WEBVTT - Elizabeth Wilson 0:00:05.921 --> 0:00:07.281 Appogia production. 0:00:10.121 --> 0:00:13.521 Hi everyone, thank you for tuning back into Tenantus for Nurses. 0:00:13.601 --> 0:00:18.241 I suspec Woodbine here this season. I am so excited 0:00:18.281 --> 0:00:21.200 to announce that the podcast as being supported by Nutritia, 0:00:21.361 --> 0:00:25.761 which is a global leader in medical nutrition. They understand 0:00:25.801 --> 0:00:28.041 the needs of nurses in the nutrition space and for 0:00:28.121 --> 0:00:31.361 over one hundred and twenty five years have provided products 0:00:31.401 --> 0:00:35.681 to support child health. Some of Nutrita's pediatric brands include 0:00:35.841 --> 0:00:39.521 Neo Kate Junior for children who have food allergies and 0:00:39.561 --> 0:00:41.801 app to Grow for those fussy eaters. And those of 0:00:41.881 --> 0:00:45.681 us who have children know many kids who go through 0:00:45.721 --> 0:00:50.040 the phases of definite fussiness. For more information and resources, 0:00:50.281 --> 0:00:54.081 visit the nutritiona Pediatrics hub at nutritia dot com dot 0:00:54.121 --> 0:00:57.401 au forward slash Pediatrics. I just want to say a 0:00:57.561 --> 0:01:00.841 huge thank you to Nutritia. Their desire to support nurses 0:01:00.881 --> 0:01:04.121 is truly appreciated, and they are allowing me to continue 0:01:04.161 --> 0:01:07.001 this podcast so that we can all grow as nurses. 0:01:07.641 --> 0:01:10.641 This season, we have some amazing speakers in the pediatric 0:01:10.681 --> 0:01:13.681 space which I cannot wait to share with you all. Hi, 0:01:13.761 --> 0:01:16.840 my name's Beck Woodbine and welcome to Tenderness for nurses. 0:01:17.441 --> 0:01:21.440 I'm grateful for the person that I have the opportunity to. 0:01:21.481 --> 0:01:25.280 Be, so I hit it and parked it for Nellie 0:01:25.321 --> 0:01:28.321 for years. We always have free will, We always get 0:01:28.321 --> 0:01:30.080 to choose. We are autonomous. 0:01:31.481 --> 0:01:35.161 Hi everyone, thank you for tuning into Tenderis for Nurses. 0:01:35.640 --> 0:01:39.321 We are very excited this season to be sponsored by 0:01:39.401 --> 0:01:44.601 NUTRITIONA and I have the fabulous professor Elizabeth Denny Wilson, 0:01:45.280 --> 0:01:51.521 who specializes in obesity prevention in babies, but also she 0:01:51.761 --> 0:01:56.441 has done some significant research into the area of mixed feeding, 0:01:57.001 --> 0:01:59.921 and probably that is what we're going to address a 0:01:59.961 --> 0:02:01.561 little bit more today. 0:02:02.241 --> 0:02:04.121 But thank you so much for coming on. 0:02:04.241 --> 0:02:06.561 I know you are super busy as a professor and 0:02:06.641 --> 0:02:08.680 studying and teaching and researching. 0:02:09.041 --> 0:02:11.881 We're all super busy, so that's no excuse. 0:02:12.681 --> 0:02:17.201 I am just so delighted and reading your bio and 0:02:17.401 --> 0:02:20.761 watching the videos that are on YouTube about you and 0:02:20.800 --> 0:02:24.241 what you have done around mixed feeding. We all know 0:02:24.361 --> 0:02:28.121 breast is best, and we all try to do the 0:02:28.161 --> 0:02:29.441 right thing by our kids. 0:02:29.520 --> 0:02:32.081 But sometimes you know you've. 0:02:31.960 --> 0:02:34.601 Got to go back to work, you're not well, you 0:02:34.601 --> 0:02:37.841 don't know the circumstances behind. So I'm making a decision 0:02:37.921 --> 0:02:43.201 to maybe mix feed. So do you mind explaining exactly 0:02:43.201 --> 0:02:44.400 what mixed feeding is? 0:02:44.881 --> 0:02:49.681 Yes, certainly, so I completely agree with you Beck. Breastfeeding 0:02:49.800 --> 0:02:53.481 is an extraordinary thing and an extraordinary thing that we 0:02:53.561 --> 0:02:56.400 can do for our babies, and it is one hundred 0:02:56.441 --> 0:03:01.641 percent the best way to feed human infants. But also, 0:03:02.041 --> 0:03:06.241 as you said, there are reasons why