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The Anniversary – Part 2

Here, to celebrate the first anniversary of the launch of my book, is the second part of my gift of the first chapter (see March 2018 blog post for part 1):

YOUR BABY SKIN TO SKIN

Chapter 1 (continued)

Coming into the World: Your Highly Evolved Baby

The first moments

Hello, little one

Mothers with their still-damp babies inhale deeply, instinctively drinking in the musky aroma of their own and their baby’s body scents mingled together like some heady cocktail. The high adrenaline level in both mother and baby heightens their awareness and ensures that these aromas fix themselves deep in the memory for good. Even months (and, indeed, years) after birth, a lot of time is spent burying their noses into each other. As sweet and cosy as this is, it is simply evolution’s solution to ensuring that a mother and baby know each other in the dark of the night and that we protect our own genetic inheritors first. Remembering this with the birth of my first son, I now find myself sniffing my grandson in a way I have never felt moved to do with the thousands of babies I have held as a midwife. I already know his unique smell and can sometimes catch it on myself days after seeing him.

Much the same happens with our baby’s first cries: they move us so deeply to respond. Even if we have never held a baby before, we hear those first tiny gasps and mewls and immediately our hands begin to hold, stroke, soothe and reassure. We slide our baby up closer to our face so we can whisper in the tiny ear and kiss the top of the warm head. The higher female voice being particularly ‘keyed into’ the baby brain, and the mother being particularly triggered by her new baby’s cries, further two-way bonding and imprinting takes place. Our baby will take a little while to learn the unique look of our face but she already recognises the particular pattern and timbre of our voice from those months listening to the bath-like echoes inside the womb. During the early hours and days, the imprinting deepens and mothers find that they are completely unable to relax until they have responded to their baby’s cry and feel anxious when separated for even a very short time. Seeing someone else holding their crying newborn will make them twitchy and want to grab her back – this complete stranger already a permanent resident in their heart.

Skin to skin

In the modern birthing environment, irrespective of how the baby made her entrance, women are encouraged to enjoy prolonged ‘skin to skin’ time. While this automatically happened before the times of mass hospitalisation, during the 1970s and early 1980s increased medicalisation led to babies being bathed, dressed and wrapped before their exhausted mothers got to hold them after birth. By the mid-1980s ‘bonding’ was all the rage, and women today still ask me if the purpose of skin to skin is to help them ‘bond’. In fact, those early hours when we hold our peach-soft, damp, warm bundles of wiggliness on our chests do very much more than give us sniffing time. This is where our baby picks up more friendly bacteria – the ones that we have bred to protect us from the harmful bacteria we always carry on our bodies. So our babies gain protection from the bugs in our homes that we have as our companions.

More than that, skin to skin time calms the baby’s autonomic nervous system (ANS) right down. We will look at the ANS in great detail in Chapter 6 as it tells us so much about why our babies behave in the seemingly random way that they do, but, for now, you just need to know that skin to skin helps the newly birthed baby to stay soothed, warm and safe while you get to know each other.

Falling asleep during skin to skin

The first in-bed snuggles after birth are often wide-awake ones as the adrenaline that has permeated labour hasn’t quite left yet. Women describe staring at their newborn baby for hours; right through the first night together. However, you might fall asleep on a sea of endorphins and oxytocin and you need to keep yourself and baby safe. The safest way to share a bed in these early hours is skin to skin together under light covers (a hospital sheet and light blanket or, if you are at home, your summer duvet tucked under your elbow); don’t swaddle your baby in your bed and don’t try to limit her movement with pillows or tucked-in sheets; if she is tucked up with you like this, she really doesn’t need a hat!

If you are bottle-feeding formula milk or are still under the influence
of labour drugs, sleeping with your baby is not safe: set an alarm on
your phone to buzz after about 20–30 minutes so that, if you do nod off despite your best efforts to stay awake, you will wake pretty soon and can put your baby in a crib. If you are at home, make sure that, if your partner is in bed with you, he or she is not drunk or been smoking.

Your baby, after the first post-birth suckling, may sleep for many hours and, as long as she is kept skin to skin, she will wake when she is ready to suck again.

 

The first suckling

Even more soothing and calming for both the baby and her mother is suckling. As we saw with our primitive baby, soon after birth, the newborn, lying seemingly helpless on the mother’s chest, starts to instinctively search out the breast. She isn’t thinking ‘I must feed. I must get just the right amount of calories and nutrients inside me and I know just the restaurant!’ She is driven by primitive reflexes and instincts, just like every other mammal on the planet, to search out a nipple. Smells, sensations and sounds guide her and, to begin with, her journey can seem pretty random. But as she gets closer to the breast, that enticing contrast line of the paler flesh against the dark edge of the areola catches her eye, and off she heads to explore. Women often tell me when I ask about the first feed that ‘It just happened. I don’t really remember doing anything. She just knew what to do!’ Of course. It would be a bit of a disaster if our primitive mother, having just given birth in the dark shadows of a cave shelter and still needing to urge out the afterbirth, had to know how to get a baby onto her breast to suckle. This baby can’t wait around for her mother to practise and learn! In any case, in the low light, the mother wouldn’t be able to see much of what she is doing. The baby can do this solo.

We are really not very far away from this early setting, and evolutionary adaptation ensures that the newborn baby, driven by a rooting reflex, hunts and snuffles around until eventually she finds the nipple and, after prolonged head-bobbing and faffing, draws it in and sucks. Endorphins and oxytocin flood the bloodstream of baby and mother, taking away the pain of birth and replacing it with a deep relaxation and sense of calm, at the same time causing contractions in the womb to push out the placenta and stop bleeding. With the surge of the placenta contraction, the mother pulls her baby in even closer to her chest and the baby suckles more deeply. There is no need to help or direct the baby and, in fact, she will manage better without you doing very much except what comes instinctively. She has a reflex and, just like with a sneeze, if you try to help it might get a bit messy!

 

Love at first sight?

You may believe you should feel an immediate thunderbolt of love hit you when you first hold your baby or, at the very least, soon afterwards.

And if you don’t, you feel there’s something wrong with you. In my experience, although many women do indeed feel an almighty rush of instant love at first sight when they first hold their baby, for just as many it isn’t like that at all. So, whereas for some new mothers it feels like an instant recognition of a loved one – ‘Oh my word, it’s YOU! I know you and I love you so much!’ – it may feel more like ‘Oh! Hello. Not quite sure what you mean to me. I’m pretty puzzled right now because I really don’t know you at all. Who ARE you?’ or ‘Hmm, you’re a funny- looking thing! Not at all what I expected and I’m not sure quite how much I care about you at the moment. We will have to muddle this one through …’

Sometimes relationships simply take a while to grow, settle and cement. Don’t worry. Your baby doesn’t have any of these worries and doesn’t care about your musings (she doesn’t know that you feel somewhat ambivalent right now). She will show you how to mother her. As you feed her and change her over the days and weeks, her smells and her cries and her searching eyes will gradually, bit by bit, get inside you if you just relax into what it is rather than try to wrestle it into what you think it should be.

 

Partner ponderings

Although much of this book inevitably looks at mothering, there is plenty here for partners. Reading through the whole of the chapters will help you understand things from your child’s mother’s perspective. It may help you make sense of her hormonal swaying, explaining why it can seem at times as if the woman you love has left the building and been replaced by a stranger! At the end of each chapter is a bit just for you, to help you discover your unique and essential role, different as it is from that of the mother. Your baby needs you and your partner to be different; this helps build flexibility of thinking and, in time, your baby will grow into a child who understands how to respond differently to different people and how to understand emotional needs.

