Becoming a Mother

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What will it mean –to become a mother? It will probably be the biggest change of your life. New mothers often say that nobody prepared them for motherhood.It is hard to recognise that our mothers prepared us by their example, and we have learned by absorption.

Recent years have brought changes in thinking and actions. This booklet is a guide for today’s new mothers to help understand our babies’ needs.

Caring for your baby – which family are you from?

Growing up in a Breastfeeding CultureIf you grew up seeing babies and toddlers breastfeeding, you would be comfortable with that and would always have known how to do it. You may have had your auntie’s milk as well as your mother’s and you will have family around you who know how to support you. You will be used to carrying babies and entertaining them.

Growing up in a Bottle Feeding CultureIf you grew up seeing babies drinking from bottles, this is what you will have learned. You will want to give babies bottles. There would have been a clock so Mum knew when to feed you, and a book to check that she was doing it right. The book might say how long you could cry. You might have had a lovely pram for rocking you to sleep, or you may even have been taken for rides in the car to lull you to sleep.

Your pacifier was always nearby so it could be popped in your mouth quickly. You have had the milk of a different mammal all your life.

It was important for women to have choices and mothers came to think that it didn’t matter which way they fed their babies. Most babies born in hospitals would have had formula.

Only in the last century we have abandoned our million year-old pattern of caring for children. We have replaced continuous carrying of the child, co-sleeping with the parents, and breastfeeding on demand with leaving the child to lie alone, ignoring its crying, and feeding it every four hours with formula. Nils Bergman

Becoming a Mother

Re establishing “ Normal” Baby FeedingAotearoa New Zealand is committed to restoring breastfeeding as the cultural norm. This can’t be done overnight. The Baby Friendly Hospital and Baby Friendly Community Initiative are processes that will help to re establish a breastfeeding culture.

A Baby Friendly Hospital protects, supports and promotes breastfeeding by following the 10 Steps to Successful Breastfeeding:

1. Staff follow a breastfeeding policy that is regularly updated2. All the staff are trained to protect and support your breastfeeding3. Antenatal education is available to help the new family get the best start4. Baby is given skin to skin contact from birth for a minimum of one hour5. Mothers are shown how to breastfeed and how to hand express milk6. Babies should not be given formula unless there is a medical reason7. Babies remain with mothers at all times unless there is a medical need8. Mothers are shown baby’s cues for hunger and satisfaction9. No teats or dummies are given to breastfed babies10. Mothers are shown where to find local breastfeeding support groups on discharge (World Health Organisation and UNICEF)

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The Gold Standard for Infant Feeding Baby should be exclusively breastfed for the first six months, then should continue to be partially breastfed along with family foods until 2 years or beyond. (WHO and UNICEF)

Exclusive breastfeeding means that no other fluids or foods have ever been given to baby. It could also be called Protective breastfeeding because it provides protections from infection, allergies and illness.

How Babies are Fed Affects Them for Life

Why breastfeeding is Important for Babies• Breastfeeding saves lives, protecting babies

from many illnesses, SIDS, and childhood cancers

• Human milk is for human babies with all the nutrients and fluid babies need

• Breastfeeding is the basis for bonding, the strong attachment between mother and baby

• It is soothing for baby when tired, upset or hurt

Babies who are not breastfed are more likely to get sick• Formula is harder to digest, lacks specific

human ingredients, and human antibodies• Formula is not sterile, the water used can be

unsafe and it may be made up incorrectly

Why breastfeeding is important for Mums • Mothers enjoy their unique relationship with

baby• Breastfeeding stimulates hormones that make

milk, promote relaxation and sleep • Breastfeeding makes babies very portable• Exclusive breastfeeding reduces fertility• Breastfeeding mothers enjoy better long term

health, and a sense of accomplishment

Mothers who choose not to breastfeed • Spend more family budget and energy on

equipment and preparation• Are more likely to experience depression and

reduced long term health

Why breastfeeding is important for Dad• Keeps mum and baby happy and healthy• Less budget goes on milk, equipment and

waste

Mother’s milk has everything baby needs. Most mothers produce more than enough milk. Some mothers will have difficulty overcoming early breastfeeding challenges. It takes time and commitment to learn to breastfeed with ease, but provides lifelong satisfaction.

