I am a Health Visitor Amy and Jenny

This episode links really well with our previous episodes about combination feeding and giving top ups (linked in resources section below). In this episode Jen shares all her IBCLC wisdom with us on expressing breastmilk. How much do you know about flanges?!

We talk about:
- when to express
- the emotional and physical load of pumping
- how to pump
- 'hands on' expressing
- does the flange fit
- how much milk to expect

Resources and Further Reading:

Our previous episode on Combination Feeding with Lucy Ruddle (IBCLC
and author of 'Mixed Up'):
https://soundcloud.com/iamahealthvisitor/combination-feeding-with-lucy-ruddle-ibclc?utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing

Our previous episode on Top Ups:
https://soundcloud.com/iamahealthvisitor/top-ups-when-what-how-and-how-much-to-give?utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing

Breastfeeding twins and triplets charity (Kathryn Stagg IBCLC):
https://breastfeedingtwinsandtriplets.co.uk

Hand Expressing Video:
https://globalhealthmedia.org/videos/how-to-express-breastmilk/

Hands Free Pumping Bra Hack:
https://www.youtube.com/watch?v=8stY-2fxt4M

Flange Sizing:
(see our instagram account 'IamaHV' for a visual)

Hands On Expressing:
http://www.nancymohrbacher.com/articles/2012/6/27/to-pump-more-milk-use-hands-on-pumping.html

Some social media pages to follow and recommend for free resources:
Olivia - Hospital Lactation Consultant
https://www.instagram.com/olivia_lactation_consultant/?hl=en

Stacey Zimmel at Feed Eat Speak:
https://www.instagram.com/feedeatspeak/

Kathryn Stagg IBCLC
https://www.instagram.com/kathrynstaggibclc/

Jen and Amy delve into the murky world of infant poo in the first six months! What to expect, what is a worry and what isn't. How is poo different between formula and breast or chestfed babies? Or mixed fed babies? What does that green poo mean? What about giving a bit of fruit juice or water for constipation? We answer all your questions and as usual it turns out to be more complicated than we imagined!

Thanks to a listener for this request!

Do get in touch with any questions, comments or suggestions for future episodes on iamahealthvisitor@gmail.com

Thanks for listening!
Amy and Jen

Resources

The baby poo gallery:
https://www.facebook.com/babypoogallery/

Philippa Pearson-Glaze IBCLC on green poo:
https://breastfeeding.support/why-is-my-babys-poop-green/

Drugs in Breastmilk Advice:
https://www.breastfeedingnetwork.org.uk/detailed-information/drugs-in-breastmilk/

Child Liver Disease on pale stools:
https://www.childliverdisease.org/wp-content/uploads/2018/01/Yellow-Alert-Stool-Chart-Bookmark.pdf

Frequency of stool slowing - Carol Smythe IBCLC:
https://www.carolsmyth.co.uk/breastfeeding-resources/posts/2016/december/should-my-breastfed-baby-poo-every-day-or-is-breast-milk-all-used-up/

First Steps Nutrition:
https://www.firststepsnutrition.org

Our previous episode on the Aptamil formula changes:
https://soundcloud.com/iamahealthvisitor/those-aptamil-formulation-changes

GP Infant Feeding Network on constipation:
https://gpifn.org.uk/constipation/

Amy and Jen take a dive into a recent research paper suggesting there may be a newly identified biomarker for infants at high risk of SIDS. We look at the recent paper in detail, review the statistics and the methodology and consider what we are able to say and what we are not, as well as possible harms that might come from misinterpretation of the results.

We also discuss the article in the context of the current theoretical approaches to SIDS research and general safe sleep advice which importantly still needs to be followed.

We love to hear from you. Contact us with suggestions or ideas for future episodes at iamahealthvisitor@gmail.com.

Thanks for listening, Amy and Jen

References and Resources for further reading:

Harrington, Hafid & Waters 2022 - the full text article:
https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(22)00222-5/fulltext

Media coverage:
1. https://www.biospace.com/article/researchers-answer-how-and-why-infants-die-from-sids/?utm_content=207502735&utm_medium=social&utm_source=facebook&hss_channel=fbp-10530620221

2. https://www.theverge.com/2022/5/13/23071364/sids-research-hype-science-studies

for context - there is so much about SIDS deaths we still do not understand:
https://www.nejm.org/doi/full/10.1056/NEJMp2119221

Critical analysis of the media hype:
https://www.theatlantic.com/health/archive/2022/05/sudden-infant-death-syndrome-cause-study/629886/

