tik tok

[daisymlaisy]

I have just wrote such a lengthy reply and just lost it just before I posted it, how annoying so this will probably be a bit blunt, as I haven't got time to go into detail all over again!

I take great offence in you saying that if I have only done a 3-day course at Unicef I am not allowed to call myself a bf counsellor( sorry this is one word, I have always had a mental block on how to spell it, even though I use it lots, and its my job - its really frustrating!) as you said in one reply "I am not a professional but a volunteer" so does this mean you have had no training as such? as in the next reply you say " I am a Nct bf counsellor" So how come you are allowed to call yourself but I am not????

My training is as follows I am a qualified nursery nurse, Nurse, and did the 3-day Unicef breastfeeding course, which is one of the most respected in the country.

I have worked a as a maternity nurse for 9 years , this is where I have had huge amounts of experiance and it is here where I have usually found that feeding more regularly than 2 hourly after the age of 3-4 weeks and if the mother has a well established milk supply can be helped, and many mothers if they are honest will say they are allowing their baby to snack when they want, rather than encouraging proper full feeds. I have a very long testimonial record for mothers who when I went to see them they were feeding very regularly as in every 30 mins -1hour thinking thats what they should be doing. However once I had explained to them to look out for other sign for example crying cause they are tired etc and obviously making sure that there are no problems of tongue tie, poor milk supply, over milk supply etc , we could encourage the baby to demand feed 2/3hourly instead. I for one who bf my own daughter til she was 7 months,if I was feeding her every 30 mins -an hour would of welcomed someone to tell me this needn't be the case. So I still stand by the fact that if the baby is over 3-4 weeks old and the mother has a GOOD milk supply 2 hourly feeds should easily be maintainable, and it is quite often mis-guided information why the mother is allowing the baby to snack every 30mins, or poor attachment, milk supply etc could be a reason for it. however it in most cases can be successfully turned around to frequent feeds every 2-3 hours.

To finish my qualifications- I have worked as a nurse on a neonatal ward for 2 years, here I did see the extremes where babies are being encouraged to feed every 30 mins-1hour to help with the mothers milk supply.

I have been practicing as a bf councellor for 2 years now.

I do feel like i have been interogated by you, and will not be posting on here any more, you have made that impossible for me anyway by tarnishing my name. So keep up the good work helping all those mothers out there and lets hope you never word anything wrong. Of course I wouldn't do this in real life, it was one of the very few times I had been on here, and I was just writing facts,and my opinions wrongly not thinking about emotional ,sleep deprived mothers who may have read it, how it was most certainly not meant. I hope to have learnt by this mistake, and think more when I am writing.

If you feel like you need to justify yourself to me , like I did to you, please do not worry, if you want to call yourself a bf counsellor, reading your threads you sound more than capable to do this. Though please do not doubt other professionals. We are all going to have slightly different views depending on our experiances and qualifications and training, certainly doesn't need one to attack another, this most certainly would put the fear of god, into already confused new mothers, who feel they don't know who to trust.

Only because name of one of fred west's kids as well as more famous women obviously.

eek - didn't know about the Fred West thing, was thinking of the buxom film starlet of the 20s, plus weak pun on living in the westcountry

Ok, sorry , as I said I am not an expert. Tiktok, someone really ought to tell the NHS the facts about breastfeeding as the infomation you are saying is not correct is still what they are teaching. It is very confusing for people.
I do think that you and daisym are on the same side and she is not necessarily less qualified than you because she has done a different course.

Yeah, if I'd even vaguely believed the 20 minute thing I would have worried about DS2 in the early days, as he had an alarming suck, and would never spend more than 10 minutes on a feed. (He was nice and fat, though.)

Of course, now he's two, he will happily feed for half an hour or more .

You're right about the confusing info from some NHS professionals. Now my baby is 5 months old and I'm getting my brain a bit together I intend to write to my local trust to constructively complain about the postnatal care I received (particularly with regards to bf support). If people don't complain, nothing changes

I honestly was told when my newborn dd was only feeding for 10 minutes every 3 hours that everything was fine. She was just an efficient feeder and as she was my second I was more relaxed and she was emptying the breast faster than my ds. She lost weight in the early weeks. She is fine now at 17 months old. I posted that info on the Saralou thread.
There does not seem to be any officially recognised authority on bfing so it is hard to know what to beleive.

Anyway I am going to watch This Life - very excited.

I have to jump in here....

I read the other thread and have skimmed this one. I am an ABM bf counsellor and am really feeling the need to defend our course. What daisy is saying is just not accurate at all. No-one would be able to complete our course in less than one year. And it is more usual to complete it in two. There is a limit set to take no longer than three years to complete. All counsellors have to update their knowledge each year after they qualify.

It may seem that there are only 8 modules (in fact, there are 10 including the introduction module and the end module), and that because you can complete them at home it must be quick and easy. Nothing is further from the truth. Each module requires an extremely in-depth level of reading. You then need to demonstrate the knowledge you have gained through answers to questions. These are not yes and no type questions, but more of the type that require pages and pages of writing. Each module is divided into both the technical side of breastfeeding and the councelling skills needed to be an effective bf counsellor.

