Christmastitis – Santa’s less welcome gift…

This guest post about Christmastitis comes courtesy of Lucy Webber, who is an International Board Certified Lactation Consultant (IBCLC).

(If you are unfamiliar with the term, an IBCLC is a breastfeeding expert. Highly experienced, trained and qualified to help mothers and babies to breastfeed, they can help with both basic and complex breastfeeding challenges. What they don’t know about boobs, breastfeeding and milk isn’t worth knowing! Find out more at the Lactation Consultants of Great Britain website.)

A pair of Christmas puddings, tastefully arranged to suggest breasts and therefore Christmastitis.

“Christmastitis – Did you know that rates of mastitis go up around holiday periods?

Why?
Well, loads of reasons to be honest. Let’s picture it shall we?

It’s your first Christmas with your baby. You’re mega excited and so is everyone else to have this gorgeous bundle in their lives. Christmas is going to be AWESOME.
Lots of travelling around in the car visiting friends and family, making the most of maternity leave to see everyone and proudly show off this little person, taking up offers to go over and be cooked for! And that is genuinely fabulous.

Breasts Not Being Regularly and Fully Emptied

But all that travelling leads to lots of time in the car seat, and for most babies the car seat sends them to sleep. And long sleeps mean long gaps between feeds, which leads to full breasts with potential for blockages…

Then the parties, the gatherings, celebrations! Lovely right?! Yes! Except everyone wants a hold of little baby Rupert and once again he has longer stretches between feeds. And when he does come back to you he’s over stimulated and over tired and only takes two minutes on the breast before he falls asleep leaving you with, you guessed it, full breasts….

Or the guests seem to think they know better than you do about baby Josie’s feeding cues and tell you she doesn’t need feeding, they can settle her for you. They talk about how ‘when they had babies you only fed every four hours and it didn’t do them any harm’. You’re then stuck between a rock and a hard place, because you would like to feed your baby, but you don’t want to upset family or the way they did things, and maybe they’re right?

Feeds are often cut short around celebrations, because you have lots of people offering to help and hold the baby so your dinner doesn’t go cold, or guests arrive, or you’re due somewhere, or you’re upstairs feeding and want to get back down to the party…the list goes on. So your breasts don’t get ’emptied’ like usual and can you guess what happens next? Yep….

Restricted Milk Flow?

Maybe you don’t feel comfortable feeding around Auntie Ethel and Uncle Bernard, so you don’t quite expose your breast as much as you might normally, and your clothes/bra are digging in a little and restricting milk flow and cause a blockage…

Maybe you’re sleeping somewhere different, the bed is different, you can’t quite get the angle of the feed right on this squishy mattress and the latch goes a bit dodgy, but you put up with it because you don’t want the baby to cry and wake everyone. Dodgy latch leads to breast not emptying efficiently…and you know the rest.

Christmas is lovely, but for a huge amount of people it’s also very stressful. Stress hormones can impact on oxytocin, which is the hormone needed to let your milk flow. So stress can temporarily inhibit milk flow leading to those full/blocked breasts again.

I might be coming across as a bit Bah, Humbug! but I’ve been around enough mothers with mastitis to know its REALLY not what you want to be dealing with at any point. It is not to be messed with, it is a serious condition and you can potentially end up very poorly.

What I’m saying is, take it EASY. Plan ahead now to make sure this holiday season is one where you can feed whenever and wherever you need to. Be led by your baby. Don’t stretch out or cut short feeds.
Listen to your body, not Auntie Denise.”

Thank you Lucy Webber IBCLC!

If you’re struggling, get help!

If you’re finding you’re struggling with breastfeeding, don’t battle on alone. People often stop breastfeeding in the first month when they experience problems such as sore nipples, inadequate milk production (real or perceived), and difficulties getting the baby feeding. These problems can almost always be overcome with the correct support – and getting help sooner rather than later is definitely the best advice.

