About the case in call the midwife....

[onelittlefish]

I have just finished watching call the midwife. The example they have of the premature baby who stays with his mother and gets breast-fed, against all medical advice and survives is just amazing. Do you think this is an example of the power of breast-feeding or was it luck?

If you don't know what I am talking about because you have not read the book the story is of a baby born 12 weeks prematurely (weighing 2 lbs). The mother fed the baby every 30 mins and then left it between her breasts in between. The baby survived against all the odds.

it's not just the power of breastfeeding, it's what they now call 'kangaroo care' - the baby staying close to its mother and getting lots of skin-to-skin, which is now known to improve outcomes.
Was she feeding it expressed milk? Because she wasn't actually bf it, was she - she was using an glass rod with a drop of milk in the end.

on the end I mean

the book clearly talks about expressed breast milk, fed with a pipette thingy every 30 mins

I was a bit re the shot of the milk float 3 secs before seeing Conchita feeding the baby

In the book it explicitly says breast-milk. I doubt she could have afforded formula anyway.

I mean, FFS, why could'nt they show her expressing?

Kangeroo care is often used in the third world. I imagine this is what the mother would have used.

www.babycenter.com/0_how-kangaroo-care-can-help-your-premature-baby-and-how-to-do_10300013.bc

I also imagine that the baby might have been more mature than thought as it was very diffciult to work out the gestational dates when the mother had had no period for years.

Humph I was just chuntering about that show. My daughter was born at 27 weeks, so just over 12 weeks prem, and she weighed 2lb4oz at birth. She's now 20 weeks old and she's still smaller looking than the baby the BBC used as the newborn. Epic fail. Some mum having a 30 weeker after watching that show is going to have one hell of a shock. Her baby would be a quarter of the size with slightly see-through skin and look more like a skinned rabbit. Many would also be unable to breathe, and the suck reflex doesn't tend to kick in til 32 weeks or so. Although BF babies can occasionally latch on earlier. Having pumped for 9 weeks til my daughter was home, I doubt the mum would have been able to have fed the baby so simply - even if he could latch. It generally takes them a couple of weeks to learn to feed, it certainly did with my DD.
As for that case on the show, for one thing I'd doubt the gestation was strictly accurate in those days and the baby was a bit older. But the care described, baby kept between the breasts and fed half hourly, sounds like kangaroo care which is still practised in third world units today, and many parts of the care - skin to skin, baby kept on your chest as much as possible, are also adopted in NICU units here. But the power of breastfeeding - no sorry. I know of many BFed premmies who died and lots of formula fed ones who lived. Beware TV, life is rarely so simple.

Also, I am sure kangaroo care does improve outcomes but by how much? I am sure modern medicine would say kangaroo care improved outcomes alongside conventional medicine. In fact I am slowly going off the idea of conventional medicine (another thread) when I see things like this.

It is a true account though. Jennifer Worth writes about it in her book. She assumed her dates must have been right because of the weight of the baby when it was born and also developmentally. Assuming the margin of error could have been +/- a week it is still an incredible story.

But people know they are watching a Drama don't they?

The BBC could hardly have got a real prem baby tho could they. The stories in call the midwife are true stories, In the book Conchita strapped the baby to her chest for three months and fed it ebm every half hour and he survived. Pretty bloody amazing I think! X

Poppet, I don't see how saying the NBC had an epic fail for u sing a baby that was or looked older than a 12wk premie, what should they have used a real 12 week premie. I think that's just nit picking.

BBC

There was a thread about something similar in Premature Birth section recently, can't link on my phone but there's an amazing post by libelulle on kangaroo care which brilliantly captures some of the emotional and practical issues of mothering a premmie.

