Breastfeeding – Supporting Without Judging.

I volunteer as a breastfeeding peer supporter in my home town. I have given talks about breastfeeding to sixth formers as part of their general studies course; I have spoken to heavily pregnant yoga mums about the joys and challenges of breastfeeding their soon-to-arrive milk-monsters; I have sat up with a brand-new, first-time, home-birth mum, in the quietest moments of the night and helped her and her baby off to a great breastfeeding start. Mostly though, I sit in a drop-in in a Children's Centre and listen to women tell me how much they want to breastfeed and why they fear they can't; I watch them feed their baby and see what adjustments can be made to make things easier for them. I give them time, sympathy, support, encouragement, understanding, tissues, tea. And some simple advice and tips which can really make a difference. Sometimes these conversations transform their feeding experience for the better instantly. Sometimes they need to come back several times before mum and baby get the hang of this new skill. Sometimes I never see them again and I am left wondering if their feeding problems are 'fixed' or whether they decided not to carry on breastfeeding, but never came back to let me know that because they worry that I might judge them.

Mothers who choose not to breastfeed, or find it too hard to continue to breastfeed, or are told or become convinced that they can't breastfeed, or in some rare cases whose breasts physiologically cannot produce milk, often feel judged (and sometimes are judged) by those who can breastfeed and do.

I was gently taken to task this week on Twitter, by someone who felt my tweets might be construed as judgmental towards non-breastfeeders. I had tweeted in quick succession: a list of the 'ingredients' of breastmilk and of formula, a video promoting acceptance of breastfeeding in public, an article about the impact on breastfeeding of the drugs used in labour, and a cheeky 'burlesque' video, also extolling breastfeeding and breastmilk:

I tweet this sort of thing because lots of my followers are breastfeeders or breastfeeding supporters and find these links fun or useful. But on this occasion a fellow tweeter was asking what purpose those links served, given that the benefits of breastfeeding are widely known. Her view seemed to be that they just reinforced the self-satisfaction of women who had been 'successful' at breastfeeding. And maybe that's true.

Our exchange started out a bit prickly on both sides, I think, but became warmer as we 'listened' to each other, and as it became clearer to me that my new tweetmate had had a very negative personal experience of being judged for not breastfeeding; given that experience it was easy to see how my tweets could have been construed as a further criticism. I am sorry that they came across that way.

So, it's important to be clear…I have never judged, and will never judge another mum for not breastfeeding.

I support mums who want to breastfeed; I hope to encourage more mums to want to try breastfeeding and to want stick with it even if the going gets tough. What I do judge is this society which makes it harder than it should be for mums to breastfeed easily and confidently.

A great weight of evidence shows that in nearly every circumstance, breastfeeding is the best way for a mother to feed her baby. Breastfeeding has many health benefits for both baby and mother, and fresh research emerges all the time to show new features of breastmilk and new benefits to the breastfeeding relationship. ( ) The majority of women in this country try breastfeeding at the start (over 75%) but many of those have chosen to stop within a couple of weeks, usually because of pain & discomfort, poor weight gain in their baby or a perception that they 'can't' succeed at breastfeeding so it will be better to stop.

By the time a baby is six months old (at which age, the WHO advice is that babies should still be exclusively breastfed) less than 20% of UK mother/baby pairs are still breastfeeding. In many cases the mother's feeling that she can't breastfeed successfully has been compounded by poor advice from people around her including her partner, family and friends, but also sometimes health professionals whose own training does not adequately prepare them for supporting women who are finding breastfeeding hard. This is a social and cultural problem, not a physiological one. British women's breasts aren't different from those of women elsewhere in the world with higher breastfeeding rates. But our lives are different, our surroundings are different, our expectations are different, our support is different.

I ran into extraordinary problems feeding my fourth child. If I hadn't already known how wonderfully easy breastfeeding can be, based on three previous experiences, I know I would not have continued. If I hadn't had the support of a great breastfeeding drop-in, in my local Children's Centre, I still probably wouldn't have continued. I know how close I came to despair many times. How could I judge another woman, whether for the choices she has made, for the choices she hasn't been in a position to make, or for the times she hasn't had a choice at all?