You cannot whizz through the modules all in one go as was suggested on here. Each module is sent away to be marked by an experienced counsellor and part of the training team. It is then sent back with comments and you are required to reflect on what you have learned. Only then do you move onto the next module.

Throughout your training, you have a mentor who you can speak to and discuss your modules. As well as this, many areas do regular meetings of trainees (rather like tutorials).

Once qualified and being part of the helpline, you still have a supervisor and are required to update your training.

I am a regular poster on mumsnet, but very rarely post on this board despite being a counsellor. This is not because I do not want to offer information (not advice - as any bf counsellor knows not to do), but because I agree with Tiktok that it is a skill to learn how to put this information across on a talk board. We have counsellors who specialise in email counselling. I am not one of these and do not feel I have the skills it takes - it really is not easy. My skills lay in telephone counselling, which is what I was trained to do.

Please do not give out inaccurate information about the ABM or any other organisation that you are not a memebr of. We work very hard on a voluntary basis to help mothers in need and to imply that we are anything less than well trained and professional is really unhelpful, and quite frankly insulting.

jaleaxandra, sorry for interupting your this life watching, I'm watching it too!

I think Tik tok and I, are saying the same also but wording it differently. When I first made the comment I was refering to a mother beginning a feed when the breast is full, and stressing the importance of reaching the hind milk, which is a fact. it gradually comes behind the foremilk, obviously if the baby only had a short feed and returns a short while later he will infact then be getting the pudding ( as i call it)
Tik tok says

Fattier milk is not present in relation to the length of the feed, but in relation to the amount of milk in the breast.
In answer to this I have never once that a feed should be x amount of time, you just can't say this, from the start of a full feed to the end can take some babies 5 mins others 20 mins - how long is a piece of string.

Tik tok also says
A relatively empty breast will have comparatively fattier milk; a relatively full breast will have comparatively less fatty milk.
In answer to this they each have the same amount of fatty milk, the latter just needs suckling on longer from the baby to reach it.

In my experiance babies who are effectively attached usually come off the breast spontaneously when they have had enough milk. If a mother cuts shorth the feed, either because she is rushed or because she has interpreted the baby's pause as a signal that he has stopped suckling, the baby may get a feed that is low in fat. He will be left hungry and the breasts will not have been sufficiently well stimulated or drained.

tik tok says:

If there are longish gaps between feeds, then more watery components trickle down to the front of the breast and become available to the baby as soon as he gets on. As the feed progresses, the milk gets fattier as the breasts become less full.

aren't we saying the same?

Jaleaxandra, I also find it very amusing that I can't even have my own anology to interpret foremilk and hindmilk to my clients and it has just been knocked, I'm happy with it and will use it, I obviously use tik tok explanations aswell to refer to other times that you don't have to reach the hind milk.

Thank you for sticking up for me about the bf counsellor issue also. I appreciate your kind words.

Please stop stressing the point of "reaching the hind milk" as a fact, because it's not.

sorry if I offended you, I didn't mean to degrade the Abm course to say it could be done within a year.

However I don't know how anyone can say which course is better than another, unless they have done all of them, and know each others qualifications and experiances prior to doing the course.

As I understand it unicef and abm cover the same 8 modules, but not as much written work and marking is needed in the unicef so can therefore be done over 3 days, doesn't mean it is any less credited than abm.

I have also found it as insulting as you that the course I have completed has also been slammed, with no-one having completed it, so I should not have insulted yours to defend my own and I'm sorry for that.

This is turning into a bit of a competition on who is more knowledgable/qualified than the other.

I think its all getting a bit out of hand so I will stop posting now and definatley leave email counselling to people better equipped than myself otherwise I may end up having a nervous break down and start to believe I really am no good, and give up bf counselling!

hunkermunker it is a fact that in a full breast a baby has to take the foremilk first before reaching the hindmilk. So I will not retract that statement.

Whoever said earlier that someone should tell the NHS was spot on. IF only! When I complained to my health trust I was told that there are regular training courses for HVs to go on to update themselves on breastfeeding but they couldnt force them to go on tehm and so many didnt. You only need to read the breastfeeding threads to see how much inaccurate information there is out there being peddled as fact by midqives and health visitors.

Of course you can argue about one course being better than the other. You simly have to look at the content, lenght of time, monitoring, follow ups after etc to see that.

How long does it take, Daisy?

Is there a clearcut divide between foremilk and hindmilk?

I have visions of poor babies having to sit through prawn cocktails and gammon steaks with pineapple to get to their black forest gateau, you see.

no hunkermunker there is no clear cut divide, if you can encourage your baby to feed until the breast feels emptyish, you'll be pretty sure that he has reached the hind milk, if you started with a fullish breast. Some babies can do this in 5 minutes others 20+, both is normal

Yes you can possibly argue which content of course looks the most indepth etc, however without actually doing it and seeing how well its taught you can't totally judge it.