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Antenatal Preparations

Preparing your breasts??Breasts develop, due to hormonal influences, and begin to make colostrum from around 16 weeks. It is useful to learn how to express a little colostrum each time you have a shower. Talk to your midwife if you think your nipples may be difficult for baby to latch onto.

Preparing your MindYour life, relationships and focus are going to change forever. However sophisticated and decisive you are, a new baby may temporarily challenge you. Your “new job” is 24/7; sleep will be disrupted for the foreseeable future, so there will not be much spare energy. Be easy on yourself.

There are some very good places to learn about becoming a mother. Spend time with your happy breastfeeding friends. If you don’t know any, plan to attend a La Leche League meeting or ask your midwife about your local Breastfeeding Support Groups. These are good places to learn positive happy parenting as well.

It’s harder to learn from a book or website, but here are some options you may find useful:

Useful Books:The Womanly Art of Breastfeeding: 8th EditionLa Leche League 2010

DVDs:Follow Me Mum: Rebecca Glover

Useful Websites: kellymom.comllli.orgbreastfeeding.comfacebook.com/breastfeedingnzfacebook.com/BestForBabesattachmentparenting.org/blogfacebook.com/HistoricBreastfeedingPhotos Lovely photos breastfeedingtwins.tripod.com Breastfeeding twinsfacebook.com/ISISonline Infant Sleep Info Sourcemobimotherhood.org Mothers Overcoming Breastfeeding Issues

Lifestyle choicesPregnancy is the time to think about your baby’s best start in life. Baby cannot escape any toxic substances that may pass your lips, such as nicotine, alcohol, cannabis or any other mind altering substances. They affect baby’s brain and organs more severely than they affect you. Think again. It is not just about you now. If medical conditions arise, they should be treated by appropriate medical care.

Eating Every day of pregnancy baby needs vegetables, fruit and proteins such as grains, pulses, meat, fish, eggs or dairy. Highly processed foods are less healthy choices. Make your choices as close to natural as is possible and safe, and freshly cooked.

It is also recommended that all women take a folic acid supplement for the first 3 months of pregnancy.‘Eating for Healthy Pregnant Women’ and ‘Eating for Healthy Breastfeeding Women’ leaflets are available through your midwife.

Weight Gain in PregnancyA healthy full term baby will weigh, on average, 3.5 kg. A healthy weight gain for you should be not more than 12.5 kg by the end of pregnancy. Weight checks are a useful part of antenatal care. Excessive weight gain in pregnancy is a life risk for you and your baby. Talk to your midwife (or check on the internet) about your BMI (Body Mass Index) score. It should be 20-25. Your midwife can guide you to a dietician’s help if necessary.

Fitness30 minutes of exercise most days is a minimum activity level. For example, walking, swimming and even vacuum cleaning. Exercises for stretching and suppleness are also very useful.

Preparing for birthYour body is built to give birth. However, circumstances sometimes change quickly. You need to be physically and mentally flexible. Every action has a reaction - labour and birth medications and procedures all impact baby in different ways. It may take days for the after effects of pethidine and epidurals to disappear in baby. Some babies take days to learn to feed after their birth experience.

Baby’s best start comes with an unmedicated birth, uninterrupted skin to skin contact after birth, and ongoing close contact with mother.

If you have chosen to feed your baby with formulaYour midwife will discuss this with you and show you how to reduce the risks to your baby. Your baby still needs skin to skin contact with you at birth, rooming in for protection, cue based feeding, and lots of time communicating with both Mum and Dad.

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Stone Age Babies in a Space Age WorldSocieties have changed but babies haven’t. All they know about is MOTHER...by taste, smell, sound, warmth and movement. They are “hardwired” to stay in contact with mother, their lifeline. They will stress and use their energy to protest if they are separated from her.

