BeMAD

NB - for our response to Christopher Martyn's 'Observations' in the BMJ click here.

___________________________________________________________

Well - the last 36 hours have certainly been interesting!

I'm not a lactation consultant or a scientist - I'm just a mum with an interest in breastfeeding issues.  I don't fully understand all the ins and outs of the studies which the opinion piece in the BMJ covers.  Fortunately for me (and for many of you too!) there are  people who can write knowledgably about the issues raised by this publication.  Step forward the Analytical Armadillo. 

However, on the basis of yesterday's press coverage of the issue, I now realise that I understand it a whole lot better than most journalists and tv presenters.  I understand how potentially damaging to young babies and their mothers the sensationalist reportage has been. 

I understand how many fragile nursing relationships have been undermined by these reports and how many mothers are - right now - questioning their (perfectly adequate) milk supplies.  I understand that introducing solid food too early can have a negative impact on a mother's milk supply and that can be the first step on a road leading to less - and often no - breastfeeding.  I understand perfectly well how many mothers yesterday, with baby in the middle of the (infamous) 4 month growth spurt may have reached for the (organic) baby rice (!) and started trying to spoon it in.  They may be reassured that it has been 'fortified' with iron - just in case their breastfed baby might be deficient.... 

Just how many of the press reports yesterday mentioned the fact that if a baby hasn't lost it's 'tongue thrust', or can't sit up unaided it isn't ready for solids?  Just how many of the press reports discussed gut closure? 

How many pointed out that one of the biggest causes of iron deficiency in babies is caused by premature cord clamping ~ which prevents blood flowing from the placenta to the baby before it has stopped pulsing? 

There are countless examples of areas where the 'science' here is contested.  If I stopped to list them all I'd be here all day, and so would you..

The important point is this:  the media created the most sensationalist headlines they possibly could in order to sell papers and increase viewing figures.  They bore NO consideration for the true health realities of what they were saying.  As the old adage says, 'why let the facts get in the way of a good story'? 

The journalists, editors, presenters and 'researchers' did not think for one moment about how many breastfeeding mothers, (mums who had in all likelihood fought hard to establish breastfeeding in the first place) would suddenly come under pressure from their mothers/ inlaws/ friends to wean their baby before they felt it was time to do so.  

Here are just some of the headlines from yesterday:

• 'Call for U-turn on when to wean baby after warnings that exclusively breast-feeding for six months 'causes allergies'' ~ Daily Mail
• 'Breast is not Best' ~ The Sun
• 'Mother's milk 'may do more harm than good''. ~ Daily Express

There are many more, and you can find a more comprehensive list of the various media coverage here.

The truth is that the review did not say 'breast is not best' or that breastmilk 'causes allergies'.  These headlines are utterly misleading, inaccurate and irresponsible.  In all likelihood the papers knew this too.  Still - they clearly felt it was a risk worth taking.  Never ones to miss an opportunity to 'diss' breastfeeding, most of these stories (and there are many more) were front page news. 

We had mums who started to give their children solids at seven weeks wheeled out (Radio 2) without anyone pointing out that there is no debate whatsoever amongst the 'experts' about this.  Introducing solids before 17 weeks is not recommended - the gut is not ready.  Even the baby food companies are too scared to recommend that you feed their products to babies less than 4 months old, the 'new' report also states this clearly.  Completely irresponsible journalism.

Best of all, none of this is news!  Experts in the field of infant nutrition have been discussing the pros and cons of the current guidelines for years.  Several years ago a similar 'review' in the USA came to similar conclusions.  More research needed. 

Although I can't help but wonder which formula companies were wining and dining the authors of that report, I am citing it here as an example of how this front-page news story just wasn't news!  So what if it was just published in the BMJ, this debate is much older than that.

Why did they do it then?

Well, we live in a formula-feeding culture where breastfeeding advocates are frequently accused of 'bullying' people into breastfeeding and 'making' them feel bad when they struggle and give up.

I personally believe that the media plays a big role in creating the 'myth' that breastfeeding advocates are bullies.  By and large that is completely untrue, and quite frankly I'm sick of it. 

Most of the breastfeeding advocates I know are mums, they know how hard it is to learn to breastfeed and they've been sleep deprived too.  They've had crap labours and been fed innaccurate information by health professionals.  Those mums seek to advocate breastfeeding because they want to help other people avoid the sadness and yes, guilt, that comes when breastfeeding doesn't work out. 

Mums who don't breastfeed do often feel guilt, but many also acknowledge that this guilt comes from within, and don't seek to blame anyone else.  They often go on to successfully breastfeed their other children, often with some help from the bullies. 

Sometimes they become so passionate about breastfeeding that they even turn into 'bullies' themselves! ;)

But the media love to bash breastfeeding because it appeals to the masses.  It's a bit like 'sport'.  It allows the majority to feel better about something they are insecure about, at the expense of the minority.  The media know that by putting a headline out which will make people feel better about themselves (even temporarily), they will sell more newspapers or raise their viewing figures.  It's the equivalent of giving out a free chocolate bar - the only difference being that giving out a chocolate bar doesn't cause people to make life-changing decisions. 

