Wednesday, 11 May 2016

The Peaceful Birth Project.

 Ancient Wisdom and Research Agree: Amazing Fruit Eases Labor and Prevents Postpartum Hemorrhage
 Eating dates to ease labor, oxytocyn and postpartum hemorrhage: ancient wisdom and research agree

The date fruit is the product of the date palm, a tree native to Northern Africa and the Middle East. There is a wide variety of dates including the better known Medjool and Deglet Noor. Each variety is unique in size, sweetness, flavor, and texture. Containing at least 15 minerals such as potassium, calcium, iron, magnesium and zinc, 23 types of amino acids, vitamins, carbohydrates, protein, 14 types of fatty acids, dietary fiber and a lot more, these sweet little fruits are a nutritional powerhouse. [International Journal of Food Sciences and Nutrition, 2003]

The photo is from a study published in the Journal of Obstetrics and Gynaecology which concludes that eating 6 dates daily during the last four weeks of pregnancy “significantly reduced the need for induction and augmentation of labor, and produced a more favorable, but non-significant, delivery outcome”.  Some significant findings:
  • Cervical dilation was significantly greater in the date-eating mamas upon arrival at the hospital
  • 83% of mothers who consumed dates had their membranes intact upon admission at the hospital 
  • 96% of the women who ate dates went into labor on their own
  • Use of Pitocin (synthetic Oxytocin) was significantly lower in women who consumed dates (28%), compared with the non-date fruit mothers (47%)
  • The latent phase of the first stage of labor was almost 7 hours shorter in the date-eating mothers compared with the non-date fruit eaters (510 min vs 906 min). Not bad for eating a few dates!

Very interesting research comparing the use of dates and Pitocin in the management of postpartum hemorrhage.  The study demonstrates a significant reduction in the amount of postpartum bleeding experienced by women who consumed date fruit compared to women who received synthetic oxytocin (Pitocin). The randomized clinical trial was done in two hospitals. Immediately after the delivery of the placenta one group was give 50 gram of dates. Another group  received 10 units of synthetic oxytocin in an intramuscular injection.  Blood loss mean in the end of first hour after delivery were significantly different in dates and oxytocin groups (104 ml vs 141.6 ml) The researchers suggest that dates are effective for management of postpartum hemorrhage because dates have Calcium, serotonin, tannin, linoleic acid, enzimes, iron and other nutrients beneficial to control bleeding and prevent anemia. Khadem, Sharaphy, Latifnejad (2007)

Thursday, 21 April 2016

Pain Free Labour for Kristyn.

Shared by Kristyn
I was 41 weeks 4 days and had, had several bouts of practice labor that never went anywhere so I was growing discouraged. Baby had certainly kept me on my toes between having to be manually turned (ecv) twice the last time being at 38 weeks as well as going so late, so I had lots of chances to practice deep meditation. The thing that helped me the most was a play list of songs who’s lyrics were very meaningful to me and my faith. When I was really worried or upset I would turn on the worship songs and close my eyes and sing even during my practice contractions. And I found that when I did it was far easier to relax and embrace them.
The reason this was important to me was the realization that contractions are there to open your cervix. If you relax through them they are not as painful and they are far more effective.
I learned this through the hypnobirthing course I took as well as the book “Ina May’s guide to childbirth” I highly recommend both in preparation for birth.
The morning of his birth I woke early with very strong waves that were coming every 4 minutes. I ate breakfast took a bath, walked around and after an hour they were still coming but this time accompanied by show, loose bowels and other symptoms that let me know this time was likely the real deal. We called everyone and began preparing the birth space. I realized that they were spacing out and again became discouraged. Around 1 pm we went in to the midwife who did a membrane sweep and we began homeopathics. They immediately started coming every 3 minutes and didn’t stop. We headed home from the birth center.
I labored for an hour before my midwife called and decided the team needed to come. I bounced on the ball and stayed upright as much as possible.
At one point my sweet husband wrapped his arms around me. I grabbed his face and kissed him. Bam fireworks. My body immediately responded by giving me strong intensely pleasurable sensations. I kissed him some more. They were definitely contractions but instead of hurting they just made me knock kneed and want to kiss him  more. My entire body buzzed. I felt madly in love and connected with him more then ever before. We did this for a good 30 minutes before the midwifes arrived and it was pure nirvana.
They checked me and I was a 7. I got in the tub and it was euphoric. I relaxed in the tub and let the warm water envelop me. I still couldn’t believe that I was actually going to meet my sweet baby boy soon.
One of my very favorite songs came on and I began singing. Soon a contraction began and it was strong. I started to tense up but then I remembered from the days before that when I sang, it became easier and so I continued to sing along and the most incredible thing happened. The pain went away, my body relaxed and I soaked in the gorgeous lyrics and beautiful melody floating across the water bringing praises to my maker. Tears of gratitude poured from my eyes and I just said thank you over and over again.