What does Baby Need? • Hold me • Warm me• Love me • Protect me• Feed me • Watch me • Hear me • Keep me with my mummy

Skin to Skin as soon as possible after birth“The first action should be simply to place the baby skin to skin on the mother, or collect baby into a warm dry towel. After drying, remove the wet towel and lie the baby skin to skin against its mother, covering both with a warm blanket”. Newborn Life Support NZ Resuscitation Council Inc 2006

When your baby’s chest lies on top of your chest in full skin to skin, heart to heart contact:• Baby is warm and calm• Baby’s heart rhythm, breathing, and temperature

stabilise• Blood glucose is maintained• Feeding behaviours emerge in a sequence• Baby begins to feed at around one hour of age• Hormones flow, and mother and baby fall in love• Milk production is increased• Mothers bleeding is reduced• Both can relax and sleep

How long should Skin to Skin continue?The minimum is for 1 hour without interruption. The more the better, there is no limit. It can be useful to continue and to reinstate skin to skin if baby is having any feeding difficulty, or is unsettled. So long as baby is in skin contact, and is warm, and you are both enjoying it, why stop?

In the first hour after birth, baby’s awareness is high and reflexes are strong.

An unmedicated baby, in uninterrupted skin to skin contact, should be able to crawl towards and latch himself to his mother’s breast.

Check out The Breast Crawl on YouTube!

What if Mum needs a general anaesthetic?Occasionally this is necessary. Baby can be reunited with mother as soon as she is able to respond. Dads can be very helpful in this situation providing cuddles or skin to skin to keep baby calm and warm until Mum returns.

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Understanding BabiessBabies have several levels of normal consciousness, and move between them:Deep sleep; light sleep, dreaming; drowsy, stirring; quiet alert (best state for feeding, learning); active alert; fussy; crying (the most disorganised state); dissociated (e.g. after crying to sleep).

Baby’s Instructions - Cues - SignalsBabies have many signals – for feeding, contentment, for listening and talking, for needing to be held, tiredness, aversion and distress. Baby’s signals include facial expressions, tensions, body movements, colour changes, and sound. It is hard to read a baby who is tightly swaddled or in another room

Early hunger signals from baby may include some of the following• frowning• tensions in fists, elbows, toes • hands near mouth or scratching face• sucking sounds• searching, restless movements of mouth and

head • crying is a late cue and will make it more

difficult for baby to feed.

Cue Based FeedingCalm babies are easier! When baby and mother are in synchrony, mother receives the signals baby sends. Feeding is offered when asked for. Baby is usually contented and grows well.

Baby’s stomach sizeBaby’s stomach is tiny at birth. The average size of feeds has been measured asDay 1 2-10ml per feedDay 2 5-15ml per feedDay 3 15-30ml per feedDay 4 30-60ml per feed

This might help you understand why babies need to feed often.Newborn feeds can take time. They are learning how to suck, swallow and breathe.They are also stimulating milk production. Demand (sucking) brings the supply.

How often do babies feed?The average number of feeds in baby’s early days is 8-12 feeds in 24 hours.Every mother and baby is unique. You will learn your own baby’s cues and contentment.

How do you know he’s getting enough?Frowning and tensions disappear. Baby’s arms hang in a very relaxed way. He can wake himself regularly and settle calmly after feeding. There will be regular output (clear urine, and yellow stools), contentment, and weight gain.

Weight gainsThere are huge variations in this and breastfed babies grow at their own pace. World Health Organisation Growth Charts 2006 show the normal growth rate of breastfed babies is:0-4 months: 115-250g per week4-6 months: 90-150g per week6-12 months: 50-115g per week

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The more breast baby takes in, the more comfortable and efficient it will be.

Sucking and Swallowing Patterns• bursts (and pauses) of sucking are automatic when baby is well latched• fast sucking means baby is looking for a “let down” of milk• slow and deep sucking with swallows you can see or hear means good milk transfer• baby may need to suck quietly after the feed to help digestion• baby needs to feed frequently in the early days – his body is using up stores• it is better to change sides often in the early days to increase baby’s intake• it is possible for baby to suck but not receive milk

Baby is supported along his back. There is no need to push or tickle baby’s head

Football Hold Side Lying Hold

Cross Cradle Hold (Transitional) Cradle Hold

Chest to chest Nose to nipple Chin to breast Baby will gape Fold in breast

Techniques of Breastfeeding: feeding is comfortable, and baby gets milkPositioning and AttachmentGetting a comfortable latch is the most important skill to learn.

