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Embracing Motherhood

Bonding with the Baby

She knew very well how babies smell; she knew precisely. ‘Well,’ the wet nurse began. ‘… They don’t smell the same all over, although they smell good all over. Their feet, for instance, smell like a smooth warm stone, or like fresh butter … And their bodies smell like a pancake that’s been soaked in milk. And their heads, up on top, at the back of the head, where the hair makes a cowlick … here is where they smell best of all. It smells like caramel. Once you’ve smelled them there, you love them whether they’re your own or somebody else’s.’ Perfume, Patrick Suskind

Having delivered thousands of babies over the years, one of my favourite moments is watching the new mother smelling her newborn baby’s head for the first time. Most are hardly aware they’re doing it, but in that split second when the mother inhales the exquisite scent of new life, she falls in love. After nine long months, she can at last see her baby, touch her baby and hear her baby, but it’s when she smells her child’s pristine dewiness that the cocktail of bonding hormones really starts to fizz. And it’s not just a temporary kick. Years later, mothers can be found wistfully sniffing talcum powder bottles in supermarket aisles and wearing talc-based perfumes (astute perfume houses cottoned on to our nostalgia long ago).

Happily, it’s a requited love. Whilst it takes weeks for the baby to decipher faces and sort out voices (everything sounds muffled in the womb), a newborn infant can detect the smell of her mother’s milk almost immediately. It has been shown that a minutes-old baby, placed on the mother’s tummy, will grapple, heave, shake her head from side to side, nuzzle into the mother’s breast and find the nipple to suckle, led entirely by smell.

It’s an amazing thing to see in action. At every birth I attend, I’m always looking for that transforming moment when the fundamental survival instinct and urge to protect becomes something deeper and more spiritual; an impulse that takes a parent beyond the instinct to merely raise a child to maturity, and actually nurture, cherish, indulge and adore the child to its best possible self.

We all know this as bonding, of course, the pop-psychology buzzword for the modern parent. But whilst bonding is indeed an inherent part of parenthood, we don’t always acknowledge that it is not an automatic response. If you want a deep, nourishing relationship with your child which soothes your soul, then it will need tender cultivation, shared experience and, yes, a smattering of hormonal alchemy.

There’s a line in Lucy Atkins’ book, Blooming Birth, which really resonates with me: ‘Birth is just the start – parenting’s the biggie.’ She’s absolutely right, and the biggest help you can have when negotiating the myriad minefields of toddlerhood, pre-pubescence and adolescence is the solid bond you establish with your child during your pregnancy and at birth. Bringing with it an empathy, sensitivity and kindness that endure throughout the myriad experiences life throws at you, it starts right here, with your newborn and her soft, fuzzy head.

why bonding matters

The endorphins released mutually by mother and baby during the birth process are very important for the deep bonding and mutual attachment necessary for the survival of the infant. This is one of the reasons why I work so hard to deliver gentle births that will promote greater levels of endorphins being released at birth. In the interests of mother–child bonding, health professionals should be geared towards preventing fearful births where the fear hormone, adrenaline, inhibits endorphin production.

Sleep Bonding

My Mother came to me and lay down beside me, and the warmth of her body comforted me. Secure in the knowledge of her love, I began to cross over into sleep.

The Red Tent, Anita Diamant

The bonding power of sleep is profound. Sleep is the ultimate surrender, when we are most vulnerable, and it’s impossible to attain if we do not feel relaxed, safe and warm. As adults we wouldn’t dream of sleeping with – or even near – someone we didn’t like or trust, and it’s very much the case with babies too.

In every respect, you are your baby’s protector. I am a firm believer in the emotional and physical benefits of mother and baby sharing a room – if not necessarily a bed – in the early weeks. Hailing from the red tent culture, I have seen at first hand the evident security this arrangement bestows upon the child. After all, having spent nine months drowsily curled up in the womb listening to the regular thud of your heartbeat, the immediate touch, sight and smell of you, the slumbering mother, is the next best thing to those warm, cosy waters. For mothers and fathers too, there is no greater sense of joy and peace than when their baby is blissfully asleep in their arms.

Shared sleep is indicative of shared love, and if you find that you can sleep through the grunts, snuffles, chatters and snores of a sleeping baby, then there is nothing more wonderful.

BEDSIDE CRIBS

A crib next to the parents’ bed is the ideal scenario in my opinion; or even better, a bedside cot with one side that opens out completely to annexe to the mother’s side of the bed. These save the mother from climbing out of her warm bed (especially in the cold, dark winter months), and she can easily slide the baby back into the safety of the cot’s confines after the feed. All the big baby chain stores like Mothercare and John Lewis sell these bedside cots, but check the height before you buy. The height of the cot may not be compatible if you have, say, an iron or a sleigh bed.

BED SHARING

Sharing a bed is a trickier issue. In principle, it seems the most natural option, but that doesn’t mean it’s the safest – there have been various tragic incidents in which the mother or father has inadvertently smothered the baby in their sleep. Alcohol, drugs, medication and extreme exhaustion are all risk factors, but there have even been instances when the baby has been suffocated by the mother’s milk-swollen breasts. UNICEF and the Royal College of Midwives recommend no co-sleeping under three weeks of age. The advice I give to my mothers is to share a room, not a bed, with the baby at night.

Case History: Karen and Ollie

I had read all the books saying not to rock/feed/carry your baby to sleep but Ollie was a restless baby, and in the early weeks that was the only way I could get him off to sleep. Still, by the time he was about eight weeks old, I knew I had to start to teach him to sleep without relying on stimulus from me. So, at his morning and afternoon nap, I began to lie on the bed with him. I turned him away from me so that he wouldn’t think he was getting a feed, and would curl my arms and legs around him, with the top of his head nuzzled under my chin, and just the feel of my body, my warmth and my smell to reassure him.

For the first couple of attempts to put him to sleep, he cried for up to 40 minutes on and off, which was pretty hard to bear. But I stuck with it and very soon he understood that when we lay down together, he was just going to have a little sleep. I didn’t sleep with him at night, so it was absolutely blissful to share that 30-minute nap with him in the day. We both slept so heavily – I’m sure our pheromones must have knocked each other out – and it kept me going at that point when the broken nights were really beginning to take their toll.

Strangely, I would always wake about 30 seconds before he did; he never once woke me up. I could actually hear his breathing change once I started to stir. When I moved him to sleep in his cot, a month later, he was absolutely fine about it and went straight to sleep without crying, but I still needed the naps too – my husband jokes that he sleep-trained me, rather than the other way round! But I’ll always treasure our baby naps together. I’m convinced they contributed to the powerful bond between us.

interesting fact

Many of my mothers claim to wake in the night moments (up to two minutes) before their baby. We still don’t know why this happens, but anecdotal evidence suggests there is a higher likelihood of it occurring where there’s a strong bond between mother and baby.

BABY HAMMOCKS

In India it is traditional to tie a sari lengthways as a long, low-slung hammock from a ring on the ceiling, so that the baby is suspended about 30 inches above the floor. The sari tied in this way is called a thottil (‘cradle’) in southern India. The thottil creates a soft cotton sling for the baby, rather like the one depicted on birth announcement cards showing the baby being carried in a sling by a stork. Sometimes, a long piece of cotton can be used to tie the thottil instead of a sari. This is called a dhoti, which men wear like a sarong. The baby feels very comfortably held within this soft cotton sling. It allows good circulation of air, and deep sleep is promoted by the baby’s spontaneous movements that rock the cradle.

Mothers who work in the fields in India resourcefully tie a sari onto the branch of a tree to create a cradle, and place their infant within. It is common for tourists travelling through India to be charmed by the sight of babies hanging in thottils from the trees!

The thottils are most commonly used in villages and in traditional families, but rocking cradles made of cane are also the prized possessions of many mothers. My mother had a rocking cradle for me and my siblings. I remember her rocking my youngest brother to sleep, and I often crept into the room to rock the cradle.

And it’s not just an Indian tradition. The Mexican culture has historically endorsed hammock sleeping too, and now Australia is following suit. Neonatal units there have studied the positive effects of babies sleeping in baby hammocks and have reported many positive benefits, particularly better quality sleep. Mainly this is because of emotional security, as the baby feels snug and held, as if the sling is an extension of the womb or loving arms. But head support – and comfort – seems to play a role too. In particular, it was noted there was a dramatically reduced incidence of Flat Head Syndrome, a phenomenon increasingly seen in the West as a result of neonatal advice that babies must only be laid on their backs. I do not contradict this advice at all, but I do advise those mothers whose babies show signs of developing Flat Head Syndrome to place them in a hammock or thottil for a couple of hours each day. I recommend buying a baby hammock from www.babyhammocks.com as these have passed all safety checks.

SEPARATE ROOMS

London is a city of lanky Georgian and Victorian terraces, and I inwardly despair when I hear my London mothers relate their middle-of-the-night stories with the baby ensconced on an entirely different floor in the house. Not only is the baby isolated, but also the poor, exhausted mother is trudging up and down several flights of stairs each time the baby stirs. Some of my mothers consider this the easier option, however, and I do sympathize when they say they simply cannot sleep in the same room as their baby. Hormones are running at such a state of high alert anyway that every whisper and sigh their baby emits can drag them out of sleep and leave them permanently exhausted. This is no good to anyone and can compromise the quality of the mother’s milk.

If you do choose to place your baby in a separate room, there is still plenty you can do to make sure the baby feels secure:

 Respond to the baby’s waking cries quickly. She needs to see you and smell you as soon as she can, as this will reassure her that you are always at hand when she needs you.

 For the first few weeks, put the baby to sleep in a swinging crib or place the baby’s Moses basket inside the big cot, beneath the mobile.

 When the baby has outgrown the Moses basket/crib (by around twelve weeks) put the baby to sleep in the big cot, under the mobile, which by now should be familiar.

