Two of my favourite things in the world are lactation and cookies, so you’d think that ‘lactation cookies’ would be my dream. Sadly, this couldn’t be much further from the truth.

“But what harm can they do?”
“What’s the problem?”
“My best friend makes them and she’s lovely”.
“They taste great and herbs have been used by women for thousands of years to increase milk supply.”
“They really worked for me!”

I am willing to join a throng of my lactation consultant and breastfeeding counsellor colleagues to be a party pooper when it comes to the world of lactation cookies. We would build a bonfire from all the lactation cookies that were given at the wrong time to the wrong people  – and it would probably smell quite nice.

1. They can be a barrier to getting the right help.

If you suspect you are struggling with low milk supply, or suspect your baby may not be getting the milk they need, you need support and information quickly. Even delaying that conversation by an extra day could be a problem.

I have just read all the recipes for lactation cookies on the first page on my internet search results.  How many of those recipes mentioned that if you do fear you may have some issues with your milk supply, please contact a breastfeeding counsellor, lactation consultant or health professional for support? NONE.

I am looking at a website that is selling commercially-made cookies and at the bottom of the home page we are seeing a ‘seek advice’ type comment. But nothing on the individual product pages. In all the cases I found, any comment about getting the right support was at the end of some text, often at the bottom of a paragraph, and not highlighted.

Milk supply is governed by milk removal. When the breasts are stimulated, we get surges of prolactin hormone. When milk is removed frequently and with an effective latch, the body receives signals to make more milk. For those of us in breastfeeding support, it’s easy to forget that not everyone understands the basic mechanisms of milk production. The more milk that is removed, the more we will go onto make.

As weeks go by, our milk supply settles and we may not experience fullness or engorgement in the way we once did. We need parents to understand how breasts work. As time goes by, the regulation of lactation has shifted to activity within the glandular tissue of the breast rather than being regulated by hormones. It's really common for this altered feeling of softer breasts to be misinterpreted as a sign that supply has been 'lost'.

Oxytocin, sometimes called the hormone of love, regulates milk release. It can be inhibited by cortisol and adrenaline. If a mum is feel extreme stress, perhaps they are expressing on return to work and not getting the results they were expecting, again they may worry milk supply has been 'lost'. Sending this mum off on a journey for lactation cookies, in a bid to 'fix' a problem is unhelpful. Instead we should be explaining how our bodies work, talking about mindfulness and relaxation techniques and ways to reduce stress and increase oxytocin flow.

If someone is worried about low milk supply, it may be that their baby’s latch needs adjusting. It may be that they need to reflect on how often milk is being removed and for how long for. There may be a factor that requires some specialist help such as a baby with a tongue tie, some retained placental fragments or a medical issue. Adding a, ‘Here, try some lactation cookies’ is stealing time and depriving someone of getting information and support that could make all the difference to their situation.

If your best friend makes them, and she is lovely, please ask her to create a banner at the TOP of her website that highlights the importance of getting qualified support and she can throw in some helpline numbers while she is at it. If you sell cookies and it’s possible for me to spend more than 3 minutes on your website without seeing a message about the importance of getting breastfeeding support, you need to change your website.

Sometimes we could be distracted by cookies when an immediate answer is just seconds away: the mum who was worried about their baby’s weight gain but had been told to always restrict breastfeeding to one breast, the baby whose chin just needed to be closer to the breast. How about the exclusively pumping mum who felt desperate when her pumping output dramatically reduced but her pump just needed replacement parts? All the cookies in the world are not going to repair her pump valve. All the cookies in the world won’t change your baby’s positioning.
 
2. Some of the ingredients could do actual harm.

Cookie is a word that sounds so harmless, but that friendly word is masking a potential risk. Lots contain a seed called fenugreek. Fenugreek has been used around the world to support lactation for a long time but just because something is a plant and ‘natural,’ it doesn’t mean it’s safe for everyone to ingest. The evidence on whether fenugreek does aid milk supply is patchy. There are some studies that suggest it could, but we also know that some people should avoid taking it.

Post-partum thyroiditis affects about 5-10% of new mothers. That’s a surprisingly high number and potentially a significant proportion of those struggling with supply issues. It may start out with hyperthyroidism (which could mean a strong milk supply) and then shift into hypothyroidism (when milk supply could be negatively impacted). Lisa Marasco and Diana West, in their book ‘Making more milk: The breastfeeding guide to increasing your milk production’, talk about the association between taking fenugreek and lowered milk production. Fenugreek is also not recommended if the parent has diabetes, hypoglycemia, asthma, a peanut or chickpea allergy or a bleeding disorder. We also have cases of it causing gastro-intestinal issues in both mother and baby.

I have spoken to mothers who took weeks and even months to get a diagnosis of thyroid issues, and during than time milk supply was a worry. If they had been buying and eating lactation cookies throughout that time (and one had), it could have made the situation worse. Imagine the mum with undiagnosed thyroiditis feeling she just hadn’t ‘found the right recipe’.

When we are a new parent, we are very vulnerable and if a bunch of people are telling you lactation cookies are the go-to, why would you not believe them? Guess how many of those recipes I checked mentioned that some of the ingredients may not be safe for everyone?
 
Brewer’s yeast is another commonly used ingredient. It tastes bitter in large quantities so is often used sparingly. Maybe that’s not a bad thing when you consider that it interacts with more than 200 medications. It interacts with some medications used to treat depression and as you can imagine can impact on anti-fungal treatments.
 
 
3. Even if they are safe for you to use, what messages are being reinforced?

Let’s imagine your thyroid is fine and you don’t have an underlying latching or breastfeeding management issues and you just fancy some lactation cookies. I would still argue that you are receiving a message that your body is insufficient. One of the biggest arguments pro-lactation cookies is that they are a placebo and they often have a positive impact because we BELIEVE that they work. Perceptions of low milk supply are widespread among new parents and in the majority of cases there is nothing to worry about. It’s normal for babies to sometimes be fussy, for breasts to start to feel softer, for leaking to stop, for pumping output to shift, for feeds to get shorter in length.

