Housekeeping!

Dear All,

I need to let you know that at some point tomorrow, for just over two weeks, I'm going 'off duty'... We're taking some time out to enjoy our remaining time as a family of three.  My daughter is going to build sandcastles, ("not small sandcastles, BIG sandcastles!"), and my fat tummy and I are going to sit nearby and admire them.  I may even read a book or two...

I started this blog and the related Facebook group just about a year ago now, at the start of July 2011 (the exact date escapes me!).  I never imagined that just a year later tens of thousands of people would have visited this blog, shared posts, or that there'd be over 4,000 members in the Facebook community.  It has been incredible to see how the group has grown, to hear from people who say they've been supported to breastfeed by it - (makes me quite emotional to think about that!) - and to watch as small (but significant) changes take place in the real world as a result of our combined myth-busting efforts!

Since I'm going to be 'out of circulation' for a little while, I've taken the decision to shut the group's wall to posts until I get back.  I'm sorry to do this, but it's just not fair in my opinion to ask one person (Julie) to run everything single-handedly. 

This means that (sadly!) you won't be able to post questions to the group until the wall is re-opened. I'm acutely aware that the ability to post questions on the wall is a very important part of what goes on here at DBM, but I think the facility can only be offered when enough admins are available.

Bear with me though - I have another lovely competition in the pipeline for when I return ;)

In the meantime, here's a reminder of some alternative sources of breastfeeding information and support:

Facebook: Breastfeeding related groups & pages:

The Association of Breastfeeding Mothers (on Facebook)

The Breastfeeding Network (on Facebook)

The Analytical Armadillo

Lactivist

The Funny-Shaped Woman 

The Leaky Boob

Kellymom (on Facebook)


Breastfeeding support - UK

Association of Breastfeeding Mothers (ABM):

'Ring our counselling helpline on 08444 122 949 to speak to one of our fully trained Breastfeeding Counsellors for breastfeeding support and information.'

La Leche League of Great Britain (LLLGB):  'Breastfeeding questions or difficulties? No problem! You can contact a La Leche League Leader via our telephone helpline and get the information and support that can make all the difference. ' 0845 120 2918

National Breastfeeding Helpline:  'This service will work alongside services provided by the NHS, in the same way as we work alongside the NHS in Primary Care Trusts and hospitals.' 0300 100 0212

Breastfeeding Network Supporterline: 0300 100 0210

National Childbirth Trust (NCT): Breastfeeding helpline: 0300 330 0771



UNITED STATES:

If you're in the US, you can find information about your local La Leche League chapter by searching here:  http://www.llli.org/webus.html  'If you are unable to find a Group or Leader near you, 24-hour breastfeeding help is available toll-free in the US from the LLL Breastfeeding Helpline-US at 877-4-LALECHE (877-452-5324).'

http://www.womenshealth.gov/breastfeeding/finding-support-and-information/national-breastfeeding-helpline.cfm 1-800-994-9662

　

OTHER COUNTRIES:

Use this link to search for LLL information for your country



　

***REMEMBER - NEVER BE SCARED TO ASK FOR HELP!  
THERE IS NO SUCH THING AS A STUPID QUESTION!***

*PLEASE NOTE - the various resources listed here are for your information only, and their inclusion should not be interpreted as endorsement.

　

The Guardian, The Press Complaints Commission, and WHY I GAVE UP....

I thought I'd better put something on the blog about the recent 'clarification' from the Guardian regards this piece which they published in April entitled:

'Doctor Doctor I plan to mix feed my baby,
will she get all the immune system benefits if I do?'

** BTW - I understand totally if you don't feel particularly inclined to read the minutiae of the  incredibly tedious complaint process, so please feel free to skip most of this post!   However, I'd love it if you'd cast your eye to the section in red at the bottom, because I need your help!**

My complaint (which was made via the PCC website and further clarified in two emails)  centered around the advice given in response to a question about breastfeeding from a mum who had a 4 week old baby and an older child.  In a very brief reply, the doctor managed to state a surprising number of 'breastfeeding myths' as fact.  I don't know how many other people also complained about the piece or took part in similar correspondence to what follows below (please let me know if you did!).  My original complaint took issue with the following statements:

1/ 'Immune benefits cross over in the first few weeks' (those with a sharp eye will note that in the online version the word 'significant' has now been added to the online version, however, it was missing from the original, more on that later).  It is well-known that breastfeeding gives  a child's immature immune system substantial support for as long as breastfeeding continues.

