Tips from the milky coalface


The following article was written for and first appeared in my friend Naomi Kemeny’s book ‘Nurturing New Families‘.positionpic1 A book not only for postnatal doulas but anyone caring for a family with a newborn in those precious first weeks.


positionpic1skintoskinAs a Breastfeeding Counsellor and Doula, I spend a lot of time talking to women (and men) about breastfeeding. I also hang out online rather a lot, reading forums and blogs about my favourite subject. Here are a few of the statements about infant feeding I hear most…and my thoughts in response.

‘Before your baby is born, you’ll probably wonder how you are going to feed your baby. Here are some pros and cons of breast vs bottle to help you decide…’
In my experience, most women know what they’d like to do. Infant feeding survey results tell us that over 80% of women put their babies to the breast at birth. That’s 80% of women being pretty positive that they’d at least like to try to breastfeed. A recent NCT survey revealed that 90% of women give up breastfeeding before they’d like to – so what’s happening between birth and switching to bottles?

‘You’ll no doubt have pressure from both sides of the feeding fence!’
As a breastfeeding supporter who also has paid work to do and a family to look after, I don’t really have time to go round pinning pregnant women against the wall and ‘pressuring’ them to breastfeed. There is a distinct difference between public health information and ‘pressure’.  I don’t feel pressure not to eat too many cream cakes. I am aware of the risks of obesity and a high fat diet. I feel a bit guilty when I have one too many biscuits, but no-one is MAKING me feel guilty or pressuring me to eat salad.
There is pressure to formula feed though – from friends and relatives who know nothing else, from TV that never shows a breastfeeding mum – or if they do, she’s having problems – adverts, social networking and free gifts/’carelines’ from formula companies and mothers who have never had the chance to fully debrief from their own experiences and therefore lay their negative feelings on other mothers. Then there are the people who liken public breastfeeding to public defecation, breastfeeding women and their advocates called spiteful names…I could go on…

‘Lots of women can’t breastfeed. My sister’s nipples nearly fell off!’
I listen to a sad stories every day. It is hellish to go through such pain and disappointment. I often wonder if a properly qualified and experienced Lactation Consultant or Breastfeeding Counsellor may have been able to shed some light on their problems. When things veer away from normal and into the category of the more unusual problem, women need a properly qualified specialist – as with anything else. (I wouldn’t expect a midwife to be able to perform a c-section, or a GP to be a consultant dermatologist, for example).

‘If it weren’t for formula, my baby would have starved! All Mothers should be free to make a choice’.
It must indeed be a relief to finally find the resolution to your pain – if no-one is offering a solution that enables us to continue to breastfeed whilst staying sane, most mothers would agree that this doesn’t leave us with much choice! Freedom of choice is of course very important indeed, so I wonder why more women aren’t angrier about the lack of skilled support available to them. Lack of information and skilled support effectively take away our free will to decide how to feed our babies.

‘It’s not as if formula is poison!’
There is a social taboo around talking about the risks of formula. It seems we only have permission to talk about the benefits of breastfeeding – and only if we don’t ‘ram our dripping breasts down people’s throats’. Like every other subject that stirs passionate feelings, there are some evangelical zealots; women who are enthusiastic about breastfeeding and want to share their own happiness with others. They may know quite a bit about the risks of formula and what the baby misses out on when denied the nursing relationship. However, they may not have much experience working with mothers and therefore lack insight into the varied and complex reasons why some mothers may feed their babies formula. They don’t have full knowledge of the social and commercial pressures that impede breastfeeding. They have not learnt to reserve judgement or how to use language that doesn’t appear judgemental – a skill that is really difficult when everyone reacts to things in different ways.

‘The Breastapo should stop sticking their noses in’
So reading my comments so far, would you consider me a card-carrying member of the ‘breastapo’? Seems a strange and wholly rude and upsetting word to choose to describe women who volunteer their time to help, support and counsel new mothers. They are women who work in drop-ins, volunteer on hospital wards, visit mothers in their homes, answer helplines late at night. They do not have an agenda to make women breastfeed. They merely want to support them to reach their stated goals…and if those goals change along the way, they will support them to find the solutions the mum can be at peace with.

But this word ‘breastapo’…is it meant to conjure up images of Nazi thugs who brutalised and murdered millions because they were ‘different’? Perhaps such grotesque language might put off some mothers calling for help? The words we use matter.

‘I thought Breastfeeding would come naturally’
Breastfeeding is an interesting combination of instinct and learned skill. We need more antenatal education, more skilled and knowledgeable support for all mothers, less intervention in birth and unnecessary separation of motherbaby. We no longer grow up surrounded by breastfeeding and therefore learning ‘at our mother’s knee’, so now it’s a skill we have to learn from scratch ‘on the job’.

‘It’s normal for your nipples to hurt at first’
How much pain, and how long for? Just as the baby latches? All the way through a feed? It’s called breastfeeding, not nipple feeding. If it hurts, if the nipple is pinched or the shape of a new lipstick, get help – whether that’s day 1, day 10 or month 36. Breastfeeding is like dancing; at first we need to find the rhythm – with the music and each other – so we can easily thread on each other’s toes. So, whilst pain while we’re learning is common, it isn’t normal.