I would much rather that the placebo, which may cause parents to feel more relaxed, is a dose of accurate information about how breasts change and how babies behave, what growth spurts are and what’s normal in lactation. I don’t want someone to spend £10 a box for that sense of calm or a feeling that they are ‘doing something’. When we are telling new parents that breastfeeding means eating and making lactation cookies, we are telling them that bodies don’t work on their own. We are saying that low milk supply is the norm and we need help to be mammals. We already live in a society where breastfeeding is often not trusted. I don’t feel the answer to this lack of confidence is to imply cookies will fix us. Do we really want a placebo that normalizes perceptions of low milk supply?
 
 
4. They are often expensive.

Here is one company selling 500g of lactation cookies for nearly £10. Here’s some more for £14. Here’s a monthly subscription for around £50.  Even if you make your own, some of the individual ingredients can really add up. Oats are a staple of many recipes. They are not expensive. Does that box really need to cost £14? We know new parents often feel that paying more means a product will be better quality. We are a vulnerable bunch. Flapjacks made with oats and some flaxseed are going to cost a fraction of some of the commercial products. You can get a packet of oaty biscuits from a supermarket for about £1.
 
Let’s be really careful about lactation cookies. For the minority who do have genuine supply issues, there may be better galactagogues (substances that increase milk production) that they should be signposted to. Even if you have researched fenugreek and other herbs carefully, and feel they are worth trying, there are other ways to take them that are cheaper and more easily controllable and potentially in more useful quantities.
 
Jil (@midsussexdoula) on Twitter pointed out that men struggling with erection problems wouldn’t be palmed off with ‘erection cookies’. They would expect knowledgeable support.

If you feel lactation cookies helped you, your role as a supporter of others is not to suggest lactation cookies before you suggest anything else. You could be delaying someone from getting the help they need and wasting their time and money. If you absolutely believe that lactation cookies had a magical effect on you, you need to work even harder to check yourself before you mention them. 

And finally, cookies are good. Eat all the cookies you want, just because they are cookies. Find ones that taste nice, make you happy and bring positives to your life. This is not an anti-cookie message, this is an anti-'cookies that undermine breastfeeding' message.

Every day since the #StayAtHome order began in the UK, I have been posting a daily activity for the children of volunteers of the Association of Breastfeeding Mothers.

Our amazing volunteers have been answering calls on the National Breastfeeding Helpline alongside Breastfeeding Network volunteers, offering remote and video support, continuing with their training and helping to train others, administering Facebook groups as well as looking after their families and continuing employment where possible.

You may find some of these activities are useful for your families too. Many can be adapted to be used with different ages.

I also had help from my fabulous assistant Emily Bruce who is 9 years old.

1. Make a mode of transport. It could be miniature (for a toy, hamster or imaginary creature) or it could be person-sized. Can you design it on paper? But then maybe make the real thing too? 

2. Do you have any egg boxes around?You can use them to make a floral wreath. Here’s a video that explains:
https://youtu.be/eCxSCd6Bqo4
 
3. Painting on a window is a great way to decorate your home and cheer up people who might walk by. And you can make your own window paint.  https://www.kidspot.com.au/things-to-do/activities/craft-activities/how-to-make-window-paint/news-story/223b3c2b2bde6e1965f19f1b57655c28?fbclid=IwAR1_XWTgQAPr09-htPvDELhJIATLOCICPEKZCh4m5osrIZAAsBF6gC9N9YM 

4. Make a mini garden. You could make one for a little toy. Or make one for a fairy or friendly mouse who might visit one day. You could make it on a plate or on a tray or in a box. You could use things from outside like stones and leaves and twigs. Or you can use inside things like paper and cardboard and lettuce and play dough. Or you can mix inside and outside things. 

5. Can you make your own butter? You need a jam jar and some cream (you can do it with milk too if you are very patient). Skimmed milk doesn’t work very well. Why not? When you have finished, do you like it better with a little bit of salt or without? https://happyhooligans.ca/homemade-butter/?fbclid=IwAR1C_edNM6qgpyE2ZSYGPctTXKmd22qeINWX8HyqOIeiznIhSlw1SQMnSnc
 
6. I saw on Twitter a teacher set her class the challenge of presenting baked beans as if they were chefs at the fanciest restaurant in the world. If you don’t eat baked beans, choose some very ordinary every day food and go for the fanciest presentation you can. 

7. Play a game called cat’s cradle. You need a piece of string or wool about a metre long. You might need to try different lengths. Essentially you’re going to tangle your hands up in the string but in a cool skillful way. Watch these videos to see how it works. Solo cat’s cradle: https://images.app.goo.gl/WKXJ4MiNhS8Hfr4v5 
Two people version: https://youtu.be/VpHTPnrYLzQ
 
8. Make musical instruments. Can you use things from around the house and garden? Musical instruments make sounds with blowing, plucking, banging, shaking. Even a piece of grass can be a musical instrument. Emily says snail shells make a good clacking sound (but snails would probably prefer to be finished with them first). Then can you put on a performance! 

9. Throw things. Get a cup or a bowl (plastic is better). Put it on the floor. Take a step back and throw a penny into it. How far away can you step back and still get the penny in? Or you can try playing cards (which will be useful if you are ever a cowboy or a film character who is bored). The playing card throw needs a quick flick. 

10. Salt dough is thought of as a Christmas decoration thing but you can make salt dough any time of year to make lots of different ornaments. https://www.yummytoddlerfood.com/activities/the-best-salt-dough-ornaments/?fbclid=IwAR3ClTliU9cwLJryYIuOTDfgNn0eRA8-CyNzYWMVz-KRmkzzu3t7E15ktI4 

11. You can take a virtual tour. You could do a drawing of something you saw on your trip. 
Baltimore aquarium: https://aqua.org/media/virtualtours/baltimore/index.html
 Metropolitan museum in New York: https://www.metmuseum.org/art/online-features/met-360-project
The National museum of the US Airforce: http://www.nmusafvirtualtour.com
 
12. You need string or wool, card and colouring pencils or pens to make a SPINNER. I’m not talking fidget spinners. I’m talking about spinners that go zoom with string after you've spun them round. They make look a bit uninteresting when they are still but trust me, when you get spinning you will go WOW. Which patterns look particularly cool? Maybe you can share a mini-video of your spinning. Instructions here: https://www.easypeasyandfun.com/how-to-make-a-paper-spinner/ 