Labour

During the labour, birth and first minutes and hours, the birthing woman is completely awash with hormones, driven by instinct and reflexes to bring your child into the world safely. It can be tough to watch. Many partners feel a huge need to rescue their birthing woman, but there is no need. She needs your strong emotional and physical support right now. She is quite safe with the midwives and doctors, who are expertly trained to do the checking and rescuing (if necessary) so that you can be the support coach to the marathon runner. There is nothing to be scared of – this is simply what we look like and sound like when we are pushing another human being into the universe. It’s fine to ask the midwife if you can watch your baby’s head emerging if you like (and if your partner doesn’t need you to hold her while she pushes) and even to ask if you can help hold the baby as she is finally born. If all is going well, most midwives are only too happy to guide your hands. Or simply watch in awe …

The first moments after birth

The moments immediately after the birth can be very emotionally mixed. Exhaustion and adrenaline mix with shock and delight. Watch now as your partner and baby, driven by deep, deep instinct, discover each other. This is millions of years of evolution laid out in front of you. Your baby may take some time to splutter and cry. Don’t worry: the cord is still pulsing with oxygen and nutrients and she will breathe for herself in good time. Stay close to your partner and just be. It’s fine to join in the gentle touching and see if you can smell those musky tones too. Your partner’s senses are massively heightened to ensure that she knows her baby’s scent from the very beginning. It won’t be so strong for you – you have a different role to play – but you may still be surprised by how powerful and good your baby’s smell seems.

Refreshments all round

When your baby starts to nuzzle and move around, searching for a nipple, don’t feel moved to help: the baby needs to take her own journey in her own time and her mother will ease her up without even thinking. Instead, while your baby sets about foraging, you can ensure that your partner is warm and nourished. Pop a warm blanket or towel over the snuggling couple first and then sort out refreshments. If she needs stitches, you will need to wait until these are done before sorting out food. You and your partner will need plenty to eat and drink, but keep it light. Tea and toast is the usual order of the day. A very newly birthed woman will tell you that the first cup of tea after birth is the best cup of tea in her life, EVER. If you make it, rather than leaving the job to the care assistant, you will get the kudos!

Skin to skin

Eventually, after much nuzzling and eating and chatter, most women want a shower and you can finally enjoy some skin to skin time with your baby. Simply put a hat on her head, pop a nappy on her bottom and then carefully pass her down your T-shirt until just the top of her head is sticking out. That’s it! Talk to your baby, kiss her, smell her, or just grin and enjoy this moment in silence.

 

Questions and answers

At the end of each chapter you will find some answers to common questions. Tempting though it is to turn straight to this bit, do read the full chapter as it will help you make sense of the answers.

Caesarean

I am expecting to give birth/have given birth by Caesarean. How can I ensure that my baby gets the friendly bugs?

Evolution has done a brilliant job of getting us here, but there are still inevitable glitches (that kind of defines how evolution works), and medical interventions give us a means to survive these glitches. Caesarean-section (C-section) births, forceps births, ventouse births, epidurals: these things have dramatically improved the lives of thousands of mothers and babies. For our part, we need to look at the bits that science can’t yet replicate and add those in as best we can. Compared with vaginally born babies, those born by C-section are more likely to develop asthma, allergies, eczema, type 1 diabetes and coeliac disease. They are more likely to be hospitalised with tummy bugs. While some of this may be attributable to the greater likelihood of these babies having formula milk in the early days, there is growing interest in the notion that babies born by C-section just don’t get the good bacteria from the mum’s vagina and perineum. Some maternity units now encourage mothers expecting to birth by C-section to collect friendly bugs from their vagina before the operation. If your unit does not suggest this to you, just put it in your birth plan and do this:

  1. Take a piece of gauze soaked in normal steriles aline.
  2. Fold it up like a tampon with lots of surface area and insert it into your vagina.
  3. Leave for one hour, remove just prior to surgery, and keep it in a sterile container (the sort of pot you collected your pee in during pregnancy is ideal).
  4. Immediately after birth, simply wipe the swab around the baby’s mouth, face, then the rest of the body.

Note: It is really important that you only do this if you are free from HIV, thrush, group B strep and any STDs or other infections. If you are in any doubt, talk to your midwife.

Also, as soon as possible, get skin to skin and stay that way with your baby for as long as possible (hours rather than minutes and days rather than hours). There is no reason not to have skin to skin while the post-op stitching is completed unless you are too poorly to hold your baby. If this is the case, your partner could, if possible, hold your baby skin to skin on you or on themselves. Let your baby suckle freely and don’t feel the need to bathe her for at least 24 hours. If possible, take your own linen into hospital and don’t be obsessive about you or your partner forever cleaning yourselves! Just normal daily hygiene is enough.

Special care

My baby is in special care! What now?

It is incredibly stressful for everyone when a baby is too poorly or too little to be with her parents and needs the care of a neonatal unit. The newly birthed mother can feel split between gratitude that her baby is in safe hands and misery that her arms ache to cuddle her newborn. This upset can be made even worse when a baby has to stay in hospital after the mother has been discharged. There is clear evidence of the benefits of ‘comfort holding’ and ‘kangaroo care’ for premature and sick infants. ‘Comfort holding’ can simply mean touching your baby with your warm hands on her skin while she rests in an incubator and it can also extend to sitting quietly in a chair with her lying on your chest. This can bring rest and comfort to mother (or partner) and baby and is also a simple, effective way of reducing stress for both when a baby has to have unpleasant procedures like blood tests.

‘Kangaroo care’ is an extension of ‘comfort holding’ and involves putting the baby, skin to skin, with mum or her partner, either sitting in a chair or while they are getting on with something else. Skin to skin has a profound positive impact on babies and their parents, settling breathing and heart rate, reducing stress and managing temperature as well as helping to protect against infection by increasing the baby’s exposure to those essential friendly bugs. As well as getting close to your baby as often as possible, express your milk for her. Even tiny amounts of your milk will protect her from infection and soothe her emotionally. Read Chapter 4 on feeding for tips on expressing.

Skin to skin during stitching

I want to keep my baby skin to skin for a long time after birth, but what if I need stitches?

If we hold and suckle our babies while we are stitched, have blood taken, have ‘after pains’ or are upset for any reason, we get a rush of endorphins and oxytocin and feel better! Most women simply don’t ask or, if a midwife says ‘I need to give you a few stitches – maybe your partner would like to hold baby?’, they don’t say ‘Thank you very much for your kind offer, but I’d like to keep her with me and feed her.’ If needs be, get your partner to hold your baby against your bare skin. Of course, your partner could hold the baby skin to skin with themselves, but the ideal is for baby to get your friendly bugs first and foremost. There will be ample time ahead for cuddles with others.

No skin to skin

I had a vaginal birth but didn’t get any skin to skin time. Is it too late?

No! Things just don’t always go according to plan. We have tougher labours and births than anticipated, we have drugs that make us and our babies sleepy, we are too sore or poorly just after birth to hold our babies … so don’t panic! Just let the dust settle and then catch up. Strip your baby down to her nappy, strip yourself off down to your pants and get snuggling. Don’t worry about your baby getting cold: as long as her tummy is skin to skin with yours and her back is snuggled under your blanket, you will share your body heat and smells with her. Explore her with your hands and face or simply relax and read a good book – you will quickly discover that those ‘lost’ moments just after birth will fade.

