Breast versus bottle: not a simple dichotomy

Picture the scene…. A good friend and I meet up for lunch in a busy cafe, we both have small babies, hers just a few weeks older than mine (and my bigger little man is off running around the shopping centre with Daddy having wolfed down his lunch already). Once we’ve ordered and our food arrives, our babies also decide that they are now hungry, so we each set about feeding them. I set up my SNS which contains a couple of ounces of formula and my baby latches on to me and begins to feed, taking in whatever breast milk I am able to produce as well as formula which is necessary to make sure he is getting enough to satisfy is hunger. My friend gets out her bottles of expressed breast milk and her baby latches on to the teat, which is something he had massive difficulty doing on to her breast as a newborn, hence her decision to express her milk and feed it via a bottle.

There we were, both feeding our babies in our own way, both happy, relaxed, feeling like we were doing nothing unusual, just fulfilling our role as mum to our own baby. It struck me how there was a huge irony in this situation: I was feeding formula at the breast and my friend was feeding breast milk with a bottle – it seemed so weird that we’d both ended up at this point, rather than the classic breast milk at the breast and formula milk with a bottle scenario.

This is actually another lunch out that we had recently, but it illustrates my SNS feeding in a cafe. It could also serve as a caption competition.... Tom and I have some very interesting expressions here! (I think Andrew took the photo, with Grandad's help)

On my way home as I was pondering, a question came to mind that appeared in an issue of a breastfeeding magazine that I receive as a member of La Leche Laegue (LLL). It asked whether, if these were the only two options available, I’d rather feed my baby formula (only) at the breast (if that were possible) or breast milk in a bottle. The point was whether the act of feeding at the breast, and the closeness and bonding that comes from this, was more important to me than the properties of breast milk such as the antibodies it contains that formula doesn’t. When I’d first read that, it made me think – which would I prefer, that’s a tough one! I like both bits of breastfeeding, the physical contact and the milk itself.

And actually, although obviously I would have loved to be able to exclusively breastfeed my babies, I’m grateful that the arrangement we’ve come to, through much persevering in the early weeks of Andrew’s life, allows us to have both. For us it’s not just a simple dichotomy like the question in the LLL mag asked, because my babies do get breast milk at the breast, as well as formula. Reflecting again on this after our lunch reminded me to be grateful for what we do have rather than feel annoyed at what we don’t have. My friend and her baby are lucky that he gets all the goodies in breast milk and doesn’t need formula milk which is expensive, produced by ethically unsound companies and at the end of the day isn’t human milk designed for human babies; but my babies and I are lucky that they both latched on brilliantly to my breast within minutes of being born (though Andrew needed some help to be more efficient at sucking by having his tongue tie snipped later at 10 weeks) and have never struggled to stay latched for comfortable breastfeeding.

As my friend said, we are both doing the best we can for our babies given our circumstances. And that is right – although our breastfeeding problems have been very different, we have a lot in common. We have both had feelings of failure in the past, that we had failed at our role as a mum because we were not able to do the ‘normal’ thing of (exclusive) breastfeeding (at the breast). Both of us have suffered, mainly emotional pain for me as it dawned on me that I wasn’t physically able to produce enough milk for my baby and had to figure out how and if I could continue breastfeeding at all, and both physical and emotional pain for my friend who desperately wanted her baby to be able to latch comfortably for more than a minute at a time and urgently sought help from health professionals whose care they were in. We both have the faff of sterilisation and having to remember and gauge how much milk to take out with us.

But both of us have come to realise that we are not failures, and that our decisions on how to feed our babies are in the best interests of our babies considering the experiences we’ve been through, and we are giving them all they need for the best start in life. The same goes for all other mums I know personally, whether they have breastfed (exclusively/ partially/ at the breast/ via bottles) or formula fed; there is a story behind every decision on how each one feeds/fed their baby. When I think about how many mums I know who have breastfed with no major problems, it’s quite a low number given how many started out trying to breastfeed.

Not that I want to put pregnant mums-to-be off, but I think it’s important to be realistic about it, and equally say how important it is to get good support, preferably set up and in place before baby arrives so you know who to turn to if you do encounter issues. Accurate information and knowledge of breastfeeding, as well as sensitive emotional support, are key to overcoming challenges, and we are very blessed that we found it at the right time. Before I had a baby, I thought that feeding one would be a simple black and white decision – breast or bottle – but since I had my first baby, I’ve come to learn that it’s a much greyer picture than that. And my friend and I painted some of that (positive) greyness one lunch time in a busy cafe, where there could well have also been a mum feeding formula milk via a bottle and a mum breastfeeding in the classic way (I didn’t notice, it was too busy and I was more interested in talking to my friend!)

Chocolate and marzipan star cupcakes

When an email popped into my inbox the other day, from a friend asking if anyone could bake cakes and/or sell them to help her and her sister raise money for charity, I thought that I could help. Baking is a great way to keep Andrew from getting bored and makes a change from the DVD and youtube watching that goes on at the moment. And we get to help raise some money, so it makes it even more worthwhile. The charity they’re fundraising for is Asthma UK, which supports asthma sufferers and their families. My friend’s sister is asthmatic herself, and despite this she is running the London marathon in April as part of her fundraising efforts too – now that sounds much harder than baking cakes! 

As it’s nearly Christmas, I decided to go for something a bit festive but not the traditional mince pies etc. as we already have so many of them at this time of year. I think it’s easier to sell little individual cakes rather than whole ones or slices of whole ones, so I went for cupcakes. They are chocolate sponge, with chocolate chips, and have a marzipan star on top (that’s the festive twist, in both flavour and shape!) The star is held on with a bit of buttercream icing, and on top of the star there is a little swirl of glittery purple icing to finish it off. The sponge has ground almonds in, partly to make it a nice moist sponge, partly to blend with the flavour of the almonds in the marzipan. Oh and the cupcake cases are silver, to make them extra sparkly for the festive theme.

Andrew enjoyed helping me – he stirred the mixture a few times at different stages, and he rolled out marzipan and cut out stars (his favourite job). During our baking session, I noticed that he has a new phrase to say: “Mummy do it” and, more often, “Andrew [A-tar] do it”. I’ve given the recipe below, if you’d like a bit of inspiration to have a go at your own Christmassy cupcakes. This made 16 cakes. Enjoy!