 Place the baby to sleep on a baby sheepskin. These really do comfort babies, making them feel held, and they seem to sleep more soundly on them. The baby sheepskins are sheared to an extra-short length but, if you like, you can place the sheepskin under the baby’s cot sheet.

 To make the big cot seem smaller, roll up two clean cellular pram blankets and lay them either side of the baby’s waist, like mini bolsters. These help the baby feel more secure and confined, again echoing the womb. Equally, you can buy special baby mats, which have attached bolsters at the sides.

 Another tip is to roll a larger cellular cot blanket lengthways and loop it in a U shape. The U-bend should pat up against the baby’s bottom, with the baby’s legs hanging bent over the blanket and the blanket running up the baby’s sides. This really helps the baby to feel held.

 If you have a cuddle cloth, tuck it next to your skin in your bra so that it absorbs your smell. Then you can tie this to the cot and help reduce any separation anxiety.

SWADDLING

One of the hardest things for the new parent – particularly the new dad – is getting used to the tiny proportions of the newborn body. An adult’s big hands and strong arms can easily feel clumsy when that little body is flailing and wriggling about. But swaddling can really minimize that awkwardness. Swaddling is an age-old custom that crosses nearly every culture in the world – from Eskimo babies in sealskins, African babies in kakoi slings to Japanese babies swaddled into the silken folds of obi wraps. Swaddling is fantastic for helping a baby feel secure. Keeping the arms and legs bound in a secure wrapping mimics the confines of the baby’s beloved womb. When the baby is born, one of the most pronounced birth reflexes is the Moro, or startle reflex, when the baby suddenly throws out her arms and legs when startled. The Moro reflex is an involuntary response to threat and acts as the earliest form of ‘fight or flight’ response. This is generally more pronounced in boys than girls, and begins to fade away gradually from three weeks. It can be alarming for the baby who, at this point, has no idea that those flailing arms and legs are actually her own and often scratches herself, hence the need for scratch mittens.

I recommend swaddling the baby in a cellular cotton blanket for the first three weeks to give her the feeling of the continuity of being held in a womb. After this time, the baby usually starts to wriggle out of it. You can then move on to swaddling the baby under the arms so that the body and legs feel held but her arms can stretch out. After a couple of days of contented sprawled sleeping, the baby is ready to go into the now-popular baby sleeping bag.

note

Only ever use a cellular blanket for swaddling, as the intrinsic holes within the cellular blanket will provide a crucial air supply should the blanket go over the baby’s face. The risk of this increases as the baby gets bigger and stronger, as the increased wriggling dislodges the blanket off the shoulders and moves it up around the face, risking suffocation.

how to swaddle

1 Take a cellular blanket and fold one corner up to the opposite corner, making a triangle.

2 Place the triangle so that the longest straight edge is arranged at the top.

3 Lay the baby down on the centre of the blanket, with her shoulders just an inch or so below this long edge.

4 Check that the lip of the blanket doesn’t protrude so high above the shoulders as to cover the baby’s mouth when she turns her head to the sides.

5 Take one corner from the right or left (whichever is shortest, depending upon how centrally you’ve placed the baby on the blanket) and snugly wrap it around the baby’s body. Make sure the baby’s arm is placed down at the sides, and pull the blanket down and around so that the corner can be tucked under the baby’s bottom. Keep the tuck as flat as possible so it’s not bulky and uncomfortable beneath the baby’s body.

6 Pull over the remaining corner – again in a downward direction, with the baby’s arm down at the corresponding side, and tuck under the baby’s bottom. Again, keep the tuck as flat as possible.

a new way to handle babies

A new school of thought amongst maternity nurses in Los Angeles promotes extremely gentle and slow handling of babies. The traditional way to pick up babies is to lift them up to you and then bring them in close, but this new method involves bringing the baby in close to you before lifting them through the air.

Water Bonding

A lot of baby bonding is about summoning the sensations and security of the womb, and much of that can be re-created in water. I have long been a proponent of water births, believing them to be a more gentle transition for the newborn from the womb to the outside world. But even after the birth event itself, I often use water to soothe unsettled babies. One of the joys of my practice is giving cranio-sacral treatment to a baby while in a warm and safe baby pool.

THE DIVE REFLEX

Nine months in the amniotic fluids equips babies with a diving reflex, which is very strong at birth but fades over the following months as they rapidly adapt from a watery to an airy environment. Babies are fully capable and relaxed when momentarily submerged; their pronounced dive reflex kicks in and they hold their breath automatically. Try it yourself – if you blow onto your baby’s face, you’ll see she automatically holds her breath.

Test your baby’s dive reflex by blowing onto her face. You’ll see she automatically holds her breath.

BABY SWIM CLASSES

The dive reflex can be retained if the baby is exposed to water submersion on a regular basis. It would be wonderful if you could find a specialist baby swim class (I recommend them from four months onwards – see Resources). As well as keeping up the dive reflex, the best of these classes also place a strong emphasis on baby water safety – teaching them how to turn in the water, float on their backs (and therefore, breathe!) and how to hold on to the side should they fall into a pond or pool.

It’s natural that you might feel apprehensive at the thought of your baby going under water, but you’ll be surprised at how much she loves the feeling of weightlessness – it’s the only time her little body is fluid and synchronized! She may well come up with her eyes wide and smiling, as babies don’t shut their eyes underwater.

BATHTIME BONDING

On a smaller, more intimate scale, water bonding in the bath can play a part in your daily routine. My grandmother in India always said babies should be bathed before midday, not at night, as this closes off the chakras (the seven energy centres on the midline of the body) and inhibits vital growth and repair during sleep. If you can bathe your baby in the morning or at lunchtime, so much the better. However, I appreciate that this is not convenient for the Western lifestyle, where bathtime is often delayed until early evening when working mothers or fathers get home. The bonding opportunities bathtime presents are of course far more precious and must be respected. Equally, you may have another child who is already in an evening bathtime routine or is at school during the day and so can only bathe in the evening. If this is the case, a good compromise is to try and finish bathing before 6pm.

One to two drops of pure lavender essential oil mixed in with milk (so that it doesn’t sit as a film on top of the water) and then added to the running water makes a lovely aromatic bath and will induce a gentle sleepiness just before bedtime.

a water bonding tip

A wonderful mother–baby bonding exercise is floating your baby on her back whilst maintaining eye contact. You can do this in the bath or in a pool (but if the pool has cool water, invest in a neoprene baby wetsuit – see Resources for details).

Touch Bonding

Of all the bonding methods, this has to be my favourite. Regular baby massage soothes the soul of every mother and child, and really forges a powerful empathy and trust between the two. I advocate daily baby massage and think the ideal time is immediately after the bath. No fancy oils are needed, just a good quality base oil such as extra virgin olive oil or sweet almond oil. Apart from the immunological and muscular benefits of the massage, these oils will really nourish and hydrate the baby’s skin, which can look dry and flaky in the first few weeks after birth.

important note

When using sweet almond oil, be sure to rule out any history of nut allergy. There has been a report that almond oil should be avoided if there is a history of epilepsy in the family.

If you would like to harness the benefits of aromatherapy for your baby, add just two drops of lavender essential oil to 50ml of your base massage oil. Lavender calms the central nervous system and is also a muscle relaxant.

I have devised these specific massage routines for you to use after bathtime. If you have followed my gentle birth method, some of the massage techniques will be familiar to you.

CREATIVE HEALING BABY MASSAGE

My method of baby massage is based on my knowledge of the creative healing lines of energy flow within the body. Creative healing was formulated and taught over half a century ago by Joseph B. Stephenson, a healer who devised a method of massage strokes that restored the energy flow within the body. Creative healing is now used widely in the United States and is beginning to filter over to Europe.

Some of the creative healing treatments are of special benefit for babies, such as the treatments for constipation and chest infections.

I appreciate that the creative healing method is more complicated than traditional baby massage, and I have produced a DVD (see Resources) which shows very clearly the baby massage routine. But in spite of my preference for this method, there really doesn’t have to be a set formula when massaging your baby. The most important thing is loving, soothing, healing touch. Touch your baby with any of these intents and you will be amazed at the effect.

In the beginning, it may be hard to massage the limbs fully, as the baby will instinctively want to remain curled up into a little ball. But as you caress and stretch out those little arms and legs, you will be setting the baby on her first steps to standing tall and stretching high. And I defy anyone not to fall irrevocably in love with those peachy thighs, chubby arms and silky tender tummies! Your baby will delight in your spontaneous kisses whilst you massage her, and there will be a terrific endorphin rush for both of you.

basic instructions for creative healing massage

The limbs: Massaged in a downwards movement.

The abdomen: Massaged only in an upwards movement.

The back:

 The upper back is massaged upwards.

 The middle back is massaged sloping downwards.

 The lower back (sacrum) is massaged only in an upwards direction. The sacral nerves flow downwards like the roots of a tree, and it is physiologically sound to lift and reposition the nerve roots equally on both sides of the sacrum. This is done by massaging the sacrum lightly in an upwards direction only with the thumbs.

 While on the sacrum, performing very small arc-like movements with your thumbs over the little dimples for a few minutes a day can regulate your baby’s bowels! If your baby is constipated, apply this very light massage for seven minutes. Make sure that your touch is very light so that you do not leave red patches on your baby’s bottom!

The chest: The front of the baby’s chest is massaged from the outer edges of the ribs converging inwards towards the breastbone (sternum). This movement also gets rid of congestion in the lungs, especially following a cough. Indeed, this movement prevents chest infections if the lungs are kept drained on a regular basis.

Routine: The first week just involves learning about your baby’s body rather than initiating a formal routine. The guidelines above indicate the optimal directions for stroking different areas of the body – according to creative healing wisdom – but at this stage you just want the baby to respond positively to your touch and learn to find comfort in it. So touch your baby gently but confidently, and revel in the joy of touching your very own pristine, beloved baby.

