December 15, 2011

Gone With the Wind

I was recently asked by a newly graduated midwife for any better tips on “winding” babies. I asked the midwife what she had been taught in university on this subject, she thought about it and replied “nothing”. We talked about why the university had not taught her how to ‘wind a baby’ and where our knowledge on this subject comes from. We often do things because they have been instilled in us by our mothers, aunties and grandmas and we come to accept it as fact. It may be quite confronting correcting old wives tales. The truth is I doubt any university in the 21st Century teaches student midwives about wind, colic or how to burp babies because there is no substantive evidence to support what we have been telling new parents all these years.

The First Two Weeks:

Parents are often very shocked when their baby has kept them awake all night in the first few days and often want the midwife to take the baby for a few hours rest. “All she wanted to do was feed and if she wasn’t feeding she was crying. She looked as if she was in so much pain; pulling her legs up, I didn’t know what to do.”

Very frequent feeding in these early days is normal and an evolutionary process to  ensure a baby’s stomach is not over distended too soon. Colostrum is perfectly designed to be small in quantity and gentle on baby’s gut therefore not increasing cortisol (stress hormone) levels.

The evidence shows that crying is a normal sign of vigour. A mother will often describe the intense feeling of hurt, pain and love she feels when her baby cries which leads to an uncontrollable urge to soothe her baby.  A mother’s powerful response to her crying baby evolved to ensure she continued to care and bond with her baby.

Normal vigorous crying, constant feeding and the need to be held almost all night long mixed with lack of knowledge and obsessions with wind can lead parents on a path to listen to any advice and try every potion there is on the market in order to find the answer, while ignoring powerful maternal instincts to listen to her baby.

Two Weeks to Three Months:

From two weeks of age babies who may have previously been “good” babies will often have a change in behaviour. The amount of crying tends to escalate up until its peak around 6 weeks. This often occurs mostly in the late evening and may last from 2-5 hours. These babies may have twisted faces and piercing wails. This can be extremely distressing for many new parents when the crying starts with no prior warning, often increasing in pitch and intensity until all of a sudden baby stops crying. About 15% of newborn babies will cry more than 3 hours per day from 2 weeks to 3 months. By 3-4 months almost all babies have stopped these crying episodes.

Studies of infants around the world indicate that unsoothable and unpredictable crying is a natural phase of early infant development due to the fact that humans are born so much earlier than our mammalian counterparts.

Over the last several million years our human brain has grown so much that we could no longer accommodate birthing our babies at the equivalent gestation of other mammals. Mammals are born with functioning brain capacity at 80% compared to a newborn brain which is only 20% developed at birth and takes a further 12 months to develop to 80% function. Within the first 3 months our sensory system can be easily overloaded and caused stress. Babies are designed to be held closely to their mother for long periods, just like our primate cousins. When babies are held in close proximity, it allows for the numerous benefits; oxytocin inducing and soporific effects of frequent feeding, baby and mother fall in and out of restful sleep together, mother responds effectively to her baby, frequent unrestricted breastfeeding is the norm and baby cries much less.

The most commonly used definition of Colic syndrome originated in 1954 by Wessel, who describes colic syndrome by using the “rule of three”: crying for more than three hours per day, for more than three days per week, and for more than three weeks in an infant that is otherwise healthy. The word colic itself is derived from the Greek word kolikos, meaning large intestine or colon as it was believed that intestinal pain caused the distress, but evidence confirms that crying behaviours in newborns is a normal process and not an “illness” that we need to cure. Even infants in primitive tribes who are held 24 hours a day and breast-feed constantly show the same pattern in peak inconsolable crying in these early weeks.

Evidence shows that in the last 10 years more and more babies are being incorrectly diagnosed as having a disorder, exposing them inappropriately to medication.  As there is no evidence that acid-suppressive drugs help in treating unsettled behaviour, medications should surely be avoided. Yet research and experience in practice points to a much higher percentage than the actual 5% of babies who do have an organic disorder, being misdiagnosed and ‘treated’ for gastro-oesophageal reflux disease (GERD), food allergies and lactose intolerance. Treatment ranges from medications, hospital admission, ceasing breastfeeding or introducing lactose-free formula milk and dietary eliminations for the mother regardless that the evidence does not support this thinking.

Promoting a normal phenomenon as a medical problem invariably leads parents to have little or no understanding at all about why their child cries so much. For many parents it can severely impact on their life and their ability to bond and connect with their baby, putting them at greater risk for postnatal depression, premature cessation of breastfeeding, long-term psychological disturbance, and child abuse.