Ingredients

  • 170g sugar
  • 170g margarine
  • 3 eggs
  • 100g self-raising flour
  • 50g cocoa powder
  • 20g ground almonds
  • 1/2 tsp baking powder
  • 100g milk chocolate, chopped into chunks (or ready done chic chips)
  • ready to roll yellow marzipan
  • 50g unsalted butter
  • 150g icing sugar
  • 1 tbsp milk
  • glitter sugar

Method

  1. Pre-heat the oven to 180ºC (fan) and place 16 cupcake cases into muffin tins.
  2. Cream the margarine and sugar in a bowl until smooth and fluffy.
  3. Beat in the eggs until well combined.
  4. Add the four, cocoa, ground almonds and baking powder, and mix until well combined.
  5. Add the chocolate chunks and stir until evenly distributed.
  6. Spoon the mixture into the cake cases to about two thirds full.
  7. Bake in the oven for about 15 minutes, until risen and a skewer inserted in the centre of each cake comes out clean.
  8. Remove from the oven and leave to cool.
  9. Meanwhile make the buttercream icing by mixing the butter and icing sugar until smooth and stiff; then add the splash of milk to make it a little less stiff and a good consistency to work with.
  10. Spoon a small blob of icing (at this point without colour) onto each cupcake; then add the glitter sugar to the remaining icing (I chose a purple glitter sugar).
  11. Roll out the marzipan to a few millimetres thick on a board dusted with icing sugar.
  12. Cut out 16 stars, and press them down quite firmly onto the top of each cake.
  13. Finish by putting the remaining glitter icing into a piping bag and piping a small swirl onto the top of each star.

Choconana muffins

Baking a batch of biscuits or cakes seems to be a great form of toddler entertainment at the moment. As it’s pretty much dark by 4pm these days, we can’t make it to the park any more after Andrew has finished napping in the afternoon. Instead a baking session is the perfect length to fit in between Joel’s feeds at this time of day, and Andrew likes to sit in his high chair and help me measure and mix ingredients. He still needs a lot of supervision of course, and much of the time it’s really me doing it and him watching intently, but he enjoys just being part of the activity no matter how much he’s actually involved.

This week I decided to make some muffins with him, mainly because we seemed to have a sudden abundance of ripe bananas that needed to be eaten. I also fancied making something chocolatey, so adapted my usual recipe for banana muffins to include chocolate – in the form of both cocoa powder and melted dark chocolate. I think it works well, and isn’t too sweet, with most of the sweetness coming from the banana rather than the chocolate. Andrew enjoyed himself, stirring the mixture on his own was the highlight for him, and we only lost a little bit on the table, which was not bad going I thought! Joel was contentedly sitting in the sling whilst we baked, so I feel like he was part of it too. Here’s the recipe…

Ingredients
  • 200g self-raising flour
  • 25g cocoa powder
  • 100g oats
  • 3 eggs, beaten
  • 125g sugar
  • 75g margarine
  • 50g dark chocolate (I used one with 75% cocoa)
  • 125ml milk
  • 2 ripe bananas, chopped small
Method
  1. Put the flour, cocoa powder and oats in a large bowl and mix.
  2. Melt the margarine and chocolate in another bowl in the microwave or over a pan of boiling water.
  3. Add the sugar and milk to the chocolate mixture and stir well. Then add the eggs to this.
  4. Pour the wet mixture into the dry mixture, and add the chopped bananas. Stir until just combined – don’t over mix.
  5. Spoon the mixture into the muffin cases.
  6. Bake at 180ºC (fan) for about 15 minutes.
  7. Leave to cool and eat as fresh as possible. You can also freeze these.

Gingerbread men ….and other creatures (inspired by the Great British Bake Off, episode 8)

Anyone who’s following the Great British Bake Off as avidly as me will know that I’m a week behind on this one. Biscuits, specifically crackers, chocolate tea-cakes and gingerbread, were the theme of last week’s episode, whereas this week was all about French baking – petit fours, gateaux, choux pastry. I didn’t have time to do any baking last weekend, as we had a busy weekend visiting my brand new niece and taking Andrew to see the ‘choo-choos’ (model railway exhibition) at our local museum. Being as biscuits are more my thing than fancy French baking, I thought I’d stick to them rather than stretch myself too far. And besides, gingerbread men are something that I’d really like Andrew to get involved in with helping me bake.

Everything out ready to start on our baking adventure
Ready and waiting with my apron and wooden spoon!

Avid followers of the GBBO will of course also know that the contestants didn’t have to make just any old gingerbread, but rather build with it structures that went beyond the quaint little Hansel and Gretal houses that you see around Christmas-time these days. There were some impressive architectural feats, like a 2-foot tall Big Ben and a 2-foot diameter Colosseum! I wanted to stick with the classic ‘man’ shape for my gingerbread – though who has ever seen a man look like a gingerbread ‘man’?! This involved buying a cutter, because I realised that I’d only ever made gingerbread as a child at home, and I don’t personally own cutters in such a shape. I thought this would be easily remedied by a quick trip to the supermarket, but it seems gingerbread men cutters are harder to come by than I thought. In the end I found a bumper pack of kids biscuit cutters in Hobbycraft, and this included one classic gingerbread man shape as well as other assorted animals, birds and geometric shapes. I saw this as a good investment, because recently Andrew has got into play dough, and I have it on my to-do list to make some, so the cutters will come in handy for using with play dough as well as with edible biscuit dough!

Cutting out a man shape. But I think it's a BEAR Mummy!!

It turned out that Andrew, when given the choice of which shapes he wanted to use for cutting out gingerbread dough, wasn’t actually that bothered about the classic ‘man’ shape, which he insisted was a teddy bear anyway. He much preferred to cut out butterflies and hearts – two words which he loves to say (‘heart’ is pretty accurate, and ‘butterfly’ is something like ‘pap-pap’, which I presume is him picking up the French word ‘papillon’), and kept saying them in very excited intonation as he cut one out, and another, and another, and another…! I did persuade him to let me cut out some ‘men’, sorry I mean bears, whilst he was in charge of heart and butterfly creation.