Breastfeeding information is needed. The benefits of breastfeeding, though widely reported, are often obscured by the slick advertising of formula manufacturers, so they need to be reiterated again and again in the same way that advertising gets regular airtime. More important than relaying the benefits, is the transmission of timely, helpful advice and support to ensure that the experience of breastfeeding is improved for the many women who find it difficult, but for whom some simple suggestions could make a huge difference.

The coming week (1 -7 August) is World Breastfeeding Week ( ) I will be supporting this week by Tweeting my top breastfeeding tips, links to fun and useful resources and – if I can make the time – blogging some more.

Although it's true that in nearly every circumstance, breastfeeding is the best way for a mother to feed her baby, in any specific circumstance this may not be true for a particular mother and baby pair. So my Tweets are intended to be supportive, fun and helpful to mums who want to breastfeed, but not judgemental to mums who don't (or didn't). I will think carefully about the language I use when I tweet and try not to upset or offend anyone. Please be assured that, although I will be cheering Breastfeeders on, if you are not breastfeeding your baby, I am not judging you. x


Breed ’em like Beckhams

I am stung by an accusation of selfishness.…

I am – like the newly expanded Beckham family – a bad role model and
environmentally irresponsible.

There are nearly 7 billion people in the world, and because more than
two of them can be attributed to me, impending global catastrophe can
be laid at my door and my family planning decisions should be open to
public debate. There is, apparently, an ‘absurd taboo’ (says David
Attenborough) about talking about family size.

It’s not a taboo for my neighbours, friends, wider family,
acquaintances and many total strangers who have felt free to comment,
enquire, judge and joke over the years. But I’m willing to believe
that some people somewhere haven’t, perhaps, been having this

So let’s have it.

How many children should a family have? I would respectfully suggest,
as many, or as few as they want. If you disagree, perhaps you could
explain to me the basis on which you would judge, let alone restrict,
anyone’s family size and the purpose such a restriction would serve?

I am not blind to the fact that the climbing human population creates
an insatiable, and ultimately unsustainable, demand on the earth’s
resources and that this is a problem that we must collectively solve.
The Guardian’s article references the ‘disastrous and often inhumane’
one-child policy in China – the fastest-growing, most resource-hungry
nation on earth. This is a clear demonstration that family size itself
is not the issue.

Simon Ross of the ‘Optimum Population Trust’ (OPT) remarks: “there’s
no point in people trying to reduce their carbon emissions and then
increasing them 100% by having another child”. This is a foolish
remark. Clearly he has never seen how most big families live. The
house I share with my brood was previously occupied by a family with
half the number of children. You can tell from the compost bins, fruit
trees, low energy light bulbs and new thermostat (set to 16 degrees)
that arrived with us that we live more sustainably than our
predecessors there. Our one, clapped-out vehicle usually travels with
every seat full; our children hand down toys, bikes, school uniforms;
they share bedrooms; we home-cook more and eat less processed food
than other families I know. Because of economies of scale, large
families are, per person, more resource efficient than small ones.
That said, I expect the Beckhams will expend more resources (because
they can) on any one of their children than I will lavish on all of
mine together.

And of course, I can’t make any strong claim to environmental virtue.
I will almost certainly use more of the earth’s resources raising one
of my children than a mother in sub-Saharan Africa will raising every
member of her average sized family (5-8 children). Big families –
using modest resources – are more environmentally sustainable than
small families (or single people) using high levels of resources.

The “environmental case that one or two children are fine but three or
four are just being selfish” is bogus.

It is not *that* we live that makes us unsustainable, it is *how* we live.

We all need to get better at living in ways that use fewer resources;
we all need stop valuing ‘growth’ (particularly economic growth that
relies on consumption) as an indicator of human success; we all need
to understand that many of the problems attributed to over-population
are in fact problems caused by a rich few annexing the world’s
resources for their personal consumption at the expense of the
impoverished many.

When the OPT calls for cuts to child benefits and tax credits and says
that ‘the government will support sustainable families but after that
you are on your own’, what they mean is that poor people shouldn’t
breed. But poor families are often extraordinarily resourceful,
reducing consumption because they must and using and re-using
materials that other families would waste. The OPT vision of
‘sustainability’ is a financial one, where you can live as
environmentally unsustainably as you like, as long as the taxpayer
doesn’t chip in. Restricting the income of families with children does
much to damage the life chances of those children, but very little to
manage down the birthrate or manage up sustainable living.

