Showing posts with label ways to improve postnatal care. Show all posts
Showing posts with label ways to improve postnatal care. Show all posts

Wednesday, 30 May 2012

The great unsaids - bottle feeeding

I'm still harping on about breastfeeding and bottlefeeding I'm afraid, not least because it's been in the news again recently with the Time Magazine cover of a mother feeding her three year old.


Before I had a baby I was a little judgemental about those who did not breastfeed. I wondered why they didn't just try harder or persevere, why they put their own needs - for sleep, for comfort, for convenience, for sanity - before their babies.

Then I had a baby and breastfeeding did not work immediately. It never worked to a point of exclusivity and we've (mostly) happily mix-fed from week 1. But I was at the hospital where I had my daughter the other day and saw one of their breastfeeding posters and I remembered something a midwife had told me when my daughter and I were there in the days after her birth. The midwife was en route to a party to celebrate a new breastfeeding policy they had just implemented in which they would not just actively encourage breastfeeding, but discourage bottle feeding to the point of not helping a mother bottle feed.

Even then, befuddled by birth and parenthood, I knew this was a bad idea. Not the supporting breastfeeding, but the other side of it. Amongst the mothers I know most want to breastfeed if possible - who wouldn't after seeing all the breast is best messages - and at least half have struggled. But to only emphasise the positives of breastfeeding instead of helping parents do whatever it is they decide to do, has bad repercussions.

First, it makes mothers feel like failures by suggesting we do not want the best for our babies. And second, it stops the dissemination of information telling us how to safely feed our babies formula.

In the nearly eighteen months since I became a parent I am still yet to find comprehensive science-based information on making a bottle. Instead we had to find our own way.

For example, a health visitor told me to boil water for my daughter's bottle then let it cool for half an hour. Using half an hour cooled water would, she explained, sterilise the milk powder the water was poured onto. Now I'm no scientist but I know this is utter bollocks. Perhaps making up the milk and boiling it would sterilise it (and I suspect it wouldn't - any chemists out there know?), pouring lukewarm water onto it will not. Plus doing this in the daytime is just about okay if you do not leave the house, but are you really going to do it in the middle of the night when you have two hours of sleep at a time? I suspect there is more danger to the parent in handling boiling water while half asleep than there is to the child in having a made up bottle kept in the fridge for a few hours - but the problem is we just don't know because no one tells us.

Another example is sterilising. We steriled my daughter's bottles, of course we did. First in a saucepan. Then in a steriliser. Then the dishwasher. Then the microwave. Then with sterilising tablets. (Not one after the other of course - I mean these are all techniques we have used). Now we give them a jolly good wash using washing up liquid and water. But you know, you decant the milk powder into the bottle using a measuring spoon that lives in the box of powder. A spoon you touch with your (usually, but not always, clean) hands. Are you meant to sterilise the spoon then?

Here are four simple measures I want for new parents who choose (or don't choose) to bottle feed:

1) Clear scientific guidance on how to make a bottle, both in an ideal world, and then also in the real world where you leave the house, are exhausted, need a bottle immediately to placate a screaming child and the fuse blows on the steriliser.

2) Reassurance that above all a well fed baby is a happy baby. Happier than one screaming for milk that isn't there, happier than one digesting blood from cracked nipples, and happier than one with  a mother so tired she can barely hold the baby to her breast without falling asleep.

3) An end to the misinformation about milk production. It will not dry up if you miss one feed. Probably not if you miss several feeds. Not if you feed from the same breast twice in a row. Not if your baby sleeps for five hours in a row. Not if you have a glass of wine. Not if you have two glasses of wine.

4) Perhaps the most important - messages that those who bottle feed love their babies just as much as those who breastfeed.


Only when this is done will we be able to have a sensible conversation about feeding our babies.


Related post: The Truth About Breastfeeding




Monday, 21 May 2012

Any other time...

I've been talking to friends about recent births and those first few weeks - how awful it all is, and the utter exhaustion. And the recovery time, not just from birth and hormone surges, but often from major surgery. And I've bene thinking about the surgery in particular - I had it myself very shortly after giving birth to remove the placenta which refused to budge. And you know what, in absolutely any other situation in your life in which you have surgery, be it a wisdom tooth taken out or an ingrowing toenail removed, a bone resetting or a lump removed, you would be told to rest as much as possible, to sleep and to rest and not to worry, that anaesthetics make you woozy for several days, and please rest some more. So why is it, after the major abdominal surgery some women have, after the drug fuelled ops that follow hours of labour, we're just left to look after a baby and never get more than three hours sleep. How can we recover, how can we look after another, when we need looking after ourselves. There must be something we can do to help women in this situation?

