Sunday, 28 August 2011

Friday, 26 August 2011

Dummies and Social Class

Mother and Baby magazine calls them “the most loathsome invention in the history of parenting” (Askamum 2011). Gill (2002) described them as “an unnecessary, unwanted intrusion in the mouths of babies and toddlers”. Dummies, pacifiers, soothers, call them what you will, almost everyone has an opinion on them. How are parents who give dummies to their children perceived by Joe Public? Is dummy-use widely associated with a certain class of people?

Sixty eight percent of parents give dummies to their babies before 6 weeks of age (AAP 2011). The use of dummies originates as far back as the 15th century when they were known under the label of “sympathetic magic”. Comforters consisting of small linen bags filled with bread, milk and sugar were used to nourish and calm children in the late 19th century. By 1909 dummy-use was already starting to be associated with the “poorer classes” and with poor hygiene (New York Times 1909). This view persists into the present day where dummy-use is associated with working-class mothering (North Stone et al 2000) which, in itself, is associated with perceptions of inadequate parenting
(Gillies. V 2005a; Gillies. V 2005b; Skeggs, 1997). A study published on Mumsnet this year looked at the use of dummies and society’s view of them.


A questionnaire was carried out for one day in each of the following UK town/city centres; Leamington Spa, Nuneaton, Coventry and Sutton Coldfield (All midlands based).

On average, about 100 individuals of all ages and sexes from each location were surveyed. When the results from all locations were collated theses were the main findings:

67% of people surveyed thought children with dummies in public looked common.

70% of this 67% were themselves not parents.

87% thought children allowed to have dummies beyond the age of three or four years old in public not only looked awful, but also suggested poor parenting.

95% thought dummies used with babies was perfectly fine, but not with toddlers.

59% thought dummies are used more for the parent’s convenience rather than the child’s.

Of the 59% above with this opinion, 76% claimed they felt dummy use was more commonly seen with single mums, with a few kids in tow where dummies are dished out for a quiet life.

47% said they associated dummy use more with lower class than middle and upper class parents.

92% with this opinion above were not themselves parents.

The researchers were particularly interested in why so many people thought dummies were vile and common, and why they associated them with less financially well off families. They attempted to find out if there was any real grounds to support this class divide concerning dummy use. The researchers spent a day at three different locations to monitor the frequency of observations for children with dummies. At each location they tried to record the total amount of children with and without dummies. Additional to this, the researchers trawled round each location collecting dummies off the floor (the ones you see lying around that get lost by children).

The results of this crude monitoring supported the opinion about dummy use being more prevalent in lower class society when compared to upper class. This time the general findings were:

It was observed that there was definitely more children with dummies at the designated lower class location compared to middle and upper class locations.

It was also observed at the lower class location that the ratio of children to parent/caregiver was higher than the other locations.

Children up to the age of 4 or 5 (estimation) were commonly seen with dummies at the designated lower class site, but virtually absent from the other locations used.

The total number of lost dummies found at the end of the day at each location was; lower-class 27, middle-class 9 and upper-class 2.

These findings correlate with larger scale studies which have shown that “mothers were more likely to give their child a pacifier if they were younger, had lower levels of education, experienced greater financial difficulties or lived in council housing” (North Stone. K et al 2000; See also Gale and Martyn 1996; North et al 1999; Illingworth. R 1991). One medical practitioner (Hawkins. MF 1961) has maintained that mothers who give their offspring dummies are “invariably unintelligent”. Academics have also linked the use of dummies with single mothering (McNally 1997).

It is clear from the research that dummy-use is seen as a symbol of inadequate working-class mothering. However why are working class mothers more likely to give dummies to their children? I hypothesise:

Because of poor education

It would appear that the general public view dummy-use by babies as acceptable but use by non-babies as undesirable. This view may be fuelled by health concerns. Dummy-use until a baby is one year old has been linked to a decrease in the risk of cot death (Fleming. P.J. 1999). Whereas dummies used into toddlerhood and beyond have been linked to speech delay and tooth misalignment (Hebling. S et al 2008). Working class parents are less likely to be aware of such information (Brown. K and Bottrill. I, 1999). Their lifestyle is generally associated with a lack of education. The situation is exacerbated by the poor training of frontline health care professionals. One study showed that only 20% of mothers receive information from health visitors about the disadvantages of dummies (Witmarch. J. 2008), which means that the majority of mothers are required to use their own research skills to facilitate their choice. The lower down the social class hierarchy a parent is, the less access they have to research facilities.

Because working class mothers are less likely to breastfeed

In addition to the risk of latex allergy, tooth decay, oral ulcers, ear infections, colic and sleep disorders (Cinar. DN. 2004; Dr Greene 2011; North Stone. K et al 2000) dummy-use can also sabotage breastfeeding (The Alpha Parent 2011). Thus, the relationship between dummy-use and working class mothers may be explained in part by the fact that working class mothers are less likely to breastfeed (The Independent 2001; Marie Claire 2011).

Because dummies infantilize children

‘Good mothering’ is often associated with helping ones child to progress and develop. It follows that infantilizing a non-infant suggests bad mothering. Giving dummies to toddlers and older children can be viewed as a form of infantilization.

Because they are cheap

You can purchase not one but two dummies for the economic price of one pound sterling from a range of reputable outlets including Poundland, Home Bargains, Aldi and Lidl. Or you could obtain a five fingered discount if you're that way inclined.

Because they are bling

We all know the chav-obsession with pimping up any object that is to be seen in public. Dummies are no exception. Beads, gems, faux-diamonds are all added. If a rear spoiler could be added it would. But we know better don’t we? (Safety first!)

Because they are convenient

Dummy use, formula feeding, disposable nappies, sleep training and spoon weaning. What do all of these parenting choices have in common? Answer: assumed convenience. They are commonly viewed (often incorrectly) as the ‘easy solution’. Parents who take easy solutions are seen as less- conscientious and to some extent, lazy. One Mumsnet member commented that “dummies are used by parents who just aren't prepared to put the extra effort in with their child” (Mumsnet 2009). The perception that dummy-using parents are lazy is correlated by academics (Haughton 1997). General discourse surrounding good mothering identifies maternal need as congruent with that of the child. As Witmarch. J (2008) observed, "good mothers are constructed without any needs of their own".

Because they are a mothering substitute

It could be argued that when distressed, babies should be comforted in the arms of their parents, rather than their distress plugged with a silicone nipple. Research has shown that babies given dummies are less likely to receive mental stimulation, encouragement to explore and learn, and parental attention (Alic. M 2011).