Only 1% of babies in the UK are exclusively breastfed until they are six months old.  That means that 99% aren't - and that's a lot of mums who fell short of the 'target'. 

99% is a really big majority, and you can see how the media might benefit from creating headlines which appeal people who feel guilty for not meeting those (all-important!) guidelines...

This makes me wonder who the REAL bullies are.  I mean, it's really easy for the papers to get mileage out of breastfeeding mums.  First of all we're women, and women are easier targets than men (yes, I know it's the C21st but it's still true).  On top of this we're a small minority of women, and people already resent us.  We're the school swots - if you like...   (Ok, I know that's not the case - but I hope you see what I mean). 

Mums who are openly passionate about breastfeeding annoy people.    You might think you're just proud and 'loved up', but really that looks like gloating to a lot of people...

Still - does that justify the press maligning breastfeeding all the time?

Not in my opinion. 

If someone is openly passionate about their religion, or their colour, or their sexuality, we might not always agree with their life-choices, but in our 'liberal' culture we accept it and we realise that they are entitled to express themselves however they want!  Not so with breastfeeding.  Because you might make someone feel guilty.

Funnily enough, persons of colour, religious groups, homosexuals, and other minority groups are protected from irresponsible reporting in the press by special guidelines. 

A headline such as 'Black is not Best' would be unimaginable (I have chosen something deliberately provocative btw - it's obviously nonsense). 

People are naturally coloured, they are naturally gay or straight, people are also naturally breastfed.  It is the norm.  It shouldn't need to defend itself but it does.  It's still OK to bash breastfeeding and breastfeeding mums.  It's ok to lie about breastfeeding facts and call breastfeeding advocates names.  It happens all the time with impunity.  But WHY?  Why is it still ok to do this?

Actually, it's not ok..  I believe the press has gone beyond criticising 'bullies' and is now on dangerous ground.  Ground that actually puts mothers and their babies at a considerable disadvantage.  The headlines and distorted reportage really have caused damage.  Despite the fact that some newspapers will now print 'balance' pieces and perhaps even have to print retractions, they KNOW that the headline was worth it.  It's the headlines that people remember.

Perhaps some of you will think that by comparing breastfeeding mums to other minority groups I'm exaggerating.  Imagine if someone was thrown off a bus for wearing a turban?  Or if a gay man felt so intimidated that they went to eat their dinner in a toilet?  These things happen to breastfeeding mums - and if you breastfeed for long enough, the chances are that you will - sadly - have a negative experience associated with it eventually.  Racism still exists in the UK, but it is tolerated far less than it used to be, and the press do not inflame it.  Imagine if they were allowed to - what sort of headlines do you think the Daily Mail would print? 

I would like to see the media forced to stop their sensationalist headlines and treat the topic with the care that it deserves.  All mothers and their babies deserve respect and access to good information.  I believe that issues related to infant feeding deserve the same respect given to other issues.

 

OFCOM is the body set up to regulate broadcast media such as television and radio.  The PCC deals with written word, such as newspapers and magazines.

The Press Complaints Comission's Editorial Code says:

'The press must avoid prejudicial or pejorative reference to an individual's race, colour, religion, gender, sexual orientation or to any physical or mental illness or disability'

But you can print prejudical headlines about breastfeeding.  The printed press in the UK is currently self-regulating.  It's code is (perhaps inevitably) light-weight.  Interestingly though, elsewhere on their website they say this:

'The PCC also does an increasing amount of proactive work with groups of people like to need to know about our work, such as Coroners, the police, witness services and bereavement support groups. There is more information about this work in the Dialogue with the Community section of the site.  The PCC from time to time issues special guidelines to editors which are designed to add even further to this protection. In 1997, for instance, the Commission issued guidelines on the portrayal in the media of persons suffering from mental illness. Other specific areas the PCC has tackled include the identification, against their wishes, of lottery winners. In 2001, the Commission produced practical advice to help people suffering from press harassment and acted to emphasise the need for care in the reporting of matters involving race and religion. In 2009, the Commission published briefing notes on the reporting of suicide; and on the payment to parents for material about their children, in the wake of the Alfie Patten case.'

I would like to see issues related to infant feeding (including breastfeeding) included on that list. 

OFCOM's code (which is considerably more robust) says:

5.13 'Broadcasters should not give undue prominence to the views and opinions of particular persons or bodies on matters of political or industrial controversy and matters relating to current public policy in all the programmes included in any service (listed above) taken as a whole.

Meaning of "undue prominence of views and opinions":
Undue prominence is a significant imbalance of views aired within coverage of matters of political or industrial controversy or matters relating to current public policy.'

from section 2 'Harm and Offence'

'2.2 Factual programmes or items or portrayals of factual matters must not materially mislead the audience. '

also here (article 10) :

1. Everyone has the right to freedom of expression. [...]
2. The exercise of these freedoms, since it carries with it duties and responsibilities, may be subject to such formalities, conditions, restrictions or penalties as are prescribed by law and are necessary in a democratic society, in the interests of national security, territorial integrity or public safety, for the prevention of disorder or crime, for the protection of health or morals, for the protection of the reputation or the rights of others, for preventing the disclosure of information received in confidence, or for maintaining the authority and impartiality of the judiciary.

