Tuesday, 31 March 2015

Why Breastfeed? Isn't Formula much the same nowadays?

Why Breastfeed?
Well, why are you considering it?  While pregnant, we probably all have our own individual reasons for thinking about breastfeeding.  For me the reasons I wanted to breastfeed was that I knew it was "better for baby" and it was natural (being from a generation that has been brought up being told we need to think about the resources of our environment, this was a big factor).

The last UK Infant Feeding Survey shows that like me, most pregnant women who intended to breastfeed, said that the reason was for "baby's health".  Most women were also able to name a health reason.  This isn't overly surprising given that most antenatal information lists conditions associated with formula feeding.  I don't want to list a lot of health information and conditions in this blog.  They are well known and well documented.  We live in a culture where the majority of people were and are formula fed, and to be honest, I feel that listing health issues doesn't really help women get through the first few days and weeks of breastfeeding (particularly when we see most of those formula fed people living full productive lives).  If you do want to read more about these health conditions there is a good information leaflet here and a link to the NHS breastfeeding site.

Aren't Breast milk and formula much the same nowadays?
You may be hearing that from others.  After all, we hear a lot in the media about the years of research that has gone into formula and how it is closer than ever to Breast milk.  Certainly formula has come a long way since the early 20th century, when infant mortality for children not fed at the breast was unthinkably high.  A history of infant feeding can be found here.
Today formula milk is still based on cows milk, and has a mandated list of vitamins and minerals which must be added.  The list is based on vitamins and minerals which are in human milk, however they are not in the same quantities as human milk.  The improvement in manufacturing processes has also made a difference and in developed countries with a clean water supply, most babies now can have infant formula as their sole food source without the devestating infant mortality rate of the past.  That doesn't mean the difference is negligible though.  
As research into human milk continues, new ingredients continue to be added to infant formula, but there is still a very long way to go, and they are definitely not "much the same".  This poster has a good visual comparison.

Clicking on the image will open it in a larger format.  This doesn't list all breastmilk components, as more are being found on a regular basis, as research continues.

So if not health benefits, then Why?

Breastfeeding is a continuation of pregnancy.  Human babies are extremely immature at birth.  Most mammals are capable of moving around independently of their mother at birth.  Even dogs and cats, although very immature when born, are able to see and explore their environments within a few days.  Human babies however, are not.  They cannot walk until sometime around the end of the first year, or into the 2nd year.  Crawling only happens in the 2nd half of the first year.  Babies have fairly basic reflexes for survival at birth and very rapid brain development happens in the early weeks and months after  birth.  This is out of necessity, as we would not be able to birth our babies if their brains were any larger.
This has led to many articles describing a 4th trimester that babies undergo, or how they have a period of gestation after birth, and are designed to be held in our arms or on our body during this time.  The relevance of this is two-fold:  Firstly it explains a lot of normal baby behaviour which is commonly mistaken for a breastfeeding problem in the early weeks (which will be covered in future blogs); Secondly, it leads us into a discussion of how breastfeeding continues the development of our babies.  Just as an incubator can provide a stable environment for a premature baby to grow but cannot replicate the development that baby would have had in your womb, infant formula cannot complete all the work that began inside your body.

Human milk guides the development of the immune system, it provides growth factors, metabolic hormones and stem cells which persist in the organs throughout that baby's life.  Something is going on within breastmilk to guide the continuing development of the baby.  Your milk is unique. It is designed for your baby, and not other.  In the same way that your body guides the development of your baby in your womb from a single cell to a newborn, so your body continues to guide your baby's development for as long as you choose to breastfeed. 

Even if weren't for all that - even if there were nothing in breast milk, it would still be worth doing.  Breastfeeding is biologically programmed in us.  Once we give birth we produce milk, regardless of how we intended to feed that baby.  Likewise, when a baby is born he is hard wired to seek out the breast and latch.  It just feels right- to both you and your baby  There is something indescribably beautiful about feeding your own baby, which only makes sense when you look down and see your baby at your breast.  Isn't that as good a reason as any! 

Saturday, 28 March 2015

Thinking about Breastfeeding? - How to meet Your goals


The aim of Mammæ is to support mums through the weeks leading up to birth and for the early postnatal period.  We know that most mums stop breastfeeding before they want to and we also know that mums who are still breastfeeding at 6 weeks are much more likely to meet their breastfeeding goals.  My goal is to answer your real concerns that you are hearing from friends, family and society about breastfeeding and to help you reach that 6 week mark.

What is so magical about 6 weeks?
What changes at 6 weeks?  Why do so many new mums stop breastfeeding during that time, and why is it different in the weeks that follows?

