Maryam's story - being a doctor with breastfeeding challenges

This week I’m talking to the fabulous Maryam, a doctor and mother from Manchester, about her breastfeeding journey. Despite initial struggles, including mixed advice, nipple shields, a tongue-tie, and pump issues, Maryam remained determined and successfully transitioned back from triple feeding to exclusive breastfeeding. We explore the emotional and physical challenges she faced, the role of family support, and the impact of her experiences on her professional perspective as a doctor. Maryam also highlights the importance of culturally competent breastfeeding support and the innovative efforts of the Medics Lactation Community (MiLC) in providing peer support and educational resources for doctors.

Find out more about MiLC at https://www.facebook.com/share/g/14LwrHajAd9/?mibextid=wwXIfr

And the Education network - https://www.facebook.com/share/g/1749BkEGfr/?mibextid=wwXIfr

My new picture book on how breastfeeding journeys end, The Story of Jessie’s Milkies, is available from Amazon here -  The Story of Jessie's Milkies. In the UK, you can also buy it from The Children’s Bookshop in Muswell Hill, London. Other book shops and libraries can source a copy from Ingram Spark publishing.

You can also get 10% off my books on supporting breastfeeding beyond six months and supporting the transition from breastfeeding at the Jessica Kingsley press website, that's uk.jkp.com using the code MMPE10 at checkout.

Follow me on Instagram  @emmapickettibclc or find out more on my website www.emmapickettbreastfeedingsupport.com 

This podcast is presented by Emma Pickett IBCLC, and produced by Emily Crosby Media.

Transcript

This transcript is AI generated.

[00:00:00] Emma Pickett: I am Emma Pickett, and I'm a lactation consultant from London. When I first started calling myself makes milk. That was my superpower at the time because I was breastfeeding my own two children, and now I'm helping families on their journey. I want your feeding journey to work for you from the very beginning to the very end.

And I'm big on making sure parents get support at the end too. Join me for conversations on how breastfeeding is amazing and also sometimes really, really hard. We'll look honestly and openly at that process of making milk, and of course, breastfeeding and chest feeding are a lot more than just making milk.

Thank you very much for joining me for today's episode. Today I'm talking to Maryam from Manchester. She is a doctor and she's a mum, and we're gonna be talking about her breastfeeding journey. We're gonna talk about how it feels to struggle with breastfeeding. While also being a doctor and, and what that means and, and the impact of that on your breastfeeding journey.

And a bit of a headline. She was giving more than 50% formula and went back to exclusive breastfeeding. So we will be talking about what that journey was like and, and how she achieved that. Not to say that's something that everybody can achieve or even would want to achieve, but I think it's important to hear how her story went.

So tell me about your little person, Maryam, who have we got? Who, who are you living with at the moment? 

[00:01:27] Maryam: Um, so I live with my husband, uh, Mein, and my little person is called Ibrahim. He's coming up to 13 months old now, so he is very energetic. I'm running around after him all the time. He's a fast crawler.

[00:01:40] Emma Pickett: Oh. Oh, fantastic. Is he walking yet? No, 

[00:01:43] Maryam: not yet. He's much more interested in crawling because he can get to 

[00:01:45] Emma Pickett: where he wants to go quicker. Yeah. Yeah. My son wasn't a super fast walker. He took one step when he was about 12 months and then thought, yeah, no, I don't really get the point of that. I'll just say, I'll just hang on for another bit if you don't mind.

So he wasn't walking again for another couple of months. Tell me about a typical day of breastfeeding Ibrahim at the moment. What does a typical 24 hours look like? 

[00:02:04] Maryam: Um, at the minute it's really variable, so it kind of depends what else we're doing. If we've got a really busy day out and about, um, he can go for ages actually without a feed.

But, um, he does feed to sleep still. Um, unless we're in the car. The car is a dangerous place at 5:00 PM Oh, 

[00:02:23] Emma Pickett: we'll all recognize that. Yeah. That, that terror of turning around and they're in a deep sleep and you're like, nah, I won't get to bed till midnight. I know. I look in the mirror and I'm 

[00:02:31] Maryam: like, no, no, no.

Don't close your eyes. But yeah, no, he feeds to sleep, um, for his naps, and, uh, he feeds to sleep before bed and then in, in the middle of the day. It just kind of depends what he's, what he's doing. He's very much, he's very much in charge still. 

[00:02:46] Emma Pickett: Okay. Okay. So responsive feeding, which feels good. Absolutely works for you.

And where's everyone sleeping at night? What's a typical night like? 

[00:02:54] Maryam: Just going this cot at the start of the night, and thankfully, oh, I don't wanna jinx it by telling everyone this, but he sleeps pretty well for a good junk at the start. I've been there when sleep has like, been awful. So condolences to everybody that is struggling with, uh, with awful sleep.

But, um, he seems to sleep quite well at the start of the night. And then when he does wake up in the early hours, maybe four or five, then we just bring him into bed and we're, we're just all. We all co-sleep at that point. It's just easier. 

[00:03:24] Emma Pickett: Okay. So there are some people saying 4:00 AM 5:00 AM It is not the early hours Mariam.

No know. It's like morning to me it's, it's like a full night sleep. So, so are you lucky? That's, that's great. I So what time is he going down for at the beginning of the night? Oh, about eight o'clock. So he's going from eight till about four or five. Well, I mean, I'm really glad to hear it because actually I think it's really important that we model that not all responsibly, breastfed little people are gonna be waking up every two hours that mm-hmm.

He's clearly not, which is, which is fantastic. So at bedtime you are feeding him to sleep and then putting him in his cot, lifting him into his cot to sleep. Yeah. And that's not causing any problems. He's obviously still able to transition between sleep cycles throughout the rest of the night. Mm-hmm. And where are you thinking you'll be?

When he gets too heavy to lift him into his cot, if that makes sense. Where do you want to go next? 

[00:04:10] Maryam: He's so heavy, Emma. Um, so I don't know. To be honest, I haven't really, I haven't really thought that far ahead. Ideally, I'd like to just get a floor bed and put that in the spare room, but we've got a bed that's got loads of storage underneath it, so.

I have to come to terms with getting rid of a lot of stuff. Um, yeah. But yeah, I think, I think a floor bed is probably the, um, the way to go the way forward. Yeah. I 

[00:04:35] Emma Pickett: mean, it might not have to be a floor. I mean, I'm a massive fan of floor beds. I think they're so useful, but it might not have to be. I mean, you could get kind of mesh.

Um, sides. Yeah. On the bed that you have, I mean, those kind of toddler guards where you, some of it's tucked under the bed and there's a mesh side that, that could work in a bed that's slightly raised off the floor and in, you know, in another few months he might, he may be capable of moving off a surface safely.