I would like to see OFCOM start to regulate to protect the health of mums and babies by ensuring they receive accurate information about feeding practices. 

I would like them, for example, to ensure that when a programme shows a mum making the decision to bottle-feed or struggling with breastfeeding (you see it all the time in the soaps), they include information about bodies which can provide breastfeeding support (such as the LLL, ABM, BFN etc), at the end of the show in the same way they do when they run a story about domestic violence, debt, gambling, or sexual abuse. 

Again, you might think this is extreme.  The statistics show that many, many women run into problems breastfeeding (65% of them have given up before their baby is a week old), and very, very few of them get the correct advice to allow them to cope.  Given the risks of with formula feeding both for babies and their mothers, it is an important issue.  The damage stopping breastfeeding can do to a mother's mental health is only just coming to light  ~ sometimes I wish this information was shared more ~ particularly by the popular press.  Both these issues impact negatively on so many women and their babies.

I have complained about misleading headlines before.  I hit a brick wall.  Others have tried too - same thing.

Although it is tempting to complain again and again I don't see what purpose it would serve.  The regulations need tightening up in order for us to have any success in defending breastfeeding from the seemingly endless media attacks on it. 

I want to ask the PCC and OFCOM to re-think the way they regulate the issues related to infant feeding.  I want to present them with a good argument, and lots of pressure. 

If you feel strongly about the way the news yesterday was presented and would like to do something about it, please, complain all you want, but please also consider taking the time to write to the PCC and OFCOM yourselves - perhaps this article will give you some ideas for what you might like to say to them.  Their contact information is below.

You can also SIGN MY PETITION.

Perhaps we can turn this press disaster into something positive - and use the disgraceful press coverage of the issues to our advantage. 

Please don't expect 'DBM' to do it all (after all, I'm really just another busy mum doing this as a volunteer!) - if you just assume someone else will complain you're on a hiding to nothing.

We all have to take responsibility for challenging the real breastfeeding bullies.

OFCOM

Riverside House
2a Southwark Bridge Road
London

SE1 9HA

You can complain via this form & you can make suggestions (like broadcasting contact information for breastfeeding support agencies with any programme which discusses breastfeeding ) here.

PCC:

Halton House,

20/23 Holburn

London

EC1N 2JD

You can make complaints here: complaints@pcc.org.uk

And you can make suggestions (like asking for special guidelines to be drawn up to protect breastfeeding reportage) here.

I would love it if a representative from every breastfeeding support group in the country wrote or rang in.  I'd love it if we ALL made the effort.  I know you're - in general - a pretty laid-back bunch, but this really has gone on long enough.  Please help to change things. 

I'll go a step further, contact your MP.  Tell them how you feel and Include a link to this blog if you want.  It's time we campaigned properly for this issue. 

To use a term coined by mum on the DBM facebook group  earlier,  'Breastfeeding Mothers Against Discrimination' or 'BeMAD!'

Don't be in any doubt, we can create change.

Of Mice and Men.

As some of you might have seen from the Facebook group, DBM members approached P&O Cruises after it was brought to our attention that their attitude towards breastfeeding was a long way from supportive. 

Within the 'Frequently Asked Questions' section of P&O's website the only mention of breastfeeding was as follows:

"Although we do not have any rules on this this, we would prefer that actions such as these are done in the privacy of your stateroom..."

Er - 'actions such as these'?  Whatever do they mean?  What comparison are they making here?  Are they comparing breastfeeding to popping a zit, or something requiring even more privacy?

Seemingly adding insult to injury, their FAQ's made it clear that bottle feeding was supported by the company, and in fact they will even provide the formula...

I left a response on their website, and wrote this on the wall of their Facebook Group:

'I was disgusted to read that you recommend that nursing mothers stay in their cabins to feed their babies but you are perfectly happy to supply powdered formula milk etc? Do you suggest mums using bottles hide away too? Breastfeeding is normal and protected by many laws worldwide. Discouraging mums from doing what is healthiest for them and their babies is a disgrace and is also sexual discrimination. I have shared this information with my group and will continue to raise awareness of P&O's questionable treatment of nursing mums elsewhere. #epicfail'

After being contacted both on their website and through their Facebook group, P&O responded, saying:

'Hi there, thanks for bringing this to our attention. We apologise that the previous wording on our website was incorrect - in fact we do not have any policy relating to where breast-feeding should take place and place no restrictions on this. We have now amended the wording to this effect.'

Shortly afterwards they made a change to the wording on this page of their FAQ's.  This maintained that they do not have a breastfeeding policy, but stated that breastfeeding was welcome without restriction on board their ships.  However, they 'helpfully' suggested that breastfeeding mums behave 'discreetly' (sadly this page was not online long enough for me to take the wording down exactly!).

