WBW2017: Q&A with Pinky McKay, IBCLC and Infant Sleep Expert

We first ‘met’ Pinky back in May, when we suddenly started getting dozens of new followers from Australia… a little detective work lead us to her page, where she had kindly shared one of our posts. Since then, she has kindly shared more of our posts and we admire the support and advice she gives to other mamas about breastfeeding and gentle sleep techniques. We were over the moon when she agreed to take part in a Q&A with us for World Breastfeeding Week 2017.    

Hi Pinky! We’re delighted to be able to chat with you for World Breastfeeding Week – we have lots of followers in Australia so it’s great to be able to share a post by a fellow antipodean!

You’re an IBCLC – tell us more about how you arrived at that vocation? What prompted you to train?

When I had my first baby, even though I was a nurse, I had no idea about breastfeeding, other than the health benefits (it was the seventies, breastfeeding rates were very low and there wasn’t all the research there is now abut how breastfeeding actually ‘works’ ). The women I cared for who did breastfeed were back in shape – uterus involution, less bleeding, comfortable boobs – so much faster than mums who weren’t.
At my antenatal class on infant feeding (taught by a nun!) this clever woman stood in front of a table laden with bottles, kettles, powder, scoops and measuring cups. She told us: “If you want to bottle feed you will have to learn all about this. I don’t have time to teach you tonight, you will have to learn in hospital.” Then she lectured us on breastfeeding. I didn’t remember anything about how to breastfeed, I just came away overwhelmed and shit scared of mixing formula, determined to breastfeed.  No matter how sore my nipples were (I suspect I had thrush but we didn’t know about that then – they gave my a mixture of betadine and castor oil to apply) all I could imagine was that visual of Sister Mary Constance’s table of paraphernalia. I was totally overwhelmed and petrified at that vision and the possibility I could make my baby sick by mixing it up wrongly.
So, despite my baby ending up in special care, cracked nipples (from a scungy hand pump) and expressing barely a teaspoon of milk at a time, I was determined to breastfeed.  At almost a year old, we moved to New Zealand (I’m a kiwi married to an Aussie) . My mother was certain that having a kid hanging off my tits would make my husband stray so I should wean! I called BS on that but had no clue about how to wean so went along to La Leche League – and learned that I could let my baby choose when to wean. Whew, what a relief! I became a group leader when I had my second baby then, after our third baby, we moved back to Melbourne. Between babies I did some nursing, trained as an advertising copywriter and then became debilitated with an autoimmune disorder so began writing for newspapers and magazines (before the internet).  I was contacted by a publisher to write a book and started public speaking. I was at a Health Professionals’ Conference when a doctor suggested I train as a lactation consultant. The thought niggled that this would be great for my knowledge base so checked out requirements and realised that, because of nursing hours racked up in a maternity ward and La Leche League, I had enough hours banked. I just needed to do the academic study and that BIG exam.  Of course, once I had passed I ‘had’ to practise and help mums who were struggling.

Our breastfeeding rates in the UK are among the lowest in the world… talk to us about BF rates in Australia.

We have a great initiation rate but things tend to slide. The National Health and Medical Research Council recommends ‘exclusive breastfeeding for around 6 months and then for breastfeeding to continue alongside complementary food until 12 months of age and beyond, for as long as the mother and child desire’.

Statistics from the 2010 Australian National Infant Feeding Survey indicate that 96% of mothers initiate breastfeeding. Thereafter, exclusive breastfeeding rates drop off. Less than half (39%) of babies are still being exclusively breastfed to 3 months (less than 4 months) and less than one quarter (15%) to 5 months (less than 6 months).

And what is the general attitude to breastfeeding there? Do you hear stories commonly about women being made to feel awkward for breastfeeding in public?

There is a pretty good acceptance of breastfeeding in public here. It’s actually against the law to discriminate against a woman who is breastfeeding in public, however it does happen both subtly with random comments (often from family members) and overtly eg: a café owner or swimming pool attendant telling women to ‘cover up or leave’. But you can bet that if this happens, there will be a ‘nurse-in’ at that venue within a few days and subsequent media coverage. It’s always an ongoing debate. I did a media photo shoot a few days ago for World Breastfeeding Week – my company, Boobie Bikkies, is sponsoring an event with 100 breastfeeding mums and babes at a movie morning, for which we have hired a cinema. I was told by a photographer from the major newspaper that, they “won’t print breastfeeding photos so won’t be taking any.” We have gained the media exposure for an instagram competition we run with a hashtag #whereareyoufeedingtoday.  The point being that its difficult enough for new mums to feel comfortable breastfeeding in public, wrangling a baby and clothing, without fears that somebody will shame them for simply feeding a baby. And every time there is a mother-shaming event reported on social media or in the media, that’s another layer of self-doubt for a mum who is planning to leave her house.