You might put some cushions on the floor or something. It's more about whether the rub itself can be, um, made safe and, and sort of baby proofed in case he woke up and he was in there alone. Yeah. I don't mean to be pushing you onto the next thing. I'm just always curious because I don't hear a lot of cot sleeping in the work that I do.

Lots of people are already co-sleeping or already doing floor beds, so it's just really nice to hear that your, your experience is working. Let's go back to the beginning, Abraham, before he was born, so you are pregnant and a doctor. And what was going through your mind when you were thinking about breastfeeding?

What was your previous thinking around breastfeeding? You know, what was your, what were your goals? 

[00:05:42] Maryam: I thought what I think a lot of people think, um, is that I, yeah, I'd like to breastfeed, but if it doesn't work out, I'm not gonna put loads of pressure on myself. Um, whatever happens, happens, and I'm okay with that.

In terms of previous knowledge of breastfeeding, zilch really. Not very much. So, um, being from, you know, having my professional background as a doctor, I really didn't know anything about breastfeeding. Um, when I was pregnant, I had a patient. Uh, so I, I work in general practice. I'm a, um, doing my GP training.

I had a patient that came in and she was five days postpartum and she thought she had thrush, and I was like, thrush what? Like, I, I just had never come across the concept. And obviously we've moved away from. Thinking about thrush as a breastfeeding problem now, but it was just a, like a baffling consultation for me because I didn't know what to do.

[00:06:34] Emma Pickett: Yeah. 

[00:06:35] Maryam: So, yeah, it, that, that just didn't help me at all. 

[00:06:38] Emma Pickett: So your general training, you didn't even get the, the nice hour on lactation, didn't even get that, 

[00:06:44] Maryam: had it after that patient. 

[00:06:46] Emma Pickett: Okay. So, I mean, Chris Vant talks about getting a kind of, you know, the literal one hour job, and some people have talked about.

You know, when, if you happen to be, you know, doing a, I dunno what they call it, not a training session, when you're alongside somebody in, you know, in a setting, you might happen to bump into someone who talks more about lactation and that's just fluke. But nothing was set down in your training. And, and you don't mind me asking, you don't, you're not old.

This is obviously, you've obviously trained, you know, in the last decade or so. Yeah. So this is, this is the reality that we are dealing with in the Yeah, absolutely. 

[00:07:17] Maryam: And you know, to be honest, I think back to medical school and I, I wonder if maybe we did get. A session on breastfeeding somewhere, maybe in first year, but I think it, maybe it just didn't really register, um, very much with me.

It's just, it, it was never applied practically when I've, I've done loads of obs and gyne and I've never, we never got any sort of like formal teaching or shadowing about infant feeding and, you know, not just even just breastfeeding, you know, formula feeding. We, we just didn't get anything and we need more.

[00:07:47] Emma Pickett: Yeah. Not least because I mean, you know, we can think about it from the perspective of the patients, but also how horribly unfair for you to be in a GP consultation, which is stressful enough, and there's someone in front of you who's very vulnerable and distressed, and you have not been given the tools to support them.

That's, that's just not fair on anybody in that conversation. So you had that lovely British, I'm gonna give it a go, but I'm not gonna put pressure on myself thing that we could embroider on a cushion because that is what so many people say because they don't want to feel. It's very significant because then if it doesn't work out, that's scary.

So there's something self-protective isn't there about saying, I'm gonna give it a go, but not put lots of pressure on myself. Did you have family members that are breastfed? Do you know if you were breastfed? So I was formula fed. 

[00:08:32] Maryam: My mom has memories of, you know, being kind of being shown how to breastfeed, but it was very rough and very forceful and not very kind.

So that was the nineties. So yeah, I was formula fed. I don't have any family members that I know of that breastfed we're quite a small family. But yeah, no one around me had breastfed. Um, I had some friends who had given birth, uh, you know, in the last couple of years and, and they hadn't breastfed or they'd had big challenges breastfeeding and then stopped earlier than they wanted to.

I think everybody tells you that it's going to be really hard and it almost sets you on the back foot before you even start. And that, I think that's why we say to ourselves like. Oh, I won't put too much pressure on myself if it doesn't work out. 'cause we expect it not to work out. 

[00:09:17] Emma Pickett: Yeah. Yeah. I mean, we know that 80% of people in the UK don't reach their breastfeeding goals.

Um, we know that's very normal, so therefore we are almost always gonna be surrounded by people that have not met their goals and, and feel that sense of frustration and dismay and, and anger at the system, or even anger at the messages that are positive around breastfeeding. You know, we are on a bit of a pickle, and if you literally have no models, I mean even more of an achievement of where you got to Maryam, if you didn't even have any models around you.

So tell me about Abraham's birth. Tell me about those early days. What happened? 

[00:09:48] Maryam: Uh, I was induced, um, uh, I was induced at 38 weeks, um, because I have type one diabetes. Um, so I knew from the start that yeah, everything was very medicalized. Um, and I, I, I knew that how it was, how it was going to be. 

[00:10:01] Emma Pickett: Can I just ask a quick question about your diabetes?

Yeah, absolutely. Did anyone talk to you about antenatal expression of colostrum? 

[00:10:07] Maryam: Yes. Oh yeah. I was doing that obsessively for, for two weeks. Um, took it to the hospital and forgot about it in the fridge. 

[00:10:14] Emma Pickett: Okay. But the positive thing is that you'd, you'd done it and that's part of it. Um, and did anyone explain to you, I'm kind of grilling you a bit here, so tell me to get stuffed if this is too much.

Did anyone talk to you about how. Breastfeeding after birth could actually help you manage your diabetes and actually may mean you need less treatment, for example, or, yeah, 

[00:10:34] Maryam: so my diabetes team were fantastic. My diabetes consultant, um, shout out Dr. Kelly Chair. Um, she was amazing and she did discuss, you know, we had a plan of it.

I'm on an insulin pump. We had a plan of reducing my total daily insulin to about 70% of what I was having before. And she did also mention about the possible impact of insulin resistance on establishing a milk supply, which no one no one else mentioned. 

[00:11:01] Emma Pickett: Okay. Wow. That rarely gets mentioned. So that's some impressed, actually, that is useful information.

Yeah. Not everyone realizes that. Not to say at all that diabetes is a barrier to breastfeeding. It absolutely can work, but it's almost actually the pre-diabetic people who are not pro actually diagnosed that are gonna struggle more 'cause they may not realize what's going on. But for her to talk to you about that is, I think that's super helpful.

Just to give you that awareness. Finitely. Yeah. Shout out for Kelly. Yeah. We love Kelly. So how, how, so you were induced and was that, well you don't know 'cause you haven't given birth to anybody else, but was that. Pretty heavy going. I mean, how did that experience go? It was, 

[00:11:39] Maryam: it, honestly, it wasn't, um, an experience that I'd like to repeat.

