Mixed Feeding, with Lucy Ruddle

Many parents feel that they have to pick a side on the feeding debate - breast or bottle. But the reality is that often families find themselves a compromise, whether that is adding an occasional bottle to their routine, or switching to formula during the day, and breastfeeds when mum gets home from work. Despite this, information about how to go about mixed or combination feeding has been scarce, until now. My guest this week, Lucy Ruddle IBCLC, is author of a guide to mixed feeding, Mixed Up, which guides you through all you need to know.

In our conversation, we touch on why you might want to mixed feed, we cut through the marketing to what you actually need to buy, and we talk about the emotional journey that many parents face when they can’t meet their infant feeding goals.

Find more from Lucy, including details of her four books at www.lucyruddle.co.uk

Please subscribe, rate and review, so we can get this vital info to as many parents-to-be as we can!

______________________

This episode is sponsored by

iCandy

• Visit  https://discover.icandyworld.com/birth-ed to shop my favourite pushchairs!
• Follow iCandy on IG and/or TikTok for helpful advice and ‘hints & tips’ too!

https://www.tiktok.com/@icandyworld

https://www.instagram.com/icandyworlduk/

The Bump Plan - visit thebumpplan.com/birthed-postnatal to access:

• Free Postnatal Pelvic Floor Recovery Workshop
• Free Online Postnatal Returning to Exercise Masterclass
• An exclusive 20% discount code to join The Bump Plan Postnatal 

POSTNATAL PLAN: A physio-approved program designed by Hollie Grant while she was postnatal, creating a unique and trustworthy experience for new mothers. This plan includes real-time responsive workouts for holistic recovery and fitness, with 24/7 access to resources and community support. Prices: £35/month, £180 for 6 months, £240 for an annual membership, including a 7-day free trial.

_____________________________

Hear More from Birth-ed

Join the Birth-ed Online Course https://birth-ed.co.uk/online-course-2

Join the BUMP CLUB FREE https://birth-ed.co.uk/bump-club

Follow us on Instagram https://www.instagram.com/birth_ed/

Transcript

Megan Rossiter  00:00

Ad - This episode is brought to you in partnership with iCandy. I've been using our iCandy peach pushchair almost daily for the last seven years and counting. And I've really put their five year warranty to the test using it for both my boys on muddy walks in aeroplane holes in and out of my car boot and aside from being completely filthy, my fault not theirs. It's still going strong. I can't wait to tell you more about my experience with eye candy later in the show. 

Megan Rossiter  00:24

Ad - This episode is brought to you in partnership with the bump plan which is honestly the best pre and postnatal exercise programme that I've come across in a decade of supporting families through pregnancy and the early years of parenting. For 20% off and access to a free pregnancy or postnatal safe workout. Follow the link in the show notes.

Megan Rossiter  00:49

You're listening to the Birth-ed podcast. I'm your host and founder of Birth-ed, Megan Rossiter. If you're looking for the evidence, the nuance the detail that's missing from your antenatal appointment, then I've got your back. The Birth-ed podcast is here to help you sort the facts from the advertising the instinct from the influences and the information you're looking for from the white noise of the internet. I hope you've got a cup of tea in hand and a notepad at the ready. Let's dive in. 

Megan Rossiter  01:14

Hi everybody. Welcome back to the Birth-Ed podcast. I am delighted to be joined today by Lucy Ruddle. Lucy is an international board certified would help if I could say that correctly. This trips me up every single time I try and say as ibclc Lucy is an international board certified lactation consultant, which is something you'll never hear people say because they will say ibclc. She's a breastfeeding counsellor, a holistic sleep coach and author of now four books - Re-lactation, breastfeeding myths, and mixed up, combination feeding by choice or necessity. And her new book about breastfeeding grief is due out this summer and is available for pre order now. So Lucy, thank you so much for joining me. Thank you for the slight correction as an ibclc. Which it to be honest, I can never even remember how to say ibclc. But you know what you are! 

Lucy Ruddle  02:06

I trip over it myself. And most people just say, breastfeeding expert wizard, someone once called me and I think we should go with boob wizard. 

Megan Rossiter  02:15

Ok, I'll redo it then! Lucy is a boob wizard and an author of now four books. In today's episode, we are going to be we've got an episode on breastfeeding that if you haven't listened to already as well worth a listen. And because of Lucy's brilliant book called mixed up, we're going to be chatting today a little bit about mixed feeding and bottle feeding. And all of that, you know, it's a conversation that just doesn't frequently happen. I imagine that's probably why you wrote a book about it. So what was it that led you to writing Mixed Up?

Lucy Ruddle  02:49

Yeah, that's such a good question. And it was a book that I felt that I had to write. When I wrote my first book I wanted to write it was mixed up, I just felt like this needs to be written. When you're a lactation consultant, we spend a lot of our time working with parents who are already using some formula. And they often don't want to be using that formula. And they have so much guilt around it. And then there's also this very strong narrative from society that you must exclusively breastfeed. And actually, the other side of that is almost like you must choose to exclusively breastfeed or exclusively formula feed. And then there's this gap in the middle where many, many parents find themselves. But there's no real information out there, they have to kind of piece it all together. And I kind of was at a point where I was like, this is this is crazy that people can't go and find a book about how to make this work, because it isn't actually that hard to combination fair to just need the information to let you do it. So yeah, I kind of was like, right, someone's gonna write the book, I suppose I write the book because I do. So I'm like, Oh, I just do it. I just write this book. And it ended up taking me like a year to write. And what's interesting about it is it's actually quite controversial because people who are very pro breastfeeding don't like it because it encourages formula feeding. And equally, people who want to kind of just formula feed for that it pushes breastfeeding. So I'm kind of in a bit of a middle ground where no one seems very happy with the book. And but it does have the people that do read it, because they want to combination feed, and that's what they want to do, or they need to do report that it's very, very helpful. So that's nice to know that it does have it actually it is reaching its audience. Yeah. Audience,

Megan Rossiter  04:31

you sort of touched on there. Maybe the reason why this conversation isn't something that happens very frequently, we get a lot of information about how to breastfeed how to prepare for breastfeeding. And then the sort of like, well, if it doesn't work, then you formula feed, or people feeling very, very strongly that they don't want to breastfeed and they only want for me to feed and you know, this is definitely reflected in the work that I do around birth as well but very very polarising. At pinions about it. Do you think that's why this isn't a conversation that happens?