2/ 'you have done enough on that basis already'.  I felt that this sentence implied that there was no point in continuing to breastfeed since she had already breastfed for 4 weeks.

3/ 'have you thought about expressing breast milk [...]? This will save time'.  As most breastfeeding mums will attest, a baby who is breastfeeding well will drain the breast far more efficiently than any breast pump.

So - to cut a very long story slightly shorter, there were several to-ings and fro-ings via the PCC about my complaint.  I responded to points made by the Guardian and they responded to one or two of mine (but by no means all..).  The Guardian stated that the mother who had received the advice was very satisfied with it - indeed they published a letter from her saying how happy she was.  They also stated that the doctor had been attempting in his reply to help her to feel 'less guilty' about stopping breastfeeding.

In their response to my original complaint The Guardian quoted the WHO and LLLI in regards to colostrum, including the following phrase:

'The colostrum gradually changes to mature milk during the first two weeks after birth. During this transition, the concentrations of the antibodies in your milk decrease, but your milk volume greatly increases. The disease-fighting properties of human milk do not disappear with the colostrum. In fact, as long as your baby receives your milk, he will receive immunological protection against many different viruses and bacteria'

(I suspect that it was on the basis of the above quote (which backs up part of my complaint...) that they elected to change the wording of the article to include the word 'significant') 

'in the interests of resolving this complaint, we would be happy to amend Dr Smith’s article by prefacing the first sentence with the word “significant”, so it reads: “Significant immune benefits cross over. . .”. Otherwise we do not regard this part of his response as regarding remedy.'

Problem is, I think that even with the inclusion of the word 'significant' before this sentence, the implication of the sentence remains that most of the 'job is done' by the colostrum.  As breastfeeding mums who have nursed their children through illness (never mind the science!) can attest, this is total rubbish.  Therefore the answer to the question 'will she get all the immune system benefits if I do?', is actually/ factually 'no'...

The newspaper explained that the doctor responding had sought opinions from a colleague and a midwife about his intended response, and both had agreed that it was appropriate.  This actually worries me even more!  Three separate Health Care Professionals apparently felt that his reply was factually accurate despite it being hugely misleading in several areas.  I guess this might not come as a great surprise to many people who have sought assistance with a breastfeeding problem from their GP, or who have been reassurred by a midwife that the baby's 'latch' is fine despite their bleeding nipples...  It really does serve as a reminder that many GP's and even some trusted midwives are NOT breastfeeding experts!  Their training simply doesn't require them to be! 

The newspaper's response continued to address one of the other points I made in my original complaint - concerning the assertion that expressing breastmilk would save the mother time... 

'Dr Smith’s suggestion that expressing milk will save the mother time seems to us to be perfectly reasonable in the context of her letter. The length of time a baby takes to feed varies hugely (anywhere from 10 to 40 minutes per breast perhaps), with Bupa suggesting “as a rough guide, each feed may be 10 to 20 minutes per breast, but every baby is different so it may be longer.”

http://www.bupa.co.uk/individuals/health-information/directory/b/breastfeeding 

The time taken to express will also vary greatly but with an electric pump in can be as quick as 10 minutes per breast. Given that this mum refers to “the long time it takes to breastfeed” her baby (and this is the reason she wants to mix-feed), this is a reasonable suggestion for the doctor to make and we see no reason to correct this point.'

Ah yes, BUPA - those well-known breastfeeding experts.....

As you can imagine, I did respond (in great detail!) to their response.  Here is part of that response:

'The La Leche League (who the Guardian referenced in their response to you) have this to say on the subject of expressing breastmilk:

'Express in a comfortable setting; avoid distractions or interruptions. Take your phone off the hook and ask those around you not to disturb you while expressing. If you're at home with older children, distract them with an activity that doesn't require your full attention'
http://www.llli.org/nb/nbjulaug07p168.html

This being the case, I fail to see how such advice is going to be of assistance to a mother whose primary reason for contacting the doctor was apparently a problem amusing her older child? Perhaps a suggestion to nurse the smaller baby whilst wearing a sling would have been more helpful since it would at least have left the mother's hands free?