13. What can you make out of a towel? Or a mini-towel? (Otherwise known as a flannel). There are many possibilities. It could be part of a landscape for trains or cars. It could be part of a costume. Or it could be an animal. This video helps you make towel animals: https://youtu.be/w4sb6OAnvAY 

14. Learn the BSL alphabet. BSL means British Sign Language and it’s a language often used by deaf and hard of hearing people in the UK. There are thousands and thousands of BSL words like there are in every language but you can also learn the alphabet to spell words out. Can you learn the alphabet? Can you learn how to spell your name?
https://youtu.be/DgIvXXdwjvw
You can learn some of these 100 common words too: https://youtu.be/gMNHvXSW4iE
 
15. Get to know Joyce Grenfell. Listen to her here: https://youtu.be/ZXhHFgDRNBQ What do you think? Can you listen all the way through without smiling at all? If you enjoyed that, you can try: https://youtu.be/vTqivGLAZXM. And https://youtu.be/8iWl36mh6vM
 
16. Make today SOCK day. What can you make out of an old sock?A cool sock puppet is always a good thing but think BEYOND THE SOCK PUPPET as well. It could be something for a toy, something useful in the kitchen, something practical for another part of the house, something very very silly. What can you do while wearing socks on your hands? What is the most challenging thing you can do? Can you wash up? Can you brush your teeth? Can you tie shoelaces? Can you type? Can you eat a banana? What other challenges can you complete with sock hands?
 
17. There is a book called ‘Paper Dolls’ by Julia Donaldson and Rebecca Cobb. In the book, a family make paper dolls. Every doll is a different little character. Have you ever made paper dolls? There’s a video that shows you how to here: https://youtu.be/CYXxoVbPzqI What little friends will you make? 

18. What birds do you share your neighbourhood with? If you have a garden, do you know the names of all the birds that live with you? Can you record the birds you see over a week? Which one is the most common? What birds can you see and hear when you go for a walk? Lots of birds are making nests at the moment. You might see them collecting food for their babies too. https://www.rspb.org.uk/birds-and-wildlife/wildlife-guides/identify-a-bird/

19. Have a look at the work of Canadian artist Raku Inoue. He makes insects using things he finds in the natural world. Can you have a go? You might be able to do it from things you have inside the house too. What about a bug made from nothing but types of breakfast cereal.

20. Today (and you may or may not already know this) it is one of your favourite toy’s birthdays! Why don’t you throw them a surprise party! You can make them some decorations, wrap them a little present (and decorate your own wrapping paper), have a special meal, send party invitations, play some party games with them and their friends, have a birthday disco. Happy Birthday __________! (If you don’t celebrate birthdays, maybe 2 toys are having a wedding anniversary). 

21. WHAT IS YOUR DREAM PET? I don’t mean - I’d quite fancy a hamster right now - I mean you can have ANY animal or creature from across the world, from history, from your imagination. They will live with you by choice and be your loving friend.You can draw a picture. Describe them and someone else can draw their picture. Make a model. Write a description or a story. Dictate a description to someone else. It would be nice to know their name.
 
22. How many pieces of clothing can you wear at once? I would add that you can’t wear anything that covers your face and you need to put all the clothes back again afterwards! But how many individual bits can you fit on yourself and still be able to walk?

23. Teaspoons have a tough life. They live in a drawer. Then someone takes them out, sticks their head in hot water and spins them round in circles. Then shoves them in soapy water. They see so little of life. I would like you to choose a teaspoon and give it THE BEST DAY OF ITS LIFE. Make it a little house, an outfit, show it your favourite film, put on a concert for it, give it a spa day. Give it a NAME. Make your teaspoon’s dreams come true. You may think teaspoons don’t care. But what if they do? Think of the stories it will tell the other spoons back in the drawer. 

24. Be a cobbler. Make a pair of shoes. Use any materials you like. 

25. Limit your language. Look online for extracts of novels called ‘Gadsby’ and one called ‘A Void’. They were written entirely without using the letter E. Can you write a story without using the letter E? Or how long can you go without saying: I, THE or AND. Can you tell a story about a trip you once went on without those words? 

26. Make a family newspaper or magazine. You could interview members of your family, include recipes, make a crossword, review a film, discuss sporting events (which may just be ones that happen in your garden). You can invent some adverts too. 

27. Have a go at writing an invisible ink message using lemon juice. You could even draw a picture and post it to someone (and give them instructions how to see it). https://youtu.be/poCnU_crpjQ 

28. Do you like ketchup on your cornflakes??This is the title of a great split-page books.You can see someone reading it on a video on YouTube here. https://youtu.be/yfqHI-oMuYA
You can make split-page books that make funny faces, make characters that wear funny clothes or monsters. You can use them to tell stories or write poems. Can you make a split-page book?
 
29. Make a time capsule. A time capsule is a collection of special things that tell people in the future what life is like now. People get a box or a tin and fill it with notes and objects that tell people about the world they live in. Sometimes we hear about people making a time capsule that gets opened 100 years later and the people who made it aren’t around any more. I’d like you to make a time capsule for your future self. You might open it when you are 30 or 50 or 80! What will your life be like?! Whatever you are up to, I think you would be interested to get a message from the year 2020. You could draw pictures, write a letter, put in a photo, put in a little toy, something about the news, a food wrapper. The possibilities are endless. But it will be something you won’t see again for a long time. Tell your future self how you are feeling today. 

30. Make a laser maze. Sometimes lasers are used to keep precious things safe in museums (but often in films about museums and banks because lasers look cool). It’s very hard for someone to wiggle past lots of lasers without touching them and setting off the alarm.If you have wool at home, you could make your own laser maze. User a timer to see how long it takes you. If you touch the wool, you have to start again. If you don’t have any masking tape or you don’t want to stick things to the wall, you can also make an obstacle course on the floor. Can you hop your way through your maze without falling over? You could use a timer to see if you can get faster.
 
31. You know those cardboard circles that come under shop-bought pizzas?They are about the size of a big dinner plate if you have any cardboard and you want to make your own. What can you turn one into? Stare at that circle. What could it become? You can draw things, paint things, stick things. It could be a face, a planet, a meal. There are so many possibilities!
 
