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

Incidence of hypernatraemic dehydration (HD) in a Glasgow population (specifically, babies born at the Royal Hosp for Sick Children) is reported here:

adc.bmj.com/cgi/content/full/93/9/811

The study looked at ways of reducing the incidence of this condition.

The baseline incidence was 4.77 cases per 1000 bf babies - or about one in every 200. After their intervention, which was weight monitoring, they cut it down to just under 3 cases per 1000. They say increased vigilance and knowledge would reduce it still further.

However, other studies do find a higher incidence when they are looking for milder cases of HD, because they spot more of them. The mild case might resolve itself without ever having been noticed.

Either way, HD is an unusual condition. Your average large city general hospital with, say, 5000 deliveries a year and say, 3500 of the babies bf, will see no more than 1 or 2 babies readmitted a month with HD...not nice for the babies or the mothers at all and a clear sign that bf support has not been available or effective for them, but not common.

Littleladybug: you have touched on something that very nearly happened to me and that bbc article you linked to is close to my heart. In fact, i gave birth in the same hospital where that paed works.

It wound me up awefully because his comments were crass. The danger in my experience came not from breastfeeding as his quote insinuates but from the lack of good information that is endemic in the hospital where he works. Now that may seem like a harsh thing to say about the staff at that hospital. However, in my experience there, I only came across one person, I am not even sure if she was a midwife, she may have been an auxiliary who showed me what I now know was something akin to best practice as far as breastfeeding information is concerned.

One other midwife, I suspect, knew what to do but she was from reasons best known to herself at the time, not forthcoming with the help I needed at the time.

I was on the post natal ward for 8 yes, 8 days with my baby so i met a lot of different staff in that time. It was by the Grace of God that she did not need a drip from hypernatraemic dehydration and this all occurred right under the noses of midwives and paeds. this was not a mum sent home etc.

Oh, the problem was not either from lack of milk, some biological problem with my baby or I, or me being a 'duff milker' whatever that is.

My problem was more simple and more easily fixed - with very basic information had the staff had it.

My problem stemmed from ignorance of breastfeeding knowledge or if it was there, failure to transmit that to me.

It is midwives, HVs, paeds and (exMWs as per this thread) with poor information who put more babies at risk of (and sadly actual) dehydration than it is women's milk supply or ability to form a successful breastfeed relationship with her baby.

experiences like mine, of which there are too many, is why CBC and others coming into contact with new mothers need to update their knowledge and be answerable to a professional organisation which oversees their work.

Foxy, elkidee, so sad to read your stories. It is through your sheer persistence that you succeeded, whereas many others might have turned to the (baby) bottle.

It is so terribly insidious this implication that some women are physiologically better at bf-ing than others ('duff milkers, wtf??) and it comes from all angles - mothers, doctors, nurses, baby media over which the unholy trinity cultivate an iron grip. Too easy to knock a new mother's confidence, particularly where it is the welfare of her baby involved.

Hence, the high feeling on mn when someone who claims to be an 'expert' or 'guru' (whatever that means) in bf-ing perpetuates lazy myths as a convenient shortcut to actually solving bf-ing issues, because they don't have the training, skill or patience to the root of the problem.

littleladybug, welcome .

Somehow I think you will feel right at home here.

?Why? for instance would she (CBC) say this ?Your Breastfeeding Problems Solved? pages?
?If you went under a bus tomorrow she would have to give up breastfeeding and take a bottle, so I do not think it is cruel to teach a baby to take a bottle as well as a breast and cup?

Because the chances of someone going under a bus when they are in the early days of establishing breastfeeding is small enough that it doesn't warrant the bother? possibly?

yes statistically, it can occur but what are the odds? hmm?

and what about the more likely risk of nipple confusion in the early days? greater than going under a bus me thinks.

oh, apologies. CBC doesn't think nipple confusion exists. and she is the guru.

"Forget everything the midwife, NCT breastfeeding counsellor and books told you about aligning your baby's nose to your nipple. It's utter nonsense. If you were bottlefeeding, would you shove the bottle up your baby's nose? Line the nipple with your baby's mouth and, instead of waiting for your baby to 'open wide', squidge your breast into a suitable shape for him to latch on to."

"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"

"Don't listen to what people say about letting your baby dictate the amount of time she should be on there. If she's on there too long you are, in effect, giving her a dummy not a bottle"

"A good way to find out how much your baby needs at each feed is to treat him as if he were a toddler. If you were giving a toddler breakfast, you would want him to have enough sustenance to go three or four hours before needing his next meal. The same applies to a baby. If he regularly cries with hunger within an hour or so of a feed, he is almost certainly not taking enough milk during each feed to last him longer. Make sure you fill him to the brim at each feed"

Just a few quotes from CBC giving breastfeeding advice on a
website I felt very when reading it. Seriously, why is this woman called a breastfeeding expert?

I wonder if limiting the amount of time and how often a baby is allowed to nurse has anything to do with dehydration?

So on the one hand they are blaming BF for dehydration and on the other hand they are telling you to limit the amount of time a young baby feeds... How on earth is that sensible?

coo, if she is expecting a baby to b-feed only once every 3-4 hours - which I read the 4th quote as saying - then that could very well be a factor in dehydration.

I have read research which says that there is a risk of strict 4-hourly feeds resulting in babies ending up in hospital for dehydration.

One piece of misleading advice I was given with ds1 (who was readmitted to hospital 2 days later with hypernatraemic dehydration) was that I could wait 3 hours between the end of one feed and the beginning of the next. It was very attractive but wrong!