Monday, 2 January 2012

Sunday, 27 November 2011

Ways to improve postnatal care #6: Be consistent

When we were in hospital in those very early days, and feeding wasn't working out as planned, I had a flurry of people come to my bedside and try to help me. There were midwives and nursery nurses and breastfeeding counsellors and peer supporters, and they all had different advice. From changing breast to trying a different hold to setting a time limit to letting the baby go for as long as she wished, from squeezing the nipple first to massaging the breast to hand expressing to machine expressing to topping up with formula to not topping up with formula, everyone had a different view. And then the shift would change and I'd see a new lot of midwives and nursery nurses and breastfeeding counsellors and peer supporters all of whom had different views again.

I suspect any single one of them would have worked had their advice been consistent, or had I been able to choose one and have the confidence to follow their advice even when their colleagues were telling me something expressly contradictory. Would it really be so difficult to be consistent, or at least have a plan to enable women to try one thing properly before moving on to the next?

Related posts:
Ways to improve postnatal care #1: Don't call me mum
Ways to improve postnatal care #2: Change the sheets
Ways to improve postnatal care #3: Help us buy the basics
Ways to improve postnatal care #4: Allow partners 24 hour access
Ways to improve postnatal care #5: A debrief for all new mums
Why I love the NHS

Wednesday, 16 November 2011

Ways to improve postnatal care #5: A debrief for all new mums

What would really have helped me in the days post birth would have been a medical professional come and talk me through what happened. I could have asked why labour went the way it did, what the implications of the medical procedures I had were and got an explanation of the medicines me and my baby were being given.

Instead I got information piecemeal - some when I was out of it on drugs, some when I was out of it on elation and some when I was out of it on tiredness. All of which means I was still piecing together what happened months later.

You might ask does it matter given both me and the baby are okay. But it matters to me. And it matters to many women.

At the moment you can request an appointment with a midwife post birth to go through your notes, providing they haven't lost them of course. But this needs you to know you can do this and to be proactive.

Instead it should be offered to all women the day after birth, or before leaving hospital, so any gaps can be filled and any questions answered. That way we'd begin our parenting experience feeling empowered by information, rather than vulnerable through a lack of knowledge.


Related posts:
Ways to improve postnatal care #1: Don't call me mum
Ways to improve postnatal care #2: Change the sheets
Ways to improve postnatal care #3: Help us buy the basics
Ways to improve postnatal care #4: Allow partners 24 hour access
Why I love the NHS

Friday, 14 October 2011

Ways to improve postnatal care #4: Allow partners 24 hours access

This applies to labour as well as postnatal care. One of the recurring themes that comes up again and again when women share their birth stories is that their partners were sent home, either when they were in labour and on the ward, having to soldier on alone and in pain, or shortly after delivery. 

Of course our partners need rest, and of course we need rest too, but it would be more helpful for our partners to be able to come and go so that we can manage our time ourselves. That way if the baby will only stop crying between 3am and 5am while being held, or indeed if you will only stop crying by being held, they can be on hand to do this. 

After all, in hospitals it's the nights that go on forever, when overstretched staff take ages to answer the call button, when you need help to get to the loo at 2am and when someone fetching a snack would be most useful. 

Related posts:
Ways to improve postnatal care #1: Don't call me mum
Ways to improve postnatal care #2: Change the sheets
Ways to improve postnatal care #3: Help us buy the basics

Why I love the NHS

Sunday, 9 October 2011

Why I love the NHS

I've been writing a series of posts (to be continued) on ways to improve postnatal care in order to make those difficult scary first days with your baby a bit easier, or at least not harder, but it has struck me that I should also write a positive post about the NHS and the care we received. Because most of it was excellent. 

