Sunday, 26 August 2012

Responsive Parenting: Why Tantrums Matter

People make different parenting choices, and that's fine. We don't all want to sleep with our baby in our bed, carry them in a sling, or nurse them until they're three. We might not like the idea of routines, we might despise the thought of spoon feeding a baby purees. But whilst these issues are often a source of interesting and sometimes heated debate, none of them really matter, or at least, they pale into insignificance compared to the bottom line, which is this: Parents need to be Responsive. No matter what other choices you make, as long as you try your best to be consistently and lovingly responsive to your child, you are 'getting it right'.

Tantrums - which mostly happen at the toddler age - are a difficult area for all parents and it's sometimes hard to know what to do. But how we respond to our children in these testing moments is very important. I've written a detailed post about responding to distress in general here: Everybody Hurts: Ten Ways to Help Children Grow Into Adults Who Cope. But let's look specifically at why tantrums matter - by which I mean, not foot stamps or pouts, but full blown, out of control, toys out of the pram, lie on the floor and beat your fists stuff. You know the one.

Tantrums are not 'Bad' behaviour
When a child is having a tantrum, they are not being 'naughty' or 'spoilt' or behaving badly, although it can seem that way to us as the parent, particularly if we were repeatedly told as children that we were being bad or naughty when we behaved in this way. But what we now know, thanks to advances in neuroscience, is that tantrums are not deliberate, manipulative or naughty - a small child's brain just isn't yet developed enough to make any other choice.

As the Adult, we need to Look Beyond the Tantrum
Often tantrums are triggered by something as simple as hunger or tiredness. Small children usually prefer to eat little and often and tantrums can be prevented by offering plenty of healthy snacks throughout the day. It's also worth looking beyond the tantrum to the surroundings (boring? over-stimulating? frightening? strange?) or to what is going on in the child's - or indeed the grown-up's - world. Have you just moved house, started something new, or been separated for the first time for longer than normal? Has there been a big change, loss or transition, for either the child or the parent? Just like grown-ups, sometimes a small thing like a broken toy or a spilt drink can be the 'straw that breaks the camel's back' and tips us over the edge. Understanding the bigger picture in this way can help us to feel more compassionate to our child and offer comfort.

A Tantrum says 'I Need You' - and you CAN help!
Faced with a child in full blown tantrum, particularly in a public place, we can often feel overwhelmed and helpless. We might feel that we just want to throw up our arms, turn our back, and despair of them. But actually, a child in the midst of a tantrum is really crying out for the input of an adult who has a more developed brain and can help steer them through and beyond these awful feelings. By responding consistently and lovingly instead of walking away, you will actually help your child to develop neural pathways in the brain, which, over time, will help them to calm themselves without help.

How you respond - MATTERS!
It really is time that the world dropped the outdated idea that children turn out pretty much the same no matter what you do. It might seem like a heavy load to bear as a parent, but this simply isn't the case. How we respond and relate to our babies and children, particularly in their first four years when so much brain development is going on, is absolutely critical to their future mental health. Genes play a part, but scientists are increasingly learning that much of who we are is epigenetic rather than genetic - that is to say, that our environment and our experience influence the way our genes behave.

Tantrums are Golden!
It might not seem this way sometimes, but it's the moments when our children are most 'difficult' that they really need us the most. When we manage to respond to them in a way that is warm, loving, soothing and helpful, we are helping them to build within themselves the resources to be warm, loving, soothing and helpful to themselves - to 'internalise' the role of 'Soother' or 'Mother', so that it exists within them and can be accessed always. People who have not internalised this experience often feel a lack of it their whole lives, and can try to fill the emptiness with addictions or other destructive behaviour. In other words, if they can't find comfort on the inside, they will look for it in places outside of themselves. As a parent, you can help them build their Inner Comforter.

Responding to Tantrums is not 'Giving In'
Some parents are concerned that responding to tantrums will result in so called 'permissive parenting' and that their child will be 'spoiled' as a result. But being kind and loving to our child when they are in the midst of a tantrum does not mean that we have to give in to their demands. We can offer them comfort, without feeling we have to give up and buy them the lollipop they wanted. We can acknowledge their disappointment at not getting what they wanted, we can help them understand and find words for their emotions, and we can teach them that love and hugs are actually much nicer than lollipops anyway!

