Risk Assessment.

Since the arrival of online mother-to-mother breastmilk sharing resources such as HM4HB (Human Milk for Human Babies), Eats on Feets, and Milk Share, a debate has been taking place amongst some breastfeeding advocates about it's safety.  When the debate raises it's head on DBM I get very nervous....  Emotions run high and people are very passionate about this topic - this makes it something of a minefield. 

However, it's an important issue and one we need to address.  Whilst I personally believe mother to mother milk sharing to be a wonderful thing, I also think it's important that we're realistic about the possibility of risk it carries with it. 

Risk is part of life.  We can't escape it - we can only manage it.  We all make 'safety-related' decisions every day.  Those decisions affect the health of our children. We choose their car-seat and the car they will travel in, as well as who will drive them.  We decide how, when, and if we should medicate them when they're sick. We make decisions about vaccinations, vitamins, what kind of foods we give them to eat and what kind of drinks we give them to drink.  Some of us make decisions about who will look after our children for us.  We can only really ever guess (to some degree) how safe our decisions are. We make our decisions based on our knowledge, our experience, and often simply on our 'gut' feelings.

Formula feeding is high on the 'risk scale' - no doubt about it.  Human breastmilk from another mother is listed as preferable to formula milk (by a considerable margin) by the World Health Organisation.  However, many people still have concerns about sharing breast milk outside of a milk bank.

Some people worry that healthy donors should be donating to milk banks in order to support the weakest and sickest babies.  They are concerned that the milk banks will suffer.  I think this is a reasonable thing to be concerned about, although I think It's also important to recognise that not everyone can donate to a milk bank.  Many healthy women are unable to donate to milk banks.  Perhaps because (as was my personal experience) they take medication, and whilst it's perfectly safe for them to feed their own baby they are necessarily not eligible to donate to the milk bank.  Perhaps their breastmilk is considered too 'old' to be given to very young/ ill babies.  Most milk banks only accept donations from women beginning when their baby is under 6 months old as this milk is more suitable for premature babies.  Should healthy babies be denied the benefits of these mother's spare milk just because they're not suitable donors for the milk banks?

Everyone, it seems, has an opinion.  For some people, the assurance that a woman is breastfeeding her own baby is proof enough that her milk is 'safe' to be shared.  Others are only satisfied if  they know the donor and their lifestyle personally, and they're uncomfortable with the idea of contacting a 'stranger' online for the purposes of sharing milk.  Some women will happily nurse each other's babies, and some other mothers who are strong believers in breastfeeding find the same notion unsettling.  Some people would simply rather give their child formula milk than milk from another woman, whatever the medical assurrances.

I think I would fall into a different category again.  I've already given my daughter another woman's milk - and I didn't think twice about it.  I will be eternally grateful to the stranger who made it possible for my daughter to avoid having any more formula in hospital.  However - that woman had donated through the milk bank.  She'd been tested and vetted by them, and I had confidence that the milk was safe.  If it had been a stranger from a website I'm not sure I'd have been as confident. 

If I were in the position of needing to feed my child milk other than my own again I'm sure I would want them to have human milk.  Without a doubt.  Milk banks don't usually have a surfit of milk available to healthy babies though, and I'd still prefer my child to have human milk.  So that milk would necessarily have to come from a mother 'outside the system'.  Would I be happy to give milk from an unscreened mother, though?  I'm not so sure about that.  You see, I'm fairly sure I'd want to have the donor screened (unless the donor was a close friend or my sister - so that's where my 'lines' are!). 

When I've asked about how one goes about getting screening most people seem to say it's not really necessary.  If the potential donor has given birth in the UK then they will have already been screened for most things as part of their maternity care. 

That's a great baseline - but what if your donor has been breastfeeding her own infant for (example) a year?  It will therefore have been well over a year since her blood was screened.  I'd be lying if I said I wouldn't be wondering at the back of my mind if things MIGHT have changed for her during that time.  How do you - or she for that matter - know that (for example) her husband/ partner has been faithful to her during that time?  What about the other infections which weren't tested for in pregnancy? 