It was, it was very difficult. Um, and I would describe it as a traumatic birth experience. Um, I'm sorry. So I had, uh, basically about 24 hours of, uh, labor after being induced. I was kind of like, uh, hyper stimulated. Then they took a pause on pessaries. Um, started again and my waters broke by themselves, which was pretty cool.

I thought, okay, we're winning. Maybe I'm six centimeters now, and I was like, two. So it, it, you know, it was, it was slow going. It was very painful. Um, I was toddling along with my TENS machine and I was in a good head space, and we're not talking about labor really, but it, it then got into a bit of a pickle and it ended up having an emergency section, um, around midnight.

And it was quite a difficult one because, because I'd just had an epidural that hadn't, um, hadn't quite worked. The spinal sort of led to me not really being conscious at the time he was born. So that was really, really difficult. Um, for me, but also my husband. 'cause he, you know, I'm, I'm not aware of what's going on, but he's watching all of this.

So yeah, that was, that was quite difficult. And then recovery was difficult because I wasn't well enough to hold him until maybe, oh gosh, a good hour and a half, two hours after he was born. Okay. Um, so we didn't get that golden hour or, you know, immediate skin to skin. Which I really, really wanted. So yeah, that was, that was tricky and hard to get over.

[00:13:11] Emma Pickett: Yeah. I'm sorry. Yeah. You mentioned your husband and obviously the focus of this conversation is very much on you, but I think it's always important to remember how stressful it is to be a partner watching that process and, and what, obviously worrying about you and then suddenly here's a baby and you are responsible for that baby, and your partner's not there yet to be with you.

That's, that is tough. And obviously your husband knew that you wanted to feed. Um, to breastfeed. Um, so you talk about an hour and a half, I guess that's not so long. I mean, I don't mean to dismiss. I'm not gonna go, oh, you had a healthy baby, Mary. Yeah, of course. I'm not dismissing your experience, but we hear people that don't meet their babies for 12 hours, 24 hours.

So, so the golden hour gets a lot of emphasis. But I meet people constantly who didn't have it and have the most wonderful breastfeeding experiences and yeah. And precious bonding with their child. Tell us about when you woke up, how were you feeling? You, did you have any, um, significant blood loss? Were they worried about anything else?

[00:14:05] Maryam: No, no. Um, significant blood loss, um, but just spinal was still very much there for a long time, so, um, it took a long time for my arms to kind of start working again, which is a bit bit odd. Um. But nothing, there wasn't anything else of concern that I was aware of. I think Umbra needed a bit of resource, um, at the time, but he didn't have to get whisked off to NICU or anything.

I can't imagine how hard it's for people that, that go through that. Like I, I feel my experience was difficult, but I can't imagine if we'd actually been physically separated, that would've been horrendous. But yeah, there wasn't anything else of concern really. It was all pretty. Straightforward after that in terms of recovery.

[00:14:46] Emma Pickett: Yeah. Yeah. Did have you had a birth debriefing? Yes. Is that something that I have? Did that feel useful? 

[00:14:53] Maryam: Um, it did. I had a couple actually, um, had one at the hospital, um, and had a really helpful senior midwife who went through things and kind of escalated a, uh, a complaint from some point in, in the journey, which was, which was really good.

You know, she, she helped me kind of identify what. The core thing that was really upsetting me, that I've not talked about, but you know, that that happened. And then I had a, a debrief, I dunno if I can mention, um, I Morrison. So she does the private birth debriefs amongst other things. And she was really fantastic.

Um, I think a lot of the things we talked about weren't necessarily, they weren't things that hadn't occurred to me or that I hadn't thought of. But having somebody else say it in words and validate your experience was really helpful for me. 

[00:15:39] Emma Pickett: Yeah. Yeah. Okay. I'm glad you've had that, that support. So your arms are eventually working.

He is, um, with you. Um, and what happened with those early feeds? Had he had any milk before you were able to look after him? 

[00:15:55] Maryam: No. Um, I don't think he had. Um, so he. I mean, I tried to feed him in recovery, and to be honest, I was still away with a ferry, so I don't really know what he did. And I think, you know, I hadn't had any, um, I hadn't had much antenatal education on breastfeeding.

I wasn't looking for, you know, kind of swallows or anything like that. I didn't know what a feed was meant to look like. So I think he probably just latched and sat there. I got the notice back later, and the midwife said that he fed well. But it was when we got to the, the postnatal ward that, um, everyone identified that he, he wasn't really feeding.

Um, he was jaundiced. He was just really lethargic. He was like an early term baby, wasn't he? So that comes with the territory often, and he, I think he probably didn't have enough milk in him to kind of get going on feeding. 

[00:16:50] Emma Pickett: Okay. And when people were saying he wasn't feeling well, that wasn't connected to anything and anatomical, that was just about him being sleepy, was it?

And just not having the oomph to, to stay attached and transfer milk. 

[00:17:01] Maryam: Yeah. Um, they did mention about, um, like me having quite flat nipples. I've never been asked if nipples were flat so many times in 24 hours, to be honest. Everybody said, have you got flat nipples? I don't know. Um, yeah, so it, I think that was, that seemed to be an issue for 24 hours.

And, um, somebody, um, introduced Nipple Shields and then someone else came and said, no, it's too early for Nipple Shields. Um, that's not going to help. So we, we did have a bit of, we had a lot of mixed advice, a lot of well-meaning advice and everybody, you know, the, the staff on the postnatal board are amazing because like every single time I said to him, I would press the buzzer and they'd come.

And, and try and offer some help. I think maybe we were just a bit complicated, and then we did see the infant feeding team, I think four days into admission. So I was a bit of a difficult patient. I said I wasn't going to leave until his feeding was sorted. 

[00:17:59] Emma Pickett: Good for you. To some degree, that's not being a difficult patient.

That's well done. That, that's advocating for yourself. Do you think that's your doctor hat that helps you to be like that? Or that's just No, that's the Merriam hat. Yeah, 

[00:18:10] Maryam: that was a me hat. Um, I didn't tell anybody I was a doctor while I was there. I didn't want to be treated differently. Um, uh, I don't know.

That's a bit of a complicated one as well. But, um. Yeah, no, I just, I think because I'd lost control of the birth, I really needed control over this feeding Jo and I needed to know that I'd done everything I could to make it work, because we were being kind of heavily encouraged. We'd already introduced formula by day two.

After he, he wasn't really feeding, he wasn't feeding at the breast. 

[00:18:40] Emma Pickett: Are you expressing at this point, is anyone supporting you to use a pump? 

[00:18:44] Maryam: So once we started the formula, that's when I started pumping. Okay. So my milk came in a couple of days later, but before that I'd been, so I'd been hand expressing for the first 24 hours, um, and giving him colostrum at the bedside.

But like I said to you before, I had loads of colostrum in the fridge that, oh, I dunno what happened. I just, I wasn't in the head space. My husband wasn't either, and we just forgot. So maybe that could have staved our formula a little bit longer. Who knows? Um, but I was hand expressing for 24 hours and then once we started Formula, I started pumping.

