Christmastitis – Santa’s less welcome gift…

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

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

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

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

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

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

Breasts Not Being Regularly and Fully Emptied

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

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

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

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

Restricted Milk Flow?

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

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

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

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

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

Thank you Lucy Webber IBCLC!

If you’re struggling, get help!

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

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

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

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

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

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

Festive Fashion If You’re Plus-Size & Pregnant

Finding fashionable plus-size maternity wear can be a bit of a problem at the best of times, but it’s a nightmare before Christmas! So here are Big Birtha’s picks for festive fashion if you’re plus-size & pregnant.

One of the pluses of being pregnant and plus size is that you often don’t have to restrict yourself just to maternity ranges (whole article on this here). If it’s a loose style with plenty of fabric, give it a try, with the additional bonus that you’ll be able to use it after pregnancy too. Most of the clothes featured here aren’t from the maternity section, so don’t forget to check out the non-maternity lines!

The Killer Christmas Dress

I think this holly print vintage style dress by HellBunny is my favourite of everything I’ve found.

It’s not a maternity dress, but because the style flares out just under the bust line, there’s plenty of fabric at the front. Depending on the size and position of your bump it could be an option. It’s being sold by high street retailer Yours, so with free click and collect and free returns, you can just try it on when you collect and if it’s no good, return it!

Mrs Claus

Not one, but two options here! I have a slight reservation with the Yours one, in that it’s described as a ‘novelty’ dress. This makes me question the quality, but both reviewers have given it 5 stars. The Shein dress is significantly cheaper, but it does say the fabric has no stretch, and it doesn’t appear to be as full as the Yours dress, so if you’re quite far along, it may not be the option for you…

Metallic, Shimmer & Sequins

There’s a plethora of gorgeous shimmery dresses this season, and with plenty of fabric in the pleats, could be perfect for the office Christmas party this year with a bump, and still wearable next year.

(I’d say next year, without a bump, but let’s be realistic!)

Burgundy Satin Pleated Midi Dress

Burgundy Pleated Midi Dress

Metallic Maxi Dress

Black Metallic Maxi Dress

I think the glittery gold dress from Shein looks really opulent. It also comes in silver. Just steer clear of that one if you’re planning on wearing it for Christmas lunch, unless you want to invite comparisons with a foil-wrapped turkey!

As well as glorious shimmery sparkle, it seems to all be about the sequins this Christmas!

Green Sequin Tunic

Green Sequin Tunic

Metallic Collarless Jacket

Metallic Collarless Jacket

Gold Open Back Sequin Top

Open Back Sequin Top

Silver Sequin Wrap Dress

Silver Sequin Wrap Dress

The sequin wrap top with a peplum is an especially popular design this year – almost every site seems to have a version of this, in varying shades.

Christmas Jumpers!

There’s always a Christmas jumper day. But fear not – I’ve found some options here!

Christmas Pudding Sweater

Christmas Pudding Sweater

Jolly Holly Jumper

Jolly Holly Christmas Jumper

Tops & T-shirts

OK, maybe it’s just me, but I keep doing a double take on these ‘Santa Baby’ t-shirts.

I keep reading it as “Santa’s Baby”!

Christmas Pyjamas

For many people, Christmas is all about being snuggly in a cosy pair of pyjamas. If so, fear not – there are some festive maternity options which should see you comfy as you open your presents on Christmas morning.

Elf On The Way Maternity Pyjama Set

Elf On The Way Pyjamas

Maternity Pudding Pyjamas

Maternity Pudding Pyjamas

Whatever you’re doing and whatever you’re wearing, be comfortable! Don’t feel the pressure to try to do everything – Christmas can be exhausting! Take it easy, and let people look after you for once.

Big Birtha x

Pile of laundry by a washing machine, decorated with lights and star to look like a Christmas tree. Festive fashion if you're plus-size & pregnant

Fat Vaginas

I’m sorry. There’s no point beating around the bush. This happened yesterday, and now fat vaginas are on the agenda:

Milli Hill, author of Give Birth Like A Feminist, spoke on BBC Radio Scotland for a discussion about induction rates. With her was Dr Marco Gaudoin, brought in for the ‘expert’ perspective. However, it turns out that Dr Gaudoin’s expertise is in fertility, not obstetrics or gynaecology… which may explain why he said this:

‘With obesity you’ve got increased fat tissue in the birth canal, which makes the birth canal that much narrower, which makes it harder for the baby to squeeze through the birth canal. So you are more likely to end up with what is called an “obstructed labour”‘

Dr Marco Gaudoin, speaking on BBC Radio Scotland 12th November 2019

What’s worse was that this happened at the end of the interview! Milli had no opportunity to challenge the doctor on his statement, or ask for evidence.

