No-BS breastfeeding resources (an ongoing project)

Suppose you're a normal mother-to-be who is planning to breastfeed... or, maybe thinking about it but not committed either way. You're looking forward to doing the sort of things the ordinary, everyday mothers around you do--you're planning a hospital birth with lots of nice drugs, you want to get your baby onto some vague sort of routine so you can plan the day, you'd certainly like baby to start "sleeping through" sooner rather than later, and you'll want to be able to leave your baby with your husband/mother-in-law/babysitter regularly so you can go out. You might go back to work while your child is still young.

Or maybe you're a second-time mother. You tried to breastfeed the first time round--oh, so very, very hard. And it didn't work out. Trouble is, by then you'd already spent months reading all the books and blogs--the ones that told you in no uncertain terms that your formula-fed child was going to be stupid, asthmatic and fat, that you wouldn't "bond" properly, and that anyway this was all your fault because you didn't have an all-natural birth bouncing up and down on a yoga ball, and because you caved and let the nurses take baby to the nursery for a couple of hours because you were too exhausted to see straight. A spiral into gloom, anxiety and hystronic post-partum depression was more or less guaranteed. Now you're girding your loins to try breastfeeding again. But the thought of reading those books again... the ones that were whispering in your ears at 3AM every morning while the tears rolled down your face...

I think you can see why most breastfeeding resources--the books, the blogs, the forums--are problematic for either one of these women. Such resources are heavily oriented towards natural birth, "natural" parenting, and natural just-about-everything-else, and waste no time in telling you about the horrors that await you and your child should you weaken and allow even a single bottle of that ghastly white stuff. And they are full of sloppy science, urban legends and pet theories.

Other books (usually not "breastfeeding books" but rather general how-to-look-after-your baby books) talk about routines and sleeping-through-the-night (almost fanatically, sometimes) yet fail to get the basics right regarding breastfeeding. For example, Gina Ford tells exhausted new mothers to start pumping pretty much from Day 1 in order to stretch out the gaps between feeds. Claire Byam-Cook and Tracy Hogg (the Baby Whisperer) tell women to measure how much milk they are producing by doing a "yield," i.e., pumping and measuring their output, apparently unaware that there are many women--including Yours Truly--who have a good supply but are mediocre at pumping. If I had followed these writers' advice, I would have been convinced that I was starving Little Seal with every feed.

For these reasons, I've decided to start compiling a comprehensive list of breastfeeding resources which I reckon are credible, science-based and reasonably representative of how most of us actually mother. I'll keep updating this as I come across more sources, but this is a start. There's some practical stuff here; there are also discussions of breastfeeding research and politics to muse on, or to wheel in as counter-evidence when someone online is talking bollocks.


Books

Actual breastfeeding books

As I moaned here, it is very hard to find breastfeeding books that don't seem to be written by someone with the shining light of the fanatic in her eyes. Marianne Neifert (in Dr. Mom's Guide to Breastfeeding and Great Expectations: Essential Guide to Breastfeeding advocates for breastfeeding but manages to do so without the harshly judgmental tone of other lactivists. She is almost alone in the breastfeeding book annals in her outspokenness about the difficulties and barriers many breastfeeders experience, and in stating frankly that low supply really exists and is not a myth. Most importantly, her books get all the nuts and bolts right; they are full of great, practical information about how the breasts work, the mechanics of breastfeeding, latching, troubleshooting, pumping and much, much more--everything you'll get in the Womanly Art of Breastfeeding, in short, but without the scaremongering and condescension. By the way, it was Estherar at Mainstream Parenting who first put me onto this book.; check out her review here. 

Solids ("weaning")

Weaning Made Easy is a fun yet evidence-based approach to weaning (=solids introduction, not breastfeeding cessation) which avoids the tedium of the gourmet-icecube tray approach (making overelaborate purees and then spending mealtimes trying to get it all inside the baby) and the pitfalls of the Gill Rapley baby-led weaning method (potential iron/zinc shortages, babies going for months on end without eating anything, neverending mess). It encourages parents to offer different foods in a variety of ways, including soft finger foods and purees of nutritious-yet-hard-to-eat things, based on sound nutritional principles--always with a stress on the individuality of each child and the need for you to feel comfortable with what you are doing. Which, I suspect, is how most people would wean anyway if we didn't have babycare writers telling us how to do it...