And are health professionals in Australia generally well trained and supportive about feeding? Or do you face the same issue as we do, with outdated information being churned out to mothers, alongside advice to ‘top up’ or switch to formula rather than offering breastfeeding support or looking at the situation holistically?

Health professionals vary in their competence around breastfeeding. Many are excellent; quite a lot of our child health nurses are also IBCLCs . But yes, there is outdated or rigid advice that isn’t helpful, or issues that aren’t picked up eg. tongue ties. Rigid baby sleep advice such as ‘don’t feed your baby to sleep’, use a ‘feed, play, sleep’ routine, ‘space out feeds’ are common and impact on breastfeeding.

What are the most common concerns you hear from new mothers?

Babies who aren’t latching, unsettled babies, mums worrying about milk supply, and baby sleep are the big issues.  There is a lot of fear about ‘creating bad habits’ even with very small babies.

You’re also an infant sleep specialist. How do breastfeeding and infant sleep go hand in hand? And what about that old myth that formula makes babies sleep better?

AAAARRGGHH! That old myth drives me bonkers! We have a couple of very high profile health professionals and baby care authors/sleep ‘experts’ who push this BS and so, of course, desperate parents start offering bedtime bottles – I have written a blog post about this.

Research shows that a bedtime bottle won’t gain mums more sleep – in fact breastfeeding at night will gain mums an average of an extra 45 minutes sleep! Bedtime bottles can impact milk supply; expose baby to potential allergens (which means baby will be more wakeful), cause constipation and one really important factor s the composition of night milk: evening breast milk is rich in tryptophan, a sleep inducing amino acid that is a precursor to serotonin. Seratonin is a vital hormone for brain function and development that makes the brain work better, keeps one in a good mood and helps with sleep cycles. We now know that ingestion of tryptophan in infancy leads to more serotonin development, creating the potential for lifelong wellbeing. Nighttime breast milk also has amino acids that promote serotonin synthesis, so evening and night time breastfeeds could be more important to your baby’s development than simply promoting sound sleep.

What frustrates you most about attitudes to infant sleep?

The fear that if parents have a wakeful baby (however that is defined by whatever ‘expert ‘ they listen to), they are either doing something wrong or neglecting to ‘teach’ their baby an important skill and they will create lifelong problems.  The most undermining thing is the lack of support for parents – if they won’t implement ‘sleep training’ they are left isolated because ‘it’s their own fault’ that they don’t ‘fix’ their baby.  So they suffer in silence and the conspiracy around what is normal and developmental is perpetuated. Babies wake up. Babies need love and care, day and night. If you have a very wakeful baby and you aren’t coping it’s always helpful to try and work out what is waking your baby (e.g.: feeding issues, food sensitivities, developmental leaps, teething, separation anxiety etc) and address the underlying causes. Support is essential  so exhausted mums can take a break and have some rest too, so being able to speak out and vent without fear of criticism is vital.

You’re passionate about maternal mental health. What do you think is the biggest threat to emotional wellbeing?

Lack of support and the pressure to do too much. The media and social media add to this pressure. (Editor’s note: We highly recommend watching Pinky’s TED talk ‘Surrender is not a dirty word’.

What advice would you give to new dads about supporting their partner and baby through those early days? How can they help mum establish breastfeeding?

They can help in so many ways. I blogged about this a few years ago.

Finally, what is your number one tip for any of our readers who are expecting their first baby?

Trust yourself. Trust your baby. Trust the connection between you and your child. You will get all sorts of advice from friends, family and random strangers. When you feel confused, you can check in and ask: Is it safe? Is it respectful? Does it feel right?’  And please be as gentle to yourself and your beloved as you are to your baby. You have got this – you are the expert about YOUR baby.

Thank you so much to Pinky for joining us for WBW2017. You can find her website (including her brilliant blog) here. A fantastic resource whether you live in Australia or not.
Her Facebook page is also fantastic if you want to see encouraging, supportive messages about breastfeeding, sleep and parenting pop up on your feed ❤  

You can download the first chapter of Sleeping Like a Baby here, for free.

Finally, if you’re struggling with a newborn and wondering, do I have enough milk? Why does it hurt? Is this normal? Will feeding always take this long? Or pregnant and wanting to learn about feeding naturally before you have a crying baby in your arms and doubt in your heart… Register now for this free webinar recording, here

Tales from the Mother Side xx

You can follow us on Facebook here.

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