Human MilkColostrum – Liquid goldThe first milk is thick and yellow, and full of uniquely human antibodies that are absorbed easily through the newborn’s open gut. Other foreign proteins such as cow’s milk protein can also be easily absorbed in baby’s early days. This may create sensitisation issues for some babies, and is just one of the reasons why exclusive breastfeeding is important protection.Colostrum stimulates the baby’s digestive system, and helps to expel the first (black) motions. Colostrum also brings some pain relief after the birth, and mobilises baby’s fat stores for energy until full milk production is underway.

Mature milk comes in around the third or fourth day after birth.Colostrum gradually changes into mature milk. You will notice baby swallowing more regularly.

Foremilk and HindmilkMilk changes from the beginning to the end of a feed. At the beginning it is thin and blue looking. This milk is thirst quenching. During a “let down” of milk, fat droplets are added to the milk. As the feed progresses there is less volume but more fat. The creamy hindmilk is very satisfying. Some babies may fuss until they get enough cream to satisfy their hunger.

One side or both?If you offer the second side, baby will decide what is needed. If you have a large supply baby may be settled after one side. If your supply is smaller, baby will take more sides and more feeds each day.

Cluster feeding in the eveningIt is normal that babies feed more in the evening, and sleep better in the early morning. You may think that you have just fed the baby, but baby tells you otherwise. There will be times when it seems relentless, but this is the way to increase your supply for your growing baby. Your production is faster after your breasts are emptied.

Feeding frequency daysThis can happen at any stage. It may be that baby is unwell or needs to increase your supply. It can also happen if you are tired, unwell or not eating well.

Some babies are fussySome babies are more needy and fussy. If your baby fusses and cries a lot you may find help in talking to your Midwife, Lactation Consultant, Well Child Provider or GP.

Should I use a Pacifier?Babies need to suck and it’s the quickest way to calm. They are usually pacified quickly at the breast. Dummies are not recommended for breastfed babies as they reduce baby’s feeding skills and milk intake. Weaning happens sooner.

GulpingGulping indicates a fast flow. Check baby’s head is extended back slightly for easy swallowing.

SpillingMany babies will spill a little. This doesn’t always mean they are over full. Spilling is often “just” a laundry problem that doesn’t worry baby. Weight checks are a good indicator of whether baby is still growing well.

Burping Breastfed babies feed at their own speed, and are not always troubled by swallowed air. But if baby‘s feeding seems ineffective, you should offer a break. Sit baby up, with his head supported slightly back to keep his airway open. If you can see baby’s face you will get his signals for returning to feed. When baby is relaxed and sleepy after feeding, with no further feeding cues, you can assume he has had enough for now.

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Useful Skill:Hand Expression of Milk

Hand expression will help you take good care of your baby and your breasts in any unexpected situation.

Early on, if baby is unable to latch for some reason, you will need expressed milk until feeding is possible.

You can learn this in pregnancy: most easily after your shower. Colostrum is present from about 16 weeks.

Place your finger and thumb at opposite sides of your areola, just beyond its outer edges.Not close to the nipple - that will just hurt.Press straight back towards your chest, then in behind the nipple.

A little expressed colostrum will encourage baby’s early attempts to latch.

Storage of Breastmilk GuidelinesBreastmilk can be stored for:• 4 hours at room temperature• 2 days in the fridge• 4 months in the deep freeze (NZBA and MOH Guidelines 2009)

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Tiredness Your biggest challenge! Turn off the phone, reduce visiting, nap when baby sleeps and accept all help offered. Tiredness will ease eventually.

Sleepy Baby Keep baby near you. Look for early waking signs- eye movements. Unwrap baby to wake up. Aim for 8 feeds/day. If sleepy while feeding, delatch and sit baby up to wake up. Change sides more often.