The eternal “wind” problem

Not all types of crying and unsettled behaviour fit the “colic” mould and they are often exacerbated by our Western culture of raising babies. For years we have been told not to spoil babies by picking them up too much, midwives have told mums to burp their babies and to take them off the breast before the fall asleep. We’re told to play with babies and communicate, but rarely are mums told about the infant states or how much is too much play for a newborn. Baby massage is recommended for babies now but slap dash classes may be given which teach the strokes but ignore the essence of real baby massage; which is teaching mothers to effectively communicate with their baby and pick up on enjoyment/love/early tired signs/distress and disorganised state signals.

James a 4 week old baby has just had a lovely 40 min breastfeed. He is starting to slow down at the breast while he enjoys the soporific and calming effect of the milk so Mum takes him off the breast. She has read how to correctly wind and play with your baby before sleep so James is then placed over mums shoulder while she bounces up and down and pats his back. After a few minutes of whining James does a burp so Mum brings him down for play time. For some minutes James is happy to stare into Mum’s face and smile and copy her facial expressions but soon he becomes tired and starts to look away to signal to her that he has had enough. As Mum has never been told about the infant states and relies on books that instil routines she misses those early signs and continues to smile and stare at him. James now becomes restless with jerky arm movements, he furrows his brow and even starts to pull his legs up and arch his back. To Mum these are signs of wind so she puts him back over her shoulder. James is now completely over stimulated and begins to cry. In response Mum jiggles him and pats him faster, he then cries louder. The more she jiggles the more he cries and the pitch and fever of the crying escalates. Mum now feels her stress building and James responds to it. James is now completely over wrought and screaming, he is red and squirming. He is unable to calm himself down at this primitive age, he needs his mum to swaddle him and calm him back to sleep. Eventually extra air swallowed from crying causes a loud burp. James is finally bought down for a cuddle, to which James miraculously stops crying and calms down!  “See”, says Mum, “I knew it was the wind pains upsetting you!”

Help for the Overstimulated Baby and Mother:

  • Listen. Parents are often seeking help from many other practitioners as well as you.  You may be the first person to not label their child with an illness, to describe this as normal.
  • Antenatal education ‘What to expect in the first few days’. Parents need to need to know why it is normal.
  • In the early days minimise visitors and separation of baby from mum.
  • Crying and unsettled behaviour is often hunger in the first 2 weeks. Parents are often told over-feeding is the cause of wind. We should inform mums that underfeeding will cause an unhappy irritable baby!
  • Encourage breastfeeding on demand; no set limits, no routines. Suckling is soothing for babies.
  • Breastfed babies do not need to be burped. Wind, flatus and burping will occur spontaneously, and often quite frequently, regardless.
  • Teach parents how to minimise everyday stimulation. Read Howard Chilton’s great article for parents here.
  • Teach parents early tired/overstimulated signs.
    • Loose eye contact or have difficulty focusing
    • Have jerky arm and leg movements
    • Have a worried look on his face
    • Close his fists
    • Pulling at his ears
    • Yawn
    • Grizzle or whinge
    • Pull legs up
    • Arch backwards
    • Crying – late sign!
  • Teach parents safe wrapping techniques, to reduce primitive startle reflex and mimic womb environment.
  • Movement – rocking, jiggling, bobbing, walking, swaying.
  • Slings are so helpful; the ultimate womb-like environment.
  • Teach parents how to transfer baby gently into the bassinet without waking. Think smell, sound, movement.
    • Often babies sleep well during the daytime in the lounge room where they can hear the hustle and bustle of life, just like they did in the womb.
    • Try using a slept-in pillow case as baby’s wrap or blanket.
    • Warming the mattress can make the transition from mum’s arms to bassinet easier.
    • “Shusshing” noise, white noise/metronome ticking. These are even in app form.
    • Rocking or jiggling the cot or bassinet gently will help remind baby that he is still in mum’s arms.
  • Dummy use!!!  (Only if it’s a choice between a mother giving up breastfeeding as she is so exhausted or distressed or occasional use of a dummy to help calm baby and herself). A Cochrane review concluded that in motivated mothers, dummy use in healthy term breastfeeding infants before and after lactation is established does not reduce the duration of breastfeeding up to four months of age.
  • The incidence of crying episodes in breastfed and bottle-fed infants is similar so changes in diet are not advisable for 95% of babies.
  • Assess for signs of illness – there will be 5% of babies where their crying is not normal. It is essential that any ‘red flags’ have an urgent medical review.
  • Although early crying has no long-term negative outcomes, persistent or repeated elevated crying after 3-4 months is linked with long-term poorer outcomes and requires medical review.
  • It is very important to assess the mother-infant relationship, maternal fatigue, anxiety and depression and ensure appropriate support.
  • Admission to a parenting centre (day stay or overnight stay) may be appropriate for 24 hour support, (depending on their philosophy).
  • Safety for parents is important. A plan must be discussed on how to manage infant crying.
  • Give parents support helplines.
  • Reassurance and time to talk. Parents need to know that their baby is healthy and this period in their lives has no long-term adverse effects for their baby.
The Period of PURPLE Crying (Barr M & Barr R) 
  • Try to talk to parents about PURPLE  an alternative way to describe what parents and their babies are going through. See link here.
From here
In order to help parents ease more peacefully into their role as new parents a paradigm shift is required in our thinking. We need to see ‘wind’ and ‘colic’ as normal behaviours due to infants acting as they should, or were designed to, act rather than due to underlying pathophysiology or pathopsychology.
References:

Armstrong K, Previtera N, McCallum R J 2000 Medicalizing normality? Management of irritability in babies.Paediatr Child Health. Aug;36(4):301-5.

Barth R, 2000[“Reading-your-baby lessons” for parents of excessively crying infants–the concept of “guided parent-infant training sessions”]. Prax Kinderpsychol Kinderpsychiatr. Oct;49(8):537-49.

Douglas PS, Hiscock H 2010 The unsettled baby: crying out for an integrated, multidisciplinary primary care approach. Med J Aust. Nov 1;193(9):533-6.

Helseth S 2002 Help in times of crying: nurses’ approach to parents with colicky infants. J Adv Nurs. Nov;40(3):267-74.

Hemann R 2001 Help for colicky babies. Clini Excell Nurse Pract. May; 5, (3);144-6.

Hiscock H, Jordan B 2004 Problem crying in infancy. Med J Aust. Nov 1; 181(9):507-12.

Hiscock H 2006 The crying baby. Aust Fam Physician. Sep;35(9):680-4.

Howard CR, Lanphear N, Lanphear BP, Eberly S, Lawrence RA. 2006 Parental responses to infant crying and colic: the effect on breastfeeding duration Breastfeed Med Autumn; 1(3):146-55.

Hunziker UA, Barr RG 1986 Increased carrying reduces infant crying: a randomized controlled trial. Pediatrics. May;77(5):641-8.

Landgren K, Hallström I 2011 Parents’ experience of living with a baby with infantile colic–a phenomenological hermeneutic study. Scand J Caring Sci. Jun;25(2):317-24.

Lucassen P L B J, Assendelft W J J, J Gubbels W, van Eijk J T M, van Geldrop W J, Knuistingh Neven A, 1998 Effectiveness of treatments for infantile colic: systematic review BMJ 1998; 316:1563

Michelsson K 1995 Why babies cry. Nord Med ;110(11):271-2.

Miller AR, Barr RG, Eaton WO 1994 Pediatrics Feb;93(2):A28.

Roberts DM, Ostapchuk M, O’Brien JG 2004Infantile colic. Am Fam Physician. Aug 15;70(4) :735-40

Soltis J 2004 The signal functions of early infant crying. Behav Brain Sci. Aug;27(4):443-58; discussion 459-90.

Scott A. Rivkees, MD 2003 Developing Circadian Rhythmicity in Infants PEDIATRICS  Aug, 112; (2):373 -381

Spencer JA, Moran DJ, Lee A, Talbert D 1990 White noise and sleep induction. Arch Dis Child. Jan;65(1):135-7.

Sijmen A. Reijneveld, Emily Brugman, Remy A. Hirasing 2001Excessive Infant Crying: The Impact of Varying Definitions PEDIATRICS October 1;108(4) :893 -897

St James-Roberts I. 2008 Infant crying and sleeping: helping parents to prevent and manage problems. Prim Care. Sep;35(3):547-67, viii.

Trevathan, Wenda R. and James J. McKenna, 1994 Evolutionary Environments of Human Birth and Infancy: Insights to Apply to Contemporary Life. Children’s Environments 11(2): 13-36.

Zwart P, Brand PL Ned 2004 [Excessive crying in infants: a problem for both parents and children (only rarely caused by milk allergy)]. Tijdschr Geneeskd. Feb 7;148(6):260-2.

