding has become both easier and harder over the year. It's easier now that both can latch themselves on. It's harder now that both can wriggle and kick and both can twiddle and pinch, especially when you have no free hands to stop them! It's easier now I have an established supply and don't need to worry about tracking anyone's milk intake or baby struggling with oversupply. But it's getting harder to cope with the nursing aversion I often feel when nursing them together. Edward has 8 teeth now and is developing his own lazy, sleepy latch, like his sister, and feeling a set of teeth on each nipple, even when it's not uncomfortable, is still quite off putting! Despite the nursing aversion, I still get warm fuzzy feelings when the three of us are together as I feel the love we share. And as well as the general love there have been some very special times too. Emotional times like our very first feed together or on Mothers’ Day this year where I felt so blessed to be able to feed my wonderful babies for so long. Heart-warming times when they reach out and hold hands, or when Rose has helped Edward latch on or his very first wave — to his beautiful big sister during milk. Funny times like when a newly mobile Edward climbed over me, grabbed hold of and determinedly tried to latch onto the side of the breast Rose was already latched on to, or when they both giggle at Edward trying to stick his fingers up

my nose or in my mouth and at Rose blowing raspberries on me. Rose has said she is going to stop having milk is very soon. I can’t decide how I feel about us moving on from tandem feeding. On one hand I feel very proud to have been able to feed her for so long and through the challenges life has given us but also worried that it is all a bit sudden, arbitrary, like something she feels she ought to do rather than she wants to. But I guess, after so long of listening to and trusting my little girl to know when she wants milk, all I have to do is learn to listen when she says she no longer wants it. Regardless of when she stops now I feel I have achieved what I hoped for when I decided to try and tandem feed: to ease the transition into becoming an older sibling for Rose and to be a way for them to bond while baby was incapable of doing anything else. My two precious children adore each other and are learning to play together as friends. Who knows how they will get on as they grow up but I’ve given them a good start! I’m sure the next stage will have its challenges but I'm also sure we can change and grow together to meet them.


My daughter Rose was born by ventouse after a relatively easy, drug-free labour, weighing a healthy 7lbs 13oz. She latched on almost immediately and fed happily from both sides — I was thrilled that it had been so easy to get breastfeeding started, and when she bit and bruised my left nipple I thought nothing of it, putting it down to not enough practice. We were in hospital for three days as Rose was on antibiotics, and feeding seemed to be going well. The midwife and maternity support worker both checked her latch, and said it “looked fine”, although one did exclaim “gosh, she’s fierce!”. I, however, was getting increasingly sore, and beginning to experience toe-curling pain. I was told that this was completely normal, though, and encouraged to persevere. Reassured that it would improve in a few days, we were discharged on the evening of day three, and were absolutely delighted to take our little girl home. It did not improve, though. By the morning of day four, both of my nipples were cracked and

bleeding and I was crying through every feed. I experienced the horrible feeling of being terrified of my newborn, and found myself willing her not to wake up so I would not have to let her latch on. I spoke to several breastfeeding counsellors on the phone, and while they were all very sympathetic, none could give me a reason for my difficulties and all reassured me that as long as her latch was good the pain would improve. No one told me that the level of pain I was experiencing and cracked, bleeding nipples were a sign that something was seriously wrong. By the end of day four I couldn’t go on — my wonderful husband made a mercy dash to the chemist five minutes before closing time and bought some silicone nipple shields. These did not improve the pain, but did remove the fear factor, and I was able to feed without being terrified that my nipples would suffer any further damage.

Rachel and her daughter really struggled to get breastfeeding started, but slowly but surely

they got there.

Rachael Ward LLL Kingston BBreastfeeding with Breastfeeding with

tonguetongue--tietie

I experienced the horrible feeling of being terrified of my newborn...


