Our Newly-Qualified Breastfeeding Counsellor!

Over 200 NCT students attended their graduation at University of Bedfordshire on 21 November 2012. The day was hosted by the Vice-Chancellor of the university and marked the graduation of all students that studied in the Health and Social Science Faculty at the university. This included 226 NCT students, many of these graduates will go on to be practitioners for NCT helping to deliver high quality services to parents. 

Of these graduates was Megan Stephenson, who gained her diploma of HE Breastfeeding Counselling.

We asked Megan to write about recently qualifying as a breastfeeding counsellor. She thought that these extracts from the last essay she wrote for her diploma would be a good illustration of the impact of her training.

Extracts from "What have you learned about yourself during your training?"

My role as a breastfeeding counsellor is as a supportive outsider empowering parents to make the best decisions they can for their families by giving the knowledge they need to do that. At the same time, if parents have decided that the solution to a problem is to feed their baby artificially then, whilst I can attempt to find alternative solutions with them the decision is ultimately theirs, and once they have made it, it is my role to support them. I suspect that at the start of my training I would have found that role incompatible with my feelings about formula milk. I have dealt with this dissonance by separating my feelings about marketing tactics used by formula manufacturers with my feelings about the milk itself.

The process of understanding more about myself ... has actually changed me, knowing about it has changed what it is. This is how feedback works - being given constructive feedback means that not only are we aware of how we are perceived but we can change and improve our practice. It is therefore vital that, in all aspects of the role, I seek out feedback from clients.

When I began the training, I imagined breastfeeding counselling taking a small, voluntary, part of my time. During the time I have been training, the NCT has changed its relationship with counsellors, bringing in tuition fees, and creating relationships with other organisations, such as Baby Café, so that the role is now perceived as comprising a larger paid component than was the case previously. Since my personal circumstances have also changed during the time of my training, I am looking forward to making the role as full-time as I can manage to fit around my children's school hours. Being paid will be welcome in this time of austerity.

This course has impacted on many different aspects of my life - my relationships with my family, my view of myself and my fit within a local community of parents. If I met myself from five years ago I think I'd recognise myself, and my counselling training would mean that I wouldn't try to argue with myself, but I think we wouldn't agree on everything.

If reading this has inspired you to train with the NCT to support parents in their journey, take a look at NCT College http://www.nct.org.uk/nct-college

Snowy day in Ely - 14 January 2013

Laura's children built a snowman

Lorraine's daughter made a snow angel

What do your children enjoy about snow?

Owain's Birth Story

by Jennie Evans

I was reaching the end of my third pregnancy, planning my second home birth. My due date came and went, but this was to be expected as I was 'late' with both my older boys too. I had a couple of niggly evenings towards the end of the week but nothing significant.

I arranged to go out for a curry with a couple of friends on the following Friday, if nothing had happened by then. At my 41-week midwife appointment on Tuesday I accepted a sweep, which must have done something as I had some definite tightenings that evening. It all stopped once I went to bed though. I carried on as normal, taking Alasdair (my two-year-old) to groups, getting rather tired of the 'so you're still here then!' comments!

On the Thursday evening (41+3) I had more tightenings, which started getting quite regular, though not massively uncomfortable. I went for a walk to try and get things going, and by the time I got back they were coming about every five minutes. We called my parents in case we needed them to look after the older boys, then called the delivery unit (DU), who called the midwife, who called me. She gave me her number and said to call back when we thought we needed her, which we duly did an hour or so later.

She came round and sat with us for a while, observing and timing the contractions, until I asked for a vaginal examination (VE) to see if I was progressing at all as it didn't feel as if the contractions were getting any stronger. She checked and I was only a couple of centimetres dilated, so we agreed that she'd go home, we'd go to bed to get some rest while we could, and would call her again if things progressed overnight. I fell asleep straight away, so they couldn't have been that bad!