Because they are unhygienic

Several studies have revealed that pacifiers are often colonized with Candida and bacterial organisms (Ollila P et al. 1997; Sio JO et al 1987; Mattos-Graner RO et al 2001). Much professional literature (see for example, McNally 1997; North Stone et al 2000) link dummies with the spread of infection and poor hygiene. Until your baby is weaned onto solids, dummies should be sterilised in the same way as you sterilise bottles. After this, thorough cleaning is enough to ensure the dummy is safe to use. And no, sucking the dummy yourself then passing it to your baby doesn’t count, no matter what your MIL may advise.

But wait: The advantages of dummy-use

If you’re reading this and you give your child a dummy, do not despair. You can justify your usage with these timely pro-dummy facts.

  • Giving a baby a dummy when they go to sleep may reduce their risk of cot death by 90% (BBC News 2005). Some researchers say this is because they prevent babies from cutting off their air supply by keeping their airways open. Others suggest that sucking on a dummy may enhance the development of pathways in the brain that control how airways in the upper respiratory system work.
  • Dummies can help premature, tube fed babies to establish feeding and thus leave hospital earlier (Baby Centre 2011).
  • Dummy-use reduces the likelihood that a baby will become a ‘thumb sucker’ and it is far easier to wean a baby off a dummy than it is their thumb. Studies have maintained that dummy-use is preferable to thumb-sucking (Adair 2003). Aside from being a harder habit to break, thumb sucking can do more damage to the dental structures of a baby's mouth.
  • Dummies can help babies with reflux. They “stimulate the flow of saliva and downward contractions of the esophagus; these actions help to more quickly move the highly irritating stomach fluid back where it belongs” (Morelli. J 2000).
  • Dummies may reduce the risk of overfeeding for bottle fed babies as they satisfy a baby’s need for non-nutritive sucking.
  • Dummies are transitional objects that help children adjust to new situations and relieves stress.
  • Dummies can soothe babies to sleep and help them to stay asleep when disturbed.
  • Dummies can provide relief for teething and other physical discomforts. The act of sucking releases hormones which function as pain relief (Sexton. S and Natale. R 2009; Zempsky WT, Cravero JP, 2004).
  • Dummies may aid your baby's immune system. Recent research suggests that the time-honored practice of parents sucking dummies to 'clean' them before passing them to their babies could ward off allergies (Stein 2013).


So with advantages and disadvantages to dummy-use, what should parents do? Chris Evans (BBC Radio 2) summed up the dilemma as follows:

"You stick a dummy in, the kid calms down and doesn't get half a feed on mummy's tired booby. Instead he works his chompers off getting proper hungry for the next time and tires himself out enough for a proper sleep in the process.

But then again, he becomes reliant on it, may communicate less and as a result and could become addicted to cigars later on in life.

If one chooses not to dummy then casual grazing continues with no real patterns and routines being shaped, the baby's always tired, mummy's always tired and he may take to sucking his thumb anyway.

What do we do people?"

Ultimately whether or not dummies are right for your child depends on your particular circumstances. My advice is to consider whether your baby is premature or full term, whether you breastfeed, whether you wish to use dummies only at times of physical pain such as vaccinations, whether your baby is satisfied sucking at mealtimes or whether they need non-nutritive sucking in between meals, and whether your baby has trouble settling any other way. The most important consideration according to medical research is your baby’s age. “Pacifier-use may be especially beneficial in the first six months of life. However, the risks begin to outweigh the benefits around six to 10 months of age and appear to increase after two years of age” (Sexton. S and Natale. R 2009).

Click here to view full citation details for this article.

Wednesday, 24 August 2011

Baby-Brain Exists!

Motherhood doesn't change just your life. It also changes your brain. Becoming a mother causes permanent changes in a woman's brain structure.

Latest neuroscience research suggests having babies permanently alters brain function. Reproductive hormones ready a woman’s brain for the demands of motherhood—helping her becomes less rattled by stress and more attuned to her baby’s needs. If you're a rat, it makes you better at finding and killing dinner quickly. If you're a human, it helps you distinguish between your baby's cry and that of other children. In either case, it's something fathers just don't get. Only mothers undergo these changes.

Source: Chapman University

Source: Azcentral

Between the first and second brain scan, women showed an increase in the grey matter volume in several areas of the brain, including the superior, middle and inferior prefrontal cortex, precentral and postcentral gyrus, superior and inferior parietal lobe, insula and thalamus. No areas of the brain showed a reduction in grey matter volume.

The researchers conclude that “the first months of motherhood in humans are accompanied by structural changes in brain regions implicated in maternal motivation and behaviours”.

Source: NHS

Motherhood improves a woman’s perception, efficiency, resiliency, motivation, and emotional intelligence (slap THAT on your CV!)  Each category is supported by many animal studies as well as some human studies showing ways in which mothers have an edge. What’s more, although it’s hard to measure whether the mind-boosting benefits of motherhood are temporary or permanent in humans; rat studies show that the benefits of mothering last until the animals reach an age equivalent to age 80 in humans.

Source: Baby Center

There is also research which shows that fathers-to-be experience hormonal changes too - elevated levels of prolactin and cortisol, and a reduced level of testosterone, which drops by a third on average in the first three weeks after the man's child is born. These are thought to be caused by exposure to the pregnant woman's hormones as there is evidence to suggest that men who spend time with mums can also experience the changes. I haven't yet found research which shows permanent changes to a father's brain structure in this way, although there are preliminary animal studies which show it happens if a father animal is present with his newborn young.

Source: Slate

Source: Scientific American

I find that fascinating - 'babybrain' exists, but not in the detrimental form we flippantly talk about. It could explain biologically why mums bore other people to death talking about their offspring, and why some dads, particularly those less hands-on, or other non-parents don't seem to understand the inherant amount of focus that mum has on her children.

Special thanks to jennyskydance for her contribution to this research.

Thursday, 18 August 2011

Top 10 Breastfeeding TV Ads

As nursing your baby does not generate money for corporations, it’s up to each country’s Government to advertise the benefits of breastfeeding. This is why for every breastfeeding TV advertisement there are thirty formula ones. Formula companies have a plentiful supply of cash to drill into their marketing.

Nonetheless, there have been some corker breastfeeding advertisements created around the globe. Here’s my top 10 countdown.

10. Breast milk (Taiwan):

9. Weight loss (USA):

8. Log rolling (USA):

7. Music notes (Canada):

6. When you need a feed (New Zealand):

5. For your baby’s health and yours (Asia):

4. Man eating in toilet (Australia):

3. Baby eating in toilet (Canada):

2. Generations (USA):

1. And my personal favourite - Other people may not notice (Scotland):

Some honourable mentions:

The Breastmilk Baby (doll)
Whip ‘em Out
Ladies Night
Get Ahead in Life
To Give Breast is to Give Life
Mom Can Feed Me Anywhere

Wednesday, 17 August 2011

Health Visitors - Help or Hindrance?

"Health visitors give advice, they don't judge, they help out." – David Cameron.

