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Posts Tagged ‘Breastfeeding’

Thinktank DEMOS got quite a lot of publicity yesterday for it’s new report entitled ‘Building Character written by Jen Lexmond and Richard Reeves.

Building Character was funded by the Equality and Human Rights Commission (EHRC) and included such names as Penelope Leach and Penny Mansfield on the advisory board.  The EHRC commissioned DEMOS to undertake research into the development of character capabilities contributing to ‘life chances’ and factors influencing the development.

The methodology looks pretty robust.  They reviewed up-to-date literature, carried out a new statistical analysis of the Millenium Cohort Study and analysed policy initiatives.  The statistical analysis looked at information given by over 15,000 families.

The report first of all defines ‘important character capabilities’ which include empath, agency (locus of control), responsibility and self-regulation.  The authors state that these should be considered ‘hard skills’ if the definition of hard and soft skills is actually useful, which they doubt.

They go on to divide parents up into 4 groups:

  1. Tough love.  Parents are attached, warm and loving and ‘high control’ more rules, consistently enforced..
  2. Laissez-Faire.  Parents are attached, warm and loving and ‘low control’ have fewer rules/more variably enforced.
  3. Authoritarian.  Parents are not attached, have ‘low warmth’ and ‘high control’.
  4. Disengaged.  Parents are ‘low warmth’ and ‘low control’.

They then also look at parents capabilities, self esteem and so on.  They look at how children’s character develops in relation to the above style of parenting.  They also compare all the usual ‘risk’ factors such as low income, family make-up, employment, ethnicity and so on.

I think the findings are remarkable.  In virtually all cases, allowing for the capabilities of the parents the ‘risk factors’ become negligible.  The style of parenting is the most important factor in how children develop these ‘hard’ life skills.  Children of ‘tough love’ and ‘Laissez Faire’ parents develop character far better when all factors are taken into account than authoritarian and disengaged.  Children of Tough Love parents do significantly better and children of Disengaged parents do worse of all.

This is probably hardly surprising but it does bring about some interesting thoughts.  All the money being poored into providing childcare, welfare-to -work, reducing teenage pregnancies and so on is seemingly wasted.  In actual fact having working or young parents makes no difference to outcomes for children.  It is the style of parenting that is all important.

Demos make a very convincing case for refocussing public spending and energy on providing parenting skills and support to impact on the style of parenting.

There is really far too much information in this report to summarise in a blog post, but I’ve hopefully whetted your appetite enough to go and read for yourself.  If not, here are some quotes from the report which might convince you!  Check out the Breastfeeding one – one of my favourites 🙂

An analysis undertaken by Kiernan of the MCS found that family status was only very weakly associated with children’s development, once other factors – like poverty, maternal depression and so on – were controlled for.

When we control for other characteristics – namely parental style and parental confidence – the relationship between family structure and child outcomes disappears almost entirely.

Crucially, the outcomes for children of lone parents and step-parents are explained by the differences in other family characteristics such as parental confidence and self esteem; being a lone parent or a step-parent does not adversely affect child outcomes in itself.

There is a strong association between children’s development of character capabilities and breast-feeding to six months. This effect remains even after controlling for all other variables in the model, including primary carer attachment

There is no connection between paid employment on the part of either the main carer, or the second parent, and the development of character capabilities in children.

Parental disability and parental ethnic background are associated with significantly different outcomes for children at age five, but all differences are outweighed when parental ability was taken into account.

Now, I’m off to peruse the rest of the DEMOS website as this report is pretty good in my opinion.  Just wonder… is anyone going to listen?

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We live in a funny old world.  We are a strange society.

A popular TV programme in this household is Harry Hill’s TV Burp (don’t ask) which is on ITV on a Saturday evening.  I was ‘lucky’ enough to catch a couple of minutes in passing this week.

He was taking the mickey out of a soap character, and she was breastfeeding her baby.  It then cut to Harry asking for a drink and being given a cup of milk and biscuit.  Supposedly the character’s breastmilk.  The audience gave the obligatory cries of disgust, and then when Harry dipped the biscuit in the milk and ate it – the uni-groan of disgust and shouts went up a notch or ten!