'Tantrum it Out' is just as bad as 'Cry it Out'
Turning our backs on our small children at the very moments they need us the most is not acceptable, regardless of how frustrated, embarrassed or over-whelmed we might be feeling. We absolutely owe it to our children, regardless of the fine details of our other parenting choices, to respond to them lovingly and consistently as much as we possibly can. This means taking their emotions seriously, and not dismissing them as naughty or manipulative. It means seeing the good in them, and taking seriously our role as their grown-up helper. 'Being there' doesn't mean 'censoring' children's emotions or putting a lid on them. We can't always prevent our babies from crying or our toddlers from having tantrums, but we must not leave our babies to cry alone, and we must not leave our toddlers to tantrum alone.

Monday, 13 August 2012

Do We Dare Teach Our Daughters The Truth About Their Bodies?

This article is on the front page of today's Huffington Post. (16th August 2012)

What did you learn about breastfeeding in school? Chances are - not much. Whether you were a pupil in the 1950's or the 1990's, it's unlikely you were told anything at all about nursing a baby, because breastfeeding has never ever been a statutory requirement on the National Curriculum, and it still isn't, even today. Teenagers are taught about alcohol, emotions, contraception, cultural diversity and more as part of their PSHE lessons. But breastfeeding? Telling girls how to do that is dangerous and downright disgusting, according to many commenters in this recent article in the Daily Mail about a pilot scheme in Merseyside teaching the benefits of nursing to 14 year olds.

Revolting!! Don't teach them how to read and write but teach them how to Gods.
Teach them how to respect themselves, how to say NO and how to keep their legs closed, along with teaching them to read and write!!
These idiots should be locked up so they cannot do our children any more harm. It’s idiots like these that only make underage pregnancy worse.

Even an 'expert' was quoted, Norman Wells, from the (somewhat conservative) Family Education Trust:
With the age of consent remaining at 16 and the average age at which women have their first child in the UK being almost 28, there is no pressing need to teach girls of 14 about breastfeeding.
Of course, this IS the Daily Mail, a paper best read with your head strapped to the back of your chair to prevent you from planting your face intermittently into your keyboard. But still - it can't be denied, there does exist an underlying cultural distaste of breastfeeding, an activity that many grown women are still reluctant to attempt 'in public'. There's a squeamishness, not just about milky mammaries, but about women's bodily functions in general, that makes it unsurprising that folk feel uncomfortable when we talk about them to school children. And there still persists the mythology that by giving our children accurate information about the sexual functions of their bodies, we are somehow inadvertently 'marketing' the idea of dropping out and becoming that most feared of stereotypes: a teenage mother.

Better, then, to talk down the whole motherhood thing, and paint it in a negative light wherever possible. They certainly did this at my school in the 80's, where we were shown a film of a woman giving birth that caused one girl to actually faint and put the rest of us off procreating for at least another twenty years. The image of a woman in Deidre Barlow glasses, flat on her back on a bed and having some sort of horror movie version of dentistry done to her nether regions stays with me still, and certainly accounts in part for the terrible fear of childbirth I had when pregnant for the first time at 32.

According to new research, as many as 1 in 3 post partum women are suffering Post Traumatic Stress Disorder, to which fear can be a major contributing factor. The research, from Tel Aviv University, was pretty narrow - it only looked at 89 women in Israel - but I still think it's worth our consideration. Whether or not it's true that 1 in 3 of us get PTSD, it is the case that most women begin labour filled with scaremonging misinformation. The fact that women's bodies are designed to give birth brilliantly and that birth can be enjoyable is rapidly becoming one of the best kept secrets of the modern age.

Even the researcher, Professor Strous, appears to have missed the point, suggesting the solution might lie in 'better counselling about pain relief and making sure that patient's bodies are properly covered during labour and delivery'. This, 'take-more-drugs-and-keep-your-shirt-on-luv' attitude ignores the grass roots of the problem - women are only fearful because they are completely misinformed and are anticipating a Deidre Barlow dentistry moment when they could be preparing for the most life-enhancing and empowering day of their life.