“A health visitor is someone who would have liked to be a paediatrician, but for whatever reason, decided that she likes being out and about in the community, offering pearls of wisdom to as many poor, unsuspecting mothers as possible.” – Mumsnet Mum.

Before I begin this article I would like to offer a disclaimer. There are many knowledgeable, non-judgemental health visitors operating contemporary, however the growing trend is sadly that health visiting is attracting more complaints from mothers than ever before (Poulton. B). This article unearths the emerging reality behind the profession. I will tackle the following questions: How do you become a health visitor? How much do health visitors earn? Why does advice differ so dramatically between health visitors? And perhaps most importantly, what are my rights and how do I complain when a health visitor oversteps the mark?

Job Description

A health visitor is a qualified nurse or midwife who has undertaken further training in child health, health promotion, public health and education. They work as part of a primary health care team assessing the health needs of individuals, families and the wider community. In theory, health visitors aim to promote health and prevent illness by offering practical help and advice. The service is distinctive from other health services in that it is supply rather than demand-driven so health visitors will contact clients whether requested or not (Heritage. J). The origins of the health visiting service lay in the sanitation movement of the nineteenth and early twentieth centuries. Strongly interventionist and targeted at working class homes, inspections of sanitation were carried out to “direct the attention of those they visit to the evils of bad smells, want of fresh air and impurities of all kinds” (The rule book of the Manchester and Salford Sanitary Association c1880).

Contemporary UK law does not recognise health visiting as a profession. Its status as a profession was removed from law ten years ago. The occupation has no legal standing and its title has no official meaning. This, argues Nursery World, “puts the public at risk” (Nursery World 2010). The legal change has made it easier for primary care trusts to cut back on health visitors and employ less qualified staff. In theory, anyone can describe themselves as a health visitor. This is legally acceptable.


In order to become a health visitor, a person should first be a qualified and registered nurse or midwife. To train as a nurse, a person will need to complete a degree or diploma. Five GCSEs (or equivalent) are required for entry onto a diploma course, and two A-levels/Highers (or equivalent) are required for degree programmes. A degree in certain subjects may allow a person to take a shortened training course.

Then the candidate should take a one year health visiting course at degree level. Courses may be completed in a shorter period where credit is given for prior experience. The requirements for entry to the course are very flexible and there is no minimum experience requirement; thus, someone who has not long worked as a nurse/midwife can become a health visitor.


Health visitors are paid on Band 6 of the NHS pay scale – i.e. newly qualified entrants normally start at £24,831, rising to £33,436 with seniority. Team managers and health visitor specialists can earn up to £39,273 per year on Band 7 of the NHS pay scale.

The sinister side of health visiting

Health visiting is an oxymoronic dichotomy. That’s just my fancy way of saying that the values of health visiting are in conflict with each other. On one hand, health visitors are required to give support to new mothers. This is the common reputation enjoyed by health visitors. Yet on the other hand they are required to place the same mothers under automatic suspicion of child abuse, erring on the side of caution at all times. Yes – child abuse. This is serious business. Commonly thought to be the exclusive domain of social services and the NSPCC, a central role of health visitors is to sniff out potential child abusers. Your friendly neighbourhood health visitor likes to do a James Bond and collect covert information on unsuspecting parents.

One example is the assessment for postnatal depression (PND). A diagnosis of PND used to be rare however now health visitors are required to screen all mothers for it using the (non-validated) screening tool: the Edinburgh postnatal depression scale (Cox et al). Developed in 1987, this rigid instrument emphasises the significance of professional lead, instead of client participation (Mitcheson. J). It consists of 10 statements, such as "I have felt sad and miserable" or "I have felt scared and panicky". Common feelings for new mums adjusting to the hormonal, emotional and practical changes a new baby can bring, are often pathologised. This means that more new mums than ever before are having the PND label stamped in their records. Rather than this leading to greater support, it has “more to do with problematising parents and their relationships with children” (The Guardian). The consensus amongst health visitors is that a depressed parent can pose a risk to a child. An overwhelming number of mothers are aware of the association between a diagnosis of depression and assumptions of parenting incompetence. “Always put mascara on before the health visitor is due to visit. That way, she’ll think you’re coping and leave you alone” one journalist mother advised (The Wiltshire Gazette and Herald).

Also don’t go thinking that because you’re mentally sane you can limbo under the radar. Even if there is no depression or other ‘problems’ health visitors screen all new parents for any likely risk of child abuse. In some areas, they even visit mothers before the birth to do so. Intentionally vague and probing questions are rattled off, such as "How loving do you feel towards your baby/child?" and "How confident do you feel being a parent?" Such questions are designed to catch mothers off guard and although some health visitors attempt to distance themselves from the procedure by attributing it to a higher authority, the questioning creates an unnecessary climate of judgement (The Guardian).

“The screening looks at risk factors such as the mother's age, marital status, education and whether the baby was premature or in special care. Many of these 'risk factors' are related to poverty, so just being poor makes labelling more likely” (Robinson. J). Mothers with physical problems are additionally picked up by the radar, so having a disability also makes labelling more likely. “Alternative lifestyles or 'non-compliance' of any kind may be regarded with suspicion - including breastfeeding toddlers, use of alternative practitioners and rejection of immunisation” (Robinson. J). These crunchy mothers undermine and challenge a health visitor’s authority, as that authority is derived from their mainstream textbook training.

Furthermore, health visitors purposely obscure their agenda from those they visit (Cowley S et al. Structuring health needs assessments: the medicalisation of health visiting). Vague smokescreen justifications are given for visits, such as “we want to get to know you before the baby arrives” and “we only want to know the depth of your problems so we can help”. The purpose of the interview is disguised. As well as the Edinburgh scale and interviews health visitors utilise cold calling (dropping in unannounced) and even more subtle techniques such as asking to use the bathroom so that they can snoop around. (Crap. I knew I should have removed the cat hairs from the sink).

Risk-assessment measures are increasingly used to pass judgments, and exploited retrospectively to justify past decisions and actions (Goddard C et al. Structured risk assessment procedures: Instruments of abuse? Child Abuse Rev; Openmarket). This increasing involvement in child protection threatens the ethical basis of health visiting (Taylor. S and Tilley. N). Is it ethical for health visitors to seek out and identify risks that they cannot effectively treat? “We cannot ask our Health and Social Services to act as a kind of anti-abuse intelligence service, smelling out the bad parents long before they have committed any crime” (Barker W. Practical and ethical doubts about screening for child abuse). The paradox is that when a mother is threatened with Social Services for “refusing” help, they are then seen as a risk when they “accept” help.