Despite all of our good intentions, things happen in life.  We encounter risk.  We encounter it every day of our lives.  All we can do is do our best to manage that risk.

As a mum, I would want to reduce all possible risk factors.  If I were lucky enough to have someone offer to express their breast milk for my child on a regular basis, I would - after biting their hand off - ask them to go through some screening.  And if the screening wasn't free, I would pay for it myself.  I am sure any potential donor wouldn't mind at all.  I should imagine I'm not the only mother who would feel this way.  

But the problem is, I don't think it's as easy as just popping into the doctors and asking nicely - perhaps it depends on your doctor, but for me I know it wouldn't be that easy ;)

Doctors should of course - by rights - be helping us all to make sure as many human babies as possible get human milk because it's best for their long term health and development.  But they're not.  Why they're not, is a whole other debate.

Recognising that the NHS is unlikely to prioritise screening for mother-to-mother milk sharing, I tried to find out a little bit about how one would go about getting the tests done privately.

First of all I called UKAMB for their advice about what blood screening their donors go through, and they were very helpful indeed.  They told me that they screen for HIV 1 and 2, Hepatitis B and C, HTLV l and ll and syphilis.  They also recommended I share with you all the most recent NICE guidelines for mothers who want to donate milk to a milk bank.  This leaflet covers some of the questions which should be asked of any mother wishing to donate her milk - whether to a milk bank or to another mum.

This link will take you to the page where the most recent NICE guidelines for the milk banks themselves are located.   UKAMB recommended to me today that any mother who engages in informal breastmilk sharing take steps to flash pasteurise their milk.  The milk banks use a system of heat-treating their stores which is not available to us mums - however flash pasteurising is a helpful safety measure to put in place.

The lady I spoke to at UKAMB said she recognised that their 'bar' concerning the safety of donor milk from the milk bank is set very high.  Hopefully most people will understand that sick babies need to have potential risks managed even more than healthy ones.  Even traces of medications in a mother's milk which are harmless to a healthy baby can be a potential threat to a sick one.  Because it's a charity, and funds are sadly limited, making their donor milk as acceptable as possible for the sickest babies is what UKAMB needs to focus it's resources on. 

I feel it's vital that we encourage any mother who is considering donating her milk to approach her local milk bank first.  You can locate your nearest one here.  If more mums donated to our milk banks, we could be sure that fewer of our sickest babies were being fed formula - and fewer of them would become ill and die of NEC.  As a mum whose child was given formula in SCBU and went on to (only) develop a dairy allergy this is something I feel strongly about. 

There is also important information on the NICE document about the best ways to collect and store breastmilk.  I know most people who would even be considering breastmilk sharing are already experts at all of this (by the way), but it's good to know where the information is in case you ever need it!  

So - if a mother wants to ensure her donor has gone through a similar 'vetting process' to the one used by the milk banks she would need to do the following:

• ensure that the donating mum is tested for - and clear of - HIV 1 and 2, Hepatitis B and C, HTLV l and ll and syphilis.  
• ensure that the donating mother does not currently smoke or use nicotine replacement therapy (NRT)
• ensure that the donating mother does not regularly exceed recommended alcohol levels for breastfeeding mothers (1 to 2 units, once or twice a week).
• ensure that the donating mother has not used, and is not currently using recreational drugs (the answers to these questions are, ultimately, a question of trust for us AND the milk banks).
• ensure that the donating mother is not at an increased risk of Creutzfeldt–Jakob disease (CJD) (see www.hpa.org.uk for information on the risk of CJD).

You can check the safety (during breastfeeding) of any medications by calling the Breastfeeding Network's 'Drugs in Breastmilk' helpline on 0844 412 4665. 