I stayed here for a couple of hours, singing through contractions, rocking back and forth, praying, and making out with my super sexy man. I was so relaxed and so grateful for this amazing day that the birth team was having a challenge determining when I was contracting.
After a while I got out of the tub and drank water, had a small snack of apples and apple juice and labored on the toilet for a while. I had loose bowels and felt the urge to poop every time I had a contraction, because of this I noticed my body tensing so when I sat on the toilet I completely relaxed and everything began intensifying. I felt him dropping, and my bag bulging. Though the contractions were more intense, as long as I sang or my husband rubbed my shoulders I could manage them well and felt them opening my cervix.
I decided to lay down for a while and asked my midwife to break my water because I felt like it would speed things up. It did. The second she broke it he moved down deep into my pelvis. The pressure was intense and I decided to move back to the tub. I was a 9 and my body was working hard to bring him into the world. I leaned against the tub and my precious midwife wrapped her arms around my shoulders.
I decided at that point that I was ready for him to be born and wasn’t scared anymore about tearing. I accepted the possibility and let go. I said out loud,
 “My cervix is fully open, He is not too big. He will fit, I won’t tear.”
And literally 2 contractions later I was pushing. 7 minutes later I was holding my beautiful son. I didn’t tear and was so relieved to finally be holding him that I cried happy tears. I wanted him to be born into a peaceful worship filled environment and I got my wish. I am still so amazed when I look back at the video and am absolutely blown away by how peaceful and pleasurable his birth was. Jorge Ryan was 8#10oz,  21 inches long and pure perfection.

Pain Free Labour books available from Amazon.

Sunday, 10 April 2016

Why I believe in Pain Free Labour/Labor

I firmly believe in Pain Free Labours. Why, because 2 out of my 4 labours where pain free during the first stage, which is when the cervix is dilating to 10cm and you can push your baby out.

My first was an induction of labour at term for hypertension. My waters were broken and I was put straight onto an oxytocic drip. Today we give women 2 hours after having their waters broken to mobilise and go into a more normal labour before offering the drip, but this was in the bad old days 34 years ago. This was not a pain free labour.

My second was a spontaneous labour at T+7. I had researched more natural labours at my local library. Google was still a distant dot on the horizon 31 years ago. I found out how primitive women laboured without fear and stayed mainly upright. I found how to relax in yoga books so I would not feel afraid. I was ready. At 1am I started having painful contractions that woke me up. Sat on the couch downstairs I did progressive muscle relaxation and the pain stopped, but the painless contractions kept coming. When I got to hospital I sat on a comfy chair and relaxed till I was 10cm dilated. This was my first pain free labour.

My third was a spontaneous labour after a sweep at 39 weeks. I was having a pain free labour at home, my mum came round to mind the boys and I set off happily for hospital. Oh dear. A midwife from HELL made me lie down on a bed with a monitor in progress. When I explained that I had to sit up on a chair she laughed at me and pushed me back down. This was not a pain free labour.

My fourth was a home birth. I started contracting on and off during the day but was too busy with my 3 lovely boys to really notice. I was not afraid to give birth as I knew I was doing it at home and no one could make me lie down again. I fed, bathed and bedded the boys and then sent for the midwife. A lovely Irish midwife came to my house, she sat with me eating biscuits and drinking tea until I leapt off the couch when my waters went and wanted to push. This was my second pain free labour.

I so wanted to share this well kept secret with everyone that I then went to university to become a midwife. One senior midwife, who I told about my Pain Free Labour book, said "What is it really called, Bollocks, Bollocks and more Bollocks?"

Society teaches women that labour WILL be painful so that when they start to contract, adrenalin is secreted and messes up their labour. There is another way.

See posts on this blog:
Progressive muscle relaxation
Why labour hurts - 1 to 5
Hazards to a pain free labour 1 to 6
Evidence to support a pain free labour 1 to 3

Pain Free Labour books available from Amazon.