Surely, overall, a lower global birthrate would be a good thing?

Well, yes. Absolute numbers of people, not individual family size, is
what puts pressure on the earth’s resources. In this context, Caroline
Lucas’s remarks in the article are more sensible. She is wise to
disparage China’s restrictive policy. It hasn’t created a reduced
population or a sustainable lifestyle.

I would welcome a focus on making contraception and abortion available
freely to all those who want them; this means we need to stop
moralising about sexual habits and get real about sexual behaviour. I
welcome a focus on global inequality; there is starvation once again
in the Horn of Africa, not because there are too many people there,
but because the developed world has disgracefully exploited that
continent and its people and continues to do so, to support our own
consumerist lifestyles. If we focus in this way, rather than
suggesting that larger families are inherently ‘selfish’, we will
bring the global birthrate down without having to restrict any
family’s personal choices. We know that we can do so, because births
are already below the replacement rate in the developed world (under
2.1 per woman) and are falling in the developing world too. And we
know why.

We know that the public health benefits of developed nations lead to
reduced birthrates; that improved access to contraception and female
sexual health services reduces the birthrate; that educating girls and
women and welcoming them as equals in the workforce reduces the
birthrate; secularisation tends to reduce birthrates too. The more
well-cared for, healthy, well-educated, free, equal and rational we
are as nations, the lower our national birthrate falls. Why not then
focus on those things? Let’s get the provision of health, education,
employment and welfare right, across the globe, and the rest will
follow. Within that framework there is a natural variation in family
size which it would be – in my view – unkind and unreasonable not to

We are already on that journey. The crude birth rate (births per 1000
population) has dropped steadily from about 37 in the ’50s down to 20
in the early 2000s.

Population growth is as much a feature of adults not dying as it is of
children being born, but we’re not yet ready to smash the ‘absurd
taboo’ of talking about when a human being ought to think of bowing
out and leaving space and resources for the rest of us. And I hope we
never are. Not least because such an arbitrary cut-off would probably
leave us without the rather lovely David Attenborough.

Come here and talk to me about my family’s carbon footprint, about our
consumer choices, about how sustainably we are living (or not), by all
means. I want us to improve in all those areas. But don’t look at
these children, brought into the world in love and joy and raised here
with a humour and generosity that extends far beyond the walls of our
home and call that decision ‘selfish’.

Pro-life…and therefore pro-choice.

I am missing the pro-choice demo today to take umpteen children to the
school summer fair. I wanted to be a mum from about the age of 10.
Having my brood came a lot later in my life than I hoped for or
expected. As a result there are fewer of them than I planned for all
those years ago. I make the most of them while they are still around
to love, tease and feed.

I am warmly, abundantly, joyfully in favour of life. ‘Pro-life’, if you like.

I am therefore necessarily, unashamedly ‘pro-choice’. I fully support
a woman’s right to choose whether or not to carry a pregnancy to term
and to bring a baby into this world.

I acknowledge that a man is entitled to hold the view that an abortion
is an unwelcome event. I believe he should express this view through
being ultra careful about consent in a sexual relationship, and ultra
responsible for contraception to ensure that no unwanted pregnancy
ensues. If he does this, his personal convictions are most unlikely to
be troubled by the issue of abortion.

Any woman who abhors abortion should be free to carry a pregnancy to
term – even if that entails putting her own life at risk. That is her

Anyone else’s abortion decision, it seems to me, is nobody’s business
but her own.

The so-called ‘pro-life’ movement is not ‘pro-life’. Members do not
value the lives of women whose personal agency they seek to remove;
they do not value the lives of abortion-providers they impinge on or threaten (and
sometimes, in extreme cases kill); they do not even value the quality of the future life
of the as-yet-unborn child whose ‘interests’ they spuriously claim to
protect. They are not pro-life. They are simply ‘anti-choice’.

That is all.

Blinded by transparency.

