Monday, August 31, 2009

Happy Birthday!

It's my baby's first birthday!

I couldn't let the occasion pass without a little post. The last couple of days have been fun as we have reminisced about what stage of labour I was in this time last year. My labour started slowly and I was contracting for a good 36 hours before I was officially in "established" labour. But I certainly felt every one of those unofficial contractions, let me tell you! And during them I picked some blackberries, baked some gingerbread men, ate some cheese on toast and knelt down with my head on the settee a lot.

Happy Birthday little one. Your father and I are confident that this grand old age will bring a new level of maturity to your sleeping habits, ie you will sleep for more than one hour in your cot or three hours in our bed.

Saturday, August 29, 2009

Cow Colostrum - A Bit Wrong?

Is it just me, or is drinking cow colostrum a bit, well, icky?

The antibody and growth-factor packed first milk is the latest performance enhancing supplement for daft cyclists (including Olympic silver medallist Gustav Larsson).

I know it's really no different to drinking cow's milk, but I just can't get away from the feeling that it's a bit wrong. I mean, aren't the super antibodies and growth factors designed for cows not humans? And what about the poor calves?

If it's not speed then it's EPO. If it's not EPO then it's caffeine. Those cyclists just can't get enough of their freaky supplements. And if you're not a cycling fan, you will probably have no idea what I'm talking about.

Cow colostrum. Not for me thanks.

Tuesday, August 25, 2009

Overdue Babies and Threatened Induction

As I mentioned in my last post, this time last year I was in my 41st week of pregnancy and hoping beyond hope that my baby would arrive before I was under pressure to be induced. As anyone who has gone over 40 weeks will know, the phone calls from family and friends start on the due date and do not stop until the baby put in an appearance.

I felt, just like any first time mother does, that my baby was never coming. I just knew I was going to be pregnant for ever. The mental leap from pregnancy to motherhood was just too big for my brain to cope with. Birth was a black hole that loomed ahead of me and sucked all thoughts of the future into its depths.

I was booked to have a home birth and idea of going into hospital to be induced absolutely petrified me. I had got myself into the right mental space to cope with birth at home and I felt certain that if I ended up in hospital I would find it vastly more difficult. So I did what I always do: jumped on the internet to reseach overdue pregnancies.

The Home Birth Reference Site is an invaluable source of evidence-based information on pregnancy and birth, whether you plan to give birth in hospital or at home. It has a brilliant page on postdates pregnancies, and here are the main points that helped me to decide what to do if I went overdue by more than 10 days or so:

* The death rate for apparently "normal" babies (with no congenital abnormalities) doubles after 42 weeks from 1 in 1000 babies to 2 in 1000.

* We are often told that beyond 42 weeks, the ageing placenta cannot deliver enough oxygen and nutrients to the baby. This sometimes happens, and sometimes does not. Research is unfortunately thin on the ground. Many people have had healthy babies after 43 and 44 week pregnancies.

* Most 42 + week pregnancies have just been dated wrong; very few accurately dated pregnancies go on for this long.

* Your body may be delaying labour for a good reason. The baby might be badly positioned for birth, for example. Sometimes we just have to trust that mother nature knows what she is doing.

* You do not have to undergo induction of labour unless you want to. Like any medical procedure, it is offered and you are free to refuse. Furthermore, the date of induction is negotiable. In the UK, induction is usually offered at 10 days or 12 days overdue, despite the fact that the "normal" length of pregnancy is anything from 38 to 42 weeks. You can delay or refuse induction if you so choose.

* The UK's National Institute of Clinical Excellence says that after 42 weeks you should be offered an ultrasound examination and twice weekly checks of the baby's heart rate.

* You can still have a home birth after 42 weeks. Your midwives might be happy to support it, or they might be reluctant. If you are really stubborn, you can insist on staying at home when you finally do go into labour. Nobody can force you to go into hospital.