32. Make a foil animal. You may have some foil in the house. Perhaps it was wrapped around an Easter egg. Can you make a little animal using foil? 

33. If you have the ingredients at home, can you make your very best sandwich? If you don’t have the ingredients at home, can you draw a picture of what your imaginary sandwich would be. Sometimes people draw sandwiches in a special way so you can see all the different layers of ingredients. You could make a poster to advertise your favourite sandwich. Or even make a little video which is a television advert for your sandwich. 

34. Make your best CIRCLES. Please use objects around your home and garden to make some art (objects that don’t normally get used for art).  You might use leaves, Rice Krispies or Lego. Look online for the work of artist Andy Goldsworthy who uses things he finds outside. 

​35. Imagine you could go on holiday to a magical island. What would be on your island? It’s magical so it can be anything your mind can create. Maybe it has different areas that members of your family will especially love. I’ve got a cliff with some puffins nesting because my family like bird-watching. And a LOT of restaurants for me. What’s on your island? You could make a map. 
 
 
 
A message from Ann, an ABM breastfeeding counsellor volunteer:

My husband, Andy, is a kind and brave man. Whilst I spend my working life helping families with breastfeeding, he spends (or 'spent') his working life organising bespoke cycling tours for small groups. Once C-19 struck, and 'lockdown' started, my work ramped up into a whole new gear. Many many hours of work, some of which is paid, all moving into new ways of working online and on the phone. Energising, yet deeply exhausting. For Andy, as for so many other people around the world 'lockdown' meant the end of his entire summer season. No work, no income, no plan for the future.

For many of us, our work is part of our identity: what we do with our time, and what we feel passionate about is part of what makes us get up in the morning and feel good about ourselves. If 'lockdown' took this away from you, I feel for you. I've been extremely lucky; Andy hasn't been, and that's true for many other people.

Whilst coming to terms with the shock of sudden unemployment and loss of income, in observing my long hours of work at the dining table, Andy saw the effect of 'lockdown' on the many families having babies during this time. Where is the support? The face-to-face encouragement? The knowing smile on someone's face as they pass a new parent the first hot cup of tea they've managed to drink for days? Andy also saw how hard many folks in the voluntary sector are working right now, to reach and engage with those families who want or need help and support with feeding their babies. Finding new and creative ways to give families the help and support they want, but without leaving our homes.

So he decided to help by wearing some rainbow knitted boobs.

He created #BikeAndBoobs

Andy likes to have a cycling challenge to get his teeth stuck into, and getting out on his bike every day is part of what keeps him - and by extension, me - sane. Instead of the Lands' End to John o'Groats trip he should have been doing right now, he's doing his daily permitted exercise weaning these jaunty boobs, which were knitted by a friend: a wonderful Health Visitor who is recovering from a severe case of C-19.

This strange and wonderful scheme has 2 aims: to raise awareness of the vital importance of skilled help and support for new families who are establishing breastfeeding and to raise funds for 2 charities who exist for this very reason.
If lockdown has been cruel to your household finances, please DO NOT DONATE. Instead, perhaps you could help Andy's project by sharing info about it with your friends and family. If, however, you do feel able to donate, your support will be very gratefully received.

Here's Andy's fundraising page:   https://uk.virginmoneygiving.com/AndyBruce6

And remember, if you ever look out of your window and see a chap on a bike, wearing rainbow knitted boobs, he's doing it for you!

It’s been a challenging month for many different reasons. But never in the history of natural-term breastfeeding, has any child ever breastfed as much as your nursling. If there were records, they would have been smashed. It’s like your child has analysed the national food distribution network and has decided that YOU need to be a major manufacturer.

Before this whole lockdown business, breastfeeding was an important part of their life, sure, but you felt as though you were on top of the situation.

Now the situation very much feels as though it is on top of you. Very often literally on top of you. With a foot in your ear. Sometimes with a car in their hand. Sometimes twisted to try to see the television at the same time. Sometimes a nanosecond after the last breastfeed.

You’ve mastered the art of the Zoom call with the screen angled so you’re seen above the chin only. You can type at a laptop while breastfeeding and it doesn’t slow you down in the slightest. You can complete a supermarket online shop, peel a potato, colour in a rainbow – all with someone attached at your nipple.

Sometimes you are so grateful that you continued to breastfeed in these uncertain times. Your child is still getting access to the immunological benefits of breastfeeding at a time in history when that has never seemed more sensible. But this is hard. Touched-out is phrase that is sometimes used. Touched-out feels like a distant memory. You don’t feel you have control over your own body.

You are trying so hard to empathise with your child. This must be weird for them. They are stuck inside. No nursery. No wider family. Life feels different and they may not fully understand why. Grown-ups may have anxieties. Something is going on. Breastfeeding is the time when they feel safe and reassured. They can control this world that appears to be out of control. They request a breastfeed and it happens. They feel connected to you and feel they have some influence over their universe. They may also feel bored. Breastfeeding is something to do.

We can be empathic, and we can value natural-term breastfeeding and we can set limits all at the same time.

Breastfeeding an older child does not mean that YOUR feelings matter less. Breastfeeding an older child does not mean that YOU are not permitted to sometimes focus on yourself. You are allowed to feel fed-up. You are allowed to have had enough.

Your child does not want to be parented by a martyr to the cause of breastfeeding. They need a real human with feelings and desires and bodily autonomy.

This is their first intimate relationship. You are teaching them about kindness to others. You are teaching them that the feelings of others matter and sometimes we need to focus on other people ahead of ourselves. You are teaching them that sometimes people need to take a moment, have some space, have a breather. None of that is incompatible with being a good parent. It makes you a better parent.

We sometimes have conversations about ‘nursing manners’ with older children. If they pinch or hit us during feeding, we want to work hard to find strategies to change this. Parents do this because they don’t like getting pinched and hit. ‘Hey, this is not just a breast. This is ME!’ But we also work on this because we want our children to understand that pinching and hitting anyone isn’t kind. Kindness towards everyone begins with these small lessons and talking to a baby who is only a few months old about being gentle and having gentle hands.