sometimes people don't 0:03:06.281 --> 0:03:09.641 want to breastfeed, or they feel pressures one way or 0:03:09.641 --> 0:03:15.000 another to not breastfeed, or they might feel like they 0:03:15.240 --> 0:03:18.121 have a low supply or that they don't have enough milk, 0:03:18.401 --> 0:03:20.721 or you know, there are lots of reasons why people 0:03:20.881 --> 0:03:25.121 might choose to introduce infant formula. So mixed feeding just 0:03:25.201 --> 0:03:29.161 means if you're combining breastfeeding with another form of feeding, 0:03:29.240 --> 0:03:31.921 So you're either feeding with infant formula in a bottle 0:03:32.240 --> 0:03:34.801 or in a cup, sometimes in a spoon, which would 0:03:34.961 --> 0:03:38.761 take a long time. So it just means that you're 0:03:39.041 --> 0:03:41.241 breastfeeding plus something else. 0:03:42.201 --> 0:03:45.721 And do you think there's a higher percentage of people 0:03:46.041 --> 0:03:50.521 doing that than anyone talks about because I know that 0:03:51.001 --> 0:03:53.841 if you have a season, you're shamed. If you don't breastfeed, 0:03:53.881 --> 0:03:55.841 you're shamed. I mean, I had a daughter that just 0:03:55.881 --> 0:03:58.481 wanted breast milk, and that was great and it suited me, 0:03:58.961 --> 0:04:02.361 but my second child had total refusal to eat. Ye 0:04:02.561 --> 0:04:05.841 period was a nasogastrically fed, then just to nuzzle a 0:04:05.881 --> 0:04:08.001 couple of weeks at some stage, and then we tried 0:04:08.001 --> 0:04:10.401 to get my breast milk back in and then he 0:04:10.481 --> 0:04:13.441 refused again. So I was very lucky that I had 0:04:13.481 --> 0:04:16.041 some amazing lactation consultants to come in, but in the 0:04:16.161 --> 0:04:18.481 end he just had to be not even bottle fed. 0:04:18.481 --> 0:04:20.041 He's one of those kids that were spoonfed. 0:04:20.601 --> 0:04:23.601 I had one of each as well, so yes, an 0:04:23.681 --> 0:04:27.081 enthusiastic breastfeeder who I fed for years and another one 0:04:27.161 --> 0:04:30.320 who it was pretty challenging. But I think we just 0:04:30.481 --> 0:04:34.041 don't know is the true answer. We know from our 0:04:34.081 --> 0:04:37.281 research and from other groups research that about half of 0:04:37.361 --> 0:04:41.601 babies will have some formula before they're six months old, 0:04:42.601 --> 0:04:46.880 but we don't have really good data on the proportion 0:04:47.001 --> 0:04:49.801 of people who were mixed feeding, so who were doing both. 0:04:50.561 --> 0:04:53.320 You know, we can kind of extract it from other studies, 0:04:53.361 --> 0:04:58.200 but we don't have really good data on the proportion 0:04:58.281 --> 0:05:01.041 of people who are mixed feeding. And I see this 0:05:01.121 --> 0:05:06.001 as a terrible gap because if we knew knew more 0:05:06.041 --> 0:05:08.840 about people who were mixed feeding, and if we knew 0:05:08.880 --> 0:05:12.960 more about why they were mixed feeding, then we'd be 0:05:13.241 --> 0:05:17.121 in a better position to develop interventions to support them 0:05:17.161 --> 0:05:22.041 to continue breastfeeding, to breastfeed more often, to maintain their 0:05:22.041 --> 0:05:26.481 breast milk supply, and we'd also be able to support 0:05:26.721 --> 0:05:32.401 our clinicians to support women to prolong breastfeeding, to increase breastfeeding. 0:05:33.201 --> 0:05:35.921 But we can't really do those things if we don't 0:05:36.001 --> 0:05:41.361 really understand who's doing it, why they're doing it, how often, 0:05:41.921 --> 0:05:45.041 whether their goal is to get through a period of 0:05:45.361 --> 0:05:49.320 challenge in their breastfeeding that they will then pick back 0:05:49.361 --> 0:05:54.561 up again. And certainly when I was had my babies 0:05:54.601 --> 0:05:57.641 and became really interested in the way people feed their babies, 0:05:58.561 --> 0:06:04.801 I was absolutely devoted breastfeeder and one hundred percent