November 9, 2011

Is the way we birth causing breastfeeding failure?

I am often asked by my colleagues “why do we need Lactation Consultants?” “There seems to be so many more breastfeeding problems these days. It was never this difficult 20 years ago.”  The answer is simple enough; birth intervention.

The World Health Organisation advises that all babies should be exclusively breastfed for the first six months of life. Complementary foods should only be introduced from six months onwards, continuing breastfeeding in baby’s diet for up to two years of age and beyond. Despite these recommendations and active work from National and State governments to implement BFHI as well as continuing education of staff in almost every health service, a continual decline in the figures is seen month to month in Australia.

WHO is focusing on these main topics to prolong breastfeeding durations:

1.            Nutritional status of mothers who are breastfeeding

2.            Nutrition of infants living in areas with deficiencies, such as in iron, zinc, and vitamin A.

3.            Routine primary healthcare of infants.

Where are the recommendations to look further into the effects of medicalization of birth on the breastfeeding initiation and continuation rates?

It is well documented that initial declines in exclusive breastfeeding in the first month are due to problems with painful nipples and latching problems, a mother’s perceived inadequate breast milk supply and early introduction of formula milk. These problems are often exacerbated when mothers have had a medicalised birth.

In the last few years we have seen many advances in obstetric medicine (whether for the greater good or further problem inducing for the majority; I shall leave for you to decide). We have enabled pregnancy to occur for women who only a decade ago would not have had this opportunity due to age, illness or disability. With such pregnancies often comes high risk obstetric  management during labour; continuous CTG monitoring, induced labour, enforced epidurals which often progresses to inactivity, directed pushing and an increased chance of instrumental or caesarean birth. Of course labour does not have to be considered ‘high risk’ to end up following a medicalised pathway. Even the seemingly innocuous impact of such ‘normal’ pain relieving actions as a shot of pethidine can have unwanted effects on how baby responds once born.  For many of us these are considered within the realms of normal birth and non-interventionist.  A regular occurrence in many birth suites all over the world and considered to be a part of everyday labour. For those babies who have had a combination of several interventions throughout the birth process; induction and augmentation of labour, pethidine, epidural, vacuum delivery or forceps this frequently leads to maternal and neonatal pain, stress and exhaustion. Babies are often separated from their mothers for resuscitation or 24 hours in special care nurseries which in turn can lead to delayed first and subsequent breastfeeds and often to “just one bottle”.  We know how this small ‘gesture’ can have confounding effects on maternal confidence, interruption with milk production and promotes a change from normal newborn behaviours. Intervention whether from birth processes or subsequently due to poor initial neonatal responses, has a great potential to impact significantly on the baby’s ability to breastfeed and respond appropriately.

Jan Riordan found that babies born to mothers who had un-medicated labours had significantly better sucking skills compared to those babies with a medicalised birth. There are some early suggestions that epidural’s can predict lower neurological behaviour scores of newborns, but exposure to epidural analgesia alone was not found to be sufficient to affect breastfeeding ability. It does show that even in normal, healthy newborns, slight differences in central nervous system functioning was sufficient to affect breastfeeding on the 1st day of life. The majority of other findings, though, are not yet conclusive on whether epidurals specifically affect breastfeeding success rates.

During an epidural continuous IV fluid will be given throughout the course of labour and if over several hours this could be several litres. A pregnant women already carries an increased fluid volume and add to that the antidiuretic hormone, vasopressin, which  exacerbates the fluid retention further and we can see how this is often responsible for breast and areola oedema we see at 2-4 days postpartum. This oedema and engorgement can last for up to 14 days. It makes the breasts very painful due to the increasing tightness surrounding the areola, babies can find it increasingly difficult to latch on to the breast and effectively drain the milk. This can be very uncomfortable and upsetting for mothers making it hard for her to breastfeed unaided.  Reverse Pressure Softening (RPS) technique is recommended prior to every feed to relieve the oedema.  Expressing the milk out prior to feeds will exacerbate this condition further if RPS has not pushed back the oedema first. See Jean Cotterman’s explanation here.

Birth trauma must not be only looked at in terms of the medical intervention involved but also the potentially disturbing psychological effects thereafter. A very good qualitative account following mothers from the US, UK, Australia and NZ found several recurring themes that either impeded or enhanced a new mother’s ability to breastfeed. The 5 themes  women reported  that had disrupted and intervened with their ability to continue breastfeeding  were:

  • Intrusive flashbacks of the birth
  • Enduring pain
  • Feeling violated
  • Detachment from their baby
  • Perceived low milk supply.