Saturday, 2 April 2016

Colic in breast fed babies?

The cure for colic

When Oliver James's newborn son got colic, he and his wife prepared themselves for the horror of sleepless nights. Then they attended a breastfeeding clinic ...

Two weeks after our son Louis was born, three months ago, he started showing signs of colic. Just when my wife Clare and I were at our most exhausted, at around six in the evening, he would cry loudly and inconsolably for no apparent reason, his back arched and his legs doubled up. Since our daughter Olive (now three) had done the same, we were not altogether surprised. But we groaned at the prospect of months of long nights walking him around to no avail and nocturnal drives with the Pet Shop Boys Introspective album blaring. (This was the only thing guaranteed to shut our daughter up. Somebody should do a study of which popular music is most effective in quieting troubled babies - I swear by the Pets.)
To add to the grief, my wife got mastitis, which we assumed was the reason each feed felt as if she were having her nipples slashed with razor blades. The antibiotics to treat it only made our son worse, upsetting his tummy. As we lurched towards meltdown and bottle-feeding, a health visitor suggested we visit midwives Chloe Fisher and Sally Inch, said to be the international queens of breastfeeding, at their drop-in clinic at Oxford's John Radcliffe Hospital.
That they could help us with the mastitis seemed plausible, but I was sceptical when Fisher told us that the colic was also to do with my wife's breastfeeding technique. I had studied the scientific literature in the past, and despite contact with dozens of health professionals over the years, and endless discussions with other parents, no one had told us that colic had anything to do with how you breastfeed.
About one-fifth of all babies get the full colic syndrome, of whom only a small minority (5-10%) have any identifiable physical cause. It's a serious problem because half of those mothers with severely colicky babies are liable to become mentally ill, falling to one-quarter if the baby is only moderately colicky (compared with 3% of mothers with none).
The ailment has baffled medical scientists seeking a biological cause. Only social, rather than medical, science seems to provide some clues. Most, if not all, babies in developed nations get some of the symptoms, yet it is rare or unknown in developing ones. A possible reason is that in the latter countries, babies are constantly held, fed effectively and on demand. Babies cry less whose mothers carry them for three hours or more, or feed on demand during the first two months.
Another reason could be the lack of social support and the hard-working, stressful lives of pregnant mothers in developed nations. A study of 1,200 mothers interviewed prenatally and when the child was three months found that a good relationship with the partner before the birth reduced colic. Seventy per cent of mothers had colicky babies if they had a lot of prenatal stress, felt isolated and anticipated needing a lot of postnatal help, compared with only 25% of babies of mothers without these problems. Prior problems with the mother's mother also predicted it. When asked during pregnancy or shortly after the birth, mothers who recalled distressing childhood memories or expected a lack of support or excessive interference from their mothers were more likely to have a colicky baby.
It came, therefore, as a great surprise to me when Fisher told us that colic in the breastfed baby is primarily due to something as simple as not attaching the baby to the breast correctly, which means that the baby is unable to "drain" the breast properly during feeds.
Arriving at the clinic on a Monday afternoon, we were met by the sight of a clutch of desperate mothers, their babies suckling for Britain. There were two pairs of twins; our frazzled minds boggled at the prospect of trying to keep them satisfied. But Fisher and Inch radiated supreme confidence that salvation was at hand, roving round the room, providing emphatic instructions.
Fisher enunciated two principles: "First, don't assume the breast is like a bottle. The milk is in the breast, not in the nipple, whereas with a bottle, the milk is in the teat. To feed effectively from the breast the baby must scoop in a deep mouthful of breast, whereas with a bottle, it can just suck on the end of the teat.
