eeding stf brea Sept/Oct 2015 mattersmatters # 209

xRelactation against the odds – the long game x xAncient breastmilk for modernLa Leche debates League GB - support mother-to for breastfeeding

La Leche League GB

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Editor: Helen Lloyd Co-Editor: Justine Fieth Photo courtesy of Contributing Editors: Emma Gardner, Hannah Bussey Lisa Hassan-Scott Graphic Design: Benaifer Bhandari LLL Farnham Editorial Consultant: Ginny Eaton

Contributions Breastfeeding Matters is YOUR magazine, we always need your letters and stories. Photos need to be clear inside… and good quality—please send high resolution digital photos to the Editors at [email protected] ’ Stories Relactation against the odds ...... 4 Personal views expressed here are not necessarily those of La Leche League. All submissions will be Breastfeeding - the long game ...... 9 acknowledged and are subject to editing. All articles Ancient breastmilk for modern debates ...... 12 published in Breastfeeding Matters become the property of La Leche League. Tandem nursing and other challenges ...... 22 LLLGB does not endorse products advertised or other Breastfeeding with tongue-tie ...... 26 organisations mentioned in Breastfeeding Matters or items included in the mailing. The brightest force ...... 29

© La Leche League Great Britain La Leche League Great Britain is a company limited by Regular Articles guarantee registered in England Editor’s letter ...... 3 Registered Office: 129a Middleton Boulevard, Wollaton Park, Nottingham, NG8 1FW Mothers on…social lives ...... 16 Company Number 01566925 Meet a Leader ...... 18 Registered Charity Number 283771 Leaflet Review - When mum can’t be there ...... 20 Printed by Roy Nadin Print Limited on 80% recycled paper www.roynadinprint.co.uk News and Events

Becoming a Leader ...... 8 Become a member ...... 17

How to get help from La Leche League GB ...... 30 National Helpline 0845 120 2918 New Leaders ...... 30 LLLGB Shop ...... 31 EEddiittoorr’’ss lleetttteerr

A remarkably constant feature of breastfeeding is change.

Your new baby arrives and you learn together, working out how to combine your bodies, support a floppy newborn, nurture yourself physically, and so on. You learn your baby’s feeding cues, how to tell whether he’s getting enough, how to work out if he’s feeding well…then wham! As soon as you have it nailed, things change. Suddenly you have a four month old who’s constantly distracted by everything around him, so you learn a whole new range of tricks to keep him focussed. Move a little further on, and you have a baby starting to eat solids, so you have to work out between you how to balance and food, and how to keep the breastfeeding relationship strong once your child can move around. Toddler nursing: again a new set of skills for you both, as he tries out acrobatics, and learns new and innovative ways to make his requests. So it’s not a case of learning to breastfeed, mastering the skill, and then cruising along (though for many mothers the initial learning is by far the hardest part).

For myself, I’m seeing this all for the second time, and have had the chance to notice that second babies aren’t necessarily like their brothers, and my top techniques from last time round don’t all work so well this time. Embracing the constant change, going along with the flow, and enjoying having to adapt to whatever my babies throw at me next: these have all been crucial to keeping my relationships with my boys happy and healthy.

Change seems to be a bit of a theme in this issue. You might have noticed a new series, in which we’ll summarise some of our popular information sheets on key breastfeeding topics – if you’ve never looked at our information sheets before, they’re a great source of information and moral support. We’re also trying out a few issues without adverts. Some people loved the adverts, but for some they were detracting from the messages about breastfeeding. This is why the magazine looks thinner – though it’s still just as closely packed with mothers’ stories and other features. Do let us know if you have strong views on this.

I love the piece on page 12 about breastfeeding and antiquity because it shows the flipside of change: continuity. Fashions come and go, and our knowledge about the worth of breastfeeding is increasing all the time, but this piece reminds us that as long as there have been people, mothers have been nurturing their babies at the . Thank you for supporting LLLGB in our work to let this carry on! Helen

Helen Lloyd is a Leader in Bath and is mum to Isaac (4) and Aneurin (1). Co-Editor Justine Fieth is a Leader in Cambridge and is mum to Josh (11) and Kezia (7).

Join us to chat on Facebook at www.facebook.com/breastfeedinglllgb Mothering through breastfeeding is the most natural and effective way of understanding and satisfying the needs of the baby. (One of the ten LLL philosophy statements) RReellaaccttaattiioonn aaggaaiinnsstt tthhee ooddddss

Emma Hawkins

Emma was thrilled to conceive after fertility issues, but breastfeeding was an uphill struggle. She and her son have moved from exclusive formula feeding back to partial breastfeeding, and here she tells us how they overcame their hurdles.

All photos courtesy of Emma Hawkins I feel it's best to tell my story from the the safest method because of reduced beginning to get a true sense of it and foetal movement and therefore the to enable others to see that relactation MLBU was out of the question. is possible even with the odds against you. During pregnancy I suffered with Symphysis Pubis Dysfunction (SPD) In our early twenties my fiancé and I and a tilted pelvis, and my tailbone decided that a baby was a missing kept shifting, so I was in a lot of pain piece of our almost perfect jigsaw and spent the last couple of months of puzzle and began trying to conceive. pregnancy on crutches. When the After a year of actively trying and not time came and I was in active labour it being successful I paid a visit to the was incredibly painful with Oscar in a doctors, and was diagnosed with back to back position adding to my Polycystic Ovarian Syndrome own back problems and there was no (PCOS). We were assigned a fertility time to administer anaesthetic with the nurse and she decided that the fertility episiotomy. Oscar was delivered by treatment Clomiphene Citrate - suction cup, he was finally here! commonly known as Clomid - was the best way to go. An hour after Oscar had been born it was noticed that he hadn't taken his After a very stressful three months bottle, so a feeding supporter came in (Clomid can have rather unpleasant to see us and tried feeding Oscar. side effects) we got the fantastic news After several attempts at using the that the treatment was a success and bottle, cup and syringe a doctor from I was pregnant. A very anxious, the Neonatal Intensive Care Unit was exciting, tiring, delightful, hormonal asked to come in. She asked if she and happy nine months later I gave could take Oscar down just to be birth to an absolutely beautiful baby looked at by another doctor and said boy on Christmas Eve 2014. We could he'd be back with us within 20 not have been happier and finally our minutes. puzzle was complete. Two hours later she came back and Due to a breast reduction I’d had for informed us that he had a suspected health reasons when I was 18, I was infection and needed antibiotics and a told from the beginning that stay in NICU. After a few days there, breastfeeding was something that I with a feeding tube, his test results wouldn't be able to do. Because of came back and we could take him this we had prepared ourselves with home. My hormones had been thrown all the equipment for formula feeding around all over the place and I was and packed it in my hospital bag. again on a high. I couldn't wait to get my baby boy home! We got home on The birth itself was less than desirable. We had chosen to be looked after by the Led Birthing Unit (MLBU) at our local hospital which would enable me to I was told from the beginning have the water birth I desired. However, late in my pregnancy, after that breastfeeding was something a trip to see the consultant it was decided that an induction would be that I wouldn't be able to do.