Lucy Ruddle  05:04

Yes, I think it's a very hard conversation to have. And when I was writing the book, there were many, many times where I was, as I was trying to word stuff. And I was thinking this is a really hard conversation to be having. Because I need to tell people, why breast milk is important for babies, what it does for babies that you know why we want people to breastfeed, but they also don't want those people to feel guilty or ashamed if they don't want to exclusively breastfeed, or quite realistically, if they can't, because we live in a society where, even though, physiologically speaking, we should all be able to breastfeed fairly easily. The society we live in, doesn't allow that to happen, that parents didn't quite get that. So they feel guilty about not breastfeeding, and the hole no matter what you do, you're going to annoy somebody, somebody's gonna be upset or offended or hurt. And when you're trying to write a book that's in that middle ground, it's incredibly challenging to do.

Megan Rossiter  05:55

Yeah, I totally get that. And I find that that's sort of where I feel like I sit as well, in terms of like birth preparation is that you can get such such such strong and often quite valid opinions from both sides. But there is there's a whole host of people that do sit somewhere in the middle. And if they're lacking that support and that information, then they can just be totally, totally lost to as you've already mentioned, there are like any number of reasons why somebody might find themselves in a situation where they are mixed feeding, and mixed feeding can look like anything from one bottle occasionally to, you know, one breastfeed occasionally. Where do you start, there is so much stuff, so much advertising, and so little reliable kind of information out there, about formula feeding and combination feeding. So where where should somebody start in terms of what do they need? And how do they choose it?

Lucy Ruddle  06:52

Yeah, I think what we can do actually, is we can push all of that aside, take the science away, take the marketing away, and just ask the parent, what do you want? If you didn't know anything at all about any of this stuff? What is your instinct telling you that you want to do? And what's interesting is most of them in pregnancy will say, Oh, I don't mind, I want I want to copy feed, and we can set them up for that and say, Okay, well, let's try and get the first feed after birth at the brass, because that's going to primal, the milk receptors, and then see how that feed goes. And if it goes, well, then you can might want to do the next feed. And if it doesn't go well, you might want to give us only the top of that feed. And then what happens is the baby is born. And usually with that surge of hormones, breastfeeding suddenly feels very, very important to parents. And they may at that point decide that they want to spend more time breastfeeding and less time, formula feeding. And if you've given them the good information in the beginning, which is you know that first breastfeed is really important to kind of set them up to be able to do that. And then problems come in. And that's when often for people the combination feeding kind of has to come into play. And then depending on whether those problems are things like babies are getting enough milk, or simply that the parent or the mom is just exhausted and needs a break, that will then influence how combination feeding looks. So for a baby that's not getting very much weight, we're going to have to really work on getting more milk into that baby, that might mean that we give more formula for the parent who just wants a good night's sleep, it might be that dad or partner or friend gives a small bottle at 10pm. And parent gets a good three or four hour sleep, you know, it really can be very, very varied depending on on the situation you're in. 

Megan Rossiter  08:33

Yeah, and it can be so different from but you know, my personal experience of having two babies is, you know, very different from baby to baby. So we similarly did, and I was that exhausted man without loads of support around. And we did the sort of like my husband worked in the evenings. So he got home from work at like 11 o'clock. And so it made really good sense for us to do a bottle he was about four months, we started giving a bottle at that at that kind of 10pm Feed. Second baby. I was like, oh, we'll probably do the same. Probably give like an express bottle at that time. No, no, he was not having any he was not having any of it. He was taking a bottle. And so the question that people are always asking me antenatally. So when they're thinking or I might, I might be that person that wants to give a bottle or to be able to go apart from the baby at some point and wanting a bottle or several bottles to form part of their feeding journey. This end I know that there's no particularly perfect answer to this, but when when and what kind of bottle and I wish there was like a magic right answer.

Lucy Ruddle  09:42

I gave a talk about this recently. So I was asked to give a talk on bottle refusal for some American lactation consultants because of course in America, they get back to work so early, they kind of have to bottle feed even if that's pumped milk in those bottles. And the science suggests that The earlier you give a bottle, the more likely it is that the baby will take the bottle. But if you do it too early, that then increases the risk of them saying the baby kind of going, No, I don't want to breastfeed. Thank you very much. So my kind of generic answer for UK moms, is if you can wait until about week four to week six, because we reintroduce a bottle that's going to give you a milk supply, good time to establish, it's gonna get your baby kind of lots of time to get used to breastfeeding. And then you can try with the bottle. However, if you are somebody who knows that you want your baby to take a bottle, you know that's going to be a thing that's going to have to happen and sooner rather than later, you're going back to work or you know, you want to combination feed, you might actually want to start introducing that bottle after about two weeks. So you've again, you've had a little bit of time to kind of get breastfeeding going well, but you've still got that more, or that window for baby to accept the bottle, assuming that breastfeeding is going well, because if you're having problems with breastfeeding, that's a whole different conversation. That gets very, very complicated. 

Megan Rossiter  11:02

Yeah. And in that case, a bottle might be introduced earlier, or would you try and use other? 