[00:19:15] Emma Pickett: So you talked to the infant feeding team, you put your foot down and said, I'm not going until I get that right. That support. How did that, those conversations go? 

[00:19:23] Maryam: So, yeah, he was born late Thursday night. Um, and obviously over the weekend. For feeding team weren't, weren't around, they weren't available. Um, so I saw 'em on Monday and they, yeah, they were amazing.

Um, they identified a tongue Thai, which we then got divided the next day, um, out of hospital. So that was really quick. We were really lucky to be able to do that. That was privately, or that was, yeah, that was privately. So the, the NHS wait list was about four weeks at that point. Yeah. 

[00:19:54] Emma Pickett: That's forever, isn't it, at that 

[00:19:55] Maryam: point?

Yeah. And I think. You know, if I think in different situations, different things are right for him, he wasn't feeding at all, and I felt like that was too long for me. 

[00:20:04] Emma Pickett: Yeah, 

[00:20:05] Maryam: it might be different for different people. Um, but yeah, it, it, we, we just went for it. Unfortunately, nothing changed 

[00:20:12] Emma Pickett: after that division.

So he, when you say he's not feeding, he's literally not attaching at all or coming on and not transferring what's happening? 

[00:20:20] Maryam: What he would do, it feels like a long time ago. I can't remember quite that well. But, um, I think what he was probably doing is latching and slipping. Um, he really struggled to maintain a deep latch.

I can count on one hand the number of times he had a deep latch in those early weeks. Um, okay. He just couldn't maintain it. 

[00:20:39] Emma Pickett: And were you using shields at this point or you'd stopped using them after someone else had told you not to? 

[00:20:43] Maryam: So, uh, we stopped, uh, in hospital and then when we had this first tongue tie division, um, we started using them again.

They advised to, to start using them again. 

[00:20:54] Emma Pickett: Okay. Okay. So you are still pumping, you are trying to breastfeed. Yeah. Not getting a lot of success and bottle feeding as well. 

[00:21:04] Maryam: Yes. 

[00:21:05] Emma Pickett: The triple feeding. 

[00:21:06] Maryam: The triple feeding and then my pump broke day five or day six. Ah. So, um, and you know, I know so much more now, but I didn't, I ordered a pump online and it came two days later, but all that time I wasn't pumping.

[00:21:21] Emma Pickett: Oh. Maryam. 

[00:21:22] Maryam: So if I could go and do that first week again, it would be completely different. Um, but yeah, 

[00:21:29] Emma Pickett: if you don't know, you don't know exactly. If you don't realize what matters, you don't, you don't know. So, yeah, not even hand expressing, no, nothing at all. 

[00:21:36] Maryam: I think I tried to hand express a bit, but I just, I didn't really get much.

I dunno if it was my technique. It was probably my technique that was off. But, um, I didn't really get much joy with it. And then I, I think I just probably stopped. 

[00:21:49] Emma Pickett: Okay. So new pump arrives, you're back on the pumping again. Yeah. Um, and in terms of support, you've got, you mentioned you haven't had other family members that have really breastfed.

Mm-hmm. Your husband's on paternity leave at this point. Yeah. So you're not on your own or triple feeding. Yeah. Mm-hmm. Um. So you're trying to breastfeed him pretty much every time. Were you being pretty consistent with attaching him? Yeah. And how are you in pain when you're breastfeeding? What's happening with you?

[00:22:15] Maryam: Yeah, very much so. Um, I had a lot of pain when I was breastfeeding, um, to the point where I would brace myself before he would latch. I think this, that got to be more of a problem in later weeks. It just got worse as he got bigger. So, yeah, it was, it was painful. Um, and it was frustrating as well because, you know, I was told to look for the, the sucking and swallowing and I just, I just wasn't seeing swallowing and it was so demotivating.

[00:22:41] Emma Pickett: Yeah. So who's supporting you? You mentioned seeing the team at the hospital. Yeah. Are you getting support, ongoing support at home? What's happening? 

[00:22:49] Maryam: Um, so I was still under the community midwives at that point. He, he hadn't, um, he gained his birth weight back, I think by day 17 or 18. So it took him a little while.

Um, and they were advising, increasing the formula, top-ups as, as we went along. I had a, a lot of support from my family. So we was actually staying at my mom's at that point. Um, in the immediate weeks after birth, I think maybe three weeks we were there. Um, which was so helpful because I could just focus on feeding my husband.

My mom were really supportive. Um, no one ever said, you know, maybe you should stop, you know, they helped me make it happen, um, which was just amazing and invaluable. 

[00:23:32] Emma Pickett: Yeah. Well, I'm glad to hear that sometimes the people we care about say, are you sure this is what you want to do? So it's the fact you didn't even get that is, is really positive.

Yeah, and, and you're okay in terms of managing your diabetes, I guess, 'cause you've got a pump, you don't have to worry about blood testing. It just all happens automatically. Yeah. But I guess maybe as his milk increases you, you notice that you are receiving less insulin and maybe that's an indication that he is taking a bit more milk.

Tell us about your tandem feeling day for anyone who's not been through it. What did a typical day look like for you during these, you know, for the first month or so? In the, with triple feeding. Yeah. Um, so, sorry, did I say tandem feeding? Yeah. Triple, triple feeding. Sorry, I dunno. Where I'm so used to talking about town feeding.

Yeah. Just triple, triple feeding. Yeah. I haven't given you another baby without you wanting wonder. I was, I was like, 

[00:24:19] Maryam: where did that baby come from? So I, um, if we start from like breakfast time, um, I'd get up and, uh, feed him and then put the pump on. Um, I was using, um. Like a, a wool pump, like a double electric.

I'm not a wearable at this point. Okay. So I would pump and my husband would hold Raheem, um, and then we'd go and have breakfast, and then I'd shower, and then I'd pump again. I'd try and just get in extra pumps through the day because. You know, you, you really wanna safeguard your sleep and sometimes the pumps wouldn't necessarily always fit with, with a feed.

Sometimes I'd do an extra little pump, you know, two hours later rather than three hours. But I'd always bring him to the breast when he had hunger cues and that milk would just be given at the next feed. You know, the, um, the milk that I would pump would just get given at the next, as the next top-up. Um, so I never had a stash.

[00:25:14] Emma Pickett: Okay. Which you don't need to. You don't need to. I think some people feel like they should, but that's not necessary. Um, I like what you're saying about how triple feeding doesn't have to mean in one session, everything happens in a row and they, and you can only pump around feed times. Mm. Actually what we call that interrupted pumping.

That pumping here and there pumping when the kettle's boiling, you know, pumping, when you're watching something on tele. You know, those little bits of pumping really make a difference because you're just getting all those lovely prolactin surges. What kind of pump did you have? Um, I had a 

[00:25:45] Maryam: Spectra S one.

