Dr. Justice Reilly, Breastfeeding Medicine

Absolutely brilliant podcast series following conception to the baby’s first birthday, will link in stories / human milk highlights too 🤍🤰🏽 https://www.bbc.co.uk/sounds/play/m001xl5b

It's been a wonderful first week of newborn snuggles! We had the homebirth of dreams at 41+5 😱. At some points I was so fed up I'd considered interventions to get her moving, but thankfully all we needed was some biomechanics from a skilled midwife. We've mostly stayed close to home, working on getting breastfeeding established but today was much busier.

🚚The homebirth equipment was collected
📃We registered her birth
👂We nipped up to RHC for her newborn hearing test
🤱🏽Did the nursery pick up, and our wonderful Glasgow City Council nursery staff let us use the empty baby room to change and feed her in their rocking chair (pictured) 👌🏽
🌳Went to our local park and had food

Tomorrow will be much more chill! I just wanted to pop on and say hello and thank you for the well wishes from our newest girl, who is so adored by her 3 big sisters. And a huge thank you to Caroline K and Kylie from the NHS Greater Glasgow and Clyde homebirth team, Mariam at , Katie at Katieoswell.com and Laurie for amazing pregnancy and postnatal care 🤍

Have you breastfed or expressed after returning to work?

There are many options but it can be daunting! Supportive colleagues and workplace policies are so important.

Combining motherhood and work after having a baby can be tough for a new mother.

And due to the nature of policing, it is often assumed the job might be difficult to fit around family life.

But those who have chosen to breastfeed their children are supported to be able to continue long after returning to the frontline if they wish to do so.

As part of Week, Inspector Katie Ellis has candidly spoken of her experiences of breastfeeding following her return to work.

Whilst on maternity leave, she was promoted to Patrol Inspector, working on response policing.

“After being told I had been successful, I was not only returning to work as an Inspector, but also as a new mother,” she said.

“My little boy was 10 and a half months old at the time and at that point, I was doing a combination of breastfeeding and bottle feeding.

“Due to being in an operational role, I needed to balance feeding with working different shift patterns, so I was able to express during work, and keep the milk in a suitable fridge to take home.

“I was also able to apply for a specific uniform that has amendments, which made me feel comfortable on the day of the promotion interview and gave me the confidence and ability to perform at my best.

Before returning to work, Inspector Ellis was contacted by her Chief Superintendent who discussed how the force could accommodate her returning to work and the requirements of the new role.

“I had a supportive supervisor and mentor who kept in touch with me whilst I was away from work and who helped me when I needed it,” she said.

“I also feel lucky to have a considerable amount of family support that allowed me to return back to work full time, but I also know that flexible arrangements were available to me too if I needed them.”

Inspector Ellis told how she “naturally stopped breastfeeding” when her baby was around 12 months old.

She added: “I’m really pleased that I was supported so that my breastfeeding experience wasn’t cut short by returning to work.”

North Wales Police is committed to creating a supportive working environment for families.

This includes keep in touch (KIT) days whilst away from work, a parent and carer support network, maternity and paternity mentors, flexible working opportunities, and other workplace amendments.

Response Policing week recognises the vital role of our response officers who keep our communities safe to make North Wales the safest place to live, work and visit in the UK. This week we are sharing stories from our front-line officers about their careers using .

We are now recruiting police officers to join . Apply to start a career like no other on our website ➡️ https://orlo.uk/FZllB

🤱BE PART OF SCOTTISH BREASTFEEDING WEEK (and beyond)!!!!!!🏴󠁧󠁢󠁳󠁣󠁴󠁿

We want to show how normal it is to breastfeed when out and about - we would love it if you could post a photo of you breastfeeding anywhere in Tayside in the comments and we may feature your photo during Scottish Breastfeeding Week and in future promotions with NHS Tayside.

This beautiful photo is of Cara, a volunteer with Breast Buddies Angus, at House of Dun in Montrose.

My last day of work before maternity leave with the !

I was brought tea, supported to deliver the lactation training session bouncing on my yoga ball and got super emosh when one of the team brought up and we all watched Embarassed. I think it hit home how far we've come, and how far we still have to go to .
🤍
Now off to nest and birth prep for the foreseeable future!

Which did you spend more time researching in pregnancy?