No you're right, of course they shouldn't have used a real premmie. I didn't spend the first 9 weeks of DD's life stuck in a hospital unit for fun. Dear god she was on a ventilator for 4 days and on oxygen for six weeks - with spinal taps, brain scans, terrifying infections inbetween. If you've watched your child fight for every breath, it is abundantly clear to you that there's no way such a premmie could have left the unit, let alone appeared on set, but thanks for pointing that out. i guess though i would have rather they had used a model, or just not done the story if they couldn't do it well. And from the point of view of someone whose just been through all this since DD arrived in August, they did not do it well.
Kangaroo care is indeed miraculous, but from having similar anti mainstream medicine views to yourself Onelittle I have to say I am now a big fan indeed of much maligned mainstream medicine too - when used where it is needed, it truly is a miracle and were very lucky to live in an era and a country where we have it. hugs the NHS

Lovely post, poppet

Sorry thread in premature birth is on kangaroo care and politics if breadtfeeding

OF!

I do think Poppet is right. They should have used a model. My DS was born at full term at 6lb 1oz and went down to 5lb7oz and was still much smaller than the baby they showed.

They had an opportunity to show just how amazing that story was by using a model or explaining more about what a preemie can't do or how fragile they are.

Of course I understand that, what a scary time youve been through with you LO my post was in no way meant to undermine your obvious knowledge of prematurely born babies as I assumed you have from your first post.

So really it was more of a failed opportunity to show bf, explicit benefits of kangaroo care and how this is done?

I felt that it was a shame that they a) didn't use a model which would have been more true to life, b) didn't make it clear that it was expressed milk and c) didn't show the kangaroo care properly (baby was mostly wrapped up in a towel which he wouldn't have been as he couldn't be skin to skin that way).

Breastmilk is a hugely important part of the treatment regime for premature babies. Formula can irritate the gut and is far more likely to trigger the potentially lethal disease necrotising enterocolitis (NEC). While breastfed babies can still contract NEC it's far rarer than FF babies. Breastfed babies also get huge amounts of protection again a variety of other illnesses which affect preemies, and can tolerate feeds orally (rather than by IV) on average 6 days sooner than FF babies, which means that there is (on average) 6 fewer days with a puncture wound from the IV - a potential source of infection directly into the blood stream. While there are pockets of excellence, shame, frankly, on the NHS for in many places not recognising this and supporting mothers of preemies to breastfeed or express for their babies - often one of the real, tangible things that a mum can do.

Donor milk offers a lot of the protection that mother's own milk does, but not all. It's still significantly safer than formula for the preemie.

In the case of Conchita's baby breastmilk was what she gave to him according to the book. I don't see his survival as "the power of breastmilk" because breastmilk is normal and using an alternative would have just made it less likely that he'd have survived. But if she'd had no other option, as many mothers of preemies find it very hard to sustain lactation with a non-suckling baby and the stress of the NICU (or in her case the stress of a preemie and 24 other children!) then she would have used an alternative and that would have meant that he'd have had less chance to survive. He still may have.

Donor milk was definitely used in the 1950s - I remember my mother telling me that when she gave birth to my sister in 1955, she expressed extra breast milk to donate to the hospital to be given to the premature babies. I think the medical professionals then knew this was the best option (not much in the way of specialised formula - again, according to my mum, older babies were weaned onto carnation condensed milk!) My mother also commented on the complete change between then and when I was born in 1965. 1955: nurses on the post natal ward would do a regular "breast" round where they offered warm flannels to help with let down, and all of them had extensive experience with BF. 1965: my mother was 1 of only 2 women on a ward of over 20 who were BF; all the other babies were FF :( In some ways it's great being the older mum of an older mum - it meant (sadly my DM died a few years ago) that I had access to this wonderful oral history of childbirth and BF.

My mum also told me about her first birth - hilarious in a bit of an annoying way. She'd read Grantly Dick Read (one of the very early natural childbirth advocates), and was resting in a squatting position between contractions, cup of tea in hand, when the midwife came in (you have to imagine a prime-of-Miss-Jean-Brodie Edinburgh accent at this point) and said "we'll have none of that primitive stuff here, Mrs XXX" and flipped her into the beetle-on-the-back position.

Lovely programme though (and I just hit the "suspend disbelieve" mental button regarding the size of the baby - obviously they couldn't have used a genuine premie, for reasons detailed above). I'm really looking forward to Miranda in next week's episode.

lurcio oh how fabulous! So sorry you lost your DM :( but thank you for sharing! Wonderful.