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mybumpbirthandbeyond · 5 years

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‘Sleep like a Baby’

I think when most people decide to have tiny humans, we all agree to sacrifice sleep. Say farewell to long lies and early nights - the time to go to bed will be dictated by your bundles of love and their feeding times. Some babies will be better sleepers than others, go to bed earlier than others etc. However, I don’t think couples realise (and by couples I really mean the mummy) that the lack of sleep starts well before the baby is here!

Two of the most useless pieces of advice you hear, and I have certainly been given, are sleep-related: ‘Make the most of the sleep now, because it will change once the baby is here,’ and ‘Sleep when they sleep.’

Inevitably as you get bigger and further on in your pregnancy, sleep becomes difficult. Unfortunately for some, the ‘morning’ sickness might be so bad in the 1st trimester, that that alone keeps you awake (thankfully that wasn’t my experience). I think I have mentioned, I got big (and I mean BIG) and fast. This meant my sleep was compromised pretty early in my pregnancy. The need to go to the toilet (maxed out at 4 times in a night late on!), the general uncomfortableness in trying to turn side to side, back pain, and those panicky moments when I woke up on my back (not allowed!), were enough to mean I was already experiencing a lack of sleep and the baby wasn’t even here yet! I used to find that I would have to move two or three times, just to roll from right to left side, and vice versa. I turned, lift myself and onto my back, then shuffled to my hip and eventually twisted onto my other side. Sometimes this alone would be so difficult, I ended up falling asleep halfway through, on my back. Personally, I don’t like sleeping on my back normally, but this isn’t allowed when you are pregnant. I think it’s something to do with blood flow to the baby and their heart rate. Cue waking up in a panic when I realised I had stopped halfway!! You also get pretty weird dreams when you’re pregnant (when you do eventually get some sleep), and I often found myself waking up just to reacquaint myself with reality. Women’s bodies are incredible, and I highly doubt the lack of the good stuff is a coincidence. I feel it’s the body’s way of teaching you to cope on less sleep, and get used to what will happen when the baby arrives.

‘Sleep when they sleep.’

I brought this up at my Baby Massage class recently. Does anyone actually do this, and successfully?!!? Who came up with that? Clearly, someone who is not a parent!!! The reality is, newborn babies sleep lots - it’s how they grow and how they develop. But let’s be realistic - the sleeping when they sleep idea really only has some traction when maybe, (only maybe) you have family staying, or your partner is off on their parental leave. If you’re breastfeeding, forget it! The minute you lay your head down, someone will call up tentatively that the baby is showing cues for needing fed, or they’re already past the point of no return and are screaming for milk NOW! As time goes on, (even just in a few days), with so many visitors coming in and out, you find yourself strategically planning housework around your baby’s naps. Washing and sterilising bottles so you don’t run out at the crucial time, hoovering, feeding the dogs, and even just washing yourself and getting dressed (even if it is in joggies and a hoody!) Eating is also important (particularly if you are breastfeeding, but it’s important anyway obviously!) and it’s amazing how much planning goes in to cooking (if possible) and eating a meal between feeds. Quite often now as Cailean gets older, it’s more about keeping him happy and from losing his mind, so my husband and I end up doing a tag team - one eats rapidly while the other soothes until the person who has finished can take over. Talk about indigestion!! Then there are the days when he doesn’t nap, fights sleep like it’s armageddon, and I'm lucky to manage two meals a day, or to be eating before 9pm at night (which usually ends up being cereal).

Which brings me on nicely to Cailean’s sleep. I think I was possibly lulled into a false sense of security the night he was born. He fed and then slept from about 1/2am until just after 7am. Result!! Then it occurred to me, his stomach is no bigger than cherry so he doesn’t need as much right now. When our dayshift midwife came in, she advised she thought he was quite mucusy and that was causing him to feel full, hence why he wasn't that interested in feeding. The second night in the hospital, I have already mentioned was pretty difficult. Alex was on a reeling chair and Cailean would fall asleep at the breast, but scream when I tried to settle him in the bedside basket/fishbowl. I had zero sleep but thankfully, Alex did get some.