QUOTE: 'the doctor suggests expressing in response to the idea that breastfeeds are taking a long time. 'Given that this mum refers to “the long time it takes to breastfeed” her baby (and this is the reason she wants to mix-feed), this is a reasonable suggestion for the doctor to make and we see no reason to correct this point.'

Perhaps the doctor is not aware that extended feeding sessions often occur when milk transfer is poor? The primary suggestion of someone with a good understanding of breastfeeding would be to suggest consulting a breastfeeding professional in order to establish whether there is an underlying problem affecting milk transfer.

 By failing to suggest this I believe the doctor and the Guardian newspaper let both the questioner and readers down and showed a poor understanding of breastfeeding. A baby who is breastfeeding efficiently will usually consume a larger quantity of milk than a pump can extract. To quote an internationally recognised expert in breastfeeding, Dr Jack Newman 'a pump is not as efficient as a well-latched baby and so a baby who breastfeeds well is the best pump'. http://www.drjacknewman.com/help/Expressing%20Milk.asp

There is also the possibility of an undetected medical issue underpinning the poor milk transfer (for example an undiagnosed tongue tie) and the doctor failed to suggest a referral which may have helped to resolve the problem swiftly.

In addition, women who express milk often report a belief that they have a supply problem, when in fact they do not. They frequently get disheartened when they find they cannot fill a bottle quickly.

'if you cannot pump a lot, this does not mean your milk production is low. Do not pump to find out how much you are producing. This is an inefficient way to judge milk supply and often results in emptier breasts for baby to feed.' http://www.drjacknewman.com/help/Expressing%20Milk.asp

Many people just don't 'get on' with expressing. If this mother were to find she was unable to express much milk (which is often the case even for women with an excellent milk supply), her confidence could be further diminished and breastfeeding would be even more likely to cease. For this reason I feel the doctor would have been kinder to make a referral to a breastfeeding expert in order to avoid reducing this mother's confidence further. 

I appreciate that the mother concerned wrote to the doctor thanking him for his advice. However, it is possible that an even better outcome for this individual and her baby might have been acheived, and certainly I still feel that the newspaper printed some very misleading information about breastfeeding to it's wider readership with this response.'

My next contact from the PCC made it clear that the Guardian wished to address none of these other points - points which I still feel are entirely valid.  The Guardian clearly felt that their offer to include the word 'significant' should be enough to make the 'crazy breastfeeding woman' disappear... ;)  The PCC's next email to me also suggested that the PCC was not going to push them to clarify these points.   I'm afraid once it became apparent that my other points were going to be ignored (unless I went to the committee) I told the PCC that I would resolve the matter there.  Yup, I rolled over.  I gave up.

My reason?  I simply don't believe the PCC take their responsibilities regards the health issues connected to infant feeding, seriously.  I don't believe some doctors do either.  I don't think my complaint would have been taken seriously by the PCC committee under the current guidelines.   The PCC ARE going to put something on their website about this correction/ clarification.  Wording to be decided.  However nothing will really change that much I'm sure about, but at least it's something.

I also gave up because I'm also a mum with a 2 year old to take care of and a sizeable bump.  It takes time and energy to chase complaints in this way.  The folks at the Guardian and the PCC get paid to spend time dealing with these things, I don't.  You can prossibly begin to see how much effort went into making a complaint about what was a very short piece - not even 'headline news'.  Now imagine trying to counter every piece of misinformation churned out and printed every day through the current system... 

Remember this?   I didn't even attempt to address the amount of guff which was printed by the press in the light of the BMJ 'review' in January - perhaps now you can understand why. 

Until the PCC agree to change their editorial guidelines to offer protection against misinformation such as this I believe efforts such as mine are simply drops in the ocean.  Frankly a bit pointless!  I feel fobbed-off, and despite getting a small change made I pretty much was fobbed off....  It's ok, I can take it ;)

Here's what we've ended up with:

OK - so it's better, (and apparently this sort of correction is something of a 'first'...)  However, it's still going to make - pardon me - sod all difference at the end of the day! 

Now, I'm not saying you shouldn't make the effort to complain (far from it - I'd love it if the PCC and OFCOM were getting a letter a day about inaccurate breastfeeding information!), but I do think we need to start changing the way we campaign about this issue.