It's important to recognise that just because someone can't donate to the milk bank, it doesn't mean they can't share milk.  Many medications are completely safe to use whilst breastfeeding a healthy baby, just not an ill or pre-term one.  Mothers who donate to the milk banks are sometimes asked to discontinue their donations for a time whilst taking some medications.  They are usually still able to feed their own babies.

Despite donor screening being discussed as a consideration, I found it hard to locate information online about how to go about getting screening done and how much it costs.  Assuming the donor's NHS doctor won't do the blood tests (and we all know how hard it can be these days to get a GP to do any non-essential investigations) where else can you go?

Since DBM is based in the UK, I contacted the UK's largest provider of private healthcare - BUPA to ask about screening.  They were about as much use as a chocolate teapot...  Although they have many and varied 'screening packages' available, ranging from sexual health screening to 'well wo/man' screening they have no package which covers screening of a potential breast milk donor.  That's as much information as I was able to get out of them - and I was directed to call three different departments before I was given the number which ended in a recorded message...

After looking at a few more websites I came acress www.medichecks.com .  I rang them up and they were a totally different story - very knowledgable and helpful.  They charge 'full price' for the most expensive test and then a reduced rate for further tests.  By my reckoning the necessary tests would cost £489.35 in total with this private company. 

However, I spoke to a member of their team, and they are now going to offer the complete package of tests for a discounted £199.  It's something there's (potentially) a real need for - and it would allay fears for a lot of people. 

It's still a lot of money though, and I recognise that some people might think that I'm flying in the face of the whole breastmilk-sharing concept to mention £££ at all ..  After all, not everyone will be able to afford that sort of money in one go, if at all.  I'm aware that some people may receive milk from more than one donor too, and this would put up the costs again.  With such a depressing economic climate it's certainly a potential problem.   However, when you take into consideration the many problems associated with formula feeding and that it also costs something in the region of £480 to formula feed a baby for a year, £199 is a financial sacrifice some families may feel they want to make.

Formula fed babies develop differently to breastfed infants.  They are more likely to encounter health problems.  Formula feeding should be the last-resort option when breastfeeding isn't possible, and yet somehow it has become the default.

A formula feeding mother can diligently and lovingly make up each and every bottle of formula with water at 70 degrees and a newly sterilised bottle.  Her child is at an increased risk of many things despite her precautions.  A mother who wishes to give her child breastmilk can take all the precautions possible and it she still won't eliminate risk entirely.  Heck, I don't even know if I have hepatitis C (it's not one of the ones they test you for in pregnancy here), but I've breastfed for over two years now and I'm pregnant again.  Since a quarter of people here in NI don't know they've got the disease, some people might consider me irresponsible.  I'd have to disagree.  The risk is negligible.  I  believe I expose my family to much bigger risks every day.     

The decision about how much risk you expose your baby to if you're unable to breastfeed them yourself  - formula made up in advance, formula made up as needed, pre-made formula, donated milk, screened donated milk, screened and flash pasteurised donated milk - is a question of where your personal comfort-zones lie, and how you perceive the risks involved. 

We don't all have the same tolerance for risk.  

My response to Christopher Martyn's 'Observations'

For anyone who may have missed it, the Associate Editor of the British Medical Journal, Christopher Martyn published an 'observation' piece yesterday (bizarrely titled 'lactation wars') seemingly as an attempt to underplay the BMJ's role in generating innaccurate press reportage of the opinion piece. 

Here's a link to most of the article for anyone who isn't a subscriber ;)

In a piece which served only to display his personal arrogance and prejudices he singularly failed to respond to the concerns of UNICEF UK, the World Health Organisation, the LLLI, the Royal College of Midwives, the Food Standards Agency, Baby Milk Action, and a long list of eminient health professionals (those he might be persuaded to consider 'peers') who wrote to express their objections to the publication's contents and the press interpretation of it.  

Instead he chose the well-worn path of trying to blame breastfeeding advocates for making something out of nothing.

“A common mistake when trying to reach a provisional and nuanced conclusion is to underestimate the ability of readers to find an unintended meaning.”

