The Milky Way UK

Are you being told that your baby is manipulating you? Crying for attention?

It’s amazing what people think a young baby’s brain is capable of, when it’s not even capable of moving their limbs in a coordinated way to grab something!
In order for someone to manipulate you they need to be able to do the following things:

1. Know what they want to happen in this situation (Young babies don’t know what happened 1 hour ago or what’s going to happen next - they just know how they feel in this momen).
2. Know what you want to happen in this situation (Young babies don’t even know you are a separate person or have brain processes which are different from theirs!)
3. Know what to do in order to change your thought process to do what they want (Again - how can they do that if they don’t even know that you have thoughts? )

It takes years for babies to be able to consciously put the steps in place to try to manipulate situations. Years.
If your young baby is crying to be held - it’s because they need it at that moment. Not because they are trying to make you do something

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A deep latch is the key. It's what will help prevent sore ni***es, blocked ducts, mastitis, help with making the right amount of milk for your baby, and so much more.
I know it can be really hard working toward getting it, but keep going. I've got lots of vids on my YouTube with tips if you want them.

And remember to keep going back to basics along the way - as they get bigger, older and we settle in to breastfeeding we often forget about checking the latch and problems can crop up.

And remember, if you're happy with what you're doing and your latch doesn't look like this, that's ok! This is general information and not individual to you.

I often get asked about strict routines for new babies, like feed, sleep, play routines, or time based routines from parenting books.
So are routines a good idea? Do they work? Are they beneficial?

For some families, they start to follow a routine and it goes well. It seems to all fit together nice and easily and everyone is happy. If that was you, great stuff.
But, for the vast majority of families this isn't the case at all. Let me explain why.

Babies do not read books.

Babies live purely on instinct. Their basic human needs of warmth, comfort, love, and nutrition. What a baby is expecting, is to be in the arms and at the breast of their caregiver pretty much 24/7. It's a matter of survival for them. They are completely dependent on their parents to do absolutely everything for them because it is literally impossible for them to do it for themselves.

Babies feed frequently. They have tiny tummies that need refilling often. But they don't just feed for hunger. They feed for thirst. Comfort. Pain relief. To pass wind. If they're hot. If they're cold. Scared. Lonely. Uncomfortable. The list goes on.

Breastfeeding and reaching out for their parents is the only way a baby knows. It is not done for control, or manipulation. It is not done consciously. It's survival.

Just like older children and adults, a baby's needs and mood change daily...or even hourly!
To try and get them to fit into a schedule for those needs (and not object to it) just doesn't make sense. Especially in those early few months when the baby is very much in a 'womb to world transition'

Putting a baby in a routine doesn't work, and then the parents feel like they're failing. Like they're doing something wrong, or something is wrong with their baby, or with breastfeeding.
For example 'I can't put the baby down for their nap without them waking up for more milk, is my supply running low'
No, its because babies don't like being put down! Their survival mechanisms kick in to make sure they're back in the arms of the people who can keep them safe.
'My baby is meant to be having tummy time now, but keeps getting upset'
The baby may not be in the mood for tummy time at that point. Maybe their tummy is uncomfortable, or they're tired. There could be a whole host of reasons, but they can't tell us what it is. So if they're objecting we need to listen to them, they're not being difficult - they have a reason.

So why do we try and put babies into routines when they just seem to cause more stress?
Well society has it so deeply ingrained in us that we are in control of the baby, and what they do and when. That we can somehow manipulate what they need and when they need it. That longer sleeps are somehow better. That they shouldn't need tending to at night time and that we can somehow teach them not to need us at night. That it's our 'job' to 'train' the baby.

It's time we flip it on it's head.
We're not in control and neither are they. It's a relationship from the very start, and as their parents we need to do what they need, when they need it, to support their physical, mental and emotional needs. We have the science to back this up too.