Helpline 0845 120 2918 Page 5 been mentioned by several midwives and nurses in the NICU, and the hospital paediatrician was told about it, but no one acted any further. We were then sent for an urgent referral to see a neonatal surgeon who specialised in tongue-ties who confirmed that it seemed to be holding him back from effective feeding. The tongue-tie was snipped and off we went home.

When Oscar didn’t start to gain weight immediately, it was decided that because he hadn't been feeding effectively he hadn't demanded the milk and built my supply up, and I was told to formula feed him from the bottle. By this point I was exhausted from all the visits and the worry and I just wanted my baby to be okay, so I agreed.

A few weeks went by and Oscar the Saturday tea-time and after gained weight fantastically. My mood opening our Christmas presents - though wasn't so great and after a few they were still sitting under the tree - people mentioning that I'd been we all went to bed as a family. ‘starving my baby’, the guilt caught up with me and in the middle of February During one of Oscar’s night time 2015 I was diagnosed with borderline feeds that night, I thought the bottle post-natal depression. had leaked everywhere but after a bit of confusion we realised it wasn't the After being on anti-depressants for a bottle, it was me! My milk had actually few weeks I started to see my come in and I was able to experience in a different light. On the breastfeed. We were visited the next way home from an afternoon out with day by a midwife who was happy with a baby screaming because he didn't Oscar’s and gave me the go want the formula because I hadn't ahead to breastfeed. The day after warmed it up, because I'd forgotten that we then saw another midwife the bottle warming flask I suddenly who noticed he had lost weight, and realised - why did I let them take over the next couple of weeks this away my chance of nursing my baby continued, with him being weighed at least every other day.

It was only two weeks later, when …after a few people mentioning Oscar still hadn’t gained enough weight, that one of the midwives that I'd been ‘starving my baby’ asked us whether anyone had told us Oscar had a tongue-tie. It had, in fact, the guilt caught up with me…

Page 6 www.laleche.org.uk who may be the only baby I ever have. Within about five minutes I …eventually four weeks after I decided to try relactating. Oscar was three months old and my milk had had started the journey I got a dried up. spray of milk! I spent the next week looking at every piece of advice on the internet, and pumping to mention I now produce informed two good friends of mine - breastmilk. one a breastfeeding mother to a baby three weeks younger than Oscar and It would not have been possible another who is a breastfeeding peer without the support of good friends supporter.Then I started my journey and those who support breastfeeding of relactation. I hired a hospital grade mothers - I was introduced to a La , bought a supplemental Leche League breastfeeding nursing system (SNS), took counsellor - who all cheered me on. fenugreek, latched Oscar on at every I hope that by telling my story I've possible moment (I'm sure he got fed been able to give at least one person up with me waving a boob with no the confidence to trust their instincts milk in his face) bed-shared, wore and fight for what they really Oscar in a sling and pumped like want. My fight was to feed my baby crazy! and I won.

After a week of pumping with no milk coming out whatsoever - this is a very difficult stage to keep going as you feel like you're getting nowhere - I spotted a few yellow dots on one of my . I carried on pumping and a couple of days later these turned into white dots. Then I started getting drops and eventually four weeks after I had started the journey I got a spray of milk!

At the present moment I am feeding Oscar with a combination of breast and formula milk as my supply is not yet enough for his demands. However we are sticking at it and like they say - every drop counts. I'm now able to nurse my baby to sleep and he latches on during the day and night for a feed and comfort too. With an awful lot of patience, perseverance and way too much

Mother and baby need to be together early and often to establish a satisfying relationship and an adequate milk supply. (One of the ten LLL philosophy statements)

Would you like to give something back to La Leche League for the support you have received?

Would you like to support other mothers to breastfeed?

Then the La Leche League International accreditation process may be the life changing experience you are looking for.

To find out more about becoming an LLL Leader, speak with your local Leader about the prerequisites and the role.

If you don’t have a group near you, contact Tracey [email protected] for more information.

Making the transition from being a mother—to being a mother who is also an LLL Leader could just be the fulfilling adventure you have been waiting for!

[email protected]

Page 8 www.laleche.org.uk BBrreeaassttffeeeeddiinngg –– tthhee lloonngg ggaammee

Lara Jones LLL Cambridge

Lara shares her Photos courtesy of Lara Jones Jones of Lara courtesy Photos experience of using the foundation of a breastfeeding relationship as a basis for mothering her son even beyond weaning. She sees how the close communication and shared understanding that begins with breastfeeding continues way past toddlerhood.

To say that when I held my first baby in my arms I found it hard to imagine packing him off to school would be a massive understatement. He was so tiny and I, as a first time mum, was so completely ‘in the moment’ I couldn’t see beyond the next hour let alone into the next four years.

Everything with my first was E-V-E-R-Y-THING, he was all I could think about: from the colour of his nappies, to whether I had put his coat on ‘gently’ enough. These concerns and so many others haunted me night and day. And my biggest query, for many months after his birth, was breastfeeding really worth it?

I remember a pivotal moment in my breastfeeding journey. Our baby was about two weeks old and I had lost it on a monumental scale. I was hysterical with exhaustion; I felt like I hadn’t slept since the birth. Everything was a catastrophe, especially my chosen feeding method. My husband calmly reminded me that I had wanted to breastfeed, and that we had decided that it would be the best thing for our baby. I sobbed, shouted, and then stormed out of the room. My husband took the baby out in the sling. He’d never been away from me before and as the minutes ticked by I grew more and more alarmed. I needed him back.