You can call the National Breastfeeding Helpline:
0300 100 0212
9:30am – 9:30pm daily or via their online chat service which is available whenever a volunteer is available. https://www.nationalbreastfeedinghelpline.org.uk/

You can find a Baby Café near you:
https://www.thebabycafe.org/ who offer free drop-in sessions for info, support and advice (part of the National Childbirth Trust, and often run by IBCLCs)

You can employ the services (if you have the funds) of an IBCLC to come to your home:
https://www.lcgb.org/find-an-ibclc/
Usually about £60-£90 for an initial consultation, but if money is a concern, many offer instalment payment options, and while it’s not really a financial decision, when weighed against the cost of months of formula, it can be an excellent investment if it helps you to begin/maintain the breastfeeding relationship with your baby that you want.

For information on the statistics of Bigger Breastfeeding, try Bigger Breastfeeding, Behind the Statistics.

If you’re struggling to find decent maternity bras in larger sizes, try Breastfeeeding Bras for Bigger Boobs.

Research on Social Networks for Pregnant and New Mums!

Hi lovely peeps!

I’ve agreed to share this information about a research study that’s relevant to BigBirthas who are pregnant, or gave birth 6-12 months ago.

I’m not involved with developing the research, nor am I a participant – had my babies too long ago now! But I’m always interested to hear of new research involving bigger mums and plus-size pregnancies. Certainly this one is taking an interesting new line in the ‘weight management’ sphere, might be interesting!

There’s more info about the study on the University of Glasgow website:

Maternal obesity is a growing public health issue, with one in five pregnant women classified as obese in the UK. Interventions to date have had modest impact on clinical outcomes. These have mainly focused on individual behaviour change and have methodological limitations.

There is growing evidence on the importance of social networks for obesity-risk behaviours. There are few trials using social networks to reduce maternal obesity and very few qualitative studies exploring social network influences on weight management in pregnancy and postpartum.

As part of this PhD study, we will explore the role of social networks in the development and maintenance of obesity in pregnancy and postpartum. We will also review current evidence related to interventions to help women manage their weight during pregnancy and/or postpartum, and take learning from this to inform the development of an intervention. The study aims to:

  • Complete a systematic review to investigate available interventions using social networks for weight management in pregnant and postpartum women

  • Explore the weight management experiences and the influences of social networks of first-time pregnant and postpartum women

  • Explore the social networks of interview participants to try to understand how these might be used to help them in their weight management attempts

  • Develop initial ideas for a theory-based intervention to support weight related behaviour change for pregnant and postpartum women that are overweight or obese.

     

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Time To Have Your Say!

The Royal College of Obstetricians and Gynaecologists is seeking feedback from women on its new leaflet ‘Being overweight or obese during pregnancy and after birth‘.

The closing date for comments is midday on Friday 18 May.

Click on this link to access the RCOG page where you can read the draft leaflet and then feed back your thoughts via their online questionnaire. Make sure you feed back on the right one – NOT the hysteroscopy one (unless you happen to be interested in that too!)

I don’t want to prejudice your thinking, so I’m not saying what I wrote, but I will say that it’s nice to be asked our opinion at last!

Aaand… while you’re busy having your say, let me do another shameless plug for our Big Birthas Parenting Science Gang over on Facebook. We’ve been discussing the topic and what we might research for a little while, spoken to some really interesting experts to get their views; this week we’re talking to experienced midwife and waterbirth expert Dianne Garland (SRN RM ADM PGCEA MSc) of www.midwifeexpert.co.uk. We’re nearly at the point of deciding what we’re going to research – come along and get involved, you don’t have to be a scientist (I’m not!) to get involved in citizen science!

Fed Up With Lazy Journalism

Another day, another article which blames obese mums and completely misrepresents the research it purports to be reporting on – lazy journalism.

Thanks Helen McArdle ‘Health Correspondent’ for The Herald @HMcardleHT, for yet more scaremongering claptrap.

Here’s the article:

http://www.heraldscotland.com/news/16071005.Foetuses_of_obese_women_develop__fatty_liver__in_the_womb/

Let’s begin with the headline:

Offspring of obese mothers prone to childhood obesity because they develop ‘fatty liver’ in womb

So, that sounds worryingly simple, and it’s reinforced in the first paragraph:

“CHILDREN whose mothers were obese during pregnancy are more likely to become overweight themselves because they develop a “fatty liver” in the womb, research has found.”

As usual, we’re to blame, and “research has found it”, so the article says, so it must be true. Surely?