Sleep

I have half a dozen infant sleep books on my shelf (ordered by my husband in a fit of Amazon-inspired shopping mania). There they sit, their spines almost uncracked. When it comes to sleep there's only one book I use--Good Night, Sleep Tight by Kim West--and it's never failed me yet. This book (by a sleep specialist who's helped countless families) is moderate, eminently sensible, and flexible enough to work with a whole range of parenting "styles"--while she emphasizes sensible routines and self-soothing, she is also extremely sensitive to the needs and feelings of babies and young kids... and she has a gentler alternative to cry-it-out for those who can't quite face Ferberizing. She also breastfed both her daughters, and that's important because breastfeeding and formula feeding have subtly different dynamics that affect sleeping patterns. A lot of "sleep books".... well, they may give lip service to "bottles/breastfeeds" in their routines, but you can tell it's really formula feeders they have in mind. When a sleep book is written from the point of view of a breastfeeder, it makes the breastfeeding mother feel "This is advice that's realistic for my baby. I feel we have a chance of succeeding with this." With sleep advice it's vital to feel confident that it's achievable and practical for your situation, or you'll never be able to put it into practice. West is not super "into" bedsharing, but discusses it in a sensitive and nuanced manner--the various reasons people bedshare, how to do it safely, how to combine it with learning good sleep habits, and how to transition away from it when the time comes--unlike some other writers who just scold and shame parents who take their babies into bed with them. She is even not-rude about mothers who nurse longer than 12 months (not common in parenting books).

Colic/fussiness
The Happiest Baby on the Block is a mildly attachment parent-y book with some good and practical advice for getting through the colicky weeks months. Generally I'm all for keeping babies on a loose routine, but when colic is wreaking its merry hell, sometimes you just have to grit your teeth and do what's necessary to get through the day. I recommend going straight to the second half of the book and ignoring the first section, which goes on a bit too much about how primitive tribespeople's babies don't have colic because they are carried round all day long (or something).

Other possibilities (recommended by others--I haven't read them)
Milk Memos (nursing and working) sounds like a good and non-judgey read, looking at the Amazon reviews. Child of Mine: Feeding with Love and Good Sense (feeding in general) was recommended by a blog reader. Baby Love (baby's first year) by Robin Barker got a good write-up from several people: "No nonsense; and she calls a poo a poo."


Blogs and websites

Kellymom
Ah yes, Kellymom. I've moaned about Kellymom a few times on this blog (and will be writing a longer post on them in the future). And yet I've sent struggling new mothers off to Kellymom for information several times, and there is presumably a reason for that. Kellymom can be really useful as long as you confine yourself to the “How many wet/dirty diapers should my newborn be producing?” kind of stuff, and bear in mind that this is an attachment parenting promotion site more than anything else. I've compiled a list of pages that I think give decent advice, but with everything that comes from Kellymom keep your skepticism close at hand. If it smells like bullshit, it may well be.  Confirm with other sources if you are not sure!

Low supply
Milk supply worries
Breastfeeding and medications
Weight gain (but see the FFF also here and here for your pinch of skepticism)
Pumping  
Milk supply and the older baby
Newborn basics
 
Much of the other stuff on the site is dodgy, especially the stuff on weaning age, solids/iron and the exaggerated benefits claimed for nursing, especially extended nursing. The forums have some pretty crazy ladies.
PS: Stay away from the sleep advice on that site if you value your sanity.

Science of Mom

A blogger I have a girl-crush on. The post on why breastmilk is so low in iron shreds some myths and misunderstandings about iron and breastmilk. It's refreshing to see a mother who can describe the joys of nursing past a year while questioning some of the dodgy data being used to push this choice onto all mothers. Meanwhile, can breastmilk clear up an eye infection? Possibly yes (admittedly, most of the breastfeeding sites have similar information, but it's nice to see Science of Mom actually confirming this with some data). Other posts cover breastmilk and prematurity, maternal diet and colic, improving milk production in the NICU and more.

Seattle Mama Doc combines evidence-based advice (sleep, breastfeeding, nutrition and more) with a kind and non-judgmental tone that makes for reassuring reading. She's worth a read!