you know, 0:06:05.161 --> 0:06:10.401 behind breastfeeding being the best food for babies and breastfeeding 0:06:10.401 --> 0:06:14.320 at all costs. But I guess what I have come 0:06:14.361 --> 0:06:20.681 to understand through my research and through the women I've 0:06:20.721 --> 0:06:23.281 met in my role as a breastfeeding counselor but also 0:06:23.320 --> 0:06:27.401 in my role as a researcher, is that it's just 0:06:27.521 --> 0:06:32.961 not always what's right for them and if we could 0:06:33.001 --> 0:06:39.921 really understand more about why they've made the choices they've made, 0:06:40.361 --> 0:06:44.241 then we might be able to intervene sooner and help 0:06:44.320 --> 0:06:48.840 them to continue breastfeeding, or help them to breastfeed more often, 0:06:49.081 --> 0:06:52.681 or find a way of mixed feeding that doesn't lead 0:06:52.761 --> 0:06:57.241 to no breast milk, because some breast milk is better 0:06:57.281 --> 0:06:58.200 than no breast milk. 0:06:58.320 --> 0:06:58.960 Absolutely. 0:06:59.961 --> 0:07:02.760 Why do you think there is such a huge gap 0:07:02.880 --> 0:07:04.080 in that research space. 0:07:05.320 --> 0:07:07.841 One of the reasons is that I think for a 0:07:07.841 --> 0:07:11.921 long time, we've had people who research breastfeeding and we've 0:07:11.961 --> 0:07:15.241 had people who research other things, and we haven't necessarily 0:07:15.401 --> 0:07:20.361 communicated very well or done really good multidisciplinary work. And 0:07:20.441 --> 0:07:24.681 I also think because our health services and our health 0:07:24.721 --> 0:07:30.561 departments have had extremely strong pro breastfeeding policies, as they should, 0:07:30.961 --> 0:07:36.521 there hasn't necessarily been a place for doing research about 0:07:36.921 --> 0:07:40.521 mixed feeding. And there's also been a really strong sense 0:07:40.681 --> 0:07:45.041 over my lifetime of working in this field that there's 0:07:45.201 --> 0:07:49.281 enough information out there in the in the ether or 0:07:49.281 --> 0:07:53.841 in the way that is accessible to mums into wherever. Yeah, 0:07:53.881 --> 0:07:57.721 to give mums who are using it formula advice on 0:07:57.841 --> 0:08:00.801 using it formula. But I think what hasn't been captured 0:08:00.841 --> 0:08:03.721 well is that, of course, there are mums who exclusively 0:08:03.761 --> 0:08:08.121 breastfeed and that's fatastic, and there are mums who exclusively 0:08:08.561 --> 0:08:12.721 use infant formula, and that's they deserve our support. But 0:08:12.841 --> 0:08:16.521 when we do our work that was initially focused on 0:08:17.161 --> 0:08:20.481 obesie prevention, and there's a reason why we're interested in 0:08:20.481 --> 0:08:23.961 infant formula for obesie prevention, I guess we started to 0:08:24.121 --> 0:08:27.441 see that. And this work was led by one of 0:08:27.441 --> 0:08:31.001 my PhD students, and she talked to a lot of 0:08:31.121 --> 0:08:35.121 mums who were using infant formula, either mixed feeding or 0:08:35.681 --> 0:08:39.201 exclusively formula feeding, and there were a couple of things 0:08:39.241 --> 0:08:42.561 that she found that really sort of broke my heart 0:08:42.601 --> 0:08:46.041 a little bit. One of them was that mums don't 0:08:46.201 --> 0:08:51.241 seek health professional advice before they start introducing formula, and 0:08:51.281 --> 0:08:54.241 that's because they don't think they can, They feel judged, 0:08:54.281 --> 0:08:57.401 they feel like it's not the right thing to do, 0:08:57.481 --> 0:09:02.361 and that they won't necessarily get support. And the second 0:09:02.361 --> 0:09:05.681 thing that broke my heart was that the place where 0:09:05.801 --> 0:09:09.961 most people who are introducing infant formula get their information 0:09:10.081 --> 0:09:13.841 is from the tin, so from the tin of formula, 0:09:14.361 --> 0:09:16.441 and I just think we can do a lot better 0:09:16.481 --> 0:09:16.801 