I hope that you have enjoyed reading chapter 1 “Your Baby Skin to Skin”. To enjoy the rest of this unique look at the first year of your baby’s life, follow this link to buy a copy …

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The Anniversary – Part 1

To celebrate the first anniversary of the launch of my book, my March & April blogs will be a gift of the first chapter:

YOUR BABY SKIN TO SKIN

Chapter 1

Coming into the World: Your Highly Evolved Baby

Reaching back …

Some days ago, in the dark of the late evening, not long after the sun dropped suddenly below the horizon, a young woman, hidden with her group in the protection of some fallen trees, felt the first cramps of her impending labour. Deep in her belly and back, sporadic waves of tension grew and eased. She rested and fidgeted through the night and walked through the days, stopping occasionally to eat, drink and rest. Her companions stayed close but un-interfering, busy as they were with surviving and finding a suitable shelter for the safe birth of their newest member.

Now, a few days later, the cramps gradually strengthen and lengthen, grabbing her attention and driving this woman into herself on waves of endorphins. As bright as the midday sun is, inside the labouring woman’s head the lights gently dim as she becomes quieter and more settled. Her companions help her into a cave shelter where she creeps into a hidden corner and hunkers down, moaning with the waves of intense power that flow through her. As the day wears on, her moans grow louder and more urgent. She is up now, swinging her aching hips, pressing her hot brow against the cold stone wall of her shelter and hanging on the shoulders of her strong companion. Oblivious to the world, she is wrapped entirely in her own experience as the hours slip by. And then, just before dusk, the cramps stop and she sleeps for a few delicious moments, listening to the reassuring hum of gentle activity around her.

So, here we are, at the very dawn of time, watching in wonder, and waiting for the moment …

Suddenly she wakes; urgent, adrenaline- filled eyes; frantically trying to get up on her haunches. Her animation alerts her companions, who now gather around her, supporting her weight and watching as she starts to gasp, grunt and urge. Throwing her head backwards, arching her back and heaving again. And now, the wave gone, she is quiet again, but attentive. And another, bigger urge, greeted with deep, throaty groans and gasps. And another, and another. It seems like forever, and just when she thinks she is nearly ready to birth, another great wave hits and the groans deepen and intensify. A sudden gasp and yelp, and now she is panting quickly with the shock of her baby’s head stretching her open with a hot burn that takes the breath out of her body. The woman, numb from the stretch, breathes silently, eyes focused steadily ahead as the moment lingers. Now the urge builds again, the stretching starts and then, emerging slowly, glistening and dark amid the wolf-like howling, a head! The baby faces away from its mother and she looks straight ahead, searching for reassurance, almost oblivious now to the nature of her work and suddenly freed for a moment or two from the stretch that made white stars dance in her eyes.

Perfectly still, silent, the baby stays, head out, aware of the cool air around its face; its body held tight inside the mother for a minute before gently turning slightly to bring it around ready to emerge. As the baby’s body turns inside, the head turns too, bringing the tiny, scrunched-up face into view. Dark skin, bubbles of fluid popping at the mouth, eyes clenched tightly shut. The mother, wondering what is emerging from her body, reaches down between her legs and the baby, in response to its mother’s touch, wiggles its head ever so slightly. Shocked, the mother draws her hands away, holding sticky fingers star-like in the air as the urgent, irresistible force of another wave rocks her body one last time.

On a wave of shiny fluid, accompanied by one long, low hum, like a grateful hymn, the baby finally slips out onto the dusty floor. The baby, lying like a landed fish between its stunned mother’s legs, takes a minute to respond. Its mother, likewise, does not grab her new baby but looks lost, unaware momentarily of quite what has happened …

… and now she moves. Hands between her legs, searching, finding her baby and drawing it up into her hot arms, close to her, where she can just see in the dim light of her cave shelter that she has a girl! The thick cord hanging warmly from her daughter’s belly to her own vagina, swollen and numb from the birth, still pulses with blood from the placenta, giving her baby enough time to adjust to her new surroundings. Even now, as she starts to cough and cry little bubbly cries, her heart is adjusting to the outside world: her circulation changing as some valves snap shut for good, no longer needed now the baby is starting to breathe for herself and her once-blue body gradually infuses to pink.

Now the new baby smells her mother, like a small, snuffly hedgehog in the dark. Her own amniotic fluid, still warm and slippery, mingling with her mother’s salty sweat. Her tongue creeps out and licks around, catching the sea tang of her mother that seals her forever-knowledge of who she must cling to now. And at the same time another sound, another sniff but this one long and deep, like the drawing in of the first sweet air of morning. The newly birthed mother, sticky hands steadying her slippery eel-child on her chest, is smelling her too! She doesn’t even know she is doing it. As the mother–baby dance begins, the new cries build and the mother, high on a sea of adrenaline, learns it by heart in that moment. From now on this cry will touch her in a way that no other baby cry has before. It is part of her own experience, a reminder of the struggle she endured to bring this baby into the world. While others may be able to turn away from this noise, it will reach straight into her heart and wrench at it until she responds. Even now, that first cry is working its purpose: mother shushes gently into her daughter’s ear, muttering and gently calling to her. No words are needed; the gentle sounds, mixed with the warm smells and touch, signal that this is sanctuary.

Before the cord has even broken, or the afterbirth pushed out, the baby bobs her head about. Her hands opening and shutting, grasping at flesh, legs pushing over and over against her mother’s damp, warm skin, gradually moving her just-landed body, heavy in the air, over her mother’s chest. She snuffles and bobs, cries and then falls quietly asleep for a moment before moving again. Creeping around, more sniffing, more bobbing. Slowly, so slowly, she searches for something of which she has no knowledge, no understanding: a nipple. Her eyes opening in the easy natural just-light, she is drawn to an area of contrast, where the flesh of her mother’s chest meets the darker flesh of her areola. No smudged line here but a sharp edge between light and dark, with an oily aroma that tickles her nose. Irresistible. She reaches her destination and then falls asleep, again! Her tired but alert mother wraps her close, beginning to feel cramping again, softer now than the sweeping torrents an hour ago but intense all the same and accompanied by a deep fullness in her vagina. Moaning and grasping at her baby, she lurches upright and the warm afterbirth falls heavily out. Another second of surprise before she turns back to her baby, who has, while her mother’s attention was away, drawn herself onto the dark nipple, pulling it deep into her mouth.

Adrenaline seeps slowly away as endorphins start to flood mother and her newborn. Eyes glazing over, the mother starts to shiver and her companions, having broken the cord and hidden the placenta from the attention of hunting animals, cover the pair and snuggle up nearby for added safety and warmth. The mother and baby, the two who have had the hardest of days, are wide awake, staring at each other in the dark, eyes just inches apart.

We will leave our primitive family now and check back over the next few days and months. They remind us of where we came from and can help us find our own way back to a calmer, more settled experience of parenting in the modern world.