Helpline 0845 120 2918 Page 9 themselves. Their breathing tells us When we are breastfeeding our something, the way their legs are restless; their temperature against us babies we are taking cues from something else, the way their eyes are wondering or how the colour of their them all the time. cheek has changed tells us something else again. And we add it all up and we say “Ah, it is this.” And that is how I needed to feed him: I needed to know breastfeeding engenders confident he was OK. I didn’t realise then just how mothering and children who are closely needing to breastfeed him and confident in their mothers. A knowing if he was OK were related. breastfeeding mother knows her child, They returned and as I rushed to put simply because breastfeeding caused him to my breast, “Yes” something new her to stop and notice him right from the inside me said, “Yes, he’s OK.” start. And if you know your child, believe Breastfeeding solutions to breastfeeding me you’re on to a winner. problems is what a wise LLL mother might say, but what she can’t tell you is As your baby grows you get into the that there are going to be so many more groove, the balls keep coming and each problems solved by breastfeeding than time the speed and the angle get a bit you can ever possibly imagine as you more familiar. That little pitcher keeps hold your first limp little bundle. trying to throw you off but you’ve been Breastfeeding is a long game, watching, you know all his tells and something you do for a newborn. Of nothing gets past you. It’s naptime, it’s course, it is vitally important: But nurse time, it’s playtime, he’s coming something you do for your future five down with something, those sleeves year old that is no longer nursing? Yes. irritate him – you’re on fire!! Your limbs

Why? Let me share a story from my loosen. You’re breathing and enjoying mothering game. the game, you just keep hitting those balls right out of the park! You’re a One morning on the way to school that mothering champion and your baby same baby announced he was tired; I knows it. Then the time comes to leave brushed it off, and said, “You’ll be fine.” the pitch, and the game is over. Except But something stirred in me, a familiar it isn’t. nudge to pay attention. When we are breastfeeding our babies we are taking So there we were, I pregnant kneeling cues from them all the time, the tired down to him, my maternity leggings eyes, the quivering lip, the enraged going soggy at the knees, autumn scream; we scoop them up or manhandle them into our arms and we nurse them. And breastfeeding works its magic. It is thirst quenched, hunger sated, anger soothed, frustration diminished, tears turned to smiles.

When we nurse, mother and baby are enclosed inside a white chalk line a bit like one you might see on the green grass of a sports field. The circle is just big enough for two and as we hold them close we say without speaking “I’m here. What’s going on?” We listen closely. And in a million ways, only We are both learning to let go perceptible to us, our children explain as Ewan moves onto the next stage in his life. leaves whipping past us while my baby space for you and your child, together. told me in a very circuitous way how he Learning how to be sensitive to him and was feeling. And I listened. We had how to help him. That line draws the drawn those chalk lines around us line, it says this is the limit. This is my again and even though other families child’s limit. Now the world, with its were rushing past and I felt an urgency opinions and expectations, must retreat about being on time and an anxiety so that it can be just us two again. about toeing the line, I stopped Tears turn to smiles over and over anyhow, I pressed pause. I knew how again on our little patch of grass, easily, to watch: alert, open and ready for simply. As simple as a ball soaring into whatever was coming my way. And it the blue. always feels so good to be back out on the pitch. So I saw his tired eyes and his pale cheeks and I saw that he was in fact Breastfeeding gave me that. That line tired, too tired for school. I heard he brought me time. Time to re-group and needed me and I heard he wanted me to find my centre again. To look at my and I said “Alright then, let’s go home.” child afresh and say to myself, “Hey, I and we did. I scooped him up, yes I can handle this.” I learned to be his was six months pregnant and yes a helpmate, his friend, his sounding four year old is heavy but I was taking board, and I learned it all without really my baby home. And if I could have knowing that it was happening. When known that when he was two weeks he was tiny and I was desperate, I old, if someone had had a crystal ball became his advocate, I grew to trust and shown me that moment I would him and to trust myself, and to make have stopped sobbing, pulled up a decisions based on what I thought was chair and a stool for my feet, told my best, as his mother. husband to get me an enormous piece of cake, make that the whole cake, And now as I watch tearful children and because I was going to be anxious mothers in the playground I breastfeeding my baby for a few realise that I will never regret learning innings yet and I was going to need to draw that line. Learning to make a the energy.

AAnncciieenntt bbrreeaassttmmiillkk ffoorr mmooddeerrnn ddeebbaatteess Laurence Totelin

Romano-Celtic goddess feeding twins. First-third century CE. Courtesy of the Roman Museum of Lausanne-Vidy, Switzerland. Like all women, I have multiple Remus were abandoned at birth, identities. To my two boys and saved by a kind she-wolf who (Thomas, 8, and Gwilym, 3), I am fed them. Romulus went on to ‘Mummy’ or ‘Maman’ (as I grew up found Rome, after killing his twin in Francophone Belgium). To my brother. This is of course a myth. students, I am ‘Dr Totelin’ or As it happens, the Latin word for ‘Laurence’. For a long time, I ‘she-wolf’ is lupa, which can also believed in carefully separating my refer to a prostitute. The kind she- professional and private wolf was most likely a big-hearted personalities. I somehow convinced whore. Still, the representation of myself that my interest in the the two babies suckling from the history of Greek and Roman wild beast became a defining gynaecology was strictly image for the Romans. What would intellectual. Things started to they have seen in it? Perhaps they change during my second would have imagined that, through pregnancy, which was much more her milk, the wolf passed on her trying and tiring than the first, and wild and brave characteristics to when private and professional the foundlings. Or perhaps, they collided. would just have – as we do – realised the incongruity of the All was well in the end, and in situation and marvelled at how the many ways, looking after a second two boys survived in those baby was easier than the first time circumstances. For, in the ancient around, especially with world, one had to be particularly breastfeeding, which went very strong to survive on animal milk well. I just listened to Gwilym’s alone. Human babies are meant to needs and to my own body’s cues. drink human milk. The milk of other After a few weeks of recovery, I animals will be difficult to digest, or regularly attended my local not nutritious enough, or plainly breastfeeding support group: dangerous because of the bacteria Penarth Baby Latte. I met it contains. wonderful women, many of whom had breastfed toddlers – something Animal and human milk in I had not done with Thomas (I antiquity stopped when he was one). I also Speaking generally, the Greeks found that these women were and Romans did not drink much interested in my work on ancient raw milk, preferring cheese. gynaecology. One thing led to the However, they used raw milk in other, and I decided that my next medical practice. In particular, work project would be on milk, and animal milk was employed to cause that I would reach out of the purges, that is, vomiting and/or academic ivory tower and hopefully diarrhoea. This was believed to show that history can contribute to evacuate bad humours that had modern debates on breastfeeding. accumulated in the body. To cause a purge, milk or whey had to be The twins and the she-wolf consumed in large quantities. Still, All Romans were familiar with the these amounts are probably not story of how the twins Romulus and much larger than what many of us