Nursing manners extends beyond pinching hands. It means having kindness when the breasts are in the middle of an important meeting or the breasts are tired, or the breasts need to go and get a drink of water for themselves. Even from a young age, it’s OK to talk about the need to wait. Even when time is only beginning to be understood, it’s OK to say, “Do you mind if we just snuggle for a bit or read a book as my breasts/ milkies/ milk-milk need a bit of a rest?” You are teaching a vital lesson about being open with feelings and how those in loving relationships can express vulnerabilities and the need for give-and-take and compromise.

None of this is incompatible with being a breastfeeding advocate and a passionate supporter of natural-term breastfeeding. If you think child-led weaning means you are NEVER allowed to refuse EVER EVER, you may be dissuading others from continuing to breastfeed in the longer term.

Gentle parenting means trying to shape gentle kind people and that happens with modelling and empathy and communication. I was once asked to contribute to a compilation of articles on gentle parenting. I offered a version of my blog on weaning toddlers and pre-schoolers. The editorial team declined as they didn’t feel talking about weaning and restricting breastfeeding fitted with their ethos. Really? I’m not sure they ever got dressed in the morning and purposely chose the shirt with the tinier, more fiddly buttons as it might mean they get a bit more work done that day.

Every time we tell a parent that child-led breastfeeding means no restrictions from the parent at all and the parent must respond to every request for breastfeeding with no limits, we are potentially shutting down older babies breastfeeding for longer. We are perpetuating the myth that breastfeeding means you can’t be a normal person with frustrations and bad days and your own goals and desires.

What might help if you have a Guinness World Record Breaker older nursling at the moment:

1. Just talk to them. Be honest. Say you love breastfeeding, and milkies is special and helps to make them strong and clever but sometimes you need a rest. Just a short one. Milkies will be along again soon. You don’t have to stretch the truth and create some biological excuse. You don’t have to pretend they need time to make more milk. It’s just OK to say how you feel. I have met parents of 3- and 4-year olds who are struggling and will do everything (including putting band-aids on nipples) rather than just try and share how they feel. We can admit to being tired. We can admit to needing to concentrate on something else. 

2. Some of this is about them looking to control their world but the world feels out of control. Their speech is developing and their understanding of communication. They ask for a breastfeed and it happens and that’s magic. What else may fulfill that desire? Can they ‘ask for a book’? It’s sometimes said that reading a book together is more like breastfeeding for a toddler than most other activities. If you can’t read at that moment, make a booking waiting room. They can pile up the books they want you to read next, in the order they want them. Or what about a toy waiting room? Or some cards with pictures on that show favourite activities and there is a board where they can stick up the next request?  

3. They may be thirsty. Do they have a cup station they can reach and use independently?  

4. If you are working from home, they are not used to it. They are not used to you being home and not getting more of your focus. This feels weird. What short activities give you 15-minute bursts of being able to work? In an office, we regularly take short breaks to grab tea, talk to a colleague, even just pick up your phone and scroll. It’s OK for focused work at home to only be in relatively short bursts. Use a timer to show them time passing. The app ‘Forest – stay focused’ allows you to plant a cyber-tree which then gradually grows over the time you have set in advance. The shoot appears, the leaves develop and the tree gradually gets bigger and bigger. At the end of whatever time you have set, you will have a fully grown tree to add to your virtual forest. They can come back and check on your device to see how the tree is growing. Is the tree fully-grown so now it’s time for a breastfeed? Or a chance to read a book? Plant a forest together made from patience.

5. Grant a breastfeed but on your own terms. It can only be ‘count to 10’ (Count slowly or quickly depending on how you are feeling). Or an older child can ‘buy’ a breastfeeding by trading a bracelet or a toy.  
“Here are 5 plastic spoons/ coins/ dinosaurs. We’re going to play milkies shop. When you want a breastfeed, you can buy one. But you’ve only got 5 until lunchtime/ dinnertime/ I finish this piece of work.”
 
It’s amazing how long they will hang onto the last one. They feel in control knowing it’s in reserve. It’s still their choice when to ‘spend’ it.
 
If you have any other ideas that have worked for you, please feel free to share them in the comments below. You may have a strategy for dealing with a #stayathome nursling that will change someone else’s life.

This is not easy. And it’s OK to need some help. It’s OK to want to set some limits. Parenting a young child at the moment, when we are all stuck at home, is not easy for anyone and just because you are breastfeeding, it doesn’t mean you are immune from that. You don’t have to be the ‘perfect’ parent who constantly puts yourself second. Finding compromises, strategies and sometimes saying, ‘not right now’ is healthy for both of you.
 
If you are really struggling, you may find resources on breastfeeding aversion and agitation helpful. You can start here: https://www.breastfeedingaversion.com/

My article on weaning older children goes into further detail about setting limits: https://www.emmapickettbreastfeedingsupport.com/twitter-and-blog/weaning-toddler-bob-and-pre-schooler-billie-how-do-you-stop-breastfeeding-an-older-child
​

So, you are home with your new baby. Someone said something to you antenatally about ‘taking time’ as a new family, reducing unnecessary visitors and making a ‘new baby nest’.

And the world has taken it upon itself to make all that happen by arranging a global pandemic.

Slightly over the top perhaps, but here we are. I hope you have everything you need. And don’t be shy about asking neighbours to help you if not.

There are negatives in this situation for so many of us, but there are also some surprising positives. You will not get work harassing you to pop in for a meeting next week. You will not have your mum’s friend Sue ‘popping by’ to make unhelpful remarks about how often your baby is feeding. You will not be distracted by the desire to go to a restaurant on day 6. You can wear pyjamas all day and feel like you are helping humanity.

We always knew partners had a key part to play in helping to make breastfeeding a success (and a partner may be a husband, wife, parent or good friend living with you in isolation) but now you are even more special as access to face-to-face trained breastfeeding support is likely to be limited for all of us.

Breastfeeding has never been more important. It’s the perfect food for your baby and a wonderful medicine – giving pain relief and delivering anti-bodies and ingredients that kill and limit bacteria and viruses while providing calm and reassurance. It can also reduce anxiety for parents too and we know that when someone reaches their breastfeeding goals, it can reduce their risk of mental health problems.