Unsettled Hungry Baby Sleep near each other. Feed when baby stirs in early days. Check close positioning and deep latch. Change sides often. Compressing your breast while baby feeds may increase his intake. Repeat skin to skin cuddles, to help baby settle. Some hand expression should also increase your milk.

Painful Shallow Latch De latch if any pinching or pain. Try latching again from further below - 3cm from the nipple base. A deep latch is comfortable, and you should just feel tugging.

Engorgement AVOID OVERFILLING. Wake and feed baby, and express if necessary, by hand, in the shower, or by pump until comfortable. Warmth just before feeding may help milk flow. Cool compresses soothe after feeds. Your supply should settle in a few days but in the meantime MOVE IT OR LOSE IT!

Damaged Nipples If you have nipple pain, try to deepen baby’s latch by approaching from further away from the nipple base. Express a little before latching baby. If the skin is broken or infected you need further assistance from your LMC or a Lactation Consultant to change feeding position or recommend treatment.

Mastitis If you develop mastitis you may have breast redness, pain, and feel unwell with fever. Rest in bed, with baby, and feed, feed, feed, to clear any blockage. Drink plenty of fluids. Pain relief and antibiotics may be prescribed by your midwife or doctor. Avoid weaning during mastitis.

Low Supply Attention to positioning and latch, and baby swallows. Offer several sides each feed time, and compress breast with your hand while baby feeds. Breasts go into higher production when they are emptied more. An afternoon rest should help. Avoid long intervals between feeds. Galactogogues are useful to some: these may be nursing mother’s teas or herbal preparations to increase milk.

Supplementation This is sometimes necessary, and should be done in ways that support breastfeeding, e.g. by cup, spoon, syringe, or tube at the breast. First choice is mother’s expressed milk. Giving baby something to drink (other than your milk) reduces his need for your milk, and reduces his protection. Longer feeding intervals reduce your supply and weaning may happen sooner.

BREASTFEEDING CHALLENGES HAVE BREASTFEEDING SOLUTIONS

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Respond to needsBabies signal their needs and hope for a response. A responsive parent provides a feeling of security and contentment. This is the basis of attachment or bonding, and good emotional health.

Carry babyBaby humans are programmed for body contact and are very happy when carried. They don’t need attention centred on them constantly, but do need to be part of family activities.

Good Things to do with Baby:

Spend time communicatingBabies are social and love to gaze at you.Even newborns look, listen, follow and respond to their favourite people. This close interaction is the basis of social development. The more time you spend communicating with your baby, the more baby will learn.

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Before becoming a mother I had a hundred theories on how to bring up children. Now I have seven children and only one theory: love them, especially when they least deserve to be loved. Kate Samperi

Rules for Baby Care: Learning to Breastfeed and the Bottle feeding CultureThis is where conflict may enter because we have been a “bottle feeding culture” for several generations.Our mothers and grandmothers had to obey the rules they were given: • How often babies should feed • How much they should drink• How long they should sleep • How long they should cry• How much they should grow • Where they should sleep

Present Day Parenting DilemmasOur parenting relies on how we were raised, what we have observed in others, and what we learn. Two very different styles of parenting are in operation, and your chosen method may be somewhere along the middle range. Whichever way you parent, your baby still needs loving, comforting, feeding and guiding.

Baby centred parenting Parent directed baby careDevelops parents’ responsiveness and child’s trustPromotes securely attached childrenRequires consistent, loving responsive caregiver during child’s early yearsParents learn cues and are in harmony with babyBabies are held, carried, worn Interactions are frequent Crying is recognised as distressBreastfeeding meets baby’s needs Understanding baby’s needs reinforces breastfeedingBreastfeeding is high level, long termMother is relaxed, goes with the flowSeparation is avoidedBaby may fall asleep at the breastBaby stays in same room as parentsSafe bedsharing is practised

Promotes routines and parent controlled schedulesFeed volumes and sleep times are importantCare may be shared with othersClock determines responsesFear of spoiling baby by picking up too oftenBaby is allowed to cry and learn to “self soothe”Pacifiers meet some of baby’s needsFollowing schedules makes breastfeeding harder Weaning happens earlyMother needs her routine, body and life backIndependence is encouragedBaby is put to bed awake Baby has own roomFear of sleeping together

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As well as a baby, a new mother is born “A baby’s mother also needs a mother” Erica Jong

What do new mothers need?