Over the next week or so it continued to go downhill, until by day ten I was too sore to feed her on the left hand side. So I resorted to expressing (which was also very painful) in order to reduce engorgement and keep up my supply. The right side was also getting worse, but not quite so much that I was unable to feed her. A couple of days later, I woke up with a high fever and went to the GP, who told me it was a bad case of mastitis and gave me a five day course of antibiotics. I saw several doctors and took four courses of antibiotics, during which time my nipples healed but the pain was not improving. It was only the third GP who suggested that I might want to get some more help with the feeding, and so I attended my local LLL meeting. The Leader, Nik, watched us feed, and noticed that Rose clicked almost constantly — something I had noticed, but thought nothing of. She also said the latch looked shallow, which no one had mentioned before. She was the first person to suggest that Rose may have a tongue-tie — a suggestion I immediately dismissed as nonsense, as she had been checked as part of her newborn top-to-toe examination in hospital. Over the next few days, however, I started to do a bit of research, and realised that our feeds displayed so many of the signs of a posterior tongue-tie - sore nipples and nipple damage, supporting the breast to feed, clicking through feeds and

dribbling milk, tiring easily, seeming constantly hungry, being generally unsettled etc. I went to an NHS feeding clinic and told them my suspicions; I was referred to the tongue-tie clinic, but told there could be a two week wait. I wasn’t prepared to wait a fortnight as the pain was as bad as ever, so we decided to get it treated privately when Rose was seven weeks old. The breastfeeding consultant we saw immediately diagnosed a posterior tongue-tie, and as soon as it was snipped I breastfed her immediately afterwards with a fantastic deep latch and no clicking! The pain was not gone completely as my nipples were so damaged, but it was much improved, and the deep cracks on my right nipple finally began to heal. In the next few months I had another two bouts of mastitis and several blocked ducts, and in May I ended up in hospital with my fifth bout of mastitis, dehydrated and worried I was developing an abscess (which thankfully I wasn't). My supply drastically diminished, and we had a couple of days where Rose was mostly being fed on formula with a bit of expressed milk, but did manage to get the feeds back up again. We are still feeding with the nipple shields because she refuses to latch on without them, but we are beginning the process of weaning her off them, and I look forward to the day when I can feed her in public without all the fuss! The process of healing my left nipple has been long and slow, but I am almost at the stage where I can consider feeding her from that side again — in the meantime I continue expressing from that side and supplementing with expressed milk in bottles. The pain is not completely

I breastfed her immediately afterwards with a fantastic deep

latch and no clicking!


gone - we have good days and bad days. Someone told me to never give up on a bad day — a piece of advice which has definitely helped me to continue as there have been so many bad days! I still occasionally find myself browsing the internet at night to find motivation to carry on. The times when I enjoy feeding are definitely increasing, and I will forever grateful to the LLL Leader for suggesting tongue-tie, but I do feel very let down by my early experiences. It was a long time before anyone even acknowledged that the problems I was having were abnormal as opposed to simple bad luck, and I strongly feel that both pregnant women and all those who care for expectant and new mothers should be much more aware of posterior tongue-tie as a problem, and trained to look for it. I hope my story can go some way towards raising awareness, and offer some encouragement to those suffering similar difficulties — I know it’s a cliché, but it truly does get better!

...never give up on a bad day.

My Perfect Person, my Sunbeam. The overwhelming wave of the impossible love you made possible sweeps supreme. Such joy with every smile that erupts, Such fun with every giggle and mischievous glance. Our little lady, too excited to sleep. Such insatiable verve. Such irrepressible, contagious joie de vivre. As the long day draws to a close eventually, reluctantly, you give in to your heavy lead lids. We curl up close in our nest and both nod. And words escape me as your chest rises and falls in the dusk and your warm, soft breath brushes my cheek through the cool evening air in your exhausted midnight slumber. Your little face flicks as you digest the day's adventures. And I watch on, mesmerised by the miracle of life and the precious gifts that you give. I couldn't be happier. I couldn't feel luckier. The apple of my eye. My pride and joy. After the imposed tears, fight and frustrations we've found one another. Instinct won out. Thank goodness. We've found one another. Instinct won out. Sarah Craddock