than that. 0:09:18.281 --> 0:09:19.401 That's where I got mine from. 0:09:19.561 --> 0:09:19.761 Yep. 0:09:21.121 --> 0:09:24.641 I just think that's a travesty because a lot of 0:09:24.761 --> 0:09:29.001 mums who are introducing infant formula are doing so at 0:09:29.041 --> 0:09:34.201 a point of distress or of christ or and we 0:09:34.281 --> 0:09:37.361 should be wrapping our arms around those mums, just as 0:09:37.401 --> 0:09:41.681 we should be wrapping our arms around all mums. We 0:09:41.761 --> 0:09:45.041 should be saying, what's your goal? Is this something you 0:09:45.241 --> 0:09:47.641 just want to do for a little while, or you know, 0:09:47.761 --> 0:09:50.761 have you thought about mixed feeding? Have you thought about 0:09:51.001 --> 0:09:53.481 this might be something you could do just to take 0:09:53.521 --> 0:09:55.721 the pressure off for a couple of days, and then 0:09:56.241 --> 0:09:58.121 you know, here's what you could do to keep your 0:09:58.121 --> 0:10:00.601 supply up, or here's what you could do to build 0:10:00.641 --> 0:10:04.401 your supply, or here's how you can do it without 0:10:04.761 --> 0:10:08.601 say that's it for my breastfeeding journey. 0:10:09.801 --> 0:10:14.521 So when someone decides to mix feed because of say, 0:10:14.521 --> 0:10:16.601 for example, they're going back and doing some part time 0:10:16.681 --> 0:10:19.161 work that sort of thing, you know, it might just 0:10:19.161 --> 0:10:20.481 be easy for them to go, Okay, I'm not going 0:10:20.521 --> 0:10:21.361 to breastfeed anymore. 0:10:21.401 --> 0:10:25.041 I'm just going to swoop to bottle formal food. 0:10:26.281 --> 0:10:28.241 But if they knew that, say, they could do morning 0:10:28.241 --> 0:10:31.721 and night exactly, just you know, a bit of a 0:10:31.721 --> 0:10:34.561 pump at lunchtime. You know, there's a room there that 0:10:34.681 --> 0:10:37.041 you know at work that you can do that, and 0:10:37.081 --> 0:10:38.761 then they can take that home and use that on 0:10:38.801 --> 0:10:40.881 the days off or a weekend when you know Nana 0:10:40.921 --> 0:10:43.521 and Papa are looking after the kid or something like that. 0:10:44.361 --> 0:10:49.241 But it's interesting I just found with my daughter, she 0:10:49.321 --> 0:10:52.321 just wanted breastpilk, that's it. And then she went straight 0:10:52.321 --> 0:10:53.841 to a cup because there was no way she was 0:10:53.881 --> 0:10:54.601 going to give that up. 0:10:54.881 --> 0:10:55.121 Yep. 0:10:55.441 --> 0:10:58.881 Jacob, on the other hand, just hated everything. I was 0:10:58.921 --> 0:11:01.401 at the end of my tether. I actually said it 0:11:01.441 --> 0:11:05.601 in a podcast previously. I was so beside my I 0:11:05.641 --> 0:11:09.481 went to the Maternal and Health Child Service Center, sat 0:11:09.521 --> 0:11:12.801 there on the steps before it had even opened, with 0:11:12.921 --> 0:11:16.441 this crying baby that just wouldn't feed, wouldn't stop crying. 0:11:17.401 --> 0:11:20.441 And I was sitting on those stairs with this baby crying, begging. 0:11:20.721 --> 0:11:24.361 I was begging for help. Yeah, he's lucky I didn't 0:11:24.361 --> 0:11:28.321 throw him in the rubbish bit seriously here. Yeah, and 0:11:28.361 --> 0:11:31.161 you know, I'm a nurse, so I have a bit 0:11:31.161 --> 0:11:32.401 of an idea about stuff. 0:11:33.121 --> 0:11:34.401 But imagine being. 0:11:34.201 --> 0:11:37.241 A mum and not having your mum around or being 0:11:37.281 --> 0:11:40.481 on your own or being a single parent or not 0:11:40.641 --> 0:11:41.681 having that support. 