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Infant feeding

Get advice and support with infant feeding from other users here.

Health visitor rang today...

104 replies

TimeWasting · 05/12/2011 21:48

She was really surprised we were still exclusively breastfeeding at 7 weeks.
Pleased sounding, but clearly shocked.

I'm beginning to think she didn't worry about DD weight gain as this would clearly pick up when I put her on the bottle. Grin
Maybe she'll start harassing me now.

Weirdly she remembered exactly how long DH had been working away when I saw her couple weeks ago, but has forgotten that DS was bf and never had a bottle.
People are funny.

OP posts:
LittleWaveyLines · 07/12/2011 20:32

Noone mentioned pain to me. I was actually so annoyed by this that I was ranting in the staffroom about it when I went to show off my DD. Of the 20 or so youngish secondary school teacher mums we all had had pain lasting at least a week, and noone had been prewarned about it... most gave up because of it. I still have pain now iif she feeds for a long time but have been told P&A is fine and there is no tongue tie, and I go to a breastfeeding support group each week, and got everyone to check.... I suspect posterior tongue tie, but at nearly 6 months old it's too late to do anything now....

I'm actually thinking of becoming a breastfeeding counsellor, a
i feel that strongly about it.

Booboostoo · 07/12/2011 20:41

I don't know anyone else who is bfing round here. My pre-natal classes focused exclusively on how you'll know you are in labour (loads of emphasis on the cervix size, but how the hell do you tell that without a doc or MW?) and no other info about anything. I am still bfing at 6 months but largely part to MN. I had no idea about latch difficulties, different positions, skin to skin, cluster feeds, growth spurts...

Alibabaandthe80nappies · 07/12/2011 20:52

I agree about the pain. There is a certain amount - IME - as the baby learns to latch, as you learn to encourage them to open their mouths wide enough, etc etc.
Once you have had a couple of poorly positioned feeds (which I think is inevitable for most people right at the start) and your nipple has got damaged in some way, then that takes time to heal and so it hurts.

With both my boys the pain disappeared at around 10 days once we had got the hang of things and they had grown a little.

tiktok · 07/12/2011 22:14

If NCT or nhs classes don't mention pain, the complain about it! Bushy no need for that pained (!) tone with me - as I said, I always discuss pain, and the way I raise it is to ask people what they have heard. If for some reason no one mentions it (yet to happen) I would raise it myself.

In the training to be a bfc, you would be expected to include in your class plan and your evaluated class(es) discussion of pain - it's not optional. If too many people are not mentioning it or not mentioning it in a way that people remember, then something is wrong but I cant put it right unless people complain to NCT naming names and dates.

I am not 'patronising people's experiences'. I believe them - I know bf can be painful. What is a 'chestnut' is the idea that everyone has pain. And if I meet that idea on mumsnet I will challenge it, because it stops women seeking help.

As for the bfc who did not mention the three week growth spurt - zimm's experience - what three week growth spurt? Babies have growth spurts at any time, and if someone tells me confidently that they have them at x weeks and y weeks and z weeks and that's why someone's baby is crying, then I know they don't understand much about breastfeeding, or indeed about helping mothers. The bfc you spoke to may well have been unhelpful but not for that reason.

zimm · 07/12/2011 22:17

Sounds we could massively increase bf rates if people got the message that most women have some pain which usually goes away, rather than thinking it will always be painful for them because they are 'doing it wrong'. Mumsnet antenatal classes anyone? We could speak THE TRUTHWink

zimm · 07/12/2011 22:23

Many people believe babies have a big growth spurt at three weeks. Whether true or not my daughter was displaying classic GS behaviour and the counsellor missed it and just told me to and feed her. I breastfeed in spite of the NCT not because of and I know others who would say the same. Tiktok your classes sound great, I wish we knew why so many others aren't. When my group challenged our bfc at post natal on her poor prep she had no defence, it was baffling.

mrsalwaysawake · 07/12/2011 23:02

I complained at great length about almost every aspect of our NCT breastfeeding session in the online questionnaire we were asked to fill in, as did my husband and most of the group, I think. I can't remember if she talked about pain, but I can't imagine she did, as that would have been helpful...

tiktok · 07/12/2011 23:40

zimm, you say "Sounds we could massively increase bf rates if people got the message that most women have some pain which usually goes away'....but that just isn't true either. 'Most' people don't have pain - they really don't. It is clear in the national bf survey that soreness is very common but it is experienced by a minority.

"The most frequently cited problem for breast or mixed feeding mothers while in hospital was a failure to latch on properly (60% and 47% respectively) followed by breast or nipple discomfort (24% and 14%)."

www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles-related-surveys/infant-feeding-survey/infant-feeding-survey-2005

I cant find the post-hospital figures but I think from memory they are a little higher - something like 28 per cent of mothers experiencing pain (some of these will be the same mothers who reported pain in hospital of course - you can't add 24 per cent to 28 per cent).