Lucy Ruddle  11:08

Yes. So we would normally want to try and reduce kind of different things going in the mouth so that it's just a boob that's going in the mouth. But of course, if a baby isn't gaining weight, and they're not able to remove the note from the breasts, we're going to have to introduce other things. So depending on their age, it might be that we do that through a cup, or it is with a bottle. And then everyone gets very confused about that. Because we're like, Well, I was told not to introduce a bottle because it can confuse the baby and reduce milk supply. But I'm having I'm not being told to give a bottle because my baby's like anyway. And it's like, I know, that's really confusing and really difficult. But we have to get the weight on the baby, and then the baby can focus on breastfeeding. But there are ways that we give bottles and we use pace feeding methods and trying to you know, make sure we're not over feeding and all that kind of stuff. 

Megan Rossiter  11:51

Yeah. And yeah, I think you know, I've supported families who've had babies in the NICU or you know, time away from the baby, and it has suddenly become a completely different feeding journey than they ever imagined. So it's really important information to have, whether you plan to exclusively breastfeed, whether you think you're going to combination feed or you know, or whether you're just don't know at this stage. So if you are, you know, you might be listening to this during pregnancy, and people might be thinking, I want to do that, and I want to feel prepared for it, or people might be listening to it. And they're kind of in the kind of throes of it in terms of what they're going to actually need. They're going to need bottles which are going to need to have teats on them. They're going to need some sort of steriliser to sterilise these bottles, and they're going to need something to put in the bottles. So that could be expressed breast milk, or it could be formula milk, it could be donor express breast milk, I think that's the exhaustive list of the things that you could put in this bottle. But when you kind of get to this point, oh, my God, it is so hard. And there are a million different opinions from mums from professionals from hospitals stuff you know about what kind of teat you should be using? What kind of formula you should be buying? So do you have any either information or any tips on kind of how do you navigate that? How do you separate the kind of the advertising from the facts?

Lucy Ruddle  13:20

So if we start with the formula, because that's the simplest, yeah. So So basically, in the United Kingdom, all formula has to meet certain criteria in order to be made and authorised and allowed to exist. So they all have the same baseline ingredients. And if an ingredient has been proven to be beneficial, like genuinely beneficial for babies, all the formulas have to include that ingredient. So anything you see where, you know, this company over here are saying that our formula is best because it's got tummy, soothing bubbles, and whatever they come up with today, if that was true, all of the formulas would have to include it in the UK. So it's just marketing. So when we kind of understand that, and we also understand that they're actually most of these formulas are made by the same company. So coingate and aptamil, are both made by Dan own in the same factory. It's just that the milk is put into different containers depending on who they're selling that milk to. So aptamil is aimed at affluent parents who probably wanted to breastfeed. And you can see that in their adverts. They talk about when you're ready to move on for breastfeeding. They have breastfeeding images in their foot in their adverts on the television. Camera gate is aimed at younger families and perhaps people who don't want to breastfeed. So those images, they don't mention breastfeeding in the slightest in those in those adverts, but they're the same milk and it's just the aptamil swapped for pounds more expensive. When we understand all of that, that then makes it much easier to choose a formula because my advice is what formula can you get in your local shop at two o'clock in the morning, and what can you afford? And that's Probably going to make it very, very easy to make a decision, because that's probably going to be one of the domain options, it's probably gonna be the red one, not the blue one. And that's not me recommending that brand is just using that as an example, that that's, you know, we don't need to spend more loads of money on this stuff, you might want to go and get a supermarket own version, as long as you can access that, if you run out in the middle of the night. That's the kind of criteria we're looking for. 

Megan Rossiter  15:21

Yeah, and I think that's just so for people that haven't heard that before is going to be my like mind blowing, because that's not the messaging that people are receiving at all. And we are played on particularly as mothers, but as parents in general, to do the best do the best for our babies, we've been told that breast milk is the best. So if we can't do that, we have to do the next best. And the next best is going to cost us 17 pounds per box. We were filming actually something for our online course the other day, and I went to purchase some formula to use within the filming. My mind was blown. Like even since my my eldest son has seven and a half. So in the past seven and a half years, I was like, oh, leave how much it has gone up by? Yeah. And yeah, and when it is, ultimately completely unnecessary. So the other decision, I suppose that people might be making is whether they use express milk for their bottle feeding needs, or whether they use formula milk. Are there any themes that you see in kind of families that are making that decision, kind of pros and cons of how, what tends to work for people?

Lucy Ruddle  16:36

Interesting one, so I find for the families that are kind of working on getting baby back to exclusively breastfeeding. So there's been some issues and their breast, their combination feeding, kind of because they've been pushed into it, rather than because they want to, they will usually be pumping and getting as much milk as they can that's pumped milk. And the families that are going into this much more like breastfeeding is just too much, it's too difficult, I haven't got the time and my mental health is going to go downhill ever exclusively breastfeed, they tend to be much happier around using formula and those top ups instead. And then we have a whole other group of wonderful humans, and I don't know how best to describe them without accidentally sounding offensive. But the word that first comes to mind is like crunchy or hippie. And I don't mean that in a mean way. Yeah, and my brain is working right now. And they will be the group of parents that will be very happy to top up if needed. And if they don't have access to their own milk be very, very happy to ask their friends to informally milk share. And informal milk sharing is a fantastic option that isn't often talked about. It's a bit taboo. Because it's the IT people feel a bit icky about using other people's milk sometimes. Which is interesting when you take a little bit of a step back and you think that we're all drinking cow's milk quite happily? 

Megan Rossiter  17:44

Yeah, we don't even know which cow? 

Lucy Ruddle  17:51

Yeah. That's a really good point. And I understand it, because there are theoretical risks to peer to peer sharing, you know, you you have to trust that somebody isn't watering it down, or that they haven't got an infection. But then the argument to kind of counteract all of that is, why would somebody be producing that for their own baby, if they have an infection or something, or they're taking medication, which means they shouldn't be given that note to their baby. In reality, it's unlikely, it's very unlikely that these people are going to cause any harm, they're gonna be doing anything unnecessary or malicious to the milk. But the potential if that does happen for that to be harmful to the baby is quite big. So that I think that's why people kind of feel a bit odd about it. But it is a really valid option. And I think, eats on feets is a really good website to go and have a little look at, they have like their four pillars of no sharing, and all sorts of things you can look at to kind of decide if it's the right decision for you. 