I am seeing more reports that wysoy formula is difficult to come by in UK supermarkets. I know this must be concerning for parents, especially those families who are ethically vegan like my own. The SMA Wysoy formula is vegetarian, the vitamin D added to all formula is made from sheep's wool in the UK. If you are considering alternatives it may be useful to know lactose-free milk is made from cow's milk with the sugar lactose (present in all mammalian milk), broken down by an added enzyme. Extensively hydrolysed formula is made from cow's milk with the proteins in that milk broken down, it is reserved for babies who are allergic to cow's milk protein and prescribed in the UK. Rice based formula is not available in the UK.
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The vegan society states:
"The definition of veganism recognises that it is not always possible or practicable to avoid animal use in a non-vegan world. Sometimes, you may have no alternative to medication manufactured using animal products. Even if other medications are available, they may be less effective, have more side effects or be unsuitable for your healthcare needs. While it can be upsetting to compromise our vegan beliefs, we encourage vegans to look after their health and that of others, enabling them to be effective advocates for veganism."
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If your baby is under 6 months old it is important they are only fed human milk or first stage infant formula. Please do not be encouraged to feed your baby fruit pouches, oats, mashed banana or off-the-shelf plant milk, even if they are marketed for use from 4 months of age. This can cause medical issues and becomes a child safeguarding issue, even though veganism is a protected right under the UK equality act. If you have concerns about your baby being allergic or reacting to a cow's milk formula, then your other option is human milk. A trusted friend or relative who is pumping or breastfeeding may be happy to provide some for your baby. The presence of cow's milk protein in the milk of a dairy-consuming parent is still thousands of times lower than that of cow's milk formula.
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You can also consider donated milk via Human milk 4 human babies, or the Heart's milk bank.

Please note it is not advised to pay for unscreened, unpasteurised human milk.

If you would like to explore relactation to provide your own milk, there are resources here:

https://www.unicef.org.uk/babyfriendly/maximising-breastmilk-and-re-lactation-guidance/

https://abm.me.uk/breastfeeding-information/relactation/ #:~:text=Relactation%20is%20when%20someone%20restarts,may%20have%20changed%20your%20mind.

https://www.firststepsnutrition.org/vegan-infants

A different post from me, but so important.

Prof Sinah discusses the importance of mothers, politics, commercial interests and environment on child health, and ultimately adult health. Have a listen and try not to get very angry 😔. Thank you Dr Clements for pointing me in the direction of this podcast and work!

"Stigma is the machinery of inequality".

Episode 3: Child Poverty and Health Listen to this episode from The Cost of Living Chronicles on Spotify. In this episode we are talking with Professor Ian Sinha, a Consultant Respiratory Paediatrician at Alder Hey Children’s Hospital in Liverpool, about the impact of poverty on children's health.

Stay at Home Mum

The house is a mess
My clothes are old
The chores are endless
As the day unfolds
Guilt is a feeling
I’ve grown to know
It follows me daily
Like a dismal shadow
Aches and pains
and all the strains
Bending and lifting
and playing games
Stay at home mum
Won’t that be fun
Finger painting and Netflix
and one on one
“No more work for you”, they’d say
“Free to relax and play all day”
Naive is a word
Not a strong enough fit
To describe this exhaustion
That fills every bit
My back is sore
My hands are dry
My lunch will be crusts
My outlet, a cry
I’m working on forgiveness
I’m working on myself
I’m trying to locate her
high up on a shelf
I’m in the best company
But still I feel lonely
These windows grew bars
For somewhere so homely
I’m juggling many balls
But that’s not the worst
Ones about to drop
Which one will fall first
I hate asking for help
Don’t you see, I can do this
But I need it some days
When it all feels so useless
Rewards and woes
The highs and the lows
Unconditional love
and that’s how it goes
Feelings drifting
So hard to pin down
Some days you win
Others you drown
Yes I am lucky
I love them to bits
and I’d do it again
Every day for these kids
They’ve helped me slow down
They’ve taught me to say ‘No’
They’re teaching me daily
about how I can grow.
I’m better because of them
I’ll continue to be
A love like no other
As they are for me
We’re stay at home Mums
We’re bloody strong
So we keep on
Keeping on.

Words from my book ‘Beautiful Chaos’ www.jessicaurlichs.com/shop
Jess Urlichs
Art:

What a wonderful project!

Mei Photography is looking for participants for their upcoming photography project.

Beyond Expectations is a photography project which puts breastfeeding in focus and celebrates parents who have nursed their littles longer than they expected, whether that’s one feed or thousands of feeds.