The Local Authority, as required to by government, publishes details 
of every payment over £500. Our communications function – deemed 
‘non-frontline’ in the cuts – has been decimated, leaving frontline 
services to take on the role of the press office. I take a phone call 
from a journalist who has an enquiry about a payment to a Travel 
Agent. The tone of newspaper reporting at the publication of this 
information has been to suggest that payments made must be fraudulent 
unless proven otherwise. Thousands of pounds spent on ‘taxi bills’ 
must be signs of employees failing to use their own two legs, rather 
than (as it turns out) the true cost of transporting children with 
special needs to and from schools and daycare provision; a large 
payment to a Travel Agent is – surely – a evidence that the Chief 
Executive and Council Leader are having overseas junkets at the 
Council Taxpayers’ expense? 

The journalist asks what the payment to the Travel Agent is for and I 
say I will find out. The journalist points out that if I don’t come 
back with details they will “print the story anyway”. I am confident 
that any payment we have made is legitimate, but I put aside the work 
I had planned and deal with this query instead. Papers seem to love 
negative stories about what we do in local government. We don’t want a 
hostile press making our already hard work more difficult. I find the 
information and call the journalist back. The payment relates to the 
provision of specialist travel and accommodation to enable a group of 
young people with complex needs to have an adventurous short break 
away from their families, supported by highly skilled professional 
carers. This is a valuable developmental experience for the young 
people and – in some cases at least – a sanity-saving respite for 
families. It is also fully-funded for this purpose by a central 
government grant. I relay this information back to the journalist and 
add an important detail: the group arrives back today. They have been 
having a fantastic time and would love to say more about it. How about 
meeting the coach? The journalist demurs. That would not be a ‘story’. 

As I checked out the details for the journalist it became clear to me 
that for the number of people engaged in the trip, the length of the 
trip, the complex (including medical) arrangements required to support 
it, and the huge positive impact on the children and families this was 
fantastic value for money. Sadly that is no story. 


I am in a room with nearly 30 senior managers and directors as part of
a multi-agency task force tackling complex community problems. In the
interests of transparency we are examining the budget for our work
together. We are spending more than the individual agencies are
contributing to the costs; several thousand pounds adrift. No one
thinks the work we are doing is unnecessary, all the agencies are
committed to it. The conversation i am expecting is one where, as
individual organisations and agencies, we each agree to contribute a
little more to offset the deficit. As we pore over the financial
report line by line one member highlights the annual cost of
refreshments (coffee, tea and biscuits). He doesn’t actually know very
much about the work of this group and his usual contributions to the
meetings are weak, but he knows (or thinks he knows) about the cost of
coffee. This £600 bill is, he says, disgraceful, especially as the
coffee is not very nice. His self-righteous indignation dominates the
discussion for which we (busy people all) have little time. The chair
notes that the opportunity cost of all these senior people considering
tea and biscuits instead of their core business is the real disgrace
and cuts off the discussion by promising there will be no more
refreshments. Ever. That one member of the group enjoys a rare ‘win’.
Much of the goodwill in the room evaporates. We have ‘saved’ £600
pounds. No agency agrees to contribute more to the greater costs.

A little mathematical endeavour would quickly show that those
refreshment costs, for the task force, its working groups and
executive meetings over the course of the year work out as pennies per
person. The goodwill lost, when ignorant sanctimony trumps serious
professional discussion, is priceless.


Eric Pickles is said to have this week praised the group of ‘armchair
auditors’ liberated by this new ‘transparency’ to take a fine tooth
comb to council spending decisions.…

It is hard to disagree with the principle of transparency when
committed activists make good use of the new arrangements to hold
public bodies to account. But there are very significant risks here.

First, the political and media-generated cynicism about public service
which seems to take as its starting point the idea that it’s all just
one giant scam or gravy train is corrosive to the very idea of the
public good and the principles of public service, which so many of us
who have chosen to work in this undervalued sector absolutely live as
core values, despite the fact that the world around us shed them long

Second, collating and publishing this data, responding to enquiries
about it and managing multiple, complex and sometimes frivolous
questions from the public and journalists are new and As yet unfunded
bureaucracies in themselves, which local government can ill-afford at
a time of cuts. I do gain some satisfaction from talking a member of
the public or a journalist, from a zero or low knowledge base about
the professional disciplines I am involved with, through to sufficient
understanding of the field that they can grasp why a particular
payment is justified. But this is not what I was employed to do. And
what I was employed to do does not go away because this new task has