Come, come now Mr Martyn.  I know you got as far as paragraph two (because you quoted it), but did you bother to read the rest of my piece?  From the outset it explains that it's not a reaction to the BMJ publication, but rather to the sensationalist press reaction which followed it. 

You accuse us blogging simpletons of missing the point  - but I suggest you missed the point of our reaction to it - spectacularly.

I did not - for example - go as far as to blame the BMJ for the distorted headline in the Sun which you so readily dismissed.  However, thanks to you, I will now.

The BMJ were responsible for facilitating a widespread misunderstanding when they took a perfectly legitimate piece of scholarship (one which was - as described in my piece - not even a new debate) and turned it into a press release with this (emboldened) title:

'Is 'breast only' for first 6 months best?'

Any Press Officer worth their salt would have realised exactly how the British Press were likely to react to a Press Release with this title, and therefore the blame for any misunderstandings rests squarely with the British Medical Journal.  The folks at the Sun only had to remove a few words, and they had their headline.

If the BMJ don't want plebs (like us simpletons) to read their publications, then why on earth would they issue a press release the day prior to publication to the dailies drawing their attention to it?  A cynic might suggest they wanted this press reaction - we already know that the publication makes a substantial amount of money from advertising formula to doctors, and of course, none from breastfeeding.

A shocking allegation of course - perhaps it's not even true - but if the BMJ wants to convince anyone they're impartial they're going about it in a rather strange way.

Surely it's the likes of the Sun newspaper Mr Martyn needs to be criticising for their 'misunderstanding'?  

Has he written to THEM?  Of course not.  He's probably dining in the same club as the editor.

But how is it that we're criticised for being unable to understand the articles, and yet Joe Public (to whom us eejits are married) is credited with enough intelligence to look beyond the front page headline and remember instead the 'faithful précis of the original article' beneath? 

Because now I AM confused.  Are we stupid or not Mr Martyn?

Well, Mr Martyn might think we're 'complete fools' but I'm not stupid enough to believe that he doesn't have an agenda of his own.

I know Christopher Martyn does consultancy work and research for Abbott Laboratories - the company behind Similac, Pedialyte amongst other formula milks sold in the US as well as many other brands worldwide.  On their UK website they state their aim of becoming 'the UK's premier health care company' - and they produce formula milks specifically for the medical market here in the UK.  I should imagine they never advertise in the BMJ either.

Totally unbiased then. 

But I guess I can understand why Mr Martyn might not realise the impact the BMJ opinion piece and it's subsequent press coverage has had.  After all, how much do you think Mr Martyn knows about breastfeeding?  How many mothers do you think he has helped to breastfeed their babies?  Given his struggle with 'overexplicit' imagery, I would imagine not many.  Therefore he cannot possibly appreciate the reality of mothers who are being advised by their Health Visitors to give their babies solids at a few months old because the 'guidelines have changed'.

Sitting in his study, Mr Martyn might well imagine that Health Professionals will have been able to distinguish between the press headlines and the actual content of the opinion piece...  

The sad thing is it just shows how very out of touch he, and the BMJ truely are.

You could be forgiven for thinking that Mr Martyn's condescending article was written in the 1970's, so patronising is it's tone.  It feels very much like the intention was to belittle all the silly women who dared to comment on things they didn't understand in the hope that they'd have the sense to shut up. 

But this is the C21st - and modern, educated women don't take kindly to such a tone from anyone.    If Mr Martyn thinks 'planet blog' is irrelevant, then both he and the BMJ are very much mistaken.  We're the ones who help the mums the doctors let down - and hence help to protect their health and the health of their babies.  Compare his attitude to that of the US Surgeon General Dr. Regina Benjamin, who invited breastfeeding bloggers and mother supporters BestforBabes to her 'Call to Action' on Breastfeeding just last month.  She clearly doesn't believe planet blog is irrelevant and understands it's ability to play a part in public health, even if Mr Martyn does not.