Waiting for all our different shaped biscuits to cool down before decorating them

The recipe we used was from Paddington’s Cookery Book, which Andrew was given as a birthday present from his uncle and aunt. It has some great recipes that are perfect for getting little hands involved in baking, and this gingerbread was so simple to make. Along with the book, he was also given a lovely little apron, which now fits him well, with some growing room still, so he wore that whilst we baked together. I’ve given the list of ingredients below, which I altered slightly by using margarine instead of butter and omitting the salt, and I’ve also added ingredients for decorating that aren’t in the book. But I shouldn’t write the method out exactly as in the book as it’s under copyright. You do what you would do for making a shortbread-type biscuit, by combining flour and fat into a breadcrumb consistency and then adding the sugar, spices and finally milk to bring it together into a firm dough that can be rolled out and cut into shapes. The finished biscuit texture is quite soft and short rather than crunchy like some gingerbread, but I think this is a nice texture for little (and big) mouths.

Ingredients

  • 200g self-raising flour
  • 2 tsp ground ginger
  • 1 tsp ground cinnamon
  • 100g margarine
  • 75g brown sugar
  • 3 tbsp milk
For decorating
  • white writing icing tube
  • 5 tbsp icing sugar
  • cold water
  • sprinkles
  • chocolate beans

    Putting chocolate beans onto an iced heart

Once they were cooled, we then set about decorating the biscuits with icing, sprinkles and chocolate beans. This was the really fun part! I was amazed at how good Andrew’s fine motor skills were, as he was able to accurately put a small chocolate bean onto each of two small blobs of writing icing that I had squeezed onto the men-shaped biscuits to make buttons down the front, in classic gingerbread man style. Even I found this tricky, though I guess smaller fingers is an advantage in this case. I then drew a mouth and two eyes onto the faces using the writing icing, and Andrew was keen to repeatedly say ‘eyes’ and ‘mouth’ as I did each one! We also mixed some icing sugar with a small amount of water to make a simple water icing that I then spread onto the butterflies and hearts and Andrew helped sprinkle the sprinkles and place the chocolate beans on the butterfly wings. I thought he might be tempted to eat some biscuits whilst we were decorating (or maybe that was just me?!) but he didn’t seem bothered, and I let him have one right at the end when they were done.

Fine motor skills in action (hence the blurry photo!)

We had such a fun afternoon making this biscuits, and I’m glad that Andrew enjoyed it and found it interesting too – it means a lot to me that he’s showing an interest in one of my favourite things to do 🙂

These hearts and butterflies are so pretty, I just can't resist grabbing one whilst Mummy is trying to take a photo of their loveliness!
Time to choose a 'man' to eat - I think I'll have this one with 2 blue buttons please

Red fruit Chelsea Buns (inspired by the Great British Bake Off, episode 7)

I made sure that I really appreciated watching this week’s episode of the Great British Bake Off (GBBO), even more than I normally do, because it cost us quite a bit of money to download, as we’d got to the limit on our monthly broadband package and ended up paying a pay as you go mobile 3G rate, which soon adds up when you’re talking about hour-long downloads. Oops! It is a bit ridiculous that we even have to have mobile broadband in such a built up area, but we just couldn’t get a decent speed through the phone line, and Virgin won’t dig up our road (I know, hard to believe, but they won’t, we’ve asked more than once!)

So I was determined to make time this weekend, despite being out for most of the day on Saturday, to bake Tom something nice, to try and make up for my expensive downloading. This week’s bakes were all about sweet dough. The first was on the theme of regional buns (for example, Bath buns, Lardy cakes, Saffron cakes, and of course Chelsea buns); the second bake was jam doughnuts (which looked very hard to make, and we don’t have a deep fat fryer); the third bake was a celebration loaf (for example, Brioche or Stollen). I made a Stollen at Christmas, and the contestants mostly seemed to be proving their doughs for the third bake overnight, so I thought that a celebration loaf wasn’t a great option for my limited time this weekend. Instead I went for a regional bun that I’ve thought about making a few times, but never got round to it – the Chelsea bun.

In Cambridge there is a famous cake shop called Fitzbillies that makes the most amazing Chelsea buns – they are their own secret recipe. When the original Fitzbillies shop had to close down in the bad economic climate, many people, including comedian Stephen Fry who tweeted about it, were gutted to lose the place to buy these lovely buns. I can’t say that I bought them that often, because they were pretty expensive, but I did on a few occasions as a treat, and was sad to hear about this independent cake shop closing down. However, I was then very happy to learn, actually again through twitter, that new owners had bought the Fitzbillies shop and were doing it up in order to re-open under the same name. The icing on the cake (pun intended) was that they had even managed to gain the secret recipe for Chelsea buns along with their purchase, so the famous buns would be back in town in no time! Hooray! And I went and bought one or two not long after they first opened.

Not that I’m aiming to make anything quite as special as theirs (I don’t know what it is about them specifically that makes them so yummy, it’s a secret, clearly), but I’d often thought about having a go at baking some Chelsea buns that were at least good enough to eat. Whilst looking through our dried fruit container, to see how much we had and whether I needed to buy any more to make the buns, I remembered that I had recently bought some more unusual dried fruit for Andrew to eat as a snack as a change from his raisins, which included raspberries and cherries. These made me think that baking Chelsea buns with a bit of a twist from the usual fruits would go down well, so I went for them instead of raisins/sultanas/currants.

The recipe I used for the dough was from the BBC Food website, and it turns out that it’s actually from another series of the GBBO. Here’s a link to the recipe. I adapted it (as always!) to include red fruits (raspberries and cherries) instead of the usual dried fruits, and I decided to bake the buns close together (see picture below) rather than spread apart on a baking sheet because I like the squarer, more compacted together shape for Chelsea buns than perfectly round and crusted all the way round, I guess because they remind me of Ftizbillies’ famous ones – they have a square-ish shape to them. I found there wasn’t a lot of glaze for the amount of ingredients that the recipe said to put in, so if you like them sticky and extra sweet, I’d probably double or treble it. I quite like the fact that they’re not as sickly sweet as the Fitzbillies ones, because my sweet tooth has definitely been affected by pregnancy.

