ABreast Start - Narelle Crane IBCLC

25/04/2025

This is such important info to help all expecting parents make informed decisions

Whenever you're offered a medical test, take a moment to consider what will happen with the information gained from it.

Is this something you're happy with?

Could a particular result limit your options in any way?

If a screening test shows that you are carrying group B strep bacteria, have gestational diabetes or have a higher-than-average BMI, for instance, you might be told that you can't birth where you wanted to.

Will it lead to things you don't want?

If you step on the scales - in pregnancy or at any other time - your BMI may be logged and you may find yourself being offered interventions you don't want, or being asked to attend clinics or groups.

As with everything, some people are okay with these offers or restrictions, and some are not. But care is standardised. That's why you need to think about how something and its consequences will feel to you, before you agree to it.

What are the alternatives?

There are always alternatives, including declining the test, or seeking care elsewhere.

Always remember it's your decision. You can say 'yes' or 'no' or 'I need time to think about this.'

And although not everybody realises this, you don't have to have those screening tests in the first place if you don't want them.

If you'd like to know more, or to better understand some of the wider issues around making decisions in pregnancy and childbirth, take a look at my book, "What's Right For Me? Making decisions in pregnancy and childbirth."

It was written to help women, parents and families to better understand how modern maternity care works and how you can make the decisions that are right for you.

More information at www.sarawickham.com/me

31/12/2024

YES! Short naps are normal. Kathryn Stagg IBCLC - lactation consultant thank you for this information.

17/12/2024

Toddler Milk is absolutely unnecessary!

12/12/2024

12/12/2024

Are you a new or expectant parent, caregiver, or responsible for the safety and wellbeing of children?

A joint initiative between COPE, and , the Baby and Child First Aid online course (Perinatal First Aid) has been created to help you prevent or be prepared for accidents, and equip you with essential first aid skills and knowledge.

More than a paediatric first aid online program, this toolkit will serve you throughout your parenting journey.

This course includes a special module on perinatal emotional and mental health.

We discuss common mental health conditions, including what to look out for in yourself or others. We also discuss safe and effective treatments, and where to access quality information, support and / or treatment.

Learn more by visiting:
https://www.cope.org.au/course/baby-and-child-first-aid/

08/12/2024

Are you Breast Pumping?
Most women are doing it wrong. And don’t even know it.
Breast pumps available on the market come with Flanges that don’t properly fit a lot of women and can cause many problems for both mother and baby.
To find out more - Click the Link Below
https://abreaststart.com.au/services/breast-pump-flange-fitting/

06/11/2024

What a great idea to help boost supply

10/10/2023

Today on World Mental Health Day, we join with people and communities around the globe to unite behind this year’s theme - ‘Mental health is a universal human right.’

As notes:

“Mental health is a basic human right for all people. Everyone, whoever and wherever they are, has a right to the highest attainable standard of mental health. This includes the right to be protected from mental health risks, the right to available, accessible, acceptable, and good quality care, and the right to liberty, independence and inclusion in the community.”

Today we are thinking of those who are currently experiencing mental ill-health and those who are caring for them.

We recognise those working on the frontline to support the emotional and mental wellbeing of expectant and new parents as well as the fierce advocates in this space who agitate for change today and every day.

Today is also a reminder that so many people still suffer in silence due to stigma, which can be particularly strong during this perinatal stage.

If you’re struggling with feelings of anxiety or depression on your journey to parenthood, during pregnancy or after welcoming a baby — please know that you’re not alone and help is available.

You can search the eCOPE directory for supports and services in your local area including online and telehealth options.

Mental health is a universal human right.

18/09/2023

The health risks of using formula milk.
Informed choice and how to discuss this in a culture with minimal breastfeeding support when for many parents the choice to breastfeed is taken away through lack of support.

What can we do in our society?