I read her book actually, skim-read it in the library after wheeling DS around town for ages to get him to sleep! I remember it having some rather dodgy advice in there. Can't remember what actually was said but I think something about cosleeping not being good for the mother, yes and I am sure about limiting duration of feeds. Sorry, but a bottle doesn't need to be stimulated to produce milk, a breast does - it's not "just using you as a dummy" - and what a ridiculous comparison anyway! Do people think stone age babies evolved with little dummies?? Sorry, just bugs me! They could at least say "using the breast as a thumb" or something.

The 'nose to nipple' thing she quotes is sometimes badly taught (or badly understood...or both!). It's not a question 'shoving' anything 'up' anywhere . I no longer use the phrase as it is easily misunderstood, but it's meant to be a reminder that putting the nipple in centrally is a quick way to ensure the tongue is in the way of a comfortable breastfeed. To help this happen, a baby with mouth closed has his nose on a plain with the nipple - and when he opens it, the top third of his mouth can come over the nipple (ie the bit of the mouth nearest the nose ) If the baby's mouth is open, it really is not good to be aiming at the nose (though you can still ensure you are not aiming in the middle of the mouth!).

The timing and scheduling of feeds she describes is unhelpful for most mothers and babies. I don't understand why she thinks caring for a baby should be the same as caring for a toddler - and most toddlers need something to eat and drink rather sooner than 3-4 hours anyway.

The thing with about filling baby 'to the brim' and giving them enough milk to go 4 hours between feeds just doesn't work with bf does it? The beauty of bf is that the baby takes just what they need at that time. They aren't supposed to get overloaded. Plus in the hot weather they'll almost certainly feed more frequently because bm acts as a drink as well as food.

Why on earth is CBC branded as an expert? How can she blame 'failed' bf for causing dehydration, when also advocating regimented feeding schedules?

""Don't listen to what people say about letting your baby dictate the amount of time she should be on there. If she's on there too long you are, in effect, giving her a dummy not a bottle"

See, I think part of the problem is that she thinks BF is simply a matter of correctly attatching a baby to a 'full' breast and allowing them to suck on it for x minutes, by which time it will be 'empty' and the baby will be sated. In other words, I don't think she sees any major difference between BF/FF beyond the actual milk.

She doesn't seem to have any idea about how BF really works, how milk is made, how supply and demand works, the importance of a true BF relationship, how women are demoralised by an unsympathetic and unrealistic culture (to which she blimmin well contributes)

And of course the whole 4 hourly crap is further evidence and part of the same thing.

It's the fact that she says "Forget everything the midwife, NCT breastfeeding counsellor and books told you" that really riles me. Who is she undermine health professionals and trained BFCs?

The nose to nipple thing always worked for us. In fact, when dd started weaning, I noticed she would hit her nose with her food, then bring in down into her open mouth. It looked rather clumsy but was very cute!

tiktok, I just read the toddler quote and thought "that's not even how we feed D" (almost 2 year old ds1) - we do have regular meals and routine scheduled to fit what works for ds1, but I tend to assume he will eat what he needs at a meal and tell us if he's hungry at another time (he's quite a good eater and I have a vision of someone shovelling food into a toddler when I read that.

TBH, my opinion is that limiting the time off feeds or the time between feeds is one of the biggest factors that cause mothers and babies problem. For a start it can cause problems with the baby getting what it needs, secondly it opens up a world of ways that the mother can end up feeling inadequate! Baby cries before next feed os due = Mother not feeding enough in one go/supply too low. Baby won't take second breast for the "required" 10 minutes = mother is over producing fore milk. Baby doesn't sleep long enough between feeds = mother is not producing enough milk/the milk is poor quality. The list of stupid lines I have heard is endless and almost all of them are sorted by the mother demand feeding and relaxing about the whole issue (which is very hard to do once you have already been wound up by the above "advice").

I know a lot of experts think they are helping and I know that more help is needed, it just seems to me, they are helping with the wrong things. Mother and baby are quite good at working out when and how long etc between them however getting a decent latch, dealing with a sleepy baby, dealing with tiredness in the mother, latching lying down etc are all things that can really change a mothers life WRT breastfeeding. (Of course this is all just my opinion and I am probably wrong )

As someone who (reluctantly) bottle fed my first baby I didn't push the whole bottle down his throat to fill him to the brim, I aimed to offer a feed about every 3 hours but would also try to follow his cues.

And does she seriously thing that a baby has the same sized stomach as a toddler??

Breastmilk is, by design, easily digested. That's one of the wonderful things about it. They do sometimes want more within an hour of their last feed, but it doesn't mean they're not taking enough.

Preaching to the converted of course!

Heck, I need feeding and watering more than once every 3-4 hours! What tosh she advises for babies and toddlers.

The thing is, though, I expect she is pretty good at teaching mothers how to 'get the baby on', even if she does it in her own particular way and slags everyone else's off in the process.

This is a skill which gets better and better the longer you do it - if her specialty is getting reluctant (new) babies and tearful, desperate mothers to breastfeed, then she will have enough customers to keep her going for some time yet.

On the occasions when it doesn't work, she will be very brisk and matter of fact about using formula, and blame it all on being a bad milker or something. Mothers may not see the limitations of this sort of 'reassurance' and I expect for some it feels right.

This sort of 'flying squad' approach to breastfeeding help is only a tiny part of breastfeeding support, but at the right moment with the right clients, it can be effective. I am guessing. If she leaves her clients thinking they should limit, time and schedule feeds, however, and they obey this, then their breastfeeding may be curtailed.

I am guessing all this, BTW - I only know of her indirectly, and by having read her book and heard her on TV and radio.

I can't get the link to work anymore

maybe too many lurkers crashed the site?