Do we dare teach our daughters how incredible their bodies can be? Can we tell them the real truth of how beautifully they can birth and feed their babies? Or should we continue to 'start them young' on the myth that it's all a bit yucky and horrific, in the hopes that they 'keep their legs closed'. Maybe, just maybe, if we risked telling them the facts, they would learn the lesson that their bodies are incredible, functional, powerful, capable and worthy of deep respect. But could they find any women to teach that? Since the opposite has been taught in schools for as long as we can remember, that might be tricky.

Sunday, 5 August 2012

And The Biggest Breastfeeding Obstacle Of All Is...Bad Advice!

For the past few weeks I've been trying to put together a post for World Breastfeeding Week about the various obstacles that women have overcome in order to breastfeed. I had a vision that I could somehow catalogue the stories in a series of posts so that they could be easily found in Google by others with the same issue or struggle. I've been asking you to send me your stories, and as I've been reading them, my original idea for the post has been eclipsed by what seems to me to be a far bigger and more pressing concern. Because what's emerging from your stories is that, whilst many women have various initial difficulties getting breastfeeding established, the most common and recurring theme, and no doubt the great big problem that's making breastfeeding difficult or even impossible for many women is simply a shocking level of ill informed, outdated and downright bad advice, often from the very professionals who are supposed to be helping and promoting breastfeeding!

Way back when I first started blogging I wrote this post about the notorious UK Health Visitors, and even wrote to my MP about them, who reassured me that they were planning to expand and improve the service. But recruiting more Health Visitors won't help breastfeeding mothers unless they stop giving out misinformation to the women in their care. And it's not just Health Visitors - I've heard some shocking tales of bad advice from UK Midwives and Doctors...and the problem isn't just UK based - bad advice is being dished out worldwide! Of course, not all Health Professionals are giving out advice that jeopardises breastfeeding, and some are excellent and provide invaluable support...but there are far too many stories of misinformation for these to be just isolated cases. Perhaps more worryingly, almost all of the stories come from women who have managed to keep breastfeeding going in spite of terrible advice...which leads me to assume that there are many more people out there who followed such advice and lost their chance to breastfeed as a result.

I thought I'd let your stories and comments speak for themselves. If you have received non evidence based, ill informed, outdated, bad advice from a professional, please tell us about it in the comments below. Please do not name names as this is not a personal vendetta. It is, however, a call to action for Health Professionals and policy makers alike: We need better training if we really want to improve breastfeeding rates. And a call to action to new mothers too...if you are struggling with breastfeeding - Pause, breathe, hold your baby skin to skin, and get a second opinion.

Naomi, Isle of ManI went to my GP a while after my son was born because my breasts were still very sore - he advised me that I was engorged (despite me assuring him that I wasn't) and advised that I should express milk to relieve it. Lucky I knew better that expressing would just increase my milk supply... couldn't beleive that was his advice and neither could my midwife!!!! I was also offered a bottle of formula on my first night in the maternity ward as I was "having a hard time" to which I replied "Listen, unless my boobs actually fall off I'm doing this OK?" People who are having a hard time bfing need support not formula!!!!

Bec, UK: With my first I was threatened with social services if I didn't switch my baby to formula. their reason, she was only on the 25th percentile where she'd track above it and below it and generally followed a curve and was meeting milestones a number of month beyond her age. She was happy, healthy and had good output but because she wasn't on or above the 50th they freaked out. that was from 3 HV's and 2 nursery nurses. I ignored them and carried on breastfeeding.

Cheryl, UK: With my first at 4 months old, from Health Visitors - "just try him on a little bit of baby rice", "A baby never died from crying, just leave him a little longer each time, he needs to learn to fall asleep on his own", "He is on the bottom percentile, have you thought about supplementing with formula?" Regardless of all this advice I breastfed my son for two years.

Tanya, UK: My Health Visitor told me I didn't look like the type to breastfeed - because ordinary looking mums don't right? A Midwife told a friend of mine who was struggling to latch baby on in the early days to stop cup feeding because baby needs to learn to suck so a bottle must be better - epic fail!

Jessica, Canada: At two week check the doctor said: "If you don't get him on a three hour feeding schedule he'll get fat; and no one wants a fat baby. And if he's fed and dry put him down, if you hold him all the time he'll never let you put him down and you'll never get anything done at home. I know cuddling feels good but you don't want to spoil your baby." We continued to do as we pleased feeding on demand and cuddling him whenever we felt like it :)

Catherine, UK: I was told to begin weaning my breastfed baby at 11 weeks because my milk wasn't enough for her. I was asked by the same Health Visitor why, at 18 weeks I was still breastfeeding? I was informed, without having asked, that formula milk "wasn't that bad" and that I should 'top her up' with formula because she wasn't sleeping for 12 straight hours like 'normal babies should'. I am still happily breastfeeding my 8 month old WITHOUT advice from the HV's!