"I’ve made it my mission to capture images of parents breastfeeding their littles (and their not-so-littles!) to help raise awareness of their journeys."

✨ Have you fed (breast/chestfed, combi fed & exclusively expressed all welcome!) for longer than you expected?
✨ Are you willing to give permission to share your story in photo & written form?
✨ Can you travel to Merry-go-round Glasgow on Tuesday 9th April (2.30pm-4.30pm) for a 10-15min photoshoot?

🌟Especially interested in hearing from families with disabilities, families who have premature or NICU babies, rainbow families, families of ethnic minorities. All these groups are underrepresented in the project so far and I would like to address that the best that I can.🌟

Send an email to get booked in or for more information:
Email: [email protected]
Facebook: www.facebook.com/mei.photography
Insta: .photography
Website: www.meiphotography.co.uk/beyondexpectations

Sport is not a barrier to breastfeeding
💪🏽🤍🏉🎾🏑⚽️🤸‍♀️

“I really hope other women my age or who are mums might see this and decide to give rugby a go."

Nicola's story 📰 https://tinyurl.com/5dad9hk2

I was so pleased to be asked to contribute to this article by Olivia Jordan Cornelius.

‘I thought weaning my toddler off breastfeeding would be liberating – instead my mood spiralled’

The end of chest or breastfeeding can be a cause for celebration, but also of transition, and grief for some people.

Thank you for sharing this perspectivejordan.cornelius

https://graziadaily.co.uk/life/parenting/i-thought-weaning-my-toddler-off-breastfeeding-would-be-liberating-instead-it-sent-my-mood-spiralling/?fbclid=PAAabNQ4o5Z_unPtfyhJxVQGTQqhgxqwKJuIvjvqUTCDSN-AcgJFg4vFYGeq8

Happy !

Especially to all the mums-to-be, those struggling to become a mum, those without their mum, those who have a complicated relationship with their mum or children, first-time mums, foster mums, single mums and those dealing with loss of their child.
💐
Your experiences are important and we see you.

If anyone has a minute today, the UK Government will be debating postnatal and parenting experiences, including breastfeeding. They're looking for your voice.
🤰🏾➡️🤱🏽
I'll post the link in stories too - deadline is tomorrow Monday 11th.
🤍✌🏽
https://ukparliament.shorthandstories.com/cet-information-support-parents-carers-of-infants/index.html?utm_campaign=0324-cet-parentinfantsupport&utm_medium=email&utm_source=mailchimp&utm_term=pastdebate&mc_cid=61f920fd30&mc_eid=142cb5334f #

I love this perspective. Perceived low supply is much more common than true low supply. No matter how much milk you make, it is still an unrivalled source of immune building blocks, protection, human milk oligosaccharides and nutrients. 🤍

Food for thought 🤱🧠💟
No-one ever suggests to a pregnant women that ‘You might not be able to produce a baby,’ but it is not at all uncommon to hear people say ‘What if I can’t breastfeed?’ Making a baby is a lot more complex than making milk!
Having confidence that you can successfully produce enough milk for your baby is really important, and the more you know about how your body provides the milk your baby needs, hopefully the more confident you will feel. All over the world, women successfully feed their babies, and in many countries most women choose to breastfeed for the first six months and then for many months and years after that. There has been a long history of women being made to feel that breastfeeding may not be possible for them. But think about what your body does to produce a baby – totally amazing! Making milk does not seem a particularly impossible task when you look at your baby and realise what you have just made. Many decades of advertising by infant formula companies have knocked women’s confidence about breastfeeding, and have given the impression that formula milk can be ‘close to breastmilk’. Formula milk is, on the whole, safe and nutritionally adequate for a baby, but you cannot reproduce breastmilk as it is a living substance, unique to every mum for her baby.
(First Steps Nutrition)

These are my personal picks for the 4th trimester.

My midwife had never used the umbilical clamp before but we worked it out! This is my 4th baby so I have zero expectation (or desire) that they will be put down or left alone. I'm planning at least a month of staying at, or near, home. That means my "essentials" list is pretty short, yours may not be.

What did you find useful? Ask me anything!