‘Breastfeeding is time-consuming and tiring’
Really? Popping my little one in a soft sling, letting them latch and getting on with my day is time consuming? Getting to sit down and watch daytime TV whilst I nurse, might be time consuming and a slightly guilty pleasure, but I’d rather do that than stand in the kitchen washing up bottles. Having a baby is tiring and emotionally overwhelming at times. How you choose to feed your baby makes no difference to that. Just so you know, the hormones of breastfeeding are designed to make sure you fall asleep quickly and easily after feeding your baby at night.

‘Nursing in public is difficult and embarrassing’
We live in a culture in which breasts have become sexualised; used to sell cars and make fortunes. Necklines plunge to the navel on an A-list celebrity whilst nursing mothers are asked to feed their babies in the toilet. It’s why we need education, it’s why we need people to be positive about nursing in public and to pass on practical tips to make it less of a daunting prospect. We need existing legislation tightened and greater public knowledge of a mother’s right to nurse anywhere and everywhere. It means empowering mothers to feel good about what they are doing and remember that there is nothing weird or offensive about using her breasts for what they are meant for.

‘Bottlefeeding Mums are judged’
Yes, some women choose not to breastfeed. Many women would be breastfeeding if things had been different. We have no right to judge. A teenage girl may fear the jibes she might get. The woman who has been sexually abused may feel revulsion at the thought of a baby at the breast. A woman so traumatised by trying to feed a previous baby may feel she can’t face even trying this time. We have no right to judge until we have walked a mile in her shoes. And that goes both ways. Breastfeeding mums are judged, criticised, asked to leave, made fun of, called names. They are the last sub-group that it is politically correct to abuse.

‘There are lots of things breastfeeding mums can’t eat and drink’
Breastfeeding Mums can eat and drink pretty much anything! There are more myths about eating and drinking while breastfeeding than anything I’ve ever come across. A mum who is drinking enough caffeine to upset her baby might want to reduce it for her own health anyway. Yes, you can have a glass of wine. And where DID the chocolate myth come from? Or the grapes, lemons and spices? Evolution would have played us a pretty weird trick if suddenly human mothers had to completely remove herself from the diet of her tribe. Since when have you seen cows stop eating grass because they’ve had a calf?

‘You’re making me feel guilty…
Mmm Guilt. That lovely buzz word that immediately gives people the moral high-ground in one fell swoop. I gave formula to both my children. I don’t feel guilty, I feel angry that I didn’t get the information and support I deserved. I feel angry that I was told I didn’t have a choice. These arguments about guilt are intellectually lazy, misleading and ignorant of the complex and subtle pressures and social mores that undermine breastfeeding and line the pockets of the formula manufacturers.

So now I’ve busted a few myths, here are my top tips for getting off to a good start.

Feed your baby as often as he stirs. Keep him skin to skin as much as possible and work with a skilled helper to perfect the latch so it’s comfortable for you both. Consider leaning back comfortably, with your baby on your chest and allowing your baby to find the breast by himself. See

If you feel the help you are receiving is not skilled or appropriate, demand to see the Infant Feeding Coordinator or call a breastfeeding helpline – arm yourself in advance with these numbers and try not to feel shy to use them; they are answered by qualified Counsellors who have trained hard to be skilled enough to support you over the phone. Oh – and they WANT to answer your call, so please don’t think you are bothering them. These women eat, sleep, breathe breastfeeding support. Yes, I know. Weird. We admit it.

Learn to hand express – you can practice this skill before your baby is born, from around 35 weeks onwards. See

If your baby has low blood sugars or jaundice, there may still be not be any need for supplementation. Hand express and ‘top up’ your baby with colostrum in a syringe or spoon and ask a Breastfeeding Counsellor or Board Certified Lactation Consultant for support.

Sleep when your baby sleeps in the first few days – the ‘cluster feeding’ often happens at the tail end of the day when you’re at your lowest ebb.

Sleep close to your baby – that way you, your boobs and your baby get into synch that little bit more quickly.

Learn to recognise when your baby is drinking, and how to keep him drinking if he is sleepy at the breast.

Trust your body and your baby – just as your body is perfectly designed to birth, so is it set up to feed and nurture your baby in the optimal way.

Problems and challenges do sometimes crop up, but it’s rare that things can’t be sorted out with help from someone skilled and experienced.

If you do decide to supplement with formula, remember that small amounts more frequently are better than large feeds less often, which can make the baby sleepy and less likely to latch back on.

Consider NOT having formula and bottles in the house ‘just in case’. It can be hard to not be tempted at 3am when things feel difficult – and if medically indicated, formula is available 24 hours a day in hospital or in Tescos.

The first days of breastfeeding can be challenging and intense, just like labour and birth. But just as labour works the way it does for a reason, learning to dance the breastfeeding dance usually results in a feelings of pleasure and empowerment for all the family – and the music of the dance is different for everyone, so try to be led by your baby.

Seek companionship and support from other breastfeeding mothers. The female of our species is designed to be surrounded by her sisters during her transition to motherhood. Things never seem so bad when you can share with others who understand. Online, there’s always someone awake with you at 3am (Try Dispelling Breastfeeding Myths for a starter)

Stay in the moment and remember that you are the expert on your own baby!

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