And it does not 'usually go away' - I have not got stats for that, but soreness is one of the main reasons at every stage for stopping breastfeeding before 6 mths. It may go away sometimes, but my experience is it needs attention, and it needs to be fixed.

I am sorry you found the counsellor unhelpful :( But labelling a crying baby as having a 'growth spurt' is not something I would do, either - your baby was not happy, and may well have needed to feed, because unhappy babies often do need to feed and it can be normal at any stage for a baby to need 'extra' feeding. My role would be to explore with you your understanding of what might be possible for you to do to help her be happier and part of this might be to ascertain how 'normal' your baby was in her needs and behaviour. Just saying 'feed' is not helpful I agree, without this counselling, listening and exploratory approach.

tiktok · 07/12/2011 23:46

And I know of no evidence that babies have a massive growth spurt at 3 weeks. I don't care if loads of people believe it or not! This is not shown in the weight charts - you'd see a spike and not a curve.

Babies may well 'perk up' at 3 weeks (or thereabouts, or indeed at any time, though) socially, emotionally....and show by their behaviour they want the closeness and reassurance of contact with their mothers, and be inconsolable without it. It's not a growth spurt, though :)

ALotToTakeIn · 08/12/2011 05:33

I watched the bump to breast DVD and it really explained latching very well. Completely failed to talk about the importance of positioning and different holds. By this point my DD had vomited my blood as my nipples were rather traumatised. My gp and mw team were fantastic and within 4 hrs I had 2mw on my bed with me DH and DD giving me a complete lesson for both breasts.
With this support, my lovely DH, and all the help I have had on here i am proud that tomorrow will mark 6 weeks, and feeding is frequently so comfortably I forget doing it! Long may it last

LittleWaveyLines · 08/12/2011 09:38

OK - Tiktok - so how do I go about getting help at 5.5 months for discomfort still? I go each week to the local breastfeeding cafe already and have given up asking for repositioning pointers, and just accepted the nipple distortion....

heroinahalfshell · 08/12/2011 09:47

I gave birth to a back-to-back 9lber with no pain relief and endured consciousness-altering pain. I could not breastfeed one more time due to the agony. I would rather have another baby with no pain relief than ever breastfeed again.

tiktok · 08/12/2011 09:49

wavey, you can ask at the group where they refer tongue ties. if they dont know they csn fond out. i dont think it is too latefor this to be investigated. hope you get help.

LaCiccolina · 08/12/2011 12:13

I had pain in the very early days - 1-5 but the latch wasn't right. We got that fixed with the midwives and habit and its never been painful since, even now we have teeth and I was very worried about that.

What I did find 'unbearable' or at least a struggle was being strapped to the sofa at first. It was such a shock (for me) and the thought of doing it for weeks made the mind boggle. However before I realised we were at 10wks and now its been a year.....

mumwithdice · 08/12/2011 16:34

I really hope this comes across as reassuring and not patronising; it's not guaranteed that you will feel pain. I'm one of the women tiktok speaks of; I felt no pain and for me, it actually felt quite nice at the start. Now DD has two teeth and sometimes bites so it isn't all nice.

But agree that antenatal classes should mention the possibility of pain.

LittleWaveyLines · 08/12/2011 17:31

(Tiktok - well tears sort of worked! Finally got a phone number for someone who might be able to have a look, but she's too old so possibly not....)

zimm · 08/12/2011 21:20

Hi tiktok et al,

With respect, I have huge problems accepting an nhs survey as proper evidence. Surveys are usually flawed (I work in data collection) and those by target driven,cash strapped places like the nhs even more so.

I would just like to know why antenatal classes are so unrealistic about breasting, with their lack of coverage of growth spurts, cluster feeds etc. Why the big cover up?

The NCT birth prep classes were very realistic and helpful, so the incongruence is puzzling. Tiktok are you in a position to share the official line on what should be included?

crikeybadger · 08/12/2011 22:17

I thought they would snip up to the age of 6 months LWL- glad you've sort of got somewhere.

Zimm- as I understand it, from talking to an NCT bfc, what they include in the courses is pretty much up to them. The session I attended recently focussed quite heavily on supply and demand and factors affecting it, how hormones affect breastfeeding and how to see that bfing is working well. There was a mention of mastitis but not of thrush, tongue tie or blocked ducts. The tutor also got the class to think about who their support network could be.

Trouble is, they only have about 2.5 hours to get the main points across. It must be very hard to squeeze everything in and get the balance right between giving women the facts about pain and not putting them off.

tiktok · 08/12/2011 23:58

zimm, it's not an NHS survey. Read the link, and you'll see more. The UK infant feeding survey is respected internationally as being sound, comprehensive, independent and as near-accurate as you can get with something like this. These are mothers - 9000 of them, IIRC - asked every 5 years about their recent feeding experiences. There is no reason to think soreness is dramatically under-reported.