* You are much more likely to have meconium in your waters when your baby is overdue. This is often enough for a mimdwife to recommend a transfer from home to hospital. But if you are overdue, it is not necessarily a cause for alarm. An experienced midwife should be able to judge the colour and thickness of the liquor and decide whether or not to recommend a transfer. This is what happened to me, and my midwife kept me at home. I am eternally grateful to her.

So here is what actually happened to me. I went to the antenatal clinic for my 41 week appointment and was offered induction. I refused it, totally flummoxing the midwife, who then called for a consultant to reason with the mad pregnant woman. The consultant was straight with me and, after discussion, accepted my wishes to avoid induction and agreed to monitor me if I should go beyond 42 weeks. A senior community midwife then came to talk to me as well and told me that they would support my desire for a home birth beyond 42 weeks. Hooray! This made me feel a whole lot better about things.

My bravery in the antenatal clinic turned out to be unecessary in the end because after two "vigorous" membrane sweeps at the aforementioned 41 week appointment, I went into labour and delivered my baby 42 hours later. The membrane sweeps felt a bit odd and uncomfortable, but I think by that stage of pregnancy I was ready to experience a bit of pain, and if it was going to help me to go into labour then I was all for it (and if you are contemplating having a membrane sweep then I would say that it is absolutely nothing to worry about). I do have a feeling that I would have gone into labour without the sweeps as I had begun to feel "twinges" prior to my appointment. I also wonder if my prolonged pre-labour was caused by the intervention. But I will never know the answers to these questions and I don't really care because I was fortunate enough to have a straightforward labour and home birth and I was blessed with a healthy baby.

I think the main thing to remember if you do go overdue is that induction is not inevitable, and is not necessarily the best thing for your baby. You always have options and if you present your views with enough conviction, medical professionals will have to listen to you.

Sunday, August 23, 2009

40+1 Weeks: Judgement Approaches

This time last year I was 40 weeks and 1 day pregnant. Cave Baby waited around another eight days before deciding to make her entrance so we are looking forward to her birthday.

But in another way, the first birthday is a bit of a scary point. Everyone has an idea of what a one year old should be like. It should be cutting down on the breastfeeds, sleeping through the night and starting to walk. And whilst the other ages and stages all melt into a blurry mess when viewed through the kaleidoscope of memory, everyone can remember what their own children were doing at age one. That means one thing: judgement.

I have already been told "She can't be having those breastfeeds for ever", and asked "Is she still going to be sleeping with you when she's five?". Aargh. I can ignore anything from strangers but I find it much harder to confront or brush off comments from family. We have relationships to maintain, and any questioning of their beliefs can too easily be taken as criticism of how they brought up their own children.

So, at this time I think it is even more important that I remember why it is good to keep breastfeeding until age two and beyond, why it is good to still sleep with my baby beside me and why I still tote her round in a backpack. It will all be worth it!

Don't you wish that people would occasionally look at your happy, healthy baby and just say "Well done" instead of passing judgement?

Tuesday, August 18, 2009

My Baby is not Yet One But She Already Knows... to brush her hair, with a hairbrush.
...that lavender is the most fascinating of all the plants in the garden. to drive her little car (backwards).
...that when mummy draws the shower curtain across, that means mummy is going to be out of commission for five minutes. And that is bad news and requires much crying and flapping of arms. to climb up the stairs.
...that books are for flicking through and pointing at.
...that going out is infinitely more fun than staying in.
...that broccoli is yummy but green beans are horrid! to howl like a wolf.
...that crinkly packets = good news.
...that keyboards are for bashing, screens are for smearing, and laptops are for closing.

Thank you Sunnytodaymama for generously giving me this award:

I am supposed to pass this on to 15 newly discovered blogs. I don't know how people have the time to follow 15 blogs, let alone discover 15 new ones, so here are as many as I can manage:

West of the Pennines
Chilliwack Doula
Chatter Box Joe

I know that's pathetic, but that's all I've got folks.