Even though Christopher Martyn doesn't agree with it, the plebs of this world do still have a right to reply, and a right to disagee, and a right to criticise.  

I'm delighted Mr Martyn chose to respond to us - though I rather think a response to the many critcisms levelled at the BMJ from amongst it's valued 'peers' would have been more appropriate.  

Or perhaps he doesn't have the guts to accuse them of getting the 'wrong end of the stick' too?

There is one thing Mr Martyn and I do agree on, however.

I am a 'fundamentalist'.  I believe breastfeeding is fundamental to good health.

Facing IVF and don't want to wean your baby?

I don't often write about my personal 'stuff' because this blog isn't about me - however - sometimes when you learn something important, you want to share it, and this is one of those times.

In life it's rare to learn anything when things are going well - the real lessons generally come out of hardship - and this is no different.  Some of you will have seen that I'm pregnant with our second child.  It probably didn't occur to anyone when I announced it that we'd had a struggle for this baby, but in total we probably tried for 20 months.  Perhaps a bit longer than anyone would like, but no big deal in the grand scheme of things you might be thinking. 

The first six months were pretty relaxed.  Then I started temping and charting.  Everything looked perfect - only a matter of time then...  However another six months later - still nothing.  We decided to have some tests done.  The results weren't good.  Following a lifestyle revamp and more tests, things still weren't any better.  Our doctor referred us to the regional fertility clinic, and we also had a (free) private consultation. 

We were told in August 2010 that we'd need ICSI to have our second child.  For reasons nobody seemed particularly interested in, things seemed to have changed in our fertility as a couple (our first child was conceived naturally and in a normal length of time) and the specialists we saw, both privately and NHS, felt that there was little that could be done to help us improve it.  Again, it happens. 

However, as I know some of you will understand, once you've committed yourself to breastfeeding an existing child to 'full term' and are told you will need IVF it means you have to choose between feeding the child you have, and trying for the child you want to have.  You aren't 'allowed' to breastfeed and go through IVF. 

For me, at that time, I felt like I'd be breaking a promise to my daughter and basically going against everything I believed in about bringing up a little person securely.  I did not want to wean her and I did not want to put myself through the undoubted trauma of IVF.  It was a really hard time.

Some friends of my sister had had two rounds of IVF (for similar reasons to our own) and neither had been successful.  After that they had chosen to go down a different route, and it was at this point in time we decided we should follow suit.  The route they chose (and which gave them both their first child and a subsequent child) was NaPro.  Natural Procreative Technology.  Sounds a bit naff doesn't it?  However, since this other couple had been so successful, the treatment is much cheaper than IVF and because it takes a much more holistic approach to fertility we decided it was definitely worth a shot. 

NaPro believe that male factor sub-fertility (which is what we were suffering from) is treatable and not 'static' in the way the IVF specialists had led us to believe.  We were told by the IVF doctors that even taking into consideration lifestyle changes, we could only expect to see a tiny percentage improvement.  I already know (thanks to NaPro) that this isn't true.  Their understanding of women's health conditions - is also incredible.  Their approach to treating infertility brings together a wide range of disciplines including the herbal/ frontier-pushing medical/ nutritional/ and the psychological - they think 'outside the box'. 

I met with my 'teacher' in late August.  NaPro give you a teacher to show you how to observe yourself and your body to look for clues about what's going on.  You meet with them monthly.  There is no temping, but the observations are detailled and carefully recorded.  You 'baby-dance' (my words - not theirs!) on the days where you see fertile mucus - and their system makes it easy to recognise this.  You don't go by opks, or temping.  (If I had, I would not be pregnant now since my 'peak fertile' day - ovulation - was a full three days after a positive opk).

