The point of GPs (and google)

When I was just responsible for my own health, I had quite a disregard for GPs. I frequently felt I knew more than them, and very much viewed them as an irritant whose games had to be played in order to get the next level, the specialist. In fact I used to joke about how we should be able to take an exam to get an 'advanced citizenship card' which would earn you the right to stand for public office, have your votes counted twice and self refer to specialist doctors. 

But GPs come into their own when you have a baby. (Or perhaps it's because I changed surgery from a horrible one to a nice one around the same time, to one where you get what you want not by shouting at the receptionists but by being nice to them.)

Sure I still sometimes know more than them after a quick google, but I underestimated the reassurance they can give the parents of small babies, particularly in the early days when every rash and spot and cough seems disastrous. Some months I feel I practically live at our surgery. Yet still they never seem to mind, reassuring me that they would always prefer to see a baby if the parent is worried, than miss a problem. 

Of course I still trust myself more. When one GP at our surgery dismissed concerns over one of my baby's eyes at three months, I called Moorfields Eye Hospital and on their advice went to their A&E where indeed a problem was diagnosed, and fixed. 

And when she has a temperature it is still down to me to ensure she gets the necessary checks to ensure she is fully well, and to remind the GP which tests they need to order. 

But working in partnership with a concerned, informed, insistent parent, they do a good job. 

So I've given GPs, in my virtual world in which I run health and education policy, something of a reprieve. For now I shall keep them. Health visitors however, well that is another post altogether...

The truth about breastfeeding

A lot of articles and blogs I have read about breastfeeding difficulties are either defensive or apologetic. I am going to attempt to be neither.

Both my baby and I struggled with breastfeeding. Hand problems (Carpel tunnel syndrome followed by tenosynovitis) meant I struggled to hold my baby to the breast. Post birth surgery meant my body was tired and full of drugs. My baby was a little poorly and also a little sleepy. Sucking was difficult. Even without all of this we may have found breastfeeding hard. Many mums and babies do. 

But when the paediatrician said yes, breast is best but really the key thing is to feed your baby, we had no choice. We gave her formula. This gave her the strength to learn to breastfeed. But my supply was low. The way to raise it, said the health visitors and midwives, is to feed the baby at least every three hours and express in between. As each feed could take an hour this left very little time for anything else. I gave up on it quickly. 

A health visitor told me to massage my breasts while feeding to encourage milk flow. I was already tired and emotional with low milk supply. After that I was tired and emotional with low milk supply and bruised breasts. 

The baby lost weight. Lots of weight. Then we started formula feeds as a matter of course, starting with breast and 'topping up' with formula. The baby started to put on weight. Since then in fact we have mix fed. At nearly ten months we still do. It works for us. 

Breast is best. I get that. It has huge benefits for the baby and it's convenient. When it works that is. But the adverts that say this, the ones with peachy looking breasts and rosebud nipples attached to a perfect baby looking blissed out, they do us a huge disservice, because they make it look so easy that if we struggle we think we've failed. Far better a campaign that says breast is best but boy is it hard and please persevere anyway. Have a picture of a mum with bags under her dull sleepless eyes and bulgy veins on her breasts and raised nodules on her nipples and a slogan that says 'It might be shitty but it might get better if you carry on.' Such ads might stop women feeling like failures. 

We're led to believe that breastfeeding is so natural that it's like one of those crafts we've lost in the modern age, like thatching a roof, painting frescoes and making our own soap from horses hooves. We feel that before formula existed women must surely have found it easy because they had no choice. 

Actually here's what I think happened to those women and babies for whom it wasn't easy.  Women whose babies had died acted as wet nurses for some babies. Other babies were fed cow's milk, water and other liquids and some of these got ill and others didn't. Some women had the village wise woman or an older relative sit with her day in day out helping her, tweaking the nipples into shape and helping her hold the baby, until they could do it alone. And some babies, well some got weaker and weaker and died. We're lucky to live in a time where there is an alternative. 

The more people who, head held high, say breastfeeding is difficult and you are not a failure if you struggle and you are not a failure if you stop, the better. Breastfeeding rates in the UK are low and I know the authorities are keen to increase them. But lying to us about breastfeeding and pretending it is easy and pretending it works for everyone is, I am sure of it, the wrong way to encourage people to do it. 

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