Annabel Karmel wants people to post questions to Clare Byam- Cook - dare you!

[RubyBlueberry]

Have been on AK forum for a while (twas good for baby food recipes) and today she has sent everybody messages asking to post BF questions ... to Clare Byam Cook .... DOUBLE DARE YOU!!

Look here this page

I knew I missed something off my post.

I wanted to support other women who are struggling with breastfeeding, not because my 2y 9m of breastfeeding (almost 16 weeks of tandeming) have been easy but because they have been so hard!

Baby 1 was born at 31 weeks and it took five weeks to get her onto the breast, then she didn't grow very well and with premature babies there tends to be more panic. I spent a couple of months crying through feeds and taking her off before she was finished (before realising she was biting her straw when she had a drink then doing the same to me, pinch the straw, she stops biting!) which eventually affected her feeds and she cut back a lot sooner than most babies that age.

Baby 2 was born at 35 weeks. She was too small for the ward so had to have an NG as I couldn't be with her all the time so of course we had to teach her to breastfeed and for all of her feeds. She stopped growing and even started to loose weight. She still struggles to latch now and when I was ill one day my Mum took her out, I spent five hours trying to get a latch because she had gone "lazy".

Women who have had an easy time of pregnancy and birth are often the ones overlooked when it comes to breastfeeding support as they don't spend so much time at the hospital. I had fantastic support from the hospital, I couldn't have done it without them. I want to pass some of that onto other women. Not because it was easy for me.

Is fussymum a MNer? If not can we bribe her to join? Round of applause for her!

Giraffes, we have had a few new posters over the last couple of days, Mummyfuss looks alright, she posted further up the thread

Welcome to the newbies

My initial interest in this thread and in the discussion on the Annabel Karmel site is as a mum who's had real problems breastfeeding. I succeeded first time round and failed the second time.

Just a quick note as im off to work.

I do think regulations are needed obviously but on the other hand i do feel "we" are over regulated.

Im a childrens nurse, due to new drug regulations children with neurological problems can no longer get melation.. no clinical reasons, just regulations... fair no..

as for regulations around CBC.. she is not claiming to be qualified just an expert, which means she has knowledge.. yes it may not be inline with WHO/DOH guidelines but alot of things arent, are they?? and they do change their minds... and they are guidelines..

I think their are many people out their selling their services as experts who need regulating in some way, but CBC wouldnt be top of my list.

thanks for the welcome!

Moondog ive been qualified to long to think all researched/evidence based practise actually all works or is indeed in the interest of the patients....

I didn't know much about CBC until I read some of her quotes on this and other forums and I have to say I am quite worried about what she preaches.
On the one hand I am sure she's helped a lot of women and I agree with her guilt thing- ie women should not be made to feel bad if they can't establish BFing but her... but her methods??
I mean if you read the following quote:

"For the first few days, before your milk comes in, a baby that is latched on correctly should only need to spend approximately 15-20 minutes (7-10 minutes on each breast) at each feed"....

I'm no 'expert' but after having nursed 2 babies I know about boosting supply.

Newborns don't have 'feeds'- what would she have said if she'd seen my son cluster feed from 9PM to 4 AM less than 24 hours after he was born? (causing my milk to come in less than 48 hours )And of course they also need the comfort of the breast as a way to bond with their mother.
And does she take into account growth spurts or is that seen as 'baby-not-satisfied-mother-doesn't-have-enough-milk'?

From what I gather she's good at getting babies to latch on- as for the reast it seems that her advice is more tailored for bottlefed babies.

Goldie, I agree that cetain professions are over-regulated. I work for the NHS myself (SALT) and the time is drawing close to where paperwork and admin. are actually taking over from the actual nitty gritty.

It still doesn't mean that anyone should be able to style themselves as an 'expert' and take advantage of women when they are at their oost vulnerable place.

The main body of advice this woman gives is incorrect. That is all there is to say.

'Moondog ive been qualified to long to think all researched/evidence based practise actually all works or is indeed in the interest of the patients....'

I'd be interested in hearing you expand on your above comment.

And as for this bit

'as for regulations around CBC.. she is not claiming to be qualified just an expert, which means she has knowledge.. yes it may not be inline with WHO/DOH guidelines but alot of things arent, are they?? and they do change their minds... and they are guidelines..'

Well, in that case, lets just scrap all regulatory bodies shall we? Can I come and see you and try my hand at a bit of nursing? I've always wanted to see how a catheter is put in.
Surgery sounds like a laugh too....