• Protect me • Show me• Hear me • Encourage me • Love me • Rest me• Feed me • Keep my baby with me

In many traditional societies mothers have a “lying in” for a month or more after baby arrives. They are rested, fed and nurtured by other family members. The return to domestic duties is gradual. Special healing foods are provided. There are celebration ceremonies. There is much we could learn from these traditions.

New confidence Becoming a mother will give you new strengths as well as vulnerabilities. Each new challenge that you face will give you experience and confidence once you have worked your way through it.

Baby bluesPregnancy, if you read the glossy magazines, can seem to be about pampering and products. Many mothers do not have the energy or resources to live up to what is advertised. Some are sad to discover their choices are limited. There is a huge adjustment to make, from being a managing adult, to finding oneself on a new page without a script. Blues can be temporary, due to tiredness, or more serious if they begin to impact daily life.

Postnatal depressionA number of celebrity mothers have found that post natal depression can appear even in wonderful lives. “The baby who we believed would fill us with warm, peaceful calm fills us with overwhelming fears, anger or even a total absence of feeling” Lauren Porter

There are many ways you can find your own clarity through dark days:• Continue to breastfeed: oxytocin will calm and

lift your spirit, and keep your baby happy too• Eat foods that have complex carbohydrates

such as wholegrain breads and cereals, and omega 3 rich foods such as oily fish (canned tuna, sardines, salmon, mackerel, eel) and oils (marine, soybean, canola, flaxseed and walnut oils or supplemented margarines)

• Exercising for 20 minutes will help immediately. Take your baby for a walk especially in sunshine.

• Contact your friends• www.mothersmatter.co.nz• See your doctor if the above measures

aren’t enough. If you require anti-depressant medication, there are several that are safe for breastfeeding....

“Healing may not be so much about getting better, as about letting go of everything that isn’t you - all of the expectations, all of the beliefs - and becoming who you are”. Rachel Naomi Remen, Physician.

The New Job Satisfaction The joy of engaging with your baby, getting a smile, hearing a belly laugh, watching a new skill develop, watching a peaceful sleep, bring a new sense of satisfaction.

Mothers are a source of beauty, comfort and goodness for our babies. We achieve this naturally. Because of who they’ve made us become. Lauren Porter. Survival Skills“Motherhood has a very humanising effect. Everything is reduced to essentials”. Meryl StreepYou will spend a significant part of your days and nights tending to baby. Your best supporters are the ones who understand this and do things that help you, such as meals, laundry, cleaning, shopping, and care of older children. When you do get time to yourself, you may not have much energy. Go easy! Housework waits.

Partner SupportYou BOTH need support, patience, understanding, love, and each other. You are in this together.

The outside world doesn’t have a lot to offer. You have to make your own heaven in your own home. Bette MidlerRelationship ChangesThe old life and its romantic opportunities may have gone. It can be easier to find fault than to find your own new ways. It is good to look for blessings, and show pleasure in the small things. In nature, the secret of survival is adaptation. If you can’t change circumstances, let them change you. Go with the flow! Enjoy the change! Find the humour! Find the little things that bring happiness to your family.

Dads are for Fun and SupportThere are many ways that Dads can bond with babies. They are great for holding, burping, bathing, walking, playing, singing and story- telling. They can’t easily be mother in the night. They don’t have the hormonal basis of feeding. Dads also have plenty to do during the daytime. You will work out how to both enjoy what you do.

What about my other job? All mothers are working mothers!

At work, you think of the children you have left at home. At home you think of the work you’ve left unfinished. Such a struggle is unleashed within yourself. Your heart is rent. Golda MeirIf you wish to continue with your career, business, or position in the community or paid workforce, there are many extra considerations around your baby’s needs, and who will provide for them. It can be done but it takes energy, planning, communication, patience, flexibility, transport and financial cost. The longer you can delay your return, the easier it will be for everybody.