From one of the emails I sent to the PCC during our discourse:

'I wonder if you might consider that this is not an isolated situation, poor breastfeeding advice and information is very common in the press. Were it to be poor advice about another health-related issue I believe the press would take greater care with their standards of accuracy.'

From this post:

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

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. [...] 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'

I want to make something crystal clear.  I didn't complain to the PCC because a mum didn't want to keep on breastfeeding her baby and I 'disapproved'!  My only desire is that mums be allowed to make properly informed decisions.  Properly supported decisions based on a breadth of sound information.  Even though this doctor was giving personalised advice to one individual, that advice was being read by thousands of others - and I believe that he should have borne this in mind when responding. 

It is not fair to assume that judging the quality of information in circulation is the same as judging other mums for the decisions they make.  Totally not the case.  Mums are all doing their best - I'm just not convinced that society currently does it's best to support them. 

I am, however, absolutely certain that mums who do try to breastfeed are swimming against the 'social tide', and I think it's high time that the press and some medics stopped making it harder!


I don't know exactly the means by which we can campaign for 'special consideration' for breastfeeding in the press and on tv - however I have asked the PCC for their advice on this.  I will let you know what they say.  I have also drawn their attention to OUR PETITION, which currently stands at just over 1,200 signatures.  It needs more!

In the meantime I do have a request:

If you have had negative experiences in public whilst breastfeeding, or if (perhaps as a result of misinformation in the press or from a medic) you have come under pressure to wean off the breast, I'd like to hear from you.  If you feel you have been marginalised or discriminated against because of breastfeeding I'd like to hear from you.  If you have experienced prejudice (perhaps at work) because of your decision to breastfeed, I'd like to hear from you. 

I'd like you to put a few words together (short is fine!) detailing your experience and send it to bcboobies@hotmail.co.uk


I won't be able to reply to you all (I know that for sure!) and I have no idea when or how these testimonies will come in useful, but I have a feeling that we are going to need a 'body of evidence' to show how this issue really affects breastfeeding mums and new mums in order to take the campaign forward.  I want to be able to prove - should it be necessary - that breastfeeding mums are a minority group who experience some marginalisation within our society.  I'm going to put the testimonies 'on file' to be used at some point in the future.  To understand why these testimonies might be important in bringing about change, take a look at this webpage under 'protecting the vulnerable'.  I consider breastfeeding mums (especially new ones!) and their babies to be extremely 'vulnerable'!


I don't believe we can tackle the huge amount of misinformation in the media by writing letters to the PCC and OFCOM.  The system itself needs to change.  It has changed before, and I hope it can again.

*please note, all bolds/ italics are mine.

Rhiann & Jane ~ Breastfeeding Stories.

Rhiann's Story:

3 years ago when I was pregnant with my first son Jasper – I was planning to breastfeed partly due to the fact my mother had breastfed me and my 3 younger siblings, maybe as a farmers daughter I thought how hard could it be – such a natural thing?!?

I was lucky enough to have a lovely home water birth with my son – encouraged by my friend and midwife Anne. I remember holding our son in my arms having prepared so well for the birth thinking – well how on earth do I start breastfeeding?!? I guess all my reading efforts had concentrated on getting through the birth – but somehow I didn’t remember the bit in antenatal classes about breastfeeding. The lovely student midwife latched Jasper on for me and I somehow fumbled my way through the next 24hrs at home! Fortunately for me my younger sister then came to stay she was currently training to be a midwife and spent the next few days showing me what to do!

The days turned into weeks and I remember my lovely midwife Anne scalding me for suggesting I use the formula cartons in the cupboard (which I stocked up on pre-birth on advice of well meaning friends!) – ‘but it feels like there’s no milk there!!’ I remember saying to her – Anne simply replied ‘don’t worry Jasper is just cluster feeding trust me your milk supply will catch up!’

Later on Anne helped diagnose ductal thrush which was so painful - I spent months battling with it mainly getting through feeds by taking painkillers. Fortunately at around the 6 month mark I finally experience the joy of pain free feeding! I continued to feed Jasper to 12months then stopped mainly due to me returning to work – I am a development chemist and as my job entailed handling chemicals I really didn’t want to risk them being transferred to my milk!