Lullaby trust statement about this article:
https://www.lullabytrust.org.uk/our-response-to-new-australian-sids-biomarker-study/

Amy and Jen chat to the inspiring Alison Spiro who has a PhD in anthropology as well as practicing as a health visitor. Listing all her achievements is a podcast summary in itself, but across her career she has worked as a breastfeeding counsellor herself, established an incredibly successful peer support service, taken both a hospital and community trust to BabyFriendly accreditation, worked on the world breastfeeding trends initiative report in 2015, contributes to the APPG on infant feeding on behalf of BestBeginnings, volunteers with the Breastfeeding Alliance, has been the iHV expert advisor on breastfeeding. Most recently, she is the author of 'Breastfeeding for Public Health: A resource for community healthcare professionals'.

We discuss with Alison some of the most important issues in breastfeeding support - from culture and anthropology to emotions, wellbeing, mental health and therapeutic communication skills. We talk about the importance of debriefing your own infant feeding experiences and bringing an unbiased listening ear to your interactions with families. Hopefully this will be an interesting and relevant discussion for your health visiting practice.

We would love to her your thoughts and comments at iamahealthvisitor@gmail.com


Reading & Resources:
Alison's new book - 'Breastfeeding for Public Health: A resource for community healthcare professionals':
https://www.amazon.co.uk/Breastfeeding-Public-Health-Healthcare-Professionals/dp/0367689561/ref=sr_1_2?crid=3M4VF06U18GP7&keywords=breastfeeding+for+public+health&qid=1652711900&sprefix=breastfeeding+for+p%2Caps%2C71&sr=8-2

World Breastfeeding Trends Report:
https://www.worldbreastfeedingtrends.org/resources/publications

Becoming Breastfeeding Friendly with Yale University:
https://ysph.yale.edu/bfci/

Kathryn Stagg IBCLC:
https://kathrynstaggibclc.com

Eve Canavan lived experience story:
https://www.app-network.org/news-events/news/personal-experiences/story-eves/

This week Jen talks to Maria Renshaw who runs a local sling library in Colchester about her experience of slings and all things baby-wearing from a very practical perspective.

She goes through different types of baby wearing from soft wrap slings to buckle carriers with some tips on the differences, fitting, safety tips including the TICKs acronym, common worries about hips and knees, how to find your local services for sharing with parents.

Thanks so much Maria for sharing your experience and knowledge with us!

As ever we love to hear from you, contact us with your comments or feedback on iamahealthvisitor@gmail.com

Amy and Jen

References and Resources:

Maria's website:
https://www.beautiful-bonds.co.uk/meet-the-team

The TICKS rules for safe baby wearing:
http://babyslingsafety.co.uk

Sling Pages (to find a local sling library):
http://www.slingpages.co.uk

'Why Babywearing Matters' by Rosie Knowles
https://www.amazon.co.uk/Why-Babywearing-Matters-Pinter-Martin/dp/1780665350

Babywearing training and resources:
https://www.carryingmatters.co.uk/training/

Amy and Jenny chat to the lovely Alice from the Baby and Infant Sleep Information Source (BASIS) about sleep pods and nests.

We cover the evidence base - what can we and can't we say about these products. Are they safe or not? In what circumstances? How do we actually know one way or the other?

We talk about what manufacturing standards these products are held to, as well as some of more the hidden risks and implications the use of these items have. We also consider the disproportionate impact on families who live with a low income, who may be tempted to recreate homemade versions and leading to a cluster of co-occurring SIDS risks.

Alice tells us about her research from a recent survey with parents about their use of sleep pods and we discuss how to have appropriate conversations with families to help minimise risk while sticking to the evidence base and avoiding scaremongering or judgement.

We have quite a few other episodes on sleep now - so do check back through our back catalogue if this is a topic that interests you!

Thanks so much for listening everyone - we would love to hear from you with any comments or suggestions to iamahealthvisitor@gmail.com

Resources and Further Reading:
The BASIS website - check out their resources if you haven't ever used them, they're brilliant:
https://www.basisonline.org.uk

Professor Helen Ball webinar on "What is Normal Infant Sleep: The View From Anthropology":
https://www.youtube.com/watch?v=g5fOogsUpIk

Lullaby Trust Resources on Baby Products:
https://www.lullabytrust.org.uk/safer-sleep-advice/sleeping-products/

and:
https://www.lullabytrust.org.uk/wp-content/uploads/The-Lullaby-Trust-Product-Guide-Web.pdf

Specific to sleep positioners:
https://www.lullabytrust.org.uk/are-sleep-positioners-safe-for-babies/