I wouldn’t win any prizes for the most consistent baker, who makes buns all perfectly the same size and shape, but the main thing is that the taste and texture are good. It’s quite handy actually that some are smaller than others (due to the shape of the rolled out dough, which ended up creating a roll that was thinner at both ends than in the middle), because the smaller ones are a perfect snack size for Andrew. He had one more or less straight from the oven, once they’d cooled down enough to eat – ‘hot’ is one of his favourite words, and he knows to wait until food is no longer too ‘HOT, HOT’! My other boy approved too, so I feel less bad about the fact that it cost us more than a few pennies to watch the episode of the GBBO that inspired this bake.

Pregnancy diary: week 31 – breastfeeding update

I thought it was about time that I wrote a pregnancy post with an update about how breastfeeding Andrew is going and my thoughts on how it might go once baby is here. In early pregnancy, I wrote about my thoughts on nursling (self-)weaning. I then wrote a sort of update at 21 weeks, but I hadn’t come to any firm conclusion about how or when I would initiate weaning if Andrew didn’t self-wean. I guess I was trying to leave it as long as possible, to see if Andrew would self-wean, even if right at the last minute. Well he’s still going strong (as strong as he has been for the past 6 months), and feeding for about 20 minutes first thing in the morning and about 20 minutes last thing before bed, plus the occasional feed in the day if he’s upset or grumpy for some reason (for example, teething).

I’ve been reading the book Adventures in Tandem Nursing on and off for a while, so I now have lots of info about breastfeeding a toddler in pregnancy and once the new baby is born. This has been very helpful, but since I know that we’re a special case, given my hypoplasia (insufficient glandular (milk-making) breast tissue), I wasn’t sure that all of the info was completely applicable to us, because it doesn’t specifically mention mums with hypoplasia. So I decided that the best thing would be to get some expert advice, more than is available in books.

Andrew reading up on tandem feeding with the book Adventures in Tandem Nursing 😉

I spoke to the leaders at my local La Leche League (LLL) group where we’ve been going since Andrew was just a few weeks old. They have been an amazing support to us, and I knew they would do everything they could to help us with this situation too. One leader in particular was very helpful. As we talked and she helped to unravel my thoughts by asking me specific questions about what I was thinking, I came to the conclusion that I wasn’t against tandem feeding in itself, but what was stopping me from thinking it was possible for us was my hypoplasia and the memory of awful supply issues that I had when Andrew was a baby. (If you’ve not read from the beginning of our breastfeeding journey, you can find it here.) I realised that IF supply wasn’t an issue (a big IF) then I’d have no hesitation in tandem feeding both Andrew and baby – I was up for that. But of course, like I said, it’s a big IF, because it’s likely that supply will be an issue again with baby. My concern would be that Andrew, although he’d help make more milk by feeding (the more he takes the more I make), would also take milk, and I wouldn’t want him to take what would be better drunk by the newborn.

My helpful LLL leader understood what I was telling her, and agreed that it’s an unusual situation to be in – there can’t be many mums out there who have hypolasia and are considering tandem feeding, or are actually tandem feeding. She recognised that our unusual situation went beyond what she had personally read as part of her LLL leader training and experienced with other mums through her role as an LLL leader. So she offered to post our question to the online national forum of LLL leaders, to see if anyone else had experienced a similar situation, either themselves as a breastfeeding mum, or from other mums they had met through their role as leader. What was our question though? Essentially it boiled down to: Is it possible to tandem feed with hypoplasia?

Within a couple of weeks, I had three very helpful leads as a result of my leader’s post to the national leader forum. One was from a mum who hadn’t had supply issues herself, but who had recently been to a conference for lactation consultants (people whose job it is to support breastfeeding mums), where there had been a paper on insufficient glandular tissue and possible ways of helping increase supply. The main focus of her emails to me was on herbs that act as galactologues (substances that help increase milk supply in breastfeeding mums). She gave me some links to resources on these, including those that are apparently safe to use in pregnancy, because relatively few of them are. I’m not entirely convinced about taking herbs in pregnancy, because Andrew is still feeding now and helping to keep my supply going, and the herbs are pretty expensive to keep taking every day over extended periods. As money will be even tighter once I leave work, I have to weigh up all the pros and cons of dealing with supply issues.

Another email correspondence I had was (indirectly via my LLL leader) with Diana West, author of The Breastfeeding Mother’s Guide to Making More Milk. She’s done some research herself into insufficient glandular tissue, and, as you can tell from the title of the book she wrote, is an expert on supply issues in general. Nothing like going straight to the top lady for advice! Her reply was very to the point: in her opinion it is possible for a mum with hypoplasia to tandem feed, though she would need to take some steps to make sure she is making as much milk as possible, such as taking herbs, expressing and using an at-breast supplementer if supplements are needed for the newborn – all the stuff you can read about in her book, which was relevant to me as a first-time mum breastfeeding just one child; the toddler would also help to boost supply. She said there was no reason that I couldn’t be treated like any other tandem-feeding mum and any other mum with low supply, in terms of the support that my LLL leaders could give me. That was encouraging!

But even more encouraging was to hear from an LLL leader who’s a mum who has personally experienced tandem feeding with hypoplasia. She gave it a go, and it worked out well for her and her children, who have a similar age gap to the one that Andrew and baby will have. She said that she definitely noticed that she had more milk with her second baby, though it’s hard to tell whether this is just the result of having a second child (generally mums have more milk with subsequent babies) or whether the breastfeeding toddler actually helped improve her supply even more than if she hadn’t have been feeding still. She also gave me some tips on herbs that she used, and told me that she always made sure that the newborn fed before the toddler did. Like us, she used a supplemental nursing system (SNS) in the early months for both babies, and she said that with her second baby she stopped using it a lot sooner than with her first, because her supply was better. She said that her toddler acted like her ‘breast pump’, by feeding after the newborn to remove even more milk from the breast so that more would be made for the next newborn feed. One thing that she highlighted, as I often do, is that breastfeeding is not just about food, and that the tandem feeding was a way for her children to bond with each other, and it helped her toddler through the transition of having a new baby in the family.

