Transcript: How An Obsession With Newborn Weight Can Lead to Problems Breastfeeding

This is a text transcript from The First Time Mum’s Chat podcast. The episode is called How An Obsession With Newborn Weight Can Lead to Problems Breastfeeding and you can click on the link to view the full episode page, listen to the episode and view the show notes.

Helen Thompson: During the life of First Time Mum’s Chat, I’ve spoken with a number of birthing professionals such as midwives and lactation consultants who have shared precious insights and tips about those special early moments with your little one, when you are commencing your parenting journey and building that all important bond.

This week I’m talking with J’Nel Metherell, who is a lactation consultant located in the UK. I was drawn to speak with J’Nel after reading a post she had written on Instagram about obsessive weighing. I could tell immediately that she had hit on a troublesome area because her post had plenty of comments from young mothers who clearly identified with its contents in their birthing journeys.

The post was titled, “What’s wrong with taking the baby’s weight at birth?”, and in it, J’Nel talks about why having blinkers on and solely relying on the baby’s weight when they are born often leads to decisions being made, which cause both mums and babies unnecessary stress, setting them on a path that can lead to feeding and other difficulties. I’ve included a link to J’Nel’s post in the show notes and I’ll let you know where you can find them at the conclusion of our interview.

Hi J’Nel, and welcome to First Time Mums Chat. I’m so delighted to be talking with you about a topic that I know you are very passionate about. Your Instagram post that I mentioned in the introduction certainly struck a raw nerve with mums, and the comments and feedback you got were very insightful. So before we get started, can you please start by telling us about yourself and how you help mums?

J’Nel Metherell: Hi thank you for having me. I’m J’Nel Metherell. I am an IBCLC, which is an International Board Certified Lactation Consultant and I’m also a cranial sequel therapist. So I provide infant feeding support to new families but also throughout their feeding journey and alongside that, I offer body work, where I feel that it helps the baby feed and also for the mother.

Helen Thompson: Yeah, so it sounds very intriguing. So what are the sort of problems if you are a first time mum and you’ve just had a baby and you are in hospital, what’s the main problems that people have with birth weight?

J’Nel Metherell: So with birth weight, It’s such a huge, complex issue because when you have your baby, what most of us do is we go along with the procedure because we don’t think that there’s anything else that we can do or would want to do. So the procedure would be that as soon as baby’s born, usually within the first hour, they’re weighed and that weight becomes the benchmark moving forward.

So that’s what your baby’s birth weight is and going forward, depending on if they lose or if they gain, it will decide how the baby is treated with regards to their wellbeing. So not much else is looked at besides that. So we don’t realize that, and we also don’t oftentimes get a lot of support around feeding and all of the things that could impact weight.

So we don’t realize that the way birth happens. So if there’s an induction, if fluids were received, medications, things like that, that that can impact weight. If there are any conditions like gestational diabetes, hyperemesis gravidarum or anything like that, those things can also impact baby’s weight.

So sometimes that first initial weighing when baby is born, is a bit more inflated than it should be. So in those first few days, hours, baby can lose a lot of weight and it’s not actually related to feeding, it’s related to other factors, but that’s not taken into account. It becomes about feeding, so it becomes about the intake.

So, in the UK, on about day 3 to day 5, babies weighed again, and if they’ve lost too much weight and that varies from area to area. Usually if baby’s lost more than 10 to 12%, then they will be readmitted to hospital and treated as not getting enough milk. So then that can impact how they’re being fed, because usually that will mean that a mum has to introduce some sort of top up. So it can really like go down so many different paths and lots of things can happen here. But really that’s just based on the birth weight and so something as simple as that can have such a huge, profound effect on how things move forward.

Helen Thompson: I know some mums say that in hospital, they’re told that their baby’s underweight and they want to breastfeed, but I think I’m right in saying this, please correct me if I’m wrong, that they want to breastfeed, but the midwives are saying, no, no, no, your baby’s underweight you need to supplement it with a bottle. From what I picked up from your article on Instagram, that wasn’t happening. They were being encouraged to bottle feed and they weren’t getting the support, in order to build up the milk supply so that they get the colostrum. That’s what I picked up from your article. That the midwives weren’t giving the mums a chance to learn how to breastfeed and encourage them to breastfeed. They were just saying, oh no, no, your baby’s way underweight, you need to bottle feed and they weren’t supporting them with the latching and everything else.