Firstly, thankfully, formula is getting a lot better as more research takes place. However, we have to be aware that research into formula is almost always subject to bias as it is usually funded by the formula industry itself. So many claims need to be taken with a pinch of salt.

Risks are discussed on a population wide basis, not an individual person's risk. There will always be babies who are fully formula fed who will be absolutely fine, and there will be babies who are exclusively breastfed who are unwell. but unfortunately, formula feeding does increase the risk of many health conditions.

I'm not actually going to list the risks of formula. You can Google it and you will get that information. And some risks will be more important to some people than others.

But it is important to think and talk about the risks. Too often, they are glossed over for fear of upsetting people. Or it is just not discussed. Or health care professionals do not know there are risks. Formula is marketed as a lifestyle choice, but it is actually a matter of public health.

In order to make fully informed choices around infant feeding or any health decision, we need to understand the risks and benefits of any intervention.

What can parents do?

Try to avoid formula, here are some ways to do so:
Antenatal education
Antenatal hand expressing
Breastfeeding support
Access to donor human milk
However, even if you do all of these, sometimes formula is clinically necessary.

Ways to minimise the risks if you are wanting or having to fully formula feed:
Make/store formula safely
Pace all bottle feeds
Cuddle during feeds
Feed and parent responsively

Ways to minimise risks if combi-feeding for choice or for low supply:
All of the above plus
Maximise breastmilk intake as much as you can
Maximise direct breastfeeding
Remember, even small amounts of human milk can make a big difference

I will do posts on some of these points later in the week.

18/09/2023

How is formula made?
Main info from First Steps Nutrition and the book "Why Formula Feeding Matters" by Shel Banks IBCLC Infant Feeding Specialist

Formula is made of 6 basic ingredients - protein, fat, carbohydrate, vitamins, minerals and other nutrients to help the gut. There are clear guidelines as to what can or can't be in formula and minimum and maximum levels suggested.

Base ingredients arrive at the factory in powdered form. They are heat treated and mixed with milk. Powdered formula is then evaporated and dried. It is tested to make sure the composition is within the acceptable range.

Proteins tend to come from cows' milk and comprise of whey and casein. Formula tends to have higher levels of protein than human milk. Proteins can be hydrolysed for allergic babies, which make them easier to tolerate. For severely allergic babies, amino acid based formula can be used.

Fats are usually derived from vegetable oils or occasionally egg or animal fats. The fat structure of human milk differs considerably from cows milk which is higher in saturated fat, so skimmed milk is generally used plus a variety of other plant based sources to try to replicate the fat structure of human milk.
DHA is now a mandatory ingredient, although the research is a little inconclusive as to whether it is beneficial. It is derived from fish oils in most cases, leaving most formulas not suitable for vegetarions, Some may use fungus or algae. (There is currently no vegan formula available in the UK)

Carbohydrate - lactose is the main carbohydrate in human milk and many formulas from cows' milk. Corn syrup can be added.

A number of essential vitamins and minerals are added to infant formula. Formula has much higher levels of iron, but the iron in human milk is absorbed much more easily.

Some probiotics and prebiotics are added to help seed the baby's gut microbiome. However, human milk comprises a unique combination of hundreds of "good" gut bacteria from the mother and prebiotics that are uniquely matched to them.

There are many factors in human milk that unfortunately can't be replicated, including enzymes, growth factors, hormones, antibodies, antiviral factors, stem cells, HAMLET amongst others

18/09/2023

Very important info about formula milk.

Formula milk

If you are using formula milk to feed your baby, either through choice or necessity, a first stage formula will be required to meet your baby’s needs and you will use it until your baby is one year of age.

Formula milk is generally made from cow's milk, occasionally goats milk.It has to be processed to change the balance of nutrients to grow a human in the right way, as cows milk is designed to grow a baby cow. Mammalian milk is species specific, so a baby human would not grow and thrive on non-processed cows' milk.