Bump looks big in this! I think it's because it's a flow-y top though, because I don't think I look so big in a more fitted top. Lots of people are telling me that I look very 'neat' or 'small' for over 30 weeks!

So my assumption that it’s not possible for us to give tandem feeding a go due to the hypoplasia and supply issue has turned out to be wrong. That’s not to say from what I’ve heard from these contacts that it would be easy, but I’m not one to avoid a challenge just because it sounds hard. I would never have continued to breastfeed Andrew if I wasn’t determined, despite how hard it was, to give him as much of my milk as possible, and in the end we’re still going now at 19 months. When I think about how much milk he’s had from me over those 19 months, I bet it’s not actually that far off what some babies get in 6 months of exclusive breastfeeding who are then weaned onto formula. Breastfeeding in early pregnancy was tough too, because I was so sick, but we’ve got through that and I’m feeling much better and glad that I was able to persevere in the hard times when I really didn’t feel like letting Andrew feed.

You can probably guess that my thoughts are now not so focussed on the necessity of weaning. My current thinking on breastfeeding is that I’m happy to let Andrew continue, if he wants to, and see where we end up. If he self-weans before baby arrives, that’s fine; there’s still plenty of time, given that weaning in pregnancy can be quite abrupt, and who knows what he’ll be like next week even if he’s going strong now. Or if he’s still feeding when baby arrives, that’s fine too. As he is pretty predictable in his feeding pattern (i.e. twice a day for main feeds and occasionally other small ones), it should be fairly easy to judge when to offer the newborn the breast before allowing Andrew to feed. If the newborn is anything like Andrew was, for which of course there is no guarantee, then he/she will feed most of the day on and off anyway, inter-dispersed with lots of activity and alertness; it would be harder if he/she is a sleepy baby, as I would then need to be more watchful as to when he/she needs to feed, especially in relation to Andrew. Or if Andrew decides to self-wean once the newborn is here – maybe because there’s less milk for him? – then that’s fine too. If breastfeeding helps him to accept the new baby and not feel jealous or like I’ve got less time for him, then I’m definitely up for tandem feeding as a means of meeting the needs of both my children.

It’s a nice feeling knowing that I have so much more info and support for breastfeeding already in place this time. At 31 weeks of pregnancy with Andrew, I had barely even thought about reading up on breastfeeding and was just getting round to booking my place at an antenatal breastfeeding workshop, which in the end was OK, but didn’t give me any info other than the textbook case, which of course we turned out not to be. I look back and wish I’d been more aware and able to get more info and support antenatally with Andrew, but it’s one of those things that is easy to say with hindsight, and Tom has reminded me that we did our best with the info and knowledge we had at the time, and that’s all we could do. At least this time we have been given another chance to learn from our first experience.

That’s all for now, except to say that this week saw Tom and I celebrate our 4th wedding anniversary. It’s amazing to think how much has happened in those four years, and I can’t believe that there are now nearly 4 of us instead of the 2 who started a journey together on our wedding day four years ago. Andrew is definitely a mixture of the 2 of us – I love looking at him and thinking of how he has bits from me and bits from Tom. I’m looking forward to discovering in what ways the new baby is another mixture of the two of us 🙂

 

Pregnancy diary: week 21 – bits and pieces

As I’ve come to sit down and write this post, quite early on in the week (although I’m posting later), there aren’t really one or two particular things that are happening or are on my mind that are specifically to do with pregnancy. So this week’s post is mix of a few bits and pieces…..

The reason I’m getting the bulk of writing done early in the week is because I’m going to the BritMumsLive 2012 bloggers conference on Friday and Saturday. This in itself is very exciting, and I’m definitely looking forward to going and meeting up with people I know mostly just from virtual conversations. But it’s not specifically to do with pregnancy. I have just found out, though, that a lovely blogger, Louise, whose blog I came across only recently, is organising an informal get-together for pregnant mums at the conference. She is only a few weeks behind me in pregnancy, so it’s great to read her posts too and know that someone else is going through similar thoughts/feelings/physical changes. From what I’ve seen on twitter, it looks like there’ll be quite a few other pregnant mums joining us. Pregnancy is generally something that inspires people to blog. I thought it would be a nice record of a journey for me, baby, Andrew and Tom. Although I didn’t think about doing this with the last pregnancy (probably because I hadn’t come across the world of blogging and what I could get out of it and what others could get out of me), I’m really enjoying writing down my thoughts each week so far. And it turns out I’m not alone – there are plenty of other pregnant mum bloggers to link up with. I’m sure I’ll post more about the conference at some point, and I’ll include a bit about the bump meet-up.

One thing that’s been on my mind from time to time this past week is breastfeeding, both weaning Andrew and preparing for baby, but I haven’t come to any real conclusions! It’s still something that I keep tossing around my head when I get time to think. I said that we’d get to 20 weeks, then reassess where Andrew was at in terms of showing signs of self-weaning, and think about what to do from there. Well, we’re now at 21 weeks and he’s not feeding less than he was before pregnancy. I explained in my previous post on thoughts about nursling (self-)weaning that he was generally feeding twice a day – once first thing in the morning and once last thing before bed, for about 20 minutes each time (I guess – I don’t clock-watch, but roughly). Ironically he then started feeding more in the early weeks of pregnancy! I’m not sure if it was because he was teething molars, or because he actually liked the ‘weaning’ milk that starts to be produced in early pregnancy (which tastes less sweet and more salty than before pregnancy), or because I was so sick and tired that all I would do in the afternoons is lie on the sofa and watch him play (in between running to the toilet) so he was more aware of milk just being there to drink with no distractions like going to the park like we usually do. Or quite possibly a combination of all these things. Whatever it was, this seems to have worn off again, and he’s back to the two main feeds a day (plus the odd short one if he’s upset and needs calming down).

