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.

Intended/Intending To Breastfeed?

Researchers from the universities of Manchester, Stirling, and Leeds Trinity are doing some research on the topic of breastfeeding.

There is a fair amount of data that suggests bigger women have lower breastfeeding rates. There are many hypotheses about why this could be, but as yet there are only questions, no answers. The researchers here have designed a workbook intended to support bigger mums to breastfeed, and are looking for your feedback. Does this sound interesting to you and would you be willing to give them your input?

They need participants who:

  • Are 24 or more weeks pregnant, with a Body Mass Index (BMI) of 30 or more and planning to breastfeed, or
  • Had a 30+ BMI at the start of pregnancy, gave birth within the last 1months and began and/or are breastfeeding.
  • Can read and understand English.

If you take part, they will ask you to use the workbook and participate in an interview/focus group. (Interviews can be by phone or in person)

The researchers are planning for the interviews/groups to last approximately 1hr, and you’ll be given a high street voucher as a thank you.

If you have any questions or comments or would like to take part in the study, please contact Stephanie Lyons (stephanie.lyons@manchester.ac.uk or 07706123929). See the attached PDF for more information about this important research on the topic of breastfeeding.

What hope if even UNICEF repeat flawed research conclusions?

Doing some research for this site, I chanced across the Baby Friendly Initiative page at UNICEF.

Now, don’t get me wrong. I’m all about the breastfeeding. It’s great in so many ways.

But UNICEF, in its clear desire to extol the virtues of breastfeeding, have saddened me with their keenness to repeat lazy research conclusions which state that breastfeeding reduces BMI, clearly made by people who are unable to distinguish between correlation and causation…

Update 2017 – (http://www.unicef.org.uk/BabyFriendly/News-and-Research/Research/Obesity/Breastfeeding-reduces-obesity-in-middle-aged-mothers/ – link no longer works as Unicef seems to have withdrawn the article – a good thing, in my opinion.)

Let’s read the title again; ‘Breastfeeding reduces obesity in middle-aged mothers’. The authors of the particular study UNICEF is reporting on concluded that while having more children is associated with higher BMI, ‘this increase would be offset if women breastfed’.

What the authors of the study actually discovered, was that women who breastfed had lower BMIs, that’s all. This is not new information. In fact, UNICEF reports it here, in a study two years prior to the one above, which makes no such unfounded claims.

Update 2017 – (http://www.unicef.org.uk/BabyFriendly/News-and-Research/Research/Obesity/Does-maternal-obesity-impact-on-breastfeeding-outcomes/ also appears to have been wihdrawn)

…obese women plan to breastfeed for a shorter period than normal weight women and are less likely to initiate breastfeeding… studies found that obese women breastfed for a shorter duration than normal weight women…

How the authors of the first study concluded that this meant that breastfeeding reduced womens’ BMIs, I do not know, but I’m very disappointed that UNICEF would then publish such an unfounded conclusion as fact, and even more disappointed to find they’ve done it TWICE:

http://www.unicef.org.uk/BabyFriendly/News-and-Research/Research/Obesity/Persistent-effects-of-womens-parity-and-breastfeeding-patterns-on-their-BMI/ (edit Sept 2015 UNICEF seem to have withdrawn this from their site)

Another article by the same authors, with similar conclusions:

The reduction in BMI associated with just 6 months breastfeeding in UK women could importantly reduce their risk of obesity-related disease and their costs as they age.

Now, perhaps it is true. It’s often reported that breastfeeding uses up to 500 calories a day:

http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/why-breastfeed.aspx#close

But let’s be clear about this, until there is evidence of a causal link between increased breastfeeding duration reducing BMIs, rather than a correlative link of women with higher BMIs breastfeeding for shorter durations, I’d really expect UNICEF to understand the difference.