Helpline 0845 120 2918 Page 13 drink on a daily basis. This is a population it certainly was not. Of stark reminder that humans have course, some mothers found it – over centuries – built a herd harder to breastfeed than others. tolerance to lactose. Although we have almost no written sources here, we must guess that Since animal milk was considered a these women relied on the help of purgative, it was not given to babies friends or family relatives, who would in antiquity. The only suitable food have taken care of the . for a baby was breastmilk. However, evidence relating to breastfeeding in Analysis of ancient bones can ancient texts and representations is help us nuance and complement rare. This is perhaps because it was the picture found in ancient texts. simply too normal for notice. Our By analysing the chemical information comes from the very composition of bones, highest parts of society, where archaeologists know how long women often used wet-nurses to babies were breastfed, and how relieve themselves from the duty of they were weaned. It appears that breastfeeding. That evidence, in the ancient world, weaning was however, should not lead us to progressive, with introduction of believe wet-nursing was ‘normal’ in foods around six months, and antiquity. For the vast majority of the complete weaning from the breast

Capitoline she-wolf feeding the twins Romulus and Remus. Renaissance representation of the Roman myth. Museo Nuovo in the Palazzo dei Conservatori, Rome. Image in the public domain. occurring between 18 months and about the treatment of children three years, with an average here, but rather that of adults. This around two years. The analysis also means that adults sometimes drank shows that weaning was a breastmilk at the source rather than dangerous time, linked to higher expressed milk. mortality. New suggestions for modern Other uses of breastmilk in debates antiquity Modern debates about breastmilk In antiquity, then, breastmilk was often mention the ‘breast is best’ the only really suitable food for catch-phrase. History, archaeology babies. Breastmilk, however, was and anthropology tell us that ‘breast used for many other purposes, is normal’ – even more ‘breast is some of which are rather surprising survival’. Our world is very different to the modern reader. This is what from the ancient Greek and Roman Dioscorides (first century CE), an one: fewer women live near their important writer on pharmacology, sisters and other close family wrote about the properties of members to whom they would trust woman’s milk: the feeding of their babies. That cannot be changed, but I would like Woman’s milk is very sweet and to see representation of nutritive. Suckled, it helps in cases breastfeeding become the norm in of heartburn, phthisis, and against history programmes, history books, poisoning by means of sea-hare. and in museums, in particular when Mixed with crushed frankincense, it they have children as their main is dripped in eyes that have been audience. injured by a blow. Mixed with hemlock and applied as a cerate, it One obstacle to breastfeeding is helps those who suffer from gout. the fact that many women come to (Dioscorides, On the Properties of breastfeeding without having ever Medicines 2.70.6) seen anyone else nursing an infant.

So breastmilk was helpful against Little by little, this will be remedied, heartburn, phthisis (a lung disease), but in the meantime, history can fill poisoning, eye injuries, and gout. In in some gaps and help educate a other texts, breastmilk is also more breastfeeding-friendly recommended for ear infections, generation. For that reason, I have and as an emollient in the started talking to social scientists application of gynaecological and consultant midwives in order to pessaries. It is important to note create activities that will bring that, when breastmilk is to be taken families together to talk about the by mouth, Dioscorides recommends history of infant feeding in local it be suckled. Now, he is not talking communities.

Human milk is the natural food for babies, uniquely meeting their changing needs. (One of the ten LLL philosophy statements) Helpline 0845 120 2918 Page 15

We asked mothers MMootthheerrss oonn ...... how their social lives had changed ...social lives since having a baby.

Mara Going out for lunch has replaced romantic evening dates. And now children come too. It's not relaxing or romantic but 'we are family'; children grow quickly and we'll be able to go out in the evening as a couple again when they can cope easily without us (so in about a year or so!). But in a year or so, we might equally be too old and exhausted to face it. Telly, chocolate, baby sleeping/feeding on my lap and pot of tea are a middle aged but perfectly nice way to spend evenings in the meantime!

Rebecca It's all gone daytime! Which is tricky when you have to match up work schedules, but fits around small children more easily. I have kept some friendships 'ticking over' via Facebook too. I may not be getting up and down the country to see old friends all the time, but at least we can see what each other are up to until the days we're all more mobile again.

Marie One thing is having to explain to people that you are not yet ready to go to events because you do not want to leave your breastfeeding baby/toddler. And explaining that's fine with you because you don't feel the need ‘for a break’.

Stef My social life wasn't as impressive once I hit my thirties as it was in my twenties and so I don't really miss it too much at all. Now I have my little girl, I have a whole new group of mummy friends that have children of a similar age. I appreciate my life much more now than I did before becoming a mum and I am very lucky to have a fantastic partner who like me loves being a . We love spending time as a family and actually don't enjoy going out without our girl as we miss her too much.

Chhaya Now it is about going out during the day or meeting up with friends after little one has gone to sleep in the evening. I've met up with friends at about 8.30/9pm when all I want to do is join little one in bed! But once I'm there it’s lovely catching up with them. I tend to stay local too in case there is a problem. I also use WhatsApp so keep in touch that way. And it's easier on WhatsApp as I have groups set up so can talk to friends at once rather than having to message individual ones asking same thing. And if they have children I arrange playdates, although most of those are spent running around children and not catching up!

Vicky Our weekend social life has moved from evening BBQs and meals with friends to lunchtimes. Personally I love it, we get fun with friends AND a nice chilled evening at home!

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Rebecca My partner is a lovely dad and every once in a while he goes out with friends (without me) and comes home 'merry' and is hungover the next day. I kind of don't mind but I kind of do. I know it's good for him to relax and see friends; after all, I do lots of a different sort of socialising during the day while he's working. But I do find myself resenting it a bit that he has the freedom he has to make that choice, even though I don't necessarily actually want to do it myself.