Does this mean we shouldn't ever use routines?
Let's face it, routine has to happen eventually for most families. With work and schooling it's inevitable really. Does that mean we should rush it or force it? Nope.
As the weeks and months go by and a pattern naturally starts to emerge, we can encourage the bits that suit our individual family circumstances. It can happen smoothly and gently with less upset for everyone.

So how do you cope in the meantime?
We are creatures of habit. We thrive on routine, control, and predictability. The way we live our lives doesn't fit with the way a baby needs to live theirs, and we end up in the difficult battle with our baby and ourselves.
Often coping is having the knowledge and acceptance of what's normal, even when the normal is really tough. Put as much as you can on hold until things are more settled - and they will be.
Reach out for as much support as you can get, both mentally and practically.

If someone says to me they had a tongue tie check and it was fine I always ask did they look in the mouth or did they actually have gloved fingers in there feeling around.

This is so important. What it looks like doesn't tell us how it functions, and how it functions is what tells us whether it could be impacting on feeding (and if treatment is needed.)

So if you're having problems with feeding and someone has just 'had a quick look' and said it's ok, please consider getting a second opinion.
And I'm really sorry that infant feeding isn't as valued as it should be

Did this happen to you?

An infuriating criticism seen on social media or in the press is that those working to support breastfeeding and lactation are often fanatics, determined to promote only breastfeeding at the expense of everything else.

Some people seem to assume that everyone working in breastfeeding support had a lovely, easy experience and simply doesn’t understand the struggles that other people face. That’s why we want them to breastfeed – to be just like us! To skip through the fields of daisies happily nursing our babies. Sheer bliss! Right…?

Often this could not be further from the truth. Many working in breastfeeding and lactation support are there precisely because they have struggled and had difficult experiences.

They may also have really struggled to find support. They may have needed to introduce formula or stop before they were ready. They carry the pain and grief of those experiences around with them and it’s because of these experiences that they want to help others.

Of course, others may have had positive experiences but rather than making them determined that everyone should just love breastfeeding and everything that goes along with it, it helps them to see first hand the difference someone knowledgeable and supportive can make to an infant feeding journey.

Breastfeeding support isn't just about supporting breastfeeding. It's about supporting the whole infant feeding experience, whether that includes formula, donor milk, using bottles or supplemental nursing systems, stopping after 3 weeks with a big smile on your face because that's more than you ever hoped for and feeling your heart break when a mother of a three year old has to stop before she was ready to do so.

So if you're working in breastfeeding support or with families more broadly, know that we see your experience and passion and what drew you there.

If you're a mother, parent or wider family member seeking out breastfeeding information and support, know that the people who are there to support you often know precisely how you feel and how important support is to you right now.

A few years we did some research into the impact of baby care books that suggest parents should put their baby in a strict routine. We were particularly interested in whether parents felt these books worked, how they made parents feel and if they impacted upon interactions with their baby.

As part of this we found that some books were telling parents not to always respond to their baby or to reduce the interactions that they had with them.

We found that about a quarter of parents said that the books led them to delay responding to their baby when they cried or when their baby indicated they needed something.

Around one in six parents also said that the information led to them not always picking up or cuddling their baby when they wanted to.

Now, if a parent makes an informed decision that they want to minimise contact with their baby that is one thing. But, many of the parents who attempted to do this were then saying that they felt terrible for doing so. Trying to ignore and avoid their baby’s cries left them feeling anxious and guilty. When many of them invariably ‘cracked’ and went to their baby, they then felt like failures.

Babies are pretty much tiny helpless mammals. They are born needing everything done for them and have a huge survival instinct to stay close to you.

When they cry, it’s their main way of communication. They cry when they need something – whether that is food, comfort, connection or simply ‘it’s a bit scary on my own’. They’re incapable of trying to ‘manipulate’ or to drag you out of bed simply for kicks.

So much research shows that responding to babies helps them feel more secure and confident. It teaches them that when they need something, their needs will be met. And that is a very good thing in helping them see the world as a good place.