0:11:42.521 --> 0:11:46.281 Absolutely, and child family health services are not as available 0:11:46.321 --> 0:11:48.121 as they used to. I mean, if you've got a 0:11:48.161 --> 0:11:51.561 good child family health nurse, they are like gold, like 0:11:51.641 --> 0:11:55.641 absolutely salute gold because the relationship that they develop with 0:11:55.721 --> 0:11:59.401 new mums is just second to none, and they will 0:11:59.441 --> 0:12:03.521 support mums through thick and thin, and they have just 0:12:03.561 --> 0:12:07.481 such a beautiful way of you know, telling mums you 0:12:07.521 --> 0:12:09.961 know you're doing a great job, and that's exactly what 0:12:10.241 --> 0:12:13.881 mums need to hear. But it's not like when I 0:12:13.961 --> 0:12:16.001 had it. You know, when I have my babies, you 0:12:16.081 --> 0:12:19.361 could turn up for a drop in visit. I think 0:12:19.361 --> 0:12:22.241 it was every morning and they had appointments in the afternoon, 0:12:22.761 --> 0:12:26.481 so it was really available and I really needed it 0:12:26.721 --> 0:12:30.401 and a lot of mums really needed it, and then 0:12:30.481 --> 0:12:32.401 at other times I didn't need it at all. But 0:12:32.601 --> 0:12:36.761 now there aren't enough China family health nurses and there 0:12:36.801 --> 0:12:41.881 aren't enough Chime family health nursing appointments available or drop 0:12:41.921 --> 0:12:46.241 ins available, and that again it's not helpful for mums 0:12:46.281 --> 0:12:49.961 who need I mean, we all support when we're learning 0:12:50.001 --> 0:12:53.801 something new, don't we And we learn something new every 0:12:53.801 --> 0:12:55.121 time we have a new baby. 0:12:56.001 --> 0:12:58.761 Oh, breastfeeding just I mean, we all think it's meant 0:12:58.801 --> 0:13:02.641 to just happen, but it's not that easy, no. 0:13:02.521 --> 0:13:05.961 And I mean I should also say that they're fantastic 0:13:06.041 --> 0:13:09.801 support services like the Australian Breastfeeding Association, which is absolutely 0:13:09.801 --> 0:13:13.721 fantastic and is available twenty four hours a day, seven 0:13:13.801 --> 0:13:18.201 days a week, and that's absolutely fantastic. But if you've 0:13:18.241 --> 0:13:21.561 been sent home from hospital within forty eight hours of 0:13:21.641 --> 0:13:25.121 having a baby, your milk hasn't come in yet, and 0:13:25.361 --> 0:13:28.721 you're only getting a couple of visits from a midwife 0:13:28.721 --> 0:13:33.441 from the hospital, it's not enough for every month. Like, 0:13:34.001 --> 0:13:38.761 we really need to be able to wrap around mums 0:13:38.801 --> 0:13:41.641 and give them the support they need, and it's not 0:13:41.801 --> 0:13:47.241 necessarily going to work over the phone or online. And 0:13:47.281 --> 0:13:52.241 in terms of formula introduction, we know that most mums 0:13:52.281 --> 0:13:57.241 turn to the internet and in some groups, yeah, and 0:13:57.321 --> 0:14:01.281 some of the information on the internet is evidence based 0:14:01.321 --> 0:14:05.441 and is really reliable, and others is not. And again 0:14:05.801 --> 0:14:09.161 I've had PhD students who have looked at the quality 0:14:09.961 --> 0:14:14.881 and the content ofant feeding websites and ofant feeding apps, 0:14:15.081 --> 0:14:19.481 and the quality is really variable. So it's really tough 0:14:19.681 --> 0:14:23.961 for mums to know when they're tired, when they've got 0:14:23.961 --> 0:14:26.681 a crying baby, when they might not have a lot 0:14:26.681 --> 0:14:30.281 of experience in this area. You know, which website do I. 0:14:30.241 --> 0:14:34.761 Trust because we don't have, you know, the extended family 0:14:34.841 --> 0:14:35.921 like other cultures do. 0:14:36.201 --> 0:14:37.841 You're quite nuclear. 0:14:38.401 --> 0:14:41.521 And I remember when I did my nursing training and 0:14:41.561 --> 0:14:43.281 people would go on and do their midi and then 0:14:43.321 --> 0:14:46.561 they would go on and do family and child health. 