Claudia, USA: In hospital...'let us top up at night so that you can get some sleep.' 'We will use a cup to prevent nipple confusion'....right, what about demand being important for establishing supply? But my absolute favourite was when I was called as a physio to maternity and asked by a nurse to do ultrasound on a women to help relieve engorgement..and was told that I was being difficult because I refused to help even though ultrasound would do absolutely nothing. The nurse didn't think feeding on demand or expressing a little under a shower to relieve the pressure would do anything. Sad thing was that the mom believed it couldn't be hungry because he had been fed recently. I bumped into the mother a few weeks later in the shops and she was formula feeding due to poor supply:(

Lynne, UKOut of hours GP: 'why are you not giving your baby boiled water?? ALL children need water' when my baby was colicky and fretful, probably because he was impatient waiting for supply to catch up with demand. Hospital midwife: 'that latch is fine' - baby was actually tongue tied and almost destroyed my left nipple. A less pig headed mother may have given up as the pain was excruciating.

Anne, UK: My first health visitor told me to stop breastfeeding at six months. My second health visitor tried to get my child removed from my care because she said he was failing to thrive and I refused to supplement with formula (a second opinion confirmed my belief that he was actually fine).

Clare, UK: I was given the old squash and post advice in hospital by about four different healthcare assistants. "Shape it like a nice hamburger and then you've got to push his face into it." Lovely. It was about three weeks before I could feed him without crying because of the pain. I had Reynaud's, which no-one recognised until an Australian lactation consultant read about my struggles on my blog. We persevered, and we're still going strong 19 months later.

Claire, UK: I was told not to breastfeed my second child as my first was extremly lactose intolerant - I ignored the doctor and went on a dairy free diet myself while breast feeding (the least i could do) and then after about 8 months slowly introduced dairy back into my diet and then his after 12 months - he was fine and has no side effects from dairy :)

Fiona, UK: Various unhelpful comments from my Health Visitor, e.g., 'what's a tongue tie?' 'Can't be a tongue tie because your husband just told me he had seen him poke his tongue out before (even though five minutes ago I had no idea what a tongue tie was!!!!)' 'you must be overfeeding him' 'space out your feeds a few more hours' 'perservere with putting him down even if he cries as he needs to learn'.

Adele, UK: Where do I begin? A GP told me to eat butter. Another told me never to breastfeeding less than three hours apart. Midwife said I had too much milk when actually my daughter wasn't getting enough because of her tongue-tie. Something like six different health care professionals told me emphatically that she didn't have a tongue-tie and that it wouldn't make a difference anyway. Self-referred and turned out that was the reason my baby's weight was static for weeks.

Aitche, USA: Paediatric receptionist (loved our paediatrician though) in Philadelphia PA told me my 22lb 5 month old was "too fat for breastmilk", that I should wean her so she didn't "become obese". I did not listen.

Jemma, UK: GP, when both my daughter and myself had thrush, she told me that it must hurt ( well obviously) and to FF which would help relieve the pain. And when pregnant with baby number 2, my midwife told me I had to stop feeding my first daughter or 'the baby would not grow right.'

Melanie, Australia:  Maternal and Child Health Nurse (community health nurse) told me that at 12 months I needed to limit my son's breastfeeds to twice daily, because that was what was recommended for cow's milk (2 x 200ml serves per day). She gave me the photocopied handout, and said that because his breastfeeds were equivalent to cows milk, that he should only have two feeds per day. Luckily I knew better and ignored her!

Amanda, UK: With my first baby a health visitor told me that a breast feed should last 20 minutes at the most -to offer my daughter a dummy after this time to satisfy her need to suck. Oh, and to supplement with a formula feed at bedtime... No wonder why my milk supply was reduced by then?! Luckily my daughter (literally) spat the dummy after a few days and I managed to express to build my supply - the only useful advice in GIna Fords book! Looking back I realise this advice was given during the 6 week growth spurt and it took a long time for my supply to catch up with my baby's demands. Feeding on demand for my next 2 daughters has been much less complicated - they didn't even lose weight in the week after birth! I feel passionately that something needs to be done to change breastfeeding support in this country. In my experience it's pretty poor.