Now, although this alteration initally seemed like progress, for me it wasn't enough.  You see, I don't need to be told to be discreet when I'm feeding my child.  I am not a flasher.  I am just feeding my child.  It is normal.  I resent any implication that breastfeeding mothers should hide-away, be it in a 'state-room', behind some sort of cover or in a dark corner. 

In order that we all come (back) to the realisation that this is a normal, non-sexual activity and that one of the functions of our breasts is to feed our infants, I (personally) feel we need to stop hiding away.  So I responded to P&O, as did several of our other members.

'I note you have changed the response on your FAQ. However, your company SHOULD have a Breastfeeding policy!!! And it should say (like any supportive family service providers would...) Breastfeeding is welcome anywhere on board our ships. THE END. Breastfeeding mums don't need to be advised about discretion, we are not flashers.'

and:

'You should have a policy. Without one 'anything goes' and that's not ok for a 'family friendly company'. Nursing mums just want to be normal. The same. Welcomed and supported.'

and (following a very illuminating conversation with a lawyer friend):

 'Just a side note - having taken some legal advice I need to say that despite P&O saying they DON'T have a policy on breastfeeding, in practice the wording we have been reacting to serves the same function as a policy. You could just as easily claim not to discriminate on the grounds of colour, but 'suggest' that persons of colour eat in their rooms. It's still discrimination. In addition 'advising discretion' is the same as having a policy that advises nursing mothers to cover up or remain out of sight. Really hoping for a positive response here P&O - and assure you that we'll be just as pro-active in sharing a pro-breastfeeding stance as what seems to be an 'anti' breastfeeding one!'

P&O responded speedily once again to tell us they were looking into the issue:

'Thank you for your feedback, which we really appreciate. We are looking into this.'

The FAQ advice regarding how a breastfeeding mother should behave whilst feeding (and the entire page) was removed from the website.

Shortly afterwards this appeared:

'As a family friendly organisation, the company recognises the benefits of breast feeding to mothers and infants, and breast feeding is welcome in all areas where infants are allowed.'

Hurrah!  Brilliant, a victory for common sense!  Needless to say we were all very pleased and many of us wrote to them to thank them for making such an important change.

But why am I bothering to write this all down for you?  Well, I'd be lying if I said I wasn't extremely chuffed that P&O Cruises took notice of the many complaints from members of our group (and others I'm sure!) and acted so quickly. 

However, that's not why I blogged about this.

I want to make a comparison between the behaviour of P&O, a multi-national company (Carnival, it's parent company is currently valued at £25.73 Billion), and another multi-national company (one valued at only slightly more, approximately £31 Billion). 

Yes Facebook.  I mean you.

You see, they have some similarites. 

• Both are multi-national companies with a world-wide outlook and presence and a similar market value.
• Both show(ed) ignorance about the rights of breastfeeding mums.  Our rights to breastfeed - and to be seen to breastfeed - are protected under countless laws around the world. 
• Both suggest(ed) that breastfeeding is something which should be done in private, to avoid causing offence. 
• Both are quite happy to promote formula and bottle feeding (in the case of P&O by providing formula and in the case of FB by a constant stream of formula advertising). 

However, there the differences between the two companies end - in my opinion.

• When P&O cruises were approached with a problem, they made it clear they were investigating and they followed through on their statements.
• When P&O realised their mistake and that they were guilty of discrimination (however unintentional), they responded and entered into a mutally respectful dialogue.
• P&O responded swiftly, admitted their error ('We apologise that the previous wording on our website was incorrect') and took steps to resolve the problem.

• Facebook are notoriously difficult to contact - they often do not respond to messages or even repeated emails.  With the exception of a few individuals, it is incredibly difficult for anyone with a problem to discuss it with FB.
• Facebook do not respond swiftly - they have been deleting photographs of breastfeeding, individual profiles and even groups for several years now!  They still have not amended their terms and conditions, nor publicly acknowledged the underlying discrimination these t&c's mask.
• Facebook do not admit their mistakes - no, they say things like this: 'The Page was disabled initially disabled in error and appears to have been affected by some sort of glitch.'

It is clear which company takes it's responsibilities to it's service users most seriously.  It's obvious which company is willing to move with the times and doesn't consider itself above listening to it's customers & responding to their needs.

 

P&O Cruises proudly announces on it's Facebook Page that it can trace it's roots back to 1837.  Facebook was established in 2004.  Customer service is everything, particularly in a recession.  No business is bigger than that.  When it comes to customer service, Facebook has been totally out-classed by the old-timers.

Which company do you think will still be around in 2061?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

You can sign a petition asking Facebook to stop deleting breastfeeding support groups and images here.

Links:

http://www.businessinsider.com/facebook-valuation-tops-50-billion-dj-vu-all-over-again-2011-1

http://www.investorschronicle.co.uk/Tips/FairlyPriced/MiniTips/article/20110105/e5abeff6-17fc-11e0-a55e-00144f2af8e8/Carnival-sees-calm-seas-ahead.jsp

www.carnival.com

http://www.carnivalukgroup.com/

http://www.northcote.co.uk/company_links/alpha.asp?SIT=1&ALR=C&SDL=NI00546

http://www.morningstar.co.uk/uk/news/article.aspx?articleid=94550&categoryid=13

DBM Admin

Hi everyone :)

For a while now I've been mulling over asking someone to help me with the FB group.