I just thought… isn’t it strange when the prospect of an adult human even touching breastmilk is enough to repulse us as a society?  If it was the milk of another mammalian breast the audience would not have reacted in any way whatsoever, yet even the idea of the milk coming from a human breast (clearly it was not) created such reactions of disgust.

I just thought it was a sad reflection of what a messed up place we are in at the moment about what is actually the most natural and fantastic life-giving substance. <sigh>

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Check out this article written about one mum’s experience of Breastfeeding in ‘the land of Genghis Khan’.

Food for thought!

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Once again the ‘risks’ of bed-sharing and SIDS is all over the news.  I am so tired of seeing

co-sleeping

co-sleeping

mis-reporting and poor methodology in these studies that I have taken some time to look over current evidence and advice.

“Over half of cot deaths occur whilst co-sleeping”

Or so says the study that is currently being used to scaremonger.  This is a retrospective study by a team from Warwick and Bristol Universities.  They looked at the evidence for 80 babies who died of SIDS in the SW region.  The BBC report that ‘sharing a bed is a factor in more than 50% of cases’ followed confusingly by the statement that ‘many of the deaths occurred when parent and infant slept together on a sofa’.  Hmmm.

So what did the study find? That in 43 out of the 80 deaths the parents were co-sleeping.  But in 7.31 (?) of those cases they were on a sofa.  In 13.3 of those cases the parents had consumed drugs or alcohol.   A further 16 out of the total of 80 babies were on a pillow or swaddled and the authors state that these risk factors were the same in either group  so we can assume that 8 babies were on a pillow or swaddled.  So around 28-29 of those 43 cases were definately not safely bed-sharing or bed-sharing at all.

The study makes no reference as to whether the parents were smoking – a contributing factor in the vast majority of cot deaths.  And there is no reference to breastfeeding – a protective factor in the vast majority of cases.

So what does this study really tell us?  That without the important information about smoking and breastfeeding 15 out of 80 of the babies who died of SIDS were sharing a bed with a parent who was not drunk or on drugs.  This doesn’t tell us very much.  I have contacted the team who authored the study asking for clarification about smoking and breastfeeding and will update the blog if I hear back from them.

Other Evidence

Moving away from this specific study, what other evidence abounds about bed sharing and SIDS?  The number of studies is huge.  To enable results that can be considered rigerous and therefore actually truthful:

UNICEF further recommends that all future research into infant death and sleeping environments should unambiguously record data on … the baby’s sleep surface, maternal and paternal smoking status, alcohol and drug consumption and infant feeding method. These factors should be recorded at the time of infant death (rather than relying on data for other periods such as feeding method at delivery or smoking status during pregnancy) and the results adjusted to control for them.

However it is very difficult to come across any study that actually takes into account these recommendations, let alone reports it’s findings within these guidelines and separates out the evidence as stated above.

The nearest I have found is a study published in the British Medical Journal entitled Babies sleeping with parents: case-control study of factors influencing the risk of sudden infant death syndrome. The study was part of the CESDI (Confidential Enquiry into Stillbirth and Death in Infancy) carried out annually in the UK.

This study was published in 1999.  It was a three year, population based case-control study.  The authors studied all cases within a population of 470,000 births.  During the three year study the authors examined 325 SIDS cases, and also those of 1300 ‘control’ infants matched for age, locality and time of sleep.  They interviewed all parents.

Findings initially showed an increased risk for infants sharing the parental bed for the whole sleep, babies sleeping in their own bedrooms and infants who shared a sofa.

However, the risk for infants sharing the parental bed was found to be not significant for older infants >14wks or any infant whose parents did not smoke.

The authors concluded that :

There is no evidence that bed sharing is hazardous for infants of parents who do not smoke.

This study found that if parents don’t smoke and BED share (rather than sofa share) they are no more likely to suffer from SIDS than babies in a cot in their non-smoking parents bedroom.   However babies in their own rooms are at more risk of SIDS than babies in a cot in their non-smoking parents bedroom.  So, why is this fact so under-reported?

More information and analysis of this study can be found at the Mothering Magazine website.

Conclusion?

Given that bed-sharing has been shown to be crucial in establishing a successful breastfeeding relationship, is practised safely worldwide and is practised in the UK and ‘developed’ world by the majority of parents it is about time that it stopped being demonised by the authorities and the media.

