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Do I have the option of taking home my placenta following birth? Is it policy for midwives to ask for parents preference? Is it considered clinical waste unless otherwise advised? Where would I find standard guidelines regarding this topic?
Your advice is appreciated

Dear Helen Twigger,

Thank you for contacting the NCT.

 I don't think a midwife would automatically ask your preference for what becomes of your placenta because (although increasing in popularity) it is still relatively rare for parents to want to take it home.  Normally, once the midwife has checked it for completeness, it would be incinerated.

I'm not sure that there are any "standard guidelines".  Hospital attitudes vary, so you might want to check whether they have any objections or whether there are any local guidelines that they would want you to follow.  Your Community Midwife may know, or you could write to the Head of Midwifery at the hospital explaining your wishes and asking what their procedure is.

It's probably worth making sure that the midwife who attends you at the birth is aware of your iplans, either by making a note in your birth plan (if you are writing one), or letting her know when you arrive at the labour suite and asking her to make a note of the request on your records.

 I hope this is helpful.

 Best wishes

I have exclusively breast feed my 9 week old son. I have been expressing with the plan for me to be able to go out without him like I did with my 1st son. Sounds good in theory but my problem is I can't get him to take the bottle. I have tried tommee tippee closer to nature, nuk, avent teats but unfortunately to no avail.
My husband tries most of the time as I don't want to cause him too much confusion.
We have tried lying on his side facing outwards, holding closely etc. Have tried when he is hungry, not hungry, wide awake and sleepy but he still isn't interested.
I have tried cupping but he tends to spit more of it out than swallow. I did try with a syringe today and I was able to get some into him but he wasn't happy.
As you can imagine I'm running out of ideas. I don't know who is getting more fustrated - him or me!
I'm open to suggestions and am willing to try anything.
Thanks, I'm getting a bit desperate.
Justine

 Hi Justine,

I am really sorry to hear that you are having problems getting your 9 week old son to take a bottle. It does indeed sound very frustrating for you as you have clearly tried several things to entice him. There is a general school of thought that if you try giving a bottle between the ages of 3 and 8 weeks it can result in a better outcome, the theory being that at this time the baby is usually well established on the breast but not too opinionated; I suspect that your son is already too opinionated! Of course there are no guarentees that a baby of any age will take a bottle anyway. Have you tried giving it to him when he is really hungry but still reasonable calm? Maybe persevering with the syringe may help too. I am sorry that there are no answers to this but remember that as a smaller version of you both he is entitled to say no sometimes as you would if you didn't like something! So you best bet may be to work round it while still persevering.

You make it clear that you just want to go out sometimes without worrying which I fully understand, is he stretching his feeds out more now that you could  do that is it is still impossible? Of course it may help to keep trying in the meantime. There is another bottle you could try called Breastflow  which flows like a breast and is also shaped like one too which may help you, if you google it it will come up straight away.

 Hope this helps a little

Best regards

Jane Saville, Breastfeeding Counsellor

 

Hi

Our baby is due in about 5 days time. A couple of days ago a community midwife and her supervisor came round to visit us as a part of risk assessing us for a home birth.
There were two points they felt strongly about, one was our desire to not cut the cord until after the placenta is devivered and the other was my desire as birthing partner to catch the baby.
They were keen to stress that I am not trained and that my partner can not catch the baby herself on dry land and as such they need to do it. Also they feel it is very important that if the birth takes place in water that the baby is bought above water 'immediately after birth'. It would be great if you could direct me towards any research that might be relevant to these areas.

Thanks

Dear Robin,

 Thank you for contacting the NCT.  We cannot give medical advice about individual cases, but here is some general information which may help you and your partner decide what is right for you.