What is more, the Government’s campaign for disallowing aggression towards NHS staff has encouraged staff to label clients as "aggressive" when they have felt threatened, despite what constitutes aggression and threat being highly subjective. You don’t have to issue a bitch slap for your behaviour to be interpreted as aggressive. Vehemently disagreeing with your health visitor could also constitute aggression. A mother who receives a label of “aggressive” is seen as posing a risk of future child abuse. Health visitors’ tendency towards oversensitivity in this way is partly explained by their training background. If they trained as a nurse their approach can be excessively dogmatic.

Once a mum is labelled as suspicious by a health visitor, her label is transferred, via her records, to all the other Primary Care Trust staff that she may come into contact with during the entire course of her mothering experience. Like garlic breath, the label will follow her everywhere and infect her interactions with: midwives, GPs, paediatricians, nursery nurses, Sure Start centre staff, other health visitors and baby clinic staff.

In my opinion new parents should be seen as potentially vulnerable, rather than potentially abusive, and the aim of visits should be to strengthen the parent-child relationship. Yet instead mothers' are disappointed that health visitors are largely there for the baby, not for them.

This climate of surveillance rather than support often makes mothers reluctant to request advice for fear that adverse judgements may be made about their knowledge or competence as a parent. These fears are justified by studies which have shown that health visitors show little effort in acknowledging mothers’ competencies and capacity for personal decision-making (Heritage. J). In situations where mothers assert their knowledge or competence, their assertions receive no acknowledgement or quasi-acknowledgement and, in a number of cases, are positively resisted (Kendall. S). Woe betide you mention opening a book or a laptop every once in a while.

Unsolicited advice

Perhaps the most common way health visitors undermine mothers’ competence is by forcing unsolicited advice upon them. As is the case with mothers in law, the majority of advice given by health visitors is uninvited (Heritage. J ). Unlike mothers in law however, you can’t tell a health visitor that their advice is bollocks because due to their status as childcare professionals, their advice is commonly perceived as effectively unchallengeable.

The tendency of health visitors’ to trot out unrequested advice like an audio-wikipedia may be explained, again, by their nursing background. This training inclines them towards “an identification, diagnosis and treatment” approach to mothers rather than one in which mothers are encouraged to take the lead in defining their needs (Heritage. J).

As health visitors are lone workers and home visits are hidden from public view the health visitor has little fear of scrutiny. Foster and Mayall have observed that health visitors are confident in the superiority of their own knowledge base regardless of whether its origins are lay or professional in character. It is not uncommon for health visitors to dish out patronising, outdated and sometimes hazardous advice. Their excessively authoritarian attitude leads to mothers’ confidence being undermined on the rare occasions that they have some. One only needs to Google “health visitors” to read innumerable complaints from mothers about disparaging comments regarding delaying weaning until 6 months, about whether their babies are getting enough while only breastfeeding, whether mothers should/shouldn't put their babies on a routine and a whole host of developmental issues where mothers have been happy with their choices prior to the visit but discouraged and undermined afterwards. Then, just when a mother assumes all her choices are ‘wrong’, she hears from friends that the same health visiting team is undermining her friends’ completely different choices.

Inaccurate and inconsistent advice damages trust and makes mothers reluctant to ask questions or act on advice given. These experiences and their repercussions are particularly alarming when one considers the fact that health visitors act distinctly different during home visits when the mother is alone than when third parties (husbands, grandmothers, friends) are present (Heritage. J).


There is perhaps no greater example of a health visitor’s potential for giving worryingly damaging advice than the area of breastfeeding. If you ask a first time mum with a newborn where she should go for breastfeeding advice, the little lamb’s first answer is likely to be “health visitor”. However the most common complaints the Association for Improvements in the Maternity Services receive are regarding health visitors’ ignorance and misinformation about breastfeeding – “and it's getting worse” (Robinson. J).

The role of health visitors in facilitating successful breastfeeding relationships should not be underestimated. Studies have shown that “infants being breastfed at the first health visit were significantly more likely to be fed formula at the second visit if their health visitors had had no breastfeeding training in the previous two years” (Tappin et al).

Organisations such as UNICEF have found that the training health visitors receive in breastfeeding is woefully inadequate (No shit Sherlock?) Training is likely to be brief, and is often given by professionals from bottle feeding industries who have a vested interest in promoting their products (The Guardian).

When a breastfeeding problem is encountered, no matter how small, the overwhelming response from health visitors is – yes you guessed it – “top up with formula” (The Guardian). This strategy is used by health visitors in an effort to increase the agreeable appearance of the baby’s weight chart – and to cover their own backs. The weight chart is given preference over the holistic health of the baby. This botched order of priorities has been recognised by academics and commentators including renowned paediatrician Dr Jay Gordon (Look at the Baby, Not the Scale). He argues that “if someone were to ask you what weight a 33 year old man should be, you would laugh. The range of possibilities varies according to height, bone structure, ethnicity and many other factors. Yet babies are expected to fit onto charts distributed throughout the country with no regard to genetics, feeding choice or almost anything else.”

If there are breastfeeding problems, the first answer should never be supplementation as this will sabotage the nursing relationship by reducing milk supply and also damage your baby’s fragile virgin gut. Instead the correct advice would be to find the most knowledgeable support available; and herein lays the problem. Many health visitors see referral to appropriate specialist as a weakness in themselves. Rather than recognise their limitations, they obscure their ignorance by giving questionable advice. This situation is exacerbated by articles in childcare books, baby magazines and online, the majority of which prescribe “if you are having breastfeeding difficulties contact your health visitor”. Is it any wonder that the UK rate of breastfeeding drops dramatically after the first week as new mums follow the ignorant, often conflicting, advice of various health visitors?

It’s not only breastfeeding which is jeopardised, health visitors often dish out advice which is at odds with government guidelines on a range of topics, including weaning (The Guardian), sleep training (Naturally Nurturing), vaccinations (Redsell et al) and toilet training (Netmums).

Your rights

Despite the power imbalance between mother and health visitor, there is much legal arsenal the mother can utilise to protect and withhold her rights. Firstly, a mother is not obliged to use the services of a health visitor and can refuse them at any time. A health visitor has no right of access to your home. Dingwall (Journal of Adv Nurs. Community nursing and civil liberty) has noted that “although health visitors have no legal right of entry, they do not make a habit of pointing this out to clients”. Health visitors have no legal power - it is social workers who have that.

Furthermore, there is no legal requirement to get your baby weighed. It is a service that is made available and advertised, but parents are not obliged to use it.

What if your health visitor has issued incorrect advice, breached confidentiality, undermined your confidence, acted discourteously or committed other misdemeanours? By making a formal complaint you can protect other families from such misconduct and improve the overall conduct of health visitors on a broader scale. You can make a complaint about your health visitor through several channels. Firstly, you should send a written or emailed complaint to your Primary Care Trust (to find your local PCT click here).

Secondly, you can send your complaint to the NHS's Patient Advice and Liaison Services (Click here to find your local PALS).