I was so lucky to have the support of my midwife Anne, my sister and the local Breast feeding support group and friends and peer supporters I met through our local NCT groups. Looking back as a first time mother I realise that I could quite easily have had a different outcome with regards breastfeeding my son without such good support.

My story continues - this time last year I was pregnant again – great I thought I’ll breastfeed this baby again too – I was really looking forward to the bonding and pleasure of getting to know my new baby. However in January 2010 I went for my 12week scan...........

I was carrying twins!!!! – but why on earth should that change my decision to breastfeed?!? I set about getting some well informed advice from breastfeeding peer supporters and reading a LLL publication called ‘mothering multiples’ I was more determined than ever that I was going to succeed in breastfeeding twins – I so wanted to give my babies the same as I had given Jasper.

As my due date approached I began to get very nervous about the possibility of the babies being born premature and problems that could arise from them not being able to feed. At 37wks I began expressing and freezing some small amount of colostrum – there was no way these babies were going to be given formula if I was not able to feed.

On 1st August 2010 (my birthday) my waters broke aided my my toddler jumping on me. My beautiful twins were born on 2nd August at 38+4wks. Anabelle born at 1.28am and Xavier at 1.44am.

But that was just the beginning of my breastfeeding journey with my twins. Only a few hours after birth Anabelle was really starting to hurt me when she fed – I knew something wasn’t quite right -the hospital infant feeding coordinators discovered she was tounge-tied. And later when Xavier

couldn’t latch I also discovered he was also tounge-tied (I was so glad I had some expressed colostrums to give to him.)

I battled through the next few days at home with the twins - again relying on the fantastic support of my midwife Anne and close friends – both the twins were making me so sore due to their tounge-tie I had horrible blisters on both nipples. I even resorted to expressing the odd feed for them just to give myself a break. Fortunately my pregnancy research and reading helped me through difficulties arising from post delivery swelling too which made latching near impossible. At 10 days old both Anabelle and Xavier had their tounge tie snipped. Feeding became much easier after that – and I finally mastered tandem feeding!

My twins are now will be 5 months old on 2nd January and I am loving our breastfeeding relationship – but it has not been without other difficulties including thrush, mastitis, severe plugged ducts and pores – all going hand in hand with my body incredibly adapting to produce just the right amount of milk for my babies. Breastfeeding gives me that special time with each of them individually which I really cherish. Not to mention the really unique way that they interact – be it by holding hands or fighting whilst they tandem feed. I honestly think that if it wasn’t for me Breastfeeding I would never get out of the house!

One of my biggest supporters for breastfeeding has actually my Dad. He always makes makes me smile with his analogies – quite frequently comparing me to a lactating sow (His outdoor pig farming days never forgotten!). But he really does appreciate the physical demands that come with breastfeeding especially in the next month or too before they wean – Remembering how tired my mother used to be when she fed my siblings and me.

I am sure that my breastfeeding journey with Anabelle and Xavier will throw yet more challenges as they grow but I relish every moment! And I take great delight in correcting many assuming health professionals who are all too quick to assume that my twins are either formula fed/ combination fed J

Having faced the challenges with shear determination I realise that there is not always good support available to breastfeeding mothers – I have seen too many friends reluctantly giving up breastfeeding due to lack of support or as a result of not particularly helpful information. My experience has made me determined to help other mums who are struggling and I am due to train as a peer supporter in the new year.

I often wonder what the outcome would have been had I given that formula sitting in my kitchen cupboard..............................

Rhiann'

Jane's reasons for 'Choosing to Breastfeed'.

'I was born in 1960, I don't know what the statistics are but by then formula feeding was well established and the choice of many mothers. My mother chose to breast feed me. I was the oldest of five children who were all breast fed. I don't remember there ever being formula in our house.

When I reached my teens and babysat I don't recall anyone breastfeeding their babies, I remember making up and feeding formula to babies. It was the norm.

Then I married and started my own family. I don't remember making a conscious feeding decision, as far as I can remember I just knew that I was going to breast feed. After all I'd seen successful breastfeeding when I was very small and just assumed that was what you did. Then people started to question how I intended to feed my baby. My unhesitating answer was always breast. People would ask me if I had bottles and a sterilising unit 'in case I couldn't feed' and I always said no.