J’Nel Metherell: Yeah, so a lot of the staff that are there, frontline staff, supporting mums as soon as they’ve had their baby don’t have the skill to support with feeding, and so they feel out of their depth. Also, it can take a lot of time to sit with somebody and help with positioning and attachment and to work out what might be going on, so the default a lot of times is just to offer the bottle, because then you can manage the intake, however many ounces or milliliters are going in. So then you know the baby will gain. So it’s an easier route for them to take, and they have to tick a box in order to discharge you.

So for them, it’s like, we just need to get you out of here and there are people that do have the knowledge and do want to help, but they’re very few in the grand scheme of things. So you do get a lot of mothers that are just being handed bottles and told, get the weight up and then you can be discharged. They’re told that they can’t leave the hospital, that they need to do a certain thing and obviously most mums just wanna get home, so they’ll do that.

Helen Thompson: Yeah, that sounds like they’re getting a lot of pressure put on them to do something that they might not particularly want to do, and they’re not getting that support to help them. For instance, if they go home and they want to breastfeed, they haven’t been given that support and they go home feeling really overwhelmed, not confident and thinking, I’m a really bad mom because I can’t do this and I’m being forced to do that. It’s really not rewarding for the mom and not supportive for the mom because they’re just feeling so stressed.

J’Nel Metherell: Yeah. So in my experience of supporting parents, I would say what happens in those situations is not that they question the support they’re being given, but that they question their own ability to do something, to feed their baby and to care for their baby. So, we’re very good at this not loving ourselves, not seeing our worth, not seeing our value in our abilities, and turning on ourselves and I think that’s what new mums tend to do, because we’re in a very vulnerable state and we don’t know how to care for our baby, we’ve not had a baby before, we’re doing it all wrong, we’re doing it badly and we don’t look at the fact that the person that was there to help us didn’t help us in that situation. We also don’t know what the possibilities were to get us breastfeeding. I see a lot of people get months down the line and start to reflect, and then they start to realize that actually this person didn’t tell me.

I see a lot of people that, one of the options you have is to express your breast milk and give that in a bottle, but a lot of people aren’t even told that, and it didn’t occur to them in that moment that they could express, so they were just giving formula. Something as simple as that, it takes months for us to really get our head back around to it and go, oh, I could have done that and because I didn’t do that, that didn’t just create the bottle issue, that created a supply issue and that created the overwhelm and all of these other things that then came in.

Obviously months down the line then you are a lot further along and a lot of other things have happened, a lot of times people have stopped breastfeeding by that point. So yeah, like I said, it can escalate really quickly in those early days and we rarely, rarely question the other people supporting us. We usually just turn on our own, that we weren’t able to do it and that we failed. I see a lot of people say, I failed at breastfeeding and that’s quite a harsh thing to say about yourself because obviously you’ve tried really hard.

Helen Thompson: Yeah, from what you are saying as a lactation consultant is that you give them that support and I don’t know if you’re a midwife as well, but you give them that support to say to them, look, I know you’re having problems, but let’s just see how we can help you and then your birth weight will get up once you’ve had the colostrum, their birth weight will get up. So even if it’s not, they can say, all right, we can let you go home with a midwife or a lactation consultant and then take it from there and if the birth weight doesn’t increase, well then you have to come back in. Wouldn’t that be a good solution to the problem?

J’Nel Metherell: That would be ideal, that would be perfect if that’s what would happen. So I’m not a midwife. Some lactation consultants are also midwives, but I came through it from a breastfeeding counselor role and not all midwives are actually trained in breastfeeding. Sometimes they can have about 6 hours of breastfeeding and it really depends on if they have received UNICEF training. So again, it varies from area to area and again, we don’t think to look into that because as mothers we don’t have that awareness that not everyone receives training and sometimes their training, their 6 hours of training was when they qualified, so that could be 20 years ago, which is very, very different now.

So when we’re seeking support from that person, that is there attending us at birth, they don’t always have the knowledge and experience that we think that they’re gonna have. Some hospitals do have lactation consultants, but not all do. So it’s so patchy from area to area. So I’m in private practice and I choose to work in private practice because it means I have fewer policies and guidelines that I have to adhere to. I do have a board, I have ethics and stuff like that, but it means that I can tailor my support to the family and I can look at all of the things that we can try. So you can first look at whether is it that the baby’s not feeding well or is it that the mom has low supply? So what are you looking at trying to fix, per se? Also, was the birth weight skewed, like from the point where baby then started gaining, are they gaining on a line that’s a healthy line?