Never, ever feel bad for responding to your baby. Never let a book override your instincts. No one lies on their death bed going ‘you know what, I really wish I hadn’t cuddled my baby so much’. You are the expert in your baby. Listen to you.

And all other ages too, but definitely around this time things can really make you question what you've been doing and how to move forward.
Trust! This is really hard I know x

'I've been advised to feed, pump and top up 3 hourly. Is it the best way? Is there another way?'

This is often called triple feeding, or as I like to call it - triple feeding torture. It is HARD.
It's meant to be a very short term, intensive plan but often parents aren't given a way back out again.
It can feel like all you're doing is feeding, pumping, washing up, repeat. Like every feed rolls into the next and you're getting no time at all for rest, or anything else for that matter. Physically, mentally, and emotionally hard, it's not sustainable in the long term, so work with some skilled breastfeeding support to come up with exit plan if you don't have one.

Is there any way of making it easier? More effective? How can you make the triple feeding plan work for you?

What's important to keep in mind is that you're doing this for probably two reasons. One, to get more milk into the baby, and two, to stimulate/increase your milk supply.
We need to make sure that whatever you're doing, whether it's a breastfeed, pump, or top up, that you're doing it in the most effective and efficient was as possible to meet those two goals and give yourself as much opportunity for rest and downtime as you can.

So...

Deep latch
For a breastfeed, a deep latch is really important. And it takes a bit of time to learn this usually, so if you're struggling you're not alone. Keep asking for help. If the baby isn't latched deeply and asymmetrically, they won't be taking as much milk as they otherwise might, so it really is worth working on.

Active feeding
It's also important to learn to recognise active breastfeeding. This means when the baby is effectively transferring milk from the breast. Actually drinking, not just sucking.
Often you can hear a baby swallowing, but if you can't, watch for a nice deep, wide chin drop.
When babies are transferring milk effectively they will usually swallow with every one to two sucks. So that's what we're working toward and encouraging plenty of.
When a baby is feeding actively they will be alert, and active but relaxed. Their arms will usually be up close to their face, and fists will be lightly balled. If they are sleepy, with arms down at their sides, and lightly sucking with long pauses, it's less likely they're taking on milk.

To encourage this active feeding there are things you can do.
-Feed skin to skin
-Encourage a deep latch
-Use breast compression, a hands on technique for helping to move more milk and encourage flow.
-Switch sides. This is important. When the active feeding slows and the compression is no longer working, it's time to switch sides. Watch your baby to see when, this may be after 2 minutes, or may be after 15 or so. The chances are though, for a baby that is needing a triple feeding plan it's probably a shorter time. The reason for switching sides is because the flow of milk that comes from that second side encourages more active and alert drinking which is important for weight gain.
You can actually repeat this pattern a few times over if you need to, whatever encourages the most active drinking. Feed, compress, switch. Repeat!

When to top up
The breastfeed may last up to 20 to 30 minutes in the above pattern before it's time to stop and top up. Why? Well hanging out on the breast when they're no longer actively taking milk isn't helping them gain weight, helping your milk supply, or giving you any time or energy back. Giving the top up now should help them settle and give you time to express and rest.

How to top up
To give the top up there are a variety of ways.
A lot of people choose a bottle, because it's what we're most familiar with. If you do use a bottle, look into paced feeding. It'll help transition between breast and bottle a little better.
Some people use cup feeding. Can be great for avoiding teat/ni**le confusion, but if your volumes of breastmilk are small and precious it may not be suitable as it can be dribbled or spilled and that's pretty heartbreaking.
Finger feeding is another method, where you use a feeding tube in some milk alongside your finger which they then suck. Finger feeding is also thought to cause less ni**le confusion.
You can also supplement at the breast which I love!
You use a feeding tube (or specialist system) next to your ni**le so that they suck up the top up at the same time as breastfeeding. Fiddly at first, but lots of benefits to this.

