La Leche League GB

Unicef UK Baby Friendly Initiative Annual Conference

Birmingham International Convention Centre November 3rd – 4th 2016
Report by Jayne Joyce, LLL Leader and IBCLC

This was my 5th consecutive BFI conference, and included the usual inspiring mix of cutting-edge research, examples of outstanding practice & the chance to talk with 799 other people who are passionate about supporting breastfeeding!  I imagine most participants would agree that one of the most memorable sessions was by poet Hollie McNish, reading from her new book, Nobody Told Me: Poetry and Parenthood.

There is far too much to include here, so I focus on some highlights.  Next year’s conference will be in Telford and I hope that many who read this will be there!

Baby Friendly News

The impact of breastfeeding on maternal and child health in the 21st century: the Lancet papers (Dr Nigel Rollins, World Health Organisation)

The session explored this series of papers published in The Lancet earlier this year. The systematic literature review about outcomes was published in a special edition of Acta Paediatrica. These are the most important collections of evidence on the importance of breastfeeding that we have to date.

What’s new in postpartum depression research: recent findings on breastfeeding and depression, birth interventions, and preterm birth (Kathleen Kendall-Tackett, La Leche League Leader, Ph.D, IBCLC, USA)

The statistic “10-15% of new mothers get depressed” is often quoted, but this is a “statistic of privilege” – white, middle class women who make it into the mental health system.  It probably should be more like 40-60%, including many of our most vulnerable mothers.  Adult adversity, such as domestic abuse or trauma is often overlooked.  Inter-partner violence is a better predictor of postnatal depression than is depression in pregnancy. Depression and PTSD seem to contribute to Preterm birth, which is the number one cause of infant mortality worldwide.  Inflammation is part of the stress response, and there is a causal link between inflammation and depression. Factors which impact depression, e.g. birth practices, also impact on breastfeeding.  In my research, planned cesarean births had the highest rate of breastfeeding problems.  “Depression (and anxiety) is a direct threat to breastfeeding”. Breastfeeding protects maternal mental health, as it seems to “dial down” the trauma response, e.g. positive effect on sleep and reduction in anger and irritability.

The effects of depression are potentially lethal: not just maternal suicide and infanticide, but also preterm birth and we can’t just ignore it.  In longitudinal studies, if depression untreated, at least half of women are still depressed 3 years later.  Birth interventions impact both breastfeeding and depression.  There are interventions that can help: mindfulness, social support, omega 3, exercis, which are all anti-inflammatory.  Many mental health professionals are still not on board with breastfeeding and need to be educated.  This will be consumer-driven through the mothers.  I think we can turn the tide in the US and here as well.

Kathy also gave a thought-provoking session on“The neuropsychological effects of sleep training”, comparing behavioural approaches to modifying babies’ behaviour with the insights of attachment theory. Her conclusions:

  • Sleep training offers no long-term benefit
  • It is a hold-over from a refuted parenting style
  • It will likely interfere with breastfeeding
  • Current studies supporting it have a number of methodological weaknesses
  • Non-responsiveness to infant crying raises cortisol levels, which is toxic to developing brains
  • May not be harmful if short-term and in a generally responsive and warm family, but given the drawbacks, it is not a technique we should recommend

Hypoglycaemia – preventing admissions to neonatal units (Dr Sanjeev Deshpande, Consultant Neonatologist, Shropshire Women & Children’s Centre)

The session reported a significant study across many UK hospitals suggesting that the blood sugar testing of full term newborns is frequently carried out at the wrong time when there is a natural dip in blood sugar, thus producing essentially false readings which lead to many unnecessary admissions to NNU.  Many babies admitted do not need treatment.  Multiplied around the country, this produces tens of thousands of hours of mother/baby separation, with repercussions for Breastfeeding. Dr Deshpande spoke about the financial cost of this care, but his focus was primarily on unnecessary mother-baby separation. In response to his research team’s work, a hospital in Guernsey began to apply existing best practice guidelines for physicians more robustly and were able to dramatically reduce their NNU admissions.

Conclusions: babies born early (37-8 weeks), born by cesarean; who become cold, are more likely to be admitted and need additional support.  Many of these babies could be cared for on postnatal wards, with good routine feeding support. The safe place for a term baby is with the mother.

The constituents of formula milk – busting the myths (Dr Helen Crawley, First Steps Nutrition Trust)

This was a fascinating session that looked at various underhand tactics used in formula marketing to confuse and mislead consumers and Healthcare Professionals, often by “blinding with science”.  If you aren’t familiar with the excellent (free, downloable, unbiased, reliable) resources produced by the Trust, you can find them here.

“Human milk is the only food fed to the most vulnerable in our society, but we permit it to be marketed in exactly the same way as shampoo”

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Jayne Joyce IBCLC
and Leader with La Leche League Oxfordshire