"Second, people wrongly assume the middle of the baby's mouth is halfway between the top and bottom lip. In fact, the middle is between the upper surface of the tongue and the upper palate. For the baby to draw sufficient breast tissue into its mouth, it must be able to get its tongue well away from the base of the nipple and that won't happen unless the breast is presented between the tongue and the upper palate."
If the baby did not attach properly, the midwives told us, it would not drain the breast properly and would keep compressing the nipple between the tongue and hard palate, turning it into something resembling minced lamb. Putting this into practice proved surprisingly difficult but after a bit my wife got the hang of it.
Next came the other important point: "Only switch breasts when the well-attached baby comes off the breast spontaneously and seems completely satisfied," said Fisher. "In offering the second breast, let the baby decide whether he wants it. If the mother starts each feed on alternate breasts [regardless of whether the baby has had one or two at a feed], the breasts will get roughly even use. The important thing is to allow the baby to finish the first breast first."
Failing to do this is the main cause of colic. Fisher also told us that the initial milk is low in fat and calories. If you switch breasts before the high-fat milk has been drunk, the baby will take more from the second breast than he would otherwise have done. Despite the relatively huge volume of liquid in its stomach, the baby will then be wanting another feed before long, because low-fat feeds are processed quickly, leading to a pattern of very frequent feeding. This can cause mental illness-inducing sleep-deprivation, but worst of all, it will cause colic.
Both poor attachment and breast switching result in the baby taking frequent, large-volume, low-fat feeds, which in turn lead to rapid emptying of the stomach into the large intestine. If too much gets there too fast, there is not enough of the enzyme lactase to break the sugar in the milk (lactose) down. The gut turns into a malfunctioning brewery, with fermentation of the sugar in the excess milk creating gas and explosive poos. The crying, arched back, rigid tummy and irritability of colic follow.
I was flabbergasted. If all this were really true, why on earth wasn't everyone told about it, especially considering the damage done to the mental health of parents by colic? Fisher replied that she and Dr Mike Woolridge had published the hypothesis in the leading medical journal the Lancet 17 years ago. "I was expecting that after that it would solve the problem. It seems pretty extraordinary to me that it has not."
Fisher believes she is right because she has seen thousands of mothers solve the problem by following their advice, but since the 1988 paper, her theory has been scientifically tested. A 1995 study compared two groups of 150 mothers: one asked to let the baby terminate the feed on the first breast; the other asked for the baby to feed equally from both breasts. Twice as many of the mothers who fed equally with both breasts had colicky babies (23% versus 12%). What is more, finishing the first breast first resulted in significantly less breast engorgement.
This turned out to apply to us too. Inch doubted that my wife actually had infectious mastitis or had needed antibiotics for it and easily proved her point. A few days after my wife had started taking the antibiotics, the problem had developed in the right as well as the left breast. Since infectious mastitis is a bacterial problem, and since the germs should have been killed by the antibiotics, Inch pointed out that such a transfer could not have happened if it was a bacterial pathology. Rather, the inflamed breast was due to back pressure within the ductal system of the breast, she said. Ineffective milk removal was not keeping pace with milk production so the milk could no longer be contained within the ductal system. It was forced into the connective tissue of the breast, where it gets treated as a foreign protein, with subsequent inflammation and pain.
All of which proved to be of more than academic interest to us. While we returned to the Thursday clinic for a booster course in attaching to the breast, from the first moment my wife did it properly, the pain was much less. From that very night our son was free of colic and within a week, the "mastitis" was disappearing.