Friday, August 14, 2009

The Pill vs Fertility Awareness

Do you trust The Pill to keep you from getting pregnant without messing up your body? I don't. My last post on the effect of breastfeeding on child spacing got some thought provoking comments (particularly Earthenwitch's) about fertility awareness. Would we benefit from having more knowledge about our own fertility? It's a difficult question: a little knowledge is a dangerous thing, as the saying goes.

If you are a man or you don't like talking about cervical mucous then you might want want to look away now. So here goes. Several years ago I started taking the contraceptive pill; it just seemed to be the normal thing to do. Within the first year of taking it, I began to feel lethargic and sad. I took B vitamins in an attempt to combat my lack of energy, but they did not seem to make any difference.

My doctor seemed unconcerned about the side-effects but I did manage to persuade him to change my prescription to a different brand of pill. And I did begin to feel better, though I don't know whether it was the new pills or the placebo effect that made the difference. But over the next couple of years I found that my breasts became increasingly sore in the days before my "period" and my interest in sex diminished. This kind of defeated the whole pill-taking exercise.

I think I got off fairly lightly with my minor complaints; a quick web search reveals a list of side-effects as long as your arm, including:

* Weight gain (average of 10lbs in the first year)
* Increase or decrease in acne
* Nausea and vomiting
* Dizziness
* Headaches
* Depression
* Vaginal infections
* High blood pressure
* Loss of libido
* Blood clots in legs, lungs, heart or brain
* Stroke
* Liver tumors (rare)
* Heart attacks
* Gallstones (rare)
* Jaundice (rare)
* Possibly cervical cancer

One morning I woke up, came to my right mind and decided I had had enough of stuffing synthetic hormones down my neck. It is much easier to do this when you are in a stable relationship within which pregnancy would not be a disaster, and I would not for a minute encourage other people to come off the pill. But for several years before we conceived intentionally, I mentally tracked my fertility and used contraceptives only on the days when I was most likely to get pregnant. This is not too difficult when your cycles are regular like mine and it requires no more knowledge than A-level biology.

Disclaimer: NOBODY should trust their own contraception to the instructions in the following paragraph! It is a gross simplification of natural fertility awareness and I will NOT be held responsible for any unwanted pregnancies! With that clear, I shall continue. To avoid conceiving you basically need to know when you ovulate, and use barrier contraception before and after that day. You can easily find out when you ovulate by observing your cervical mucous for a few cycles. Ovulation is accompanied by a sudden increase in clear, stretchy mucous and if you don't see it when you go to the toilet then - yes girls - you just have an exploratory feel (you know where) and see what you can find (as a rough guide, ovulation usually takes place 11-14 days after the first day of your period). Given that sperm can live for 2-3 days, you need to use a barrier method for a good 5 days or so before your predicted ovulation date. And after ovulation, I'm careful for another 5 days or so, just to be on the safe side.

The good thing about being aware of your own fertility, apart from avoiding nasty hormone pills, is that when you do want to become pregnant, you are already aware of the days when you are most likely to conceive.

Now I repeat that nobody should base their own family planning on this information. But I do think that with a bit of knowledge about fertility it is possible to avoid taking the pill without losing too much spontaneity in the bedroom. If you are in a position where pregnancy is undesired but not unthinkable, natural fertility awareness is a realistic option. A bit of cervical mucous monitoring has to be preferable to that terrifying list of side-effects, doesn't it?

Tuesday, August 11, 2009

Less Breastfeeding = More Babies

There were some wonderful posts last week in honour of La Leche League's World Breastfeeding Week. The topic of this year's World Breastfeeding Week was "Prepared for Life" and lots of bloggers (including Cartside of Mummy Do That!, Edenwild and the Breastfeeding Carnival bloggers) wrote about the importance of breastfeeding in developing countries.