You’ll also find that getting to know your baby’s body will empower you for when the baby becomes ill. It’s easy to feel intimidated by the apparent fragility of those little bodies. With daily massage, however, you will know how yielding your baby’s tummy is to regular touch and be able to identify when it is hard, distended or tender. Equally, you will instinctively learn the skin’s natural colour and tone whilst you massage it, and therefore become more alert to rashes.

how massage increases baby’s immunity

The constitutional benefits of touch are pre-programmed by Mother Nature. Every time you touch your baby, you create a virtuous circle whereby you pick up the bacteria living on your child’s skin and pass it into your own system. Your adult system can easily develop antibodies against these bacteria that then pass into your breast milk, protecting your baby and boosting her own natural immune system.

Many of my mothers like to sing songs, rhymes and lullabies whilst they’re massaging the babies, which is a lovely form of sound therapy. The classic songs ‘You are my sunshine/My only sunshine’ and Summertime are favourites, but I know some mums who swear by Don McLean’s Wonderful Baby, not only because of the joyous baby-oriented lyrics, but also because of the many verses!

Best of all, maintain eye contact while you massage. Before you know it, your little butterball will be wriggling off to play some more and you’ll consider yourself lucky to get her nappy on. So treasure these little rituals while you can and you’ll have the memories to cherish forever.

tips from mothers

I receive a lot of correspondence from mothers who follow the gentle birth method – either through my clinic or the book – and many of them stay in contact throughout the first year. Over the years, the tips I have received from these mothers have formed a massive store of information, some of which I will scatter throughout this book. Here is a collection of tips from Sonia Revelli, mother of four children.

Baby stretches to prevent colic. Sonia has found these to be invaluable and they can be done at every nappy change. However, avoid doing these immediately after a feed, as the baby may regurgitate.

Method

 Stretch the legs out first, then flex them at the knees and push the little thighs and legs back to the abdomen. Stretch and flex about four or five times.

 Then bring the little legs straight up and down by flexing both legs and extending onto the baby’s tummy as much as possible. Repeat five to six times.

 Then cross the baby’s ankles, left over right, and flex both thighs onto the tummy. Repeat by crossing the ankles, this time right over left.

 This becomes a lovely routine to do at all nappy changes.

Try not to breastfeed your baby lying down. Sonia feels that this predisposes the baby to getting glue ear, due to milk tracking up the Eustachian tube, which joins the ear to the throat.

If the baby has a cold, you might find the ‘Mouche-Bébé’ nose-blow device very useful. A French invention, it is a suction device with a reservoir which you can use to suction the nasal passages to aid breathing, and help the baby to sleep (see Resources for details).

If your baby has a chest infection, try using Moxa sticks. Cover the baby’s legs with a cotton cloth so the skin isn’t heated directly. Gently warm the outsides of the baby’s legs with heated Moxa sticks, held at a safe distance from the baby’s skin. Move the sticks up and down. This is amazing at clearing the nasal passages and lungs. [Moxa sticks are used in Chinese medicine and have excellent success rates. I use them a lot on pregnant mothers with breech babies. They have a 77 per cent success rate in turning the baby.]

TOUCH BONDING FOR PREMATURE BABIES

Touch bonding is never more important than with premature babies. How much you can lay on hands is, of course, determined by how early the baby came. But even if your child is in an incubator, there is still so much you can do to communicate and build a bond. For some parents, their child is so tiny the mother’s little finger dwarfs the baby’s hand, but no matter how small the baby, her instinct will still be to hold on to that finger as tightly as she can. In fact, it is months before babies develop the ability to actually let go, so you can maintain physical contact – albeit limited – for as long as you both want to.

Another comforting touch is placing the flat of your hand on the baby’s tummy, avoiding the umbilical stump. Your warmth and the weight of your hand will be registered by the baby’s body, and there’s even evidence that suggests the baby will recognize the hand as yours – doctors have found that unborn babies kick more vigorously when their father’s hand is placed on the mother’s bump, as opposed to, say, the doctor’s, so there’ll be even more recognition with direct skin-to-skin contact.

Stroking the ‘Third Eye’

Try very gently stroking the area between the eyebrows in a downwards direction – stroking downwards is very sedating. This space relates to the ‘third eye’, and stroking it can invoke deep mental relaxation. In Ayurveda, there is a renowned massage which involves pouring warm oil onto the third eye for up to an hour. It is noted for bringing about a profound sense of peace, and I have found this to be true for the modified stroking variation I use to settle fractious babies and to calm anxious pregnant mothers.

Stroking the Aura

You could also gently mould your hand in a cup shape around your baby’s head and stroke her hair with your thumb. Then move your hand up to an inch away from the baby’s head and make a series of long strokes, starting from the nose and sweeping to the back of the head or as far as you can go. This method, where you do not need to actually touch the baby’s head, makes it ideal to calm premature babies. This is known as ‘stroking the aura’.

You can also use this method to take the heat off the baby’s head if you notice that her head is hot. Repeat as above, without touching the baby’s head or neck, and stroke in one direction only as this flow is very relaxing for the baby.

Sceptical? If you relax and close your eyes and do it on yourself for a minute or two, you should be able to register an almost tingly sensation, like an electric current. Do this for about five to twenty minutes, or as long as you like. It’s a loving, rhythmic sequence which can really get you involved with your baby’s physicality, until such time as the baby is ready for full-on cuddles.

‘Kangaroo Care’

When the baby can come out of the incubator for periods, take every opportunity to enjoy skin-on-skin touch. If you have been expressing your milk, you can now try direct breastfeeding. Equally, the father can try giving the baby a bottle of your milk. Both of you should try as much as possible to feed the baby without your shirts on as it’s important that the baby can smell you and learn to associate your smell with loving touch. Remember, there are lots of bright lights around incubators – the baby may even have worn goggles – so she won’t have terribly strong visual impressions of you. But she will have been able to smell you, so the closer she can actually get to you and your scent, the more relaxed she will be.

This intensive form of touch bonding is known as ‘kangaroo care’. It has been proven to bring remarkable positive responses in premature babies. So take every opportunity to hold your baby against your chest. Let her smell your skin, nuzzle into your neck, sleep on your tummy, look up into your eyes. Don’t put her down until the nurses are practically tugging her free. Every minute of skin-on-skin will make a difference.

Case History: Kangaroo Mother Care (KMC) for Premature Babies

This case history was contributed by paediatrician Dr G. Pramood Reddy MD DCH of the Fernandez Hospital for women and children in Hyderabad, India. The hospital was set up by my friend, Dr Evita Fernandez, whom I greatly admire for her dedicated work on the cutting edge of obstetric and neonatal care in India. It is Evita’s – and my – wish that Kangaroo Mother Care is provided as an absolute necessity in developing countries where two-thirds of the world’s low-birth-weight babies are born.

Rama Mani, a 35-year-old first-time mother, was treated for fertility issues for more than 14 years before she finally conceived. Unfortunately, during her pregnancy she suffered from many medical problems, including gestational diabetes, pre-eclampsia, fibroids and the problems that accompany an Rh-negative blood group! Despite the obstetric precaution of placing a cervical stitch to prevent premature labour, she went into labour at 30 weeks and delivered a baby girl weighing only 1.28kg. The baby was initially looked after in an incubator but as early as possible – by day 12 – she was moved to the Kangaroo Mother Care Ward.

Rama said that finally holding her baby next to her skin was one of the most joyous moments of her life. She was able to breastfeed her baby on demand and the baby gained weight notably faster than she would have if she were still in an incubator.

More importantly, Rama finally felt that she was able to nurture and mother her baby, and she confidently took her daughter home less than three weeks after the birth. Rama was so fascinated with the concept of Kangaroo Mother Care that she made her husband carry the baby around as well! Subsequently her daughter thrived and, despite her uncertain start to life, progressed rapidly to catch up with her full-term peers.

Play Bonding

Babies learn through play, but they also love through play, and so do we. Playing is an intrinsic part of bonding because to play with your baby is to delight in what she can do. There is no sophistication in baby play – no cultivated wit or superior irony – only the unbridled joy that comes with achievement and the thrill of the new. It is obvious, naïve, heartfelt and worn on the sleeves of both her babygro and your jumper.

Toys are great educational tools for the early months, but contact play – such as tickling or raspberry blowing – boasts benefits beyond the immediate joy of close touch. The skin is an organ which is stimulated by touch. The skin’s nerve centre, the brain, releases a rush of feel-good hormones called endorphins every time you squeeze, stroke or tickle your baby. In fact, there is mounting evidence that deprivation of touch in childhood can actually reprogramme the brain and contribute to antisocial behaviour in later life. So getting physical when you play with your baby has far-reaching benefits, as well as boosting self-esteem and making you both feel good.

The skin’s nerve centre, the brain, releases a rush of feel-good hormones called endorphins every time you squeeze, stroke or tickle your baby.

You can’t help but clap with delight as your baby builds her first tower; both giggle helplessly when you tickle her on the changing mat, and revel in the excitement when your baby does a ‘boo’ to your ‘peek’. Playing is like smiling when you’re sad – it instantly makes you feel better. Each time you play with your baby, the world is new to you again, fresh and waiting to be explored. So turn every waking moment into an opportunity to share a giggle or show something new. Each time you do, your soul is renewed, your heart grows larger and your love becomes deeper.

Breastfeeding

By rights, the issue of breastfeeding should be included in the ‘bonding’ section, as it is one of the most profoundly intimate and loving exchanges between mother and baby. The physical skin-on-skin contact helps the baby still feel closely connected to the mother’s body, which has protected and nurtured the baby during the pregnancy. This feeling of security cannot be underestimated as the baby has, of yet, no sense of being physically separate from its mother. To the baby’s limited sense of self, they are one person, and breastfeeding helps enormously in preserving that security. For the mother too, breastfeeding acts as a halfway house, as she adjusts to the physical separation from her child, which is, of course, the necessary result of birth.