Fast forward to our first few nights at home. Cailean would more or less feed every 3-4 hours and slept in his Moses basket next to my side of the bed. The difficulty I had, was the dreaded transfer from me once he had finished feeding (when I was still breastfeeding), to the Moses basket without waking him. He struggled to settle and we relented in giving him a dummy pretty early to help. We had all these great ideas of not giving him a dummy, but let’s face it, if it helps, do it!! Apart from anything else why is it such a bad thing?! Our midwives knew what they were talking about when they said he would need one, minutes after being born. It became exhausting for me to feed exclusively from the breast. With hindsight, it probably didn’t help that I was fighting off a massive infection which I had no idea about, but Cailean was just so hungry ALL THE TIME!!! I felt like I wasn’t producing enough for him. I know now, that the cluster feeding was his way of getting the breasts to produce enough for him when he needed it to grow, but I'll be honest, I was on the brink of an exhaustion-induced meltdown one night. We then decided we would give a bottle of formula at night to fill him up. My mum had done it with me, so we decided to give it a go. This was when we realised that Cailean struggled with reflux.

You usually find, that most babies don’t tend to need much winding when they’re breastfed. I think i even asked out loud - do I need to wind him after feeding him from the breast? The short answer is I don’t really know, so ask your midwife!! With formula, you absolutely do. This is when we discovered the reflux. Cailean would regularly (and by regularly, I mean at least once almost every feed) bring milk back up. Sometimes it was a stream, sometimes a dribble, and only once or twice was it projectile. Sometimes it was also partially digested - which is called posseting. Bit gross, but it comes out lumpy rather than just milk. 9 times out of 10, Cailean would almost immediately bring up whatever he had just drank when we winded him. We started winding three times during a feed, which has now reduced to two times - once during and once after he’s finished. Boy does he hate it!!! He screams the minute the bottle is taken from him - sure sign my boobs had no chance!!! Because of how often we were winding him, and how often he was being sick when we put him back down in his Moses basket, the night-time feed routine would consist of: nappy change, feed and about 30 minutes post-feed winding and trying to make sure he wasn’t going to be sick when we eventually put him back down.This, as you can imagine, added to the length of time we were up, and reduced the sleeping time between feeds. We tried to help each other out - one got the bottle ready, (initially of either formula or expressed milk) while the other changed and fed him. Then we would swap. Even though we took turns, the resentment you feel to your partner who has successfully dropped back off to sleep within minutes is real!! Probably because I would feel guilty for Alex, so would stay awake as long as possible to help with the settling after - not to mention the fact it was hard to fall asleep when the Moses basket was right next to me! There was a many a sick Moses basket sheet and a change during the night, but thankfully, Cailean always seemed to know to roll on his side to be sick and never did we have to worry about him choking (although we inevitably still worried).

As time went on, and we wanted to dress Cailean in more than just sleep suits, it became frustrating how many outfit changes there were - bibs, tops, muslins, trousers, the lot, were changed multiple times a day. We were lucky in that it didn't seem to adversely affect his weight, but it still wasn’t ideal. With the exception of the Anti-Reflux milk, we’ve tried everything. Anti-colic bottles (we found MAM to be the best, plus they’re self-sterilising so great for travelling!), infant Gaviscon, Carobel, tilting the Moses basket, changed milk, slow flow teats the list goes on! We tried to do one thing at a time in order to eliminate the problem. At first, we only used slow flow teats on our bottles. You’re advised to change the teats to faster flow once your baby has reached a certain age, however, given how greedy Cailean was, and how sicky, we stayed on the slowest flow teats (1) for ages. Even when we moved up a teat, we quickly went back down again, when the sickiness increased.