Here is another spin on why breastfeeding is so valuable to mothers in the third world. Breastfeeding suppresses a mother's fertility so that she is less likely to conceive another child soon after she has given birth. The high levels of prolactin in her blood caused by frequent feeding prevents conception by suppressing ovulation and making an embryo less likely to successfully implant in the uterus if an ovum does manage to get fertilised. Fertility returns slowly, and though lactation amenorrhea (cessation of periods whilst breastfeeding) lasts for over a year for some mothers, others will become fertile much more quickly.

The old wives' tale that you can't get pregnant while breastfeeding is not a myth - the "lactation amenorrhea method" (LAM) is even recognised as a method of birth control here in the West. If you a feeding on demand through the day and night AND breastfeeding exclusively AND not giving your baby a dummy or any other nipple substitute AND your baby is less than six months old then LAM is comparable in effectiveness to other birth control methods. But we all know someone who did get pregnant when they were breastfeeding - I know someone who was expecting their second child two months after delivering the first.

Luckily in the West we have good nutrition and healthcare and we can generally support two close-together babies. But in less developed countries with less plentiful food supplies, an extra mouth to feed can put a considerable strain on a family. Customs of carrying babies and breastfeeding them frequently have in the past prevented women getting pregnant too soon after having a baby, but in countries where bottle feeding has been encouraged, inter-birth intervals have been seen to decline. Meredith Small writes in Our Babies, Ourselves that the rate of pregnancy in Kenya has increased in direct correlation with the increase in formula feeding. Women in Kenya average eight babies in the lifetime, compared to only four in the more traditional !Kung San of Botswana. In fact Small even quotes another anthroplogist, R.V. Short, who went as far as to say: "The changing history of breastfeeding is the history of human population explosion."

Saturday, August 8, 2009

My Fat Baby

Scene: a warm afternoon at the baby weight clinic.

Health visitor: "She's a little heavier than we would like her to be."


HV: "Yes."

Me: "Well she's still breastfed and she eats very healthily, just fruit and veg and a little bit of meat."

HV: "How many breastfeeds does she have?" (What kind of a question is this? How many breastfeeds does she have? Have people who ask this question got any idea of what on-demand feeding is like? So what counts as "one" breastfeed: the quick one minute burst in the middle of the night? The two minutes to calm her down when she's hyper? The ten-seconds-on-ten-seconds-off public feeds? This question has always puzzled me, from when she was newborn and fed all the time, to now when most feeds are blink-and-you'll-miss-it quick.)

Me: "Er, I have no idea. She feeds on demand."

HV: "Oh [looking puzzled]. She's obviously doing well on her solids. You could drop a breastfeed." (And which breastfeed would you suggest I drop? The one that comforts her when she's banged her head? The one that gets her to sleep for her nap? The one that guides her out of the fog of sleep when she wakes up? The one in the middle of the night that stops her fidgeting and moaning? The one she has on the evening when she's getting cranky, crying for me and pawing at my front? Have you any idea of the role breastfeeding plays in the lives of me and my baby? It is not so much about food as about mothering. And she is only eleven months old!)

Me: "Hmm. No, I'm not going to drop a feed. Maybe I could give her less solids."

HV: "No you can't do that. The solids are very important." (And what about the breastmilk? Is that not still protecting her against all manner of diseases? Is it not supposed to form the main part of her diet until she is a year old? Surely a breastfeed is worth more to her than an extra rice cake or half a potato, for example, especially given that she has no problems taking solids.)

Me: "Oh well. I'll do nothing then. I mean, look at her, she's perfectly fine."

HV: "Hmm. But she is heavier than we would like her to be."

Me: "Wouldn't you have to measure her height to see if she was in proportion?" (In fact we have measured her at home and she is in proportion. But she was born a skinny minnie, and now she's a big bouncy chubby thing, so she has failed to follow The Curve. So obviously there must be something wrong.)

HV: "Hmm."