Okay. Um, and then later I got a, a mom, cozy, wearable. Okay. Just, I think when I started feeling very trapped by the pump, that's when I, I chose to get a wearable and see if, try to see if that made a difference. 

[00:26:00] Emma Pickett: So, yeah, the Spectra is popular just because it's, it's the multi-user pump that is more reasonably priced compared to some of the other options out there.

And you're happy about flange size. That felt good. 

[00:26:12] Maryam: Yeah. So, um, I didn't know about flange size issues in the first couple of weeks. Um, and then I think I was probably reading something on the internet and, um, measured and went down a few sizes because obviously the majority of us, I think probably don't fit.

The standard flanges that are sold. So yeah, I did have to change flange size. Um, and I was expecting that to make a huge difference to my milk output and it didn't make one jot of difference. Okay. But it was a bit more comfortable. 

[00:26:42] Emma Pickett: Okay. Well that sounds good. We want, we want that too. Yeah, absolutely.

Yeah. Yeah. So the quite often pumps give you the standard, you know, 24 millimeter and very few people will be using that. Yeah. Most, a lot of people will be under 20. So you're, you're bottle feeding, you're breastfeeding, you're pumping throughout the day. Were you somebody who did lots of logging? Were you writing down his formula total and every, every day and looking at the balance of formula plus, plus breast milk.

And, and how was that process for you and how, how is your mental health doing at that point? As you can guess, mental health was in the ditch. 

[00:27:15] Maryam: Um, probably hugely contributed to by the. The logging, it didn't work for my brain, but I also felt like I had no objective review of how he was doing, how he was feeding, how much formula he was getting, and I was a bit obsessive about the amount of formula he was having, to be honest.

And I felt disappointed when his formula volumes went up. Yeah, I felt like a failure. Didn't know why. And yeah, it was just really devastating for me, to be honest. And then. I actually, so I live on the border between two NHS trusts and the trust where I gave birth. Their funding for breastfeeding support ends at 28 days or something like that.

So I then had to switch to a different infant feeding team. Which I'm probably technically under the catchment for anyway, I saw them and they suggested stopping the tracking and just doing pace feeding, which I already was doing, but being a bit more responsive rather than tracking everything and seeing how these volumes are changing to actually just watch him from the cues, let him feed as much as he wants on a top up, limiting the time at the breast, and yeah, just eliminating.

The logging. 

[00:28:27] Emma Pickett: Okay. Eliminate, did you say limiting the time at the breast? Yes. So we limited just, just when he wasn't swallowing, you mean? Just kind of taking him off and moving the feeding. 

[00:28:35] Maryam: It was just a, it was just a, a time limit of 30 minutes at that point 

[00:28:40] Emma Pickett: just to make everything manageable and to get, yeah, I think that was, 

[00:28:43] Maryam: that was the rationale, just so that I had time just to do things.

[00:28:48] Emma Pickett: I, I love the message of stop measuring. I think that's, that's, we so rarely hear people being told that, but actually that, that is so crucial. I, I meet people so often who, what you've just described about how when the formula quantity increases, you feel this wave of disappointment. I hear that so often people saying today was a rubbish day because it was 600 mils, not 450 mils.

The whole day is a failure. The whole just, it. Just those numbers in an app just absolutely color your whole mental health and if you can switch that off, what a powerful thing that is. So that made a, made a big difference to you? 

[00:29:26] Maryam: Yeah, definitely. Definitely gave me a bit of freedom and a bit of time to just watch my baby.

Enjoy him, um, rather than sitting on an app logging everything. 

[00:29:36] Emma Pickett: Okay. And were you also able to kind of let go of counting how many milliliters of milk you pumped? Um, how, how are you doing with that side of things? 

[00:29:45] Maryam: I think that was a bit more difficult for me to let go of. But yeah, I think I stopped logging that as well.

I think it just probably registered. 'cause obviously as. Emptying the, the bottles into the fridge. Like you notice how much you've pumped. And, um, I did have to start using the sock trick, you know, putting socks over the bottles so that I wasn't watching the milk. So, yeah, that, that, um, obsession was a bit harder to let go of, 

[00:30:10] Emma Pickett: I think.

And you're still in pain breastfeeding at this point? Yeah. Or is the team the other trust giving you some tips to sort that out? What's happening with your actual feeding? 

[00:30:18] Maryam: So everybody gave lots of tips, um, on positioning and attachment, and I think they were, they were really, um, really helpful with that.

But I was still in so much pain, and I remember, I'm jumping a bit ahead, but about two months in, I went to see a lactation consultant, which I hadn't sought out before. And while I was, after I'd had a first appointment with her, I went to the local drop-in from the feeding team and. I said, you know, I'm, I'm just in so much pain.

I've not, I've really struggled feeding overnight. I just really need a second pair of eyes. I need some help. And I'd mentioned you fill out a little form when you get there just so that they know what, what help you need. Um, and I mentioned that I'm also seeing good. A lactation consultant because, because of weight concerns.

'cause his weight was really plateauing at this point. He'd gone from the 50th centile at birth to about the fifth centile. Okay. Um, he'd really, really dropped and wasn't gaining properly. And I remember a comment made to me like, why, why are you here if you're getting private help? I was just so desperate for some help there and then, and that really, that really broke me actually.

[00:31:30] Emma Pickett: Oh, that's, that person needs a bit of a slight with a wet fish, don't they? I mean. People, sometimes people can afford one slot with a lactation consultant. Yeah. And that's exactly huge financial sacrifice and that is never gonna happen again. And, you know, you might live in a, in an area where you know something's not a lot of availability and the idea that you have ongoing support from the lactation consultant just 'cause you've seen someone once is.

Not necessarily the case at all. Exactly. And, and you sometimes you just want a second opinion as you say, you second pair of eyes and Yeah. And it's that, you know, crowdsourcing, you know, what's it called? Wisdom of crowds. You need more people to look at things differently. Exactly. That person was not having a great day.

'cause they should never No exactly that to, to a new mom. I'm so sorry that happened. No, that's okay. So did that mean that group didn't feel like a sort of safe space for you? 

[00:32:16] Maryam: Yeah. Um, it's, uh, you know, I, I did raise concerns over whether. The tongue tie was resolved. Um, and she popped a finger in his mouth, you know, a gloved finger, obviously, and said, no, no, there's no tongue tie.

And was, and said, you know, if she, she also said she was, I think she was having a really bad day because she said that if the positioning and attachment was proper, we wouldn't have to triple feed this long. Which again, just that really upset me like 10 months on I, I remember that conversation and it really upsets me.