 

Highly evolved beings

Modern life can look so very different from that of the earliest humans, but some things bind us together in our experience. Birthing our babies, bringing a new human being into the world, discovering our child for the first time – none of this has changed in thousands of years. Whatever our birth story, we are linked, down through generations as far back as you care to go, to our mothers, grandmothers, great-grandmothers, to our friends and to strangers. All highly evolved to carry, birth and protect the next generation. This simple knowledge is at the heart of this book: you and your baby are the highly evolved survivors carrying, silently and without realising it, the knowledge and ability to do just fine.

Of course, life is complex and noisy and we can’t get away from that – the house must be cleaned, the car must be serviced, the shopping must be done, not to mention the emails that must be answered! But mothering our baby does not need to be scary or fraught with impractical rules. If we can relax and watch evolution at play, just as we did at the start of this book, we will realise that, far from needing to learn how to wrestle our newborn into some book-invented, regulated creature to save us from creating ‘a rod for our own back’, our babies will show us perfectly well what it is to be a new human and we can find ourselves just simply responding. So scary to think that we should know what to do and how to teach this tiny being; how much more fascinating and creative to watch and learn from evolution itself.

The newborn baby comes with its very own set of reflexes and instincts. These have evolved over many millions of years for one purpose: to ensure survival. The process has been long and messy: in order to achieve the survival of the fittest, a lot of weaker babies have been lost along the way. This is how evolution works, whether we like it or not. Other branches of early human-like creatures became extinct while our own branch strengthened and evolved, gradually getting better and better at adapting and surviving. We developed language and social structures, discovered fire and cooking, and learned to control our environment. The rate of the explosion of knowledge and learning has been staggering and we now feel so sophisticated and smart in comparison to our early ancestors that we forget that they had to survive against the odds.

But our babies are not sophisticated like us. They are not able in their earliest weeks to make choices and conscious efforts to control their environment. They are little bundles of instinct, without critical thinking, and this is what keeps them safe.

 

Birthing instincts

Think about a modern birthing scene. Mentally strip away the buzzers, lights and machines, and you will see the same things happening as in our primitive birth scenario – even in assisted births, many of these things still happen, and are noticed by the midwife, although the mother may not be aware of them. Here we’ll examine what the mother may experience while birthing her baby naturally, and what she may feel without any epidural. If you had an assisted delivery or Caesarean, you may feel robbed of some of the emotions and experiences described above and grieve for them even though your baby was born safe and healthy. Turn to the Q&A section of this chapter for more on how you can capture some moments of wonder, whatever your birth story.

 

The importance of healthy bacteria

The baby comes into the world, generally speaking, facing downwards towards the mother’s bottom, the mother’s pelvis perfectly shaped to help this happen. This may seem odd – why wouldn’t the baby want to see the mother looking down at her? But in our ancient scenario the gloom would make seeing a face difficult, and babies cannot clearly see that far (they have no need to). There is something more important right now to the baby’s long-term survival: this baby is just about to exit a bug-free environment and enter a very dirty world! Facing the mother’s bottom as she emerges into the world allows the baby’s face to pick up some of the mother’s gut bacteria, which contain, among the bad bugs, millions of helpful bacteria that will get into the baby and help her to fight infection during the early days. What a brilliant adaptation!

But when I first trained as a midwife, and we knew a baby was about to be born, we swabbed the mother’s thighs, perineum and vulva enthusiastically with cleaning solutions. Apart from the horrible sensation of having cold water sloshed onto your delicate vulva during maximum stretch and concentration, it prevented the baby from naturally obtaining protection from the very bugs we were swilling away. Somehow we thought that babies should be born into a sterile environment because they lack the ability to fight off bugs, when all the while, had we looked back, we would have seen that evolution had taken care of things for us. Happily, we stopped doing this many years ago, but women still worry about being dirty when they give birth. Of course, the very first labour contractions usually cause the bowels to empty well before birth and, in any case, once the baby’s head is in the pelvis there really isn’t room for anything else, so pooing is not an issue. The vagina and perineum, uncleansed with chemicals, provide just the right number, type and mix of bugs to ensure that the infant skin and gut become quickly inhabited and protected.

 

How the ‘ouch’ of crowning protects us and baby

The birth of the head takes a few contractions, giving the vagina time to stretch gently and the baby to adjust to the different pressures in the outside world compared with those in the tightest parts of the pelvis. A very fast birth of the head can cause your baby to have quite a headache, so evolution has sorted that out for us and slowed it all down just enough. Women have huge, irresistible reflexes and urges and, in most cases, need absolutely no guidance as to how to birth their babies. Over millions of years we have evolved to do just the right things to keep us and our little ones safe. So, as the head crowns, the intense heat of the stretch causes women to gasp and pant, which, in turn, slows down the speed at which the head slides out, thereby adding protection. Women will often instinctively bring their thighs together a little as they gasp and pant away the burning and stretching and this adds further protection by steadying the pace and taking a little of the stretch off the perineum, protecting against tearing. We may wish the head could pop out double-quick, but this wouldn’t serve us or our baby at all well. And then, at the exact second the head finally births, as women we know for absolute certain exactly how a champagne bottle feels when the cork has been popped! The relief is instant, the contraction has ended, there are a couple of minutes before the next contraction comes, and, awash with adrenaline, women often start to talk animatedly, telling the midwife about their latest shopping trip while seemingly unaware that there is a baby’s head just outside their vagina! A midwife’s job is often a surreal one.

With the next contraction the baby’s body slithers out with a sudden rush, which can leave us feeling as if ‘someone has just walked over our grave’. More often than not, the midwife either quickly puts the warm newborn on the mother’s chest or suggests that the mother ‘takes’ the baby herself. Sometimes a midwife will let the baby lie, just as in primitive times, between the newly birthed mother’s thighs. In any event, the same thing happens if you watch closely: there is a brief moment during which the mother is not quite ready or aware. She doesn’t immediately engage with her baby but time stops for a tiny moment, a brief suspension in the clatter and noise. And then she shakes back to reality, takes her baby onto her chest and the sniffing begins!

 

Head back here next month to read the second part of chapter 1 “Your Baby Skin to Skin” and, if you can’t wait ’til then, follow this link to buy a copy …

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Giving up the white stuff (when they no longer want to booble)

I was contemplating my second birth last night. The reason for my reverie was that I suddenly realised that it was Pancake Day and I hadn’t had a pancake – my brain was obviously nudging me in a carb-deprived way!

Twenty-nine years ago I gave birth to my second son on Ash Wednesday having thought that the tummy cramps and diarrhoea I’d had all day were a result of dodgy pancakes the previous evening. I have photos from a couple of minutes post-birth of me and the midwife (still wearing her coat) looking white with shock – the midwife on the phone telling the second midwife to stand down as it was too late for her to come with all the home birth kit: baby was already here! He came yelling into the world wearing a glorious surprise of thick, long black hair and a sweet little “bum chin”.

Last night I was pondering the notion of “giving up for lent” and decided that now was as good a time as any to finally bite the vegan bullet. This is an easy ask for me as, not long after the birth of “Ash Wednesday Boy”, I became anaphylactic to egg and so, as a long-term vegetarian, the only thing I need to cut out is the occasional dairy cappuccino and a grating of strong cheddar on my Spag Bol.