0:14:46.801 --> 0:14:49.441 Is that still offered as a. 0:14:49.121 --> 0:14:52.081 Oh yeah, yeah, but you don't have to be a 0:14:52.121 --> 0:14:54.721 midwife to be a child and family health nurse. You 0:14:54.801 --> 0:14:59.681 can do that qualification from your bachelor degree. And similarly, 0:15:00.281 --> 0:15:03.721 a sort of fairly recent change is that you can 0:15:03.921 --> 0:15:07.001 get a child and family qualification and work as a 0:15:07.121 --> 0:15:10.601 child and family health nurse if you've done a Bachelor 0:15:10.601 --> 0:15:13.721 of midway free rather than a Bachelor of nursing. So that, okay, 0:15:13.801 --> 0:15:18.521 that has been a fairly recent change and has been 0:15:18.761 --> 0:15:21.321 really welcomed by some in the field and not by 0:15:21.401 --> 0:15:24.641 others in the field. So I'm remaining agnostic on that one. 0:15:25.721 --> 0:15:28.361 I just wanted to be more support from others. 0:15:29.721 --> 0:15:31.521 I couldn't agree more. 0:15:31.561 --> 0:15:35.121 And I just think my milk didn't come in until 0:15:35.361 --> 0:15:38.441 what day three, and I was a hot mess that day. 0:15:38.401 --> 0:15:41.321 Yeah, and literally a hot. 0:15:41.281 --> 0:15:45.601 Mess, and with these massive boobs, and I was sobbing 0:15:45.641 --> 0:15:48.321 at the side of the baby and someone came me 0:15:48.321 --> 0:15:50.561 in and I burst into tea like I was a mess. 0:15:51.081 --> 0:15:52.521 So if I hadn't have. 0:15:52.561 --> 0:15:55.521 Had that support that I had, yeah, you know, from 0:15:55.561 --> 0:15:58.841 my mom and from the nurses in the hospital, I 0:15:58.881 --> 0:16:00.281 would have really struggled. 0:16:00.681 --> 0:16:03.241 Yeah, and you need to be told, don't you this 0:16:03.321 --> 0:16:08.641 is normal, this is just what happens. Everything's temporary. It'll 0:16:08.681 --> 0:16:11.561 be better tomorrow, it'll be better the day after that. 0:16:13.081 --> 0:16:17.321 You need to hear that reassurance because it's a pretty 0:16:17.361 --> 0:16:21.201 phenomenal new thing in your life that's happened to you. 0:16:21.641 --> 0:16:25.561 And I think we have to be kind and supportive 0:16:25.721 --> 0:16:30.281 and make sure that mums have all of the support 0:16:30.361 --> 0:16:34.081 that they need to feel good about their mother ing 0:16:34.321 --> 0:16:38.361 and the extraordinary thing that they've just done, grown a 0:16:38.441 --> 0:16:40.601 human being. 0:16:41.121 --> 0:16:45.041 Do you think, because I feel that there's this big 0:16:45.121 --> 0:16:50.161 gap in healthcare in this space, you know, in my 0:16:50.241 --> 0:16:53.601 own clinic, we obviously we can't treat women for anti 0:16:53.681 --> 0:16:56.121 wrinkle or for lasers and things like that if they're pregnant, 0:16:56.121 --> 0:17:00.081 and often if they're breastfeeding. And you know, all of 0:17:00.081 --> 0:17:03.521 them say the same thing. They all wanted to breastfeed, 0:17:03.641 --> 0:17:06.041 and some did for a period of time, others didn't. 0:17:06.600 --> 0:17:09.600 But it was very interesting that I hear that some 0:17:09.640 --> 0:17:11.400 of them go. You know, I didn't tell anyone I 0:17:11.481 --> 0:17:14.360 wasn't breastfeeding because you know, I was shamed so badly, 0:17:14.600 --> 0:17:17.801 or someone had something to say, or someone will make 0:17:17.840 --> 0:17:22.281 a comment. And I don't think people realize we're very 0:17:22.360 --> 0:17:27.281 sensitive about our mothering and our mothering skills, especially when 0:17:27.281 --> 0:17:30.641 we're in umup. We're just looking to be built up 0:17:30.761 --> 0:17:34.840 and supported. And when you hear these women just going, 0:17:35.080 --> 0:17:39.041 I felt shamed or I embarrassed, you know. I just 0:17:39.080 --> 0:17:45.041 think we're really letting our sisters down by not supporting 0:17:45.080 --> 0:17:46.360 them in whatever. 0:17:46.001 --> 0:17:46.761 Their choice is. 0:17:46.840 --> 0:17:49.561 And yes, like you said, breast is best, and I 0:17:49.600 --> 0:17:51.360 had on heart can say it was the best thing. 