Megan Rossiter  18:46

And just I suppose on that, that is something that you do see in a kind of more formal way for babies in NICU isn't it, you might be told if your baby's born early, you know that if they're able to receive breast milk, then that improves outcomes for the babies. And if it was, and if it's unable to be your breast milk, then there are milk banks and stuff, but that does tend to be reserved for kind of poorly babies.

Lucy Ruddle  19:08

So that milk is pasteurised, it goes through all sorts of rigorous testing. And even the donors have to have blood tests and stuff done before they can donate the notes of the hospital. And I would also like to put in a little caveat here that anything I'm talking about with regards to can't be fleeting, I'm assuming a full term healthy baby as soon as we have a preemie, it becomes much, much more important that that baby gets exclusively human milk for as long as possible because of the risk of some really awful things that these premiums can get, I think don't get human milk. And that's why the donor milk is offered in the hospital setting because these babies really need it for their guts and for their good health outcomes.

Megan Rossiter  19:42

Yeah, amazing. So well, we're just chatting about formulate some, I suppose a time where people might reach for formula is they're going back to work. Babies in nursery they're now not able to keep up with kind of pumping demands on top of everything but that life is bringing They're kind of over maybe six months now or maybe, you know, between six months and a year. Can you talk to us about something that exists in the UK that is called Follow on milk?

Lucy Ruddle  20:11

Sure, you want to get me started on following. Everyone buckle in for this. Okay, so follow on milk was invented purely to get around the advertising guidelines or rules that the former companies have to abide by in the UK, they're not allowed under UK law to advertise their milk to parents of babies under the age of six months, because they're not allowed to advertise breast milk substitute. Once the baby gets to six months old, those guidelines drop off because we're introducing solids to the baby. So it's not that important. But it is important. But as far as the UK law is concerned, it's not. And what you'll see when you go down the supermarket aisle is you will see that the stage one and the stage two and even the blimp and stage three milk and the clumps, and they'll they all look almost identical. And they've done that because they can put their stage two milk on the television on a big billboard, and they can advertise it to you, without telling you about their stage one milk. But what they're really doing is they're advertising their stage one milk by actually telling you about the stage tomorrow, because no one's no one who was happily breastfeeding five and a half months is thinking, Oh, should I switch to Florida in a minute. What they're doing is they're they're selling a friendly face so that when you struggle to breastfeed, you can remember that advert of the ballerinas or the children laughing in the highchair and the colours associated with it, and you go to that company to get your formula from, there is no need for follow on milk, you can continue to use first stage male stage one milk, right that your baby is 12 months old. The only difference really in follow on milk is it has a little bit more iron in it. But your baby should be getting that that little bit of extra iron from solid foods, because you introduced it as six months. There are some rumours and I wouldn't know if I've never tasted it, maybe I should do this experiment. And apparently, some people say that the following milk is also slightly sweeter, so that it is more palatable for the babies. And then the toddler growing up milk, which comes after that, again, apparently, I've heard is also slightly sweeter again, so your baby's more likely to want to drink the total amount compared to like regular cow's milk or oat milk or whatever you're using. 

Megan Rossiter  22:15

Amazing. And I think that's just people don't realise that. And they don't realise that stage one formula. It's not advertised on TV. And when I say it to people, but I've seen I've seen it, I've seen the TV, they were definitely a baby and you're like, you know, probably six months in a day or yeah, they're a little one. And that I think is one of the hardest things when navigating either exclusively formula feeding or mixed feeding is like, actually just all of parenting in general, right? Like, what should they sleep in? What should they wear? What should we feed them? Like, is navigating like what actually is? Like instinctive intuitive? What do they actually kind of need from an evolutionary biological perspective? And what is sort of like very, sometimes quite sneaky advertising from companies that have billions of pounds basically. And when we can start to kind of unpick that it puts you back in control of parenting your baby, and not. So yes, that's it, the rich white men in an office. Call me a sceptic!

Lucy Ruddle  23:20

They make billions in profits, they make so much money and profits. And again, I think people sometimes get getting me a little bit mixed up here. They think I'm kind of saying, Oh, hey, formula, a formula is amazing. Like, so many of my clients have to use formula and choose to use or I used formula. What I hate is the sneaky marketing that makes us think that we need it. I mean, even I'm thinking about the adverts that say, you know, can be used from six months alongside breast milk, or can they use from six months alongside solid food? That implies that you need to stop breastfeeding in six months and switch to the formula. And my husband actually thought that was true when we had our first son, because that's your stop at six months and switch to formula, right? Because that's what the advert said I was like no breastfeed for as long as you want, like, recommendations is two years. Yeah, it's so so sneaky and fast, that alongside how big their profits are. And if they just kind of maybe pulled back on the advertising, and spent some of that money on improving their product, maybe we could get to a position my formula is really close to breast milk, wouldn't that be amazing? Keep her as well, so that people who are struggling to pay for it could afford to pay for it. But instead, that money is going on advertising the formula and then it pushes the price up for the consumer at the end of the day. And this is where we have a product which should have been in medicine should have been used in a medical clinical way to help babies. And and, again, people get a little bit twitchy when I say that you should be used as a medical intervention. I don't mean again, I don't mean it in a mean way. I just mean that all babies can drink as milk. So it shouldn't be something that we have to pay lots and lots of money for. We shouldn't be battling marketing and commercialization of it. We should just be able to go and get Do It and it should be affordable because our babies need it if you can't, what else are you supposed to do? You know?