Too often we separate birth from breastfeeding as if they are two separate entities. How many women are informed that the type of birth they have may impact on their baby’s ability to breastfeed? Do we even discuss the effects of perineal pain or surgical scarring and the mother’s ability to sit comfortably and feed her baby? Do we give enough support and time to mothers who have had a medicalised, if not traumatic, birth? Are we able to build self-esteem and confidence in the small amount of time allocated to women’s psychological needs in hospital postnatal wards? If the evidence and our own knowledge supports this, why is there often little value and respect given to the midwife who spends time listening and talking with a mother, instead of the midwife who completes her tick-list of physical maternal checks? Do we value productivity over holistic care?

So how can we best help those babies who are neurologically impaired and not yet interested to feed? The most helpful answer is to go back to basics. A mother who has had a medicalised birth does not need another ‘expert’ to help her get breastfeeding going.  Long labours, drugs and intervention lead to exhausted mothers and babies. At this time it is difficult for new mums to absorb and process new information. Let her hormones do the thinking by keeping mother and baby together, preferably in skin to skin contact and for as long as possible. Allowing both to rest and recuperate.

Hopefully the parents have been taught antenatally about the benefits of establishing milk supply early and are able to initiate hand expression without having to take on board too much new information.  By maintaining babies sugar levels with frequently (2-4hourly) expressed colostrum until baby is ready to establish breastfeeds will ensure mother and baby are left alone together. This ‘us’ time can enhance bonding, reduce cortisol levels in mother and baby and allow gentle recuperation.  Once baby is ready she will crawl down from her comfy spot, in-between mother’s breasts, find the nipple and initiate an instinctive Biological Nurturing form of attachment; baby led and mother learnt.

In a nutshell:

  • Skin to skin contact (prolonged)
  • Keep baby close to the nipple. Smell, smell and more smell, important!
  • Express some colostrum onto nipple and baby’s mouth
  • No strong smells of perfume on mum (future post to come re baby’s sense of smell and the relevance to breastfeeding).
  • If baby doesn’t want to feed yet, offer help to the mother to aid her hand expressing her colostrum every 2-3 hourly.  Give all EBM to baby.
  • Reassure, Reassure, Reassure! Mums need to be calm and relaxed to help milk to flow and provide a reassuring environment for her newborn. Loving partners can give a well needed shoulder massage which will enhance oxytocin and help milk to flow.
  • Once baby wants to breastfeed try the laid back style of Biological Nurturing to keep mum and baby relaxed. See this link to watch clip on biological nurturing.

If we leave mothers without adequate lactation support in the first few days and weeks we will inevitably continue to see this rapid decline in breastfeeding rates.  Government initiatives have introduced BFHI into many hospitals but yet we see the biggest decline in breastfeeding after the first week; once mother and baby have left the hospital.  How are breastfeeding rates to increase if we discontinue our lactation support at a mother’s most vulnerable stage? I admit, in many community areas there is fantastic support services for mothers and babies; I have worked in breastfeeding and postnatal drop-ins in both in the UK and Australia with amazing results. I have also worked as a community midwife in the UK for many years, but looking back even though most mothers received 3-4 postnatal home visits I felt we often did not provide the time needed.  Unfortunately drop-ins and home visits are still not universal and prolonged postnatal care and lactation support is not on a high agenda for local or national governments.  If we are to make a change we need to stand up for the basic rights of new parents to all receive universal support and care in the first 4-8 weeks.  Lobby your local government, make breastfeeding awareness week count, be heard, stay positive and give and seek the best care possible.

Referrences:

Beck, Cheryl, Tatano, Watson, Sue 2008, Impact of Birth Trauma on Breast-feeding: A Tale of Two Pathways Issue: vol. 57 (4), July/August , pp. 228-236

Colson S (2007) Non prescriptive recipe for breastfeeding. Available at: http://www.biologicalnurturing.com/pages/downloadarticles.html

Cotterman, KJ 2004 Reverse Pressure Softening: A simple tool to prepare areola for easier latching during engorgement . J Human Lactation, 20, 227-237.

Growing Up In Australia: Longitudinal Study of Australian Children (LSAC) – Annual Report 2006-07 – Breastfeeding.  Available at: http://www.aifs.gov.au/growingup/pubs/ar/ar200607/breastfeeding.html  viewed 01 October 2011

Halpern, SH Levine,T  Wilson, DB MacDonell, J Katsiris, SE & Leighton, BL 1999 Effect of labor analgesia on breastfeeding success. Birth, 26, 83–88.