In a lot of cases you can just throw out the birth weight and everything was fine. So it wasn’t even something to worry about or yeah, if there is something going on, then how can we approach that and how can we get things back on track so that feeding can work out for you the way you want it to.

Helen Thompson: So I guess as a new mum in a hospital that didn’t have a lactation consultant, just had a midwife, I’m thinking of a mum listening to this. So what are some of the questions they could ask a midwife, so they’re not pushed, forced onto the bottle.

J’Nel Metherell: So, I would say before you have your baby, so in the antenatal period you can check which hospital you are going to be birthing in, and you can check to see if they are a baby friendly hospital. So you can go on to the UNICEF website and you can check your hospital and see what their baby friendly accreditation is, and that will tell you whether they’ve had up to date training.

If a maternity ward is baby friendly, then they will have regular updates on their training. Actually I should say, one of the other things I always suggest is if you are writing a birth plan, writing breastfeeding into the birth plan, because a lot of people don’t realize that they can do that, they just focus very much on the birth. You can write in, I want to breastfeed my baby, I do not want to offer supplements. I want all of this stuff to be encouraged and write that in. You can express colostrum beforehand and have that prepared so that if there are any issues, then you have a little bit of colostrum to give once baby’s there if you need to.

So if you are being supported by somebody and you have wishes and you don’t feel that they’re listening to you, it’s okay to not do what you are being told. A lot of times the language being used can be very commanding and things can be stated instead of offered. So, it then makes you feel like you have no choice, but you do have choices. This is your baby, so you can choose how you want to approach things. So like I said, if the hospital is saying well you need to be able to show us cuz it’s one of the things they say, we need to see baby feed before we will discharge you. We want to see at least one good breastfeed before we will discharge you.

In the UK you can self discharge despite that. You can say I am seeking private care even when you’re in the hospital and speak to somebody and get feeding going that way. Or you can if you want to, cuz this is the other thing is a lot of people feel so overwhelmed, they just want to do what they’re being told to do so they can get out of there. It’s okay to do that and if you do that, it’s not a case that you cannot breastfeed again, and this is what really breaks my heart sometimes, is people feel like, well, I’ve already given a bottle, I have to give up now. Like it’s all or nothing and in those cases where people do that, I feel like if you do that, even if you have like a day, two days a week where everything just kind of goes out the window and you have no idea what’s going on, you can still get it back with the right support. So phone somebody as soon as you can really, phone somebody who you feel comfortable with and like any health professional, you want to make sure that you like that person, that you vibe with them and yeah, and see if they can support you to reach your goals.

Helen Thompson: Yeah, I’ve heard so many moms getting so stressed, as I said, and overwhelmed with it all, that they just do what they’ve gotta do to get out of there. From what you are saying, if it’s in the birth plan, then hopefully the midwife would read the birth plan and understand where the mother’s coming from.

J’Nel Metherell: Yeah, if you have somebody, like, if you have a birth partner or somebody else supporting you, then making them aware as well. A lot of times as mothers, we’re in a very vulnerable place in those early days and weeks, so having somebody who can voice what you want, your wishes can help because they usually have the energy, they usually have the head space and they can say to people have you read the birth plan? I know whenever I had my second, I had a doula then, but also my husband, when the midwife came in, said, we want you to read the birth plan because a lot of times, especially if things are hectic, they don’t, so having somebody who can really step up and take that for you and not make you responsible for it, then that’s really helpful as well.

Helen Thompson: That could be the husband or the doula, whoever, to make sure that that’s done. So definitely.

J’Nel Metherell: So for me, the big aspect is how it impacts the wellbeing of the mother, and then it has the knock on effect with their relationship and with the baby. So I say that what I see a lot of times happening is that the actual baby gets lost in it. The baby then becomes just a conglomeration of all of these quantifiable factors.

So people are coming in and weighing constantly and you become very fixated on volumes and getting volumes into babies so that the number on the scale is, whatever it is that they were saying it needs to be and every time baby cries, is that because of the weight? So then more milk is going in and we’re not really enjoying the early day experience. We’re not connecting with our baby, and it has a huge impact on the emotional and mental wellbeing and then a lot of times when we get further along, months down the line, we reflect and we think we didn’t enjoy that time, we didn’t connect with our baby. We resent a lot of what happened. There’s a lot of grief that doesn’t get processed, so I offer a lot of support around that side of it because I feel like a lot of times that’s the thing really that starts to impact the feeding journey. It’s the wellbeing, it’s the way we feel about things that really gets in the way because then we kind of get this like, oh, I don’t care, I can’t do it, I’m a bad mother and it doesn’t then just impact those early months, it impacts going forward for those first few years. Everything is I’m not a good enough mother. So that is one of the things that I always like to talk about.