From a practical point of view breast is best and easiest, and it’s always just the right temperature. It is easily digestible, organic and, best of all, free! Plus, it helps the mother regain her figure more quickly. Breastfeeding burns approximately 500 calories a day. The baby’s sucks stimulate the release of oxytocin from the mother’s brain – the hormone responsible for contractions in labour – helping the womb shrink back into the pelvis far more quickly, and the mother to lose tummy fat and get back into her jeans!

Of course, the nutritional benefits of breastfeeding are what we really want to shout about. As well as passing on vital antibodies, which boost the baby’s immune system, a mother’s breast milk is perfectly tailored to her baby’s individual needs. There are so many health benefits to breastfeeding that they alone are most women’s incentives to carry on:

benefits of breastfeeding

 Reduced incidence/severity of eczema and asthma, childhood diabetes, gastric, urinary and respiratory tract infections and ear infections

 Higher IQ

 Less likelihood of cardiovascular disease or obesity in later life

 Long-term breastfeeding (at least a year) can reduce the risk of several cancers, such as ovarian and pre-menopausal breast cancer

 La Leche League has reported that breastfeeding can protect from osteoporosis in later life.

the father’s role in breastfeeding

Yes, fathers actually play a very important role in breastfeeding. Studies have shown that the father’s attitude to breastfeeding can determine whether or not the mother begins and continues to breastfeed. If he is against it, it is usually a direct response in which he sees his partner’s breasts as sexual organs and is reclaiming them for himself, especially if his partner didn’t want her breasts to be touched during pregnancy. The father might also feel that the side-effects of breastfeeding – such as tiredness or low libido – puts too much pressure on the parents’ relationship and ask for breastfeeding to be abandoned. If this is the case, try to negotiate a time frame you are both happy with, up to which you will feed. Stress to your partner that this is only a temporary stage and your hormones will return to normal after you have stopped feeding.

Even if your partner is fully supportive of you breastfeeding, it is still worth encouraging him to feed the baby as much as possible. You can easily express your breast milk so that the father can feed the baby and feel more involved in this aspect of nourishing and nurturing his baby.

The Different Stages

THE FIRST FEW DAYS

Breastfeeding changes with different stages. The first stage occurs in the first few minutes after birth until three to five days later, and is the real ‘feed on demand’ stage – the more sucking the baby can do in these early days, the more bountiful the milk supply. Some babies (particularly those born by Caesarean section), however, may be exhausted and sleepy after the birth, and the appetite centre in their brain may not switch on for as long as 48 hours after the birth. In this acute period, the baby feeds on colostrum – a thick, creamy-yellow first milk that is absolutely jam-packed with goodness. It is the most optimal food of a baby’s entire life, quenching their thirst, filling their tummies for the first time (and so helping pass the meconium from their bowels) and equipping them with a hit of vitamins, minerals and antibodies which will last for up to six months. In the UK, 69 per cent of mothers begin to breastfeed after birth.

correct latch technique and tips

 Tummy to mummy: lay the baby across your lap, with the baby’s tummy lying next to your tummy. The baby should be supported high enough so that her face is at breast height. A C-shaped breastfeeding pillow is ideal as it is long enough to curl around you, support the full weight of your baby and bring her up to the right height for you. This will help you to sit comfortably without having to bend over, preventing neck and upper back strain.

 Nose to nipple: Move the baby towards the breast and stimulate your baby’s rooting reflex by brushing your nipple on your baby’s upper lip. This will encourage the baby to open her mouth. (Never move your breast to the baby – it must always be the other way round.)

 When the baby’s mouth is open very wide, place the baby on the breast so that her bottom lip is curled back and her chin is pressed into the lower breast area (her chin should touch the breast first). In ratio terms, her mouth should cover the areola above the nipple one part to three parts below the nipple.

 The nipple should be directed at the back of the mouth, as far away as possible from the baby’s tongue, as the baby doesn’t actually suck the nipple itself, but stimulates the wider areola for milk release (the NCT says pertinently: it’s breastfeeding, not nipple-feeding).

 Sit centrally. This is vital for back care.

 If your baby is particularly windy, modify this technique by sitting the baby into a more upright position. Each time the baby naturally breaks off, wind gently.

 To break the latch, never just pull the baby off, as they get a powerful suction going! Put your little finger into the corner of her mouth first to break the suction.

Breast and Nipple Protection

In the early weeks, your breasts and nipples are naturally going to feel sensitive, even sore, until they adjust to breastfeeding. The most important preventative measure is to make sure the baby is latching on properly (see above). Some mothers like to use a barrier cream such as Lansinoh (which is pure lanolin) or Kamillosan after every feed for the first few weeks until you adjust. It is not strictly necessary to wash it off before the next feed, but I do advise it, as the commercial varieties do contain some preservatives.

An alternative way to treat sore nipples is to express and rub a little of your milk onto them and allow them to air dry. Equally, if the nipples are very bad, or bleeding, some midwives recommend applying Vaseline before putting on the lanolin barrier creams. I have had mothers swear by it. If your nipples are too sore to feed, latex or plastic nipple guards are available at most pharmacies and can tide you over for a few days whilst the nipple heals. But if it is getting to this stage, please see a breastfeeding counsellor or lactation consultant for advice. They may also recommend that you express your milk for a couple of days and feed from a bottle (remember to express 30–45 minutes before the feed is due, so that the baby is fed on time).

If your breasts feel hot and tender when engorged in the early days, savoy cabbage leaves from the fridge naturally cup the breast and provide an instant cooling balm, or just drape over a cold wet flannel. Equally, you can buy gel-pads that you leave in the freezer. They are breast-shaped and can be placed reasonably discreetly inside the bra.

Although it is normal to feel a slight sharpness in the early days, breastfeeding should be comfortable. If you experience any sharp ‘cut glass’ shooting pains (indicative of thrush, see homeopathy for third-degree tears) or redness of the breast tissue, lumps or feverishness (indicative of mastitis, see mastitis) see your breastfeeding specialist or health visitor immediately. Mastitis can be treated with Bowen treatments and massage (see massage technique for blocked milk ducts) or in some cases antibiotics. Thrush can be treated with antifungal creams/tablets.

massage technique for blocked milk ducts

The following light massage technique clears the breast lymphatics and reduces the incidence of blocked milk ducts and mastitis. Using the middle three fingers, gently massage in ever-increasing clockwise circles from the edge of the areola to the upper breast and armpit area. Perform eight to ten times, twice a day.

bowen technique for all grades of mastitis

Bowen moves can be performed around the breast in an elliptical pattern, and I can vouch for the fact that mothers experience almost immediate relief. You can treat yourself whenever you feel your breasts are becoming sore or engorged.

THE SECOND STAGE

After three to five days (usually five days for Caesarean mothers), when most of the placental hormones (oestrogen and progesterone) have left the mother’s body, prolactin is produced and the main milk ‘comes in’.

Most textbooks on breastfeeding explain that the breast milk flows in two stages: the fore milk and hind milk. Whilst I respect this viewpoint, I reject the concept that there are two types of milk. I am also sceptical of rigid feeding times in the first two weeks. Some babies are better than others at breastfeeding, and their skill can make a big difference to how long a feed takes. Another important factor is how quickly the mother ‘lets down’ her milk. Again, some are faster than others, which determines how long the baby is on the breast. I therefore advise my mothers to relax if their baby stays on an individual breast for just 20 minutes.

Breastfeeding Problems in the Second Stage

This second stage of breastfeeding is characterized by engorgement and leaky nipples, and mastitis is most common at this point. This is because it takes a few weeks for the milk supply to even out. Mastitis occurs when residual milk becomes compacted and the surrounding tissues inflamed. If you suffer from mastitis but are leaving the baby on for 40 minutes or more, check the baby’s latch (see box, correct latch technique and tips). Poor latch technique is incredibly common and can lead to prolonged and inefficient feeding. Sometimes the difference between a good and poor latch can be a matter of millimetres, so I strongly recommend seeing a specialist/counsellor at a breastfeeding clinic who can analyse and correct your latch. (Your midwife/health visitor will be able to give you details of your local clinic.)

Mothers sometimes get into a habit of feeding their baby in one position, or they favour one side over another. Vary your routine, but always start each feed on the same side you finished the previous feed. Some mothers keep a notebook next to their feeding chair to remind themselves of whether it’s left or right this time, but you can also try reminding yourself by pinning a ribbon around the front clasps on your breastfeeding bra or wearing a hair band on the corresponding wrist. I laugh that you can always tell the more practised breastfeeding mothers – they’re the ones who absent-mindedly cup their breasts (one side will be heavier than the other) or gently press the upper breast area in the café or in the park. They become so fine-tuned to the subtle difference between breast swell and heaviness, they check their breasts unconsciously!

Introducing a Feeding Routine

This is also the time to introduce more of a feeding routine, rather than baby-led demand feeding. I recommend a schedule of feeding every three to four hours in a 12-hour day. I have noticed that when babies are introduced to breastfeeding within an hour of birth, they naturally seem to want to feed at more regular intervals and sleep for longer intervals between feeds.

THE THIRD STAGE

By four months, into the third stage, the leaky nipples and feeling of engorgement/heaviness have gone. It is common for many mothers to think their milk supply is drying up and so stop breastfeeding. This is usually an incorrect assumption. Often the lack of engorgement is just a case of the milk supply being highly regulated – both in quantity and timing – as the breasts adapt very quickly to their natural role. They’re still full, just not swollen. It’s worth remembering during this ‘doubting’ period that breast milk provides all the nutrition that most infants need up to six months of age, and that it is still the best option for your baby. Unfortunately, this advice tends to fall on deaf ears, as in the UK only 28 per cent of mothers are still breastfeeding by four months, and 21 per cent by six months.