Me: "Right, I'll do nothing then. Bye." (And I wish I could say that was the end of it, but that darned health visitor has planted the seed of doubt in my head now and for months I will be worrying about Cave Baby's weight, even though the rational side of my brain knows that there is not a jot wrong with her and the only problem is with our health service's draconian attitude to babies' weight gain. I do remember reading this post on Breastfeeding 1-2-3 about babies' weights, which made me feel better.)

Is this scenario familiar to anyone?

Thursday, August 6, 2009

What Makes a Difficult Baby?

We all label some babies as "difficult" and some as "easy". I didn't think twice about describing my tiny daughter as difficult. I was all too aware of how she failed to measure up to my previous expectations of babies: she would not sleep without me lying beside her; she almost always woke when I tried to put her down asleep; she would not lie in a bouncy chair; she cried whenever she was not feeding, in a carrier or in a pram; she fed hourly through the night.

If I knew then what I know now I would have put her in a sling from the moment I woke up to the moment we went to bed and I would not have hesitated to co-sleep with her from the day she was born. But, back then, I took some solace in the fact that things were so very hard because I had a particularly demanding baby to care for.

As Cave Baby has grown up and I have talked to more and more mums about their "difficult" babies I have come to realise how little I valued her "good" traits. I was so preoccupied with her sleeping problems that I never realised how fortunate I was that she breastfed well from the very first attempt; that I never suffered particularly sore nipples; that she kept her milk down and brought burps up easily; that she could lie beside me all night without ever needing to be winded; that she fell asleep when the lights went out without fail, and was content to lie in bed with me until late in the morning. Even if she had been the best sleeper in the world, I would probably have still called her "difficult" if she come up short in some other department.

Reading Our Babies, Ourselves by Meredith Small has given me a different perspective on difficult babies. I now realise that "difficulty" is always relative to the culture in which the baby lives. If I had been part of a culture that customarily co-slept and carried its young then Cave Baby's "difficulties" would not even have shown up. Perhaps in such a culture it would be the babies who fidgeted excessively in a sling, or who wriggled at night, that would be considered "difficult".

And there is another side of "difficulty". My baby's reuctance to sleep alone and her insistence on human contact were simply her ways of telling me what she needed to grow and thrive. All babies know what is good for them, but the "difficult" ones are just a bit more determined to get it. There is an interesting anecdote about this in Meredith Small's book. In the 1970s a researcher named Marten de Vries followed some Masai infants and identified the ten "easiest" and the ten "most difficult". When he returned three months later, only thirteen of thh babies were left, the rest having moved on. Over the next three months of famine, seven of these babies died: six "easy" babies and only one "difficult" baby. Perhaps it was their "difficulty", their determination to have their needs met, that helped the "difficult" babies to stay alive.

I will share a couple more bits from Our Babies, Ourselves but in the meantime you might like to read Hobo Mama's review of it.

Monday, August 3, 2009

Three Moments That Made Me Thankful I Breastfeed

Welcome to the August Carnival of Breastfeeding! This month the theme is the motto of World Breastfeeding Week: Prepared for Life. And please have a look at all the other excellent carnival posts at the end of this post.

Why am I thankful that I breastfeed?

Sleepless nights combined with a fussy, crying baby made for one exhausted mum. My salvation was to drop all housework, fall into bed with my little one, latch her on to my breast and promptly fall asleep. No more effort was required. I often used to wonder what I would have done if I had not been breastfeeding, and I honestly do not know the answer. But I know that it would have been harder and more frustrating to try to grab those moments of daytime sleep if I had not been breastfeeding.