The group has grown to a considerable size, and it takes an increasing amount of time to monitor the posts and provide help when it's necessary.  It's a lot for one person to manage, and I can see it potentially becoming even harder for me to do alone in the coming months.  I think it's healthy for me to have someone to brain-storm with and I'm a great believer that two heads really are better than one!  For now, I've asked one long-standing member of the group to come on board and help me admin the page.  In the future we might need additional help, so if you're interested, let me know!

I have never wanted DBM to be a 'one-woman' show, but rather a collective.   I love your input, your posts, and your ideas.  Some of you might have something related to breastfeeding you are burning to write about, and if so, I'm more than happy to provide a platform for this via the blog.

Your experiences, and your opinions, help others - and without you - DBM is pointless. 

It can be a little daunting at times running a group like this - so I'm really glad to have some backup! ;)

I have asked Julie, a mum of three breastfed babies and a trained peer supporter to help out on the page.  You'll see her commenting as 'DbmTeamAdmin', using the DBM logo.  In her own words she is:

'passionate about breastfeeding and the benefits it can provide to both baby and Mum.'

We're really lucky to have her, and others like her, posting on the board regularly.   Julie has tons of experience helping mums both in the community and through her breastfeeding support group.  I am grateful to her for accepting the (obviously unpaid!) post and I know she will be a massive asset to our group in her new role.

Thank you Julie for agreeing to help out - and I look forward to hearing from the rest of you about your creative (burning) ideas!

xo anne

Myth ~ All Breastfeeding Mums love Breastfeeding.

'The lactating woman who has D-MER experiences a brief period of dysphoria that begins just prior to the milk ejection reflex and continues for not more than several minutes. It may recur with every milk release or only with the initial milk release at each feeding. D-MER always presents as an emotional reaction but may also produce a hollow or churning feeling in the pit of the stomach.  When experiencing D-MER mothers may report any of a spectrum of different unpleasant emotions, ranging from depression to anxiety to anger.'

~ From Wikipedia

'I've got a bad feeling about this'

~ by Anon (reproduced with permission).

'Firstly, a bit about me and my views on infant feeding.

I am not the most passionate advocate of breastfeeding in the world. Compared to many I'm an extremist, but my attitude to the Great Feeding Debate is comparatively mellow.  I've read The Politics of Breastfeeding (or, as it's known in milky corners, The Politics), and I've been appalled by the stories I've read in there.  Reading that book, you'd be forgiven for thinking that infant milk manufacturers are the single greatest evil ever to stalk this earth, and the area of infant nutrition has been unlucky in falling prey to a unique kind of irresponsible profit-mongering.

You'd be wrong.

In America in the 1950's a senator named Dudley LeBlanc started selling a patent medicine called 'Hadacol'. Hadacol had no identifiable curative properties, but it was supposed to be good for everybody.  It was a retail sensation.  People who had to choose between buying food, or Hadacol for their children would buy this drug, they'd buy it instead of shoes, instead of prescription medications.  It was snake-oil - an unscrupulous salesman exploiting peoples' desire to keep themselves and their families healthy.

Even worse has been the unscrupulous work of Matthias Rath and affiliates, campaigning hard in Africa to ban AZT- anti-retroviral therapy for sufferers of HIV.  Dubbing AZT to be 'toxic' and actually responsible for the deaths of AID's sufferers, they suggested that, if HIV exists at all, it can be treated by eating wild garlic and African potatoes.  This man had the ear of the then-President of South Africa, Thabo Mbeki, who reacted by withholding AZT from thousands of HIV sufferers.  This is death resulting from bad science- a vitamin-pill entrepreneur exploiting ignorance in the pursuit of profit and fame.

Such it is with formula companies. When deregulated companies are let loose on vulnerable communities, the result is death.  We absolutely should care about babies who die because their mothers were persuaded to give formula, but this is part of a bigger picture.  When we say that capitalism isn't working, it's about more than the credit crunch, it's about the death toll.  The fight is bigger than breastfeeding - it's a fight for good science, tougher regulation for markets that have anything to do with health and nutrition, and, of course, the fight to end global poverty.  Breastfeeding is part of a jigsaw.

So, with that in mind, why do I breastfeed?  Breastfeeding, these days, is fabulously counter-cultural.  It's revolutionary, not just because it's free, but also because it's a symbol of female potency.  I am a woman, I make milk.  I give life, and that's a power that's generally reserved for gods.  There's a reason why Christian's believe that the Communion wafer either is, or represents the body of Christ - it represents an ultimate sacrifice - giving of yourself to sustain another - it's the greatest thing you can do, and that's basically how breastfeeding works.