This article is a summary of some key things you need to know to be the best enabler of good breastfeeding in the days and weeks to come.

1. Despite how it may feel, you are not alone.
 
In most areas, you are being called by your community midwife soon after getting home and if you need to be seen face-to-face, that can still happen. You will get a face-to-face visit within the first few days where your baby will be weighed. Most babies will lose some weight after birth but ideally not more than 10%. If you are ever worried about any aspect of feeding, find help. Don’t wait to see if problems will work themselves out. The breastfeeding support community (lactation consultants, breastfeeding counsellors and peer supporters) are sitting at home too. Calls to the helplines are answered by volunteers who are specifically trained in being able to talk about breastfeeding without being able to see you. It always sounds a bit daft, but we know how to support with positioning and attachment without being in the same room. Try the National Breastfeeding Helpline on 0300 100 0212 (9.30am-9.30pm).  There are several other helplines with different hours. You can also contact lactation consultants from across the UK who will use phone and video consultations to support you.  Many local breastfeeding drop-ins have moved to being online.
​
Have a look here for details on how to find different kinds of support: https://abm.me.uk/wp-content/uploads/COVID19.pdf
 
2. Use technology to your advantage.
 
Many lactation consultants and local breastfeeding support teams are using remote support like Zoom consultations, WhatsApp chat, Facetime calls and Skype. We can SEE breastfeeding sometimes more effectively than we were able to before. It’s useful for us to check how a baby is swallowing (more on that later). Usually during a breastfeeding assessment, we politely lean over to take a look at the baby on the breast for a few moments. With video, and a moveable camera like a phone or iPad, we can hover 5cms about the baby’s cheek for 10 minutes and no one thinks we are weird.
 
It’s really useful if you can record some short videos to share with your breastfeeding supporter. Short ones that are less than 30 seconds will be easier to send. Take a video of the feed from different angles including standing a few steps away. We’re looking at how the baby is held, the arms holding them, the chair, the cushions. And close up too – from above and then come around to the side so we can see both of the baby’s cheeks. Stay above for a moment so we can see the baby’s chin moving as they are at the breast. And at the end of the feed, as the baby comes off, what does the shape of the nipple look like?
 
We will keep these videos securely and respect your privacy. We may suggest that during our conversation, we all watch the videos again together. A bit like you are a professional tennis doubles team and we are your tennis coach watching a replay. We’ll talk about what we notice and how perhaps slight changes can improve things.
 
3. If breastfeeding is uncomfortable, there are small changes that could make all the difference.
 
You don’t always have to be trained in breastfeeding support to be able to suggest some changes that could really help. If your partner is in pain, just one comment, just one observation could transform everything and help the baby to get more milk. Breastfeeding isn’t supposed to be painful. A stretching feeling in the first few seconds of early breastfeeding is not the same as a feed that is painful, hurts all the way through and leaves a nipple looking squashed/ pointed/ ridged. If breastfeeding hurts, talk to someone. However, you may also be able to make some suggestions.
 
Are they moving the breast TO the baby? Almost like they are bottle-feeding with a breast? Perhaps they are leaning forward, pulling the breast out of its natural position to reach the baby? If that’s happening, chances are that it’s shifting inside baby’s mouth once baby is on and bringing the nipple back to rub somewhere it shouldn’t. We talk about BABY TO BREAST. Make sure, if cushions are being used, they are the right height. Check they aren’t leaning forward to get to the cushion or lifting up their breast so there’s space for baby to fit in. This article outlines lots of the common adjustments that can make all the difference: https://www.emmapickettbreastfeedingsupport.com/twitter-and-blog/breastfeeding-is-just-like-golf-a-tiny-adjustment-makes-all-the-difference.
 
We want the baby to come to the breast CHIN FIRST. The chin is the first thing that makes contact with the breast. We want the baby really close to you. If clothes are bunched up in the way, or baby’s hands are at their chin, they will get less breast in their mouth. And we want their mouth full of breast. If they come to the breast chin first, with the nipple under their nose, they are more likely to tilt back and get a good mouthful.
 
If I offered you a drink of water now, you’d naturally raise your chin away from your chest to swallow. Try and swallow with your chin pointing down – it’s hard. And it’s also hard to swallow if your neck is twisted. We want a baby’s ear, shoulder and hip to all be pointing in the same direction. Babies don’t like it if they don’t feel anchored and secure and they don’t like it if someone is pushing on the back of their head and holding their head tightly. They want freedom to be able to tilt their head back, so we support their bodies and around their shoulders. Often leaning back helps make breastfeeding more comfortable. Have a look at some of the resources online about biological nurturing or laid-back breastfeeding: http://www.nancymohrbacher.com/breastfeeding-resources-1/2016/12/26/natural-breastfeeding-video
 
Remind yourself about what an effective latch looks like by watching this video: https://globalhealthmedia.org/portfolio-items/attaching-your-baby-at-the-breast/
 
Sometimes a few days go past, or weeks, and things change without us even noticing. If breastfeeding has become more uncomfortable, it might be that a baby has got a little heavier and the position you used when baby was tiny now means their weight is pulling them off the breast.
 
4. Know how to measure how much milk is going in.
 
It’s true that most new babies are going to be weighed a little less over the coming weeks. Again, if you are really worried, there are people who may be able to support you with this, but we’re not going to be popping to the weighing clinic as we once did. Some families are hiring or buying baby scales to use at home. Sometimes this is valuable, but over-weighing is not always useful and can make you feel more anxious. Talk to someone about how often is sensible for your situation. It’s not a great plan to rely on using normal bathroom scales and trying to weigh yourself and then weigh yourself holding baby. This will often have accuracy problems and we are usually only talking about 100 grams here and there.
 
Nappies are the key. When a baby is one day old, we’ll see one poo and one pee in 24 hours. On day 2, two poos and two pees. From then on, we’ll see AT LEAST two poos every 24 hours (the size of a £2 coin or bigger). More poo is better and babies taking in lots of milk will do often more than 4. The poo will change in colour. The first day we will see black sticky tarry poo called meconium. As the days go by, the poo gets paler. By day 2-3, often a bit greenish. We don’t want to see black poo any more after day 4, and talk to someone if you do. By day 4-5, we should be seeing pale, mustardy poo. We carry on seeing several poos a day for the next few weeks. Only around 6 weeks does it slow down for some exclusively breastfed babies and their poo rate may start to slow down and they may skip some days. But young babies do not skip days. We need several poos a day to know milk is going in as it should.
 