During teaching this week I went off on a bit of a tangent about how we, as placental mammals, have evolved to birth and feed our babies. The characteristics of all mammals are that we

1. Have warm blood
2. Have fur or hair
3. Give birth to live babies
4. Make milk for our young
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Conception, gestation, birth and lactation aren't particularly magical or special, when you consider the millions of years of evolution and trial and error it took. Eventually, bringing us to a place where it usually worked well for maternal and child health and survival. In large bodied primates like ourselves, continued responsive breastfeeding typically continued for years. This keeps intervals between babies longer so the maternal body doesn't lose blood/iron every month, builds up micronutrient stores, and the child has a better chance of survival due to a steady supply of milk and immune factors.
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In more recent millenia, we have seen many environmental, sociological, cultural, nutritional and medical interventions, which now make that process very difficult for humans. Today, people are even being sold creams and serums to reduce abdominal pigment, rather than have it explained to them the important reason why it is there, and feeling able to honour the change.
🤰
Recognising the biological norm of our species, and our pregnant and birthing bodies, is the first step to trusting in that final stage of the reproductive cycle - lactation.

Have you ever witnessed a breast crawl or physiological 3rd stage?

What are your favourite birthing affirmation audios 🙏🏽? Bonus points for breast crawl/feeding visualisations!

I'm sometimes asked what the "must have" item is by expecting parents. Obviously everyone wants to navigate the post partum period with as little stress and anxiety as possible. Over the past 10 years between expecting my first to my 4th child, I have noticed a dramatic increase in products designed to hold babies, simulate human contact or prolong independent sleep.
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This isn't a post to shame parents who use them, I probably would have bought some of these for my first child if they were available! But knowing what I know now, I hope to inform and empower parents to trust their instincts and know how important THEY are.
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A fair number of feeding assessments I see are in babies who are unsettled or not growing well. Sometimes there are feeding, muscular or medical reasons for this. Often though, part of the picture is the parents expectations. If you've invested hundreds (sometimes thousands) of pounds on a product designed for your baby to sleep in, and they don't, sometimes it's natural to question the baby's behaviour rather than the product because "surely they wouldn't sell if they didn't work", right?
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All primates are born hardwired to expect constant touch and connection. We are born with reflexes that are meant to protect us from being left alone, vulnerable to predators. So when we are in those containers, instead of being held close to a body, voice and movement we are familiar with, it can feel wrong and unsettling. Sometimes babies are unsettled BECAUSE they are continually being placed apart from us, rather than held constantly, as we have done with infants for most of human history.
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Then, there are consequences of "container baby syndrome" where we are continually moving them from one contraption to another, and not giving them the freedom to move and orientate their bodies as they would have otherwise done. They then aren't moving and strengthening muscles and bone formation is altered.
🤸‍♀️
Most parents in Western Industrialised nations will have heard of the importance of "tummy time". Did you know nature's tummy time is a baby pushing up on their mother's chest and doing a breast crawl, lifting and moving their head, neck and shoulders and legs from birth? Babies held in arms and slings outside also use their core and upper body muscles and start to fix their gaze further away. Breastfeeding and other reflexes are integrated once the baby gets practice in rooting, orientating and self-attaching at the breast.
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Milk supply and infant growth also RELY on frequent feeding, baby recognising when they are hungry, and early feeding cues being responded to. This process is disturbed when babies are swaddled, rocked from side to side and tricked into thinking they are back in the womb. Or, when they go from car seat which turns into a pram, then on to a bouncer which turns into a sleep space - their parent is also denied that physical contact which protects and promotes milk production and relaxation.
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So insidious is our expectation to separate babies from their natural instincts that a patient shared with me last week their health visitor actually discouraged the use of a stretchy sling (the one given free to all families in Scotland in the baby box because it is shown to reduce unsettled behaviour). Apparently they shouldn't want their child to get used to close contact.
😢
In summary, the "must have" item for the 4th trimester and beyond, is the arms of a loving caregiver. Nothing can replace giving your baby that security and attention they need at a crucial time. Skin to skin develops brains, reduces crying, and promotes breastfeeding success. It's the most important investment you can make.

If motherhood was more supported in society then we may not be facing a falling population. 

I don't personally consider immigration as a problem, because I'm not racist or xenophobic.  If people are concerned about the birth rate though, they should look at issues that are stopping people having multiple children (and no, it's not because women can now have careers and start later).