Enid, UK: My first health visitor, over 30 years ago, advised me to stop breast feeding when my son was 3 months old as I had a tummy upset. When I listened to her advice lots of problems happened: mastitis, etc and had to give up feeing my son. My GP and consultant later told me it would have been fine to continue. With my daughter I fed her until she was 2 and a half: a joyful experience for us both! 

Bianca, USA: My experience was with a nurse at the hospital shortly after I gave birth (Miami, FL). She told me that my son should be nursing for AT LEAST 10 minutes per side, both sides every time, and if he didn't start nursing longer, we'd have to supplement. I read up on breastfeeding before giving birth, so I knew that a. it was normal and b. I didn't want to supplement. My husband and I wrote in times that would satisfy that nurse so that we didn't have to battle with her every time. Nearly 18 months later, our son still nurses like a champ! :)

Jane, UK: Doctor told me to feed ten minutes on each side then give formula.

Jennifer, Canada: I was at the OBGYN's office to get a refill prescription of the birth control pill that is safe for breastfeeding women. The doctor told me "You're daughter is already 13 months, there's really no point in breastfeeding anymore, I could just prescribe you a regular birth control pill." I had never been more shocked or offended, by both the untrue advice coming from a medical professional and that medical professional's complete disregard for my needs. Needless to say, I took the prescription *I* requested and continued to breastfeed until my daughter weaned herself at 23 months (I was hoping to go longer).

Hazel, UK: I've been told 'stop feeding on that side now, it will have run out!'. (midwife) 'don't feed your day old baby more than every two hours, give her cooled boiled water if she cries in between' (mw #2). And 'if your baby's weight doesn't go up more than this next week, you'll have to start her on solids' (HV when 12 week old had one single blip of just a two ounce weight gain that week after a beautiful curve up til then). All of these are a little over a decade ago. Of course things will now have changed and be perfectly supportive ;-).

Maria, USA: I went to my first pediatric visit and my pediatrician told me that the baby had lost too much weight and that I needed to give him formula. I explained I wanted to breastfeed. He said that I was harming my baby and that I needed to stop being selfish and do what was right for him. I asked for a referral to a lactation consultant, he said that was a crock.

Lissette, USA: A nurse at the hospital i gave birth at said some babys never latch on and just need to go on formula ... Not true!!!!


New Water Birth Book edited by Yours Truly...and I need your stories!

I'm extremely excited to announce that I have been asked to edit a book - Water Birth: Stories to Inspire and Inform, to be published by Lonely Scribe. For me, the chance to immerse myself in a subject that I am so very passionate about, coupled with the fact that at the end of the process I will hold my book in my hands...well, it just couldn't get any better!

The book will be about nine or ten months in the gestational stage, then spend it's fourth trimester with the publisher, so we are hoping to introduce it to the world around about July 2013.

I'll obviously be blogging about the process along the way, and hopefully readers of The Mule will be able to help me out, as I am looking for stories of birth involving water. I'm hoping that the book will offer a wide variety of stories from different perspectives and serve to educate and inspire readers about the use and benefits of water during labour and delivery.

This might be -

  • a classic home or hospital birth pool experience
  • labour or delivery in the shower, hot tub or bath
  • a birth or labour in open water for example a river or the sea.

Most stories will be from birthing women, but the book will also offer other viewpoints: for example -

  • fathers
  • elder siblings 
  • grandparents
  • midwives
  • doctors
  • doulas

It is also hoped that one or two pioneers and experts in the field of Water Birth will contribute stories, but all stories will sit side by side offering equal value and insight.

My hope is that the book will inspire and inform anyone with an interest in birth as a positive, natural, normal and unmedicated experience that empowers new mothers and gives babies the best start in life. It will offer evidence based information about the use of water in labour and birth as well as first hand experiences and view points from those who have found it helpful.

If you'd like to share a birth story please get in touch with me: We can discuss your contribution and I will then send you the Guidelines for Contributors. 
The book has a Facebook page and is Twittering @waterbirthbook.
I'm very excited about this project and can't wait to read all your wonderful stories!