0:17:51.840 --> 0:17:54.920 It was wonderful, but I couldn't do it for my 0:17:54.961 --> 0:17:56.961 second child. I tried but couldn't. 0:17:57.961 --> 0:18:02.201 So I sort of think about different layers of breastfeeding 0:18:02.441 --> 0:18:07.521 kind of feeding, and I feel like an individual mum 0:18:08.201 --> 0:18:12.640 who has struggled with breastfeeding or has decided not to 0:18:12.840 --> 0:18:18.441 breastfed for whatever reason, Why are we shaming her when 0:18:19.080 --> 0:18:21.600 there's all sorts of reasons why she might have made 0:18:21.600 --> 0:18:24.440 that decision that are kind of out of her control. 0:18:25.080 --> 0:18:28.360 So does she have the support at home? Did she 0:18:28.481 --> 0:18:32.480 receive enough support to breastfeed? Does she have to go 0:18:32.600 --> 0:18:35.200 back to work in a minute because she's got a 0:18:35.281 --> 0:18:38.521 huge mortgage, or she's the primary bread winner, or you 0:18:38.561 --> 0:18:41.960 know one hundred other reasons. Does she get all of 0:18:42.001 --> 0:18:46.401 the education and support and advice that she needed when 0:18:46.441 --> 0:18:49.640 she was in hospital? You know that's another layer. Does 0:18:49.721 --> 0:18:54.720 the society that we live in actually support her to breastfeed? 0:18:54.840 --> 0:18:58.681 Can she breastfeed in public without feeling uncomfortable? 0:18:58.961 --> 0:18:59.401 Actually? 0:18:59.681 --> 0:19:03.761 You know, is she being bombarded by social media that's 0:19:03.880 --> 0:19:07.281 suggesting that she should feed with him from formula rather 0:19:07.321 --> 0:19:11.480 than breastfeeding. I mean, all sorts of things at all 0:19:11.521 --> 0:19:15.881 sorts of different levels are impacting on that woman. So 0:19:16.281 --> 0:19:20.080 why would we be shaming her or making her feel 0:19:20.160 --> 0:19:23.841 uncomfortable when we don't know anything about what's going on 0:19:24.041 --> 0:19:27.281 with her. We should be telling her you're doing your. 0:19:27.281 --> 0:19:29.840 Great job, or can I give you a hand? 0:19:30.521 --> 0:19:35.801 Exactly if we knew more about why people stop breastfiting 0:19:36.080 --> 0:19:39.601 or about why they might be mixed feeding and if 0:19:39.600 --> 0:19:42.680 our clinicians, our time and family health nurses, our GPS, 0:19:42.801 --> 0:19:45.721 all of the people who see mums a lot, if 0:19:45.761 --> 0:19:50.321 they knew how to sort of ask mums the right questions, 0:19:50.921 --> 0:19:54.041 then they might be able to say, actually, you're going 0:19:54.080 --> 0:19:56.281 back to work in a few weeks time. Did you 0:19:56.360 --> 0:19:58.521 know that you could mixed feed? Did you know you 0:19:58.561 --> 0:20:01.400 could keep breastfeeding, you could breastfeed in the morning, you 0:20:01.441 --> 0:20:05.520 could breastfeed at night. Or your partners said, isn't it 0:20:05.561 --> 0:20:07.880 time to stop breastfeeding? Well, here are some things you 0:20:07.921 --> 0:20:12.041 could say to alleviate their concerns. Or you think your 0:20:12.120 --> 0:20:15.120 supplies low, Here's how you can tell if your supply 0:20:15.321 --> 0:20:18.840 is low. And here are some tips for increasing your supply. 0:20:19.521 --> 0:20:21.920 You know, there's all sorts of things that we could 0:20:21.961 --> 0:20:26.240 be doing to support that mum that are just not 0:20:26.360 --> 0:20:32.441 happening in a systematic way. A here's the Health Department's policy. 0:20:33.001 --> 0:20:36.481 We're going to see what we can do about increasing 0:20:36.521 --> 0:20:40.001 people's supply. Or here's the things we can put in 0:20:40.080 --> 0:20:43.200 place to support mums to continue breastfeeding at work. 0:20:43.961 --> 0:20:51.440 So, statistically, has breastfeeding increased. Our initiation rates of breastfeeding 0:20:51.481 --> 0:20:56.080 are fantastic. So in Australia, we've got very very high 0:20:56.160 --> 0:20:59.561 rates of breastfeeding initiations, so people are breastfeeding in hospital, 0:21:00.281 --> 0:21:04.440 but the drop off in that first month is really high, right. 