But a mother with aversion or D-MER gives more than just calories and antibodies.  She sacrifices her happiness to give that milk, she pours away (however temporarily), her sanity.  I know the feeling that you're putting 'bad vibes' in the milk, as you screw up your face and ball up your fists, trying to cope with that awful skin-creeping feeling that steals over you while you feed.... but the baby doesn't know that.  The baby has warm milk and a soft breast, the baby is happy.  You're lending out your happiness, and unlike other mums, that means you're not going to have it for a little while.

I think this is probably too much to ask from a woman.  I read another lady saying that she thinks aversion is a sufficient reason to wean, and in my heart I agree, but it's far from that simple.  A mum with aversion, or D-MER, may be even more invested in breastfeeding than a mum who enjoys the process, or is indifferent to it, because she is trying so hard to keep going.  She can feel her soul being sucked out through the nipple, the creeping feeling of being patted by little hands that can be so unnerving during the feed, and *constant* reiteration of 'I am doing this for my baby' can be the only thing standing between her and throwing the baby down and running away.  Women who hate breastfeeding can be more dedicated to the cause than anybody else, because they are paying so much more to get the benefits for their child.

So, many mothers suffering from D-MER or aversion will find themselves wanting to keep feeding, despite exquisite emotional pain, and in this case distraction is key.  Television is good, but I find that once the commercials come on I get right back to feeling that awful awful sucking, and I have to either de-latch the baby or flick over to something that's going to occupy my mind.  I've also found that breastfeeding in public is much easier - even if you're not talking to anybody there is more life around you to occupy your mind.  Books, if you're so lucky that your baby won't beat them out of your hand, or a computer, or a conversation. It helps to be able to say to someone 'I am so hating this right now'.


The night feeds are worse, and within weeks of the aversion feeling creeping up on me I had to night-wean Dexter.  Lying there at night I felt intensely vulnerable, and breastfeeding at those times left me feeling molested by my child.  Before I weaned I would often get up completely and take Dex down to the living room, and he'd feed while I watched Lead Balloon.  Not ideal, but better than what I would have done, which would have been removing him from the breast, and then having us both cry together.

These days I've put boundaries around our nursing partnership.  I'm no longer able to feed whenever he wants, for as long as he wants, so I offer 10 minutes a feed, 3 times a day.  He's 13 months corrected, so thankfully he's not reliant on my breastmilk as the sole source of sustenance, and knowing that I only have to deal with these feelings for 30 minutes a day makes them much more bearable.  I didn't want it to be like this, but I think that had I gone on offering whenever, for as long as he wanted, I would have ended up weaning completely.  When breastfeeding makes you unhappy, you need to be able to contain the unhappiness - prepare yourself for it and know that it's not going to be forever, it's only for now.  You need to know it's going to end, because endless unhappiness is just despair, and no mother should have to feel that.  I think that understanding what is happening to you is a big part of coping with it- at the crucial moment of let-down, when you're consumed with misery and anger, you know in your conscious mind that this isn't you, it's a physiological problem that has temporarily hijacked your brain.

I've also found that it helps to be physically prepared.  If I've eaten well and slept well, the feeling isn't so bad, I can cope with the antsy feeling better, I can steer my thoughts away from what I'm doing.  Someone told me that caffeine helps them with their D-MER feelings and I agree - I don't feed Dexter until after my morning coffee, and for some reason that helps me feel less overwhelmed.

But even so, it's hard.  I've had cracked nipples, I've had mastitis 6 times, and breastfeeding aversion very nearly beat me.  It is so difficult to explain, especially when someone asks you why you aren't breastfeeding, or you feel the need to explain why - such exchanges need to be short - and you find yourself saying 'It feels icky', you can hardly blame your companion for rolling their eyes, but they don't understand the chasm of feeling that's lurking beneath the 'icky' feeling.  The emotional distress that some nursing mothers feel is very real, and I have found it worse than any of the physical barriers I encountered on my breastfeeding journey.  Women suffering with these problems feel abnormal; they feel bereft of what was supposed to be a 'special season' in their lives.  They feel that they have ‘issues’, personally I've wondered whether breastfeeding feels this way to me because I'm some kind of pervert.  Looking at me, or even chatting to me about breastfeeding, would give you no clue of what I think about when I'm trying to feed my baby in the armpit of a dark night, but it shouldn't be a secret, because now I know it's not just me.'

Ed's note:  All italics/ bold are mine.

Some additional links:

http://community.babycentre.co.uk/groups/a3869875/nursing_aversion_d-mer (UK - based online support group)
http://www.infantrisk.org/content/dysphoric-milk-ejection-reflex
http://www.facebook.com/pages/Alia-Macrina-Heise/114427398622601?v=wall&ref=sgm
(link to the personal FB page of Lactation Counsellor Alia Macrina, who specialises in D-MER & maintains: http://d-mer.org/)
http://www.postpartumprogress.com/weblog/2009/06/for-moms-who-feel-bad-before-breastfeeding-this-may-be-why.html
http://blog.placentabenefits.info/index.php/2010/11/placenta-helps-with-d-mer/ (some thoughts on how placenta encapsulation may help with D-MER).

Olga's Story - Exclusive Pumping.