Jess I've found it hard that my husband would still like us to go out in the evenings, but I just don’t want to leave my baby. Sometimes it feels like I’m really pulled between them. There isn’t always enough of me to be mummy, wife and the sociable friend I was before babies!

Emma Now my children are older (youngest is 5) I feel more inclined to go out for an evening with friends. My needs and my children’s’ have changed as we've become older. I can’t do more than one evening every few months! And my children are don’t miss me when I do go out.

Daisy My social life is now with other families. Predominantly with other mums because of the nature of the average working family. I'm happy to put my adult social life on hold for year or so until my youngest either weans or doesn't feed to sleep.

Jaime Breastfeeding means I can take baby with me without the need for masses of preparation.

B LLLGB!

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By becoming a member you help us to:

ioperate our 24/7 National Helpline iproduce leaflets and information sheets iprepare new Leaders istart new groups

As a member you will receive this members' magazine Breastfeeding Matters

An annual membership cost only £30 for 12 months (£18 for an unwaged family)

Join online at www.laleche.org.uk/content/join-us

Helpline 0845 120 2918 Page 17

MMeeeett aa LLeeaaddeerr Each issue we talk to a Leader, asking them about their involvement with LLL. This issue we talk to Anna Patecka-Gebka.

Tell us about you, your family, and which LLL group you're involved with. My husband and I are originally from Poland and we came to the UK after living for a decade in Germany, however our son was born here and my husband is now British too. I became a Leader with Tyne & Wear nearly five years ago. Photos courtesy of Anna Patecka-Gebka

What was your first involvement with LLL? After a few months of struggling with breastfeeding I ended up expressing and combination feeding and didn't know what to do. Like many mums I see LLL was the last resort. If it wasn't for LLL, practical help, meetings and books I would have given up breastfeeding. Instead I breastfed my son for 4 years and we both we fond memories.

...and what made you decide to become a Leader? I knew I wanted to be a Leader from the first time I met Amanda Dunbar, who then became my supporting leader. The vast knowledge and experience combined with the philosophy really spoke to me. It was LLL and the LLL tribe that helped me to be the mother I am, listen to my baby and seek information and make my own decisions. The way LLL supports mothers by providing information

Page 18 www.laleche.org.uk and being a sounding board supporting mothers in making decisions is unique. It's very empowering. Plus the various forms we provide support, one-to-ones, Helpforms, Helpline, meetings — there is something for every mother and Leader.

But it was too early in my breastfeeding journey for me to apply so I spend several months reading all the books and attending meetings. Determined as I was, my application took five months.

What's a typical meeting of your group like? Busy! LLL Tyne & Wear does two meetings a month, one in Washington and one in North Tyneside.

Is there anything LLL does — or could do - beyond your group that you'd like to tell the world about? We have very strong links with LLL Poland and myself and another Leader in Tyne & Wear have helped with application processes for Polish Leaders.

If you had a friend with a new baby, what would you take as a gift on your first visit? Flowers and chocolates!

What would you say is the biggest benefit of LLL membership? Knowing each membership directly helps LLL, including LLL Tyne & Wear, to continue to provide support to every mother who needs it. Plus you'll be treating yourself to Breastfeeding Matters!

In the early years the baby has an intense need to be with his mother which is as basic as his need for food. (One of the ten LLL philosophy statements) Helpline 0845 120 2918 Page 19 Support is absolutely Support is

When mum can’t be there LLeeaafflleett RReevviieeww LLLGB Information sheet

LLLGB produces a range of information leaflets and booklets on many aspects of For the carer—before a baby you breastfeeding. Here, in the first of a new will be caring for is left with you, feature, we summarise one of the practical allow as much time as possible leaflets which is written for someone who for him to form an attachment to may be caring for your baby if you are away. you whilst still in the presence of his mother.

A breastfed baby is more likely to allow someone else to feed him if CARING FOR THE BREASTFED BABY his mum isn’t present. So phase in your Mothering through breastfeeding is the caring very slowly. most natural and effective way of understanding and satisfying the needs of Breastfeeding considerations the baby. Try to keep separation short at first, especially for a very young baby. It helps Nature intended mothers and babies to if the baby’s mother can nurse before she stay together as much as possible leaves and immediately on return. because breastfeeding is the normal way Breastfeeding is the perfect way for to care for a baby—providing him with the mother and baby to reconnect, so avoid comfort and security of his mother’s feeding the baby a large amount near that presence as well as with milk which helps time. protect him from many illnesses. If the baby can have access to his mother Babies and separation during longer separation that is better for In the early years the baby has an intense the mother’s comfort and baby’s anxiety. need to be with his mother, which is as basic as his need for food. Food and drink Breastfed babies are often good at A breastfed baby’s ‘primary attachment moderating their intake to only what they figure’ is likely to be his mother. need. A happy baby is more likely to take Separation from her will be distressing for any food and drink that is available than him unless he is in the care of another go hungry or thirsty. If a baby is eating person with whom he has already formed solid foods, this will help if he is reluctant an attachment. Otherwise, however kind to take much expressed breastmilk. Many and caring that person may be, it is foods contain water, especially fruits. It’s frightening for a young child. Many babies also possible to offer expressed milk and toddlers show distress at separation mixed with solid foods. Baby-led weaning by becoming upset or misbehaving. around six months where the baby helps Others become quiet, withdrawn or may himself can be a fun way to pass the time. sleep a lot. It’s important to know that a quiet baby is suppressing his emotions Sleep and is in need of care and attention just Being cuddled and rocked, carried in a as much as a baby who cries or protests. sling or perhaps taken for a walk can help These behaviours are less likely when a a baby ease into sleep when he’s showing baby knows and trusts his carer. signs of tiredness.

Page 20 www.laleche.org.uk FEEDING A BREASTFED BABY babies—as much as 25% fewer calories A baby can be offered breastmilk in at four months. Most breastfed babies several ways depending on age, comfort take between 60–120ml about 8 to 10 levels and his mother’s preferences. times per day. Don’t be surprised if the Many breastfed babies never have a baby doesn’t drink much milk. A —even when separated from their may adapt to his mother’s working mothers. hours, taking very little milk from his caregiver and then nursing very Expressed breastmilk frequently when his mum is around—this A mother’s own milk is the best possible is perfectly normal. food to help her baby grow and develop and is full of antibodies, live cells, and How often? other substances to protect him. There are no routines. Learn about Expressed breastmilk is remarkably feeding cues like fussing, rooting and fist resilient and stores well due to its sucking—all early signs of hunger. A antibacterial properties. Comprehensive nursing baby is used to feeding information on how to store breastmilk frequently so offer his mother’s milk and prepare it for use is included in quickly, before he gets frantic with LLLGB’s information sheet Storing Your hunger—little and often works well for Milk. most breastfed babies.