TThe brightest force The brightest force

Photo courtesy of Sarah Craddock

How to get help from La Leche League GB

Our Helpline might be our best known contact point. Call us on 0845 120 2918, any time at all. Your call will be taken by a La Leche League Leader – a trained breastfeeding counsellor – in her own home. This means it can sometimes take a while to get through to someone so please don’t be disheartened. It might be a good idea to try again at a different time of day (meal times are quite often fraught, as many of us have young children!). If you want individual help but you find it hard to get to the phone, you could try an Online Help Request. These can be accessed at www.laleche.org.uk/content/submitting-help-request (which also has helpful links to other information). If you fill in as much information as you can about your query, someone will be in touch. You might find the answers to your questions on our websites www.laleche.org.uk or on one of the fantastic information sheets we sell in our shop www.lllgbbooks.co.uk Or if you’d like a longer read, the La Leche League book The Womanly Art of Breastfeeding, also available from our shop, contains a huge amount of information in a very friendly format, covering all ages and stages from pregnancy through to weaning. If what you really want is the mother-to-mother support that we’re known for, you’ll always find it at your local LLL group – find it at www.laleche.org.uk/find-lll-group (and watch these pages for information about new groups being started). This page can also help you to find details of any Leaders local to you who you could call for a chat.

For keen Facebook users our LLLGB because Breastfeeding Matters page shares interesting links and articles, and we’ll repost your queries if you send them to us there, so that other mothers can comment too. You can follow us on Twitter @LLLGB – here, again, we share interesting links and snippets.

Finally, of course, you always have this magazine. Please email us on [email protected] if you have ideas for content, or write us a letter for publication, or consider sharing your story with our readers, or submit a question for our mother to mother page: the possibilities are endless!

LLLGB is proud to announce and welcome our most recent Leaders: Joanne Killey—LLL Isle of Man Lindsay Dalton—LLL Northampton Orla Olivieri—LLL Milton Keynes


Shopping with LLLGB Books makes a difference.

Choosing to buy your breastfeeding and parenting books from our LLLGB Shop directly helps other

mothers and babies.

All our profits go to support LLLGB’s charitable work. It’s money well spent!

For our full range of information leaflets and books

on breastfeeding and parenting, visit:

lllgbbooks.co.uk

LLL Books Ltd, P O Box 29, West Bridgford, Nottingham, NG2 7NP Company No 1566925 Registered Charity No 283771

make a difference ...

Photo Lois Rowlands

La Leche League PhilosophyLa Leche League Philosophy

The basic philosophy of La Leche League is summarised in the following statements:

Mothering through breastfeeding is the most natural and effective way of understanding and satisfying the needs of the baby. Mother and baby need to be together early and often to establish a satisfying relationship and an adequate milk supply. In the early years the baby has an intense need to be with his mother which is as basic as his need for food. Human milk is the natural food for babies, uniquely meeting their changing needs. For the healthy, full-term baby, breastmilk is the only food necessary until the baby shows signs of needing solids, about the middle of the first year after birth. Ideally the breastfeeding relationship will continue until the baby outgrows the need. Alert and active participation by the mother in childbirth is a help in getting breastfeeding off to a good start. Breastfeeding is enhanced and the nursing couple sustained by the loving support, help, and companionship of the baby's father. A father's unique relationship with his baby is an important element in the child's development from early infancy. Good nutrition means eating a well-balanced and varied diet of foods in as close to their natural state as possible. From infancy on, children need loving guidance which reflects acceptance of their capabilities and sensitivity to their feelings.

The ideals and principles of mothering which are the foundation of LLL International beliefs are further developed in

THE WOMANLY ART OF BREASTFEEDING 8th Edition

www.lllgbbooks.co.uk

Documents

2015 # 209...Emma was thrilled to conceive after fertility issues, but breastfeeding was an uphill struggle. She and her son have moved from exclusive formula feeding back to partial