I woke around 2:30 with more contractions, so I went downstairs and got the wood burner going again as it had died down. I paced around the living room for a bit, resting on the sofa every now and then, with clary sage oil on my oil burner. I eventually decided that it wasn't going to happen then either, so went back to bed about 5:30 and again went straight to sleep.

The alarm went at 7 as normal, and at 7:30 my mum called to see how things were going, as she hadn't heard from us overnight and wanted to know if we needed any help. I said that I was still getting quite regular contractions so she said she'd come over straight away to take Jamie to school so Tom didn't have to leave me on my own. She then stayed and entertained Alasdair for a couple of hours, by which time we'd decided that it was happening after all, and called the DU again (the midwife we'd seen the night before went off shift at 8am, so we had to go through the whole process again).

At about 11am Mum took Alasdair back to their house, and we agreed that she'd come back at 3pm to pick Jamie up from school and collect an overnight bag for the boys at the same time (I know, we should have had this packed as well as my hospital bag, but we had assumed I'd labour overnight as I had done with Alasdair and they'd sleep through it – not this time!). The midwife arrived shortly after Mum and Alasdair left, and I texted Kate to say that I didn't think I'd be going for a curry after all!

The midwife read through my birth plan, sat and timed my contractions and made some notes. I was still using the contraction timer app on my phone, but as the contractions got stronger I decided I'd get more benefit from pressing the button on my TENS machine than pressing a button on my phone, so I got it out and the midwife put it on for me.

After a bit I asked for another VE to see if things had moved along, as the contractions were quite a bit stronger. She said I was about 5-6cm, so I was getting somewhere! My waters were 'bulging' but I knew from my previous labours that they wouldn't go until much later on. Unfortunately midwives aren't allowed to break waters at a home birth unless it's medically necessary, so I just had to stick it out. I distinctly remember telling them later on that it was necessary, because my dad was coming in an hour to pick up the boys' bag, but this wasn't deemed a good enough reason!

At some point the first midwife called the second one to come over as she thought we might need her soon, but I have to admit I don't really remember this happening. I kept moving around the room, doing all the things we'd practised in my yoga classes to help me through the contractions; the midwife commented that I was moving really nicely, circling my hips to help the baby down. I wasn't doing this consciously, I have to admit, it was entirely programmed into me through the yoga classes – thank you Sally! Tom kept feeding me flapjack and made sure I was drinking enough – the fridge was stocked with water and Powerade.

The midwives decided we should get things ready for baby, so Tom brought the fire guard through to lay the baby clothes out on to warm, and we got the change mat and towels down. I felt like I wanted to rest a bit as I'd been standing all day, so we also spread an old duvet on the floor and I lay down. With hindsight, this should have been an indicator that we'd be meeting our baby fairly soon, as I felt the same with Alasdair, but of course that didn't occur to me at the time!

According to the midwives, I actually fell asleep for about 15 minutes – I wasn't aware of having slept, but apparently I did... I woke up with some very strong, 'pushy' contractions, a definite feeling of wanting to bear down. My waters still hadn't gone, and I think the midwives were getting a bit concerned that I was getting tired, as I recall them saying that they'd give me until 4, at which point they might want to think about some sort of intervention.

One of them asked me to turn onto my back so she could do another VE; this was really not what I wanted at this point, as I was happy on all fours, but I reluctantly agreed to a quick check in between contractions. As one contraction eased, I moved most of the way onto my back, so she could do the VE, and as she did so, the next contraction started and my waters went – right in her lap!

I got straight back onto all fours and could immediately feel the baby well on his way. He crowned with the next contraction. I remember saying out loud 'please don't slip back' as I knew we were nearly there; two more contractions and he was out! I sat back onto my heels as he arrived, so the midwife didn't actually need to do anything, he slipped down onto the duvet between my knees. Tom picked him up while I took my nightshirt off, then handed him to me for skin-to-skin.

The midwives wrapped the two of us in my dressing gown and a towel and got a hat on him while I stood holding him. It was at this point that one of the midwives noticed he had a full knot in his cord – thankfully the cord was so thick that the knot hadn't caused any problems during labour, they had no idea it was there until he'd arrived!