It is certainly not uncommon to leave the cord uncut at least until it has stopped pulsating, and some parents also choose to leave it intact until the placenta is birthed (or even afterwards, in the practice known as "lotus birth").  Provided the mother does not have any risk factors for postpartum hemorrhage (heavy bleeding after birth) and the birth has been straightforward then the risks of delayed cord clamping to the mother are thought to be low, and it has the advantage of letting the baby receive the extra blood volume and iron supplies contained in the cord.  You might want to ask your community midwife whether there are any specific reasons in your partner's case that would make delayed cord clamping inadvisable

 These websites http://www.thirdstageoflabour.org/index.html   andhttp://www.homebirth.org.uk/thirdstage.htm provide a lot of information about the choices for the third stage.

The issues of who "catches the baby" is trickier and I cannot point you to any specific evidence - but obviously there are situations in which the mother's partner catches the baby - either from choice or because the birth has been fast and the midwife has not yet arrived!  Again, it may be worth asking the midwife what her specific concerns are, and see whether there is a way to work around these.

If your partner chooses to give birth in water then it is quite common for the mother to be the one to lift the baby up in this situation (if only because she's the one who can reach most easily) - though there may be a slight risk of the baby being stimulated to breathe to soon if handled fot too long under water.  For this reason (although there is ttle evidence either way) it is thought to be best to bring the baby's to the surface straight away.  There is some discussion about third stage in water, which includes issues around when to leave the pool, here http://www.homebirth.org.uk/water.htm

 I hope this is helpful, and wish you and your partner all the best for the birth that you want.

I exclusively breastfed by daughter Olivia until she was 7 months old at which time I began weaning on the advice of the health visitor. She is now 8 months and 3 weeks old. At around the same time as I started weaning, I tried to introduce a bottle but Olivia has totally refused even if it contained expressed breastmilk. Again upon the advice of my HV, I gave up trying with a bottle and have introduced a beaker/cup. Although Olivia is becoming more adept to using it, she still doesn't drink from it properly and totally refuses it if it contains formula milk.

Olivia does eat solids; fruit, vegetables, cheese, bread etc but not a huge amount!


My main concern, and here is my question, is that I will be returning to work in 8 weeks.


Will it be enough for her if I breastfed her before leaving for work at 7am and then at bed time - 7pm? I am panicking that she is going to be hungry all day but I just do not know what I can do for her. Any advice you can offer would be greatly appreciated, thank you.

Hello Donna, thanks for your email.

You’ve explained how Olivia has been happy breastfeeding, and has started taking solids, but doesn’t seem keen on taking milk any other way. It’s a scenario that I think many mums would recognise, in fact I’d go so far as to say it’s pretty typical behaviour for a baby of this age.

Breastfeeding has worked beautifully for Olivia and it’s developed into a hugely efficient system which supplies her with the milk she loves in a familiar and comforting way. Of course she has no understanding of your concerns about returning to work, and why she should accept a new process. It’s good to hear that she is showing she can use a cup – if she does feel thirsty she will be able to meet her needs this way.

Many breastfed babies seems less than keen about formula milk. Simply put, it is very different to breastmilk in smell, taste, texture and ‘mouth-feel’, so it’s understandable when a baby won’t treat it as a substitute. Instead, what many babies tend to do when their mothers return to work is to show a behaviour pattern which is so common it’s even been given a name: ‘reverse-cycling’. They feed with huge enthusiasm first thing in a morning and as much as possible when re-united with their mother, and take just enough drinks for the rest of the day to satisfy their basic thirst. They often to back to a more typical feeding pattern for weekends and days off – and a well-established milk supply will tend to cope just fine with this. Then as they become more accustomed to the new set-up, their eating and drinking balances out once more. Some mothers choose to offer extra night-time feeds (such as at their own bed time) to reassure themselves that their baby is feeding fully – this can be a tough choice if you’re pleased about the way your baby settles, but it doesn’t seem to cause long-term disruption,

You’ve explained that you still have eight weeks before you return to work, and that Olivia will be nearly a year old by then – the accepted marking point at which milk may no longer have to be her major source of nutrition. Eight weeks can show tremendous progress, so while it makes good sense to plan ahead as you are doing, I hope you will see Olivia becoming more accustomed to her cup during that time. I am sure you can appreciate that one thing to avoid would be pressuring Olivia in any way to drink more, or allowing her to pick up on any anxiety you may be feeling. Babies can be quick to respond to such things, sometimes by refusing the cup altogether.