So, yeah, it, it left, it left a, a lingering bad taste in my mouth. And then a couple of weeks later, well actually the next time I saw the lactation consultant, she said that he does have a posterior tongue tie. And we then proceeded, you know, again, I'm jumping forward a couple of months now, but we then got that Redivided and within a month we were exclusively breastfeeding, so, okay.

It was that, that seemed to be the problem that this Tong tie just wasn't fully, kind of, hadn't been fully addressed. Obviously he was really tiny when it was first done. It just needed a revision, but I felt so dismissed at that point and there was a problem. I was in pain. It's not normal to be in pain, and I just wish that, I just wish that she'd heard me.

[00:33:36] Emma Pickett: Yeah. There's no empathy happening there. Is there? Yeah. I'm sorry. That was your experience. It is interesting how one really powerful conversation can have such a big impact, and people do work with new families. Well, you know this as well with a doctor hat on. I guess when you work with anybody, when you're talking about their health, you've got such a responsibility.

Mm-hmm. Um, and you know, yes, people have bad days, but unfortunately those bad days stick with someone for years and years and years on occasion and never leave them. So you were exclusively breastfeeding. A month after that, that division. Yeah. How did that transition happen? Uh, one thing I'm particularly interested to hear is that some people who have triple fed for a long time, it's quite scary to let go of bottles that, I mean, you literally don't see what's going into your baby.

It's quite nerve wracking. And, and you lose that sense of confidence and oversight and it's So how did you get to the place where you weren't giving any bottles at all? 

[00:34:31] Maryam: Um, so I just carried on the responsive feeding that we'd been doing for, you know, five months at that point. Um, so I would still give him a top up after, or I'd offer him a top up after feeds.

Um, I think by that point it was probably needing four or five top-ups a day rather than eight. And increasingly those top-ups were able to be, you know, expressed breast milk rather than formula. I guess I was pumping more, or he wasn't needing quite so much in the top up. So my, my express milk was, um, was kind of covering the, his requirements.

Um, and then he just stopped needing the top ups. He just stopped asking for them. He started, you know, like falling asleep and not, not waking for more, um, at nighttime. So it just happened, it happened really naturally. But yeah, what you said about, um, that being a really scary jump, um, absolutely. It was, it was terrifying.

And I kept thinking, I'm following my instincts, but am I, am I doing it wrong? Because I felt like I'd followed my instincts through, you know, the start off eating journey. And I really messed up because as weight had plummeted and nothing was working. But yeah, thankfully we did, you know, reach my goal of exclusively breastfeeding just in time for solids.

[00:35:48] Emma Pickett: Yeah. Wow. Wow. What, what an achievement. Um, and I just love how it happened with this gorgeous organic IHI leading the way. He was the one telling you it wasn't you coming to count millimeters and, and cut back the formula consciously and wait to see what happened. He was letting you know, and his weight was stable through that period.

His weight was not a concern. It started to have more of an uptick. 

[00:36:12] Maryam: Yeah, he gained really well. So he, he jumped up from, he was probably. 25th Centile at that point, and he's now between the 75th and 90th. Okay. So he is really jumped up. 

[00:36:23] Emma Pickett: Yeah. Gosh. And then introducing solids is another time that can feel a bit scary because you kind of think equal, what's gonna happen to my milk supply?

How am I gonna get this right? How, how did you go about doing that? How, what was your experience of that? 

[00:36:34] Maryam: Um, I didn't really have many worries about it, if I'm honest. Um, it was quite fun. I remember our, um, days of introducing solids is quite fun. Um, and he, he really enjoyed food as well. He enjoyed, um, having different tastes and textures.

It's a different story now. He's going through a fussy phase where everything just ends up on the floor. Mm-hmm. But yeah, no, it, it. It wasn't too much of a worry for me in terms of supply. I, I, I don't know. I maybe it just didn't You relaxed. Yeah, I was been naive about it. I think I had relaxed. Yeah. 

[00:37:05] Emma Pickett: Yeah.

And that's, that's great. That's what we want. We don't want you to be, um, filled with nerves. This, this, the transition you went through helped you build up your confidence and helped you, you know, feel like you knew you were doing and you absolutely did know what you were doing. I want to tell you about my brand new book called The Story of Jesse's Milky.

It's a picture book for two to six year olds, and I wanted to write a book that was about weaning, but also not about weaning, because breastfeeding journeys end in all sorts of different ways. So Jesse's story is presented as having three possible endings. In one ending, his mom is pregnant and Jesse's going to share his milk with a new baby.

In the second, his mom was getting really tired and it's time for some mother led weaning. And in the third, we see a self weaning journey as Jesse's attachment to breastfeeding gradually fades. There are beautiful illustrations by the very talented Jojo Ford, and the feedback from parents so far has been so lovely and touching and I'm really excited to share the book with you.

If you're interested in my other books for Older Children, I have the Breast book, which is a guide for nine to 14 year olds. And it's a puberty book that puts the emphasis on breasts, which I think is very much needed. And I also have two books about supporting breastfeeding beyond six months and supporting the transition from breastfeeding for a 10% discount on the last two.

Go to Jessica Kingsley Press. That's uk.jkp.com and use the code MMPE 10 Makes milk picket Emma 10. So here we are now 13 months. Yeah. Going through his beautiful, classic fussy period, but breast milk's still, um, very much there. To back things up. How do you think, this is an impossible question to ask, but I'm gonna ask anyway.

How do you think your breastfeeding experience will have changed how you are as a doctor when you are talking to new moms and new families? What difference do you think it would've made? 

[00:38:59] Maryam: Mm-hmm. I think just knowing, having some objective knowledge about breastfeeding and infant feeding is, is obviously the first point.

You know, we're, we're taught so, so much subliminally about infant feeding and how it should be, and you know, babies need 150 milli milliliters per kilo per day, or et cetera. We're given so many kind of subliminal messages about. Volume and what babies need. But we are not taught anything about responsive feeding or responsive parenting, or even the physiology of breastfeeding really.

Um, so I've done my peer supporter training while I've been on mat leave, um, and that it's just given me the tools to understand different experiences of, you know, like relatively normal breastfeeding journeys and common challenges. Um, and that'll make me more able to, to talk to patients and support patients.

Um, and even just knowing where to direct them, you know, to send them for a feeding assessment when appropriate. So my knowledge has definitely improved, but I think more importantly, knowing how to speak to people at that really vulnerable time postpartum. Um, I think that's the biggest skill needed. You know, I had a million wonderful contacts and then one.

Really negative one. And that's, that's the overriding memory of that time. Just one contact, positive or negative can make the world of difference to, to people. So just being aware of that really, I think it's gonna have made me more empathetic and, um, more understanding of, you know, new moms. 

[00:40:38] Emma Pickett: Yeah. Yeah.

And, and how those breastfeeding goals are so important and Yeah. Um, and, you know, really drive them forward. Yeah, I mean, I guess if we talked to you in pregnancy and said, oh, you're gonna be pumping for all these months, it's, you know, it's gonna feel like the most important thing in the world to get back to breastfeeding.