After a few months of charting their way, it became pretty obvious what was going on with me.  No symptom - emotional or physical was overlooked - and my teacher guided me emotionally and practically through the system.  We learned that taking Co-Enzyme Q10 (200mg) daily can have a dramatic effect on a man's swimmers.  Whilst the IVF clinics look for 'perfect' sperm (those they term 'normal') for IVF, NaPro are more concerned with how well the swimmers SWIM - letting mother nature decide which sperm is perfect since there is no evidence to suggest that 'abnormal-looking' sperm make abnormal babies.  The most important thing is that they get there!  My dh started taking his Ubiquinol Co-Enzyme Q10 and I started charting.

It looked like I was ovulating regularly, but there were some indications from the chart that my progesterone levels were a bit iffy.  How could they tell?  Here's the TMI bit:  I had a little tail-end brown bleeding, an abundance of cervical mucus (you thought that was a good thing I know - but only when it's at the right times!), chronic PMT (we're talking years of misery people..), and my monthly blood tests for oestradiol and progesterone showed that my levels (whilst completely acceptable and normal to the NHS at 28-30) were half (HALF!) what is considered optimal for sustaining a pregnancy (60-100). 

This really shocked me - after all - here we'd been thinking that the 'problem' wasn't me ;) 

I was surprised to learn that 'normal' doesn't mean 'good'.  Normal as far as the NHS is concerned is 2 miscarriages - 3 and then they will start investigating.  NaPro aim to help couples avoid the heartbreak of miscarriage, and this is why their criteria for optimal progesterone are at least double. 

After three months of charting we got a cancellation to see our (frankly utterly incredible) consultant in Dublin.  I am already married, but I tell ya, what a guy.... 

My NaPro chart - showing two cycles, the second of which ended in my pregnancy.

We drove down to Dublin in the middle of the 'big freeze' to meet with our consultant Dr Phil Boyle.  He was so on the ball it was amazing.  He told us that what NaPro wanted to do was 'get us both in good shape' emotionally and physically, and then the baby would come.  Kind of makes sense don't you think?

He explained to me, very kindly, that my years of chronic PMT were in all likelihood down to sub-optimal progesterone levels.  Those same levels may have meant that even had I conceived in the past (nearly two years) there was a reasonable chance it might not have 'stuck'.  I fell in love with him a little when he made a comment about the Irish Dairy Council and the amount of money generated by our over-consumption of dairy products, and he was entirely supportive that I was still breastfeeding.  Nothing more was said about that. 

He talked about how a significant number of doctors are coming to the conclusion that many chronic conditions (including infertility) are linked to low-endorphin levels within the body.  These 'endorphin deficiency states' impact on the body's immune system, creating an imbalance which opens the door to all sorts of conditions.  Early findings show that treating the endorphin deficiency state with a drug called 'Low Dose Naltrexone' (another good link is here), can have a dramatic impact on a wide range of health problems, including some infertility conditions such as endometriosis and PCOD.  You can hear Dr Boyle discussing Low Dose Naltrexone here.

We discussed my husband's situation, and for the first time someone listened to HIM.  He'd been having pains 'down below' for some time, and his tests had shown abnormal cells present.  These were sent for analysis twice but because no culture was grown the doctors had told him he did not have any sort of infection.  This is despite him presenting himself at the emergency room on one occasion because he was in so much pain.  We also paid for a private consultation with a urologist who also told us there was nothing wrong.  Dr Boyle explained that bacterial cultures of this type are notoriously difficult to grow.  Just because you get a clean test result does not mean you don't have a low grade infection.  Low grade infections of the prostate and surrounding area are a cause of male sub-fertility.  It's a cause the IVF docs don't really seem to acknowledge yet - at least not in our experience.  My husband had every symptom in the book, he just didn't have the 'test result' to prove it.

However, since this doctor was listening and making a diagnosis based on symptoms and a belief that his patients weren't idiots, my husband was given a 4 week supply of a simple antibiotic to treat a low grade sub-clinical infection.  His most recent test results were promising too - whilst the abnormal forms were still extremely high, the motility (the number SWIMMING!) had gone from a poor 39% to an average 51%.  This was all down to the Co-Enzyme Q10.  I can say that confidently because the poor man had been off the booze for months with no such improvement...  We were told that if the antibiotics didn't solve the problem there was a lot more they could do to help, but they were simply taking it stage by stage.  As I said, NaPro don't treat sub-fertility as static...  