Now I have also recently had a number of questions about weaning and how to move babes from mum’s milk to cow’s milk: when, how much, which type, formula or regular etc etc. So here is my guide to giving up the white stuff …

When we booble our babies, because of the language that surrounds us, it is easy to think that the boob is simply just another milk vessel. That a baby should switch his affection in time from the human to the bovine drink. But all mums know – even though they forget that they know – that babies don’t see the boob like that at all. To our baby the boob is quite simply his “sucky thing”. He doesn’t pop on and off and on and off and on and off ALL day and night because he is hungry or thirsty. He is heading chestwards to soothe, to snuggle, to warm, to fret, to chat, to off-load, to reassure (him and you) and to relax. He might have a few glugs of warm, endorphin-rich milk whilst he’s there, but he might not. Offering him a bottle of any milk, human or formula, will generally be met with complete bafflement.

As we start the long process of introducing our baby to family foods, our mum’s milk continues to be a vital source of nutrients and calories. Then over the months, slowly but surely, family foods start to provide more and more of her daily intake and the boob, whilst continuing to be the main source of comfort and sleep-soothing, gradually provides a smaller ratio of the nutrition. This really is a slow process and, until the first birthday, most family foods make up a very small percentage of the overall dietary intake. It can be useful during this time to offer water from a beaker during family food times and then offer the boob freely through the rest of the day and night. The same goes for the bottle-feeding mum (whether the bottle is full of formula or mum’s milk) – water with family foods, milk at all other times.

From the start of sharing family foods at about the 6-month mark, the boobled baby can have full-fat cow’s milk on cereal and in sauces. But there is no need, or advantage to introducing drinks of milk. In fact dairy milk inhibits iron absorption (unlike mum’s milk which can help it) and a beaker of it can simply fill a baby up so she no longer feels hungry for her nutrition-rich beans on toast. There is also no need to introduce formula – it really tastes, smells and feels nothing like mum’s milk. Follow-on milks are not recommended for any babies, formula-fed or boobled, as they are nutritionally almost identical to regular formulas and the added iron which is advertised as being important for the older baby cannot be absorbed by the human infant but can cause constipation.

It is so common as to be almost ubiquitous for the exclusively boobled baby to wean from the breast and never drink a glass of milk ever again. Milk on cereal, in foods and as cheese, yoghurt and cream, yes. But a drink of milk? Rarely if ever. When health care professionals and NHS websites talk about giving formula alongside family foods and of ensuring a baby still gets a pint a day, they are talking to the bottle-feeding mum, not you!

If your own diet does not include dairy but is a healthy, balanced diet with plenty of complex carbs, protein, healthy fats, fruit and veg, then, just like your omnivorous friends, wean your baby onto your family foods along with whatever milks you might use in sauces and cereals (rice, soy etc). Good sources of non-dairy calcium are nut butters, calcium-set tofu (check your packet), bread, dried fruit, hummus, baked beans, other pulses and brassicas (broccoli, cauliflower etc). Remember, and this is true for ALL weaning babies, that your little one needs calorie-dense foods so don’t go filling him up on broccoli with its meagre calorie count so that he can no longer face his mum’s nutritious milk. Babies are growing fast and he will soon be on the move and burning up the calories at a colossal rate, so choose foods that will give far more bang to the buck.

Current medical advice is that ALL boobling mums and weaning babies should have a daily vitamin supplement containing vitamin D. There is a growing body of opinion that, in the northern hemisphere, everyone (women, men, babies and children) should have daily vitamin D supplements but the government guidelines are not quite “there” yet – watch this space …

In short, babies will slowly wean themselves off their mum’s milk and onto a gradually more varied diet over many, many months. There is no need to replace your own milk with dairy or any other milk drink as time goes on but ALL humans need adequate calcium in their diet and this can be found in a wide variety of healthy family foods. Supplement yourself and your baby with a daily vitamin containing vitamin D and get out in the fresh air to soak up what little sunshine we see during these winter months. And, of course, continue to enjoy snuggling up with your baby for a long, cosy booble in front of the TV for as many months and years as you both wish.

Now please excuse me whilst I go and finish my soy cappuccino before it goes cold!

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Biting the hand that feeds you!

As I settled down to tuck into my first (but very much NOT my last) mince pie of the Christmas season, a message pinged into my WhatsApp folder like a cheery little festive jingle. “Help!” … all my work messages start that way … “My 8 month old baby has started biting me when I feed her. What can I do?”

Another bite of mince pie and a glug of sherry (come on – it was Christmas!) to ease me into my reply and another message popped up, this time by Email, saying exactly the same thing. One sure way to ruin your mother’s Christmas? Take a hearty chunk out of her nipple!

Some babies are born with teeth: little razor-like pearls peeping out of pink gums. Most babies, however, get their first teeth some time between months 4 and 7 with the two bottom front teeth being the first to push their way through. After the two bottom front teeth come the two front top teeth and then, as time goes on, the gaps fill in.

As soon as your baby starts dribbling a lot, around the 2 to 3 month mark, the world and its mother will tell you that “she’s teething”. In fact, dribbling starts with babbling and coo-ing: extra saliva is produced to moisten the tongue, lips and gums for vocalisation and babies take time to learn how to keep the extra drool in their mouths. For at least a year and a half, any excess saliva simply escapes out of their mouth and covers your clean clothes just seconds after you’ve got dressed in the morning. There will be another increase in saliva production around the 5-6 month mark in preparation for starting family foods.

Having said that, you might notice EVEN more dribbling when a tooth is erupting but, given that the amount of dribbling in the baby over 3 months is so big, you’d be unwise to place a bet. Some babies do get a hot, red cheek, swollen gums, and an irresistible urge to gnaw on things when cutting a tooth but, more often than not, the first tooth appears some time after all teething symptoms have disappeared and you’ve stopped checking. There is no evidence that teething causes diarrhoea or a temperature so, if your baby seems unwell, see a doctor.

So, having admired the first pearly white, bought the first toothbrush and sickly-flavoured baby toothpaste, you’ll quickly realise that, because the tongue covers the bottom gum during feed times, boobling remains perfectly pain-free. And then one day …

She is boobling quite happily whist you catch up with your favourite Netflix box set. Just as you take a slurp of tea, your sweet little “butter wouldn’t melt in her mouth” baby pulls her tongue back and delivers a killer bite! You yank her off, yelling uncontrollably, tear at your shirt to inspect the damage (you just know that you’ll be missing a nipple now) and, at the same time, plonk your bemused child unceremoniously on the floor.

Satisfied that you still have two decorative nipples gracing your boobs, you’re suddenly drawn back to your nipper who is lying desolate on the floor, looking heartbroken and crying REAL TEARS! Guilt sears your soul and you grab her back into your arms, profuse with apologies, and plant her firmly back on the other boob.

Given the visible, and audible, shock that your little boobler experienced when she saw and heard you completely lose your rag, why then does she repeat the experience before the day is out? Surely she won’t want another heartbreak? How can you continue to booble your baby whilst preserving your nipples?

Not many babies bite the boob when their teeth first emerge but most do so eventually and it is tricky to know what causes that first chomp. In truth, the why does not matter overmuch. You simply want to know how to stop it before you become nipple-less. Mums generally say that the bite occurs either as their little one tries to come off the boob, or as he nods off for a good boob-in-mouth doze. He seems to forget where he is for a moment. Away in a milk-drunk haze, he starts to fall off and then jolts awake and clamps down. It isn’t meant and it isn’t personal. It certainly isn’t naughtiness but it is painful.

The reason why most mum’s get into a pickle of being repeatedly bitten is actually very simple … lack of congruency.