If you are feeling that, it’s okay to seek support around that and it’s okay to not be happy about your feeding journey, and it’s okay to not feel loads of joy around the whole experience because it’s very common. It doesn’t mean that you are a bad person, it just means that to this point, no one has held you in your grief and you need to find those people or that person and that space to be able to really unfold with that.

Helen Thompson: Yeah, I think that’s a good point that you mentioned because I come from a baby massage side as well as childcare, and I very much aware of how baby massage can not only help the mum but it also helps the baby with that bonding and if they are having postnatal depression or whatever it is and the baby’s very fussy and being taken away from the mom because they’ve gotta be weighed and everything else, the skin to skin is the key. The skin to skin is just so important. Whether that’s breastfeeding or not, or just having the baby on your chest, it’s all skin to skin and it’s bonding time. If they’re being pulled away to be weighed constantly, the baby’s gonna get fussy, the baby’s gonna be upset, and so is the mom gonna be upset.

It’s just giving the parent and the baby that time at the beginning is what you’re saying, just to relax with the baby and feel the bond between you both and enjoy, even if it’s just for 15, 20 minutes.

J’Nel Metherell: Yeah, exactly. I think you can say again, in your birth plan, you can say, I want to have an hour or two hours without interruption. However long you wanna say and again, you might come up against some people wanting to take your baby, but you can just say, no, I’ve written it down and if you have someone else there who can advocate for you, then that also helps because it’s a lovely way to co-regulate. We talk a lot about nervous systems these days, and when you do skin to skin that’s co-regulating between you and your baby, and you’re both calming and connecting, it’s nice.

Helen Thompson: I can imagine. Yeah, I think this conversation is such a powerful one for moms, and I think it’s important that they can actually have somebody to talk to. So if somebody wanted to to get in touch with you or find out more about what you do, how do they go about doing that?

J’Nel Metherell: Yeah, so my website is BreastfeedingHelp.co.uk and all my services are listed on there. So like I said, I do offer breastfeeding stuff alongside cranial sacral stuff, but I also offer a healing breastfeeding grief and trauma course, which is very much, we look at this sort of thing and how it plays out and like I said, the emotions around it and I offer video appointments, so you know, anywhere in the world if anyone wants to just have a chat, go through things, have an antenatal appointment, and prepare, I’m available for that, definitely.

Helen Thompson: I could sit and talk to you forever about this topic because I think it’s a topic that’s definitely not encouraged at the moment. I don’t know very much about it in the UK, but I know in some of the classes that I’ve been teaching in baby massage, that a lot of the moms, I hear them chatting, after I finish a class and a lot of it is what you’ve just said, that they don’t feel that they’ve been supported. So thank you for sharing all your wonderful information. It’s great to be able to talk to people like you who’ve got that knowledge and who can support moms in that way. So thank you for being here. It’s been a great pleasure talking to you.

J’Nel Metherell: I really liked it. I could go on forever about it. I get quite passionate too.

Helen Thompson: Wow, J’Nel offered some great advice for mums who will be facing the whole birth process and likely to be dealing with the usual hospital maternity environment. I think it is very wise, as J’Nel suggested, to not be afraid to be assertive at times or find someone who can help you by acting in this capacity. You need to do your utmost to ensure that you get off to a good start in your parenting journey.

So don’t let professionals walk over you. And don’t forget that a lot of frontline staff supporting you when you have your baby, are out of their depths when it comes to feeding, which they don’t have the skills to support you with. I’ve included links to J’Nel’s breastfeeding help website, her social media and “What’s wrong with taking the baby’s weight at birth?”, Instagram post in the show notes, which can be found at MyBabyMassage.net/podcast/123, that’s MyBabyMassage.net/podcast/123.

Next week I’m going to be sharing hints for newborn bath time, so be sure to listen to this episode when it comes out, and please subscribe to First Time Mum’s Chat via your favorite platform so that you get quick and easy access to all our episodes when they are live.