Goldie, I don't think you are 'getting' the objections to CBC's practice. People can practise without following DH guidelines, as they are not law, and not even 'regulations' in any way. I don't know if CBC is telling people anything different from these guidelines, anyway, is she? (If by guidelines you mean recommending 6 mths exclusive bf - I can't think CBC would tell people not to do this, anyway).

I do think knowledge gained from experience is valuable - not everything we do can be evidence-based, or researched, and some things will never be wholly evidence-based because you can't really quantify experience, intuition, sensitivity, judgement, common sense, and a good practitioner brings all these things as well as the more formal knowledge and evidence....I'm sure it's the same with you.

However, without some assessment and supervision - the sort of thing you get with qualifications and on-going monitoring of practice by colleagues/superiors/professional body - there is a capacity for at best, ineffective 'help' and at worst, actual harm.

Someone selling a 'revamp your wardrobe' service doesn't need any assessment and supervision. But anyone offering a service in the health, well-being, emotional and family support fields does...and I would say breastfeeding support services fall into that category.

My problem with internet "experts", baby books etc and their attitude to breastfeeding is that they cannot provide one-to-one assistance and do not take into account that every mother and baby is different. What works for one person, or twenty people, or two hundred people may not work for someone else. A lot of the time the guidance you get from these pages can go totally against a mother's instincts, which can vary depending on age of baby, time of day etc.

The single best piece of advice I ever got on breastfeeding was from a midwife on the maternity ward, the morning after DD was brought up to me after 2 days in SCBU. DD was jaundiced, sleepy and reluctant to latch, had had problems with blood sugar and salt levels, a drip and formula, and I hadn't been encouraged to BF frequently for the 48 hours or so that we'd been separated. She woke up just an hour after her last feed and started to cry. Confused as to how to deal with it - she was supposed to be having blood sugar tests before feeds but only every three hours or so - I wandered over to the midwife and said, "She's woken up again - should I feed her?"

The midwife looked me straight in the eye and told me calmly, "She's your baby - you tell me!"

We never looked back. Exclusively BF till 6 months (when I went back to work full time), piled on the weight, combo feeding but still having 1-2 BFs a day at 8 months.

I do appreciate that mothers need help, and reference pages can be a good start, but a BFC who can attend to you as an individual, and your baby as an individual, without judging or bringing their own agenda to the matter, and encouraging mothers' own instincts to develop is surely the ideal?

Moondog...I didnt mention regulatory bodies, they are very different from guidelines, are they not?

There are many experts who provide information which is not inline with government recommendations, which to me is good thing.. i think its the minority of people who are not able to view a range of information and use whats appropriate/suits them.

Most research/evidence based practise is underpinned by finance... its always good to look at whos funded the research, and who is actually benefiting?? i know in my line of work different research is released depending on current goverment targets.

TicToc... Im hearing you about being supervised. Is this lady still on the NMC website? Does her practical BFing advice count as practise? I wonder if she remaiins registered... unfortunately BFing is in a sense an open playing field, anyone can advise... some think thats a good thing some obviously dont!!

"Most research/evidence based practise is underpinned by finance... "

Well - research needs to be financed by someone. That's doesn't mean that all research findings are necessarily compromised by the interests of those who are providing the funding for them.

Personally I can't see how it's a 'good thing' that people are providing information which is not in line with government recommendations, if government recommendations are based on best available evidence. At least not when it comes to the issue of things that affect the short and long term health of mothers and babies. And I don't accept that it's only a 'minority' of people who aren't able to assess whether information available in the public sphere on these issues is appropriate for them or is safe. In relation to breastfeeding there is widespread bad practice within the health service, and ignorance among parents themselves. There are consequently high rates of breastfeeding failure. How does it help mothers that there is so much conflicting advice and information on this subject available to them, and the fact that so much of it comes from those with a vested commercial interest in this area?

Im not saying all research is, it just pays to find out.

I think everyone would have different opinion on if government guidelines are always based on the best evidence/research around, but thats a different topic altogether.

I just believe in freedom of choice.

Goldie, my understanding is that CMC is no longer registered with the NMC, and she certainly describes herself as a 'retired' midwife.

I don't understand your point about research, sorry. Someone has to pay for it. In fact the guidelines on breastfeeding come from impeccable sources - unless you think Cochrane systematic reviews are somehow suspect! - and while they can never be the last word, they are a useful basis for the public health message about breastfeeding. Individual situations demand individual judgement and sensitivity, and that's where being accountable for one's practice comes in.

In your job, in the clinical area, I expect you have guidelines for the care of sick children, which don't always fit 100 per cent the needs of each and every child. You are allowed, as a professional, to use judgement and experience in addition to the guidelines, and in fact you'd be encouraged to do this, as long as you knew why you were departing from standard guidance, and could justify it to your superviser or equivalent.