Megan Rossiter  25:04

Yeah, absolutely. And that and that message that subliminal message and that advertising even gets into healthcare. I remember seeing my GP and they had an issue with my breasts when I was breastfeeding found basically a lump on the breast and they will it will come back when you've come back six months when you're finished breastfeeding and we'll check it and you know, I was me at this was only a few years ago, so I was sort of fine to be like, Well you know, that messaging Can you can take that upon yourself straightaway and be like, oh, oh, right. Okay, what's finishing it six months, and then I've got to come back. And you know, they did sneak they sponsor conferences and all and all. Yeah, Mac in like midwifery magazines, and they're in all Sneaky, sneaky, sneaky places. 

Megan Rossiter  25:53

Ad - I remember choosing a pram for my first baby almost eight years ago and honestly it required as much research as giving birth. Is it going to fit on my beat when it converts would double one day? Will it last and past 18 months old? Can I attach a car seat? Will it roll in mud? Can I put it down with one hand? And eventually I found the answer to all my questions. For me it was the iCandy peach which by the way, fits into the back of a Fiat 500 car which sounds unbelievable for pushchair that sturdy but seriously it does. We knew then that we hope to have more than one baby. So choosing something that was going to stand the test of time and not end up in landfill in a year was really important. iCandy pushchairs come with a five year warranty. And believe me we've put it through its paces. It's been up mountains and wailed, it's been on and off the escalators and the tubes of London Underground. It's been in and out of my car boot every day on the school run. It's flown all over Europe. And yet still seven years on aside from being completely filthy, it's going strong. If you're looking for a push out or travel system that's really going to see you through the early years with this baby and maybe any future babies, nieces nephews, best friends children that might join your family. For me iCandy has been an investment worth making. Follow the link in the show notes to find the perfect pram or travel system for you. 

Megan Rossiter  27:07

Ad - I'm actually so excited to be sharing with you our sponsor for this episode, the Bump Plan - Pregnancy. So the Bump Plan is a Pilates strength and cardio based prenatal fitness plan. And you move through your whole journey alongside Holly, the founder of the Bump Plan who was actually pregnant to in all the videos. And he's exactly the kind of knowledgeable empowering and understanding person you'd want by your side throughout pregnancy. I've worked through one of the Bump Plans myself and it feels so safe, inclusive and accessible. So whether you're looking for a gentle introduction to movement in pregnancy, so you feel stronger, more energised and more comfortable in your swiftly changing body, or you've exercised for years but needs support in adapting your training to suit your changing pregnant body, you're in such safe hands with Holly at the Bump Plan. Holly and the team at the Bump Plan have been kind enough to share with the Birth-ed podcast listeners a free 45 minute workout and 20% off their plans. You can sign up for this via the link in the show notes or visiting www.thebumpplan.com/birthed-pregnancy. I promise I'm not just saying this the whole plan whether you're trying to conceive pregnant or postpartum is actually brilliant, and I really hope you guys enjoy it.

Megan Rossiter  28:31

So, formula, we've ticked so you may want to purchase formula. And you know which which sort of things you're potentially looking for. The next thing that you're going to want to purchase is bottles if you are bottle feeding. And again, we go back straight back to marketing. And everybody will tell you that this one is the shape of the breast and this what is the shape of something else? This one's super soft. This one's super slow. What What? 

Lucy Ruddle  29:00

No, it's so hard. And it's

Megan Rossiter  29:02

very articulate. That is what's going on in people's minds.

Lucy Ruddle  29:09

So and this is what it does, it's a bit more complicated than a formula question because there are different shapes of t. And what it boils down to, really is you have three different shapes of t. So you have your longer narrow ones, you have your shorter, wider ones that look a bit more like a boob with a nipple at the end of it. And then you have what they called orthodontic ones, which are slanted at the edge of the teeth, whatever these companies are telling you. Those are the three things one of them, there can be certainly one of those three bottles. And the problem is we have very little scientific data that hasn't been carried out by the companies themselves. So it's really hard for us to know if there is a better or best option and at the moment, we don't know. So the conclusion that I came to in my book was that you probably don't want an orthodontic shaped teeth because if your nipple came out slanted at one end of refeeding Got a problem. So let's not encourage that sucking action. So we can probably discard the orthodontic ones. So that leaves you with a low on fan of a short and fat ones. And I think genuinely it comes down to what your baby will accept some babies and actually active band children as a as an example here my eldest, so I formula fed him while I'm relaxed, hated, I stopped breastfeeding him and then went back to it a few weeks later, he was bottle fed in the middle. He didn't care what bottle he had, he was quite happy. As long as I had milk in it didn't bother him. My youngest would only take the Philips event or event which is the very long, narrow teat. And they were more expensive than the other brands we've been using. And I was like, Are you kidding me? And but he actually wouldn't breastfeed, he had to take a bottle. And looking back, he had a very high palate. And I wonder if the longer thinner teeth was what needed to get past that high palate to stimulate the soft palate and get him to suck? And that's kind of a really long Wofully answer that kind of explains my answer. You know, it depends on the anatomy of the baby's mouth and what they will take. With all of that in mind. Again, let's not go and spend 30 pounds on the bottle because some companies are claiming that it's the closest to a boob, it's not go to pan lands, you know, start off with the cheapest bottle you can find with a slow flowing teat and get that because you want to slow flowing teats and the baby can control the flow of the milk. You don't want to fast blame when it's going to overwhelm them. And if that doesn't work, try a slightly different different brand, maybe a different team. Again, nice and cheap. And if those don't work, then let's move up to the more expensive ones. But let's start with short and fat. longfin. Cheap. That's all you need.

Megan Rossiter  31:41

I know and it's it. And you know, exactly my, my eldest was exactly the same. And he actually took exactly the the sound sounds like an advert for that bottle. But he actually took but that was the only one we tried. Similarly, because, yeah, that one. 

Lucy Ruddle  31:55

Yeah. This was eight years ago for me with basic nutrients told me to appeal Philips at that event back then. Yeah, I think maybe we're just coming onto the market. But that was those were our options, you know? 