Parenting is exhausting at times, and perhaps never more so (at least physically) in the first few weeks. It is exhausting for all mothers, regardless of how they choose to feed their baby.  Birth is a major biological event for the body and we need to recover.  Many mums, who birth by cesearean section have a surgical wound to heal, our organs need to readjust from where they had moved during the pregnancy, our hormones dramatically shift and we begin to produce milk.
On top of these shifts we suddenly have a new person to care for.  Whether it is our 1st or our 5th baby, caring for a newborn can be overwhelming.  There is a steep learning curve of finding out about this new person and their needs, and a seemingly constant cycle of feeding, winding and changing which continues day and night.  It can be a profound shock to the system and the broken sleep of the early weeks can be hard.  
How does breastfeeding play into that picture?  

Breastfeeding is a skill.  It is natural, yes, but many skills that are natural need to be learned.  Take walking as a perfect example.  Walking is so natural for most of us that we don't even think about the actions we are taking, but look at a toddler.  A toddler taking their first steps wobble, they fall and they need someone to hold their hand for a few weeks until they gain their balance.  Learning to breastfeed takes more effort to learn than learning to bottle feed.
Look again at the graph though.  Although breastfeeding begins as more effort, the effort required drops rapidly.  By the time the graph reaches 5 weeks (which incidentally is when milk production is fully established) it crosses the line with bottle feeding, and continues to drop, until a low at 8 weeks where it settles as an easy, effortless way to feed your baby.  Bottle feeding however continues to have the effort involved in making up formula in a safe manner, washing, sterilising etc

6 weeks is the magic number as that is when breastfeeding becomes the easiest way to feed your baby, and it remains that way.  Partly the change occurs as both mum and baby get more skilled in breastfeeding.  Partly it occurs as expectations change - the family becomes more adapted to the rhythm change that has come with having a small baby in the house, and mum has adjusted to the needs on her time.  Partly it also occurs as the baby has become slightly more mature, he has settled into his new home and his feeding has become more efficient.  We'll deal more with the immaturity of small babies in a later post.

How do you maximise your chances of getting to 6 weeks?
Forewarned is forearmed!  Just being aware that breastfeeding will continue to get easier and that it will make parenting easier in the longer term will in itself help you to reach 6 weeks.  The biggest thing that you can do to maximise your chances though is to get informed and have realistic expectations.  Learn as much as you can about breastfeeding and what to expect before you give birth.  Through this site I intend to give evidence based information that will be realistic and practical, and to point to other sources of good information BUT online support (no matter how good) is never a replacement for real life support.
Find out where your local support group is and go along before you give birth.  Talk to the mums who are there.  There is no better way to set realistic expectations about life and breastfeeding with a new baby than to talk to mums who are in the middle of it.  You will hear the good, the bad and the way those mums cope with difficulties.  You will hear how they may be struggling with getting enough sleep but how the smile of their newborn, or the milky falling asleep cuddles make it all worthwhile and that they wouldn't want it any other way.  You will find a group of mums that you can lean on in a few weeks when you need them, and you will know where to find help.  If you find a breastfeeding group that has a qualified breastfeeding counselor or lactation consultant, you will also know where to go if you have problems or wobbles and it is likely that you will.  We all wobble when we are learning to walk.  Breastfeeding groups exist because we all have to get through those 6 weeks of learning.  The beauty of finding a group near you, is that you come out the other side not just with easy, effortless enjoyable breastfeeding, but also with new friends who understand. 

Over the next few posts I hope to cover what to be prepared for in the first 6 weeks.  Maybe you have questions about how best to get breastfeeding started, or perhaps you are worried about stories you have heard.  Maybe you are wondering if there is anything you need to buy, or to do.  Let me know and I will cover them in another post.  In the meantime, find your local support group and say, "Hello" :)

Friday, 27 March 2015

Welcome to Mammæ

Hi everyone, and welcome to the newly launched blog, Mammæ.

Mammæ is a new resource for pregnant and breastfeeding mums, providing evidence based information on breastfeeding, focusing on the first 6 weeks.  There are probably hundreds of websites /blogs and apps on the Internet supporting breastfeeding, so what makes this one any different, and why should you follow Mammæ?
My goal at Mammæ is to reach pregnant mums and to provide the information they want during their pregnancy, give information about how birth affects breastfeeding, how to best get started, and to be here as a continuing support for them afterwards.
Reaching pregnant mums with breastfeeding information is really difficult.  Help me to get it right.  Spread the word about the site to your pregnant friends.  Follow the blog and let me know what you wanted to know when you were pregnant or what you had questions about in the early weeks.  Tell me what was surprising, what was amazing and what was more challenging for you about life with a newborn.  If you are pregnant, please do post on the blog with your questions or email me at mammaeblog@gmail.com
Hopefully we can build this into an amazing resource for new and expectant mums, as well as those who have been parenting for a while.

Let's talk :)