The, the woman who said, oh, I'm just gonna give it a try. Might have said, what you on about? What are you doing? Um, but something in you said, Nope, this is gonna happen. I'm gonna get there. I'm gonna, this is what I wanted to achieve. And that, and that goal happened, um, after, after he arrived in the world. Um, tell us a little bit about milk.

MILC 

[00:41:14] Maryam: Milk is, uh, the medics lactation community, and it's a really fantastic resource. It was something that. Was absolutely invaluable to me, um, while I went through all of this. What it is, is it's a Facebook group that offers peer support to breastfeeding, just feeding parents, um, who are doctors. So it's, you know, it's like a beautiful safe space for, um, for medics who are going through difficult feeding journeys or, or, you know, lovely feeding journeys that maybe have a question about, um, pumping or return to work or, or whatnot.

You know, like I've said, we, we, we have so much, maybe so many hangups from, from our work experiences or what we've seen clinically. Or maybe people sometimes are just a bit embarrassed that they don't know anything about breastfeeding, even though they're healthcare professionals. Um, and that's why it's such a wonderful thing because it's, no one's gonna say, oh, you should know this.

You're a doctor. You know, we're all in the same boat. Yeah. So it's, it's, it's been amazing. And I've now joined the peer supporter team. Um, on there. So I, I offer virtual peer support. Basically people submit posts about their, um, their questions, their issues, challenges, worries, and we, we answer and try and direct them to the right help or the right resources.

Yeah. 

[00:42:37] Emma Pickett: Brilliant. It's so important, I think. The impact of one doctor reaching their breastfeeding goals has a ripple effect on an entire community for for decades to come. And those of us who have been in lactation support for a while, we hear the story of someone who's met a gp, who obviously has got trauma from their own breastfeeding experience.

And you can just tell from the reporting of the mom, this is what they said about breastfeeding. This is what they said about the fact I'm still breastfeeding at 12 months. And you think, okay, that woman's got trauma. Or you know, whether it's because of their own breastfeeding journey or a partner's breastfeeding journey.

Um, so when we can get it right and that trauma doesn't happen, what an amazing gift that is. I sometimes wonder and, and tell me if this is nonsense, that people who become doctors are. Almost always the cleverest people in the room throughout their lives, they've, they've always achieved at school, they've had the answers.

They've, they've, they've not done a lot of failing in their lives. So when you get to being a new mom. And you don't control and it's unexpected and you feel like you're not doing what you're supposed to be doing in Inver, that that sense of failure, which is, you know, obviously not something that other people would define it as, can feel, I think more significant just because they've always succeeded.

Is that that after my, is putting doctors on a pedestal there? 

[00:43:51] Maryam: No, I think you've hit the nail on the head that, 

[00:43:53] Emma Pickett: yeah, 

[00:43:54] Maryam: I think a lot of us are type A personalities. I think the element of control is. Yeah, absolutely. Integral to, um, perhaps why we have such, such a kind of common and unified experience. And, you know, in our jobs, we, we have to quantify things, you know, we have to write observations in, in numbers.

And, you know, I think the days of objectively assessing patients are, lost the word, but, you know, the, we have to quantify a lot of things when we assess people and when we treat people. So leaning into a, a breastfeeding journey where you use your intuition and your instinct and, you know, non-quantifiable measures can be really difficult for us.

[00:44:39] Emma Pickett: Yeah. It's, it's scary and this little person is the one who may have the answers and, and the way you let Abraham kind of guide the end of his supplementing and move to exclusive breastfeeding. Taking your hands off the steering wheel and Yeah. And he's the one that's guiding that. And that is scary if you're, as you say, if you're always used to the one having the answers.

[00:44:58] Maryam: Yeah. And I think it would be, you know, it might be easy to tell someone else to do that if I had my doctor hat on, but it was very scary for me to do that. And I think, you know, your experiences as a parent are just like nothing else you've ever experienced. The amount of worry and anxiety is, um, second to none in my experience.

[00:45:19] Emma Pickett: Yep. I relate to that too. And, and Milk is also doing some educational work, aren't you? Yeah. It's not just about peer support. Tell me more about that. 

[00:45:25] Maryam: So, um, just in the last few months, um, milk E has been set up. So, um, milk is specifically for people who want peer support for breastfeeding or, you know, want to offer that support.

Um, Milky is open to all doctors in the UK who want to learn more about breastfeeding. You know, like you said, the effect of a GP that is well informed is so far reaching and that's what we want to be able to offer. And doctors of any specialty that will come into contact with, you know, breastfeeding patients, a way to kind of find good quality evidence-based information to enhance their own understanding of breastfeeding and infant feeding.

[00:46:06] Emma Pickett: So you're gonna be setting up sort of online modules and, or is it just gonna be a sort of discussion community? What's the plan? 

[00:46:12] Maryam: Yeah, so currently it's a Facebook page, so you know, that's available for people to join. Now the idea would be, you know, to expand the modalities that we can offer teaching. Um, but for now it's, it's a Facebook community and, you know, there's lots of things in the pipeline to hopefully help grow the community and widen its reach.

[00:46:33] Emma Pickett: Brilliant. So I'm gonna ask you for some links to put those in the show notes. Absolutely. Yeah, I'd love to get that. Yeah. Um, so what's your plan for the future? When are you back at work and how are you feeling about breastfeeding and, and combining that with work? 

[00:46:49] Maryam: Um, so I'm going back to work in October.

I'm going back three days a week. So, um, you know, I'm feeling very nervous about not being with him all the time, but it's. The next adventure, isn't it? Um, and I know it'll be harder for me than it'll be for him. Hopefully, 

[00:47:06] Emma Pickett: who's gonna be looking after him? This will, by the way, when this episode goes out, he will already be back at, back in his day.

Childcare. You'll be back at work. Everything will be fabulous. You'll listen to this episode and on the way to your surgery and think, oh yes, we're all good. Uh, who's gonna be caring for him? Um, he's gonna go to nursery. Okay. And you're doing super long days as a gp is that will be, what is that? What will be happening?

[00:47:26] Maryam: So in, in theory, they should be sort of 8, 8, 9 hour days. Um, but in, in reality, let's see, you know, sometimes it has the potential to, to be a bit longer than that. So my plan is to express twice a day probably. Um, I don't really get eng engaged anymore. Um, even if I've been away from him for six hours. You know, I don't, I don't really get many problems.

Um, but I have been prone to block ducks in the past or. You know, ductal inflammation. So I, you know, I, I need to kind of, um, have that discussion with work about having some protected time, um, for expression. So, yeah, we'll see how that goes. Um, but I'm quite lucky that I'm not doing, um, you know, I'm not, I'm not working in hospital and being on call carrying bleeps and things.

And so in theory it should be easier for me to sort out those, those expressing breaks. 