And as to who is the most qualified after a course, no-one can possibly judge as there are plenty of factors to consider like each persons qualifications and experiance beforehand all play a major part not just the qualification they gained on the course

So , daisy, can the breast be empty?

So what about expressing? FOr those women who it takes 20 minutes to reach the hind milk , do they have to express past this?

that is a very open-ended question and could prove to be very controversial and how I word it could really spark something and as I have proven I am not the best online counsellor! so I will not answer a yes or no as it is not as clear cut as that it all depended on the oxytocin reflex and whether its being helped or hindered, and who knows what scenario your refering to as I have nothing else to go on, I don't feel I can answer that.

To maximise ongoing milk production, the milk must be removed frequently and as completely as possible. This requires the baby to be effectively attached to the breast and to be allowed to feed for as long as he wants.

that was in answer to can a breast be empty? by the way

My understanding of it is that the breast can be nearly empty but never completely. I dont understand your post, sorry.

that is correct! sorry very tired starting to ramble, must go to bed, its been a very busy mumsnet day for me! good night

I was referring to your scenario of the baby feeding to teh "dessert" and the breast having the feeling of being emptied. Personally I never had that apart from when expressing although dd could have a long feed straight away from the breast I'd been trying to express from.

I need a confused face now!

All I have to add is that I felt reassured that I knew Tiktok was an NCT breast feeding counsellor as I struggled to BF when I asked for advice. ( Unfortunately BF didn't work cos of undersupply due to PCOS. But have informed DH that when we have baby number 2 he has to get a posting near to Tiktok (although I have no idea where that is!!!!!) so I can go to see her cos determined to do it next time.

My Mum is a volunteer Nurse Tutor in Malawi, she updated her midwifery qualification before leaving and did the UNICEF course talked about. She said says she would never consider herself a BF counsellor, she did it as part of her midwifery requalification and as I'm only child she only BF one baby 30 years ago (amazingly for 18 months) she felt she needed to, if she was not so far off from her BFing days she said she'd train an NCT BF counsellor.

I would like to thank Tiktok for her level and balanced posts on this thread, which clearly show that she is a Counsellor.

I wholeheartedly take issue with Daisymlasy when it comes to training. For a start she clearly misses the point of 'counselling'. A 'qualified' counsellor from ANY organisation not just breastfeeding but Samaritans or whatever; is required to have ongoing supervision! You can quite rightly call yourself whatever you chose, as has been said, some labels aren't registered, but doesn't that just mean that we are giving a disservice to our clients? I would for example, expect to be sent to a heart surgeon if I had a heart attack and not be treated by my GP just because he'd done the basics and he knew about hearts!

As for the level of Training for breastfeeeding counsellors, please see IlanaK's post about ABM training. Do not rubbish training here unless you are prepared to stand up yourself. It 'may' have been possible in the past to complete ABM training in 'just' under a year - I think actually 2 people in 8 years have managed that, but now it will take at least a year flat out, and is expected and designed to take 2 years.

The 'introduction' or MS module takes on average 30 odd hours (so MORE than the UNICEF course), and then there are a further 9 modules. There are counselling scenarious and practice breastfeeding observations(almost identical to unicefs) but more of them. (actually ABM were instrumental along with other vol organisations in helping to develope it)

I have the distinct advantage I feel in that I have done the ABM training, I have done the Unicef 3 day training, I have had the privilege of being close to someone who has done the BFN course, and have helped NCT trainees complete training assignments. I don't currently know the latest of LLL training, however many uears ago - 28 to be precise, the ABM split from LLL and the initial ABM training was identical at that time, but it has since been greatly enhanced and expanded.

IMHO of having seen and been involved in much BF training, I would like to say that whilst the 4 vols orgs training takes different forms, the end results are fairly similar in levels of skills and knowledge. Of course there will always be those that take on more and those that are at the base of their learning.

The UNICEF course whilst excellent 'grounding' - that is what it is - a basic course on which to built other skills that I wish ALL breastfeeding 'professionals' undertook. (BTW I also teach HP's and Midwives a breastfeeding course based on the unicef one). The unicef course does not IMHO teach any counselling skills - it shows here. It also does not do more than teach the basics - it does not go into much detail about breast refusal, weaning, drug transmission into breast milk, feeding multiples, or babies with special problems such as cleft palate, tongue tie, relactation etc.etc. which IS something that the voluntary organisations cover in their training.

We know there are also peer supporters and this is another issue. In my experience of some peer schemes, they are most definately on level pegging with the unicef course - in fact some also go onto the course to back up their knowledge.

So, please support breastfeeding mums wherever you can. Provide information and knowledge that you are trained and skilled to do. Don't mislead people with your skills. Learning is ongoing - everyone I'm sure will agree that we can never know everything, and be kind to people here.