You talk about how Olivia is taking a good range of solids, although you don’t feel the amounts are large.  It sounds as if Olivia has learnt to meet her needs through months of breastfeeding and is now balancing her needs with a wider range of foods. I hope that this can give you confidence to feel that she will be able to go on meeting her needs through her healthy natural appetite – a really valuable behaviour to take with her as she grows up.

Donna, Going back to work is always a concern, and I can appreciate that you don’t need anything extra to worry about! I hope that you can feel that by offering Olivia plenty of chances to breastfeed when you are together, and ensuring that her care providers know her preferences, have a drink on hand for her at all times, and offer her solids without pressure, then she will be able to respond to her needs for food drink and comfort as successfully as she has shown she can so far. Your health visitor should be able to talk to you about any of these aspects, and you’d also be welcome to call the NCT Breastfeeding Line on 0300 33 00 771.

I do hope this helps. Best wishes to yourself and Olivia.

Kirsty Nicol

Breastfeeding Counsellor

Hi, I have a 22 month old baby boy, I stopped breastfeeding when he was 6 months old. I am still leaking milk, is this ok and normal?

Hello Wendy

Thanks for your query. I'm sure you can appreciate that it's not possible for anyone to give a medical diagnosis via email, but I hope I can give you some information which may be of use to you.

When a woman establishes breastfeeding, it 'switches on' the milk-making process, and this change may be felt by women for decades to come. Women tend to find that their milk comes in quicker with subsequent children, and they may feel the tingle of a let-down when thinking about babies even years later. Women may also find that they produce drops of milk for many months. Your GP would be best placed to confirm for you that what you are experiencing fits within the normal range. It may help for you to talk about: how much this happens and how often: many women find it's more likely when they are in the bath or shower, at certain points in their cycle, or when their emotions are high. You could talk about whether this has been ongoing since you weaned, or whether it stopped and then restarted.

You may also find this Department of Health leaflet useful. It stresses that each women is different and knowing what is normal for you is the key.

Wendy, I do hope this helps

Kirsty Nicol

Breastfeeding Counsellor

 

Hi my baby is 13 days old. i have just got past the sort nipples stage and all was going well. he has been feeding approx every 3-4 hours but in the last two days has started stopping half way through then waiting 10 minutes then getting all panicky and feeding again so its taking 1-1.5 hours to feed him. I am thinking of feeding him by expressing if it wont settle down. Please help Thanks

Hi, Nikki. Thanks for posting to NCT.

I can understand that this seems confusing and hard to understand, especially as it is a change from what was happening before. However, what you are describing sounds well within normal for a baby of this age. It was more unusual what he was doing before! Most young babies would feed rather more often than 3-4 hourly, so it's not surprising that he is sort of feeding twice at a time now, with a short gap between feeds and then a longer one - this is far closer to what most babies would do, in fact. It's still very early days, and he may change his pattern again in a few days time. 

 

1 to 1.5 hours per feed - actually, sort of two feeds, really - is normal, too, and some babies cluster feed, feeding on and off for rather longer than this, especially in the evening. Then this tendency reduces as the baby gets older.

 

Expressing and feeding by bottle can be a really time-consuming hassle  - you'd have bottles and pumps to prepare as well as having to find time to collect the milk and keep it stored hygienically.

Perhaps a call to the NCT breastfeeding line would help you decide what to do, on 0300 330 0771.

 all best wishes

 

Heather Neil 

I hope this helps a bit.  

My husband is struggling to come to terms with fatherhood and the way things are working out with our new baby ( now 10 months ) do you have any courses or counselling services for new dads , or courses for new parents? Any help would be much appreciated.

Hi, Lisa. Thanks for contacting NCT.

NCT runs a postnatal line, a telephone counselling service for all new parents, and you can call this number:  0300 330 0773

Opening times are here: http://www.nct.org.uk/info-centre/getting-help/helplines

This is a fairly new service, and the hours are somewhat limited at the moment, sorry - I do hope he will be able to call, though. 