They asked if I wanted to sit on the sofa; I tried to sit down but it was too uncomfortable so I stood up again. 'How about sitting on your birth ball?' was the next suggestion; I tried that but again just couldn't sit down. We soon realised why this was, as just as they were confirming that I definitely wanted a physiological third stage, as per my birth plan, I felt the placenta coming. We waited for the cord to stop pulsing, then it was clamped and cut, and I finally flopped down on the (dust-sheet-covered) sofa and baby Owain had his first feed, quickly followed by his second – he had both sides within 30 minutes of birth!

The grandparents were called, the birth announcement posted on Facebook, then Tom and one of the midwives cleaned Owain up and dressed him, while the other one helped me up the stairs to the shower. I showered, changed, and went back downstairs for more cuddles!

Unfortunately it did not all end there. The midwife realised I was still bleeding, even though she had previously thought that my uterus had contracted back down. She helped me to the toilet, as apparently going for a wee can help, but it didn't. I was still losing blood, and getting some pretty strong after-pains with it. She gave me a shot of syntocinon, but it didn't stop. She then called the DU as she was getting concerned about how much I'd lost; the senior midwife there said to give me another syntocinon injection and if that didn't stop it then I should transfer in.

By this time I was getting a bit wobbly, so I lay down, but every time I moved, I bled again. The midwife decided that I needed to go into the hospital, so she called an ambulance. The First Response car turned up, the paramedic took one look at me and agreed that I needed to go in, so he put a cannula in my hand for IV fluids in the ambulance if necessary. The ambulance got there soon after, the paramedics somehow got the trolley round our stairs and into the living room, then back out again with me on it and into the ambulance.

Tom put Owain in his car seat; I said I wanted them with me rather than following in our car – I couldn't imagine anything worse than leaving them at that point – so we all piled into the ambulance. I was taken straight up to DU and hooked up to IV fluids and syntocinon. A doctor arrived pretty swiftly, and removed a 'dinner plate sized' clot which had been stuck in my uterus. I was also given misoprostil to help stop the bleeding, and the midwives warned me that this may give some nasty after-pains, so to ask for pain relief as soon as I needed it. However the pains I got from the medication were far milder than the ones I'd had when the bleeding started at home, so I was fine! 

Thankfully, as we were on the DU not the postnatal ward, we had our own room and Tom was allowed to stay – they found him a mattress to put on the floor. Another junior doctor took a blood sample, to see if I was anaemic, and they left us to rest.

The following morning, the blood test results were back and my iron levels were fine, my uterus was back as it should have been and I was allowed some tea and toast. One of the new shift of midwives did Owain's newborn checks and we were told that we could go home! Of course our car was at our house, and the bigger boys were at my parents' house, so Dad and my sister came to the hospital to pick us up, while Mum sorted the boys out. We called her when we were nearly home, and she brought the boys over – this gave us a chance to sort the house out, as neither of us were entirely sure what state the living room had been left in! As it turned out it wasn't too bad, so we were all settled by the time Mum arrived; the boys were very excited to meet their new baby brother. There were lots of cuddles all round and some lovely pictures taken, before Mum and Dad left with my sister and let us start properly settling down to life as a family of five.

Mothers may pass on jab fears to infants

A preliminary study of 50 mothers indicates that babies with first-time mothers exhibited signs of significantly more pain before the needle insertion and during the vaccination than those with experienced mothers. Researchers believe the heightened pain levels could be directly related to the mother’s anxiety about the procedure. Meanwhile, the mothers were also asked to estimate the pain felt by their baby during the procedure.The findings, published in the Journal of Reproductive and Infant Psychology, suggest that both new and experienced mothers overestimate their child’s pain.
Nursing Times 9th January 2013

Sleep Problems Worsen in Late Pregnancy

This probably won't come as a surprise but a recent study has confirmed that sleep problems increase in late pregnancy.