Olga's Story:

My daughter is over two years old now and this is my breastfeeding story.  I will also give you some background on her birth as I think that’s where all the problems began.  Or maybe it all went wrong earlier – as during my pregnancy I did not read anything about breastfeeding.  I attended some antenatal classes with my husband, but midwife was talking only about ‘benefits of breastfeeding’ and why it’s the best way to feed your baby.  That I already knew – for me it was the ONLY way to feed my baby. I expected the whole experience to be blissful and natural – isn’t it what my breasts were for at the end of the day?  Overall I didn’t give breastfeeding much thought, I concentrated my research on homebirth, reading lovely homebirth stories.

My pregnancy was uneventful, though from the beginning I felt unsupported in my desire to birth Freya at home.  A few days before my due date, traces of protein (+1) were detected in my urine, so I was advised to go in for monitoring.  All was fine and my baby was happy. During the monitoring my blood pressure was taken and it read 150/75.  I didn’t think that was cause of concern as it’s classed as borderline, but the doctors weren’t happy.  I was advised to come back the next day. The following day I came back to the hospital, baby was fine during monitoring, again there was +1 protein in my urine and blood pressure was 150/75.  This time at the end of my appointment a consultant and two additional midwives arrived and started explaining that I had to be admitted later that day to be induced or I would be putting my baby at risk.  I attended this appointment on my own and found it difficult to defend my position.  I knew I did not have pre-ecclampsia and my baby was fine, but they made me feel like a bad mother for wanting to deliver Freya at home, naturally.  I agreed to come back later that day for induction and went home in tears.

My induction started at 8pm with a prostaglandin pessary.  I started having mild contractions but they weren’t really doing anything so I had another pessary at midnight and another one at 8am.  I did not sleep at all that night.  By 10am the next day I was still only 2cm dilated, so doctors decided to put me on oxitocin drip and break my waters to speed up the process.  The exact cascade of intervention that I was reading about and dreading was happening to me.  And as much as I was coping with the pessary induced contractions on my own, things became quite different after being put on oxitocin drip.  I was begging for an epidural, though I originally wanted to avoid pain relief drugs at any cost.  It took two hours to get the anaesthesiologist ready during which I became very dependent on gas and air.  I wanted to go in a birth pool, but wasn’t ‘allowed’, was lying on my back, strapped to foetal monitoring system.  Everything I wanted to avoid was happening.  After epidural finally kicked in, I couldn’t feel a thing but mentally felt miles better.  Every time epidural was wearing out, I was offered another top up. I had five top ups throughout the day.  I was dilating slowly and finally reached 10 cm by 11pm.  At this time midwife that was looking after me had to go home and new midwife arrived.  She introduced herself promptly and then left me alone with my husband for an hour (at 10cm dilation).  I knew I was ready to push but there was no midwife to help me, so I waited patiently.  When the midwife came back, I finally was ‘allowed’ to push and Freya arrived at 12.25am, after 30 hours of labour.

 

As soon as she came out, we had some skin-to-skin contact, but Freya was very sleepy.  Midwife asked me if I wanted to breastfeed, and I said yes.  Next thing I remember was midwife grabbing my breast and pushing Freya’s little head onto it with almighty force.  Both me and my husband froze, as she was really forceful, and Freya just started crying.  I remember thinking that poor little mite was going to suffocate. Later we had some more cuddles, Freya wasn’t interested in suckling at all.  I had a bath while midwife left for another half hour and then I was immediately moved to postnatal ward and my husband had to go home. By that time Freya was fast asleep and we were left alone till morning.

Nobody came to see me till 9am (8 hours after birth), I wasn’t offered a drink or food.  Freya slept pretty much all this time and I couldn’t get her to latch on at all.  During my stay in the hospital I expressed my concern that baby wasn’t latching on, so I was offered a bottle of formula, which I refused.  Paediatrician that came to check the baby didn’t seem concerned, just told me to ‘keep trying’.  During that day at the hospital I was left alone for most of the time, no one came to help me with positioning and latch, but midwives were doing their formula rounds every couple of hours, which I refused to accept every time.  At 2pm I was so fed up that I decided to discharge myself ‘against medical advice’.

At home same situation continued – Freya was asleep and no matter what we did, she just wouldn’t latch on. Every time I was putting her to the breast, she was becoming more and more stressed and upset.  I started expressing bit of colostrum with some cheap electric pump I had and gave Freya her first feed 30 hours after she was born.  I was only getting out 10ml at the time, so decided to give Freya some formula (in a bottle).  Midwife that came to visit during that time wasn’t helpful at all and told me that I had flat nipples and that’s why Freya wasn’t latching on.  That really knocked my confidence, but I still kept trying to latch my little girl on.  After three days she started screaming as soon as the breast was out and was fighting me off.  I still tried expressing, but unfortunately the motor on my pump died.  I sent my husband to Boots, and he got me a manual MAM pump.  Pumping with manual pump wasn’t easy and my milk didn’t come in till five days after Freya’s birth. By that time she was fed mainly formula, mixed with whatever I could express (which was about 150ml per day).