My seven month old daughter was scalded on her torso and arm by hot coffee; between arriving at Accident & Emergency and our discharge some eight hours later, breastfeeding was the only thing that came between me and meltdown. In the immediate aftermath of the accident, the hospital staff were able to examine her injuries when she was pacified on the breast. And throughout the long hours of waiting to transfer to a children's burns unit and see a specialist doctor, I was able to keep her calm by suckling her. The burns happened at a cafe and when we left the house we had only expected to be out for an hour; thanks to the wonder of a mother's never-empty breasts I was able to keep her belly full until we could finally retreat back to the sanctuary of our home and collectively lick our wounds.

A warm summer's afternoon (rare in Britain), a pretty canal and a few happy hours spent walking the towpath with baby bouncing along in a sling. When the afternoon stretches into the evening, it is so tempting to walk that extra mile instead of turning back and heading for the car. But the great thing about breastfeeding is that you can walk that extra mile, or three, if you feel like it. On several occasions our little family has wandered further than we had planned but when our baby has complained, all we have had to do is stop for a while, give her an impromptu open-air feed and get on our way again. It has given the other walkers something to smile at.

So what does all this have to do with breastfeeding being preparation for life? Well, breastfeeding is obviously the best way to prepare a baby for life, but it is also the best way for a new mother to be prepared for whatever life throws at her. Without breastfeeding, life would have caught me out many times, and I am thankful that I am a breastfeeding mother.

Now enjoy all these other great carnival posts:

Hobo Mama: "Prepared for Life: Breastfeeding in local and global crises"

Zen_Mommy: "Welcome, Carnival of Breastfeeding readers!" on how breastfeeding has shaped her toddler's view of breasts

Pure Mothers: "Marketing Away 'Real Milk'"

Chronicles of a Nursing Mom: "Tips for Consistent and Long-Term Breastfeeding Success"

Motherwear Breastfeeding Blog: "Breastfeeding in Emergencies"

Blacktating: "August Carnival of Breastfeeding: Prepared for Life" on the implications of formula feeding during disasters

Fusion Parenting: "Breastfeeding - Prepared for LIFE!" on breastfeeding and living a real life

Breastfeeding 1-2-3: "Breastfeeding as a lifesaver in emergencies"

Sunday, August 2, 2009

There IS a Fathering Instinct

New research has shown that men have increased oxytonin levels after they become fathers.

Oxytonin is sometimes called the "mothering hormone" because it promotes caring, protective feelings in mothers towards their babies. Levels in a woman's body increase towards the end of pregnancy when oxytonin causes labour to occur. Oxytonin is also one of the key hormones of breastfeeding because it causes the let-down reflex. Its release is stimulated by the action of a baby sucking on its mothers nipple.

The new research looked at fathers' oxytonin levels six months after the birth of their children and found that they made more oxytonin than childless men. Furthermore, men with higher oxytonin levels played with their children more and had children who displayed more attachment to them.

So there is a biological foundation to the fatherly instinct after all.

Saturday, August 1, 2009

Happening to Breastfeed on Facebook

If you use Facebook, you should be aware that they take it upon themselves to remove pictures that depict breastfeeding. Facebook spokesman Barry Schnitt has said:
"Our policy is against nudity and we feel strongly that policy is important to keeping Facebook clean. The small number of photos we have removed are of naked women who happen to be breastfeeding. These policies are designed to ensure Facebook remains a safe, secure and trusted environment for all users, including the many children [over the age of 13] who use the site… Photos containing a fully exposed breast (as defined by showing the nipple or areola) do violate those terms (on obscene, pornographic or sexually explicit material) and may be removed."
Users will verify, however, that photos containing a baby feeding from a breast with no exposed nipple or areola, and no other nudity, have also been deleted.

Read what one-of those women and TopHat have said about Facebook's policy, and if you are a Facebook user, consider joining in the virtual nurse-in next week (which happens to be World Breastfeeding Week). The nurse-in is organised by the Mother's International Lactation Campaign (M.I.L.C.) and all you have to do is change your profile picture to an image of a woman breastfeeding her baby.

Enjoy the gratuitous breastfeeding photo taken by Peter Redman from Canada's National Post