If you need assistance with making your complaint The Independent Complaints Advocacy Service is a national service that supports people who wish to make a complaint about their NHS care or treatment (Click here to find your local ICAS).

If you're not satisfied with the way the NHS deals with your complaint you can take your complaint to the independent Parliamentary and Health Service Ombudsman.

Another channel of complaint is the Nursing and Midwifery Council. This Council can investigate complaints from individuals who feel a health visitor, midwife or nurse has mistreated them. The Nursing and Midwifery Council has the power to remove or caution any practitioner who is found guilty of professional misconduct.

The address for the NMC is:

Nursing and Midwifery Council
23 Portland Place
London W1N 4JT
Tel: 020 7333 6541

You are also legally entitled to use The Data Protection Act to obtain any record that is compiled about you by the health visitor. First submit a written or emailed request to your health visitor’s Primary Care Trust (their employer). This is called a “Subject Access Request”. A small fee may be charged to process your request, usually around ten pounds sterling. You will need to send some documentation showing proof of your identity (photocopy of passport page) and proof of your residence (a utility bill). It should take about a month for the Trust to process your application.

If your request under the Data Protection Act is declined you may appeal the decision. To do this, send a written or emailed complaint to “The Head of Service” at the Primary Care Trust. Your appeal should be processed within one month.

As well as appealing internally you can also complain directly to the Information Commissioner. They are professionals appointed by the Crown to enforce information laws. The Information Commissioner can force the Primary Care Trust to disclose your data.

You also have the right to send The Primary Care Trust a notice within a reasonable time period asking them to stop processing your information. This is called a “data subject notice”. The notice must specify that the processing of personal information “is causing or likely to cause you or another person substantial, unwarranted damage or distress” and give reasons why.

Another legal right is the Right of Rectification. If you believe that the data recorded about you or your family was inaccurate, you can write to The Primary Care Trust and request the data be rectified. If you do not receive a satisfactory response from the Trust you can apply to the court for an order, or to the Information Commissioner for an enforcement notice, either of which may require that the inaccurate data, and any expression of opinion based on it, is rectified, blocked, erased or destroyed.

And finally, word of mouth is an excellent tool for disgruntled mothers. Discuss your experience with other parents and you may find that they have similar concerns. There is strength in numbers. Plus of course, you may ask for a different health visitor.

I wrote this article for the lovely ladies over at Free Your Parenting.

Friday, 12 August 2011

Mumsnet Seal of Approval

Those acquainted with me will know that I've got quite a crush on Mumsnet. So imagine my thrill when I log on to find this on their site: "Featured Blogger".

However being the cautious pessimist that I am I assumed that it was a clever piece of marketing code, and that only I could see it. So I Tweeted to Mumsnet HQ. A few hours later they reassured:

As the blog is only 2 months old I am thrilled to be recognised so soon. Regarding awards, I thought I may win a couple of tiddlers before bagging the big boy some day. I never imagined that day would come whilst my blog was still in its infancy. I’m modest like that.

Monday, 8 August 2011

For and Against Breastfeeding in Public

One of the prolific debates in the Breastfeeding Mums Vs Formula Mums, and Breastfeeding Mums Vs The Rest of Society wars; it seems everyone has an opinion on breastfeeding in public. In this piece I lay out the arguments for and against nursing in public. I do not include the health benefits, as that would be too easy. Instead I focus solely on issues strictly related to the public side of breastfeeding.

Arguments FOR Breastfeeding in Public:

  1. Breastfeeding in public is more convenient than bottle feeding in public. Breastmilk is sterile and always at the correct temperature. No hunting around for somewhere to warm a bottle and waiting for it to be warmed whilst your baby abuses your, and everyone else’s, eardrums.
  2. Being a hermit is not much fun.
  3. You never forget to take your breasts out with you.
  4. Nursing covers are an unnecessary and highly unfashionable expense. They also act as a flag that says, “I am breastfeeding my baby now”, thus defeating the point.
  5. Try telling a hungry three month old, “wait until we get home”.
  6. It gets rid of the in-laws and other irritants (see this post).
  7. You will receive brownie points from intelligent, informed people. Some will approach and ask for your autograph.
  8. A nappy and a pack of wipes is all you need to take out with you. No bottles or formula to lug around.
  9. No formula powder, water or milk exploding in your bag.
  10. No having to go back home because you’ve ran out of milk.
  11. It normalises breastfeeding and encourages more mums to breastfeed. More women view breastfeeding, thus more women likely to breastfeed, which causes greater health for the nation, and less NHS expenditure.
  12. Expressing breastmilk is tedious and can reduce supply as well as risking nipple confusion.
  13. Not breastfeeding in public can lead to mums giving their baby formula for public outings (not everyone can express) thus damaging their baby’s virgin gut and diminishing their breastmilk supply.
  14. Not breastfeeding in public reinforces the myth that nursing is ‘obscene’ and should be obscured.
  15. Not breastfeeding in public harms the environment. A nursing mum would be using a lot of petrol driving back and forth between public and home for feedings. If she chooses to use formula for public outings, there is the added environmental damage caused by formula paraphernalia (Why Breastfeeding is Best for Babies...and the Environment. Eco-Mama).
  16. Not breastfeeding in public often leads to weaning too early (Poll Results: Moms Who Don’t Cover Do Breastfeed Longer. Breastfeeding Moms Unite)
  17. You’re not taking up a toilet cubical from someone waiting to use it for its intended purpose. (Would you eat your meal in a toilet?)
  18. You won’t have to declare your boobs for inspection at the airport.
  19. It’s hands free and facilitates effortless multitasking. Just place babe in a sling. Now you have both hands available to inspect bargains/eat cake/bitch on Mumsnet in Costa whilst feeding your baby the good stuff.
  20. Get a soothing oxytocin rush on tap. Perfect for de-stressing during a relentless shopping spree or intense family reunion (Breastfeeding and Resilience Against Psychosocial Stress. Arch Dis Child. 2006).
  21. Hunting around for a designated ‘Breastfeeding Area’ is like looking for a needle in a haystack. It is time-consuming and can be distressing with an inconsolable infant in tow.
  22. It’s your legal right. The Equality Act 2010 has made it illegal for anyone to ask a breastfeeding woman to leave a public place such as a cafe, shop or public transport (Click here for more info info about the law and how to sue).
  23. It’s a feminist act. “The more women breastfeed out in the open, the more everybody will get to see women's breasts fulfilling its natural function of feeding babies, the less taboo the breast becomes, and the less obsessed men will be by it.” (Breastfeeding in Public
    & Discreet Nursing. Female Intelligence Agency
  24. Cleaner clothes. Breastfed babies spit up less, and there’s nothing worse than being publically marinated in milk with no change of clothes (The Prevalence of Regurgitations in the First 2 Days of Life in Human Milk- and Formula-Fed Term Infants. Breastfeed Med. 2006).
  25. Harmonious outings. Nursing is a natural baby tranquiliser. Not only do the hormones released relax mum, they do the same for baby. So if your baby is fussing whilst you’re out, you can calm her down instantly. Thus saving you and Joe public from enduring screaming baby.
  26. Comfortable baby. No matter what the temperature is outside, your breasts heat your baby up more effectively than any blanket. They can detect a one degree drop in your baby’s temperature and warm up accordingly. Like a mobile hot water bottle. Likewise they can cool down if your baby is overheated. (Immediate Maternal Thermal Response to Skin-to-Skin Care of Newborn. Bergström A et al).
  27. It’s a confidence booster. Once you’ve got the hang of this public breastfeeding lark it feels liberating. It boosts your confidence as a mother when you see your ability to meet your child’s needs immediately and on demand.
  28. Random strangers will wait on you. Most people are aware that breastfeeding can be thirsty work. From shop assistants to waiters - free beverages coming your way!
  29. It helps the economy and local businesses rather than simply lining the pockets of Cow & Gate et al. Mums who nurse in public spend their money in public cafes, coffee shops, restaurants and pubs rather than hiding at home.
  30. Breastmilk ‘from the source’ is permanently fresh, whereas prepared formula can only be kept unrefrigerated for 1 hour (Formula Feeding FAQs. Kids Health). Is that enough time to go anywhere? Readymade formula cartons stay useable for longer but are significantly more expensive.
  31. The ‘blanket over the head’ look is so 1990s.
  32. The wet t-shirt look is equally outdated. Your baby will cry and your breasts WILL respond whether convenience allows or not. Yes your breasts have ears, and like babies, breasts are impatient.
  33. Less risk of mastitis as your breasts will be emptied regularly.
  34. Your older children are not restricted by their younger sibling’s need to nurse. They can visit the same places and participate in the same activities as any other child.
  35. It’s ironic but not breastfeeding in public is antisocial. You have to leave interesting conversations/dinners/parties to nurse in a room on your own for an indefinite amount of time.
  36. Breastfeeding in public helps to heal lactophobic people. Research shows that the best way to overcome a phobia is Exposure Therapy. “This consists of exposing you to the very thing you are afraid of” (Phobia Fear Release. Heering. J). People who have a negative response to viewing breastfeeding need to view more of it, then the act will no longer elicit a sensational reaction.