Megan Rossiter  32:05

Yeah, I don't remember it being there being many, many options. And then my second came along now three years ago, and we try. I did manage to sell all the ones that we hadn't used as like anyone was like an entire selection. If you want to try them all, collection boxes and bottles, he was not happy even. And similarly, he wouldn't take a dummy. Which again, with us, my eldest son, he had been quite a helpful tool for us as a family. And we tried every dummy every bottle and he was like, No, I will be three. So that part of it is going to be the baby is going to make the decision on these things. As much as we like to try and plan and control as parents, you know, we can't always and then I suppose in there comes. The final thing that you'd want to be buying would be steriliser and ultimately doesn't really matter.

Lucy Ruddle  33:04

Now, it depends on what suits you. When I was pumping, I actually find some sterilising fluid and a very big musical by special buckets for it, but I just found a massive Tupperware tub that would fit enough water in it and put a lid on it. Because steriliser fluid lasts for 24 hours, I'd simply wash the bottles, bind them straight in a sterilising fluid and then just take them out when I needed them or the pump parts when they needed them. So that is not the prettiest option, but it was the cheapest option. And it meant that I didn't have to keep putting them like turning the microwave on turning the microwave off or that sort of stuff or using lots of electricity. You just pour pour the fluid into cold water and it's good for 24 hours. So that was the most economic option, I think, for our family at the time. Then you've got your microwave sterilisers. And then you've also got the big plug in ones as well. And genuinely, they all do the same job. They they heat the bottles up to sterilise them. Soon as you take the lid off, they're no longer sterile. So it's a little bit of a little bit of an interesting one. But actually in other countries, particularly in America, they don't sterilising isn't a thing. They just don't do it. Which is interesting, I think. I do think it's important to particularly with formula to make sure things are incredibly clean and if you can keep them sterile do but again as with all this stuff, the right size steriliser at the cheapest price is probably going to be the best way forward.

Megan Rossiter  34:24

Yeah, yeah, we just got I think it's like a five pound microwave one. Yeah. And then we stored it in the microwave so we didn't have to look at it upset.

Lucy Ruddle  34:33

Yeah, absolutely. Um,

Megan Rossiter  34:34

so then comes the kind of making up off the bottle. So let's assume you're using formula in the bottle. And what is like important to know when it comes to making it your very first bottle of formula if you were using you could use liquid formula or you could use powdered formula. 

Lucy Ruddle  34:54

Yeah, and I often say if you're if you are someone who's a little bit anxious, and although it costs more money, the liquid formula and it's sterile, when it comes out of, of its pocket, it can't mess it up, you can't kind of forget how many scoops you put in all that sort of stuff. So if you are somebody that that might be tricky for, if that's what the liquid stuff is, although it costs a lot more money than you need to make sure that everything is as clean as possible. And you also need to make sure you're using water at the right temperature. So we've got these perfect prep machines, haven't we, and they're a little bit controversial because they deliver this hot shot of water that we think by the time you add, the hot water hits the powder, it's not going to be at the right temperature anymore, because not enough of it to hold its heat. And the reason we say that formula should be made about 70 degrees centigrade, is because that's a little bit of a compromise, it's hot enough to kill most bacteria, but not so hot that it it won't kill most of the good stuff. So you're kind of saying we want to keep most of the good stuff and get rid of most of the bad stuff. Because if we made it at 100 degrees centigrade, it would just kill off all the good stuff in it as well, all the kind of nutrients in it. So we kind of keep it in the middle ground. Because for minerals made in a factory by humans, there is risk of contamination with it. And that's why we need to use the hot water in it is to kill off the bacteria in the formula. And people sometimes think it's to kill off the bacteria and the bottle. No, because we sterilise the bus. So we've know we've given that a really good clean, it's yeah, oh, they

Megan Rossiter  36:15

think it's to kill off the bacteria in the water. That's

Lucy Ruddle  36:17

the other way around the water? No, it's not that it's because of the potential for the bacteria in the formula. And again, this is where we get to a really difficult conversation because it sounds like I'm shaming people. For us if we're going to say, Oh, you're putting your child at risk by using formula because it could have bacteria in it. It's bacteria in solid food. We risk food poisoning every time we you know, cook food for our family. I made a race on Mother's Day on Sunday thinking am I gonna poison you know, is this meat cooked properly, you know, and it's just when we have such little babies, our immune system and their tummies are not ready to fight off those those potential nasties, yes, we have to be extra careful with them. And we have had some really nasty cases over the years of contaminated food or causing huge, huge issues, people also might have been in China. Um, so we do have to be really careful with it. So make sure the water is at the right temperature, I encourage people not to use the perfect prep machine, it's a lot of money. We don't know if the water is hot enough, they get a lot of mould and bacteria. And then you can just boil your kettle and you can even get kettles that you can boil to 70 degrees centigrade. And because you're not just delivering a little bit of a hot shot, you put make the whole bottle at 70 degrees, it's more likely that water is going to hold its heat when you use that. 

Megan Rossiter  37:24

And then I guess that I guess the reason why somebody might reach for the perfect type of machine is that then when they the bottle is ready, it's ready to feed the baby. And when you've got a bottle that is 70 degrees, you're not going to be putting that in your baby's mouth, just this unit, they can't quite handle a cup of tea just yet. What you know, what is it? Do they wait, they pull it down? 

Lucy Ruddle  37:46

Yeah, so um, you could run it under a car tap or stick it in a cold drink of water. And that will normally pull it down quite quickly. And I think this is also where I like the liquid formula. Because you don't have to do that you could feed it from the fridge and that fridge temperature, you can warm it up quite quickly. It's much easier to deal with and quicker to deal with. So often I say to parents, you know, for the middle of the night feeds, when you just want to get back to bed as quickly as possible. That's a really good time to use the liquid formula because you haven't got to faff around waiting for a bottle to fall down. We used to say that you can make up all of your bottles, put them in the fridge and then take them out and reheat them as needed. That's no longer recommended. Although interestingly, if you were to go and take your child to nursery, it would be suggested that you make up the bottles in advance, call them down, put them in a freshman nursery reheat them. But the guidance is that if you are at home, the general kind of purposes, you should be making bottles as you need it. Because of course, if you're cooling something down and then warming it back up again, you've got the risk of bacteria getting in? 