Dr Boyle told us that between my DH taking the antibiotics and myself getting some support for the progesterone phase of my cycle he 'fancied our chances'.  We left the clinic, went to Eddie Rockets for lunch (my guilty pleasure!) and headed home feeling good.

Two days later I got a positive pregnancy test.

Now, I'm not saying that simply being in the same room as the NaPro doc was enough to get me pregnant (although it's a good story!) - but it seems that by charting their way, basing our baby-making on my natural fertility cues, and by taking a few initial steps to help my dh's boyos get to where they needed to be in greater numbers, we (who were told we'd need ICSI only 4 months before) managed to get pregnant ourselves.

I have absolutely no doubt at all that we managed it with plenty of room for improvement too! 

After this baby is born (all being well) I'll go back to the NaPro doc and I'm pretty sure they will put me on progesterone during the second half of my cycle or perhaps Naltrexone the whole time.  I have no doubt that they will help my PMT.  NaPro supported us as a couple, and they are seeing to it that this baby gets all the help it can in the form of continued progesterone support to my pregnancy.  When they scanned me at just over 7 weeks, and we found that - to the day - my baby's size tallied with the peak day on my chart.  Proof positive that observing your mucus and not just following an opk is the way to go.

Just a word about where NaPro originates.  It's really a 'Catholic' thing.  That's not to say that you need to be a Catholic to be treated - you don't and we aren't.  But you do need to be married if you want to use the system to conceive.  If you just want to monitor and improve your health, then it doesn't matter if you're married or not.  I know some people will find this hard to stomach, but all I can say is no-one else is funding this research, and if the Catholic Church are willing to fund it then I'm willing to use what they are learning! 

There is one other thing I want to say though. Compared to IVF NaPro is relatively new. However, the statistics are showing that the success rate for this type of treatment can be higher than for IVF .  Between 1.5x and 3x higher.  The side-effects are, obviously, considerably reduced as the treatment is much less invasive for the woman.  The cost is also a LOT smaller (we spent in total around £500 and had we continued with monthly treatment the cost would have been about £80 per month).  Compare that with the cost of IVF.  It can be really helpful for couples who have endured repeated miscarriages and also offers an alternative treatment for post-partum depression.  The system can also be used to avoid pregnancy. 

What's all this got to do with breastfeeding though?  Well - for any women out there who are in the same position as we were, I should imagine it's got a lot to do with it.  Some mums do carry on breastfeeding through IVF choosing that the benefits of breastfeeding outweigh the risk to their little ones of the drugs.  Some mums choose to wean in order to try to give their child a sibling.  For the record, I am not making a single judgement on either type of mother.  I support entirely any person who goes through IVF - infertility is SO tough. We never ruled it out entirely for us, we just chose to take another path.  I chose not to wean my daughter and decided against IVF at that point in time.  Not wishing to wean her was a big part of that decision.  I am glad my daughter continues to breastfeed - less now, but still from time to time :) and I feel extremely blessed that we were able to get around our problem without weaning before full-term.

I want to share this information with breastfeeding mums out there (and anyone else experiencing infertility) because it is a real alternative to IVF and therefore to weaning your child.  You might not talk about your fertility problem (and no-one talks about it do they?), but I'm pretty sure you're out there ;)  and I really, really hope this information helps some of you.  Not only can this treatment help you to make another baby, but for sure it will also make you healthier. 

Before anyone asks, no - I'm not on commission.  My bonus is due at the end of the summer.

xo

PS ~ You can read one woman's story of her treatment with NaPro here and if you want to learn more, I can assure you all you have to do is google NaPro. There are clinics in the UK, Ireland, throughout Europe, in the US and in Canada.  NaPro is not suitable for women who have a confirmed menopause or who have completely blocked fallopian tubes, or for men with no living sperm.