This line will also be able to signpost your husband to other sources of support. 

 

all best wishes

 

Heather Neil 

I am currently breastfeeding but would like to start expressing milk for a bottle feed. How do I fit expressing into my baby feeding schedule and when is it best to express? Also if my baby feeds from one side should I express straight away from opposite side and then which side should the baby feed from on it's next feed?

Hi Nic,

Thank you for your mail.

The main thing about expressing is that everyone's experience is different. The more you stimulate the breast however you do it the more milk you will make. It is best to experiment, many  women find that they are fuller in the morning as the milk production hormone peaks in the middle of the night and so this often helps to get quite a lot more quickley. It helps to be relaxed and have your baby close by to help with the letdown of milk. It may indeed help to feed from one and express from the other, if you do that then you can allow the baby to finish on the breast you have just expressed from and feed from the first side again next time, it is just about keeping them balanced. As time goes on it usually gets easier and you will know how well it is working for you. There is a great leaflet available as a download on the breastfeedingnetwork.org.uk site.

Hope this helps

Best regards

Jane Saville

Breastfeeding Counsellor

vbamc. Have you heard of or had expereince of someone attempting (or even being allowed to attepmt) a vbac after multiple c-sections. I have had 4 sections and would like to know if there is anything in my favour to help me even contemplate trying for a vabc.

Dear Jo,

Thank you for contacting the NCT.

I can't comment on your individual case, but here is some general information that I hope will be helpful.

For the majority of women a repeat Caesarean, unless there is a specific medical reason for doing it, probably offers no advantages compared to VBAC, and of course carries risks of its own.

There is not a great deal of research on the outcomes for women who choose vaginal birth after multiple Caesareans, although there certainly are a number of cases of women who have done this successfully - even after four Caesareans.  Some studies suggest that the chances of success are as good as for a woman who has had only one previous Caesarean.  Others appeared to find a lower chance of success and a somewhat higher risk of problems - but overall the chance of serious harm to mother or baby remains very low.  

 You might like to look at the leaflet "Caesarean Birth and VBAC" in the "Informed Choice " series (available to order or download from http://www.infochoice.org/ic/ic.nsf/Purchasepage?OpenForm), which gives a very good summary of the research evidence around this topic.  It concludes that "If you have a history of two or more previous Caesareans you should not be discouraged from attempting VBAC".  There is also some good, research-based information on VBAC after multiple Caesareans here: http://www.homebirth.org.uk/vba2c.htm

You do not say what the reasons for your previous Caesareans were, and of course those may affect your chances of a safe and successful vaginal birth, so you might find it helpful to talk this through with a senior midwife (some hospitals now have Consultant Midwives who offer a "VBAC Clinic" for exactly this purpose) or a sympathetic Consultant Obstetrician.  They can tell you more about the risks of both options in your particular case, and should also discuss how you would like your care to be managed whichever choice you make. 

I hope this information is usefu to you, and wish you all the best in planning the birth that is right for you and your baby.

 

I have a bicornuate uterus.what are my chances for getting pregnant?

Dear Bwawani,
Thank you for contacting NCT.
It is perfectly possible for women with a bicornate uterus to become pregnant; many women do not realise they have this condition until it is discovered in pregnancy. The  UK babycentre website has general information on bicornate uterus, which has been approved by a medical panel, which you may wish to access:
http://www.babycentre.co.uk/preconception/suspectingaproblem/couldhaveaproblem/#8
 Here at NCT, we are not medical professionals. As there are many variations of the condition, you could seek advice from the professional who diagnosed this. If that is not possible, you could seek advice through your GP, on how the condition affects you personally, and your chances of pregnancy. Your GP can discuss how to take this forward, and whether this can be done straight away; for example, you might have to try for a baby for a certain period of time, before referring you to a specialist.

I hope this helps.

Kind regards
Barbara
NCT Antenatal teacher.

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