[00:48:19] Emma Pickett: Yeah. Yeah. I mean, it's good to be flexible, I suppose, if you're gonna be responsibly feeding the other days of the week, you may find that you are, you know, the day you're back at, back at work, your supply's a little bit more stimulated and needs a bit more protection.

Yeah, 

[00:48:32] Maryam: yeah. 

[00:48:33] Emma Pickett: But is how loud is your wearable? Is it, could you possibly wear a wearable during a consult or does that just not feel right? No, it would be too loud, I think. And I'm 

[00:48:41] Maryam: always nervous about kind of knocking it over. I've bought a, um, a manual pump as well, um, just to see if that's maybe a bit less faf, um, than lugging a spectra to work.

But, um, yeah, I need to have a think about logistics and, um, I've not pumped for ages to be honest, because the sound of the spectra just gives me the heebie-jeebies. 

[00:49:02] Emma Pickett: Yeah. Oh gosh. Remembering those stressful days. Yeah. Gives me flashbacks. You may not need to, you may not need to pump. Lots of people don't.

Even with the history of blocked ducts, it may be that things have resolved a bit by now and. Um, and it may be that you might feel a little bit full towards the middle of your working day and you might just take a little bit of an edge off, but you might not necessarily need to. It's just good to have those options.

Um, yeah, that's my hope. Yeah. And, and what are your goals for feeding Ibrahim? Do you have, are you just gonna play it by you or do you have a particular goal in mind? 

[00:49:31] Maryam: Um, so my goal at the start was six months. When he was born, it went down to six weeks, and now we've got to 12 and a bit months. I think we'll just see how it goes.

We'll play it by ear, but I'm, I'm overjoyed to have got to this point, so anything now is just a bonus. 

[00:49:49] Emma Pickett: Yeah, yeah. Oh, that's an amazing place to be. And you worked so hard, Maryam, I can just hear that determination in you. You just were like, no, I'm blooming gonna make this so happen. And, and uh, you know, and all that time in pain.

Breastfeeding moms are amazing and you are one of the amazing breastfeeding moms. So, um, congratulations on getting to where you are and very, very best of luck going back to work. Thank you. Um, is there anything we haven't talked about that you wanted to make sure we covered? 

[00:50:16] Maryam: Um, I think one thing that, um, is always at the forefront of my mind is, um, kind of cultural competence, cultural safety, and breastfeed support.

I think that the lactation world is, is a lovely. Welcoming place, um, in a lot of ways, you know, but, so I'm a, I'm a mixed race woman that wears a hijab. Um, I'm Muslim and you know, there's not a lot of people that look like me in this space. And, you know, when you go to breastfeeding groups and whatnot, and I think for us all, you know, that work in, you know, breastfeeding support and I don't work in breastfeeding support, but that, that kind of, um, think about breastfeeding support.

I think it's really important for us all to be conscious of maybe why people like me are underrepresented, um, and to keep, keep the doors as wide open as we can. I think that's something that's important. An example that I think of often, um, is feeding in public. So, um, I remember asking somebody, you know, oh, my baby's getting a bit bigger now.

Like, can you recommend any kind of large. Breastfeeding covers, um, and they're like, no, you need to be really proud of breastfeeding. You should breastfeed without a cover and be proud of what you're doing. And I am proud. I'm so proud, unbelievably proud of feeding my son. And I also feed with a cover, and those two are mutually exclusive.

Um, and I think sometimes these, these things can lead to sort of fissures and disconnects within the support world. And it's, it's always well-meaning, but it sometimes needs more critical thinking. You know, I, I've been to a breastfeeding group that's in like an open fronted glass cafe, and 

[00:51:57] Emma Pickett: oof, 

[00:51:58] Maryam: it might be good for some people, but for others it might not be.

And it's, it's thinking, how can we adapt what, what we do, um, to welcome everybody, you know, it's like how we adapt language, like, you know, breastfeeding and chest feeding. It's, it all fits into the same thing. We're all here for everybody. Um, but we need to keep those doors firmly open. 

[00:52:19] Emma Pickett: Yeah. Thank you very much for sharing that.

I think that's, that's, that's so, so, so important. Can I just ask you from, for your, some of your thoughts on. Groups where partners are welcome. Mm-hmm. So that's something that is, you know, increasingly, obviously, you know, you've, you've shown it in your story as well, the importance of your husband supporting your journey.

Yeah. And we do get people with newborns and the partner comes along as well. Yeah. What do you think is the ideal setup for, let's imagine a community who's doing peer support groups during a week? Yeah. Do you think it's important that there is a group that is women only and that's a group that maybe Muslim women may feel more comfortable going to?

What would you recommend? 

[00:52:56] Maryam: I think that it is, it, it can be even as simple as just having like a couple of screens. Like I think that if we, if we get things to be exclusive, then we're, we're shutting somebody else out. I think it's amazing when partners come to support groups. That's, that's fantastic. But having like two screens in a corner.

You know, everybody can talk as a group, and then if somebody wants some face-to-face help and they're not comfortable, you know, being exposed in front of, you know, men in the room, they can just go behind a screen and get some, get some one-to-one support. I think shutting people out isn't the answer, but welcoming everybody.

And providing extra adjustments is probably the way forward. 

[00:53:41] Emma Pickett: That's a really great idea actually. You know, I've never heard of any group having kind of portable screens, and that's such an obvious thing, isn't it? The little kind of fold up screen that you can open up if you need to and, and to fold away when you, when you don't need it.

[00:53:52] Maryam: It's probably a faf to transport. 

[00:53:53] Emma Pickett: Well, they can just stay in their room half the time. I mean, even rooms that have multi users popping up in the corner is not the end of the world. You'll have to write your health and safety that the screen might fall over. But provided that's, that's not gonna happen.

[00:54:04] Maryam: Especially if you've got toddlers in the room. 

[00:54:06] Emma Pickett: Yeah. But there's always something as you say, and it's good. Yeah. I love what you're saying about let's not shut people out, let's find ways to bring everybody into the same space and, and everyone would be comfortable in that space. Thank you so much for your time today, Maryam.

I really, really appreciate it. Yeah. And, uh, very best of luck with the work that Milk and milk E so that's milk with an E for education at the end. Yeah. Um, the work that they're doing is just sounds so important, so I hope hopefully it will push a few more people in your direction as well. 

[00:54:34] Maryam: Thank you so much for having me.

Really enjoyed it.

[00:54:41] Emma Pickett: Thank you for joining me today. You can find me on Instagram at Emma Pickett Ibclc and on Twitter at Makes milk. It would be lovely if you subscribed because that helps other people to know I exist and leaving a review would be great as well. Get in touch if you would like to join me to share your feeding or weaning journey, or if you have any ideas for topics to include in the podcast.

This podcast is produced by the lovely Emily Crosby Media.