Congruency means harmony. When it comes to giving our babies and children clear messages, if we are not totally congruent, we can cause confusion and the message can be misunderstood.

Imagine that you have just bought a new outfit. You are thrilled to bits with your purchase and decide to show it off to your partner. “What d’you think?” you ask cheerily. Your partner looks you up and down, tightens their shoulders, furrows their brow, winces and then says, “Lovely!” in a tone of voice that says “It stinks!” You look crestfallen as you wail, “I thought you’d like it.” “I just said it was lovely didn’t I?” You know this conversation, we’ve all had them. Your partner maintains that, because they said the outfit was lovely, surely you should be delighted. What’s the point in you asking their opinion if nothing they say is right? You know that, no matter how much they protest, there is no doubt what was meant. Your partner was saying one thing, but everything about their face, body language and tone of voice said quite another.

We are essentially pre-verbal for many years. Sure we learn to talk our mother tongue from the first year but, long after we start to speak we continue to rely on the non-verbal cues to get us through a conversation safely. Indeed, as the scenario above demonstrates, even as adults, when there is a mismatch between the words and the body cues and tone, we will “go with” our first language: the non-verbal.

You think your baby understands every word you say, but he doesn’t. He is a master of the non-verbal and, if you give him a mixed message, he will go with the unspoken. So when your little baby sits howling on the floor whilst you tend to your poor, nipped nip, and you, overcome with guilt, turn your horror to a ready smile, soften your yell to a song and draw that rosebud mouth back to the scene of the crime with a warm apology, it is little wonder that you get nipped again. The message you have given has been, “Sorry poppet! My mistake! It’s perfectly fine to do that bitey thing. All’s fine now, carry on …”

Next time you get even the faintest hint of an impending bite, take your little one off quickly with a look that says, “No you don’t!” Bring her back in gingerly ensuring that your message is clear, “Go steady, sweetie. Mum’s nipples are a no-bite area”. If you’re too late and the teeth get there before you can swipe her off, do the honest thing: take her off, fast, and say as loudly as your poor nipple asks you to, “NO!” Don’t sugar-coat this with an apologetic smile or a tone of voice that says, “Gosh, what a busy day we’re having!” Be congruent. And when your nipper howls at being put on the floor whilst you tend to your own trauma, sort yourself out and then pick her up as nervously as you feel. Let your face show your anxiety as you tell her, “No biting!” No need for theatrical screaming. The tone of your voice, the look on your face and the hesitancy in your subsequent pick-up will be perfectly adequate.

Our babies and children need clear, un-muddled messages if they are to keep themselves from getting things wrong. Our children want to please us; they are desperate to learn how to get things right and we can help them, and ourselves, by just saying what we mean and meaning what we say.

NOTE: There seems to be a fashion on some social media breastfeeding groups for suggesting pulling a biting baby firmly into the breast to close off the nose and prevent breathing until the baby has no option but to let go. This is thought to frighten the baby enough to prevent further biting. This is unkind and potentially dangerous. It teaches your baby nothing about how we naturally deal with a hurt and sets a bad example to any older child watching of how to manage a biting baby. Just don’t ever do this!

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Desperate about your young baby’s behaviour?

Sunshine follows rain, night follows day, cats sleep on newspapers and babies cry all evening. Such is life in all its glory. Every parent I see will accept that, when they announced that they were planning a family their news was met with smug grins and a threat of “just you wait for those sleepless night!” And yet, when those sleepless nights arrive before the ink is dry on the hospital birth notes, parents quickly come to the conclusion that their baby is unusual, broken, poorly or just plain naughty!

Erratic, fussy, irrational and impossible to soothe, the young baby is the same the whole world over and once you understand exactly why your little one keeps you on your toes (don’t you dare sit down) all evening, you will be more able to accept that what you need are coping strategies rather than a non-existent cure.

Colic is the name given to the particular pattern of crying and fussy behaviour seen in the Baby in the first 3-4 months of life. The pattern starts towards the end of the first week following birth and is characterised by regular, nightly crying bouts between about 5pm and midnight and then again between 2-3am and 4-5am. The baby draws up his legs and appears to be in pain. Suckling and rocking appear to help for short bursts but nothing gets the baby to sleep for long, until the end of that particular colic bout when baby falls soundly asleep.

It seems that colic has been around since the dawn of time and, from an evolutionary point of view, makes perfect sense for the survival of the species. After all, noisy babies get cared for, quiet ones get put in a corner (of a cave) and left alone …

You will hear all sorts of explanations for colic – wind, reflux, silent reflux, naughtiness, manipulation, poor milk quality, stress in the mother, but none of these make sense when looked at from a scientific, rational standpoint.

Colic simply means spasm and this is exactly what your baby is experiencing – painful gut spasm caused by high blood levels of hormones that make the smooth muscle of the gut contract. These hormones are circulating in all of us – they cause labour contractions, amongst other things. They are at their lowest between about 7am and midday, which is when your baby will be most settled and pain-free, and peak daily between 5pm and midnight and 2-5am. The evolutionary reason for a baby to be settled in the warm morning hours when the sun is up and mum is busy out hunting and gathering, and then demand to be kept very close in arms and soothed continually in the dark, cold nighttime hours are pretty obvious when you stop and think about it.

Happily, evolution has given us built-in soothing strategies – skin to skin, suckling and breastmilk, and when a baby comes to our boob all these three things happen together automatically. Suckling creates an endorphin release into baby’s bloodstream and, also, human milk contains endorphins. These natural opiates RELAX smooth muscle and therefore ease gut spasm, but they also wear off very quickly – in about 5-10 minutes. So the picture a mum typically sees is… baby in pain with gut contractions; baby gets driven through reflex behaviour to give suckling cues; baby suckles and produces endorphins at the same time as receiving a little endorphin-rich milk; baby’s gut relaxes; baby stops suckling; endorphin level drops off over about 10 minutes; gut contractions return; baby gets driven to suckle again, and so on and so forth. It is easy to see how mums think that somehow their breastmilk is actually causing the problem whereas, really, the baby is self-medicating on endorphins with each return to suckling.

People call this behaviour “cluster feeding” but in reality it is “cluster SUCKLING”. Because babies need to stay close all night to keep warm and safe, their highly-evolved, spasm-ing gut keeps them on high-suckle alert. Suckling alone produces endorphins and so babies do not actually need lots of milk during these hours – if they could get lots of milk every time they suckled overnight, they would either vomit huge amounts or you would be pushing them to school in a wheelbarrow in a few years! So, as mums correctly perceive, when a baby is at her most suckly, mum’s supply adjusts down. In the less suckly morning hours, mum’s supply adjusts up. In this way, babies can suckle as much as they need to and also get, over 24 hours, just the right amount of milk.

Now, how to deal with the problem. Firstly, it can help to know that there is no cure; only coping strategies until baby develops out of this very vulnerable state and is more able to cope for longer periods without skin to skin and suckling. This developmental stage arrives at around the 4 month mark. Next, it is useful to remember that colic is definitely not caused by wind or foods (with a couple of notable exceptions, for which, see later) seeping into the milk. In fact, all the weird and wonderful ideas you’ll hear about food really don’t bear scrutiny: human milk is made from our blood and our blood cannot become gassy, acidic or spicy and nor, therefore, can our milk. The trick is to keep endorphin levels as high as possible as this is what relaxes the painful gut. Now, as suckling raises endorphins and human milk contains endorphins, boobling will always be the most obvious solution, and you cannot put the baby to the boob too often. Baby will simply do lots of non-milk boobling and then, periodically, when a really bad spasm hits, he will draw a little endorphin-rich milk out to supplement his own suckling endorphins.