Megan Rossiter  38:46

Yeah, yeah. Oh, so it often makes it and this is the thing that I always find. People will often say, you know, breastfeeding is really difficult. So I'm just going to leave that hanging Hang on there are you know, it's not necessarily always a kind of completely easy option. Unfortunately, when it comes to feeding babies, there just isn't any easy way to do it. And I don't you know, we don't have time to go into tonnes of detail on the kind of ins and outs of pumping. But just on that that conversation that we're having. Sometimes we go, uh, you know, this was certainly my experience was like, you know, I need to make my life easier for myself. So I'm just going to pump and give a bottle. And then what you end up doing is breastfeeding, pumping and bottle feeding. So rather than just doing one you're gonna do or three,

Lucy Ruddle  39:32

just to make life harder for yourself. Yeah, it's a punishment.

Megan Rossiter  39:36

Yeah. And so it's again, like it's, I guess it's a case of kind of just getting easy on yourself and doing what feels right for your family and what works works for you as an individual. And within that kind of conversation leads us on to, I suppose the emotional journey that is attached to feeding our babies so you It can be that somebody has always intended to use formula or add a bottle into or just exclusively bottle feed. And sometimes they can be faced with lots of judgement for that decision. And they can be made to feel quite guilty. Sometimes people didn't want to do it at all, and it has formed part of their journey. Do you have any, like advice or anything for anybody that is this is it's it's a difficult cleaning journey for them.

Lucy Ruddle  40:27

And actually, this is the fourth book, which we think is going to call breastfeeding, grief, recovery and understanding. But we're not sure yet we're still wrestling with the title. That's why I've written this because my previous books have been around re lactating, rebuilding and that supply. And also took combination feeding and both of which are very emotive topics because you're you're coming to me lactation normally, because you feel so blimmin, all syllabi stopping breastfeeding, you want to start again, and most people who are combination feeding and doing so because they feel some level of guilt about formula feeding. So it felt like a natural kind of next step to then write a book about and here's what to do with your feelings. We know that not reaching or breastfeed or nor meeting your infant feeding goal, whatever that happens to be significantly increases the risk of postnatal depression. And we also know that when you are dealing with postnatal depression, you feel just you may feel disconnected from your baby, you may not be the parent that you want to be, and then that feeds into that guilt. And then you feel even worse. And I think, I mean, it's a very difficult complex topic. But when I was researching for my for the next book, what I kind of the conclusion I came to was that actually, and this is also backed up with here's a do debriefs for parents. I don't think it's ever the parents fault. If breastfeeding doesn't work, I think we can pull it always back to the society that we live in. Let's say you're somebody who you have your baby and you have really no birth that you wanted, it was fine, you had that, that first feed at the breast skin to skin, it was all fine. And then on day five, your babies lost 10% of their birth weight. You might be tired at that point, okay, pump and top up. If you then get to week three, or week four, week five, and you're still having issues, people are just gonna say to you just some people just can't breastfeed, just go and get some formula, you've tried your best. But there are tests that we can do to see why you're not making enough milk, there will be a cause for that. And we don't investigate the cause is that we say to the parent, you can't make enough milk for your baby. And that's when the guilt and the grief and the shame starts to really come in. Because you're being told that you are the problem. I'm actually maybe your thyroid is not working properly. Maybe your baby has a tongue tie.

Megan Rossiter  42:42

Yeah, and it's it's so it's we talked there is rising conversation now around birth trauma, we know how frequent it is for people to experience birth trauma, we know how frequently that is at the hands of the system, as well as occasionally the kind of physical experience sometimes a combination of both. But it feels like the conversation around grief and trauma in someone's feeding journey isn't isn't something that is happening. But similarly, you hear you know, you can speak to people, my mum, my mom's age, and it stays with them. You know, my mum was in her 60s, and she can recount her first breastfeeding, difficult breastfeeding experience to me like it was yesterday. And these things do stick with us. And it's that validation of Yeah, of course, you're happy that your baby is healthy and that they're getting milk. And to suggest otherwise I just think is quite insulting. And similarly with birth, you know, you've got a healthy baby, it will obviously like of course I'm happy with that part of it. But the other emotions that you feel are really valid. And sometimes they get kind of brushed aside because you're expected to kind of get on with life things

Lucy Ruddle  43:53

like fed is best anyway, isn't it unhappy mummy happy baby and you're ever sad, I think but I'm not happy. I wanted to breastfeed my baby, you know, like, and it's that and then well, meaning I don't think anyone's ever being unkind. When I say to my mom, you know, we'll pick this bastard, you did your best. I think they're trying to make her feel better. But what they're doing is shutting down that conversation, and not allowing her the space to talk about how I actually know I'm really sad that it didn't work. I feel really guilty about it. And I want to talk about that. And when we know that, when you talk about stuff, that's when it starts to shift and feel better. And that is demonstrated actually the fact that we need to talk about it. I don't tell people I'm a lactation consultant. Because if I say what I do for a living at a wedding or a party or something you can guarantee I'm gonna get someone's trauma thrown at me. And I just go Oh, yeah, I support parents and babies. And that's enough, you know, even that can be Oh, yeah. If I say I support breastfeeding, oh, I couldn't do that, oh, I tried so hard to do that or I could have done with you and they just didn't get into their stories because they're not given the opportunity to talk about it. So when they do find somebody that understands it, it just all comes pouring out and so I felt it just because again, society hasn't given them the space, they need to grieve properly.