How much top up
How much top up to give is very individual depending on your baby, their age, their size, how much weight they need to gain, and other factors.
So you'll need to work with your support to get the right volumes for you.

Expressing
Expressing can be a key part of the plan, but it isn't as straightforward as 'then Express'
How long, how much, what with, why?
The reason you're expressing, is because for some reason the baby hasn't been able to drive milk production as needed, or transfer as much milk as required. So by expressing, you're giving your body extra stimulation and helping remove some extra milk that your baby hasn't been able to.
If you're able to, get hold of a hospital grade double electric pump. This will really help in the short term in getting bigger volumes, but also the long term by increase supply quicker and getting you off the plan and back to breastfeeding.
Whichever pump you use, it's vital to check it's the right fit for you. The actual breast shield that fits over your ni**le comes in different sizes, and having the right size for you can make a huge difference to your output.

Doing breast massage before and during pumping has been found to be a really effective way of increasing volumes expressed. Also adding in some hand expressing before and at the end of pumping. Having something that smells or reminds you of your baby can be useful too.

Rest. Rejuvenate.
Ideally we want to try and keep this whole feeding plan of active feed (with compressions and switching), top up, and express, to an hour or less. That way the plan is effective but marginally more manageable.

Should it be three hourly?
The reason 3 hourly is often mentioned, is because that's 8 feeds divided up in 24 hours. What actually may work better, is working toward 2-2.5 hourly in the day, so that you can do 4 hourly overnight.
The key is getting in at least 8 feeds no matter what pattern you do it in. And remember, if the baby wakes before the planned next feed, start the cycle over. They often start to get quite the appetite as they get more milk on board!

So I guess the 'too long:didn't read' version is
-Get a deep latch
-Watch and encourage active feeding with compressions and switching sides. 20 to 30 mins.
-Top up, doesn't have to be by bottle
-Express using hands on and a well fitting pump
-Keep the whole thing under an hour
-Fit at least 8 times in 24 hours, doesn't need to be 3 hourly
-Get yourself as much support as you can
-Have an exit plan.

Both Amy & I hear our fair share of sleep myths. You’ve already heard about solids, schedules & milk. I’ll chime in with a few that I hear:

1. Give a bottle – sometimes people mean formula, but often even if someone is promoting exclusive breastfeeding they will recommend a bottle so that a mother can sleep. Or they will claim that this helps to make sure babies drink more, and sleep longer. But as Amy found, there is no evidence that this will work, and often just makes life more complicated.

2. Feed on a schedule – if you hear this, just unfollow for the sake of your mental health…

3. By x age/weight they should sleep through – I hear certain weights of children, or number of weeks, or when they’ve doubled their birth weight. It’s all a load of rubbish.

4. Start solids – you know the answer to this one already….

5. Stop breastfeeding – I call breastfeeding a ‘sleep scapegoat’. It’s a parenting behaviour that often gets the blame, even when it doesn’t deserve it. I cannot tell you how many parents have told me that they stopped feeding to sleep, or feeding at night, and it didn’t actually improve sleep

6. Stop bedsharing – bedsharing isn’t for everyone. But most people do it to preserve their sleep and their sanity. Stopping bedsharing often means, at least in the short term, that it will mean less sleep for the parent…

7. Move the baby out – again, this may just mean you have to traipse down the corridor to another room, or the baby may fully wake up and then be harder to calm down.

8. Ignore their cries – this can be stressful, difficult, and it doesn’t always work. It also flies in the face of a lot of what we now know about responsiveness.

9. Drowsy but awake – this is SO hard in the early weeks and months. It’s normal for babies to fall asleep feeding. Trying to keep them awake can just mean you’re setting yourself up for a difficult and unsuccessful bedtime. If they do it naturally – great. If not, let it go.