Arguments AGAINST Breastfeeding in Public:

  1. Upon seeing you breastfeed every formula feeder within a 1 mile radius will launch into a 20 minute presentation on why they “couldn’t” breastfeed.
  2. Your boob might get cold.

Sunday, 7 August 2011

Friday, 5 August 2011

The Proper Preparation of Formula and Breastmilk

A Step-By-Step Guide to Preparing a Powdered-Formula Feed

Step 1 Fill the kettle with at least 1 litre of fresh tap water (don’t use water that has been boiled before).

Step 2 Boil the water. Then leave the water to cool for no more than 30 minutes so that it remains at a temperature of at least 70ºC.

Step 3 Clean and disinfect the surface you are going to use.

Step 4 It’s very important that you wash your hands.

Step 5 If you are using a cold-water steriliser, shake off any excess solution from the bottle and the teat, or rinse the bottle with cooled boiled water from the kettle (not the tap).

Step 6 Stand the bottle on a clean surface.

Step 7 Keep the teat and cap on the upturned lid of the steriliser. Avoid putting them on the work surface.

Step 8 Follow the manufacturer’s instructions and pour the correct amount of water that you need into the bottle. Double check that the water level is correct. Always put the water in the bottle first, while it is still hot, before adding the powdered infant formula.

Step 9 Loosely fill the scoop with formula, according to the manufacturer’s instructions, and level it off using either the flat edge of a clean, dry knife or the leveller provided. Different tins of formula come with different scoops. Make sure you use only the scoop that is enclosed with the powdered infant formula that you are using.

Step 10 Holding the edge of the teat, put it on the bottle. Then screw the retaining ring onto the bottle.

Step 11 Cover the teat with the cap and shake the bottle until the powder is dissolved.

Step 12 It is important to cool the formula so it is not too hot to drink. Do this by holding the bottom half of the bottle under cold running water. Make sure that the water does not touch the cap covering the teat.

Step 13 Test the temperature of the infant formula on the inside of your wrist before giving it to your baby. It should be body-temperature, which means it should feel warm or cool, but not hot.

Step 14 If there is any made-up infant formula left after a feed, throw it away. (Source: NHS UK)

A Step-By-Step Guide to Preparing a Breastfeed

Step 1 Lift your top.

Monday, 1 August 2011

Tea in Babies' Bottles - and Other Vulgarities

Lack of education, being stupid, being selfish, as well as following outdated advice from elder generations can lead to parents ‘abusing the bottle’. Read on to discover why putting anything other than breastmilk or formula in your baby’s bottle is not only dangerous; it also makes you look like a prick.

Tea in Babies Bottles

The totally unbiased UK Tea Council has chirped, “It's never too early to introduce your children to the pleasures of drinking tea.” We’re talking non-herbal bog-standard tea here. Giving a baby tea in a bottle is pretty grim. Apart from looking rough as a badger’s chuff, it is also unadvisable for a host of reasons.

The most obvious is caffeine. Why anyone would ever want to give their baby a stimulant beats me. Any beverage containing caffeine can inhibit sleep. Also, because caffeine is a strong diuretic, it can lead to dehydration. Sleepless nights and bedwetting – great things to look forward to. Furthermore, caffeine is known to act on the central nervous system, increasing heart rate and blood pressure. It is such a powerful stimulant that attempts to stop consuming it can produce symptoms of withdrawal.

Some parents assume decaf tea and green tea are safe alternatives to caffeinated tea. However, “it is impossible to determine how much caffeine is in a given cup of tea purely on the basis of the type of tea. Several factors, including how the tea was grown, soil, processing, and preparation determine how much caffeine is in a given tea” (Petersen, The Health Risks of Decaf Tea).

Even if a parent was to know the exact caffeine content of their baby’s bottle of tea (see, even typing it looks gross), there is the pertinent issue of mineral absorption. Tea contains a substance called tannin which inhibits the body’s ability to absorb minerals like iron, calcium and zinc from food (BBC, Weaning). These minerals are necessary for the healthy function of your baby’s immune system and digestion. A lack of such minerals can lead to conditions such as iron deficiency anaemia, which can lead to failure to thrive. Not something you want stamped on your baby’s red book.

Tannin is also responsible for staining the teacup, the teapot, and of course, babies bottles. The most common victims of tannin staining are babies’ humble tooty pegs. It is hardly surprising that tannin discolours teeth when you consider that it is used in the chemical staining of wood.