Options include: • Having your baby with you, or in a nearby child

minding facility• Having your baby brought to you for feeding• Expressing your milk to leave with your baby’s

carer• Continuing your breastfeeding on reuniting with

your baby• Working part time

Since April 2009 the Employment Relations Act requires employers to provide appropriate facilities and breaks for employees who wish to breastfeed or express at work where it is reasonable and practicable to do so.

It’s useful to know that stressful changes in a baby’s life, such as mother returning to work, may bring anxious behaviour such as clinginess to Mum, and increased night feeds.

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Baby’s SleepMother’s arms are made of tenderness and sweet sleep blesses the child who lies therein. Victor HugoMany books have already been written on this subject. When all is said and done, babies have sleep rhythms and will sleep when they are fed, relaxed and comfortable. Sometimes they want to stay awake and learn about becoming a person. Sometimes they need help to relax enough to sleep.

Night waking in babies is normal, healthy and protective.It allows frequent feeding, brain and body growth, reconnection with mother, and helps babies avoid the long periods of deep sleep that make them vulnerable to SIDS. Babies deep sleep cycles may be around 45 minutes before they are in a light state again. Babies wake for many different reasons, and researchers know that night- long infant sleep is not well established until around 5 years of age. Most adults also wake in the night.

Crying and Controlled Comforting? Separation from mother causes alarm in baby. Repeatedly leaving baby to cry may be harmful as babies cannot self soothe and may become overwhelmed. This can bring a stressed state with a drop in temperature, change in heart rate, and it affects baby’s digestion, growth, immunity and anxiety level. Baby’s stress responses and emotional health are formed by early experiences.

A mother’s arms are more comforting than anyone else’s Diana, Princess of Wales

Safe Sleeping: Face Up, Face Clear, Smoke FreeKeep your baby near you. Babies are always safest in the same room as their mother. You can keep baby’s cot next to you, so baby is aware of you, and you can reach him when needed. If you fall asleep together while feeding, this is what nature intended. Just make sure there is plenty of safe space for baby on a firm surface, without possibilities of • suffocation under coverings or pillows• falling • wedging between surfaces• overlaying by any adult or any other child

You should NOT SLEEP IN THE SAME BED WITH YOUR BABY if Baby has been exposed to nicotineBaby was prematureBaby is formula fedAny person in the bed is affected by alcohol or other substances, Anyone in the bed is very overweight, or overtired Help your whole family relax and sleep better with any of the following: an outside walk together, baby massage or just quiet back stroking, warm bath to relax

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Why Should I Breastfeed My Toddler? • It is the World Health global recommendation• It is convenient and easy• Ongoing immune protection• Soothes when hurt• Manages dehydration during illness• Allergy management• Tantrum taming• Instant naptime• Uses mother’s fat stores• Continues emotional development• Nutrition – still a valuable part of daily food

intake• Environmentally friendly

Like most other mothers of toddlers, I originally continued nursing out of a desire for convenience. Frankly, it was just easier to keep going than to stop. Along the way, I discovered how much simpler continuing to breastfeed made our lives. If at all possible, the transition away from Mummy should be a gradual one, made at the baby’s own pace. Toddler life is difficult enough. Why not make it a little more manageable for everyone? E. Bruce

WeaningThe fortunate baby will have his mother’s milk for at least 2 years. Some may want to continue for longer. In an ideal situation mother and baby will reach the weaning point together. If only one has decided, the other may feel rejection and grief. The best advice is to wean gradually, and with love. Drop one breastfeed a week, by replacing with other nutritious foods and provide fun activities that baby and mother enjoy together.

Weaning Milk is High in AntibodiesThe immunity provided in weaning milk is increased, and will give baby ongoing protection during the time of increased vulnerability. It’s good for mother and baby to draw out the weaning process for as long as possible.

Breastfeeding Support Groups near YouFind your local La Leche League or Cultural Support Groups for breastfeeding. If you need some technical help ask a Lactation Consultant.