On the one hand, I see the fact that he’s still feeding as a good thing. It means we’re maximising the chances of me developing more breast tissue and therefore producing more milk for baby than I did for him, and minimising the gap between him stopping feeding and baby starting feeding. On the other hand, I’m concerned that if he feeds into the third trimester, he’ll start drinking some of the milk (colostrum) that I’m producing in preparation for baby. If I didn’t have hypoplasia, this wouldn’t be a bad thing because my breasts would produce plenty; but given that my milk supply is not necessarily going to be enough for this baby either, even with all the knowledge and support I have this time round, I really want the newborn to have everything that I can produce. The one (kind of) conclusion that I’ve come to is that I need to talk to some experts about this, because we’re a special case and I can’t decide what’s best to do based on books and online reading.

Bump getting bigger....

Another thing that’s been on my mind (and therefore Tom’s given how much I’ve brought it up in conversation) is what we might need to buy for baby. Of course as Andrew is only 16 months, we have most things already. But the two things that I’ve been researching are nappies and a sling.

I posted a while ago about cloth nappies, and told of their greatness! As we only have enough for one, we’ll need to expand our stash. Recently Andrew has been becoming a heavier wetter than he was, because he’s suddenly discovered the taste of squash (thanks primarily to his childminder!) and drinks it like there’s no tomorrow. I’m generally happy that he does this, because I think he can’t really drink ‘too much’, but it is possible to drink too little, and this has always been at the back of my mind since he was a 6-day old baby in hospital with dehydration. The nappies have started to leak sometimes, because we haven’t put (m)any extra booster layers inside, since the style we have get quite bulky with extra layers. So we’re thinking that it could be a good plan to buy some more absorbent but slim-fitting ones for Andrew, and use the ones we already have for baby. I’ll write more about the specifics of what I’ve researched on nappies when we’ve bought them, as it’ll need a post in itself.

When Andrew was a baby, we were given two slings second hand from friends. One was the Baba Sling, and one was the Baby Bjorn. I used both of them a bit, but neither of them were very comfortable to use for more than quite short distances or short periods around the house. By the time I stumbled across the wonderful world of ‘babywearing’, Andrew was a toddler and it wasn’t long before I was pregnant again. I discovered that there are many types of sling different from the two we had, which looked far more comfortable and came with excellent reviews and recommendations from what I could see in all the online babywearing information. I’ve done some research on what would suit our needs, and we’ve decided that instead of buying a double buggy, we’ll buy a good quality, comfortable sling that I can carry baby in and Andrew can continue using the single buggy. We can then reassess when baby is older; by that time I think it’s likely that Andrew will be fine on a buggy-board and baby can go in the buggy. Given that people ‘wear’ their babies right through into toddlerhood, this initial arrangement could last us quite a while. One of the prizes in last week’s Keep Britain Breastfeeding Scavenger Hunt posts was a Moby sling (or ‘wrap’). As this is one of the choices of sling that I have narrowed down to, I’m waiting until after the competition winner is announced before I go any further with going about buying a sling. Again, I’ll write another post specifically on this at some point.

I think that’s enough rambling for this week. Hopefully I’ll have some more decisions made on weaning, nappies and a sling over the next few weeks, so I can update you with what we’re doing.

‘We love you Daddy’ mini heart-shaped cheese scones

So it’s the Saturday morning before Fathers’ Day, and I suddenly realise on an unrelated search through the fridge that we have 2 eggs that are at the day before their use-by date. This is probably because I’m doing less baking these days and I keep forgetting to do boiled eggs now that Andrew seems to be not so keen on scrambled but will eat boiled. Tom and I hate throwing away food, and very rarely do it – as we live so near the shops and do most of our shopping by foot or bike, we buy fresh stuff every few days and only as much as we need. So I was not going to let these eggs go to waste. I’m still not exactly back into baking like I was, but if it was bake or throw away food, I know which I’d rather do. As I’m generally feeling pretty good these days in the morning, I set about thinking up a recipe (or what turned out to be two) which would use the eggs up, and, to kill another proverbial bird whilst I was at it, bake something I knew Tom would particularly enjoy as a Fathers’ Day treat.

Given that Tom likes pretty much anything edible, I had quite a free rein on that front. The main factor in deciding on recipes was of course they had to have egg in. As my sweet tooth has yet to return from the pregnancy taste changes, I thought I’d give a savoury recipe a go. I flicked through some books to get inspiration, and the scones in good old Delia Smith grabbed my attention. I love a good cheese scone, so that was one egg decided on. For what I did with the other you’ll have to wait for another post.

Here’s the recipe that I used. It’s roughly based on Delia’s, but I always adapt recipes to suit our tastes and cupboard/fridge contents. I went for a ‘mini’ size so they would be easy for Andrew and also good as a snack. The heart-shape was supposed to be a sign for ‘We love you Daddy’ and we’d like to thank you for all you do.

Ingredients

  • 75g wholewheat flour
  • 75g self-raising flour
  • 25g margarine
  • 100g mature cheddar, grated
  • 1 egg
  • 3tbsp milk
  • 1 pinch cayenne pepper
  • 2 pinches cumin seeds

Method

  1. Rub the margarine and flours together in a bowl using your fingers, until it looks like bread crumbs.
  2. Stir in the cayenne and cumin until evenly distributed.
  3. Mix in about 3/4 of the cheese until evenly distributed.
  4. Beat the egg and 2/3 of the milk in a cup, then add it to the other ingredients, and stir until it forms a stiff dough that you can roll into a ball. If it’s too dry, add a bit more milk.
  5. Flatten out the dough on a floured surface to about 1cm thick, and cut out scones using a biscuit cutter. I used a small heart-shaped one, to make the mini scones as a ‘we love you Daddy’ treat 🙂
  6. Place the scones on a lined baking tray.
  7. Brush them with the rest of the milk, then sprinkle with the rest of the cheese.
  8. Bake in the oven at 180ºC until golden brown.
  9. Let cool and eat as fresh as possible.

We had ours with tomato soup, which worked brilliantly. In fact Tom liked them so much he ate most of them in one go! Andrew and I just about got a look in. I hadn’t expected them to be that popular, even knowing his appetite. He said his excuse was that they’re best eaten on the day of baking. I said he didn’t need an excuse – they were his treat!