10. If you don’t teach them to sleep, it’s bad for their development – many people cite literature that relates to older children and true sleep deprivation, rather than the normal sleep fragmentation of infancy. They’re not the same thing folks…

**Taken from: Let’s talk about your new family’s sleep, by Lyndsey Hookway

Breastfeeding to Sleep Mothers are often told not to let their baby fall asleep breastfeeding in case it creates a bad habit which might

There's a lot of things you can do to get a more comfortable (and effective) position and latch. Here are some simple tricks to start with.

Baby Boys And Girls Receive Different Nutrients In Breast Milk? Harvard University Study

"Mothers are producing different biological recipes for sons and daughters," said Katie Hinde, an evolutionary biologist at Harvard University.

Studies in humans, monkeys, and other mammals have found a variety of differences in both the content and the quantity of milk produced.

One common theme: baby boys often get milk that is richer in fat or protein -- and thus energy -- while baby girls often get more milk."

*****Want More? Online Live Lectures: Experience a Paradigm Shift in how you View Breastfeeding:******
https://birth-psychology-classwomb.teachable.com/p/breastfeeding-bundle

Read the article about the Harvard University Study here:
https://www.scientificamerican.com/article/boys-and-girls-may-get-different-breast-milk/

Have you been told by a physician that your baby has colic? Colic isn't a diagnosis, colic is the crying. It means more investigation is needed but by using it as a diagnosis it is often the end of investigation instead.

There are several reasons that babies might cry more than normal

1. Undiagnosed oral restrictions ( lip/tongue tie)
2. Poor feeding at the breast or bottle
3. Pain caused by body tensions
4. Food intolerances or allergies

If your baby is experiencing 'colic' then an appointment with an experienced IBCLC is a good place to start. We can observe feeding and see if that is causing problems such as positions, low milk supply or even over supply, we can identify oral restrictions and guide you to providers who can treat and also recommended bodywork.

This is something else that came up in my real parents stories this morning.
Infrequent pooing in the first six weeks.

After six weeks old it's very common for babies to start stooling with their own pattern, this can be very frequently, or very infrequently! Sometimes up to a week or longer.
Unfortunately, this message has got confused (even by health professionals) and is assumed to be the same for babies under 6 weeks as well.

But actually the evidence based guidance is very clear across the board. Infrequent poo in the first 6 weeks is something that should be assessed. Most commonly this is to do with milk intake, and changes to the way the baby is feeding can make all the difference. Occasionally this is due to something else, like allergies.
Sometimes, it's seemingly normal for an individual baby, but this should never be the first assumption.

If your baby is under 6 weeks and not pooing often then access some trained support.

If your baby is over 6 weeks and this happened to you when they were younger, please don't worry. If your baby is growing and thriving then likely all is well. If you have concerns then speak to someone.

The national breastfeeding helpline is a great place to start. 0300 100 0212

I'd heard there was a comment on the radio and had assumed it was a throwaway comment. Turns out it's deliberately mentioned and singled out.

Why not simply a new mothers starter kit or support for a new mother? A top up to her healthy start vouchers so she could pay for formula if necessary or food for herself if not?

How will bottles help women who are breastfeeding exclusively? Is there a bottle free option where she gets support in a different way?

The mention of isolating is strange as it seems to think she will need bottles for the first time during this period. Bottles don't run out like other things like food do. It's not the immediate thing you can think of and could be ordered online if needed.

Wouldn't a voucher for things she needs (and then she could buy bottles if she does) be more useful for more mothers? We know formula can't be donated so this feels like a way of circumnavigating the rules to potentially promote a product.

Looking online, the cheapest bottle sets are over £10 though. I would be interested to see if they are branded and whether donations are occurring and will be writing to ask.

It also feels assumptive that a mother living in poverty world automatically not be breastfeeding. Formula poverty is a big issue. Supporting as many women who want to breastfeed to do so supports them financially.

Again this isn't about criticising how babies are fed but the ways in which industry and assumptions affect norms and the way women are supported. Give women the financial support they need rather than use this as an opportunity to potentially promote products.

'I just can't get them to tilt their head back'

This is definitely something that you hear a lot when you work with breastfeeding parents, so let's explore it a bit.