Feeding options Reassurance Using either an open cup or a baby A nursing mum and baby will find it hard beaker with a simple spout (no valves) is to be apart from one another. The an option for a baby from three months separation will be much easier on both if old. A younger baby can be fed his the baby has an attachment to you and mother’s milk using a small flexible his mother knows she can trust that plastic cup, medicine cup or spoon filled you’ll do your best to meet his needs half-full. Hold the baby upright and whilst she’s away. close. Rest the cup gently on his lower lip and tip it so a small amount of milk touches his lips. This will encourage him to extend his tongue to lap the milk. Don’t pour milk into his mouth, leave the cup in position as he swallows, then offer again. Let the baby set the pace, lapping the milk.

An oral/medicine syringe (ask for one in your local pharmacy) can also be used to drip milk slowly into his mouth just inside his lower lip or gum, so he has chance to taste then swallow without choking.

How much milk? Much will depend on his age, how well fed he is beforehand and for how long he is left. You will become used to how much he takes. Fully breastfed babies require less milk than formula fed

Written by Karen Butler, Sue Upstone and mothers of LLLGB. Abridged by the editors. This, and many other leaflets, are all available from www.lllgbbooks.co.uk Photos courtesy of Abigail Axton Axton of Abigail courtesy Photos

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Abigail Axton LLL Chilterns

Abigail and her daughter, Rose, had some issues getting breastfeeding going, but she was determined to continue for the long haul, and they continued when her son, Edward, was born. Here she tells us about their tandem nursing journey so far and the extra challenges of breastfeeding children with allergies.

Page 22 www.laleche.org.uk …nothing and nobody was whether it was a little or a lot and she said it was “much milk” but I don’t know if she was worried I would say going to come between Rose stop if she said it was only a little! and her ‘beebies’.. During the pregnancy I got vasospasms (excruciating pain Breastfeeding Rose had been a caused by reduced blood flow) in my struggle in the early days. She had nipples if they were exposed to cold tongue-tie and severe colic, and was for a period, which got increasingly later diagnosed with cows’ milk worse as the pregnancy progressed. protein allergy which meant that, if I Nursing became increasingly wanted to continue breastfeeding, I uncomfortable and Rose’s sleepy, had to stop eating anything containing comfort nursing latch was quite bad. I dairy. I decided I was going to often experienced nursing aversion at breastfeed until at least two years as this point but literally gritted my teeth cows’ milk substitutes (almond, soya through it as my need for sleep was etc) are not suitable as a main drink greater than the aversion. We had for children under two. transitioned her into her own bed by this point but she was still waking So we waited to expand our family as (and being fed back to sleep) up to I was concerned about pregnancy- five times a night. I think the regular induced weaning. As it turns out I day and night nursing did help need not have worried. It seems maintain my supply but it was hard nothing and nobody was going to and got increasingly more difficult come between Rose and her being in her bed or getting up and ‘beebies’. down to her as my pelvic girdle pain worsened. When I was pregnant with Edward I had a copy of Adventures in Tandem I had to go into hospital to be induced Nursing on my desk, unread, for a and it was so hard leaving her behind. long time. When I finally got to read it, We had special milky hugs before I hugely pregnant, I was surprised at left and the photos my husband took how much was in there about are some of my favourite from my continuing to feed your older child pregnancy. She was able to visit me while pregnant. Looking back I can once a day and have a short feed but see how nursing while pregnant was those three days stuck on a ward, very much part of my tandem feeding waiting without her, were horribly journey; after all I was nourishing two long. The only thing that stopped me children and had to find room on my doing a runner was hearing how lap for two as my bump got bigger! wonderfully she was coping without me. We continued to co-sleep for the first half of the pregnancy and during that Eventually our new baby arrived and time I was exhausted with constant to my amazement he took to nausea so I slept with Rose at nap breastfeeding like a complete pro! He time too. My supply did eventually was a big baby (10lb 8oz) and had drop in the later months and she did good head control and no tongue-tie. dry nurse during the night. I asked her From the very first feed he was pretty once how much milk she was getting: much latching on himself. Our first

Helpline 0845 120 2918 Page 23 Support is absolutely Support is

tandem feed wasn’t until day two ‘quick milk’ and we could practise her when the three of us snuggled up in counting skills past 10. our bed for a well-earned cuddle. It was bliss. I was so happy to be home. Gradually her milky demands got less and I was able to spend time doing On the morning of day four I woke up activities like dough with her and my milk had come in. I had talked while Edward slept in the sling instead to Rose during my pregnancy about of trying to work out how to get a how once the baby was born my milk boob out of my top and the side of the would go back to normal and there Moby wrap without waking the baby! would be lots of yummy white milk. So when she snuck into bed that morning Edward started to get the familiar I told her she had an important job colic symptoms and we found out he and how I needed her to have special was allergic to both dairy and soya. mummy milk very gently as my Tandem feeding children with ‘beebies’ were very full and sore and I allergies is double the responsibility needed her help to empty them a bit. and worry. One slip-up with dairy She was very happy to oblige! means over a week of cramps and upset tummies for both children and I decided early on that while it was hardly any sleep for anyone in the nice feeding them both together (and house. And of course constant waking saved a lot of time) I didn’t want to be means constant feeding back to sleep pinned under two children for large and lots of milk for comfort during the portions of the day so I tried to limit day too. I don’t mind that too much as the times where I was feeding them I know that, even when contaminated together while still giving Rose as with an allergen, breastmilk is still much milk and mummy time as she doing a great job of healing any needed. She got a little milk-drunk damage done to their little intestines. during the first few months and The lack of sleep, sore nipples and wanted milk an awful lot; I didn’t terrible guilty feeling of having agree to every request but I said ‘poisoned’ my babies can be very “Yes” as often as possible… even if it hard to cope with though. came with conditions. A year on and we have a regular I hadn’t previously time-limited feeds, pattern. They have assigned ‘sides’ but I was surprised at how often she for their shared morning and night- was happy with ‘milk for 10’ where I time feeds, Edward feeds before and just counted to 10. It seemed to often after his two day time naps and for his meet her need for connection and frequent night wakings but the rest is reassurance. I never enforced it and if negotiable for them now. I only ever she seemed upset that it was too feed Rose at night now if she is very short we’d keep going until I felt she poorly and try and send Daddy in to had enough. She also went through a phase where she would get upset if I counted aloud. She was happy to stop after the allotted time even if it Tandem feeding children with was only three seconds but it had to be counted silently! Soon it became a allergies is double the game where we could negotiate how long it would be if I could only do responsibility and worry.