This is very good news for women suffering the curse of colic who are dedicated breast feeders. I always thought breastfed babies could not get colic. Will pass thin info on to all my new mums.
Pain Free Labour books available from Amazon. 

Wednesday, 16 March 2016

Untucking the Tail for Birth.

The forgotten art of untucking the tail.

This post was originally published on 7 Nov 2015 at

A tiny detail we’ve lost since the hunter-gatherer times and how to fix it
Illustration by Jillian Nicol at
I’ve been spending most of my time lately learning about biomechanics, healthy alignment and how movement affects our bodies in relation to gravity. The research from the last few years shows that the way we move affect us not only mechanically, as it was previously thought, but also causing biochemical changes on cellular level, changing us from inside out. This process of the body adapting to and being shaped by movement is called mechanotransduction.
We seem to be living in the world that encourages sitting with the tail tucked under.
The furniture we use sitting all day is optimised for comfort and convenience, but usually not ergonomically adapted for pelvic floor health. Who would even think about that?
There is a well spread myth in our society that pelvic floor issues are a normal consequence of pregnancy and birth, or ageing for men. But we would rarely think of looking for a cause a bit deeper, in the way we have been living and moving before that.
Did you know that the anatomic function of our remnant of a tail is, amongst others, to control opening and closing of the pelvic outlet. If you look at a dog, or a another tailed animal, you can see that they keep their tail up, happily wagging when they are in a good mood. And this is the default. When you see a dog wearing his tail down between his back legs, it is usually a sign that the dog is on the fight of flight mode and his pelvic floor is tense as a part of his whole body reacting to danger.
Even though we now have only the beginning of what was once a real mammalian tail, it behaves the same. Untucking the tailbone opens the pelvic outlet, tucking it closes it — tightening the pelvic floor. The dog with his tail down between his legs is an equivalent of you sitting on your sacrum, the back supported by a chair or a couch. If you spend multiple hours a day in this position, your pelvic floor doesn’t really have a chance to release and allow the muscle fibres to regain their natural length at resting state. So gradually it shortens.
In his book Pelvic Power, Eric Franklin compares natural movement of the pelvic floor to a kite. As you stand up the pelvic floor slightly lifts and narrows similarly to a kite picking the wind and taking off. Reversely, as you sit down (with untucked tail, using your sitbones) the pelvic floor widens and releases to its full length, like a kite descending down, opening and landing. But what if we never allow it to release?
Tight muscle does NOT equal a strong muscle.
Biomechanicist Katy Bowman compares an optimally functioning pelvic floor to a trampoline. It supports the weight of all our pelvic organs and allows any extra load to just bounce off its healthy, elastic fibres, tensing and releasing naturally. Keeping the muscles short all the time doesn’t let them perform their function optimally. And further on, as our bodies naturally adapt to the way we use them, we gradually end up with shortened muscles.
This is further exacerbated by using pelvic floor exercises (‘Kegels’) on ‘the more the better’ basis — Bowman explains. Doing more and more repetitions of contractions of the muscle isolated from the rest of the body without allowing it to ever fully release, you get a muscle that is tight and locked short. Tight muscle does NOT equal a strong muscle. A strong muscle is able to both fully contract and fully release.
So why I am telling you all this now? Reading Katy Bowman’s last book — Move Your DNA, I’ve started to incorporate more movement into my life other than and independently from exercising. And especially, I’ve started to squat more, when playing with my toddler, picking things off the floor and even going to the toilet.
Learning to untuck my tail has made me finally realise why I still had to push my baby out and not bear it gently down, letting the gravity do the job, in spite of all the birth preparations and beautiful relaxation techniques I mastered beforehand.
To “breathe the baby out” you have to first untuck your tail.
Anatomically, in order for the baby to come out the pelvic floor has to release, but you can’t possibly release the pelvic floor with the tailbone tucked under. You can only use the strength of your muscles (transverse abdominals and diaphragm as they instruct you to hold your breath and “puuuuussssh!”) against your pelvic floor. And that’s a sure way to end up with a nice tear and possibly a pelvic floor disfunction. I was lucky that the athletic challenge, how my birth experience felt to be honest, ended without any serious damage. My body just took over at the last moment and following a very primal instinct jumped on a dining chair opening the pelvic outlet fully. The squats and kneeling with rounded back would have probably taken me to an assisted delivery.
“Modern birthing science has placed a large burden on secreted hormones (like relaxin) to prepare the body for needed mobility.” Katy Bowman says. Yes, hormon relaxine is useful in letting the body open up for the birth, but it’s not enough, unless we have strong muscles that can fully contract, but also fully release. But then, strong isolated muscles are not enough either. In order to have smooth births we ned to have a whole-body endurance. A great way to develop endurance is to walk as much as you can. “The woman who wants to go about a birthing process naturally can follow the lead other “natural” processes women have been doing for millennia — walking 5–6 total miles per day, and squatting to bathroom multiple times daily.” — she adds.
So, the bottom line is: get off your tail and sit on your sit bones instead, walk more, squat more, move more. It’s all about really using the body. Reintroducing a variety of movement we can strengthen the muscles of the pelvic girdle and release our tail once again, allowing it to respond freely to the demands of natural movement. And this can make a big difference for our pelvic floor health and the general level of our wellbeing.

Even more reason to keep off the bed during labour and birth? Not sure about "squatting to bathroom" though, sounds messy.
Pain Free Labour books available from Amazon.

Friday, 4 March 2016

Your first labour does not have to be long and hard.