Infant Feeding Survey 2005. Published May 2007. Available at: http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles-related-surveys/infant-feeding-survey/infant-feeding-survey-2005 Viewed 06 November 2011

New Zealand Ministry of Health, (2002). Breastfeeding: A guide to action

Radzyminski, S  2005Neurobehavioral Functioning and Breastfeeding Behaviour in the Newborn JOGGN Clinical Research, May/June

Rajan, L 1994 The impact of obstetric procedures and analgesia/anaesthesia during labour and delivery on breast feeding. Midwifery, 10, 87–103.

Riordan, J Gross, A  Angeron, J Krumwiede, B & Melin, J 2000, The effect of labor pain relief medication on neonatal suckling and breastfeeding duration.  Journal of Human Lactation, 16, 7–12.

Scherer, R Holzgreve, W  1995, Influence of epidural analgesia on fetal and neonatal well-being. Eur J Obstet Gynecol Reprod Biol,  May; 59, 17-29.

Thompson, RE Kildea, SV Barclay, LM et al. 2011, An account of significant events influencing Australian breastfeeding practice over the last 40 years. Women and Birth: the Journal of the Australian College of Midwives, Vol. 24, no. 3, pp. 97-104

World Health Organization 2002, The optimal duration of exclusive breastfeeding: Report of an expert consultation. Geneva, Switzerland.

November 3, 2011

Thoughts on birth and breastfeeding

I am a Midwife and Lactation Consultant who’s passion is to enhance a parents’ self belief and demystify the old wives tales from the truth. There is so much confusing advice out there it is often difficult to know where to start or whom to listen to.

We have become a society who doubts our own ability to birth naturally and feed our babies. As women we have been created for this sole purpose and we need to confidently embrace this and have a resounding self belief in womanhood if we are to succeed in passing on these natural abilities to our own children.

For women in the 21st Century it can be extremely overwhelming to even know where to start once they find themselves pregnant. Consider the average 1st world child’s exposure to birth and breastfeeding. We grow up in a society obsessed by media, sex and airbrushed flawlessness. The icons of today are not the suffragettes of the early 1900’s but spuriously famous celebrities who’s only talent is being famous. Our first exposure to breasts are most likely on MTV or in a magazine and they are most definitely not being used for feeding! Celeb pregnancy is often a buzz theme and the images we are exposed to show them “blooming” over the weeks and finally going to a very exclusive hospital to have their C section, all the while glammed up. We wait with baited breath for the first pictures of baby (inset strange name here) and then a few weeks later the media frenzy when X arrives at the Ivy already back into her pre pregnancy clothes.  Cut to the ‘real’ woman  who finds out she is pregnant and is faced with the many dilemmas ahead of her. Nearly all of her pregnancy will be focused on the day of the birth; which obstetrician should I have, which is the best hospital, natural or C section, what about these midwives and do I need one, is midwife-led care safe, what is a birth centre, what’s a doula….?   Apart from buying nearly everything in the baby shop this poor mother-to-be has probably not even had time to stop and think about how her life may change once her baby arrives.

It seems unreal how 99% of all celebs seem to breeze through the initial weeks of parenthood, when from experience we know that this is probably the most amazing and beautiful but tiring and teary and exhausting and overwhelming time of a new mothers life! Why are these women not shouting out the truth from the rooftops? Why are young women rarely aware of what is ahead with a beautiful new baby? Is this not setting us up to fail by giving us a false reality? I think yes. I think we have lost the art of nurturing instinctively. I think that the years of doctors telling women what to do has led us to feel shocked and helpless after birth. The biggest problem now appears that society is so ingrained with these old fashioned ways that our own mothers, aunties and friends will frequently be heard telling new mothers what they should do.  “Don’t spoil that baby by picking it up too much.” ” You know, controlled crying is the only way to make that child sleep”. “Why do you keep feeding that baby you will give him wind.” The origins of this information does not come from women sitting together telling real life stories to the next generation, but from ‘Mother’s handbooks’ written in the late 1800’s by male paediatricians. Remember this was also the era where children should be seen and not heard, women had to cover their own ankles in long dresses for fear of inducing arousal in men! How many other books do we still relate to from that era?  Why then are we still advising  new mothers of these out dated and potentially harmful customs? Should we not be encouraging women to listen to their own natural instinct? How do we learn to listen to our instinct in our technology savvy, career focused, yummy mummy orientated world?

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