With pee, we want 3 pees on day 3. Four pees on day 4. On day 5, five wet nappies. From then on, 6 or more heavy wet nappies in 24 hours. You shouldn’t have to think, “Hmmm, was there a pee?”, the nappy should feel heavy enough that you know. If you aren’t sure, talk to someone.
 
https://www.nct.org.uk/baby-toddler/nappies-and-poo/newborn-baby-poo-nappies-what-expect
 
5. Know how to see milk going in.
 
It’s not only nappies that can tell us a baby is getting milk. We can look at the top end too. I don’t mean a baby is being sick (although that sometimes happens, and if nappies are good and the baby doesn’t seem to mind, and it’s not projectile, that can be OK.)
 
I’m talking about knowing what a baby swallowing milk looks like. Breastfeeding happens for lots of different reasons. Sometimes babies are there to feel safe, to help them fall asleep, to feel comforted. All that is important and to be valued. Babies are supposed to ‘use us like a dummy’. They have a lot of brain development to do and they are learning important things about trust and comfort. But we don’t want them to only be on the breast to suckle and comfort themselves. It’s good to be able to recognise when milk is definitely going in.
 
At the start of a feed, a baby will suckle quickly to get the milk flowing. Then they will settle into a suck/swallow pattern where you will be able to hear them swallowing milk. In the first few days, when your milk is still the rich colostrum, you may hear less gulping. But when the milk has begun to transition around day 2-4 and it’s changing to mature milk which is lower in protein, higher in fat and higher in volume, you’ll hear some swallowing at the start of a feed. As the milk gradually gets fattier (which happens gradually as the minutes go by), you may notice they do more sucks for every swallow. But they will still be swallowing. How do you tell when a baby is swallowing?
 
Have a look at another video from Global Health Media:
https://globalhealthmedia.org/portfolio-items/is-your-baby-getting-enough-milk/?portfolioCats=191%2C94%2C13%2C23%2C65
 
And this video from Dr Jack Newman:
 
https://www.breastfeedinginc.ca/really-good-drinking
 
We’re looking for the chin to come down and a pause in the chin to indicate a swallow. By the way, you can’t always tell how much milk a baby is getting by counting how many minutes they are on the breast. A feed that lasts 30 minutes isn’t necessarily ‘better’ than one that lasts 8 minutes. It’s all about what they are DOING in those minutes.
 
This breastfeeding assessment tool from UNICEF Baby Friendly explains that an effective breastfeed may be anything from 5 to 40 minutes. There are lots of good ideas about how to check feeding is going well here:
 
https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2016/10/mothers_breastfeeding_checklist.pdf
 
 
6. Feed often.
 
New babies feed frequently. You might have been told something about ‘feeding on demand’ and waiting for babies to tell you if they want the breast, but anyone who specialises in breastfeeding will tell you otherwise. SOMETIMES WE HAVE TO TAKE THE LEAD AND MAKE SURE FEEDING HAPPENS.
 
New babies can be sleepy. They sometimes have jaundice. They sometimes sleep through feeds and their blood sugar levels drop. We may have to be bossy at the start. Being bossy also reduces the risk of getting engorged which happens in the first few days and our breasts are moving from colostrum onto the next stage of milk.
 
We don’t want a young baby to go longer than 3 hours from the beginning of a feed to the beginning of the next feed. That includes at night too until we are really confident they are putting on weight and doing well. We will need to wake a sleeping baby sometimes. If a baby is sleepy, you might take off layers or tickle them or blow on them. As long as they are attached to the breast, you can also push milk into them using a technique called breast compressions: https://breastfeeding.support/what-is-breast-compression/
 
And just because we talk about not going longer than 3 hours, that does not mean we are aiming for 3-hour gaps. That really would be a minimum. Healthy babies breastfeeding will often feed a lot more than that. We need to respond to their requests to breastfeed as that helps make sure they get enough milk, they feed calmly and don’t take in more air because they are upset. It also means our milk supply gets the signals it needs. It’s important we don’t try and push babies to ‘go longer’ thinking that will make breastfeeding easier. It can have some serious consequences: https://www.unicef.org.uk/babyfriendly/breastfeeding-the-dangerous-obsession-with-the-infant-feeding-interval/
 
A baby asking to feed will show you in lots of different ways. They will be a little restless, move their head from side to side, open their mouths and sometimes make murmuring noises. They might suck on anything nearby. Crying is what we call a ‘late stage’ hunger cue. But if you are ever not sure a baby wants to be on the breast, you can’t go wrong by offering. You can’t overfeed a breastfeeding baby. If they aren’t wanting to feed, they may suckle instead. As mentioned before, breastfeeding has a lot of value that goes far beyond feeding.
 
7. Expect babies to want to be close
 
We are primates and like other primate parents, our babies want to be close to us. When they are close (and skin-to-skin isn’t just for straight after the birth), they are calmer. Their heart rate and respiratory rate is optimised, and it helps us to notice when they are asking to breastfeed. Babies like being held and you can’t ‘spoil’ a baby. They might like being held in a sling, which can also be helpful if you have other children to look after. They want to be close at night too. About 70-80% of breastfeeding families share their sleeping space with a new baby and it’s important to know how to do that safely. When we don’t prepare and fall asleep accidently when holding a baby, there is far greater risk. The BASIS website has guidance around safe sleep for babies: https://www.basisonline.org.uk/
 
8. If a baby isn’t feeding at the breast…
 
…You’ll want to get some help. You can call a midwife or a health visitor (once you have been discharged by the midwife). You can call a helpline or sometimes you may have been given a number to call at the hospital. In the meantime, there are ways to still get milk into your baby. You can hand express (take milk out of the breast by hand): https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html
And you can give milk to the baby in different ways. Cup-feeding using something like an egg cup or small plastic medicine cup is one option (Do watch a video as it’s not pouring milk into a baby’s mouth and needs some care): https://breastfeeding.support/cup-feeding-newborn/
 
You can also spoon feed milk into a baby. Even getting them to suck on a milky finger may mean they take a little milk which may help them to breastfeed.
 