Experiences of Some Recent New MothersBreast feeding is an initially challenging but eventually rewarding experience. If you are like me, as a first time mum, you just assume it will come naturally - but, like anything, it may be hard work at the start. However, the bonding between mother and baby is deeply satisfying. Breast feeding has so many other benefits - improved immunity for baby, weight loss for Mum post-pregnancy, well adjusted babies, and the convenience of being able to feed anywhere, anytime. Breast feeding when you return to work may mean expressing but, for me, the long term advantages outweigh the short term inconvenience. We have also found breast feeding makes travelling so much easier, especially flying. But above all, breast milk is the best food for the baby. Henry was a wee thing when he arrived five weeks early, but he is now a robust, healthy young boy who is teaching his parents the joys of dirt, trucks, and sunrises. Lesley Rumball

Breastfeeding is the most natural form of nourishment for our babies. Unfortunately for some of us mums, it doesn’t always come so naturally. After my first child I suffered terribly with cracked and sore nipples due to a poor latch. After only a couple of weeks, I gave up feeding her. My second child came along nearly 8 weeks premature. We had 3 months of expressing, trying to latch and failure to thrive. With that pressure I sadly gave up feeding him too. Now with my third child, I sought lots of help from the very beginning. We had a shaky start with a few negative comments for me and weight loss for the baby. This time though I was determined, and knew a lot more about the benefits for me and my baby. The first few weeks were spent expressing at every feed to keep a good supply going, and trying each time to get the latch right. I got loads of support from the hospital lactation team, my midwife, Plunket, and of course my partner –all of which made life so much easier. After about 6 weeks things finally started going perfectly. Riley is now 6 months old, breastfed and thriving. The effort was worth everything, knowing that I’m giving my baby the best start I can. I joined Deli’s mothers’ support group and was offered the chance to train as a peer support counsellor. For me the course was an absolute wealth of knowledge both for myself, and for any other mother who might seek my support in the future. Melissa Clark

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Life is a Precious Gift – A Story of Huge Drama, Commitment, and Support My baby girl, Chorana, was delivered by emergency caesarean at 24 weeks, weighing 640g. She was flown up to Dunedin hospital and I travelled by ambulance the next day. The shock of what happened was almost overwhelming. Her Father arrived from Afghanistan after travelling non-stop for 3 days.

For the next 12 weeks while her life and prospects hung in the balance, she was cocooned in an incubator and cared for by devoted medical staff. It

was difficult to be told of each drama that arose. I prayed in desperation for her and comfort came in different ways.

What helped us through each day was our faith and knowing that so many people cared about us, our whanau, friends and medical staff.

I expressed milk for her first 3 months which meant waking to a machine instead of a baby! When strong enough she began drinking from the breast. I faced challenge after challenge, but managed to keep her breast-feeding because I wanted to help her fight off infections and illnesses, I wanted to give her the best possible start. Moana van Hijum

Now Look! At 18 monthsPapa and Chorana in hospital

Mothers milk - a precious gift for premature babiesMothers milk can be life saving. It is well worth finding out how you can provide breastmilk for your baby. Some mothers who are expecting to deliver early, learn how to express and store colostrum before baby arrives.

Mothers milk saves lives in emergency situationsIn emergencies, even power cuts, babies who have breastmilk are safe. Mother’s milk is a crucial resource.

RelactationIt is worth knowing that sometimes lactation can be restarted if baby needs this. It takes time and determination.

Mothers – Making the world a better placeWhatever the circumstances, mothers just do their best each day to keep the family happy and together. By helping each child to find its way mothers continue of the circle of life. Being somebody’s mother involves lifelong learning and challenge. All mothers go about this differently, whether quietly or publicly, at home or elsewhere. There is always plenty of scope to make the world a better and safer place, starting at home.

ACKNOWLEDGEMENTS

• Thanks to HEHA for funding• Southland Breastfeeding Advocacy Group• Southern NZ Mothers and Babies for

sharing their photos and stories • Google for quotes • Artworks, positioning photos and diagram

used with permission

Author: Mary Grant IBCLCSouthland Hospital, Invercargill, New Zealand. 2012