Megan Rossiter  45:04

Yeah, it was actually I was sad. I went to an event yesterday and was sat down next to people. And as soon as they found out my job, obviously I got recounts entire birth stories, and it happens every time somebody finds out what I do for a living. On the flip side, there can be the opposite emotions, there can be, somebody has finally found a solution that brings them a little bit of peace. And they feel so grateful and so relieved. And it's exactly what they needed. The parallels between the experiences of feeding me experiences of birth, so you know, it's very, very tight. Yeah, what I say with birth is it's so weird to feel conflicting emotions. And we often haven't done that at any other time in our life yet to feel like absolute joy and extreme disappointment, or trauma and gratefulness. And to have all of these feelings at the same time, and just letting yourself there's no correct way to feel about these things. 

Lucy Ruddle  46:06

Apart from to acknowledge the feelings and let them do that. And if you can, if it's safe to do so let them out cry journal, pushing up against the wall, and really good for feeling angry because you kind of you're pushing up against the wall, you're pushing against yourself, you're kind of getting that anger out in a safe way. And we're talking about relief. If you've put yourself through pain and anxiety 12 times a day, and you've had 16 Different people telling you 12 different things, cause you're gonna feel relieved. That's it? Of course you are there's no need to be to feel guilty about feeling relief, like. And again, I remember when I stopped when I stopped breastfeeding, Alfie the first time, like, yeah, I was gutted. And I went on to relax, hate, but like, in that, that first day, it was like, Oh, I don't have to do this. It was visceral. It was like, I felt like I've been let off the hook. Like, what it sounds really extreme, but almost like, I'd have like a last minute warrant for my death row. Like, you don't have to go through this. It's okay, you're free. And for me, it didn't last. And I went, I said went on toilet paper for many people. And again, people think because I'm a lactation consultant, I'm going to say, well, you must get back to breastfeeding, why don't know you need to do what makes you feel like yourself. And as a good parent and a good mum, because when you feel like a good, happy, connected mum, that helps your self esteem and makes you feel better, it helps your connection with your baby. There are many, many, many ways we can connect with babies, it doesn't have to be through breastfeeding, wonderful when it is. But if it doesn't work for you, guilt is the last thing I want you to be feeling. It's never ever the parents fault. I really believe that.

Megan Rossiter  47:39

Yeah, and that's, that is just the message that carry us through. All of I know all of your work. And all of my work is that actually, if we can just shake everybody else's opinion, and find the kind of confidence and trust in ourselves to go well, this, you know, this is what works for me, my baby, our family, and stop worrying about, you know, this is obviously much easier said than done. But stop worrying about what somebody else is going to think of you. When you're bottle feeding your baby in a cafe or when you say that you're not doing something that you wanted to do, if we can shake that it sets us up so well just for the rest of parenting because you know, it starts with birth, or it starts probably with conception because everyone's got opinions about that. Then it's been it's for then it's how we feed them. And it can sometimes feel like okay, well, as long as I've done that this carries on forever, I'm afraid. It's childcare, it's education, it's it goes on forever. And the more we can kind of tune into our own needs, our individual family's needs, yeah, the better you're going to be set up from this point, and then forevermore, because

Lucy Ruddle  48:49

if you are dealing with grief and depression and trauma and sadness, and shame, you can't can't be who you want to be as a mom or a dad or a parent or whoever, like you're you. It just doesn't work. So you have to in some ways, almost be a little bit selfish so that you can meet everyone else's needs. And that's okay. And when we're talking about particularly the topic of combination feeding, breast milk is dose responsive. So it's not like as soon as you introduce formula, you're undoing all the goodness of breast milk. It's just the more breast milk you get, give the greater the how that comes out. But it's a sliding scale. You know, you're reducing risks by giving any breast milk and you're reducing them further and further by giving more and more of it. Actually, breast milk can help mitigate some of the issues with formula because it's going to protect the guts when the formula goes in. So can be feeding is a really lovely compromise and not something to feel guilty or ashamed about.

Megan Rossiter  49:46

Amazing. If that is something that people are thinking about doing or that they're in the midst of I would really really recommend getting hold of that book in particular which is called mixed up combination feeding by choice or necessity. You can get it on Amazon, you can get your local bookstore to go and purchase it. And Lucy's new book breastfeeding about breastfeeding grief is available for preorder when this episode goes out. So, again, if that aspect of things is ringing true for you, that'll probably be a really, really, really helpful read, you know, we've probably got people listening, having their second baby and maybe kind of thinking actually, that was me, first time. So So, so, so much helpful information there. The work that Lucy shares, like freely on Instagram, and everything is also really, really useful and helpful. So do go and find her. So if people would like to find you either to kind of access your resources, your books, or work with you kind of on a more close one to one basis, where can they find you?

Lucy Ruddle  50:43

So Facebook or Instagram will guide you to my website, but my website is recently changed. I think it's just literally if you just search Lucy Ruddle IBCLC in Google, it comes up and weirdly, this is just a random side tangent. If you ask Alexa, who I am, she tells you and that is the weirdest thing I found out recently.

Megan Rossiter  51:02

So cool, I'm gonna do that. I will do that after this!

Lucy Ruddle  51:06

Just ask Alexa apparently.

Megan Rossiter  51:08

Yeah, I will. I will post links to your Instagram, your website, your books in the show notes are there so people can just click through as well. 

Lucy Ruddle  51:17

And the book is fully evidence based as well. And it's not going to push you one way or the other to just follow the feed or trust breastfeed. It is designed so that if you want to combination feed breast milk and formula, it will allow you to do that.

Megan Rossiter  51:29

Amazing. Thank you so much. 

Lucy Ruddle  51:31

Thank you

Megan Rossiter  51:39

Thank you so much for listening to today's episode of the Birth-ed podcast. It's my actual life mission to get these conversations in front of as many expensive families as possible and you can be a part of this mission. Don't worry, I'm not recruiting you into my cult. But if you leave a five star rating and review of the podcast then we creep up the charts getting more ears, change more births, change more lives and come on, you know you want to be a part of that change.