There is no rigourous evidence that safe bed-sharing is related to an increased rate of cot death.  FACT.

Find out how to bed-share safely with the information from UNICEF or Dr Sarah Buckley.

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I have just come across a study by Swansea University, catchily-named Associations of drugs routinely given in labour with Breastfeeding at 48hrs: analysis of the Cardiff births survey that has found that routine use of synthetic hormones during the third stage of labour appears to reduce the chances of successful breastfeeding.

Once again, the report doesn’t take the common-sense option of recommending that the use of the synthetic hormones be restricted to those cases where they are shown to be necessary.  Instead they insist that universal managed third stage should continue but that health professionals should be aware of this evidence and provide more breastfeeding support.

Considering that the hormones can be given if the mother appears to be bleeding too much, and that ‘too much’ is defined as 1litre in France and 500ml here (so what does that make you think about our 500ml limit?) and that there are other undesirable side effects to the drugs this advice doesn’t seem to make a lot of sense.

The study found that the universal administration of synthetic hormones in the third stage reduces the rate of breastfeeding by 6-8%!  This amounts to up to 50,000 babies who are not breastfed every YEAR in the UK alone.  For those 50,000 babies who would potentially be breastfed the cases of adult obesity would reduce by 1000, the cases of asthma in the first 9 years of life would reduce by 2-3000, and the cases of breast cancer in those mothers would also be reduced.

So the fact is that only a tiny minority of these women would have experienced a PPH, and those women could havebeen given the injection of synthetic hormones at that point then the real health benefits of increasing the number of breastfed babies are being jeopardised by the supposed benefits of universal managed third stage.

More information about PPH generally, but also specifically in relation to home births can be found here on the homebirth.org website.

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I can only assume that there has been some big weight-gain initiative for Health Visitors and Midwives lately.  Stories I am hearing over and over again from new mothers are that they are being advised to top-up their breastfeeds with formula more frequently than I have ever come across before.  In most cases completely unnecessarily.

Why do I say completely unnecessary?  What makes me think I know more than a health professional?  Well…

In virtually every case the baby is thriving, alert, has wet and dirty nappies regularly, is developing normally and the mother senses there is nothing wrong. However the baby may not be putting on weight at the rate that the charts say that he or she should or has lost slightly more than the 10% that is the norm after birth.

Surely any advice on such a crucial issue should take into account all factors, not just the stark figures.  Everyone knows that something as simple as being weighed after and then before a feed or a dirty nappy can have a significant impact on the apparent weight gain.  If you take into account that the baby is doing perfectly well, as mentioned above, then no further action should be taken.  However this seems to be when the top-up crew really get to work.

Planting the seed of doubt into a new mother’s mind.  The seed of doubt turns to anxiety, which can turn to an actual delay in let-down and a seemingly unsatisfied baby which could mean…. well could the midwife be right?  The seed of doubt grows and flourishes and before you know it a first-time mother who is just feeling her way and learning about her baby suddenly doubts that she is able to nourish it.  Maybe a bottle of formula would help this poor baby that she loves so much.  Everyone around is telling her that formula is fine these days and there is nothing to be guilty about.  This all chips away at her confidence in herself to provide the perfect food for her baby.

Before long the baby will be breastfeeding slight less often or for shorter amounts of time.  The critical supply and demand system that is so important in breastfeeding reacts accordingly and the mothers efficient body does start producing less milk.  This may be proof enough for the unsupported mother that she can’t make enough milk and more bottles are introduced.  Before long breastfeeding ‘just didn’t work out’ or she ‘didn’t make enough milk’.

All that was needed in the first instance was that oh-so-difficult-to-find attribute: common sense.  If a HV or MW sees that the baby is thriving then why can’t they leave well enough alone?  Or why not give the mother some tips on increasing supply along with a well-earned pat on the back?  Mention skin-to-skin, upping the mothers fluid levels, eating well and so on.  And tell her what a fantastic job she is doing nourishing and nurturing her baby who is clearly doing so well on it.  Bolster her, she will get enough of the negative comments from everyone else.  When will health professionals become the guiding light for new mothers instead of the additional burden?

If I hear another mother telling me they had to top-up with formula as their perfectly healthy baby had lost 11.5% of their birth weight – instead of the regulation 10% I think I will scream!

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