My confidence was very low, and I had no help from healthcare professionals.  Midwives doing home visits weren’t interested; all they cared about was how much Freya weighed.  And as she only lost 2oz of her birth weight – so we were promptly discharged from midwife care.  On the last midwife visit I was given a telephone number for hospital lactation consultant.  I called her a few times every day, for about four weeks – she was never at her desk and I left multiple messages with different people – she never rang me back.  At home the same situation continued – both I and Freya were becoming more and more unhappy.  She wouldn’t latch on, I felt rejected and like a failure. I was producing less and less milk every day.  The midwife told me that pumping wasn’t possible long term and I believed her.  I was becoming very depressed as it wasn’t the way I wanted to feed my baby.

When Freya was four weeks old – I came across term ‘Exclusive Pumping’ (EPing) on internet.  I found iVillage EPing board and, to my own amazement – not only was it possible, but many mums in USA have done it with great success. I found a book ‘Exclusively Pumping Breast Milk: A Guide to Providing Expressed Breast Milk for Your Baby’ by Stephanie Casemore and decided to try it.

I bought a new pump – Ameda Lactaline and started pumping every two hours, day and night.  I started writing down the amounts that I expressed and after three weeks of following this strict regime (and taking Domperidone) – I was finally making enough for my daughter and stopped supplementing with formula. I have kept a ‘pumping diary’ everyday till thirteen months post partum. At peak I was making 42oz of milk per day and Freya was having a maximum of 30oz a day. I started donating milk to Chester Milk Bank and I have donated over 1500oz during Freya’s first year.

I suffered with bleeding and cracked nipples, ductal thrush, continuous blocked ducts problem (which sorted itself out after taking Lecithin supplement) – but all that didn’t matter because my daughter was getting my milk. I began to feel less and less guilty and started enjoying being a mum more.  Exclusively Pumping was the most difficult thing I have ever done – at times I felt like I was chained to the pump.  Having to pump at night while my daughter started sleeping through at five weeks was especially difficult, but I wouldn’t change it for the world.  I managed to continue till 14 months post partum.

Stopping was my decision, as it became increasingly difficult: looking after active toddler, working and pumping.  If I was a stay at home mum, I would carry on for much longer. I am very proud that I managed to feed her for so long.  I still tried to latch her on till about 6 months of age – she did it twice, both times using nipple shields.  Eventually I decided to give up and made my peace with the fact that I will be an EPing mum.

I still feel very sad thinking about our early days and lack of support.  I did complain to NHS about it, but they blamed me for discharging myself from hospital against medical advice.  I didn’t pursue it further. I wish I had known more about breastfeeding or had some support network available. I wish someone would have told me earlier that EPing is possible and maybe if hospital staff had lent me a breast pump in the early days. I do feel grateful for the internet and all the information available, without it my daughter would probably have been formula fed from about six weeks. It is such a shame that women and babies are let down by midwives, doctors and health visitors throughout the county every day, and that they believe their so-called ‘professional advice’ – which is often damaging for breastfeeding. My experience made me question everything I hear from health care professionals. I have to check everything out for myself now. And in that way – the whole experience has made me stronger and a better person.

I am currently pregnant with my second baby, and this time I will do my best to succeed, I will not let that happen to me again.

Thanks for reading,

Olga

Olga wished to add the following to her story:

'I think it's important in a way [that this challenges the myth that] 'you cannot EP long term or your milk will dry up'. EPing though done in UK, is not very popular for some reason.  On the other hand, in USA with their short maternity leave, lots of mums choose to EP from birth, try to create insane oversupply from the begining for when the baby goes to nursery. [The] cost of professional grade or rental breast pump is prohibitive for some mums in UK (though insurance might cover it in USA) and to be honest - it's difficult to suceed with not-so-perfect pump.


EPing is very difficult emotionally.  You just 'don't fit' anywhere.  You're not a formula feeding mum (though people always assume it's formula in the bottle) and EPing makes lots of FF mums guilty (that's a difficult one - especially ex-breastfeeding mums who switched to formula find it difficult).  You cannot go to get help from breastfeeding groups as they just don't have a clue about EPing know-how. I found that successful breastfeeders couldn't understand how was it possible that my DD didn't latch on, no matter how hard I tried.  And yes - maybe I should have persevered harder to try BF 'from the tap', but the amount of stress that it caused Freya (and I mean it - she started to scream as soon as she seen the breast) and me, after I already knew that EPing is a viable option - was just not worth it.  EPing isolates you in a major way, especially in early days when pumping schedule is tight, every 2-3 hours.  You cannot go out at all, you have to pump around the clock night and day.  I know breastfeeding in public can be challenging, but EPing in public is just not possible.  It does get easier when you can reduce the amount of pumps, but still you have to take your pump with you everywhere.
And the last one - you get asked FORVEVER the same question - 'why just not switch to fomula, it would be so much easier?'.  Even so-called 'well meaning' family members will ask you this question.  I know that I would never been able to do it without my supportive husband.  He wasn't BF himself and no women in his family did before, but after I told him WHY it's so important for me - he never questioned my decision and helped throughout the way.'

Please note: all editing, bolds and italics, is mine (ed)