Other tricks that will stimulate your baby to produce her own endorphins are massage, skin-to-skin, rocking and jiggling, firm bottom patting, car rides, warmth (such as a bath), and stimulating her senses with certain white noises such as the hoover! Just remember that endorphins have a very short half-life, so every time you stop doing the soothing, you have about 10 minutes or so before the spasm and crying will return. Simply put, if you stop soothing your baby, your baby will stop being soothed!

Trying to cure a baby of his colic is like trying to cure him of being a baby. He will grow out of it at about 3-4 months no matter what you do (everything or nothing) when his immature nervous system stabilises. Of course, if you try different remedies, whichever one you are trying when baby is 3 months old will be hailed as a miracle cure and you will urge all your friends to try it.

Some great news about colic is that the baby who spends all evening and night soothe-suckling and in close skin to skin contact at the boob is less likely to get infections or suffer SIDS. Colic also seems to badly affect the brighter, more sociable babies – again, all that time in arms being rocked and talked to brings dividends. So much so that, even if your baby seems much calmer than your average baby, it is worth treating her as if she were really colicky and keeping her in arms as much as possible.

Colic can be more obvious in the atopic baby so, if you have eczema, asthma, hay fever or migraines on either side of the family, then your baby may be more severely affected. Many atopic people are sensitive to dairy, and cow’s milk protein is one of those rare exceptions where tiny food proteins can pass into mum’s milk and cause upset in very sensitive babies. The atopic mum might find that cutting out all dairy in her diet may possibly cut down the severity of the colic bouts. However, it is also very possible that the teeny weeny exposures to dairy proteins via breastmilk might actually help prevent dairy sensitivity when older. Remember though, the idea that the foods you eat can make your baby windy or cause your milk to be too acidic or spicy is simply not true – mums milk comes from your blood and your blood cannot be windy, acidic or spicy!

So, to sum up, your highly evolved baby survives the early, vulnerable first months by ensuring he spends long periods in arms, suckling. This arms-seeking behaviour is driven by painful hormonally-triggered gut spasms, particularly in the evening and night hours. As well as keeping him safe, this prolonged in-arms, soothing phase of life forges strong bonds and developmental leaps in language and socialisation. The mum who can just can trust her own instincts to pick up her baby up and soothe him continually helps rather than hinders this stage, and her milk carries soothing, gut-relaxing endorphins to ease the pain.

Your colicky baby will almost certainly turn into an outgoing, physically active baby (the more severe the colic, the more the baby may be likely to fit this personality type) who is an utter delight to mother (although you’ll need your wits around you as the little trouper raids every cupboard in sight!) There is light at the end of the tunnel – best to batten down the hatches for 3 months and emerge when the storm has passed and the sun is shining!

“There was never a child so lovely, but his mother was glad to get him asleep …”
Ralph Waldo Emerson

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Ask Rachel – Using Bottles

On an almost daily basis, people introduce me as an independent midwife and lactation consultant when I would never describe myself as either! In fact, I struggle to describe myself in any particular way – some days I am like this, and some days I am like that and some days I barely know who or what I am!

Always looking slightly from the outside of any particular pigeonhole, I avoid belonging to tribes. They seem, to me, to be about exclusion as much as about inclusion and this makes me feel deeply uncomfortable. I can sign up to some elements of a club, but am always at variance with others and so then feel at conflict with the other club members. If I belong to any tribe, it is the one where its members could sign the “any other” category.

So it is with feeding our babies. If you are known as a mum who suckles her baby, it is ten to one that people assume you also an “earth mother”, that you demand feed and co-sleep, that you “baby-wear”, and that you do not want a routine-led household.

If you bottle-feed, then there is an assumption that you want a more separate relationship from your baby, that you will start weaning at four months, that you rigidly work towards a four hourly schedule for feeding etc. etc.

So what about those “any other” mums who want to mix and match? Those who suckle their babies but want to work towards a daily routine in due course or those who bottle feed their babies but want to co-sleep, throw out the clocks and “wear” their babies until they are ready to sit their GCSEs?

Today, I speak to those mums who use bottles (always or occasionally) for feeding their babies but want to better fit in with their baby’s naturally evolved way of being.

Q. What sort of bottles should I buy?

A. Once you step into the world of “Baby”, you really are at the mercy of advertisers. Their job is to make you believe that their product is best. They have many thousands of pounds to spend and they are good at their job. The latest fashion is for bottles that “stop colic” and teats that are “more like a breast”. Don’t be fooled! Anti-colic gimmicks in a bottle are just that, gimmicks. Furthermore, they require additional cleaning and sterilising. Remember that colic is hormonally driven and an evolutionary, inbuilt protective strategy to ensure survival. Read my other blogs for lots about colic and evening crying behaviour and you will see that a bottle really couldn’t and shouldn’t cure your baby of being a baby.

What you need, quite simply, is a device for holding the milk, and then a good feeding technique. Stick to a simple bottle that is cheap to replace regularly and you won’t go far wrong. Your bottle will need to be thoroughly washed and sterilised every time you use it (if you only bottle feed your own milk then a hot wash with soapy water will suffice), so the plastic will not last for ever. Tiny cracks develop over time and these can harbour bugs. If your bottle is looking well-loved, buy a new one.

Teats are an important buy so choose smartly. The “closer to nature” type are nothing of the sort and can interfere with the normal feeding motion of the tongue. See the pictures here for the type of teat I am talking about – all fancy promo and nothing positive for baby:

When a baby boobles, he gets a lot of boob flesh into his mouth and then compresses it. This causes a good, broad pressure from the boob against the roof of his mouth and, over time, the palate develops a great shape for both speech and hearing. Babies who suckle on teats miss out on this broadening and spreading of the palate and the speech can be less clear and the baby can be more prone to ear problems. The “closer to nature” style teats look great but actively prevent the baby getting the broad part of the teat into the mouth and working it, so the baby is forced to slide back onto the thin nipple of the teat. If he tries to suckle on the broader part then, often, the teat deforms and milk splurges all over the best rug, missing the bemused cat by inches!

Look for a teat with a high, fat bulb beneath the nipple bit. Get the teat out of the pack and squeeze it (you know you want to anyway!) The bulb should be easy to squeeze when the teat is on the bottle, and there should not be any deforming of the teat under the retaining ring. The idea is that the baby works the bulb and the nipple bit sits right back against the soft palate. That will give your baby a more normal work-out for the tongue and jaw and, whilst you will not be able to fully replicate the way a baby is evolved to suckle on a boob, you will have a better chance of him broadening his palate for speech and hearing. Have a look at these pictures to get an idea of what I mean by a high, fat bulb:

Q. What sort of formula should I use?

Here again, you are at the mercy of multi-million pound companies, all competing for your attention. The dangers here are potentially greater than with teat buying. So, here is some really important information for you to read, re-read and read again …

The law in this country states that ALL infant formula milks MUST offer your baby her complete nutritional requirements. Notice that I did not say “minimal requirements”. So every formula marketed, including those made from goat’s milk or soya MUST, by law, give your baby absolutely every vitamin, mineral, carbohydrate, protein and fat that she needs. Sure, not one of them gives your baby the protection to fight infection or a whole host of other stuff in mum’s milk, but you know that! What you almost certainly do not know is that the milk manufacturers add a heap of other stuff, over and above the legal limit, in order to be able to boast to you and make you think that their milk is superior. But the other extra stuff is not only “surplus to requirement” but we genuinely do not know if it is ok for babies. The companies do not provide adequate evidence to say that their magic ingredient is safe to give eight times a day for many months to your baby. The “not needed” stuff adds cost to the milk which goes into further promotion and new products in order to boost profits.