I don't know of any cover ups - I do know that we may have actually less than 2.5 hours - I only ever have 2 hours - to teach about bf. We aim to help a class understand something of how bf works, what to expect from their baby's behaviour (in an attempt to prepare them for babies who feed unpredictably and often), bring out some misunderstandings and myths (this is usually a class who have no knowledge of bf at all, and often what they do know is unhelpful - such as babies feed every four hours, or you can't eat tomatoes, or breastfed babies are always clingy, or parents need to ignore their baby at night or they will never sleep through.....all true and recent examples of what parents come to a class 'knowing'). Just unpacking the unhelpful stuff could easily take a whole class. Then we have a lot of questions about bras, breast pads and pumps - people love talking about equipment and what they can buy - which we try to minimise, as again you could spend too much time on it.

badger, the class you saw sounds typical. But we don't have a totally free hand about what to include, because it would be imperative to talk about positioning and attachment, how and why breastfeeding works best if it is responsive to the baby (and not to the clock), and to help parents think about where they will get help and support. Yes, you would also expect to hear something about how you know bf is going well, and something about how long to bf for, their feelings about bf in front of others, different positions. Needs of fathers are always included, I would say, too, as a typical class includes fathers who worry they are being excluded, and at least one mother who thinks it will be easy to express half the feeds from day 1 to allow him to share the feeding, or easy to start off half breast half formula.

Try getting everything I have written about in this post into a 2-2.5 hour class. We do it, or at least the better ones among us do it, and it's a real skill.

Sometimes, women do not always remember what they have heard in a class. All bfcs have the experience of reading an evaluation which asks why they did not cover x, y, or z....and they absolutely did! That;s not to say I don't accept what people sometimes say about the bf class. But to be honest I really don't believe all of it.

tiktok · 09/12/2011 00:00

PS zimm - that independent survey has been going for well over 30 years....long before targets in the NHS.

zimm · 09/12/2011 07:43

Ok sorry tiktok, should gave read the link. Still not a survey fan, but of the infant feeding survey is one of the better ones.

Perhaps the info can't be got through could be included in a follow up email? I would strongly suggest more time on NCT antenatal course is given breastfeeding and less time doing relaxation exercises (people can take warms baths and put their feet up at home) or discussing feelings about birth. It's nice to discuss your feelings but it's a he'll of a lot nicer to be properly prepared for breastfeeding.

Incidentally we had five hours of breastfeeding on our course and the tutor said she couldn't fill the second session!! But I think she a special case...........

Queenkongmerrilyonhigh · 09/12/2011 08:11

Definitely agree zimm. We had to spend ages brainstorming what it was like to give birth in the stone age/1800s/1950s etc and talking about our own births (wtf?) Utterly pointless. Our BF session was pretty good but felt a bit rushed, which was a shame as it was one of the few 'practical' sessions of the course.

crikeybadger · 09/12/2011 09:03

Funny what you say about pumps tiktok- there did seem to be a general obsession about expressing (especially among the men - must be a gadget thing!) and the thought that the partners could give the women some rest by getting them to express some feeds for them to do.

The class I observed did talk a little bit about attachment but not positioning - the tutor felt that any details of this would overide the mother's natural instinct. Biological nurturing was discussed though.

But yes, it's definitely a skill to cover everything.

tiktok · 09/12/2011 09:41

Most (all?) classes get a bunch of written material including many factsheets on aspects of breastfeeding, covering stuff that may not be in the class or which works better as a leaflet. NCT website has a ton of stuff, too.

I would not want 5 hours on bf. Class members are focussed on The Birth, understandably. They are not in a great place for learning reams and reams of 'stuff' about breastfeeding, and they tend to want to know things which will turn out to be less relevant to them, or which they can easily find out when the time comes (individual details about expressing and storing milk, for instance - mother A's needs will be different from mother B's, and in any case, are best handled later....who's going to remember at 4 months postnatal what was said about expressing and storing 2 months antenatal?).

zimm I don't know how people can be 'properly prepared' for bf in the sense of covering everything they might need to know. My feeling is that true support and preparation for bf happens at a social and cultural level, backed up with knowledgable, skilled and readily available help as soon as it is needed when the baby is actually there. I don't think the antenatal class on bf has much impact on this, to be honest. In any case, only a tiny minority of women even attend one.

I don't talk a great deal about positioning, badger - like a lot of bfcs I have a large library of pictures and I strew these about and just highlight the way different mothers are holding their babies differently, and that they should feel free to experiment with what feels right and comfortable for them, including the option to do 'biological nurturing'. When their babies are born they will prob be shown one position only and they do need to have some awareness that they don't need to stick with that one.

tiktok · 09/12/2011 09:43

badger, all classes ask about expressing and there is a growing feeling that it is an essential part of bf for everyone.

I think expressing is useful for many and necessary for a few - but no one needs to know every detail of it at 7-8 months pregnant, and in politer terms, I tell classes this.