0:21:05.041 --> 0:21:07.360 I would argue that the drop off in that first 0:21:07.441 --> 0:21:11.761 month is high because people are not adequately supported, and 0:21:11.801 --> 0:21:15.281 they're not adequately supported because they haven't received the support 0:21:15.281 --> 0:21:16.521 in the education or the. 0:21:17.561 --> 0:21:20.240 Not just verbal education. But you know, here's how you 0:21:20.321 --> 0:21:23.080 do it, here's physically how you do it, and here's 0:21:23.120 --> 0:21:27.360 how you could troubleshoot some things that might happen. And 0:21:27.801 --> 0:21:30.960 that's probably what's causing that big drop off in the 0:21:31.001 --> 0:21:34.680 first month. And then the drop off later is for 0:21:34.721 --> 0:21:38.360 all sorts of reasons. But we really need to know 0:21:38.921 --> 0:21:44.561 a bit more and to understand how to intervene to 0:21:44.721 --> 0:21:48.160 increase the duration of breastfeeding, make sure people are giving 0:21:48.281 --> 0:21:53.480 some breast milk. So if I could tell you my story, please, 0:21:53.600 --> 0:21:56.080 So when my son was born, he was born in 0:21:56.080 --> 0:21:59.201 the United States, which doesn't have a strong breast threading culture, 0:22:00.241 --> 0:22:02.720 and so he was in the nanatal nursery for a 0:22:02.761 --> 0:22:06.921 month and after about a week I was expressing quite 0:22:06.961 --> 0:22:09.760 large quantities and one of the doctors said to be oh, 0:22:09.761 --> 0:22:13.920 are you still doing that? We yes, I am, and 0:22:14.001 --> 0:22:17.400 so I persisted, and luckily we had a fantastic nurse 0:22:17.441 --> 0:22:21.281 who really got breast feeling going because he wasn't particularly 0:22:21.281 --> 0:22:24.720 interested because he'd lost his suck reflex from being inchbraded 0:22:24.721 --> 0:22:27.561 and blah blah. And then because it was the United 0:22:27.600 --> 0:22:29.400 States and I had to go back to work after 0:22:29.481 --> 0:22:32.841 three months, I used to have to travel a bit 0:22:32.921 --> 0:22:35.160 for work, and I would travel with an eskie and 0:22:35.201 --> 0:22:37.481 I would express while I was away and come home 0:22:37.481 --> 0:22:40.241 with the eski, and some of the sort of senior 0:22:40.961 --> 0:22:43.761 men in the company would look at the eski coming 0:22:43.801 --> 0:22:47.721 around the baggage and say, oh, I don't even want 0:22:47.761 --> 0:22:49.840 to ask what's in there, you know. So there was 0:22:49.880 --> 0:22:53.640 sort of this ky thing, and there was nowhere to 0:22:53.721 --> 0:22:58.721 express a work except the toilets. So after persisting with this, 0:22:59.201 --> 0:23:04.080 I just was really determined to exclusively breastfeedd him. After 0:23:04.080 --> 0:23:07.280 a while, it just came a bit too difficult, and 0:23:07.321 --> 0:23:10.801 so I did persist with that morning and evening, and 0:23:10.840 --> 0:23:13.681 that worked really well for us until he was almost 0:23:13.721 --> 0:23:17.001 a year old, when he chose to end it. So 0:23:17.840 --> 0:23:20.160 it can be done. But I was just really lucky 0:23:20.241 --> 0:23:24.241 that my cousin was a breastpending counselor. I had friends 0:23:24.241 --> 0:23:27.321 who were midwives and I could get that advice and 0:23:27.400 --> 0:23:30.640 support because it wasn't available to me in the health 0:23:30.640 --> 0:23:31.841 system there. 0:23:32.001 --> 0:23:35.441 Because when I had Jacob and I had all those issues. Yeah, 0:23:35.561 --> 0:23:40.321 lactation consultants were around, but it was fairly new and 0:23:40.360 --> 0:23:44.001 they were fantastic, but it was expensive, and that is 0:23:44.041 --> 0:23:47.400 something some people do say that if you get a 0:23:47.441 --> 0:23:49.880 private lactation consultant, for some. 0:23:49.801 --> 0:23:51.441 People it's just out of their budget. 0:23:51.600 --> 0:23:54.200 Yeah, you know, I understand people have to run a 0:23:54.201 --> 0:23:57.041