Now, I'm a Yorkshire lass, an area of the country likened to the Scots for their careful ways with money. We don't like to spend on unnecessary frills and bottles and sterilising units are unnecessary frills when you don't plan to use them. The decision not to have these things in the house was probably what saved my babies from the dreaded formula. I lived in a city and could easily and quickly have got supplies if necessary - a point I regularly made if people said I *should be prepared*. It was in 1885 and supermarkets were open until 10pm most nights of the week, the local garage sold bottles, formula and dummies and was open 24 hours so I made the decision not to have 'emergency' supplies. On days when my babies seemed insatiable I quickly realised it was because of growth spurts and my supply was just catching up with their demand - it wasn't that I didn't have enough milk, or that I was drying up - it was simply that my baby was growing and needed more. On days when I wanted to give up because my nipples were sore, by the time I was dressed and had readied the baby for a trip to the garage or supermarket the pain had gone, and the problem wasn't important enough to go shopping - call me lazy, Then I'd think about how long it would be before the supplies I bought would be usable - hmm wait 12 hours for sterilising fluid, wait half an hour if I sterilise by boiling, realistically none of that was going to happen. and baby would need feeding again!

On top of that the cost of these things... bottles, teats, formula, sterilising unit, sterilising fluid/tablets. Or the alternative steam sterilising units that cost to run. The smell of sterilising solution is vile - surely it has a taste and a residue not something I wanted to put in my babies systems. And then which formula do you choose? There are so many to choose from - all making claims as to how they are the perfect formula for feeding babies, then they market a new improved version - so the old one wasn't perfect huh? Then you have to make it up - either in advance, in which case you have to keep it cold and discard it if kept more than 24 hours - really? or is this just another money spinner (Yes I AM cynical). Then you have to feed cold milk to your baby or warm it up - meaning your baby has to wait for it's feed. OR you make it up when your baby needs feeding and then it has to cool down - so you risk burning your baby or your baby gets distressed while waiting.

Then there's the space these things take up. My kitchen was a tiny 5'6" wide x 11' long, with a door at one end that accessed the cellar, meaning the usable space was about 8'. After the cooker, sink and fridge were in place there was hardly any room for storage cupboards the amount of work surface was also very limited meaning a sterilising unit on the counter top would leave very little space for food preparation. You need enough bottles for more than a days feeds - you need to have enough to use and enough to sterilise.

So why is formula feeding the easy option - breast milk is perfect, it's the right temperature, it's available when baby needs it, there are no bottles to wash, clean, sterilise, there's reduced risk of contamination (breasts are not sterile) and it's FREE.

By default, laziness and meanness, my babies were breast fed. I knew breast was best but had no idea why, other than it was what nature provided. I could compare the sweet smelling yellow curds of my babies nappies with the foul smelling copiously filled nappies of formula fed babies and thus question the suitability of formula - pooh is, after all, the waste the body doesn't need and can't process... I had absolutely no knowledge of the possible dangers of feeding formula - other than the risks associated with poorly cleaned and sterilised equipment. I fed on demand, weaning my first off the breast when he was 13 months old and I was pregnant - no talk of tandem feeding back in 1986 - my second self weaned and at 24 months decided she was no longer interested in the breast.

Would I do it again - I most certainly would - with the information I have now I think it would be easier, I'd have fed my first longer, possibly even tandem fed as he was only 18 months old when my daughter was born. My children (now adults) are not super intelligent or super healthy. They had illnesses just like any other, the severity of their symptoms did not seem particularly different from their formula fed contemporaries, but my babies were happy and content.

Breast feeding isn't easy but there are things you can do to make it easier. Prepare yourself for feeds - get yourself comfortable, have a drink handy and the phone by your side (it always rings when you least need it). Have the numbers of friends/family/peer supporters/midwives/health visitors/GP on hand and don't be afraid to call. Go with your gut instinct - it's usually right - we're programmed to feed our babies and instinct is amazing. Find some nipple cream that you don't have to wash off before feeding - I used Kamillosan and would swear by it, there seem to be many more products available now. If you have sore nipples try rubbing breast milk on them - I never did - I never even heard of it before DBM - but so many mums swear by it there's no reason not to try - it can't do any harm and it quite probably works.

Jane xxx'