Remember that, no matter how annoyed you feel about that midwife who bent your ear about breastfeeding, she does not make a single penny out of you if you choose to suckle. She gets the same wage whether you booble for a week, a month or a year. Nor does she lose out if you choose to formula feed. It is no skin off her nose. This is the very opposite of the formula folk. Every extra tin of their milk that you buy, goes towards their profit margin. If you drift towards another brand, they lose out. This is why the manufacturers advertise so hard and why they add unnecessary ingredients – it’s a marketing dog-eat-dog world out there!

In essence then, if you buy the supermarket own-brand formula, your baby will get all her nutritional needs completely and totally met. Buy one of the top brands and your baby will get more than you bargained for, and not necessarily in a good way. Your posh formula may well be a more risky choice for your baby’s health than your supermarket cheapo.

Avoid buying according to your tribe (and those well known brands are very tribal – some are more popular amongst the middle classes and some amongst the working classes and some amongst vegetarians) and, instead, buy thoughtfully for your baby. If you can’t bear to see your friends turn their noses up at your choice, either don’t tell them what milk you use, lie (lying is not illegal if you are not the president of the United States) or transfer your formula to a sterile, air tight container so no-one has any idea of which brand you have chosen. Which formula brand you choose is your business alone and mothering is tough enough without the unsolicited opinions of other people to contend with.

Finally, don’t be duped into thinking that you should choose your formula and then stick to it. Most women, and most healthcare professionals, believe that changing formulas leads to tummy problems. This is no more true than I get tummy ache if I have toast for breakfast and rice for lunch (my tummy ache is caused by pigging out on vast quantities at each meal and then topping off with chocolate ice cream).

In fact, because each formula is slightly different in taste and texture, you could be doing your baby a favour by ringing the changes now and then (or even through the day or week). Exposure to different flavours (through mum’s milk or by using different formulas) can make life easier when it comes to weaning. The baby who has had the same flavoured meal six to eight times a day for six months can really struggle with the complex flavours of family foods. The companies which make formulas also make endless expensive but very bland weaning foods to give to those babies whose palates have never been challenged.

You are a savvy, modern woman so resist the pull of the advertisers and buy smart, not posh, and vary the formula when the mood takes you. Finally, if you want more information on smart bottle feeding, including how to give a feed in a way that reduces wind, vomiting and over-feeding, take a look at chapter 5 in my book “Your Baby Skin To Skin”.

Stuffed!

Three days on from Christmas and my stomach is stretched beyond comfort and my head is aching from lack of sleep (I lay awake until 3am on Boxing Day doing the maths to work out if 2017 is a prime number – it is, as I had suspected for a couple of weeks now). I swear that I will not over-eat ever again and that I will swim my socks off regularly until all those extra unnecessary calories are burned.

One of the questions I hear every week from at least one parent is “How do I know when my baby has had enough milk?” If you have not spent much time in the company of babies, this would seem an easy question to answer: when a baby stops suckling, he has had enough! But, as all new parents know, it is not that straightforward. Babies suckle in weird ways: in the evening (and sometimes all through the day) they can spend over an hour boobling merrily away, suckling for a short while before dozing for a longer while and then waking and having another good nosh. Rinse and repeat ad nauseum.

Then they come off, immediately start rooting and squeaking again, go back on, decide it was a bad idea; come off again; yell and wiggle some more, have another good go on a boob or two, come off and and then chuck back what seems like a week’s worth of milk before diving back onto the boob all over again. Occasionally, when I have over indulged over the festive season, I think, somewhat wistfully about the Roman love of the vomitorium and how much easier it might have been be than all the post-Christmas exercise. Some babies seem to have retained the Roman habit! When my first son was tiny he could vomit so splendidly that it seems that I might as well simply run around the room gaily squirting my milk directly at the walls and soft-furnishings and cut-out all that time spent lovingly nursing my boy!

The idea put about by health care professionals that babies “feed” for half an hour on each boob and then come off and settle happily for a couple of hours is quite obviously information about an alien species. This may be how babies hang loose for those first couple of days in hospital but, within a week of being at home, things are very different. I will look at the causes of the constant evening boobling and nonsense in the next blog but let’s think about that vomiting.

Many mums are now told that their babies have “reflux” and that they can medicate it away. If their baby displays the rest of the miserable picture described above but doesn’t throw back any milk, they may be told that their baby has “silent reflux” which can also be medicated away. I sometimes have groups of mums at the local South Oxfordshire drop-in with 100% hit rate for reflux (silent or otherwise). Some pharmaceutical companies are laughing all the way to the bank at the same time as many parents are crying all the way to the shops to buy yet more useless medication.

Reflux simply means “bringing back”, so it is perfectly accurate as a diagnosis when there is vomit all down your back but that does not mean that the vomiting is abnormal or needs medicating. If your clothes are a sick-free zone then, if your baby is doing the suckle-squirm-yell-suckle dance all evening then chances are that your baby has the normal, healthy and life-protecting horror we used to call “colic” (about which much, much more next time).

So, if your baby is peeing lots, being happily dirty with a nice splurge of yellow or greeny-yellow poo every day or so and is otherwise well, then the vomiting is simply nature’s highly evolved way of ensuring that your little one does not over-eat. Why does she take down too much in the first place? Because, your milk contains lots of gut-soothing endorphins which calm her hormonally-sensitive gut from its immature spasms. She takes down the milk, gets the gut-calming benefits from the endorphins and then splurts back the unneeded milk. And, of course, being permanently at the boob, snuggling away, keeps your tiny one warm and safe from all those hunting bears in the forest which come out at dark …

Now human milk is also highly evolved (natch) and is super thin and easy to throw back. Babies need to keep their stomach only lightly full because, if it stretches up too much, it can make breathing more difficult. Evolution is about survival so stop worrying that your baby is a slightly wonky model that needs fixing and accept that, whatever it looks like, evolution has actually put some pretty damn fine protection strategies in place. No need to try to cure evolutionary protective strategies with medicine that can make your baby constipated. No need to give thickened formulas which stop the protective vomits. You will soon find that your baby will gain weight even when he is a happy chucker: my biggest vomiter – number one son – also gained weight the best. He just was very, very colicky and so soothe-suckled far more for those great milk endorphins and the needed to off-load all the unnecessary de-endorphinised milk.

If you have a baby that pees loads, vomits regularly, is otherwise well but gains weight very slowly, there may well be a pesky posterior frenulum (some people call this a tongue-tie but that is not my favourite term). I will cover tongue-tie in due course but, for now, if you think this is you, get checked by a specialist.

In short, lots of pee tells us that your baby is getting and keeping down plenty of milk and the vomiting is just your baby’s way of being a Roman!

Now, where did I put that last mince pie?