Good Enough Mum

A terrific set of posts from a terrific blogger. She writes about nightweaning for a breastfeeding mother, and breastfeeding the second time around, gives her view on the "Watch your language" thing, and on why brutally unpleasant lactivism is everyone's business, while giving her vision for what positive breastfeeding promotion could look like. She also shreds some of bad science surrounding extended nursing--it's not as beneficial as you think (which doesn't mean you shouldn't do it if you want to)--and takes issue with the idea that a single bottle of formula will ruin your child's "gut" forever.

Fearless Formula Feeder
The majority of breastfeeders will use formula at some point, yet most breastfeeding resources say little about formula other than "Don't" followed by a list of terrifying reasons why--or descriptions of "correct formula preparation" which one suspects have been presented with the deliberate intention of making formula use look as intimidating as possible. That's why the Fearless Formula Feeder site (and upcoming book) can be the breastfeeding mother's friend. Learn the real deal about combo feeding and supplementing, jaundice, the mechanics of formula feeding, spotting formula allergy/intolerance, why you can't use goat's/cow's milk as a formula replacement, growth charts for formula-fed and breastfed babies and much, much more. Suzanne's site is extremely respectful of all safe feeding choices for babies... and what's more, it manages to be scientifically rigorous, well-written and nice--three things that are very hard to combine in online writing.    

Mainstream Parenting, while now defunct, is still a great source of skeptical commentary and mythbusting, some of which covers breastfeeding.


Miscellaneous

Skeptically Speaking's 15-minute podcast on breastfeeding is well worth a listen for an interesting scientific slant on lactation.

Trolls With Wooden Spoons

Trolls (you have to join; oh, and despite the name, the group has nothing to do with the internet phenomenon of "trolling") was created by a bunch of Mothering.com escapees who had become disillusioned with the craziness and horrible moderation on that site. So it's crunchier than I am, yet is also one of the few places where you will seldom get extremist natural-parenting stuff pushed at you; people started this site to get away from all that. And it's full of experienced breastfeeding mothers. There is a refreshing absence of pretension and bullshit on the site. The Woo-Busters page is a good place to get a second opinion on anything which sounds like woo but you are not quite sure!

NB: Avoid Trolls threads on carseat safety or Thanksgiving.

Mammals Suck... Milk! looks at the science of lactation across the animal kingdom, including human beings. Not a "how to breastfeed" blog, certainly, but fascination stuff and great background information.

Going with the flow...

It's now March, and this month Baby Seal will turn one.

Before Baby Seal was born, I said to anyone who asked that I would "give breastfeeding a try, but if it didn't work out, I would feed formula with pride and joy." After she was born, and I astonished myself with being about to actually, like, produce milk from my own body with next to no problems, I decided to breastfeed for "at least six months... maybe nine." Nine months came and went, and I realized with a jolt that I only had three months or so left. Then I realized with another jolt that I didn't actually "have" to wean her at 12 months. I could keep right on going, just as long as I wanted to.

It was a strange moment. It wasn't that I had ever thought of nursing past 12 months as being improper or icky (I've been in too many parts of the world where women will flip an entire tit out to feed a toddler to be under such delusions). It's just that I never, ever thought of "extended nursing" (even now, it seems so odd to see those words applied to myself!) as something that people like me did. Extended nursing was for mothers who gave birth in paddling pools and kept their babies in slings on a permanent basis (except, of course, when in the Family Bed). Or for women in poor countries who had to nurse for years on end. Not for normal developed-world mothers like me, who do paid employment for The Man and who told their obstetricians that during labor they wanted to be as high as a ****ing kite throughout.

For this change in attitude, I have my beloved knitting website, Ravelry (aka "Facebook for knitters") to thank in part. It's crunchy-ish, but not insanely crunchy, and above all does seem to have a lot of "mothers who think"(well, we are knitters/crocheters, after all). And there are lots of women who nurse past 12 months over there. Call it "peer orientation" or whatever you will, but just being around mothers who nurse for longer really does make it seem less of a freakish thing to do.

The flip side of websites and forums that supported extended nursing is that in general, they can't limit themselves to supporting extended nursing; rather, they tend to foster an atmosphere that pushes it on every woman. Ravelry, thank God, is largely free from overt pressure in this respect... unlike, say, Kellymom or Mothering, where a mother asking for tips on how to get her 12-month-old to accept cow's milk so that she can wean her will get responses ranging from outright criticism to "Could you explain why you are weaning her right now?" In that polite tone of voice that tells you so much more than the words themselves.