It's simply not true that most people can judge for themselves which info about breastfeeding is safe, or correct, or helpful. They, understandably, rely on the people whose job it is to support them to be able to judge and share with them best practice.

If you think infant feeding is not important, then you won't think sound professional practice is important, either. But I think you do accept its importance....

Don't understand the 'freedom of choice' thing at all....I am in favour of it, too!

"i think its the minority of people who are not able to view a range of information and use whats appropriate/suits them."

goldie, I'm an information professional with a special interest in information literacy and I can say catagorically that you are mistaken about the above.

Not really following the thread, but I saw this and had to comment - it's a popular misconception that most people have these sorts of information skills.

TicTok.. Im refering to the governments use of manipulating information depending on national frameworks and targets, im not in any way saying that the BFing guidelines are suspect. The goverenment use councils like The Scientific Advisory Committee on Nutrition, and if the findings dont fit they arent published.

I am really saying that personally i would rather all information be out there so i can make my own mind up, im aware that offical guidelines are the "correct" way but sometimes i need other ways. And i do think that most people can make that decision, those that cant would maybe influenced by different factors anyway (family/friends/heat magazine..)

Im not talking about advice from midwives/HV but advice from "experts" or internet based information.

I can see exactly what your saying, but i think we just have a difference of opinion.

At work we have policys we must follow, clinically there is scope to treat people as individuals which more times than not means working out side of govenment guidelines, and yes if its justified cliniclly not a problem.

Hope that made sense!

Golide, I too think you are sadly mistaken about the amount of research the average person does when looking into breastfeeding. (In fact people seem to be quite research averse in general). Mumsnet is a bit of a non-representative sample in terms of research but even here it is clear that many people would rather not read up themselves.

I agree that there is room for various options and approaches, some will work for one person, others for another person. However, in this case we are talking about someone who is being quite heavily promoted in lots of ways, someone who is reaching large numbers of the popultion, someone that your average woman would therefore take to be "right". IMO it is important that the person or method that is getting all this publicity is also the person that is best fit for most people. One of the factors, for me, is that they should not be a person who stands to gain by knocking all the other options available.

Goldie, you are seeing conspiracies where there are none. I don't know what you mean about SACN stopping things being published - that's just utter rubbish. The literature is out there, in the peer reviewed journals....SACN has no power to stop this.

Your second and third paragraphs are mystifying to me - I literally don't know what you are saying. I think you mean you and others want to go beyond guidelines and see and judge for yourself - no one is stopping you! Anyone with access to the academic literature can read what they want - I think this is beyond most people in terms of time and committment, though.

I am not fighting anyone's right to seek advice from whomsoever they want - I just think people selling their information and their services in the health and social care field should be subject to some form of supervision and accountability. It's not illegal to practice without either of those things, so people should be aware of these shortcomigs and judge accordingly.

This is just a thought... but the average new mum would recieve advice about BFing from Midwife/HV/Friends/family.... both midwife and HV advice should be your standard DOH guidelines... then if mums having issues, HV should give info/refer on to BF support of some kind...

Mums that still struggle or have found previous advice unhelpful would look else where? books? internet? WOM?... and thats where i think info should be available.

And no bad mouthing other approachs is not good, surely everyone wants to promote breastfeeding?..

There are alot of people financially benefiting from giving advice about children.. bf/sleeping/behaviour/food/diet/exercise.. the list goes on.... some better than others.
We tend to gravitate towards advice that suits us as individuals.. like the pregnant smoker whos dr told her cutting down is better for baby than giving up...
sorry bad example!

anyways i will be shutting up now!
Good to hear everyones points, interesting reading.

Councils like the The Scientific Advisory Committee on Nutrition have alot of research which isnt published fact. Why is that?

Sorry last bit..

what im saying is all information should be available to everyone, regardless of it not fitting the current guidelines.

not given out by health prof but available if people wish to look for it.

make sense?

sorry i withdraw my comment about The Scientific Advisory Committee on Nutrition its a whole area i cant go in to.

No one here has argued in favour of censorship of information, goldie. No one wants to prevent women from seeking information from other sources, or other people, beyond their midwife or HV.

Just that those other sources - if they are charging money, or presenting themselves as experts - have a responsibility to stay updated, stay supervised, and to stay accountable.

I don't know what you are on about when you say SACN 'has a lot of research that is not published fact'..you are withdrawing this statement, I see, but I am assuming it means
you are thinking that official bodies are somehow deliberately hiding information, or twisting it in some way, in order to promote an agenda.

I'm sure that happens in some circumstances, but why would information about breastfeeding be hidden, or withheld? Who could possibly gain?