Breast milk provides all the nutrition that most infants need up to six months of age.

Bear in mind, too, that milk supply is a question of mental attitude. Milk is produced by the hormone prolactin and is let down by the hormone oxytocin, both of which are regulated by the pituitary gland in the brain. So although milk comes from the breast, it is controlled by your brain. If you believe in your ability to produce milk and wholeheartedly want to carry on breastfeeding, you will produce sufficient milk.

If you are worried about your milk supply, consider using an electric pump (so much better than the manual ones) very gently for 15 to 30 minutes at the end of the day. You may well have scarcely any milk (1–2oz) at this time for the first few days but that will very quickly build up as your body responds to the new demand. Also, keep an eye on your diet, particularly once you start weaning (from four to six months) and begin to drop feeds. That is the most dangerous time for breastfeeding as the reduced number of feeds is registered as less demand by the brain, so less milk will be produced. Avoid skipping meals (in fact you must try to eat up to 500 calories more, each day). Drink at least two litres of water per day and avoid alcohol. Exercise only gently and rest/sleep properly. You’d be amazed at what effect tiredness has on milk production!

How To Make Great Milk

WHAT TO EAT

The hormones in your body naturally make milk after birth (even whilst you sleep), but quality control is your responsibility. Those of you who followed the gentle birth method will be used to a fairly controlled diet. If you are new to the gentle way, this may come as something of a shock: I advocate a sugar-free, wheat-free diet during pregnancy to moderate the weight gain of both mother and baby, and minimize fluid retention.

For at least the first month after birth (and longer if they can bear it), I encourage my mothers to stick to their antenatal diet but for quite different reasons. In the womb, your baby will have ingested what you ate, and so have become accustomed to your dietary tastes. After birth, your milk will be uniquely and subtly flavoured according to your preferences, and it is my personal belief that many instances of colic/wind in babies can be attributed to the mother’s sudden change in dietary habits.

You can go for a low-wheat, rather than no-wheat diet, and keep sugar to a minimum – but rather than thinking about restrictions, you should try to think about what your diet can do for your milk.

Try to think about what your diet can do for your milk.

The way to view it is that until the baby is fully weaned, breastfeeding is, to all intents and purposes, another segment of pregnancy – your baby is still as dependent on you for nourishment as she was in utero. Of course, watching your diet is another sacrifice for you, and after nine long months of pregnancy and a tiring birth, you may well have had enough, but you’re on the home straight, and this is a relatively short period of time in the grand scheme of things.

Foods to choose:

 Small fish (high in omega fats) such as sardines, kippers and herrings

 Lean proteins

 Vegetables

 Oats

 Salads

 Fruits

 Lots of water (room temperature)

This will create a nourishing, rich milk upon which your baby will both thrive and settle. I think that poor-quality milk is a prime suspect in fractious, irritable babies.

FISH SOUP AND GREAT MILK

In the tropics where I grew up, the fisherwomen’s baskets were full of small coin-like fish, or little elongated fish or sardines. They were all grouped together under the common name podimeen, which literally means ‘small fish’. I distinctly remember my grandmother advising my mother to make a light soup of these fish and consume it daily to improve the quality and quantity of breast milk to feed my younger siblings. Perhaps you could modify a suitable recipe from your cookbooks at home to take whilst breastfeeding?

POSTNATAL PUDDING

Something I recommend highly, but which is quite a cultural departure for most of my mothers, is the postnatal pudding, raagi kallie (a common name for a nutritious pudding or paste). In southern India, this pudding is made from a grain called raagi (‘finger corn’ in English), but you can make kallie using ground millet grains.

Recipe for Raagi Kallie

Take a cup of powdered grain and add to a pint of boiling water in a saucepan on the hob. Stir the mixture all the time. As it begins to thicken, add two tablespoons of ghee (clarified butter) and a tablespoon of powdered jaggery (palm sugar) till the whole mixture takes on the consistency of firm dough.

The end product is warm, moist and very tasty – little wonder that it’s an intrinsic part of the immediate post-partum programme in India. Formulated especially for the needs of the new, breastfeeding mother, it contains high levels of calcium, protein, fat and carbohydrate, which all provide amazing nutrition for good breast milk production. Of course, you’ll have precious little time to make this yourself, so following the red tent concept (see the importance of bonding), ask someone close to make it for you. You may feel like this is another favour to ask other people to do for you, but people always want to help when there’s a new baby and I’m sure your partner, mother, best friend or doula would be delighted to make it for you during the first two weeks after the birth. The ingredients themselves are cheap and can be easily found at larger supermarkets or at Asian grocers (I found jaggery at Tesco).

WHAT TO DRINK

So your diet should be optimal, and so should your fluids. Keep off alcohol, especially spirits, but if manners or sanity dictate accepting a small tipple, limit it to one small glass of wine on very special occasions. If you can’t completely give up tea or coffee, please at least give up coffee and drink just cups of weak tea – but if your baby is unsettled or windy, you’ll have to come off it altogether. Herbal and green teas are ideal. Many midwives swear by fennel/nettle tea for reducing wind/colic/fretfulness in babies. Please remember to drink at least two litres of water per day, as hydrating yourself will boost your milk volume and quench your baby’s thirst. Keep a bottle of water next to your feeding chair and another next to your bed so that it’s always to hand – many mothers report a mad thirst as soon as they begin a feed.

PROBIOTIC SUPPLEMENTS

As with the gentle birth method, I advise you to top up your diet with probiotics to help encourage the growth of friendly bacteria in your gut and prevent thrush (which is very common in the first week after birth). And a supplement of digestive enzymes will ward off indigestion and prevent bloating, both of which are problems due to the massive hormonal shifts after birth. By extracting every morsel of goodness from your diet, these supplements will help boost the quality of your milk; and by eliminating wind from your digestive system, the milk you pass on to your baby should be correspondingly flat.

EXERCISE

Strenuous exercise should be avoided for the first few weeks, certainly the first three, and ideally introduced after six weeks. This is because your body is still tired from the birth and trying to recover. You will probably find that you are losing a lot of weight in these first few weeks anyway and added exercise could have a big effect on your milk production, especially in the early days. Your body needs an extra 500 calories per day just to breastfeed (that’s more than double the excess you needed during pregnancy) so do conserve your calories, or the quality of your milk will suffer.

COMPLEMENTARY THERAPIES

If you think your milk supply is low by the end of the first week, homeopathy can really help your milk come in. I recommend the following, three times a day for three days:

 Sepia 30c – If you are exhausted

 Cocculus 30c – If you are exhausted with broken sleep

 China 30c – If you are exhausted from breastfeeding

I also prescribe to the mothers at my clinic a homeopathic remedy that supports breastfeeding. I source this remedy from a revered 95-year-old homeopath in India. The formula decidedly improves the quality of breast milk and is great for the early days during transition from colostrum to more copious quantities of breast milk. He has named it Lactors and the remedy includes Calc flour 6c, Lecithin 6c and Asafoetida 6c (see Resources for details).

Reflexology has long been known to improve lactation, and I always perform some reflexology on the new mothers at my clinic. It has now been formally trialled at one of the main teaching hospitals in London to see if it can improve breast milk production for mothers of premature babies, and the results were favourable. I hope this will mean a more widespread take-up of reflexology among postnatal health professionals such as midwives and health visitors, and at breastfeeding clinics.

Case History: Reflexology and Breastfeeding

One of my colleagues referred a mother of Asian origin to me, just one week after her baby was born. She was unable to produce any breast milk at all.

I prescribed deep reflexology three times a week, concentrating on the pituitary and hypothalamic reflex areas in the brain, as well as on the breast reflex and digestive areas. I also prescribed my favourite homeopathic remedy, Lactors, which improves breast milk production. Along with this I advised her to make a soup of small-boned fish like sardines or whitebait (see FISH SOUP AND GREAT MILK). She was advised to pressure-cook the fish – to really pulp it so that the bio-available calcium could be extracted from the fish to help her lactation. I also recommended a daily drink made from an infusion of fennel seeds (see below).

Within a day she went from producing 10 drops of milk to 50. A day later she was up to 10ml and then again up to 20ml. Within two weeks she was breastfeeding satisfactorily, even though she did supplement at night.

Recipe for Fennel Tonic

The Ayurvedic herbal tonic called Jeerarishtam is a boon to new mothers in India and improves lactation tremendously. The main ingredient of this preparation is fennel seeds, and for mothers who can’t get hold of Jeerarishtam, then a simple recipe is to take a teaspoon of fennel seeds, boil it in half a pint of water, reduce it down to a cupful and drink this daily for three months after the birth.

The following postnatal milk-boosting recipes are Syrian in origin, and contributed by one of my favourite mothers, Rima Stait.

Recipe for Chicken Broth Porridge

1 whole chicken

5 cups of boiling water

Salt and pepper to taste

1 cup of Quaker Porridge Oats

Honey and a sprinkle of cinnamon

1 Cut the chicken into relatively small pieces. Place in a saucepan and cover with the boiling water.

2 Cover and boil for an hour. Season with salt and pepper to taste.

3 Allow to cool and remove all bones from the chicken, shredding the meat into bite-size pieces.

4 Boil the porridge oats with the remaining chicken broth (which should be about 4 cups) in the saucepan (without the chicken). Stir for 15 minutes over a low heat.

5 Add the chicken and stir occasionally for another 15 minutes.

6 Just before the end of cooking time, add honey and a sprinkle of cinnamon to taste.

NB You can substitute lamb off the bone for the chicken.

Recipe for Caraway Dessert

Traditionally this recipe is made by the grandmother, and it’s a labour of love.

6 cups of boiling water

2 cups of sugar

1 cup of powdered rice

¼ cup of caraway powder (see Resources)

2 tablespoons of cinnamon

Mixed nuts (pistachios, almonds, walnuts, pine nuts …)

1 Mix all the ingredients together in a saucepan, except for the nuts.

2 Leave to boil gently over a low heat for an hour, stirring continuously, until the mixture turns thick. (Thickness can be controlled by adding more boiling water if needed.)