 
No one is expecting you to know everything. You don’t have to solve every problem or know every answer. There are lots of people who are here to help you. But there are some keys principles that will help you to feel more confident and help breastfeeding to go well: know that breastfeeding shouldn’t be painful, know how to tell if a baby is getting milk, know that we respond to baby’s requests for feeds but sometimes we may need to nudge, know where to get help.
 
If a parent breastfeeding does get unwell, continuing to breastfeed is ideal. Your baby will benefit from the anti-viral antibodies that are tailor-made to fight this specific virus and delivered in the milk. There is no evidence that the virus is carried in breastmilk. Some are choosing to express some extra milk and have a store of some milk in the freezer as a protection in case they feel very unwell. For most people, their symptoms will be mild and they can breastfeed as normal while being more careful around hygiene. You can read more here: https://www.breastfeedingnetwork.org.uk/coronavirus/

Here's a conversation starter that can be used with any age group. Can you find all the babies in this picture? Which ones are feeding? Which ones were feeding 10 minutes before? Breastfeeding happens all around us and often we don't even notice when it does.

After a long wait and a thorough consultation with more than 11,000 responses, the Department for Education released its updated guidance for Relationships, Sex and Health education a few weeks ago. From 2020, relationships education is compulsory in all primary schools in England and sex and relationships education is compulsory in all secondary schools.

As the chair of the Association of Breastfeeding Mothers and someone who writes about breasts for parents and young people, I predictably jumped on my computer minutes after its announcement and searched the fifty-page document for the word ‘breast’. There are zero responses. 

Disappointing.

While menstruation gets 13, and even gets its own sub-heading.

The PSHE Association scheme of work is recommended as a resource to be used in schools. Let’s check there. A scheme of work that covers 5-to-18 year olds. Anything about breast development, breast function?

There are three mentions of the word breast: two are about breast self-examination. Girls are taught about when their breasts are dangerous and pathological, but not when they are healthy and functional. The final reference in Key Stage 4 (14-16 year olds) talks of “parenting skills…to be able to make informed choices about parenting including issues around breastfeeding.”

‘Issues around breastfeeding’: there’s a phrase that doesn’t warm the cockles of your heart. Those of us who work to support new families to feed their babies can tell you something about the issues around breastfeeding. Girls are growing up not knowing how their own bodies work. They don’t know how breasts start to develop, so spend months thinking they may have cancer (because that’s the only time lumpy tender asymmetrical breasts get a mention) or they are abnormal. They are taught that breasts are to be hidden away and nipples made invisible. But then confusingly, women who show them in particular ways often seem to get more attention, especially on social media.

Girls rarely know that their breast tissue goes into their armpit. They can rarely use the word for the coloured ring of skin around the nipple (the areola) and they even less commonly know how to say it. It’s a clue this is a nationwide problem when 3 different pronunciations are all considered acceptable: arry-oh-la, a-ree-oh-la, uhrowla. They don’t know the very simplest facts about how their body might milk in the future or that breastfeeding isn’t just about making milk anyway but giving comfort, developing relationships and reducing their risk of maternal mental health problems.

The guidance claims to be about promoting healthy relationships, positive mental health and it claims to be about valuing parenthood. But there is a huge hole – and it’s breast-shaped.

If normal breast development and breastfeeding isn’t discussed in schools, we see the consequences years later when parents are expected to gain all their knowledge and confidence between finding out a baby is expected and its arrival. In 2017, The Royal College of Paediatrics and Child Health called on government to put breastfeeding into the school curriculum and that call has been ignored. It’s not about getting everyone to breastfeed. Some mums don’t want to, and some mums are unable to, but we know around 80% try to start and more than ¾ of them are let down by lack of support. We end up with a country with some of the lowest breastfeeding rates in the world as a result.

The new curriculum covers some tough realities: forced marriage, honour-based violence and FGM. Children are to be taught about the treatment of sexually transmitted infections and that alcohol and drugs can lead to risky sexual behaviour. They are taught about adopting and aborting a baby, but not feeding one. In Scotland, we can see places where breastfeeding is on the curriculum and schools can even be awarded ‘breastfeeding-friendly’ status. Why is England not joining up the dots? It’s not happening in this new guidance and it’s not happening in the science curriculum where pupils are taught about ‘the effect of the maternal lifestyle on the foetus’ but nothing about breastfeeding.

You can’t talk properly about ‘the changing adolescent body’ without saying the word ‘breast’. And if you don’t talk about breastfeeding, and instead the breast is simply a sexual organ, you are missing a huge section of the human experience.

If we don’t talk about healthy normal breasts openly, then when it DOES come time to worry about breast self-examination, the discussion is uncomfortable and embarrassing. Young women avoid doctor visits and worry alone. If we don’t talk about what breasts can do, that gap gets filled with a conversation controlled by photo-shopping, air-brushing and breasts as commercial tools to sell products. When girls and women don’t feel like they are good enough, they are encouraged to spend money to fill the void. And women who don't feel they are good enough and their bodies are deficient become mothers who don't feel their bodies are good enough.

We might imagine that retail and modelling has become more body positive but look closer. Breasts aren’t yet part of that conversation. The larger models being used have round, even, symmetrical breasts with invisible nipples. Attractive models of any size don’t sag, breasts are immoveable and symmetry is essential. We have a long way to go and it’s dangerous when we think ‘real women’ are being celebrated when parts of them are still required to fit an ideal of artificial perfection.
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We need to get this right now. We need conversations in schools and we need to talk about real breasts doing real things. If we don’t get this right, those of us supporting new mums, and talking to young women about their body image, will pick up the pieces in years to come.


"The Breast Book: A puberty guide with a difference – it's the when, why and how of breasts" is available now.
http://www.pinterandmartin.com/the-breast-book

​​https://www.amazon.co.uk/dp/1780664753/ref=cm_sw_r_tw_dp_U_x_p9mSCbCWGFCPX