Third, the new bureaucracy generates a huge opportunity for exactly
those organisations who have enjoyed such a gravy train over the past
few years at the tax-payers’ expense – private sector consultants and
IT companies who are brought in at vast expense and on contract rates
to deliver the ‘information systems’ which will support the new
transparency industry. Their over-hyped business process engineering
converts skilled professional staff (in disciplines the business
analysts never truly understand) into strange data-feed monkeys whose
job becomes not to do their job but to ‘report’ on the doing of their

Fourth, the new transparency doesn’t distinguish between ‘information’
and ‘knowledge’ or ‘understanding’. As I tweeted earlier this week,
let’s now watch while the machinery of government grinds to a halt as
public servants are diverted into the task of justifying every bill a
member of the ‘armchair auditor’ brigade disagrees with or doesn’t
understand; let’s watch public services clog and congeal as ‘informed’
consumers argue the toss with clinicians about medical treatment based
on cost or shiny newness rather than clinical need; as parents argue
with schools based on their league table position or their ‘per pupil’
spending instead of meeting the teacher and finding out whether their
children are inspired.

Above all else though, the risk is that this so-called transparency is
a distraction. In the week that the Guardian reported that all
spending on government credit cards is to be published in order to
‘expose profligacy and waste’ (er, because of course all public
servants misuse and abuse government credit cards terribly)……

…the same paper reported that a planned torture enquiry has been
dismissed as a ‘sham’ by human rights groups and is being boycotted by
lawyers for the victims because it is to be held in secret…

…and that 1 in 5 MPs don’t see why they should submit receipts for
their expenses:…

This government is in favour of transparency only in so far as it
serves its own other nefarious agendas. The flood of ‘data’ about all
our public services now under threat may occasionally tell us
something useful, but mainly points to an ignorant, almost philistine
disregard for professional expertise. There’s no apparent willingness
to shine the same light on the private sector, so public sector
organisations can be vilified if their own service delivery arms are
perceived as poor value, and then vilified again if they externalise
those services and Them private contractors don’t deliver. Where this
happens it becomes characterised as a failure of public sector
commissioning, not of private sector delivery.

Cosy in the pockets of their private sector chums MPs think it
laughable to be asked for receipts, and a public deemed competent to
‘audit’ public service across a range of professional disciplines and
spheres is not considered ready to understand our politicians’
complicity in illegal acts that may have been carried out in our name.

We are blinded by the shiny newness of our transparency. We are as
transparent as mud.

“Social Justice” or something else…?

When I’m in charitable mood, i think that Iain Duncan Smith just
doesn’t get it. He uses all the right phrases – “early intervention”,
“social justice” – well-meaningly but doesn’t manage to sound like he
means them. On my cynical days, I think he ‘gets it’ completely – in
the sense that he knows full well he is using these words and phrases
to conjure something egalitarian and compassionate, while instead
supporting practices that are coercive, exploitative and fundamentally

Who in their right minds would argue against “early intervention”?

Fig6 on p17 of the Marmot Review “Fair Society, Healthy Lives” shows
how bright toddlers of poor families fare so badly, compared with rich
toddlers with low cognitive capability, in the period between 22
months and the end of Key Stage 1. This should be considered a
terrible failure of social justice in this country.…

Marmot’s policy recommendations include increasing spending on early
years development and early education, improving parenting and family
support, including through paid parental leave, and focusing these
efforts on (though not restricting them to) harder to reach and more
disadvantaged children and families.

As practitioners who really know this field are well aware, the
evidence base for early intervention has been building for decades.
This C4EO publication, Grasping the Nettle
provides as good a primer as any for those who are new to the concept.

Iain Duncan Smith appropriates this language well.

So, early intervention acts against profound social injustice, has the
potential to improve the lives of millions and – crucially – is
significantly lower cost in ‘whole system’ terms than waiting for
things to go wrong and then having to step in with welfare programmes,
prison costs, drug and alcohol interventions, social care placements
etc. This is a fantastic argument for directing the expenditure of
funds fairly gathered through general taxation Into interventions that
will improve lives and eventually lower costs to the taxpayer.
Progressive and redistributive. Socially just.

Is that what IDS is planning to do? No.