Parenthood isn't that desirable when we have such high rates of birth trauma, breastfeeding trauma, formula poverty, employment insecurity, the motherhood penalty, limited high quality childcare options, underfunded health and education services, a housing crisis and a patriarchal society that blames mothers for any and all childhood outcomes.  Then there are valid ecological concerns and the strain of necessary fertility treatments.

We still live in a world where male partners aren't even expected to be responsible for their children, financially, emotionally or practically. It's still unusual to see fathers on the school run or to take more than 2 weeks paternity leave.  But yeah, let's blame the folk with uteruses and feminism for the fact immigration has to rise to support the pension fund, for the people who vote for these policies in the first place. 🤔

Anyone else feel like screaming at this subheading??

TRIGGER WARNING - pregnancy announcement

I wasn't sure whether to post about this but it's getting a wee but hard to avoid!
🤍
I am delighted to say the Breastmed family is expanding in Summer! Thank you to my family, all my patients, colleagues and friends who have been so understanding, especially last December when I was really struggling with nausea and had to reschedule A LOT.
☀️
There will be a few changes in how the service is offered. I am no longer taking NEW inducing lactation patients (I do have a plan for those currently awaiting their babies and beyond).
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Clinic time may be reduced after April but I'm hoping to keep going with home and virtual appointments until the end of May.
🤞🏼
Having been totally immersed in pregnancy, birth and lactation for the past DECADE 😅, the process is still truly incredible to me and I want to send love to anyone struggling with fertility, loss, birth trauma and lactation at this time. First and foremost I am a human and a mother and I know how hard these posts can hit. I'll be posting resources in my stories.

Justice x

For some people breastfeeding comes easily. But, for most it is a journey more like one involving two cancelled ferries, and rail replacement service, than a first class jet.
✈
We can plan and inform ourselves, but often we have very little control over what issues crop up. Daily I speak to people who put all the responsibility on themselves to get the latch looking just right, baby gaining weight to the gram or in mastering certain positions.
❗
The thing is, breastfeeding requires a huge learning curve for both parties. We aren't often in control of how birth goes, when their cord is cut, if we are given excess fluids that transfer to baby, how often a baby wakes to feed, whether they are jaundiced or have been in an awkward position in the womb for several weeks. We aren't in control of how the baby is feeling that day or how we subconsciously react to that. Then, added to the difficulties we might have unsupportive families, partners or encounter health professionals who are overstretched. We live in a culture where breastfeeding isn't valued, so at every challenge, we're dismissed and told to just drop trying, it's not working.
🆘️
Sometimes we need to do what works at that moment in time. Then, look at the bigger, longer term picture. Sometimes progress looks like a straight line, but sometimes it's 2 steps forward and 1 step back. We can still call that progress 🤍

Who can relate to all round 👑 ?

I have an exciting project with this week so have had to shift appointments. There is still availability this Tuesday in clinic though.
🤍

I'm at our first Scottish Breastfeeding Collaborative meeting of the year this morning and we had a great update from Charlie Middleton on Dysmorphic Milk Ejection reflex.
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Her PhD research shows the importance of diagnosis and how it can be misdiagnosed as post natal depression.
🤱🏿
Highlighting DMER is an important step for those struggling with symptoms, but experiencing misunderstanding from the medical community. I'll link to the article in stories too.

This is a confusing one. We know there are huge benefits to practising hand expression, and having an "insurance policy" of colostrum available for early newborn challenges.
💛
If hand expression of colostrum was a reliable way to stimulate labour, we would have much fewer medical inductions and save the health service a lot of money. Unfortunately it doesn't work that way.
🤔
My reason for sharing this perspective, at risk of going against NHS advice, is because too many people have been frightened into waiting to hand express, when their baby would have ultimately benefitted from some, or more colostrum. Human donor milk is amazing, but it doesn't replace the unique immune, bioactive and gut protection a baby receives from colostrum direct from their mother/birth parent, who shares the same environment and exposures as they will.
🦠
The idea that it's "just safer not to" isn't rooted in science, and removes someone's bodily autonomy if they are unnecessarily warned not to explore their own changing form.
🤰
If we don't advise abstaining from s*x and or**sm, why are we telling people not to hand express colostrum?

I saw my first baby of the year today for a home visit and it's wonderful to help families become more confident and empowered.
🤱🏿
If you need in depth lactation and breastfeeding support there are lots of different options. If you are already working with a lactation consultant who can refer, then my appointments are charged at a follow up rate.

Booking link in Bio

All the best for 2024 ✌🏽🤍