Page 24 www.laleche.org.uk Support is absolutely Support is

her if she wakes to avoid having to refuse her, but in fairness she hasn’t asked at night apart from when sick. And I am mainly glad about that, though it has been an adjustment for me to get used to her being settled by him when before only milk would do.

Tandem feeding has become both easier and harder over the year. It's easier now that both can latch themselves on. It's harder now that both can wriggle and kick and both can twiddle and pinch, especially when you have no free hands to stop them! It's easier now I have an my nose or in my mouth and at Rose established supply and don't need to blowing raspberries on me. worry about tracking anyone's milk intake or baby struggling with Rose has said she is going to stop oversupply. But it's getting harder to having milk is very soon. I can’t cope with the nursing aversion I often decide how I feel about us moving on feel when nursing them together. from tandem feeding. On one hand I Edward has 8 teeth now and is feel very proud to have been able to developing his own lazy, sleepy latch, feed her for so long and through the like his sister, and feeling a set of challenges life has given us but also teeth on each , even when it's worried that it is all a bit sudden, not uncomfortable, is still quite off arbitrary, like something she feels she putting! ought to do rather than she wants to. But I guess, after so long of listening Despite the nursing aversion, I still get to and trusting my little girl to know warm fuzzy feelings when the three of when she wants milk, all I have to do us are together as I feel the love we is learn to listen when she says she share. And as well as the general love no longer wants it. there have been some very special times too. Emotional times like our Regardless of when she stops now I very first feed together or on Mothers’ feel I have achieved what I hoped for Day this year where I felt so blessed when I decided to try and tandem to be able to feed my wonderful feed: to ease the transition into babies for so long. Heart-warming becoming an older sibling for Rose times when they reach out and hold and to be a way for them to bond hands, or when Rose has helped while baby was incapable of doing Edward latch on or his very first wave anything else. My two precious — to his beautiful big sister during children adore each other and are milk. Funny times like when a newly learning to play together as friends. mobile Edward climbed over me, Who knows how they will get on as grabbed hold of and determinedly they grow up but I’ve given them a tried to latch onto the side of the good start! I’m sure the next stage will breast Rose was already latched on have its challenges but I'm also sure to, or when they both giggle at we can change and grow together to Edward trying to stick his fingers up meet them.

Helpline 0845 120 2918 Page 25 Rachael Ward LLL Kingston Breastfeeding with Breastfeeding with Rachel and her daughter really tongue-tie struggled to get breastfeeding tongue-tie started, but slowly but surely they got there.

My daughter Rose was born by bleeding and I was crying through ventouse after a relatively easy, drug- every feed. I experienced the horrible free labour, weighing a healthy 7lbs feeling of being terrified of my 13oz. She latched on almost newborn, and found myself willing her immediately and fed happily from not to wake up so I would not have to both sides — I was thrilled that it had let her latch on. I spoke to several been so easy to get breastfeeding breastfeeding counsellors on the started, and when she bit and bruised phone, and while they were all very my left nipple I thought nothing of it, sympathetic, none could give me a putting it down to not enough reason for my difficulties and all practice. reassured me that as long as her latch was good the pain would We were in hospital for three days as improve. No one told me that the Rose was on antibiotics, and feeding level of pain I was experiencing and seemed to be going well. The midwife cracked, bleeding nipples were a sign and maternity support worker both that something was seriously wrong. checked her latch, and said it “looked By the end of day four I couldn’t go fine”, although one did exclaim “gosh, on — my wonderful husband made a she’s fierce!”. I, however, was getting mercy dash to the chemist five increasingly sore, and beginning to minutes before closing time and experience toe-curling pain. I was told bought some silicone nipple shields. that this was completely normal, These did not improve the pain, but though, and encouraged to did remove the fear factor, and I was persevere. Reassured that it would able to feed without being terrified improve in a few days, we were that my nipples would suffer any discharged on the evening of day further damage. three, and were absolutely delighted to take our little girl home.

It did not improve, though. By the I experienced the horrible feeling of morning of day four, both of my nipples were cracked and being terrified of my newborn...

Page 26 www.laleche.org.uk dribbling milk, tiring easily, seeming I breastfed her immediately constantly hungry, being generally unsettled etc. I went to an NHS afterwards with a fantastic deep feeding clinic and told them my suspicions; I was referred to the latch and no clicking! tongue-tie clinic, but told there could be a two week wait.

Over the next week or so it continued to go downhill, until by day ten I was I wasn’t prepared to wait a fortnight as too sore to feed her on the left hand the pain was as bad as ever, so we side. So I resorted to expressing decided to get it treated privately (which was also very painful) in order when Rose was seven weeks old. The to reduce engorgement and keep up breastfeeding consultant we saw my supply. The right side was also immediately diagnosed a posterior getting worse, but not quite so much tongue-tie, and as soon as it was that I was unable to feed her. A snipped I breastfed her immediately couple of days later, I woke up with a afterwards with a fantastic deep latch high fever and went to the GP, who and no clicking! The pain was not told me it was a bad case of gone completely as my nipples were and gave me a five day course of so damaged, but it was much antibiotics. improved, and the deep cracks on my right nipple finally began to heal. I saw several doctors and took four courses of antibiotics, during which In the next few months I had another time my nipples healed but the pain two bouts of mastitis and several was not improving. It was only the blocked ducts, and in May I ended up third GP who suggested that I might in hospital with my fifth bout of want to get some more help with the mastitis, dehydrated and worried I feeding, and so I attended my local was developing an abscess (which LLL meeting. The Leader, Nik, thankfully I wasn't). My supply watched us feed, and noticed that drastically diminished, and we had a Rose clicked almost constantly — couple of days where Rose was something I had noticed, but thought mostly being fed on formula with a bit nothing of. She also said the latch of expressed milk, but did manage to looked shallow, which no one had get the feeds back up again. mentioned before. She was the first person to suggest that Rose may We are still feeding with the nipple have a tongue-tie — a suggestion I shields because she refuses to latch immediately dismissed as nonsense, on without them, but we are beginning as she had been checked as part of the process of weaning her off them, her newborn top-to-toe examination in and I look forward to the day when I hospital. can feed her in public without all the fuss! The process of healing my left Over the next few days, however, I nipple has been long and slow, but I started to do a bit of research, and am almost at the stage where I can realised that our feeds displayed so consider feeding her from that side many of the signs of a posterior again — in the meantime I continue tongue-tie - sore nipples and nipple expressing from that side and damage, supporting the breast to supplementing with expressed milk in feed, clicking through feeds and bottles. The pain is not completely