We then got him prescribed infant Gaviscon. One of Alex’s colleagues had sworn by it, so we thought it was worth a shot. It definitely helped initially, or at least improved the reflux. He did initially get a bit constipated with it, but his still eventually returned to normal once he had adjusted.

Next, we switched milk. We had been on the Mamia formula from Aldi. All formulas are standard in terms of the ingredients - it’s the law. However, the quantity of the ingredients varies from brand to brand and the price varies quite a bit. Mamia is the cheapest, and then there’s the likes of Hipp, Cow & Gate etc, with Aptamil the most expensive. Wouldn’t you know, being my son, Cailean has a taste for the more expensive things in life - Aptamil turned out to agree with him more. The benefit of this though, is that Aptamil comes with ready made larger bottles, and mini bottles for when you’re out about. Really handy to have! This combination of Aptamil and Gaviscon seemed to work great.

The problem persisted however, particularly when Cailean was taking more fluid ounces per feed. Each time we increased the volume, we had to increase gradually, so that every second feed was the larger amount, and never right before bed. This usually had to be introduced via the slow flow teat as well, just to be sure we minimised the reflux as much as possible. The time between feeds gradually increased as he took more, so that we are now 4 hours between feeds, with the exception of the last two, which are 3 hours apart.

Within the last few months, we have been prescribed Carobel by our health visitor, which is a milk thickener to make it harder for Cailean to bring it back up. We’ve hit the jackpot with this! We still give him the Gaviscon, as well as Carobel, but have had to move back to the faster flow teat (2), in order to allow for the milk to come out more easily. He has to work harder to get it, which is another reason he’s less sick - he can’t guzzle as easily!

You may wonder why I've strayed off the topic of sleep, and written about reflux. The thing is, they are so closely related that I couldn’t not mention it. The reflux inevitably makes Cailean more uncomfortable, and therefore more difficult to settle. That’s still the case now, even at 6 months’ old. He doesn’t nap during the day so well, and hours after a feed he can still be being sick and/or needing to burp. Somehow, the reflux doesn’t affect him so badly at night, but during the day it’s always been worse. It varies from feed to feed, but it can drive you mad - I get him dressed in a lovely outfit, and before I can get a bib on him, he’s puked and I have to change his whole outfit. Or at classes (especially Baby Sensory), he’ll lie on a mat and constantly be sick. Or he’ll be sick on me once I've got nice clothes on (including the day we had photos taken!!). In the early days, what made it worse was not knowing the cause. Thankfully, we seem to be in a better place with it, but as you can tell, it took some time to figure out the best way to tackle it.

Now I know this is not going to be a popular decision, and people may criticise me for it, but I would not be true to myself unless I stood by my decision. The NHS guidelines say that the baby should be in with the parents until they are 6 months old. That’s just it - these are guidelines and not the law. Every baby is different, and you do what’s right for you and your baby. I did and my son has been sleeping through the night since he was 10 weeks old. Does it seem like I'm gloating? Well, I'm not. I went through the sleep deprivation just like everyone else, and have had a horrendous recovery - I’m due some luck!!

My husband and I always knew we wouldn’t be keeping Cailean in with us for 6 months. For one thing, I'm going back to work just after that (sob 😢). Trying to get him used to sleeping in his own room, as well as me going back to work, would be too unfair on him, and too damn hard on everyone. We spoke before he arrived about how long he would stay in our room. We agreed at least 4 weeks, but we would play it by ear. NHS guidelines are always changing - when I was born we had to sleep on our sides, we weren’t allowed on our fronts or backs. When my sister was born two years later, it was the back. They’ll no doubt change again if I have another child. The factors that led us to decide to put Cailean in his own room at 6 weeks were numerous.