Pregnancy diary: week 19 – feet up & animal instincts

This week started with a 4-day weekend, and it’s also been half-term. My parents-in-law came for the long weekend, and my mum-in-law (who is a teacher) has been here with us for the rest of the week. This means that I’ve not had to do any house work, shopping or general chores because they did them, and they have been a big help in entertaining Andrew. So I’ve had more opportunities just to put my feet up and relax compared to a normal week. I’ve still been at work for 2 days (I got half a day off for the Tuesday bank holiday), but even so it’s been less tiring than usual. I’ve also been feeling a bit less sick, which makes sense because sickness is correlated with tiredness in this pregnancy, and I’ve definitely noticed that both have dropped a bit this week. It was about this time in pregnancy with Andrew that I started to feel more normal again, so hopefully it’s not just the relaxing week that has helped in this, but a sign of how things will stay.

Definitely looking bumpy from this angle now

Despite the unusually (for Cambridge) wet weather at the weekend, we did manage to get out for a couple of days, and visit a farm on Sunday and a zoo on Monday. It was nice to get some fresh (if a little damp!) air and amble around whilst entertaining Andrew, who really needs to run around even when it’s wet. He’s just started to get interested in animals and watching what they do, so these two venues were perfect for him.

The farm was very quiet, so we got some interesting demonstrations with just us there, including a sheep being sheared and feeding time with the calves. The calf feeding time was particularly interesting from a breastfeeding point of view. There were two calves, both of whose mums were dairy cows. The farmer explained that they take the calves away from dairy cows at about 24-48 hours after birth, otherwise it leads to problems with their milk supply. Because the cow produces loads of milk even without a calf (that’s what they are bred for), the calf would have a continuous, over-generous supply to deal with, sometimes drinking more than it needs to, and often drinking from just one nipple on the udder because it doesn’t need to change to another as the supply is so generous. This leads to the cow getting mastitis in the other parts of the udder, and you end up with a poorly cow. The reasons why the farmer takes the calf away 24-48 hours after birth (and not straight away) are (a) that they do allow the calf to drink the colostrum, the early post-birth milk full of antibodies, direct from the cow, and (b) so that the cow and calf haven’t had chance to form a bond. Once they are separated, the calf still gets to drink mum’s milk, but from the calf equivalent of a baby bottle! It’s a similar thing, but with a cow-sized teat rather than a human-sized teat. Basically these calves were being fed expressed milk from a bottle! I wish I’d taken some photos, but it was so wet I just didn’t think about it at the time.

This got me thinking about how ‘animal’ breastfeeding is, in the sense of ‘natural’, and that ultimately we are just another species of mammal, similar to cows (and dogs, cats, pigs, sheep etc.) in how we’re designed to feed our young. In fact the very name ‘mammal’ comes from the fact that mammals have mammary glands (in females) that produce milk to feed the young offspring. The milk that a cow produces is tailored to provide the calf with what it needs to survive until it’s old enough to not require the milk any more, just like human milk is tailored to provide the baby with what it needs to survive until it’s old enough to not require the milk any more. This experience of hearing a farmer talk about mastitis and colostrum (two things featuring prominently in antenatal and postnatal breastfeeding info), whilst giving some calves expressed milk from a mummy cow in a bottle, really brought home to me just how biologically natural breastfeeding is.

After this demonstration, we went to look at the pigs. Initially I walked away again, repulsed by the smell and gagging, but Tom persuaded me to try holding my nose because he thought I would love to see the little piglets that were suckling on their mum. So I braved it (actually holding my nose worked surprisingly well), and it was worth it to see the tiny baby pigs climbing all over each other to get at a nipple! There was also another mummy pig who was nearly due her piglets, and definitely looked like she was going to pop any moment! I could relate to her too 🙂

Andrew looks on as a family of tapirs munch on a bush (the stripey baby is so cute!)

Babies was a theme at the zoo too. In the past few months they’d had a ‘baby boom’ as it said in the guide book. Here we’re not just talking about mammals though, but birds too. There were some owlets that had been born back in April, which didn’t look quite as cute and fluffy now as they did at a few days old in the pictures in the guide book, but still cute (you’ll have to take my word for it because I didn’t take a picture, again!) The lemurs had also been reproducing, although I’m not sure we actually saw the babies – if we did they’d grown to adult size as all the ones we saw looked the same size. Something I did capture on camera was a lovely family of tapirs – daddy, mummy and baby were happily munching on a bush in their enclosure. At one point a squirrel ran very fast through their enclosure, and it must have startled them, because all of a sudden they all ran quickly across to the other side, and the parents were very protective of the little one in their movements. Again, this reminded me of the protective feeling for my child(ren) that I have as a parent, and how we have quite a lot in common with animals: we are, after all, animals.

Next week we’ll have reached the big 2-0, the (roughly) half-way point. We’re looking forward to having another scan on Tuesday, so I’m sure there’ll be another inside the bump picture to go with the regular outside one. Where are the weeks flying to….?!

When tongue-tie is more than being stuck for words

Once again I seem to be blogging about the same topic twice in a few days (obviously not including pregnancy – the last time this happened swimming was the thing on my mind) This week it’s been breastfeeding, which I guess isn’t surprising given that I’m thinking ahead to a new baby. So, apologies if you’re not interested in hearing about breastfeeding, but here’s another thing that’s been on my mind.

We found out, the hard way, after nearly 10 weeks of Andrew struggling to gain weight as a newborn, that Andrew was born with a tongue-tie. ‘What’s that?’, you might say, or ‘I’ve heard of it – doesn’t it just mean when you’re put on the spot and can’t come up with the words to say?’ Personally I used to associate the term ‘tongue-tied’ with the (slightly geeky and cult) comedy series Red Dwarf (some of you may know what I mean; see here if you don’t!) Basically it means a tongue which is anchored to the floor of the mouth to a greater or lesser extent by a piece of skin called a frenulum. A more technical term for tongue-tie is anklyoglossia (anklyo – anchored; glossia – tongue). It is sometimes measured (roughly) as a percentage, so a 100% tongue-tie is where the frenulum goes all the way to the tip of the tongue, and in a 50% tongue-tie (for example) the frenulum goes about half way to the tip.