Women need to find their own way of coping in labour. For some it will be to use relaxation techniques like hypnobirting, bake a batch of cup cakes, or for one lovely young lady I know it was walking round and round in a circle! 
12 February 20:00
"Hi Ann! Thank you very much! I can't believe how quick it all was!
I woke up at 1.45 in the morn Srom'd (her waters went)  started getting tightenings at 2. They were every 2 mins from the word go so I went downstairs and thought I'll start timing them. I was just walking around in a circle focusing on going round and round! By 3 I thought these are pretty strong now, woke hubby up. Needed to wash my hair thought I cant go into hospital without doing that so managed to have a shower between the contractions! By half 3 I rang MAU (Midwifery Assessment Unit) and said I think I'm going to have to come in. Got into hospital for just after 4 (put the hypnobirthing music on in the car on the way!) Was examined and said I was fully dilated! I said are you sure can u recheck?! I was shocked despite the pressure I had with every contraction i still thought no way could I come in fully dilated with my first baby!
Went to the birth centre got in the pool had some gas & air just to use as the contraction built up before I pushed then had him at 5.56 in the pool! It was amazing my perfect labour I couldn't have asked for anything more!"

Your first labour does not have to be long and hard. Distraction techniques like walking have been used for centuries to take women's minds off their labour. When women center totally on their contractions they start to panic and then adrenalin, released due to any kind of anxiety,  'sticks' to the cervix and makes it harder to open. Whatever coping technique you choose be confident in your ability to birth your baby, we are women, we are built to give birth and when we take charge during our labours we can have the birth of our dreams.

Pain Free Labour books available on Amazon.

Sunday, 31 January 2016

Increasing breastfeeding worldwide could prevent over 800,000 child deaths and 20,000 deaths from breast cancer every year.

January 29, 2016
The Lancet
Just 1 in 5 children in high-income countries are breastfed to 12 months, whilst only 1 in 3 children in low and middle-income countries are exclusively breastfed for the first 6 months. As a result, millions of children are failing to receive the full benefits provided by breastfeeding. The findings come from the largest and most detailed analysis to quantify levels, trends, and benefits of breastfeeding around the world. 
Then why are women still not getting the message?
 Although breastfeeding is one of the most effective preventive health measures for children and mothers regardless of where they live, it has been overlooked as a critical need for the health of the population.

"There is a widespread misconception that the benefits of breastfeeding only relate to poor countries. Nothing could be further from the truth," says Series author Professor Cesar Victora from the Federal University of Pelotas in Brazil. "Our work for this Series clearly shows that breastfeeding saves lives and money in all countries, rich and poor alike. Therefore, the importance of tackling the issue globally is greater than ever."

Breastfeeding not only has multiple health benefits for children and mothers, but it also has dramatic effects on life expectancy. For example, in high-income countries breastfeeding reduces the risk of sudden infant deaths by more than a third, while in low-and middle-income countries about half of all diarrhoea episodes and a third of respiratory infections could be avoided by breastfeeding. It also increases intelligence, and might protect against obesity and diabetes in later life. For mothers, longer-duration breastfeeding reduces the risks of breast cancer and ovarian cancer.

Furthermore, the authors calculate that boosting breastfeeding rates for infants below 6 months of age to 45% in the UK would cut treatment costs of common childhood illnesses (eg,  pneumonia, diarrhoea, and asthma) and save health care systems at least 29.5 million in the UK.

Yet, worldwide rates of breastfeeding are low, particularly in high-income countries. For example, the UK (<1%), Ireland (2%), and Denmark (3%) have some of the lowest rates of breastfeeding at 12 months in the world. "Breastfeeding is one of the few positive health behaviours that is more common in poor than richer countries, and within poor countries, is more frequent among poor mothers. The stark reality is that in the absence of breastfeeding, the rich-poor gap in child survival would be even wider. Our findings should reassure policymakers that a rapid return on investment is realistic and feasible, and won't need a generation to be realised."

Persistent underinvestment in protecting, promoting and supporting breastfeeding by governments and international funders has exacerbated the issue. Social media do not portray breastfeeding women in a positive light. It was banned on FB to show a BF woman as you could see some of her breast! OMG.

Powerful political commitment and financial investment is needed to protect, promote, and support breastfeeding at all levels -- family, community, workplace, and government, say the authors. Additionally, more needs to be done to regulate the multi-billion dollar breastmilk-substitute industry which undermines breastfeeding as the best feeding practice in early life. The authors point out that the International Code of Marketing of Breastmilk Substitutes could be an effective mechanism if adequate investment is made to ensure its implementation and accountability across all countries.

Global sales of milk formula (including infant formula and follow-on milks) have increased from a value of about US$2 billion in 1987 to about US$40 billion in 2014...Political commitment, investment, and effective international, national, and local leadership are needed to end promotion of products that compete with breastfeeding."

Ask your Community Midwife for help and advice about breastfeeding your baby before you decide. There is lots of help and support out there when you have had your baby, just ask.