Cailean is a long baby. He kicks everywhere but (ironically), in the pool, and generally wriggles ridiculously. He hated the blanket being over his feet in the Moses basket. So much so, that we had to drape it over the end so it wasn’t weighing on his feet, but to make sure he was still warm. He didn’t like not having the space in the Moses basket the bigger he got. The noises he made kept me awake most of the night, straining for every sound and paranoid there was something wrong. We also have an excellent baby monitor. Angelcare have produced a video monitor that has night vision, a nightlight, a parent device that has the ability to speak to your baby, and most importantly, a sensor mat that detects the slightest movement, even breathing, from the cot. The sensor mat goes under the mattress, and movement is monitored by a beeping pendulum on the parent device. If no movement is detected, an alarm sounds on both the parent unit and the monitor. We ended up getting ours during a baby and toddler even in Asda, but they sell them in most places. One thing worth investing in for your baby (apart from the travel system/pram), is definitely a decent monitor.

We also got Cailean used to his cot gradually. Each morning after his feed, and at night after his bath, we would put him in his nest in the cot when he was tiny, then without as he grew. We would put on the mobile and Ewan the Dream Sheep to entertain him while he was awake. At 6 weeks we took the decision to put him down for his bedtime in his cot and see how got on. We always put him on his back in his sleeping bag, feet at the bottom of the cot. Whether he stayed that way, was another matter, but he quickly got into the routine of just waking twice for a feed, then once, then 4 weeks later we were amazed when he slept the whole night - 10pm - 7am! Thinking it was a fluke, we couldn’t believe when it happened again and again, until it became routine and waking up earlier than 7am became unusual.

I’m not entirely sure what people think when I tell them that. My health visitor actually said, you do what works for you, but I got the impression she didn’t really mean it when I told her he was in on his own, judging by her reaction! I should point out, that we have changed Health Visitor, but not for that reason and I will cover that in another post.

Invariably, new mums are both amazed I put him in on his own so early, but also, possibly even slightly envious. At the end of the day, I chose to do what suited me and my baby. Not everyone will be able to, or even want to do what I did, and that is absolutely fine - no judgments here! However it worked, and continues to work for us, and that’s what matters. I would never judge another parent for their sleep/feeding routine or for anything for that matter, as I firmly believe you do what works for you and your baby. Parents get enough unsolicited advice and judgment as it is - the least we can do is support each other, regardless of how differently we do things. You do you!

#postpartumrecovery #newmum #firsttimemum #mybumpbirthandbeyond #newblog

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babymilkaction · 6 years

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BFI Blog: Taking action against misleading marketing

Taking action against misleading marketing

Patti Rundall. 20 August 2018

Building on her interview on Dispatches, this guest blog from Baby Milk Action’s Patti Rundall discusses misleading marketing of breastmilk substitutes and how we can better protect families from commercial interests.

C4’s Dispatches, Breastfeeding Uncovered, focused primarily on the lack of support for breastfeeding women in the UK – and included just a quick look at what the baby food industry has contributed to this problem.

The painful experiences shown often came down to bad advice or no support. In a culture where bottle feeding has become the norm, we’ve lost breastfeeding skills, and the state of UK knowledge about something so basic and important is shocking. But let’s not forget the role the baby feeding industry has had on that culture. On top of its marketing budgets, this industry has poured funds into nutrition education,1 health professional training and parental advice, designed to encourage the use of their products. With tempting funds on offer, it’s easy to forget that commercial meddling in public health and education is a big risk. Many messages that undermine breastfeeding, including the idea of the ‘hungry baby’, of not having enough milk, of soreness and pain being inevitable, lie at the baby food industry’s door. And it’s intentional. Indeed, it’s at the heart of a global, centuries old strategy to destroy breastfeeding and grow a lucrative market.

Cow & Gate advert: “I’m thinking about getting a T Shirt made – ‘Danger! Sore boobs’.

The strategy was formed around the idea that mothers had better things to do with their time than nurse their babies … We were appealing to the idea that if you nursed your babies that you might suffer from what is referred to as ‘bosom sag’ and that this would be obviated of course if you used these marvellous products … I don’t recall anyone ever suggesting that the water be boiled or anything.