Example of a tongue-tie (about 80%) (yes, this is my mouth - the mouth of a breastfed baby all grown up) Note the frenulum, the thick piece of skin anchoring the tongue to the floor of the mouth behind the lower front teeth.
Example of a tongue without a tie (thanks to my lingually superior to me husband 😉 ) Note there is no frenulum anchoring the underside of the tongue to the floor of the mouth, so it is free to stick up this far.

‘What’s this got to do with breastfeeding?’, you might well ask. It shouldn’t be too hard to imagine that the physical state of the tongue can affect a baby’s sucking action, because that’s what they suck with. The problem with this for breastfeeding is that a tied tongue is unlikely to be very efficient at removing milk from the breast, and therefore the mum’s supply will suffer, because the process of breastfeeding is such that the more milk that gets removed by baby from the breast, the more the breast produces. Poor supply leads to less milk for baby, and so poor weight gain in the baby.

However, I should point out that it is not an absolute fact that all tongue-tied babies will have problems breastfeeding and gaining weight. I found out on the same day as we found out with Andrew that I have a severe tongue-tie (more severe than Andrew did), and yet I was exclusively breastfed as a baby and my mum had no major problems doing that. There are clearly many factors involved in each individual breastfeeding relationship between mum and baby, and what causes an issue in one may not cause an issue (or the same issue) in another. But my point is that tongue-tie CAN have a big effect on breastfeeding, as Andrew and I (as well as many others) can attest. For that reason, I’d like to do my bit to try and raise awareness of this.

In my experience, one of the most important places to start with raising awareness of tongue-tie is with medical professionals, believe it or not! Of course there are exceptions to every rule, and I’m sure there are doctors, midwives and health visitors who are very clued up on this, but that was not the case in our story. I won’t go into details of our tongue-tie story here, as you can read in a separate post that will follow this one, but we were wrongly advised by two GPs about what to do about tongue-tie. I understand that they are general practitioners, and so I wouldn’t expect them to know everything there is to know about tongue-tie, but I would expect them to refer us to a specialist, given the symptoms that we were displaying as a breastfeeding pair. In the case of these GPs (and others in Cambridge that I have heard about through mums having had similar experiences), the problem is their ignorance of the potential effects of tongue-tie on breastfeeding and, to some extent, ignorance of the importance of breastfeeding itself.

But it’s not really the fault of these individual medical professionals, rather a wider cultural issue resulting from the fact that breastfeeding lost its status as the norm of infant feeding to bottle feeding, though this is currently in the process of being reversed again. Tongue-tied babies can still suck a bottle teat and drink all the milk in the bottle (but they might be slower or messier than a non-tongue-tied baby). Knowledge about tongue-tie and how it potentially affects breastfeeding has dropped off the radar in the training of medical professionals, because it was not an issue for bottle fed babies. So it’s not surprising that our GPs weren’t clued up on tongue-tie – it was probably covered in just a line or two in their massive textbooks that they read once whilst cramming for exams! I read somewhere (but I can’t find it now I’ve come to write about this, so it might be an urban legend or old (mid!)wives’ tale) that midwives used to keep one of their little finger nails long and sharp so that they could inspect the baby’s tongue when it was born and sever the frenulum quickly using the nail if the tongue was tied.

Note the 'heart shape of this tied tongue - the frenulum is pulling it down in the centre when I try to lift up the tongue. Sorry for slight blur - it's actually really hard to take pictures of tongues as they are hard to keep still!

‘Wouldn’t that hurt the baby? Sounds a bit cruel to me?’, you might say. Actually in very young babies, the frenulum has little blood supply and nerve tissue, so they don’t feel much, if anything, when the frenulum is snipped. The younger the better, because as the baby grows, the more the frenulum develops blood supply and nerve tissue, and by the time you get to my age, it would be a major operation under general anaesthetic if I were to get my tongue-tie snipped (which I won’t because I don’t need to, thank you very much!) These days, when tongue tie is actually treated in babies, it’s done with a sterile pair of blunt surgical scissors, without any anaesthetic, not even local. ‘OK, that does sound cruel’, you might say. Well, it’s no more cruel than sticking a needle in their thigh for their immunisations. In fact in Andrew’s case, he cried less (loudly and long) for his tongue-tie snip than he did for any of his injections, and quickly calmed down whilst feeding from me, during which the action of sucking helped to close up the cut effectively. I’ve heard from other mums who had their baby’s tongue-tie snipped at just a few weeks old that the baby didn’t even wake up from their sleep when it was done. So overall I would say that the small amount of pain is nothing compared to the long term benefit of having an efficient tongue suck for breastfeeding, just like the short term pain of immunisations is nothing compared to the long term gain of not catching life-threatening illnesses. Both are choices that I as a parent have had to make on behalf of my child.

Look at how near the frenulum comes to the tip of the tongue! Sadly this is about as high as I can lift my tongue in my mouth when it's this far open, and I certainly can't stick it out very far at all.

With a second baby, I’m sure there are many examples of things that will be easier because we’ve encountered them before (of course there will be new things that didn’t crop up with the first too!) Tongue-tie is one thing that I will definitely be personally more aware of with our new baby than I was with Andrew. As I said, my experience of tongue-tie was once limited to a comedy series, so I can’t stand in my greenhouse and throw stones at people who don’t know about tongue-tie – I don’t fancy getting covered in smashed glass. What I do know is that this time I will be more persistent in getting specialist advice as soon as possible, because it is quite likely that this baby will also be tongue-tied to some extent, as it runs in families and mine is so bad, though thankfully Tom’s tongue is not tied at all. I will have more  knowledge myself to try and impart on anyone who is involved who does not seem to have it themselves. If we catch and snip a tongue-tie early this time, this might help to build up my supply more in the early days, and might mean I can breastfeed with less (or no) formula supplementation.

The follow-up post to this intro on tongue-tie contains the letter that I recently wrote to our GP practice, as feedback on our experience of advice on tongue-tie. I’ve anonymised it: my point is not to name and shame, as this practice is not alone in the way they deal with this condition. I thought it would be useful to share, to complete this bit on raising awareness of tongue-tie. In the meantime, I’ll leave you with a very helpful website, which (in its own words) aims to dispel the myths and reveal the facts about this little-understood condition, just in case you’re interested in finding out more: www.tonguetie.net (need I say more….)