The antenatal appointments checked that the baby and I were safe. Blood tests were taken using clean equipment and results came back quickly. I had choices over pain relief. Pregnancy bleeding led to a trip to casualty and to the early pregnancy unit where both times we were seen quickly, scanned and reassured. My blood pressure was frequently checked. The baby's heartbeat was often listened to. Had I needed to get to hospital in an emergency I knew I would have been able to call an ambulance. We had scans to pick up and monitor any problems. I had my own room to give birth in and was constantly monitored by midwives determined to safely deliver me a healthy baby which they did, and to leave me as unbattered as possible, which they did. Doctors operated on me post birth in a clean operating theatre using strong drugs and great skill. Midwives and doctors looked after my baby when she was sick in the first few days, and looked after me too. The wards were clean. I was given food. The medicines were plentiful. The most up to date technology was used to diagnose my baby and to treat her. And in the days and weeks and months since the birth every time we have needed to see a GP, we have been able to, all
medicines needed have been free and all hospital appointments have been with experts. Wow. 

I have complaints and suggestions for improvement but it's important, I think, not to lose sight that all of this was free at the point of use, available to anyone who needs it and delivered in a clean and safe environment by well trained staff. 

So this is a post to balance out the ones about improving postnatal care and to say how grateful I am to the NHS and all who work for it. How lucky we are to have it. 

Related posts:
Ways to improve postnatal care #1: Don't call me mum
Ways to improve postnatal care #2: Change the sheets
Ways to improve postnatal care #3: Help us buy the basics

Ways to improve postnatal care #4: Allow partners 24 hour access

Tuesday, 4 October 2011

Ways to improve postnatal care #3: Help us buy the basics

Really I think as many maternity pads and nappies as needed should be provided by the NHS, free at point of use, during your stay in hospital. After all we don't take in our own bandages and antiseptic when we have an operation. Let's begin from what the current situation is however and accept that they aren't. 

But even if they aren't free, they should be available. No one knows how long they will have to stay in hospital post birth so no one knows the quantities they will need. And no one wants to have to send their partner, parent or friend on a hunt to find supplies when they should be with you. 

Have a shop in each maternity unit, or even a trolly going round the beds, and sell maternity pads, nappies, wipes, cotton wool, nipple cream and even shampoo and toothbrushes. And do so at high street prices, not vastly inflated prices. 

If you can have burger bars in hospitals then how about a branch of Boots or Superdrug - it really would make life easier. 

Ways to improve postnatal care #1: Don't call me mum
Ways to improve postnatal care #2: Change the sheets
Ways to improve postnatal care #4: Allow partners 24 hour access
Why I love the NHS

Tuesday, 27 September 2011

Ways to improve postnatal care #2: Change the sheets

I had hoped my experience was just a one-off and that by staying in hospital for several days after my baby was born I somehow got lost in the conveyor belt of people going home six hours after their baby was born, but having spoken to many new mothers since becoming one myself, I realise that I am not an unusual case. But while my baby and I were in hospital after her birth, I had to ask for my bedsheets to be changed. I plucked up courage to ask twice which meant they were changed twice, in a five night stay.

Yet the days post birth are particualrly yukky. You bleed. Lots. You may be a bit leaky when it comes to urine. Your breasts produce liquid, not necessarily to order but nearly always when you have found a dry patch to lay on. The baby poos and wees, also not to order, and as you don't yet know how to do a nappy properly, this also leaks. Current policy seems to be not to wash the baby post birth, but to let the fluids that cover it when it is born come off naturally over the next few days, so this too gets everywhere. Then there's sick. And of course spillages of food and drink that come from trying to grab a mouthful whenever you can while juggling your slippery newborn.

So you're sitting there in poo and wee and blood and sick and food and you think that's okay, whatever else it is nurses and healthcare assistants do, changing the sheets is key and they will be along to do it soon. And you wait. And wait. And wait.

The dirty sheets are not only a health risk but a downer on morale too. Change the sheets, every day, maybe twice a day, and don't wait for women to ask.

Ways to improve postnatal care #3: Help us buy the basics

Ways to improve postnatal care #1: Don't call me mum

Thursday, 22 September 2011

Ways to improve postnatal care #1: Don't call me mum

This is a plea to midwives, nurses, doctors and health visitors who see women in the hours, days and weeks following the birth of their baby. Don't call me mum. There is one person in the world currently allowed to call me mum, and she can't speak properly yet. 

I know it's easier to just call everyone by the same name, but you manage to use names in every other ward so let's do it in maternity too. You may have put your hands up our most private bits, you may have seen us grunt and cry and bleed and push and poo as our babies came out, but pretend for a moment we're not just on the birth conveyor belt and that we're individuals with names and feelings. That way we might just feel your plans for our health and the health of our babies are individualised too. 

Ways to improve postnatal care #3: Help us buy the basics

Ways to improve postnatal care #2: Change the sheets