1989 interview with Harry, a retired advertising consultant about advertising project for Nestlé in the mid 1970s.

Unpicking the marketing claims

The Dispatches team asked me to look at a range of Infant Formulas (IFs), Follow-on Formulas (FUFs) and so-called ‘Growing up Milks’ (GUMs) that Kate, the presenter, had just bought. Easy. The packaging was covered in idealising images – teddy bears, shields, hearts and claims that were easy to shoot down. What I didn’t expect was Kate to say that she had believed the ‘specially formulated for your baby’ claim – and that maybe the formula was actually better than her own breastmilk. The industry would never admit to making such a claim and I’d forgotten how clever and misleading that one is. They are describing a product that can stay on the shelf for up to two years and is traded globally to millions of babies who live in vastly different environments. The only thing that was ‘specially formulated’ for Kate was the marketing message.

There were astonished responses to my statement that none of the products – except the newborn infant formulas – were necessary or recommended by the UK or the World Health Organisation, and that all the formulas for babies over 6 months (that look identical to infant formula) had been invented by the baby food industry with the direct aim of getting round the advertising bans that apply to newborn formula. The composition of these products are less well regulated than newborn formula, and yet they are freely advertised. Indeed, when Prof Michael Crawford at London Zoo analysed some FUFs for us in 1984, he said they were more like rhinoceros milk than human milk and UK health visitors, alarmed at their composition, said they should be considered a ‘pudding’.

Baby Milk Action and IBFAN have campaigned against FUFs since the early 1980s; we succeeded in getting the age of use raised from 4 months to 6 months for the UK, and the 1986 World Health Assembly (WHA) Resolution said these products were not necessary. But the adoption of the Follow-up Formula Standard (Codex STAN- 156-19872) in 1987 ensured their global trade and unlimited misleading marketing ever since. While their composition improved in the EU, the marketing got worse and sales boomed.3 It’s been an amazing success story for pure marketing hype.

Over the years WHO has issued several reinforcing warnings, but its clearest guidance came in 20164– saying that all formulas targeting babies 0-36 months function as breastmilk substitutes and are covered by the 1981 International Code of Marketing of Breast Milk Substitutes (The Code) and subsequent relevant WHA Resolutions – a clear message that national controls should end this misleading marketing. But without a strong political will to enforce it, this message won’t be enacted – a problem we’ve recently seen on the global stage at the WHA.

What can we do?

There are many ways we can take action on these issues to better protect public health:

Support Baby Milk Action-IBFAN’s work to protect all families, whether breastfeeding or bottle feeding, from misleading marketing

Raise awareness of resources from First Steps Nutrition Trust, designed to provide health professionals and families with information about infant feeding which is free from commercial interest

Sign up to Unicef UK Baby Friendly Initiative’s Call to Action campaign, urging UK governments to support breastfeeding and protect all families from commercial interests.

So, while we think about the UK, nutrition, food safety and child health, let’s not forget the commercial interests that lie behind the dismantling of public health safeguards and the importance of us all standing up for accurate, unbiased and independent infant feeding support for all families.

Notes

A US delegate to Codex told me that she saw marketing as a form of education – I could see why we would never see eye-to-eye on the right to accurate independent information.

Codex Alimentarius Commission is the UN’s standard setting body.

FUFs are almost identical compositionally to IF in the EU, but there are no rules for GUMs. FUFs and GUMs are fuelling the rise in global formula sales – predicted to reach $70 billion in 2019. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00103-3/fulltext

WHO, Guidance on ending the inappropriate promotion of foods for infants and young children: http://www.who.int/nutrition/topics/guidance-inappropriate-food-promotion-iyc/en/

Visit our blog to hear more from people interviewed on this week’s Dispatches. Amy Brown, Sue Ashmore and Emma Pickett

https://www.unicef.org.uk/babyfriendly/category/blog/

BFI Blog: Taking action against misleading marketing was originally published on Baby Milk Action

#breastfeeding #infant formula #Nestle

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