In the UK, we have regulations around the composition of infant formula milk. If research shows us a nutrient is important to a baby’s growth or well-being, it will be in there. And it has to be in every stage 1 formula by law.

Some companies will try and make their product more attractive with scientific claims, newly discovered ingredients, or claims that where ingredients are sourced will make a big difference to your baby, but ultimately if it is needed to be in formula to help babies grow appropriately, then all formulas would have to be made like that. Anything that does not appear in all stage 1 formula is not necessary.

More expensive formula milk does not mean better; companies may just have spent more on marketing or even just the packaging is different to make their product seem more high end, but the milk composition inside is exactly the same.

It used to be suggested to keep your baby on the same formula throughout their first year, but there is no evidence that this is necessary. It is likely a myth to encourage brand loyalty.

There is no need to move on to stage 2 or follow on milk. Stage 1 is appropriate and more regulated up to 1 year. Then your baby no longer needs formula, and full fat cows milk can be given instead.

Specialist formulas such as comfort milks, anti reflux milk, and hungry baby milk are not recommended, and the research is not there to back up the claims. Allergy milks should be used only under medical supervision and are usually prescribed.

For more info on formula milk please visit First Steps Nutrition Trust’s website or https://www.infantmilkinfo.org for unbiased and accessible info.

18/09/2023

This is a great explanation about how your milk supply increases over the first days and weeks after birth

Let’s talk about supply ‘regulation’

This is a phrase or word I hear often, and sometimes I worry that parents think there is something bad about it. But it’s not a bad thing and it’s not a ‘set in stone’ thing.

In order to understand what is happening we have to understand the stages of lactation – some may think this is a boring human anatomy lesson, and I debated writing so much, but I believe it is important that we understand what is happening in our bodies.

First, there is Lactogenesis I (Roman number for 1) – this happens during pregnancy, hormones start to ‘wake up’ the breasts and the milk ducts grow (fun fact – the breasts are the last organ to full mature, which only happens during the first pregnancy). Prolactin starts to make colostrum, but progesterone from the placenta inhibits it from making large quantities. For more information on colostrum here is an article I wrote awhile back - www.cherishedparenting.com.au/single-post/amazing-colostrum-facts-and-myths

Then there is Lactogenesis II – this happens from the moment the placenta is birthed and the progesterone is removed from the circulation. Prolactin receptors increase and the milk increases in volume and changes from colostrum to mature milk. This is often marked by the milk ‘coming in’, although we are trying to move away from that term, because colostrum is milk – it doesn’t magically arrive at this stage, it has been there all along.

Finally there is Lactogenesis III – the ongoing production of mature milk, through demand and supply, until the mother and baby wean from breastfeeding altogether.

It is the change from Lactogenesis II to Lactogenesis III that people are referring to when they say the supply has ‘regulated’.

However, I get the impression that many think this means that their supply is now at a set amount – that they cannot increase it if it drops.

But this is not true.

What it means is that hormones are no longer driving your supply – now it is about demand and supply. What you and your baby ‘demand’ your body makes, it should. So if you need to increase it, you should be able to…

With FREQUENT and EFFECTIVE milk removal above all else – not lactation cookies, not tablets, not smoothies, not any other food or drink.

There is a good and a bad side to this ‘regulating’ of your supply – it can mean that if you were leaking, getting engorged, etc your supply may calm down a bit, your body may now recognise that it doesn’t need to make so much.

On the flip side, if milk wasn’t being removed frequently and/or effectively enough, the supply can drop. And if you are not aware of why or how, it may take some time to bring it back up again.

There are reasons why this may not always work as nature intended – underlying hormonal issues, insufficient milk duct growth, being unaware or unsupported of how often or effectively a baby should feed (not the parents’ fault, but the system’s for not educating us properly).

Getting support and informed is key to breastfeeding success (even if that ‘success’ is not 100% exclusive breastmilk feeding) – www.cherishedparenting.com.au/lactation-consultant-perth