The head tilt is a really important part of getting a deep, comfortable, effective latch.
Try this for yourself. Tuck your chin down onto your chest and open your mouth...doesn't get very wide huh. Now try sticking your finger in there and getting it to the back of your throat, not easy. (I'm guessing your finger hit about mid tongue)
Now tip your head back and look up to the ceiling, open your mouth wide, notice the difference? Now see how easily you can get your finger to the back of your mouth in that position.
That's why the head tilt is so important, it makes a huge difference to where the ni**le reaches in the mouth. If the ni**le only gets to mid mouth, it will get compressed and rub against the hard palate which IS as painful as it sounds. It would also mean there wouldn't be much/any breast tissue in the baby's mouth. This leads to the baby not taking enough milk, and supply going down.

But how do you get them to tilt their head back?
Do you ever notice when you're holding them upright against your body that they start to head bob or 'peck'? Their natural reflexes and searching behaviours encourage the head to tip back, they have a lot more movement and control than most people realise.
Positions that can use these natural reflexes can be really beneficial.
The laid back position, or biological nurturing, is great for this. Get comfy on the bed or sofa, ideally skin to skin with baby, and have them lie on top of your body and let them find their way themselves with only gentle guidance from you.

For other positions though, there are certain things you can do to encourage them to tip back.

The first thing, is making sure there is nothing on the back of their head. We get told our whole lives to 'protect the baby's head!' so naturally when we're feeding them we try and give their head plenty of support. But actually we need to let their head be free, and provide support around their shoulders and neck. Even a finger on the back of their head can interrupt things.
It can take a bit of practise to find the right spot to hold so that you feel you're supporting them enough, but without restricting their freedom to tilt back, but keep trying.

Get pillows out of the way! They may not look like they're in the way but they are. If you really need pillow support, have it under their bottom but not under their head.

Next, is making sure they're not all scrunched up, try and have them fairly stretched out if you can. You can try that for yourself too...if you curl your body up, you can see it just doesn't feel as easy to tip back as it does when you're sitting or standing up straight. Think of you baby as less like a banana, and more like a cucumber. (Yes, yes I did just compare your baby to food...)
And you want their head and body in a straight line. Try turning your head to the side and swallowing...not easy or comfortable, so make sure they're nice and straight.

In this position, tuck their bottom in reeeeeeally close. You don't want to even be able to slide a piece of paper in there. This helps gets their body at a good starting angle.

Now have a look where they are lying compared to where your ni**le is. You want your ni**le to be opposite where their nose or even eyes are, not opposite their mouth.
Move them down in the direction of their feet, and then probably further still! This will encourage a head tilt as they reach up for the ni**le. (Their up, not your up)

So now we have the baby lined up in the right place, and we need to be really patient. Bring them forward to rub your ni**le on their nose. When they open their mouth don't be tempted to move your breast down and in. Stay by their nose. As they start to root and tip back a little keep your ni**le by their nose, chase it, follow it. It may feel a little like you're teasing them, but it really helps get the head tilt. Keep doing this and you'll find their chin is lifting right up.

You should now see a really good head tilt and wide mouth, and you can bring the baby forward really swiftly at the same angle, chin first (not up and over and nose first). The bottom lip should stay in the same place, well away from the base of your ni**le. It's a split second, so it often takes a lot of attempts.

If your baby is still reluctant to tip their head back, consider getting some expert skilled support, like your local bf support group, or an IBCLC, to see if they can spot any changes that may help.
It's also worth considering if the baby may have some tightness in the jaw/neck/shoulders from pregnancy or birth as this can have an impact on head tipping too. Some people seek out body work such as cranial osteopathy or chiropractic, but this is a personal decision. Anecdotally I'm aware of a lot of families who have found it a great help.

Latching is definitely a skill that takes a lot of practice. It can be really frustrating and disheartening when it takes so much time to get it right, but keep going. You'll get there.
Xx