3 Pour into small dessert glasses and refrigerate.

4 Soak the nuts in warm water for an hour and peel off any excess skin.

5 Remove the dessert from the refrigerator an hour or so before serving, as it is best eaten at room temperature. Sprinkle the nuts over each dessert glass.

Emotional Minefields

Baby Blues

One of the most oft-heard statements in the delivery room is: ‘This is the happiest day of my life.’ But I’ve long felt that statement has a lot to answer for because it implies that happiness is absolute, untainted by any other more complex emotions such as anxiety, anger or resentment. Three days later at home or on the postnatal ward when the baby blues kick in, it’s usually a different story anyway! Whilst for many mothers the love for their baby is instant, deep and undeniable, for equally as many others, the maternal response is cautious, fearful and even apathetic.

As I wrote earlier in this chapter, bonding is neither automatic nor immediate. Even those mothers who reported a love-at-first-sight reaction will tell you that however powerful that thunderbolt, their love has grown infinitely deeper with the years. Initial ambivalence doesn’t signify lack of maternal feeling – or, as some fear, psychosis – but rather a hormonal flux.

During your pregnancy, practically everything that can be measured and evaluated is recorded – blood pressure, sugar levels, volume of amniotic waters, size of the baby’s tummy, the size of the fundus (your tummy!). And yet the catalyst for all this activity is the dramatic hormone change. During pregnancy, levels of the hormone oestrogen from the baby’s placenta are 300 times higher than normal, while progesterone and relaxin levels are 30 times higher. During birth your body is flooded with oxytocin from your own hypothalamus and pituitary gland. After giving birth, the oestrogen and progesterone ebb away to allow for the greater flow of prolactin from your pituitary gland. The rigours of pregnancy and birth are small beer compared to these rocking hormone changes, so it’s little wonder if you feel emotionally fragile.

Put frankly, it takes time to feel normal, and the immediate postnatal phase should come with a mental health warning! Fortunately, the mental and emotional aspect of birthing is becoming more understood. At antenatal classes, parents are told to expect the baby blues coming along with the milk, and any residual stigma or taboo surrounding postnatal depression has disappeared as we’ve learnt more about it. Postnatal depression does not mean a maternal vacuum – it’s just chemistry.

WHAT CAN YOU DO ABOUT BABY BLUES?

Well, the first step is recognizing the symptoms and asking for help. In the first week after birth, extreme tiredness, apathy about the baby, loss of appetite, anxiety, insomnia, weepiness or desperation are all indicators of the baby blues and incredibly common. Fifty to eighty per cent of mothers experience one, or a range, of these emotions, so it’s more likely that you will too. The cause is straightforward: the milk let-down hormone, prolactin, is present in ever increasing levels during pregnancy but surges in greater quantities once the main placental hormones – oestrogen and progesterone – have mostly been excreted after the birth of the baby and the expulsion of the placenta. This means a massive drop of oestrogen and circulating progesterone as well. This is like a hormonal cold turkey for the body and it takes a couple of days to readjust. Medically, it has become common practice to treat postnatal depression with a natural form of progesterone in large doses. I have found that rose otto oil massage really helps too, mostly because it is highly oestrogenic and is a safe source of plant oestrogens.

tips for beating the baby blues

I ask mothers to look in the mirror every morning and say out loud to themselves: ‘I love my life’ several times, maybe even 30 times! This feels strange initially but after a few days the programming kicks in and you really will feel better about your life. For milder cases of depression, I also encourage my mothers to sing – yes, really. To begin with, they often have to force themselves, as singing – like smiling – is naturally joyous. But it’s a case of ‘fake it till you make it’. The joy that comes from this small gesture is deeply underestimated and irrepressible – and your baby will love it too.

Postnatal Depression

Postnatal depression isn’t quite so textbook as the baby blues. It can come on at any time up to a year after the baby is born. Many mothers feel more depressed at four to five months than in the first week, as the immediate post-birth euphoria is attributed to the endorphins that are released in great quantities during the birth process. Once the endorphin levels drop, the broken nights take their toll. Breastfeeding depletes the mother’s fragile energy reserves, and the days can easily settle into a tedious, unending schedule of nappy changes, naps and feeds. This routine can be particularly tough on career-minded mothers.

Postnatal depression (PND) affects 15 per cent of mothers, which is still statistically significant. Symptoms include those of the baby blues (see previous page), compounded with:

 feelings of inadequacy

 despondency

 panic

 guilt

 mania

 no desire to breastfeed

 not caring about your appearance

 exhaustion

 headaches

 chest pains

Serious cases of PND are called postpartum psychosis and are fortunately rare (only one to two per cent of mothers are affected). Symptoms include severe mood swings and in some cases suicidal thoughts or thoughts of harming the baby. The mother may also experience hallucinations or confusion.

PND is an imbalance of the brain chemistry, but I always reassure my mothers that their hearts are still beating for their baby. An instant tonic, which can really elevate your mood, is an aromatherapy massage with rose otto essential oil. This contains many oestrogenic substances and is as therapeutic as it is luxurious. Rose otto works like a cerebral ‘upper’ to bridge the gap when hormone levels fluctuate, and it can have astounding results (see case history, Case History: Rose Otto Oil Massage and Postnatal Depression). Remember, communication can happen in many ways, and if conversation about your feelings is just too confrontational, allowing yourself to be massaged and touched will keep you connected to others and stop you withdrawing into yourself.

After the birth, fathers who have learnt creative healing techniques in pregnancy can use their skills and treat the mother to postnatal treatments. This will give the father a wonderful opportunity to maintain close physical contact with the mother when she needs physical and emotional comfort.

note

In all cases of post-birth blues, a good homeopath will help you find the appropriate remedies to help you work through your hormones and find your true emotions.

Case History: Rose Otto Oil Massage and Postnatal Depression

I remember very clearly a mother who was referred to me with clinical postnatal depression. She had stopped breastfeeding, had a very offhand attitude towards the baby, who was 10 days old, and her mother and husband had sought professional help when she had aggressively flung the baby onto the bed. The consulting psychiatrist wanted to hospitalize her when she was brought to me. I prescribed an aromatherapy massage with a massive dose of rose otto oil, much more than I would normally recommend. (Rose otto holds a higher concentration of the medicinal fractions of the rose oil.) She received a total body massage for a full hour, followed by some reflexology. I worked really intensively on relaxing her and making her feel cared for. The result was almost instant – even by the end of that first session, her demeanour changed and she seemed more interested in the baby, although she still wasn’t allowed to handle him.

I asked her to come back every other day, and by the third session she had improved so much that she resumed breastfeeding under supervision. Her husband had taken a month off work to deal with the domestic crisis but was able to return after just over a week. Her mother stayed with her during the day so that the new mother felt supported, which gave her an ability to cope. I advised her to carry on daily with the rose otto massage (although at lower dosages) – either as self-massage or administered by her husband – to keep her mood lifted. And it worked – she never needed to come back to me again.

rose otto oil self-massage

1 Blend ten drops of rose otto oil into 20ml of base oil such as extra virgin olive oil or sweet almond oil.

2 Firmly apply to the arms and legs in long downwards strokes. 3 Apply to the upper half of the torso in an upwards direction in small clockwise circles, draining the tissue fluids over the neck and upper chest into the triangular area above the collarbone. (For those of you who have followed the gentle birth method, this massage follows the creative healing lines of drainage described there.)

4 The abdominal area is massaged in an upwards direction and the waist swept from the periphery to the central areas.

5 Repeat daily. Do not wash off the oil for at least four hours.

rose otto oil bonding tip

If you are performing the massage in the morning, and so wearing the scent during the day, the baby is going to associate rose scent with you. You might like to strengthen this connection and comfort the baby by burning rose oil or a rose-scented candle in the nursery. Or dab a drop of rose otto oil onto a piece of muslin and tie it to the side of the cot.

Recipe for a Good Postnatal Anti-depression Herbal Tea

½ teaspoon of raspberry leaves, dried

½ teaspoon of rosemary leaves, chopped

½ teaspoon of skullcap

½ teaspoon of liquorice, shredded

Add all the herbs to half a pint of boiling water. Allow to steep for twenty minutes, then strain and drink. Take this daily for about two months after the birth.

OTHER CAUSES OF PND

Poor Acceptance of Birth Experience

Postnatal depression primarily occurs from hormonal imbalance, but there are extenuating factors that can compound it, such as facing up to the birth experience (see ‘Birth Acceptance’). A whole host of feelings can complicate the mother’s emotional landscape. These include disappointment with how they felt their bodies performed, anger, feelings of violation, frustration and even guilt.

You can start to accept the birth either by writing everything down, or talking it over with someone – be it your husband, mother, best friend, midwife or health visitor. You could even apologize to your baby if you feel that you might have resented being pregnant. Your baby will hear you and you will both feel released from tension. It sounds kooky, but you’d be amazed at the relief that can come from articulating pent-up guilt.

Case History: Julia and Felix – Accepting the Birth and Apologizing to Your Baby

I had to have a Caesarean with my first child – which was deeply against my wishes – and so was determined to have a vaginal delivery [or VBAC: vaginal birth after Caesarean section] with my second child. The pregnancy progressed easily, without complications, and I was hoping for a similarly smooth birth. Unfortunately, the shape of my womb meant the baby couldn’t rotate properly and so his head couldn’t descend. My baby also presented in the occipito-posterior position, which meant I was dilating very slowly and becoming exhausted. The doctors were monitoring me closely but because the baby’s heart kept dipping – a possible sign of my Caesarean scar weakening – they were warning that it was likely I would have to have another Caesarean. I was adamant I didn’t want it and eventually my second son was born by forceps and ventouse.