His own Comment is Free article, and Patrick Wintour’s piece in the
Guardian this weekend (below) outline his latest wheeze.…

IDS starts to anger me from his first paragraph, where he lazily, and
mean-spiritedly equates love with prosperity. In a Tory world-view,
where pretty much everything can be purchased, maybe this is a truism.
But he needs to understand that the cramped homes of the workless,
where families often struggle, are not love-free zones. And money
can’t buy us love.

IDS is excited by ‘innovatively funded’ early intervention schemes,
which will channel ‘private billions to the poorest children’. Oh
really? So far, this government’s innovation in the field of early
intervention has been to bundle together more than 20 grants to local
government which were for a range of early intervention programmes, to
re-name the bundle the ‘early intervention grant’ while cutting its
value by up to 20% and to remove the ring fence against a background
of other cuts, so that it doesn’t have to be (and in many cases won’t
be) spent on early intervention at all.

If the government’s commitment to early intervention is this
lacklustre, what can the current fuss be about? The fuss is about the
‘powerful message about social justice’ contained in the IDS
proposals. This powerful message seems to be ‘rich people won’t act to
make the lives of poor people better unless they can make money out of
doing so’ (sorry!… unless they are financially ‘incentivised’).

(IDS’s method of ‘incentivising’ poor people into work is to remove
money from them by cutting their benefits. Yet rich people are
incentivised by giving them more money? There’s social justice in
action for you! A blog for another day, perhaps)

Volunteers all over the country give their time to communities for
nothing, hundreds of thousands of low paid public sector workers are
daily engaged in helping the most vulnerable for wages that
millionaire ‘philanthropists’ wouldn’t get out of bed for, but for
rich people to work* in this field IDS thinks they should expect a
return on their investment.

(*when I say work I don’t mean actual, get-your-hands-dirty work,
obviously, I mean the kind of work where you give some of your money
that you don’t need, to someone else for a little while and then get
it back in its entirety, plus some more. Cos you’re -what? prosperous
and loving? Nice.)

Apparently we ‘start re-engaging the top of society with those at the
bottom’ (and don’t you just love that sort of disparaging language?)
and ‘reviving the sense of shared community’ by finding ways for rich
people to interfere in the lives of poor people and make money out of

People already working in early intervention are often engaged in
highly focused projects with specific objectives, but all understand
that entrenched social problems are ‘whole system’ issues; that
positive impact in one area can be offset by negative impact in
another; that families with problems (not ‘problem families’) often
need the support that additional time, effort and professional
resources can bring but that their greatest and potentially most
effective resource is the families themselves. And people already
working in early intervention also understand that ending
intergenerational poverty and disadvantage is a ‘whole life’ issue.
That next week’s positive ‘outcome’ must lead to a further positive
outcome next year, and in five years time, and in twenty-five years
time. And that the interconnectedness of these interventions,
resources and outcomes means that if done well, and sustainably, early
intervention calls on the resources of the whole of society and the
reward should rightly belong to society as a whole.

Instead, IDS wants to take the ‘savings to the public purse’ from
successful early intervention and to direct them into the hands of
private investors, privileging the narrow impact of the interventions
that they sponsor over the value of the collected effort of wider
society. His ‘powerful message about social justice’ is biblical: “to
the one who has, more will be given”.

I predict that a financier-driven ‘payment by results’ system of early
intervention will prioritise short-term outcomes over long term ones;
will skew individual and organisational behaviour towards the
externally set objectives of financed programmes and away from
focusing on how best to meet individual needs and enable individuals
and families to take control of their own lives and progress; will
introduce competition rather than integration between programmes so
that particular programmes can claim ‘success’ and therefore their
financial reward; will lead to ‘cherry-picking’ so that families whose
problems seem intractable are diverted out of privately-funded
programmes so as not to negatively impact on their ‘ROI’ and into
public-sector programmes which will provide the inevitable safety-net
and for which they will be derided for ‘inefficiency’ (translation:
working hardest within the most complex and challenging situations).

The last paragraph of Patrick Wintour’s Guardian article explains that
there will be tax breaks for charities and companies ‘investing in
social impact bonds’. In other words, a form of legitimised tax
avoidance from next year, for a scheme which ‘could take 15 years to
bear fruit’.

I am an ardent believer in the value of early intervention, and the
importance of social justice. These proposals are not social justice.
They are a rich man’s scam.