Fat Vaginas – Fact or Myth?

It’s no surprise that Milli had never heard this before, because there is NO EVIDENCE for Dr Gaudolin’s words whatsoever. They echo a theory suggested in a research paper back in 1997, and no-one has provided any evidence for it since.

It’s just more fat shaming.

Fat Vaginas: a display of inside-out purses looking remarkably like a selection of vaginas.
Vaginas come in a plethora of different shapes and sizes… image courtesy of The Vagina Museum

Ugh. Makes me want to beat some people over the head repeatedly with a copy of Give Birth Like A Feminist. Shame it didn’t come out in hardback.

You’d really hope that a qualified doctor would stick to established, evidence-based information. Sadly (too often, in my experience) when some doctors feel under pressure, they dredge some half-truth they heard somewhere from the back of their mind and present it as fact, rather than admit they don’t know.

It’s why I recommend anyone embarking on a high BMI pregnancy journey do their research and ensure they’re informed.

I have spoken to countless midwives (who have extensive experience of actual vaginas giving birth) and most agree that with the right support, there is no reason why a high BMI pregnancy shouldn’t proceed as with any other. Indeed, most of them do.

What Happened Next?

On Twitter, plenty came forward to challenge the “expert’s” ill-informed and misogynistic statements.

Then to my surprise, for once, the print media responded positively to the story! This may be thanks to Milli Hill knowing the right people to approach, but it was a refreshing change! The resulting article was comprehensive and well written.

Screenshot of Grazia online article on fat vagina comments.

Then other media outlets picked up on the story, including the Sun, who got an actual expert in obstetrics and gynaecology to comment!

Dr Virginia Beckett, consultant obstetrician and spokesperson for the Royal College of Obstetricians and Gynaecologists clarified that having an “obstructed labour” has nothing to do with “fat vaginas”. Which we knew, but it is nice that someone well qualified to address the issue has done so.

Screenshot of the Sun online article about fat vaginas

Next Up to fight our corner was the Daily Mail!?

Yes, really! Asking lots of people with much more experience and expertise… and me. So, yeah. That happened. I was tempted to be indecent and suggest that if our vaginas are so ‘restricted’, how lucky must our husbands and partners be? But I behaved myself. And contrary to my expectations, the journalist didn’t twist or change what I wrote at all, bar removing a paragraph that had already been covered by a previous interviewee. You can read what I wrote here:

https://www.dailymail.co.uk/femail/article-7680527/Doctor-claims-obese-women-fatter-vaginas-likely-experience-obstructed-births.html

Jaw on floor.

The article came with the usual stock headless belly image, naturally! But as soon as I realised and offered an actual picture to replace it, it was quickly swapped.

Of course, the article goes on to report the bloody relative risk stats rather than the true percentages, as always. So there’s still a way to go, but feeling strangely positive at how this story has turned out, for once!

As I have said before and seem to need to keep saying; having a higher BMI while pregnant is associated with a slightly increased risk of some less desirable outcomes. But there is also evidence that the precautionary way high BMI labours are managed may contribute to this.

There is no evidence that fatter people have fatter vaginas. There is no evidence that having a fat vagina (if such a thing exists) is a cause of birth obstruction.

If you want to read more about how micromanaging our births can cause a spiral of negativity and interventions – see article I wrote on The Impact of Negativity on Labour and Birth.

‘Encouraged’ to delay contraceptive removal

Are you thinking about removing your long-acting contraceptive method (coil/implant) because you’d like to try for a baby? Did you make an appointment to have it removed, only to find instead you were ‘encouraged’ to delay contraceptive removal and lose weight? I’ve been hearing murmurs lately that this has started happening in the UK, and it’s taking people by surprise.

Researchers at Cardiff University and Cardiff and Vale NHS University Health Board are conducting a study and are really interested to find out from anyone who is or has been overweight and has used a contraceptive implant/coil/rod their thoughts about this.

If you complete their online survey you could also be in with a chance to win £100 worth of high street vouchers.

3 larger women smiling - ad for Plan-it study about being encouraged to delay contraceptive removal

The study has ethical approval and has the support of the National Institute for Health Research. It’s not very long, so isn’t too arduous to complete. There are lots of free text fields for you to voice your opinions!

The survey portal will be open until December. So if you have an opinon on the appropriateness of being encouraged to delay contraceptive removal, please act quickly! It’s important we don’t miss the opportunity to make our voices heard!

Click here to go to the survey (opens in a new window):

https://cardiff.onlinesurveys.ac.uk/plan-it