When I saw the huge purple bruise over my baby’s eye from the forceps, and the bruising on his head from the ventouse, I was overwhelmed with guilt. I felt my need to avoid a Caesarean had been selfish – I had avoided surgery but at a cost to my son who was subsequently born in a forceful way.

Every time I held him in my arms, I couldn’t stop kissing his bruises and apologizing for what I had done. I applied arnica cream to the affected areas and he fed ravenously. The bruises faded within two days and I took him to a cranial osteopath a week later. He sent us away without treating the baby, saying there was absolutely no tissue trauma to the head and he was in robust health. His incessant feeding had helped reshape the moulding on his head, but I’m convinced he had accepted my apologies too!

Lack of Help

Another external stress for the depressed mother is insufficient help. Learning about the general care of babies, as well as getting to know your own baby – her character and unique needs – is a full-time job. Keeping the house and providing meals as well is too much for anyone in the immediate post-partum period. It’s the antithesis of the red tent concept (see the importance of bonding) and I strongly advise extra help. Your partner may be off work for the first two weeks but in addition, line up family or very close friends who can help you in the third, fourth and fifth weeks.

Your partner may be off work for the first two weeks but in addition, line up family or very close friends who can help you in the third, fourth and fifth weeks.

Maternity Nurses. You may think of hiring a maternity nurse – a costly but worthwhile investment. The good ones are worth their weight in gold – they can help settle the baby at night after feeds (often the worst part) and help establish a routine – but choose carefully. I strongly recommend choosing from personal recommendations and interviewing before the baby is born.

Night Nannies. Consider a night nanny once or twice a week. They will do the job of the maternity nurse – bringing the baby to you for feeds and settling her afterwards, or just giving a bottle so that you can have an uninterrupted night’s sleep – but at a fraction of the cost.

Doulas. Many women are beginning to turn to doulas for help. ‘Doula’ is a Greek word that means ‘handmaiden’ so it encapsulates all the aspects of personal care and help. The doula’s training is short and is intended to give her an understanding of how to be present as a companion to the mother during birthing. Some doulas are more than birth support partners, but are also trained in therapies that will help the progress of labour. Postnatally, your doula may agree to help with the cooking and housework. Of course, to avoid disappointment you must ask your chosen doula what her role will be both during and after the birth – clarify everything well in advance. I have had feedback that some doulas may decline to help around the house, especially if you already have another young child. In this case it might be better to arrange additional home help.

Birth Acceptance

Why did I not know that birth is the pinnacle where women discover the courage to be mothers?

The Red Tent

Few of us have fairytale lives, but for most women, life is nonetheless a series of stories with a distinct beginning, middle and end: the wax, plateau and wane of relationships; dating, engagement and marriage; pregnancy, birth and motherhood. All follow a natural life cycle which we neatly précis and shape into stories to share and bond with our friends.

At every NCT (National Childbirth Trust) group across the country, thousands of women who are practically strangers to each other sit drinking tea with babes in arms and recounting their birth stories in explicit detail. This scene is repeated across the world as women forge friendships out of the universality of this uniquely female experience. It’s a bonding exercise, but also a catharsis.

Knowing and accepting your birth story is one of the most important elements of embracing motherhood. Before you can become a happy mother, you have to be happy with how you became a mother.

Knowing and accepting your birth story is one of the most important elements of embracing motherhood. Before you can become a happy mother, you have to be happy with how you became a mother. So many problems can stem from denial of this – postnatal depression, low libido, trouble bonding with the baby, fear of getting pregnant again – and I always urge my mothers to write down their birth experience. Many send their stories in to me, as I of course have a great interest in their pregnancy and birth, and I try to learn something new with the hindsight of each tale.

There are lessons to be learnt even from the archetypal gentle birth. But if you experienced complications during the birth – as so very many mothers do – addressing the issues it throws up is key. Many women feel violated if instrumentation was used; disappointed if they had to have a Caesarean section; or robbed of the entire experience if they delivered under a general anaesthetic. In all events it is good to have a friend or confidant with whom you can talk about your true feelings openly, as sharing your story will make you feel understood.

Of course, for some of you, going over every last detail might be the last thing you want to do, but you will invariably learn something that might alter the course next time. If you can, sit down with your midwife or obstetrician – ideally before you are sent home and the experience is as fresh in their minds – and ask pertinent questions like:

 Was the baby breech because of the shape of my womb?

 Why didn’t I dilate quickly?

 Why couldn’t the baby turn?

 Was Caesarean really the only option?

 Did the epidural slow down my contractions?

They will know whether your pelvis is shallow or deep, if the baby was too big for your frame or if your vaginal muscles were too tight to avoid an episiotomy. You can’t change the past but you can forgive it. By being armed with full knowledge, you can make the changes you need to shape your future – and get your happy ending.

Following is a birth acceptance visualization, which I hope will enable you to experience the kind of positive uplift you can receive as a new mother – whatever your birth story. If you followed the gentle birth method, you will already know how to invoke deep muscle relaxation. To start, sit in a warm, dim place, ideally stretched out in a position you can comfortably maintain for 20 minutes.

Note: If you have a close friend or partner who can read this to you, close your eyes and get into a comfortable position of rest and relaxation, making sure you are warm. Ask them to read very, very slowly and in a soft voice:

Birth Acceptance Visualization

Take three deep breaths into the lowest part of your tummy and let your breath go all the way down into your pelvis. As you breathe out, visualize that your pelvic muscles are utilizing the new oxygen you have just breathed in, and are revitalizing and toning up your amazing birthing spaces. After those three initial breaths, breathe more normally. As you do so, remember that when you close your eyes, you automatically generate the alpha-wave patterns within your brain that induce meditation and a receptive frame of mind!

Take another deep breath to indicate your readiness to let your subconscious send positive messages to your mind and body for total healing, so that you can glorify the fact that you have given birth. Your soul accepted becoming a mother quite spontaneously and unconsciously, and when you learnt you were pregnant you generously welcomed your tiny little baby into your womb. Your baby grew within your womb for ten whole lunar months, and all the while you talked to your baby and watched your baby grow. You have been so generous with your love!

Of course your baby too gave you untold joy while within your womb, especially when you noticed your friends and even people walking by on the street looking at you with warmth, pride and even curiosity! You pretended to ignore their curiosity but you felt proud within as you smiled to yourself and walked away.

As your baby’s birthing day was approaching, you enjoyed curling up on a sofa and tuning in to your thoughts. You visualized holding your baby in your arms and rocking your baby to sleep. The most intimate moments of your baby’s life were while you were still carrying your baby within your womb. You intimately shared every thought, every emotion, every rush of love! The closest relationship between two individuals is the relationship of you, the mother, with your baby within your womb. You look back and remember the joy you experienced when your baby moved reassuringly and prodded, nudged and kicked you from within your womb!

Half open your eyes and look around, then close your eyes again as you take three more deep breaths. And as you do so, all your happy moments that you can recall during your pregnancy will flash before your eyes as vivid colourful images – all bright, all beautiful! Almost as if you are seeing yourself in a television screen. Every time you take three deep breaths from now on you will instantly tune in to those wonderful memories that awaken in you feelings of great joy!

You begin to tune in to the fact that the whole purpose of getting pregnant was to hold your tiny baby in your arms and nurture your precious bundle! Your strong maternal instinct is ever-present, even when you are tired, and your baby knows that instinctively. After all, your baby was within your womb all those months and has become finely tuned to the way that you express yourself. You even notice that people on the street smile at you as you walk around your neighbourhood with your baby. They seem to be unconsciously drawn to your subtle radiance.

All that we visualize becomes a reality, so let us visualize that from this moment onwards every time you wish your baby would go to sleep, he/she will … Close your eyes and visualize two special guardian angels spreading their wings of protection around you and your baby, making both of you equally sleepy. Their presence radiates warm waves of sedation that surround you and your baby like a magnetic blanket, sending you both into a wonderful sleep! As you fall into a deep and dreamless sleep, the kind that automatically nurtures and nourishes you and makes you feel immersed in our great universe, you receive an insight that everything you visualize becomes a reality. And you visualize physical help and emotional support for you and your baby for each and every moment of your life.

I invite you to know that each and every birth is unique. You allow your inner mind to forgive your busy lifestyle that might have compromised your birth fitness, and you resolve that next time you will give yourself the total rest that you, as a pregnant mother, truly deserve.

Even though your birth was different from what you expected, we are going to now use your special gift to visualize what your birth should have been like. So let us imagine you and your baby’s guardian angel. She is sweeping her arms across the sky as your first contractions come on, sprinkling you in snowflakes which tumble over your hair and down your shoulders, easing all the tension out of your muscles, until your body melts into the consistency of softly set jelly. As you relax, she whispers into the ear of your partner. He envisages his beautiful baby inside your body, preparing to be born, dropping down all the way into your pelvis with the baby’s chin on his/her chest so that his/her head is well flexed and fits easily into your inner pelvic space, ready to smoothly slide down your birthing spaces … stretching and moulding all the way down to your vaginal opening. You visualize your baby actively participating in the birth process by secreting even more elastin and relaxin that automatically widen and soften your pelvic spaces, magically expanding them into a wide-open channel for your birth process.

From where we are now, your angel eases the tenderness and the tissue memory from all of your muscles that are healing so well. Your angel understands and transmits to your inner mind what you needed to know at the time of your birth so that you forgive the past easily and proceed to heal smoothly.

Your inner mind suddenly becomes aware that both you and your baby have together created a wide-open channel within your pelvis that a tiny baby can easily slide out of. Check this out with your inner mind, and if your inner mind agrees then take a deep breath in and out and let your whole body relax even further as you allow all the tissues in your body to behave as if they have just experienced your dream birth!

Take another deep breath in and out as you ask all the tissues in your body, especially in your pelvis and birthing areas, to release all old tissue memories and imprint the new visualized memory of the birth that you and your baby have now created within your minds.