Unless you read on.

But the trouble is, how many people do read on?

How many mums, glancing at this and feeling sick to the pit of their stomach at the potential harm they’re doing to their baby/have done to their children, breath deeply, and flick past to something lighter to brighten the mood? If you’re already pregnant/have had the baby there is little point in finding more things to stress over – being a parent is hard enough!

How many healthcare professionals, busy on a lunchbreak, notice the heading and possibly the first paragraph and move on, because there’s no need to read it – it’s clearly just going to tell the thing they already believe to be true; overweight women are harming their children through greed, laziness, and ignorance?

Not all health professionals think this way, certainly, but I’ve met enough to know many do. Newspaper articles like this don’t help matters.

The second paragraph kicks us again when we’re down.

“It has long been known that overweight and obese women are more likely to give birth to heavy babies and that these infants are at greater risk of childhood obesity.”

Actually, (and please correct me if you know of more recent studies to the contrary) the link between big mum = big baby is only shown in studies which failed to adjust for poorly controlled blood glucose levels (often through poorly managed gestational diabetes). Where this is accounted for, there is no established correlation between otherwise obese mums and heavier babies at birth.

The second claim, that ‘these infants are at greater risk of childhood obesity’ does have some grounding; there are plenty of studies that show a correlation between maternal obesity and childhood obesity. It’s very easy to find data on the mother’s BMI at her booking appointment – and so again, lazy researchers have been known to draw conclusions that pregnancy BMI is a factor in the obesity of a 10 year old, failing to account for the environment the child is growing up in after its birth! Funny how these studies are so rarely interested in paternal obesity as an indicator, isn’t it, since that data is so much less readily available?

Then we get onto the third paragraph and the headline starts to unravel…

“However, research published in the Journal of Physiology has revealed for the first time how fat accumulates in the liver and metabolic pathways are disturbed in foetuses developing in obese mothers with diets high in sugar and fat.”

Hang on a second! That additional information makes quite a bit of difference!! “Obese mothers with diets high in sugar and fat“. So not ALL obese mothers, but the ones with poor diets. Obviously much less catchy as a headline though, isn’t it?

Then comes not just the unravelling, but the full scale chopping up of the headline with the sword of Damocles… if you read further down to paragraph eleven.

“The study was carried out using obese pregnant monkeys.”

I’m sorry? What?! Obese. Pregnant. Monkeys??!?

They didn’t mention that in the title, now, did they? No, in fact, The Herald used the word ‘childhood’ in the title. Could have used the more factually correct ‘infant’; it even comprises fewer letters, but implying that this is research on humans makes this a more compelling read, doesn’t it?

The very first word of the article itself is ‘Children’, which we now know should read ‘Baboons’!

While I concede that humans share 91% of their DNA with baboons, there’s definitely enough of a difference between us for that distinction to be quite important.

Baboon hanging from its tail above water - I can't do this!
Believe me, I could definitely make use of a prehensile tail…

I can’t do this, for instance. And I’m not overly fond of bananas.

If you google a bit, you’ll discover that Helen McArdle didn’t even write all of the article herself. Most of it, the accurate stuff, was lifted directly from this press release from the Physiological Society. The Herald’s only input was just to add confusion and a click-bait title – and bury the essential information deeper in the text. Standard journalistic fare, sadly.

So what can we do?

My advice? Always read the whole article if the headline makes you feel uncomfortable about being a bigger mum. More often than not, the article unravels itself as you read, and your fears prove false.

Even better, read the research for yourself, if possible. Info here on how to access research documents for free. (Be aware, this particular research paper also discusses the deaths of not-quite-to-term baby baboons…) [wpfilebase tag=file id=235 tpl=simple /]

This lazy journalism is so frustrating. The scientists will have spent months, maybe years conducting the research. They then wrote several thousand words to explain the research and their findings. But often the details and nuances are twisted and lost when distilled by a journalist into an attention-grabbing article.

This is all I have to say about that…


If you’d like to get involved in some citizen-led science about high-BMI pregnancy in conjunction with Parenting Science Gang, funded by the Wellcome Trust, then do join our Facebook group here: https://www.facebook.com/groups/1955647771354577/

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Big Birtha