There was recently a post on one of the Ravelry groups where the posters were discussing the scientific case for nursing past 12 months. All the usual sources were cited in favor--Kellymom, the World Health Organization, that bloody Gulick study. I kept quiet, as I suspected that my own opinion might not be too popular--my opinion being that in developed countries, the benefits of extended nursing are likely to be extremely small for the child (ironically, there is probably better scientific evidence for extended breastfeeding's benefits for the mother, in the form of a slightly lowered risk of certain cancers).

As for the fact that the WHO recommends breastfeeding to two years or more, I am afraid I really could not care less. The WHO is the World Health Organization, and as such it (reasonably enough) tailors its advice primarily to those most in need of it: poor parts of the world with high infant and child mortality rates. If you are living in a community with no clean water, no pasteurized animal milks, not a lot of nutritious food for toddlers and no birth control for mum, then breastfeeding for years genuinely does raise children's survival rates. If you are living in the developed world, breastfeeding for years is more on the level of taking your child to Mommy and Me classes; it's harmless and a pleasant thing to do if that's your thing. It's not remotely necessary for producing a surviving, thriving child.

However, I am going to shut up now, since Good Enough Mum has discussed all this far more eloquently than I could ever do.

While I'm glad whenever I see the You Must Wean At 12 Months, Because Nursing After Then Suddenly Becomes Icky attitude being questioned, I'm not sure how much of an improvement it is if this just gets replaced with You Must Breastfeed Until Two Otherwise Your Child Is Being Deprived (especially when the claims as to why are so scientifically dodgy). Just a modest proposal, but how about a different idea; the idea of just stopping when you damn well want to... for whatever reason? No plans, no dates or deadlines (in either direction), no pressure. Just you and your child and whatever feels "right" for both of you. The more I think about this idea, the more I like it. Just stepping into the water and letting the current take you, and seeing where you end up. Going with the flow.

So why am I going to keep going for a while? Well, mostly because we both enjoy it and I see no reason to stop. Plus--can I be honest?--it's a convenient lifestyle tool for me, because nursing time is increasingly my internet time! The to-wean-or-not-to-wean question has come up recently in my due date club, and all I can say is that there seems to be a very strong correlation between babies' distractability and mothers' weaning intentions: those of us who were planning to keep going were all saying things like "It's our relaxation time, he blisses out at the breast while I catch up on Facebook," while those who were stopping or planning to stop shared stories about how their babies were so distractible that nursing has become a fight and a bore, and they were taking this is a signal that He's Just Not That Into You any more. An example of "seeing where the current takes you," and a very good one.

By the way, this is another reason why I'm so wary of the increasing pressure found in some quarters to breastfeed until two as a maternal duty. Extended nursers may enthuse loudly about how nursing an older baby or toddler makes parenting a toddler more convenient, but it would be truer perhaps to say "No, nursing your particular child makes life more convenient for you." Increasing pressure on all mothers to breastfeed for two years no matter what will inevitably mean that many women will feel obliged to keep struggling away with nursing even when their particular circumstances or child means that this is not convenient or a tool that makes parenting easier; for example, even if their child is so distractible that the only way to nurse is to shut yourself and baby away in a darkened room, or even if they get pregnant again and are in pain and resenting their child. As if that's not bad enough, there seems to be more and more cases of advice along the lines of "If you [give bottles regularly/spoonfeed solids/nightwean/don't allow access to the breast at all times] your baby is likely to self-wean early" (which then means you are breaking those all-important finger-wagging WHO guidelines). "Nurse to two years no matter what" thus easily becomes a tool for frightening or guilting mothers into practicing certain mothering styles which they may or may not be comfortable with. Not good.

That said, since I am fortunate enough to have a baby who is prepared to ignore my flickering PC screen during milky time, and since we both still enjoy the closeness of nursing, I am going to "go with the flow" and take full advantage of this, and nurse until I feel like stopping.

I even had nursing to thank for getting me through a hellish day last week when my childcare provider cancelled on me on a day when I had several deadlines to meet--somehow the day's work got done, though a mixture of making the most of naptimes and letting Baby Seal hang out at the milk bar as much as possible while I typed with one hand. Oh, and Peppa Pig on DVD, if I'm honest. And letting her pull things out of cupboards and strew them all over the room and destroy the baby gate, as demonstrated above. Such is the life of a freelance worker with a small child. Bring on Year 12-24 Months--I'm ready!