Take another deep breath into the lowest part of your tummy and ask your amazing inner mind to let your eyes open … only … when your inner mind has totally integrated this special healing into all the parts of your mind and into your tissue memory.

questions to ask after an assisted delivery

Following an instrumented delivery, such as a ventouse birth, you may want to ask your doctor or midwife the following questions to get a better idea of what was needed and why, its effect on the baby, and whether it’ll be necessary next time.

1 Was the baby’s head fairly well down or was it quite high in the pelvis?

2 Was the suction pressure increased too quickly?

3 Was the traction applied forceful or gentle?

4 Was the baby’s head delivered slowly and gently?

5 Was it wise to attempt a vaginal delivery i.e. if the baby was too big to fit through the mother’s pelvis?

6 What was the condition of the maternal tissues – swollen or rigid?

A careful and skilful obstetrician can indeed minimize the risks to mother and baby. As always, prevention is better than cure. I advocate that all mothers try and follow the guidelines set out in my first book, The Gentle Birth Method, so that even in the eventuality of an instrumental delivery there can be easier application of the instruments with a gentler delivery for the baby.

A good homeopathic remedy to help ease the disappointment of instrumentation or a Caesarean section is staphysagria 200c immediately after the birth and, if possible, three times a day for three days afterwards.

Baby

Post-Partum Care

Here is a summary of useful treatments and care techniques for the baby in the first week after birth.

Light reflexology. At this point, it’s more of a gentle foot massage for the baby. Very gently lift your baby’s foot and softly massage the toes, one by one. Then, with either the heel of your hand or the knuckle of your crooked index finger, lightly stroke the soles of the feet in an upward direction. This area helps digestion and encourages the baby to relax, and it’s something you can do easily whilst feeding.

Cupping and cooling. Otherwise known as ‘stroking the aura’, this non-touch remedy can really soothe irritable babies. Put a drop of Rescue Remedy onto some cotton wool and wipe it over the fontanelles. Then mould your hand into a cup shape and, at a distance of one inch from the baby’s head, gently make long sweeping strokes in one direction only, from the baby’s forehead to the occiput at the back of her head. Repeat for at least five minutes, and up to twenty minutes, as often as you like daily.

Cranio-sacral therapy. Take the baby to a reputed practitioner in the first few days after the birth, especially if your labour was long or instrumentation was used. Go, too, if you had a Caesarean. A good cranial practitioner can make a big difference if your baby is fractious, irritable, difficult to settle, or suffered moulding to the head during the birth.

Cleaning the umbilical stump. Do this twice a day with a solution of 20ml of boiled and cooled water, mixed with a drop of tea tree oil.

Eye contact. Make lots of eye contact with your baby, especially when talking to her. You may well find your voice is naturally higher and softer than normal. This is known as ‘motherese’ and is an instinctive response – babies find it easier to listen to a higher-pitched voice.

Holding your baby. Your newborn baby feels most secure and is easiest to hold when snugly wrapped in the swaddling blanket and held up with her head nuzzling into your neck. There’s a natural nook for her there, and she can rest her head and smell your hair. Baby bliss.

Sleep. Place your baby to sleep in a small space, such as a Moses basket, thottil, hammock or crib. Avoid letting her sleep in the car seat as lying in this crouched position for too long can cause her blood circulation to pool. Allow your baby to sleep as long as she wants to between feeds.

Swaddling. During naps, fully swaddle the baby to make her feel secure and held (see box), and to minimize the Moro reflex.

Nappy changes. Keep them brief – dress the baby in sleep suits with leg and crotch poppers to minimize tugging and wrestling with arms and legs. This will cut down on crying time in the first days.

Songs and Lullabies. Choose a short song or lullaby that you would like to sing to your baby every day. Sing it whenever you do a nappy change, or softly hum it during feeds. Let her associate the tune with closeness and care from you.

Winding. This should be gentle and relaxed. Many mothers frantically jiggle their babies on their knees, or pat their back hard, or rock them backwards and forwards to encourage the burps to come up. I have always felt that the gentler the touch, the more relaxed the baby will be – and if she’s relaxed, there’ll be less resistance or internal tension keeping the wind down. Only wind when the baby has naturally broken off during the feed, and again at the end of the feed. Gently sit the baby up and, holding her under the arms, lift her just off your knees so that she is stretched out and her body is stretched long under her full weight. Hold for a moment, then return her to a sitting position on your lap. Place her chin in the cradle of your hand (between thumb and index finger) and put your other hand on her back. Gently stroke the back rhythmically, preferably only in a downward direction. Pause frequently to ‘allow’ the baby to bring up the wind. Another winding method is to rest her on your shoulder with her arms hanging over your shoulder and down your back (the positioning is crucial for this method). This places light pressure on her abdomen, and the stretched-out position makes it easier for the air bubbles to come up. Place a cloth over your shoulder to protect your clothes!

Mother

Birth Recovery

Arnica. Take immediately after the birth and then every thirty minutes for the first five days. Arnica is very important in reducing post-partum bruising and swelling, even after the gentlest birth.

Hypericum. If you had a Caesarean or suffered a tear/episiotomy, take 200c immediately after the birth and every six hours for five days.

Painkillers. Take as necessary if prescribed by the hospital if you have had a Caesarean or an episiotomy.

Ice packs. If your perineum feels bruised and sore after a vaginal birth you could apply an ice pack for ten minutes, three times a day, whilst sitting or lying down. You can bathe your perineum with cotton swabs soaked in a solution of 50ml of water containing ten to twenty drops of the mother tincture of calendula.

Supplements. Start taking vitamin B₁₂ and Floradix (a natural iron supplement) to help build up your haemoglobin levels. This will counteract the effects of any significant blood loss during the birth. Anaemia can cause tiredness, anxiety and dizzy spells. Take 500mg vitamin C daily. This is important for the cell membranes and will speed healing in all your tissues after birth.

Massage. In India, it is traditional to massage the mother from the day of the birth using Ayurvedic oils. As is the custom, the pregnant mother goes to live with her mother and gives birth in her childhood home. Then her mother or aunt will massage her daily with warm coconut or cured sesame oil. The more aware women use Ayurvedic oils. I adapt this for Western cultures by advocating a rose otto oil massage (see rose otto oil self-massage). This will help lift your mood and banish the baby blues. Repeat daily if possible.

Ayurvedic herbs. Baladi choornam tones up the uterus as it involutes (the same herb I prescribe in my first book, The Gentle Birth Method). It is also a strengthening herb. Take once a day after your evening meal for a total of forty days postnatally (see Resources for details). The following Ayurvedic elixirs taste like sweet sherry:

 Jeerarishtam helps to bring in your milk: the main ingredient is cumin. (See recipe in Recipe for Fennel Tonic for substitute fennel tonic.)

 Dashamoolarishtam tightens the pelvic ligaments and tones the uterus.

 Dhanwantaram kashayam tastes like bitters and is also prescribed for postnatal recovery of the tissues.

Visualizations. From the first day, practise daily, short visualizations of your uterus involuting and shrinking back into the pelvis – imagine it becoming small, round and tight, like a tennis ball. You may well feel afterpains. This is due to the fact that suckling stimulates the release of oxytocin, the hormone responsible for the womb contracting. This helps your uterus involute and return to its pre-pregnant size. So please practise these visualizations during feed times and whenever you have a moment when you can sit down, close your eyes and relax!

Take a shower. Preferably take a shower in the hospital. If you have been sent home within the first twenty-four hours, then you could have a shower or short bath at home. Beware: too hot a bath may cause you to have heavier lochia (vaginal bleeding). There is always some degree of bruising in the vagina, so avoid prolonged baths within the first twenty-four hours as bruised tissue is more susceptible to absorbing water, swelling up and getting infected.

Healing waters. After day two, run a bath of warm water (about 36 degrees centigrade) and add a herbal infusion made up of dried marjoram flowers, comfrey leaves and St John’s wort leaves and flowers (see Resources for stockists). Wrap up a handful of each of these three herbs in a muslin cloth and let this bundle steep in a litre of boiling water for twenty minutes. Then decant and pour into your normal bath water. It smells bitter and looks dark brown, but it will relax you profoundly, ease all your muscles and heal your perineum really quickly. If you prefer, you can infuse some camomile tea bags in a teapot and pour the lot – including the teabags – into the bath. Birth utilizes a lot of nervous energy, and camomile is renowned for its soothing effect on the nervous system. It is also very good for repairing damaged local tissues.

Drink two litres of water a day. This will encourage milk production.

Add lemon or cranberry juice to your drinking water. This will alkalinize your urine, helping to prevent cystitis, which is very common in the first few days after birth.

Toilet trips. You will find you are going to the toilet a lot. This is because your body is shedding up to five litres of extra fluid from your blood volume that was required during the pregnancy.

Light reflexology. From day one, ask your partner to massage your feet, working especially on the tops of the feet where the tendons are. This pertains to the breast reflexes and encourages good milk let-down.

Take Lactors. This is a homeopathic remedy I source from a 96-year-old homeopath in India. It helps create better quality milk that can calm irritable babies. Available to order from our website www.gentlebirthmethod.com (see Resources for details).

Feeding. Feed yourself and your baby on demand!

Diet. Be vigilant in following a low-fibre diet but with the addition of gentle greens like steamed runner beans and okra for the first few weeks, to protect from constipation. The strain of pushing when constipated can cause pressure on fresh episiotomy or Caesarean scars. Prunes and figs and cooked beetroot can really help in loosening your bowels to help you eliminate easily. You may have been prescribed lactulose by your doctor but this can only do so much – make diet your main priority. Remember the fish soup for non-vegetarians and other calcium-rich foods. For both vegetarians and non-vegetarians, pear compote and my favourite postnatal pudding, kallie, provide additional sources of natural calcium (see recipe Recipe for Raagi Kallie).