I know what you’re thinking, “This is feel good stuff”; But wait, there’s more. It has been suggested that tannin increases the risk of nasal and esophageal cancer (Elvin-Lewis et al 1977, Medical botany: plants affecting man's health; Nutrition Health Review, Tannin Linked to Esophageal Cancer; Hung et al 2004, Association between diet and esophageal cancer in Taiwan; Wang et al 2007, Diet habits, alcohol drinking, tobacco smoking, green tea drinking, and the risk of esophageal squamous cell carcinoma in the Chinese population; Barclay 2009, Hot Tea Consumption Linked to Higher Risk for Esophageal Cancer).

Even decaffeinated tea contains tannin. So the tea doesn’t have to be hardcore Yorkshire Tea that you can stand a spoon up in; it can be weak decaf and still pose health risks to your baby. In 2008 the Government considered banning the serving of tea in schools due to tea’s “minimal nutritional benefits” (The Telegraph, Schools Face Ban on Serving Tea to Under-16s). Babies that drink tea lose out on the fat and calories in breastmilk/formula that are essential for growth and development because the tea gives them less desire for their milk. As for parents who put sugar in their babies’ tea, they need a stern bollocking from a health visitor; But they’ve got nothing on parents who practice the following...

Rusks in Babies' Bottles

Some parents put rusks into their baby’s bottles in an effort to thicken up the milk so their baby sleeps longer/is satisfied for longer/looks cute/whatever. In my opinion putting rusks into babies’ bottles thickens up the contents so that the milk matches the parent. The practice stems from outdated advice circa 1970 and can be extremely dangerous.

Not only is it nonsensical to put rusks into bottles, it is tantamount to force feeding. In order to get the milk, the baby has to take the solid matter too. Thus, baby does not get their thirst quenched without having to consume the extra calories contained in the rusk. If baby cried later because they were still thirsty, their parent may interpret this as more hunger, and propagate a vicious circle. The baby would become dehydrated due to taking in inadequately diluted fluid; and because rusks raise the sodium content of the milk, their tiny kidneys would become overloaded. The unfortunate baby would not get their thirst quenched but would be getting fatter and fatter, and their tiny stomach would become stretched. Then the baby’s appetite would grow in accordance with their stretched stomach and produce genuine hunger pangs (Leach, Your Baby and Child: From Birth to Age Five).

One reason rusks are so calorific is because they contain copious amounts of sugar. Rusks contain more sugar than chocolate digestives (The Independent, 2009). They are “more unhealthy than junk food” (The Times, 2009). There is 3.5g of sugar in a reduced sugar rusk, and 4.9g of sugar in a regular rusk. Next time you see a box of rusks, check out the small print. There is no natural nutrition; the main ingredient is flour. The other main ingredient is... you guessed it - sugar! The vitamins you see touted in marketing by Heinz and Co are artificially added to entice parents to buy the product. Our bodies are designed to absorb and digest natural vitamins and minerals; artificial man-made ones are much harder to process. On the topic of man-made substances, a popular mainstream brand of rusks was even found to contain weed killer (UK Food Standards Agency, 2006). How thoughtful of Heinz.

Back to the issue of sugar; an obvious danger of the high sugar content of rusks is the effect on teeth, and this issue is exacerbated by putting rusks in babies’ bottles. Liquid flows slowly through a bottle teat and sits in a baby’s mouth for longer than it would in a cup, thus leading to rotting teeth and ulcers. Furthermore, even if a baby does not have visible teeth yet, the acidity of their saliva (caused by sugars from the rusk feeding the bacteria) can damage the teeth while they are still in the gums. Babies have teeth, even if you cannot see them.

Some parents argue that tooth decay in babyhood is not a concern because all baby teeth fall out eventually regardless of tooth care. However this is an ignorant attitude. If a baby tooth is lost too early, the teeth beside it may drift into the empty space. When it's time for the adult teeth to come in, there may not be enough room. This can make the teeth crooked or crowded (American Dental Association).

Another reason why putting rusks into babies bottles is irresponsible is the risk of choking. Bottles are designed for a runny liquid to come from them, not a gloopier mess. Some parents who give rusks in bottles argue that the choking risk is minimal. Their reasoning is that if the substance was small enough to fit through the teat of bottle, it is unlikely to choke a baby. However even teats designed with larger holes do not prevent the choking hazard. Lumps aside, the thick liquid can be aspirated into the baby’s lungs and cause serious problems.

As well as turning their babies into fatty bunters, dehydrating them, rotting their teeth and putting them at considerable risk of choking, parents who put rusks into bottles also increase their babies’ likelihood of developing allergies. Most rusks contain gluten which, if given to babies under six months, is a prime instigator of allergies and coeliac disease. Symptoms of the latter include chronic diarrhoea, abdominal pain, weight loss, failure to thrive, fatigue, and mouth ulcers. Not great gifts for your baby.

At this point, you may be wondering why parents continue to crush up rusks and place them into their babies’ bottles notwithstanding the substantial health risks involved. One of the main reasons is tradition. As the practice was common in the 70s, contemporary Rusk Parents like to retort “They did it years ago and we’re all okay”. When I hear this excuse/argument I find so irritating that it feels like a cheese grater on my brain. So many parents use it to justify outdated practices. There's a simple reason why the “we're all okay” argument is twaddle. Hands up, all those reading this blog who were fed solids in a bottle and choked to death or died of aspiration pneumonia. No-one? Before you accuse me of being unnecessarily extreme, consider the following scenario. What would you say to someone who slung a carrycot on the back seat of a car and drove off without strapping it in? They're unlikely to have an accident, but if they do, it's very likely to have devastating consequences.

In addition to tradition, another main culprit in Rusk Parents’ reasoning is the quest for more sleep. However this is misguided optimism. Babies do not sleep better because they are full. They sleep because they need sleep. Hunger is not the only reason babies wake. If a parent gets into the habit of giving food in a bottle, they are making a rod for their own back. As parents we all made the conscious decision to raise our babies and accepted significantly less sleep as part of the deal. So why are some parents so desperate to fill a baby up with total karp so they can get an extra hour or twos sleep? As well as rusks, such parents also like to employ...

Rice in babies' bottles

Putting baby rice, or as I like to call it - wallpaper paste, into babies’ bottles alongside their regular milk is common practice in some parts of Europe. However medical opinion maintains that if a baby is too young to take rice off a spoon it certainly should not be sucking it out of a bottle. Babies have tiny stomachs and need feeding little and often, not stuffing with food that's gruelling for them to digest (Spare a thought for the Virgin Gut!) The claim that putting rice into a baby’s night time bottle will help them to sleep is a misconception. Studies have found that it makes little difference (NIH Medical Library - Study on Infant Sleep and Bedtime Cereal). Breast milk or formula has more fat per ounce than baby food, especially rice. In fact bottle feeding rice can make sleeping worse if the baby’s digestive system isn't ready for it. The World Health Organization & the American Academy of Paediatrics concur with this and recommend that only milk be placed in babies’ bottles. On a practical note, the baby may have a hard time learning to eat from a spoon, if she gets used to taking solid foods in a bottle (Harvard Medical School, 2 Month Old Baby Care).