Sleep disturbances in late pregnancy are common. The study, 'A postal survey of maternal sleep in late pregnancy,' aimed to survey sleep problems in third trimester pregnant women and to compare sleep in the pre-pregnancy period with the third trimester.

Third-trimester women were sent a postal survey containing questions relating to sleep experience, including perceived sleep quality, sleep difficulties, night waking, sleep environment, snoring, daytime tiredness and daytime napping. The women were asked to report on sleep before pregnancy and in the last week.

The main findings were as follows:

• Before pregnancy, the average reported duration of night-time sleep was 8.1 hours; in the last week this had decreased to 7.5 hours. 
• Only 29% rated their sleep quality in the last week as very good or fairly good, compared with 82% rating their sleep this way before the pregnancy.
• The main reasons for sleeping difficulties were discomfort (67%) and pain (36%).
• Snoring increased significantly over the course of the pregnancy, with 37% reporting snoring often or every night in the last week. Those with a pre-pregnancy body mass index of greater than 25 were significantly more likely to snore.
• Only 4% of women had an abnormal Epworth Sleepiness Scale score prior to pregnancy, whereas in the last week 33% scored in the abnormal range.
• 5% had regularly napped during the daytime before pregnancy, compared with 41% in the last week. 

The study concluded that sleep problems are common in women in late pregnancy, and increase markedly compared with before pregnancy

A postal survey of maternal sleep in late pregnancy. Hutchison BL; Stone PR; McCowan LME; et al, (2012). BMC Pregnancy and Childbirth , vol 12, no 144, 10 December 2012 .
Full text available via http://www.biomedcentral.com/bmcpregnancychildbirth/contenthttp://midirs.us5.list-manage1.com/track/click?u=e4298fe3c18412b19e25c1507&id=70179eea15&e=709b0c7d49> 

A New Year message from NCT's Chief Executive, Belinda Phipps

I wish everyone had NCT's support – together let’s make 2013 the year this wish comes true.

In 2013, across the UK about 800,000 babies will be born. Four hundred thousand new families will be created and the rest will adjust to the addition of a new person. The lives of the parents, especially the newly created ones, will change forever.

I’m sure I don’t need to tell you that society often prefers to look the other way or talk only about the joy of a new baby. Parents are often under-supported and scapegoated for the ills of society at large. Too often businesses can see new parents only as an important source of revenue rather than a target for nurturing – no wonder emotional turmoil, physical exhaustion, relationship strain, loneliness and feeling time- or money-poor are so common.

Each year we set out to tackle this, and each year – with your help – we have achieved more. So I want to put on record my appreciation of your contribution to NCT’s achievements and the difference we have been making for over half a century.

But as I give you my thanks I ask for more: not for me, but for the hundreds of thousands of children and parents who have yet to, or could further, benefit from our support. I want them to benefit from your experience, your joys and your troubles.

And as the recession continues I want to ensure we offer the support of NCT the length and breadth of the UK. So in the first months of this New Year we will be working to put an NCT helpline card into the hand of every mum or dad-to-be.

We have printed 1.8 million NCT helpline cards. A sheet of 6 will go to most midwives, health visitors and students. You will get a sheet inside NCT Matters. A sheet will go to everyone who attends an NCT class to pass on. I hope also that every branch will include a sheet with their newsletters. And many more are waiting for branches to order them via the branch order system.

I urge you to join me and pass six on: perhaps to people you know, but more importantly to people you don't. Do you have the courage to say hello to a pregnant women and hand her a card? I know I certainly will. If we don't, who will make sure she doesn't miss out? Just those few words from you may be enough to make her feel OK to call us or visit our website.

I am planning on 2013 being a good year, and with your support to get a helpline card to every new parent in your patch, it could be great year – not just for you and NCT, but for those hundreds of thousands of babies and families too.

Here's to a happy, healthy and successful New Year.

Belinda

Babies Learn Language Basics While Still in Womb

A study reported in this Medical Daily Article recorded the responses of babies at 30 hours old to sounds some in their native language and others from different languages and found that babies can already differentiate.

MedicalDaily.com 2nd January 2013