Helpline 0845 120 2918 Page 27 gone - we have good days and bad days. Someone told me to never give ...never give up on a bad day. up on a bad day — a piece of advice which has definitely helped me to continue as there have been so many bad days! I still occasionally find myself browsing the internet at night to find motivation to carry on.

The times when I enjoy feeding are definitely increasing, and I will forever grateful to the LLL Leader for suggesting tongue-tie, but I do feel very let down by my early experiences. It was a long time before anyone even acknowledged that the problems I was having were abnormal as opposed to simple bad luck, and I strongly feel that both pregnant women and all those who care for expectant and new mothers should be much more aware of posterior tongue-tie as a problem, and trained to look for it. I hope my story can go some way towards raising awareness, and offer some encouragement to those suffering similar difficulties — I know it’s a cliché, but it truly does get better!

Page 28 www.laleche.org.uk TThhee bbrriigghhtteesstt ffoorrccee

My Perfect Person, my Sunbeam. The overwhelming wave of the impossible love you made possible sweeps supreme. Such joy with every smile that erupts, Such fun with every giggle and mischievous glance. Our little lady, too excited to sleep. Such insatiable verve. Such irrepressible, contagious joie de vivre. As the long day draws to a close eventually, reluctantly, you give in to your heavy lead lids. We curl up close in our nest and both nod. And words escape me as your chest rises and falls in the dusk and your warm, soft breath brushes my cheek through the cool evening air in your exhausted midnight slumber. Your little face flicks as you digest the day's adventures. And I watch on, mesmerised by the miracle of life and the precious gifts that you give. I couldn't be happier. I couldn't feel luckier. The apple of my eye. My pride and joy. After the imposed tears, fight and frustrations we've found one another.

Instinct won out. of Sarah Craddock courtesy Photo Thank goodness. We've found one another. Instinct won out.

Sarah Craddock How to get help from La Leche League GB

Our Helpline might be our best known contact point. Call us on 0845 120 2918, any time at all. Your call will be taken by a La Leche League Leader – a trained breastfeeding counsellor – in her own home. This means it can sometimes take a while to get through to someone so please don’t be disheartened. It might be a good idea to try again at a different time of day (meal times are quite often fraught, as many of us have young children!).

If you want individual help but you find it hard to get to the phone, you could try an Online Help Request. These can be accessed at www.laleche.org.uk/content/ submitting-help-request (which also has helpful links to other information). If you fill in as much information as you can about your query, someone will be in touch.

You might find the answers to your questions on our websites www.laleche.org.uk or on one of the fantastic information sheets we sell in our shop www.lllgbbooks.co.uk

Or if you’d like a longer read, the La Leche League book The Womanly Art of Breastfeeding, also available from our shop, contains a huge amount of information in a very friendly format, covering all ages and stages from pregnancy through to weaning.

If what you really want is the mother-to-mother support that we’re known for, you’ll always find it at your local LLL group – find it at www.laleche.org.uk/find-lll-group (and watch these pages for information about new groups being started). This page can also help you to find details of any Leaders local to you who you could call for a chat.

For keen Facebook users our LLLGB because Breastfeeding Matters page shares interesting links and articles, and we’ll repost your queries if you send them to us there, so that other mothers can comment too.

You can follow us on Twitter @LLLGB – here, again, we share interesting links and snippets.

Finally, of course, you always have this magazine. Please email us on [email protected] if you have ideas for content, or write us a letter for publication, or consider sharing your story with our readers, or submit a question for our mother to mother page: the possibilities are endless!

LLLGB is proud to announce and welcome our most recent Leaders:

Joanne Killey—LLL Isle of Man Lindsay Dalton—LLL Northampton Orla Olivieri—LLL Milton Keynes

make a difference ...

Photo Lois Rowlands

Shopping with LLLGB Books makes a difference.

Choosing to buy your breastfeeding and books from our LLLGB Shop directly helps other mothers and babies.

All our profits go to support LLLGB’s charitable work. It’s money well spent!

For our full range of information leaflets and books on breastfeeding and parenting, visit:

lllgbbooks.co.uk

LLL Books Ltd, P O Box 29, West Bridgford, Nottingham, NG2 7NP Company No 1566925 Registered Charity No 283771 Helpline 0845 120 2918 Page 31

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The basic philosophy of La Leche League is summarised in the following statements:

Mothering through breastfeeding is the most natural and effective way of understanding and satisfying the needs of the baby.

Mother and baby need to be together early and often to establish a satisfying relationship and an adequate milk supply.

In the early years the baby has an intense need to be with his mother which is as basic as his need for food.

Human milk is the natural food for babies, uniquely meeting their changing needs.

For the healthy, full-term baby, breastmilk is the only food necessary until the baby shows signs of needing solids, about the middle of the first year after birth.

Ideally the breastfeeding relationship will continue until the baby outgrows the need.

Alert and active participation by the mother in is a help in getting breastfeeding off to a good start.

Breastfeeding is enhanced and the nursing couple sustained by the loving support, help, and companionship of the baby's . A father's unique relationship with his baby is an important element in the child's development from early infancy.

Good nutrition means eating a well-balanced and varied diet of foods in as close to their natural state as possible.

From infancy on, children need loving guidance which reflects acceptance of their capabilities and sensitivity to their feelings.

The ideals and principles of mothering which are the foundation of LLL International beliefs are further developed in THE WOMANLY ART OF BREASTFEEDING 8th Edition

www.lllgbbooks.co.uk