Furthermore, adding rice derails a baby’s “full up” mechanism. Like rusks, the practice forces babies to take in deceptively large amounts of calories. It teaches them to overeat. (Dr Greene, Baby Bottles and Cereal). Even more importantly, the sucking and swallowing actions are not fully coordinated in some babies, which can lead to pulmonary problems as they inhale rice partials into their lungs. This can have lethal consequences.

Aside from the important issues which arise from feeding rice through a bottle, the dubious benefits of baby rice as a food in itself have been called into doubt. A third of baby rice on sale in the UK has been found to contain so much inorganic arsenic, a human carcinogen, that it would be illegal in some countries (The Independent, 2006). This is because rice soaks up arsenic from the soil more readily than other grains do. Yet health visitors, GPs and dieticians will commonly recommend giving it as baby’s first food. Why? The reason is yet again, tradition. Giving baby rice has been received wisdom for 60 years as a result of baby food companies in the 1950s that “launched an advertising blitz trumpeting the benefits of white rice cereal. But there is no scientific basis for this recommendation. None at all.” (The Nutritional and Food Web Archive, 2010).

In reality white rice is a refined carbohydrate. Its highly processed nature means that fibre, vitamins and other nutrients have been stripped away and artificial nutrients added in their place. Reflux babies aside, there is no reason to give an infant baby rice (Kellymom, First Foods). Not only is the rice itself nutritionally devoid, but when added to breastmilk or formula it reduces the amount of milk in the bottle thus diluting the nutrient density, making each feed less nutritious in terms of calcium, other minerals, fats, and protein (Widome, Your New Baby and Sleep). The result is that baby may not get adequate milk volume for optimum growth and development; and as with rusks, the decreased milk volume can dehydrate a baby leading to constipation and illness.

Even more importantly, white rice has also been linked to increased rates of heart disease, insulin resistance, eye damage and cancer. Feeding infants baby rice can increase their risk of developing type 1 diabetes and can prime their appetite for a lifetime of processed carbs. It is a “nutritional disaster” (USA Today, 2010). Dr David Ludwig, a specialist in paediatric nutrition, suggests that baby rice is among the worst food for babies. He maintains that baby rice “digests very rapidly in the body into sugar, raising blood sugar and insulin levels and could contribute to later health problems, including obesity” (The Associated Press, Experts Seek to Debunk Baby Food Myths). Yet despite these publicised risks, baby rice continues to be the most common type of first food introduced to babies, with 57% of UK mothers giving it as their babies' first introduction to solids (Infant Feeding Survey 2010).

Renowned US paediatrician Dr Alan Greene has said that giving baby rice is no different than adding sugar to formula (ABC, Stanford Doctor Says White Rice Bad for Babies). He has launched the ‘WhiteOut’ campaign to encourage parents to ignore corporate marketing and wean their babies on natural food when their babies are ready.

Juice in babies bottles

It is hard to fathom anything more gross than seeing a bottle of juice propped up in a buggy or a toddler running around with a bottle of juice giving their teeth prolonged exposure. The bacteria in a baby’s mouth feed on the sugars found in the juice. These bacteria then produce acid as a by-product of their feasting. It is this acid which attacks the tooth enamel and causes cavities. Each time a baby drinks juice, the acids attack for 20 minutes or longer (The American Dental Association). Additionally, constant sugar in the mouth can lead to a build-up of bacteria to a point where more harmful types of bacteria start becoming predominant. These bacteria cause gingivitis by invading gum tissue and releasing toxins. In severe cases, the bacteria and their toxins can attack bone structures supporting the teeth (periodontal disease) resulting in permanent damage (Save Your Smile, How to Prevent Baby Bottle Tooth Decay).

Some parents argue that fruit juice is healthy because pieces of fruit are healthy. However there is no advantage to giving a baby juice instead of whole fruit. In fact, fruit juice lacks the important fibre that whole fruit contains. Both the UK Foods Standards Agency and the American Academy of Paediatrics state that you should not give babies juice before they are at least 6 months of age. It follows that if a baby is old enough to drink juice then they should be old enough to use a beaker rather than having the juice in a bottle.

In 2006 a toy company called Dolls World created artificial milk and juice bottles for baby dolls:

After receiving complaints (probably from Alpha Parents!) the company redesigned the juice bottle into a juice beaker:

A number of parents believe that diluting juice makes it tooth-safe. Although diluting reduces the sugar content it does not affect the pH (acidity). Juice in a bottle, whether natural or artificially sweetened, whether diluted or not, is one of the big dental health no-nos. It keeps the liquid in contact with the teeth for much longer than a free-flowing cup and increases the risk of cavities. When a baby puts a bottle in its mouth, the teat is placed against the baby’s palate, and liquid from the bottle pools around the upper teeth, particularly the back surface of the upper front ones. If the bottle contains juice, the acids attack the enamel which, over time, is lost.

Aside from the important dental issues, commercial juices often contain preservatives or artificial sweeteners. Making homemade juice for babies is not recommended either. This is because the juice remains unpasteurized and thus can contain bacteria or other nasties which can cause serious illness (Parish 1997, Public Health and Nonpasteurized Fruit Juices).

Furthermore, as with tea, rusks and rice, juice displaces the amount of breast milk or formula a baby drinks thus compromising nutrition. Therefore it is sad but unsurprising that malnutrition and short stature in children have been associated with excessive consumption of juice (Smith and Lifshitz 1994, Excess Fruit Juice Consumption as a Contributing Factor in Nonorganic Failure to Thrive). My advice is to forget the juice. It is far easier not giving your baby sugary drinks in the first place, than to stop the habit later.

In Conclusion

From 6 months, even formula fed babies don’t need bottles. They should move onto cups. Not just from a dental viewpoint but from a speech angle too; they need to work out how to move their mouth in many different ways to eat and to talk. Use of a teat affects tongue mobility and discourages vocalisation.

The practice of putting random substances into babies’ bottles is a by-product of capitalism. The majority of babies do not need bottles, rusks, rice, juice - full stop. Yet capitalism has convinced many parents, through extensive marketing, that such products are safe, even desirable. If a baby was exclusively breastfed straight from the breast, it would be impossible to add solids to breastmilk; thus if baby was hungry or unsettled, mum would just feed for longer. This is what nature intended. It is how babies’ and mums’ bodies are designed to function and thrive.